Lucky Socks

    It’s been an eventful 6 weeks since my last post. I started my dream job at Primary Children’s NICU and I truly feel so lucky to have the opportunity. The stakes feel as high as they come to be trusted to care for a family’s newborn. Most of my brain power these days is devoted to studying all there is to know at my new job. It’s going to take years to finish the education available for the unit and reach the highest level of care, but I like that there’s a built-in trajectory. There was a time when I was afraid NICU would be too painful and triggering for me, so I’m celebrating this victory.

    ICU level nursing is no joke. It’s been drinking from a firehose; mentally, emotionally, and physically exhausting. An experienced nurse who had been on the unit for 25 years said to “give yourself two years” to feel comfortable. I think the perfectionist in me is terrified (and excited?) about how much I have to learn.

    The benefits offered to me at this job truly have no downside. The coverage is about twice as good, for half the price. When agonizing over the idea of taking over our benefits, I realized it would drop our deductible by about 13K; it was clearly necessary. I had so much pressure sitting on my chest for days, just thinking about it. So much anxiety surrounds this obvious shift in roles. Even though I’ve been working full time for quite a while, I felt like I was “supplementing” the income while trying to run the household. Now I feel the pressure of maintaining hours for benefits and that is really scary. I’m excited that there are so many opportunities for me to grow within the company, but also torn knowing I would want to be home if I had a baby. I’ve put in too many years of infertility and loss. I think the stress comes from the perceived lack of flexibility in the future. Change is so uncomfortable. We have our hands full with our jobs (and Kevin just picked up a small second job), the kids, symphony, and literally everything else. I try to remember we can work out whatever comes. Unfortunately, this new insurance did cause our therapy costs to skyrocket, so Jack and I are both taking a break from counseling. Never a great thing to do at a stressful time. 

    When Kevin got his doctorate, I thought I wouldn’t ever “have” to work again if the kids needed me at home. Certainly not full time. But his career has been full of surprises and so has the economy. I don’t think many families can survive on one income anymore. I’m happy that I’m able to have a career; it’s the commitment that’s scary.

    It may be hard for some people to understand the reality of living with a condition like fibromyalgia. Chronic pain and fatigue is all too real and can truly be debilitating. It’s exhausting to mask it and carry on. Muscle through. The idea of taking on more is terrifying because you wonder, what if I literally can’t do it? Maybe I can most days, but if I push myself too far I will pay for it ten times over with a flare up. When I work several nights in a row, I usually have a flare up for a few days where the pain is more extreme and I have almost no energy. Like a very bad flu. Sometimes it’s even visible. The inflammation pops up in red splotches all over my feet and legs. My neurologist thinks it’s auto immune related and when I see the spots, it’s a red flag that I need to slow down and rest more. But those red flags always pop up when I work full time hours. I get more muscle spasms. I feel pain deep in my bones and shooting through all my nerves. It’s the main reason I’m afraid to stop my medications (which would be required if I were pregnant). I’m worried about how I would function with these full time hours I’ve committed to.

Fibromyalgia is usually invisible. But when these little red flags show up, I know a flare up is starting.

    I did officially get news that my doctor wanted to do a scope and D&C as the next step in trying to treat this antibiotic-resistant chronic endometritis. I was told I needed to start a hormonal treatment (the mini pill) for a few weeks to keep my lining thin and suppress my ovaries for the procedure. I started taking that prescription the same day. I was really nervous. I tried the mini pill in my early 20s for a couple months and was in absolute misery the entire time (I can’t take regular birth control due to the estrogen- because of my risks for blood clots). I was worried I would get nauseated and possibly have terrible migraines on these pills, which seemed like really bad timing with a new job.

    After hearing all the costs associated with this surgery it really hit me that, “wow this really is our last shot at this” because it’s just not financially sustainable. I immediately did, probably the most extreme thing, and signed a contract to work every Friday, Saturday, and Sunday night for 4 months (after orientation) because it comes with a small lump sum that could help pay for the surgery. I will have to take a break from one season of playing with the symphony and I already miss it so much. Music is so good for the soul. 

    In the meantime, we have tried to keep summer activities going as much as we can. We were able to attend an amazing family reunion (For my side! It’s been over a decade since I saw everyone!) It was so special to see lots of loved ones meet and interact with my kids.

    Aidia also took charge of updating her room. It’s been the same since it was her nursery and she was ready for a big girl room! We painted it purple (with glitter mixed in the paint, which I must say is amazing).

    I’m currently in the process of planning Jack’s 13th birthday party. Which reminds me again that we are entering a totally different phase of parenting- the teenage years. It really is a crazy idea to try and add a baby to the mix, but I feel that it would be so good for all of us and bring so much joy. I know Jack and Aidia would be so loving to a baby; they would appreciate a baby because they are so much older. But this can’t go on forever. I’ve spent my entire adult life trying to build a family and have babies. The painful triggers still pop up when you least expect it (see below- thanks government I was just trying to pay my loans). 

I honestly struggled to answer this question

    I started on the hormones as instructed. I immediately bloated up like a balloon while my mood simultaneously deflated. Within a couple of days none of my pants fit comfortably. I felt like I was either depressed, numb, or overwhelmed. I was having the kind of anxiety that comes with literal chest pain and palpitations. I do not do well on hormones, everything instantly felt like it was too much at once. My resting heart rate went up; I was fidgety and restless. I was crying all the time and my nerve pain was exponentially worse. I was getting up at 530am for work and usually didn’t make it home until 8-830 at night, totally fried. I worried about the kids all day because it’s summer and they just call constantly to ask “how much longer” until I get home. I get it- no one loves being babysat all day.

Quick sidebar- How can working parents avoid feelings of guilt/inadequacy when balancing work and family life during the summer? Any days off I have, I feel like I just have to recover. Is everyone with young kids just in survival mode all the time? How do you keep your house clean and fridge stocked and finish all your projects? How do you keep up with exercising? How do you reduce your kids’ screen time when you feel like you’re just fighting-for-your-life tired? Figuring out child care for while working day AND night shifts (while trying to tend to my kids’ emotional needs) in the SUMMER may be the most complex puzzle I’ve ever put together. When I’m finished with orientation it will be much better. I hope. Probably unrelated, but grey hair has started showing up in droves. 

Anyway. I was overstimulated with everything new at work and felt like my brain on the mini pill would just freeze when overloaded instead of pushing through. I could almost feel my eyes glazing over when I didn’t understand something being taught. At night I was desperate to rest but kept waking up in cold sweats. I always felt freezing and continually had vivid and violent nightmares. Kevin never slept well either because of my shaking/shivering/thrashing all night. I would get up and change, only to sweat through a second set of PJs. I’m not looking forward to menopause. Look, hormones are not something to mess around with.

I was definitely not at my normal baseline mentally to use healthy coping mechanisms to deal with all the changes at once. Most days I felt like curling up into a little ball and focusing on breathing in and out. Fortunately, I was confident that a fair amount of this struggle was hormone med-induced. The good news is, I was right. Once I stopped the mini pill I felt a little sunshine break through and I’m feeling much more myself. 

The night before surgery finally arrived. Kevin was in Salt Lake with Jack at a concert and I had settled Aidia in bed for the night. I was picking up around the house and prepping everything for the morning. I was ready to settle in and get some actual sleep before the big day. I went to grab something from the laundry room and casually pet Lumiere on the floor outside the door. I did a double take when I looked down at him. He was breathing fast. Really fast. He had been totally normal, happy, and playful all day, but I took one good look at him and knew something was seriously wrong. I scooped him up to put him in his carrier to take him to the animal ER. He didn’t fight me at all. He was like a limp noodle.

I no longer cared about getting any rest before surgery, I wanted to see him stabilized and not in pain. He just turned 6 this summer and I’ve had him since he fit in the palm of my hand. To see my big strong panther so weak was jarring. They took him right back in the ER because he was panting at that point. Things felt chaotic as they tried to figure out what was going on. His labs were decent, it wasn’t normal cat issues (like kidney stuff) but his temps were cold and he had low blood pressure. I was worried about that level of shock when the cause was still unknown. They couldn’t rule out pancreatitis, which is really painful, so I signed for him to go into ICU level care. He was getting oxygen and fluids and good pain meds. I just didn’t want him to be in pain, but I hated that he was back in the ER without me. The doctor came in and said she thought maybe he threw a clot or had some kind of vascular event. She said they needed to rule out if it went to his heart or if he needed to go home on blood thinners.

I sat in that little consult room and cried like a baby. He is so beloved. I was by myself, it was the middle of the night, fasting for my own surgery that was starting in a couple hours. They let me give him a little pet goodnight and I told him I would be back after my surgery was over. He was stable and just waiting for the heart specialist to check him out in the morning. I wish I had known that was goodbye. I would have taken longer with him. 

A few hours later, it was morning and it was pre-op time. I already inserted the cytotec to start dilating my cervix when I got a call that he took a turn for the worse. He still had a heartbeat, but he had stopped breathing. They intubated him and put him on a ventilator. The new theory was that he had an asymptomatic lymphoma that started affecting his central nervous system. I was praying that my kids could just hug him goodbye. But Jack was at summer camp, Aidia was with a sitter, and I was headed an hour in the opposite direction for surgery.

It wasn’t long before they called again and said he had died. It was such a shock to the system. Such a lack of closure. No one got to say goodbye, have a last day with him, or tell him he was a good boy. The kids would come home without a clue he was sick, and he would just be gone. We thought he had at least 10 more years. He never missed a checkup or preventative care. I cried all the way to surgery and through pre-op. Maybe I looked crazy to the staff but it’s like “sorry, my cat just died unexpectedly when I was on my way here.” At home after surgery, instead of trying to rest and recover, I had to tell the kids and hear the grief in their sobs. Unbearable. They kept asking if they could go say goodbye, but he had already been gone for hours.

There were some little silver linings looking back on this tragedy. The day before surgery I was at work, and something told me on my way out to stop at the hospital gift shop. I nearly talked myself out of it because my kids don’t need any more stuff. I decided to just look for a minute, and saw a toy cat that looked exactly like Lumiere. I had never seen one like it before. Aidia doesn’t need any more toy cats. But I bought it anyway. I brought the toy home that night and Aidia loved it. We introduced Lumiere to the toy and snapped a picture of the meeting, having no idea that it was the last evening we would share with him. I get chills thinking about how I randomly bought that toy, and how my kids spent the next several days hugging it and holding it in place of Lumiere when they cried. 

I was originally supposed to take Jack to the AJR concert in Salt Lake that night, but with my new work schedule it was too hard to pick him up from camp for the night and drive all the way back to SLC after my shift. Kevin ended up taking him, which was fine, but I was kinda bummed because I bought the tickets for Jack and I to do something fun together. After everything happened, Kevin mentioned that he probably wouldn’t have noticed Lumiere’s respiratory rate and would have just gone to bed. I’m so thankful I was home. The worst thing would have been if Lumiere had died alone in the night at home with no pain relief. We will always miss him.

Baby Lumiere

Forever 6 <3

Last picture of healthy Lumiere

A couple hours before bedtime with “toy Lumiere.” We had no idea :(

Maybe it was thanks to the distraction and shock of losing Lumiere, but surgery went really well all things considered. It really ended up being more of a scope than a surgery because once he was able to visualize everything, the uterine lining looked really good and there really wasn’t anything to remove. No major polyps or anything as we thought- and the inflammation from the endometritis has really come down with all the antibiotics. He took another biopsy just to be on the safe side. I’ve lost count what number biopsy this is. I actually stayed asleep through the whole procedure which is what I was most scared about. I did have quite a lot of pain when I woke up, but after they ended up giving me a shot of Demerol in the thigh, my pain actually got under control and I had a better recovery than I expected. Most of my lingering pain was the fresh grief. Before I went into the OR, there was a little care package on my bed with “Lucky Socks” gifted to me from the Utah Infertility Resource Center. Maybe it’s just a little joke but I got choked up. It was so nice to feel seen and know that someone had thought of me in that vulnerable moment. Plus they were way more comfy and warm than normal OR socks. Such a funny token; I hope Kevin wears them the next time they have a funny sock contest at work.

Here I am pretending like I hadn’t just been crying for hours

Lucky Socks

About a week after the procedure, my biopsy results came in. The pathology did show some fragments of polyp. The biopsy was technically positive, but with far fewer of those CD138 cells (5 per 10 high power fields). My doctor reviewed the results, and combined with the appearance of the endometrium, he didn’t feel any endometririts was clinically significantly at this point. FINALLY.

To support a healthy ovulation, they want me to take Femara during a specific five days in my cycle. This would hopefully avoid having to do vaginal suppositories of progesterone twice a day for several months in early pregnancy (which I did with Aidia). Femara is used to treat breast cancer but is used off label for infertility. My doctor said the chance of twins only goes from 0.4% naturally to 0.8% on this med. Which helped with the instant nerves regarding an ovulation med. They told me I was cleared to try to conceive on my next cycle. 

After so many months waiting for that news, I told them I would be waiting another cycle, to give myself some time to recover. Plus I know my cycle will be really delayed since I took hormones for several weeks. I need some time mentally and physically. I also need to catch up on all the supplements I need to be taking. I was able to cut the quantity down some, but still have about a dozen pills to take each day.

Thankfully, the anxiety about trying to conceive has greatly diminished. I can provide all the love, nutritional building blocks, and preventative treatments and procedures. But I don’t actually get to decide if a growing baby will be healthy or not. I think working in the NICU has helped me see and accept how little control we have in so many situations, and how to move forward and make the best of it. All I can do is my best, and it’s almost a relief to turn a bit of it over to fate.

It’s empowering to remember that we make the life we want. We don’t always have control over our circumstances or difficulties, but our attitude has a lot of power. Maybe we sometimes forget that we can choose to make our life what we want it to be. You can buy a birthday cake for dinner if you want. You could move across the world.  We have to take chances to create our happiness.

Dreams Come True (Not Always in the Order You Think)

Sorry in advance for all the pictures in this blog post; life has been very full and very busy lately (which I’m thankful for!) I’ve been working hard and playing hard.

One night in April, I was feeling particularly frustrated, emotional, and maybe a little manic. I was still processing my latest biopsy returning positive. In addition, the one constant I planned on (my job) was going south fast. I planned on staying at SDCH through any fertility treatments or maternity leave, due to its flexibility and my seniority. During to the company acquisition, we started to have a mass exodus of long-time employees. We were all frustrated with the reduced benefits, cuts in compensation, and the lack of communication. We were extremely short staffed. As I ruminated on all the changes combined with my lack of progress at the fertility clinic, I impulsively applied for my dream job: a NICU position at Primary Children’s Hospital. I didn’t want to wait around on an imaginary timetable before advancing my career. For years I’ve been afraid that working in a NICU would be too hard when dealing with loss, infertility, and longing for a baby. For a fleeting moment, I didn’t feel that fear. I had a rush of confidence and knew I could trust myself as a nurse to love my patients and set myself aside. This is the speciality I’ve always longed to end up in. I just wasn’t expecting to try so soon, so unexpectedly. I’m scared of the triggers, but decided: be afraid and do the dang thing anyway. 

The morning after I applied, I felt a pit in my stomach. Even the idea of change is scary. I know I am very needed at my job, which is a gift. Someone needs to take care of these long-term acute babies and their families. I know my job matters. I care for my patients deeply. It’s a humbling calling to care for others’ babies; it would feel almost impossible to leave a tiny baby in the care of a stranger and I want to earn families’ trust. One family calls me “Auntie” when I take care of their baby and it’s literally the sweetest thing. I want to give every child the best chance in life, regardless of the hand life has dealt them. The more my coworkers quit, the more essential I felt to keeping the place running smoothly and safely. But my gut said- apply for the dream job- and I did. There’s no use in putting off career dreams for a baby- when in reality, that might not happen for us again. When I look back on the years covered in this blog, I see that I’ve learned how to make hard decisions. I just have to trust myself.

While waiting for a rejection or interview invitation, I was able to play a concert at Abravanel Hall. It was my second performance there, and still such a dream come true. I hope Salt Lake will reject the proposal to tear down the concert hall. I just feel like the luckiest to have somehow found a spot in the most wonderful community symphony. I can’t believe I just celebrated my 5-year anniversary with them!

Abravanel Hall

In another wonderful twist of fate, Kevin is joining the symphony for the season! We haven’t played percussion together since the early days of our marriage (We met and started dating when we were on the same drum line in 2010. We married the same year.) Now we bring our kids to symphony rehearsal and it’s my favorite kind of new family tradition!

2010

I still love watching him play the drums

I didn’t hear back from Primary Children’s Hospital right away, which allowed me time to stew in all my concerns. If I land this job, will I have to put off fertility treatments even longer? Is there ever a perfect time to have a baby? (No.) How would I balance a full time job at a major hospital with a high risk pregnancy? Could I meet my financial obligations if I had to cut my hours? Would childcare cost too much if I stayed full time? We experience all the regular pressures of being solidly middle class- debt, taxes, insurance premiums, medical bills, student loans, a mortgage, and a mini van. We still want to give our kids summer trips and sign them up for sports and music lessons. I mean have y’all been to the grocery store lately? One carton of eggs is like $18. Kids seem to get more expensive the older they get. I think I will end up paying for four sets of braces between the two of them. Jack is only a few years away from driving. How far could I stretch myself to bring another life into the world? It would benefit us in countless ways financially if I stayed full time and paid for our benefits. Kevin also picked up a PRN job as a side gig to supplement us, which is awesome. I don’t know when he’ll find time to do it, but I’m proud of him! We’ll find a way to make it work.

A NICU orientation takes months; and honestly, I would have years of training ahead of me. I LOVE to learn and my ultimate career goal is to get my neonatal critical care certification (which takes a few years.) I just felt so unsure about the timing! It’s my dream job and it seems like the worst time to make another big change. I have too many things in the air and it’s making me dizzy. Women want it all.

A week passed and I was mostly waiting on a rejection email, as IHC initially weeds out lots of potential candidates that way. It’s no secret that it’s a competitive position. It really all depends on the candidate pool, internal hires, etc. Fortunately for me, they did call to schedule an interview. I took the interview time, even though with my work schedule it meant I would be surviving on only naps for 3 days. Definitely not the best state to be interviewing in. I was pushing myself around the clock, and any spare moment was spent writing/rehearsing interview prep. The big day arrived. I have not been that nervous for an interview in years.

Interview Day

Fortunately, I felt calm and collected during the interview. I didn’t anticipate most of the questions asked, but my prep was close enough that I was able to respond without sitting there dumbfounded and speechless with racing thoughts (we’ve all been there right?) I thought the interview went as well as possible because I felt I had represented myself in the truest way that I could.

Then- radio silence. As my brother said, “To land your dream job you have to be good AND lucky.” As the weeks dragged on, my hope dwindled that I secured the position. You start telling yourself it’s “for the best” because “we have way too much going on,” and “it’s too far of a commute anyhow.”

I’ve been doing EMDR periodically in therapy. It is healing and I completely recommend it- but- it’s shocking when those really deep hurt feelings make their way to the surface and expose themselves. One day, after a particularly intense session was over, I was still wiping my tears and grounding myself, when the phone rang with a job offer.  

Just like that, my dream opportunity was in front of me for the taking. I’m determined to make it work. I’m so happy to return to a not-for-profit company. Maybe in the long run that could help with my student loans. The available benefits are so much better than those we currently pay for. I’m at a major crossroads of what choices I want to make for my life moving forward. 

NICU orientation and training is intense- or in their words, “robust.” I’m going to be very busy for the first couple months. I’ll be working day shifts and night shifts, which I am fine with, I just hope the kids handle it okay. It’s rigid, so they give me the schedule and it’s my job to make it work. 

Working out a babysitting schedule for training, in the middle of summer (no school to break up the day!) has given me a major stress headache. Let’s talk about mom guilt. I feel guilty when I’m at work that I’m not home with the kids. I feel guilty when I’m home that I’m not out making money. When I am actually home, I’m exhausted from work. Turns out when I have no energy, I am not Mary Poppins. I’m too tired to constantly entertain my children and enrich their lives with endless activities. Don’t kids ever just go outside and play anymore without first being threatened?! If you have a kid with behavioral issues on top of everything, it’s a whole other layer. Solidarity to working moms trying to figure it out. Feeling guilty for going to work is ridiculous. 

I finally finished my antibiotics and it was a marathon of the worst kind. I finished them just in time for our summer vacation- Las Vegas! We haven’t taken an extended trip with just the four of us before and it was wonderful. We were able to make some fantastic memories!

My favorite part of the trip was hearing the kids laugh uninhibited. So often I look at my kids and I love them so much it hurts. I can just feel my heart break in half. That is enough. Of course it is. Having children is sending your heart out into the world to walk around outside your body. It is wonderful and terrifying. If no other babies come, we still have everything we need.

After Vegas, I went in for my endometrial biopsy. Third one this year, fourth total. Since I survived the more intense course of antibiotics, I was actually excited. The idea that we could get the green light to try to conceive sounded too good to be true. Just in case, I told my doctor about the 2023 research regarding antibiotic-resistant endometritis. He asked me to send him the journal (Read here). I was covering my bases in case I once again ended up in that “rare” margin. Overall, I felt optimistic. Happy even. One very long week later, the results finally came back. Positive biopsy yet again. I am now fairly confident that I’ve had this infection for 5 solid years, and that it never cleared up with treatment in 2019.

When I asked what the plan was from here, the NP said, “We’re going to have to do some research.” I almost laughed. I sometimes feel like I’m rare only in the worst ways. She said my chart was “fascinating.” Hey, medically, I’ve got that going for me. When I mentioned the research I already sent, she actually found a note from my doctor regarding treatment if I was still positive. Right now, it is looking like I probably need a hysteroscopy to look for polyps and a D&C. I know that I had at least one polyp because they incidentally sampled one during the first biopsy this year and the pain just about killed me. I don’t see a downside to surgery, other than my less-than-ideal responses to anesthesia-type meds. I’m genuinely afraid of not being numb or sedated enough. It’s happened too many times. Maybe I’ll be lucky and they will put me all the way under. I’m nervous about the cost too, as insurance likes to reject anything remotely related to fertility. 

I really liked this new NP, who works with the doctor I’ve been seeing since 2014. She asked how I seemed to know so much (before seeing on my chart I work as a nurse) and immediately told me I should go further in school (noooooo). However, in this realm, my knowledge has really come from doing my own research and learning how to advocate for myself for over a decade. I credit a lot of that work leading me into nursing practice and I’m grateful for that.

I thought maybe I would feel a slight sense of relief if the biopsy came back positive again since so much is happening with the new job and having the kids home for summer. But I just felt deeply and wholly sad. The heart wants what it wants. It’s hard to imagine walking away from a dream you’ve been planning for so many years. It’s like slamming my head into a brick wall over and over again. If it’s not one thing, it’s another, and it’s always the same frickin’ brick wall. I’m just trying to have a baby and that wall that stops me in my tracks every single time. I was told chronic endometritis is “98%” curable with antibiotics; I sure find myself in that 2% margin frequently.

My top source for history, politics, therapy advice, and news is of course- true crime podcasts. A couple weeks ago I was listening to My Favorite Murder as they were discussing how we need to stop intellectualizing our feelings and actually let ourselves feel them. While I’ve heard that concept a million times, the next tidbit changed my understanding. They said most emotions only last about 90 seconds before they shift. So now I try to grit my teeth and let the emotions have their moment. Maybe they won’t come back to bite as hard later.

Wish me luck, the new job starts Monday! <3

Outlier

If you’ve been reading my blog for the past ten years, you‘ll appreciate my similarities to the bagel. 

When I concluded my last blog post, I was looking forward to finishing up treatment and finally moving towards a resolution of our fertility journey. When I finished the two weeks of Cipro and Flagyl together I felt like I won a gold medal. I was so relieved to be rid of those meds and braced myself to endure the repeat biopsy, it would all be worth it because the end was in sight. I just had to wait for the proper cycle timing for the biopsy appointment.

I asked my doctor’s opinion regarding my full time position working nights as I’ve been concerned about harm to a potential pregnancy. I’ve read limited research about night shifts (obviously) messing with your circadian rhythms and hormone regulation, potentially leading to an increased risk of miscarriage.  I wanted my doctor’s advice to navigate this. Clearly, many people work nights all the way through their pregnancy and have perfect outcomes. I just always feel like I’m the outlier. 

My doctor did not feel that it would be a major risk to a pregnancy to continue working nights despite my complicated history. It was a huge sigh of relief to hear I didn’t need to change my schedule, but the relief was short lived. I still felt worried about it. I know of at least 3 coworkers who have miscarried while at work during the night. It’s empirical evidence and probably not clinically significant, but my anxiety wins in this situation. I really feel the need to reduce the stress on my body. It’s no secret that working 12-13 hour shifts, 3-5 nights in a week, is hard on the body. 

Jack and Aidia are nearly out of school for the summer, and as I was trying to determine how to balance work and childcare, I decided it was best to reduce my hours to part time temporarily. While it reduces the cost of childcare, it’s still a leap of faith to drop to part time. I hope by the end of the summer we will be out of this period of uncertainty. By the fall, I imagine we’ll have a better understanding of our fertility situation and can make the best decision about work schedules. 

We are in the exhausting limbo phase. I feel restless and impatient. We haven’t even been trying to conceive yet, and I’m feeling the strain of 6 months of testing with the fertility clinic. I think it feels heavier more quickly because it’s compounded with the past decade. It just feels like this part is taking forever. I either want to be pregnant, or endure the worst and know that the door is closed for us. Trying to plan a life around “what ifs” is so mentally exhausting. My kids are soon headed into 8th grade and 2nd grade. I’m in a totally different phase of parenting and need to know if I’m going to be caring for a baby and a teenager simultaneously, plus one in the middle.

Thankfully, in the middle of all this cognitive dissonance and disequilibrium, Kevin and I were able to go away for a weekend as part of a work conference. It was absolutely the best thing and I needed the breath of fresh air. We jam packed as many activities as we could and it was a reminder of what it feels like to actually be alive; not so bogged down with daily responsibilities and parenting. We even did a zip line, which was scary but I finally crossed something off my bucket list!

The trip was a reminder to me that there is lots of joy to be found in life, whether we get a final miracle baby or not. All hope is not lost, and there is lots to live for and look forward to. We have some summer shows, concerts, and family reunions planned. We’re even taking the kids on a little vacation to Vegas. I’m happy to find what life looks like solidly into our 30s. It’s so much better than our 20s. Aging is fantastic. The “just in case” aspect of planning months in the future is still hard. I worry about “what if I’m going through a loss in x amounts of months.” But, it’s wonderful to feel like I’m actually living my life. I don’t want to wait on it anymore. 

Before the trip, I happened to see a job listing for a PRN position for a RN at Maternal Fetal Medicine. Immediately, I was excited about the prospect, but didn’t submit a resume because the stress of picking up another part time job seemed like too much. More so, I worried about my own personal triggers while trying to care of others. Some of the most traumatic and sensitive experiences of my life have taken place in clinics like an MFM office. But the job stayed in my mind the whole weekend away. Perhaps my experiences would truly serve me in the ability to be a compassionate and empathetic nurse. Since I couldn’t stop thinking about it, I applied when we returned home. Turns out they had already filled the position so I didn’t even interview, but it still felt like a win. Despite my mixed feelings of fear at the idea of working in a triggering environment, I was equally excited about the possibility of serving women in a population I’ve been a part of. I proved to myself that I can still put myself out there, in the speciality of my interest. I can keep progressing while carrying all my complicated feelings with me. 

The time came for the repeat biopsy. I wasn’t looking forward to the procedure but I was ready to move on from these tests. Doing the repeat biopsy was really just for my peace of mind, since the treatment I completed is so effective.

Thankfully the repeat biopsy was much more tolerable than the previous one. Maybe they didn’t remove a polyp in the process this time. I also thought if the endometritis had cleared up, maybe the tissue would be less sensitive. I was very hopeful. 

When my results came in, I was ready to tie a nice little bow on the testing phase of our fertility journey. I was so excited to move on and possibly conceive a healthy baby. The worst surprise. My biopsy came back positive again. The clinic was so sure treatment would work, they said I didn’t need to do a repeat biopsy. The studies clearly show that most cases of chronic endometritis are cured with antibiotics. Again, I’m the outlier. I’m so glad I listened to my gut about repeating the test. Still, I felt so shocked about the result and really sad.

Upon seeing the result, one of my first thoughts came with a jolt. I wondered, “does this mean I need ANOTHER biopsy?” That would be a grand total of 4, 3 of them being right in a row. It hurts my womb just to think about it. I really don’t want to go through it again. But could I risk NOT getting another biopsy after realizing how stubborn this infection is? Probably not. 

I’m wearing out. I could not even imagine doing more antibiotics. I’m so exhausted by all of this. But it’s not even like I can just say “ok we’re just going to be done, it’s too much,” because I can’t just walk around with a lingering infection forever. I started considering the idea of a D&C to try and cure this. Just scrape me out like a pumpkin. It’s fine. Here’s a link to a study published last year about using a surgical approach in the treatment of chronic endometritis.

However, my doctor decided on the treatment that I initially did in 2019: doxycycline twice a day for a month. I'm so overwhelmed. Another MONTH of antibiotic therapy is my nightmare right now. I wish I could just get these meds infused, I am not going to have a stomach left. Plus, fun fact about doxycycline, you are supposed to avoid the sun as side effects include photosensitivity; even a small/normal amount of sun exposure could potentially have pretty bad outcomes. Time to break out the hard core SPF.

The med bottle may as well have read, “Please do not enjoy spring while ingesting this poison.”

Perhaps unironically, this was the same day I started finding my first grey hairs while fixing my hair for work. How did so many pop up all at once?!

I reduced my vitamins for the time being and added more probiotics and lysine to counteract the mouth sores and tummy upset from the antibiotic. It’s still hella pills though.

Fortunately I have a depressing new Taylor Swift album to bask in this week, which is helping a lot. 

Shout out to my Swifties

Fortunately, I have a really great therapist and we’ve been doing a lot of work to help me get through these challenges in a healthy way. I think many people fail to realize that with recurrent loss, all these desperate feelings and disappointments are compounded with all your previous hardships experienced in years before. Small bits of bad news can sometimes feel crushing and you can slip back into horrific moments of loss that came before. 

We’ve been working on “radical acceptance” which is a concept I had somewhat been finding on my own, without the official name.  A lot of therapy principles we work with stem from Daoism and Buddhism. When you remove some of the spirituality, these Eastern concepts morph into very effective Western (clinically-proven) therapy techniques. I love the wisdom found in Eastern dogmas.   

Basically, radical acceptance is a way to prevent pain from turning into suffering. It’s recognizing that reality includes pain, and accepting it anyway. It’s understanding that some things will remain out of your control. It’s accepting emotions and circumstances that may not be changeable. Embrace (and don’t avoid/ignore) what you can’t change. 

In my mind, I go to the Beatles, who summed it up so beautifully. Let it be. 

“Parts work” has been extremely effective for me. I try to acknowledge each little “part” of me and appreciate its purpose and how an emotion may be trying to help or protect me. “No Bad Parts” is a great book if you are interested in learning more about this model.

I learned in therapy that confusion and clarity are two sides of the same coin. If we allow ourselves to sit with the uncomfortable, it can become clarity.

All of this is not to say that things are easy. They often feel heavy, depressing, and I get restless. Not to mention the physical effects from treatments. But therapy like this is getting me through. It helps. 

In what felt like that moment of clarity, I applied for my dream job. A full time NICU position at Primary Children’s Hospital. I was trying to build experience little by little before ever applying, and I thought, screw it, can’t hurt to go for the gold. I have spent the past couple years working in what is essentially a step-down NICU. I mean, I’m not pregnant and my uterus isn’t getting better. I could be months away from even trying to conceive. I don’t want to put off an opportunity for a “what if.” If we miraculously conceive a healthy baby, I will cross that bridge when I get there. 

It’s a big career goal of mine to get my neonatal intensive care certification. It takes a couple years of working in the NICU setting and then you can sit for the exam to get that beautiful RNC-NIC credential.

 

It’s a long shot at a competitive position. I’m sure it depends on what type of candidates apply, especially if there are potential internal hires. I don’t know how I would work out the full time with rotating days and nights, yet. But I would be stupid not to try. Opportunities come and go, and I’m proud of myself just for giving it my best shot.

All I Can Do Is Everything Humanly Possible

I was so thrilled when it came time to schedule my IUD removal. To think, either we’ll have a baby in the near future or we’ll decide we’re finished trying- which would mean a vasectomy for Kevin and I never have to worry about an IUD again 🙌🏻

For some reason the removal was extra painful and made me feel all emotional. It’s so easy to forget how intense pelvic pain can be, and for me it brings back a lot of bad memories from the past decade. I left with a bit of dread hanging over me; knowing I had an SSG and endometrial biopsy ahead of me still. The doc tried to encourage me saying, “You’ve had vaginal deliveries, you can handle it!” But is that really the pain threshold we want to set? Childbirth? Woof.

I had to wait five weeks after the IUD removal for the biopsy. Kevin and I got all our ducks in a row regarding all the supplements and meds we’re supposed to be taking starting now. It’s a lot. Definitely hard on the stomach. If I’m lucky, maybe my hair will get thicker🤞

I completed my initial full-time contract at work, which felt like a huge accomplishment. I’ve been at this hospital for about a year and a half and I didn’t sign a contract right away. I wasn’t sure how to work full time nights with kids at home, plus I was still in school for my BSN. But we needed the money that came with it. I signed the contract and was financially relieved, but pretty devastated emotionally knowing we would have to wait even longer to try for a baby. I already felt anxious to start the testing process after I graduated with my RN. I was nervous to put it off again for an entire year. In spite of the mixed emotions, it feels great to know what I’ve accomplished this year for my family. Both financially and career-wise. It was the right choice and I’m relieved that the pressure of fulfilling a contract is off. Though, I am still full time for the foreseeable future.

I met with my neurologist and my OB; they were both so supportive and hopeful for me, which was wonderful. My OB said I didn’t need to “draw a hard line” at 35 and thought I had a few good years left. Putting biology aside, I think I need to draw a line at some point for myself. After all we’ve been through, having started my reproductive efforts at 20 years old, it’s been a lot of my life dedicated to this. It’s not as if we’ve just been waiting on Mother Nature to do her thing, it’s always a long and expensive process. It’s a lot of collaborating with several doctors. 

It has to come to an end sometime soon. I remember the exact day the doctor confirmed my pregnancy with Jack, because it was 1/1/11. To think that was over 13 years ago. I don’t want us to put more of our lives on hold due to a “just in case.” Closing the door after a tenth pregnancy, no matter how it ends up, will open more doors for us in the long run. More experiences for our children, more financial planning, and more peace.That’s not to say I’m not scared of losing another baby. I worry about falling back into that dark place. I find myself already making a “Plan B” list of things to be hopeful or excited about if a baby doesn't work out. I’m discovering what other goals I could dedicate my efforts towards.

My OB approved my plan to stay on a couple meds during a pregnancy. Also, I can continue all my medications while trying to conceive, which is a huge sigh of relief. It eases the stress and pressure if it takes a long time to fall pregnant. At least I won’t be suffering with chronic pain sans meds.

Lots of notes from appointments on how to try to preserve a pregnancy

Looking at our plan can feel overwhelming and like a Hail Mary attempt. I keep telling myself: All I can do is everything humanly possible.

I will try to give life a chance to grow and accept the fact that I likely have very little influence over the outcome. Most factors are entirely out of my control. Maybe that's also a good thing? If all was healthy, I likely could do very little to accidentally hurt a little life growing.

I try to take courage in the fact that my body has always done everything it knows how, to the best of its ability, to protect new life. I’ve successfully produced a son and daughter, despite all the odds. I'm trying not to live in traumatic moments of the past. Who's to say the next pregnancy won't be perfectly normal and complication free? It's absolutely in the realm of possibility. I’m trying to have faith that “life finds a way” ;)

Appointment day was rough. I felt a little crazy. Why not stay up through the day, then work all night, then stay up into the next day to drop a grand on what feels like having a hole punch eat through your uterus? Why the hell not.

The biopsy was so much worse than I remembered; electricity was just shooting up my spine. Like literally are you sampling my vertebrae in there 😭 I had a harder time with the recovery too, it almost felt post op. I had to splint while walking or coughing and wasn’t allowed to take any hot baths which is my go to for pain management.

The SSG was more manageable and the NP said it was the most “perfect and beautiful uterus” she’s seen in a while. At least I have that going for me.

In 2019 when I was first diagnosed with endometritis, they gave me the choice of doing two weeks of antibiotics with a follow up biopsy, or doing a month of antibiotics with no follow up (because it was like 98% successful.) I couldn’t afford a second biopsy so I did the month of meds and it was just miserable. I know the protocol for treatment has changed in the last five years. We were never able to get pregnant after the antibiotic treatment before we took a long break from trying to conceive, so I was never totally sure if the endometritis cleared up. 

As horrible as the biopsy was, it would be completely worth it if the results came back negative! While waiting on results I put all the vibes out there- please please please be negative. Then the results came in.

And my reaction was somewhere around here:

I instantly felt dread just thinking of the constant nausea from the antibiotic treatment. I was prescribed Cipro and Flagyl and told to take both, twice a day, for two weeks. RIP my gut flora. I am taking a probiotic in between doses to minimize side effects, but I am just so freaking sick. It reminds me of morning sickness but worse, and my head is just spinning all the time. Work has been difficult because when I have 10 patients it’s hard to just run off sick and hide in the bathroom until the cold sweat stops. I will be taking antibiotics until the 10th of April, followed by another biopsy to confirm effective treatment. If I survive that long. The flu-like symptoms seem to get worse every single day of meds. 

My sweet friend just happened to stop by within 20 minutes of me getting the crummy news and brought flowers that she just happened to buy because they reminded her of me. Such an angel. She saved me from spending the afternoon crying.

Endometritis is caused by an infection in the uterus and can be due to several different types of bacteria. It is more likely to occur after a miscarriage or childbirth. It’s also more common after a long labors or a C-section. The incidence of chronic endometritis is very high in patients with unexplained infertility. 

From a scientific standpoint I think all of this advancement in understanding the endometrium at the cellular level is really exciting. Secondary infertility is more common than primary infertility and I wonder how frequently this is a contributing factor. Especially since the treatment is relatively conservative and easy with a high success rate- the data really speaks for itself.

Maybe I’ve had endometritis for a long time. I had 6 miscarriages in between Jack and Aidia. Jack was a long labor (like 28 hours) and a rough delivery. Maybe I developed it after giving birth to Aidia. Or after my miscarriage after her in 2019. I also had IUDs inserted and removed several times through all those years. I do have pelvic pain often, but with fibromyalgia it’s really hard to distinguish actual clinical symptoms when it comes to pain. A biopsy looks at the cellular level so it wouldn’t be surprising to me if chronic endometritis often flies under the radar with no symptoms. I imagine women who unknowingly have endometritis are often diagnosed with unexplained multiple losses or infertility. Even if I wasn't having any more children, I want to treat this to keep my own risks down.

Here’s a Link if you would like to read more about it.

Life will always throw curveballs and we just have to learn how to handle them. My hospital was just purchased by a new company and it really threw all my plans for taking a maternity leave out the window. Losing benefits randomly is scary and it just confirms that all we can expect is the unexpected. I really hope that also means unexpected joyful news. Thanks for all the love and support. Send me all your favorite foods to eat when you can’t eat anything without getting sick ;)

In the meantime, I’m going to do tough girl stuff. Like going to therapy.