What to Say

Dear Zuzu,

I'm learning so much all the time, thanks to you. This past month, the learning seems to be centered around strength and grieving. I'll be covering strength in other posts.. For now, though, I wanted to write to you about grieving.

It's different for everyone: grieving, loss, pain. And as a result, one would think that what to say or not to say to a grieving person is going to be different for everyone.
As I've become more acquainted with grieving, though, I now believe this is not the case.
I also now think that we need to bring grief out from under a cloud of doom. Grief is a part of life, a healthy part of a good relationship and a way to express our affection for others. Why should grief be clouded in shame or silence?

I don't think it should. So, I've done a little research and come up with three lists (yay! lists!)

List 1: What NOT to say (note: none of these things were said to me) when someone says, "I've had a miscarriage."

• Well, no matter what, the sun will come up tomorrow and life will go on, right?
• It wasn't really a baby, you know.
• God doesn't put the soul in until later.
• Good thing you have at least a few more eggs in there, huh?
• You should just be happy that you have a next-door neighbor who has kids, so you can babysit theirs and they can have a break (insert 'friend', or 'sibling', or 'cousin' here - variations on this one abound) 
• __ suffered from infertility, too, and never had kids. Look how happy she is!
• Oh yeah, I have loads of friends that have had miscarriages. Trust me, it's no big deal.
• Now you can have your life back - just think, pregnancy and kids are a big responsibility!

And on the flip side, a very good friend of mine told me that she had no idea what to say to me when I told her. Totally understandable. A few years ago, I probably would not have known what to say either. And unfortunately, I've recently struggled with folks who just avoided me altogether because they didn't know what to do or say. As I mentioned above, I did some 'testing' and asked around about what people wanted to hear when they were grieving. This is the list I got back:

List 2: What TO say to a grieving person:

• I'm so sorry for your loss.
• This must hurt so much.
• I will miss him/her too.
• It sounds like he/she was very loved.
• Would it help you more if I talk about him/her and missing them? Or would it be better to distract you?
• What are you struggling with? 
• How can I help?
• I don't know what to say, but I wanted you to know that I care about you and I'm sad this happened to you.

Surprisingly, this list was very universal across all losses and all walks of life. I identified with every statement on this list and heard these things from loving, empathetic family members.

Another universal response - people who'd lost someone close to them were surprised by how quickly after the loss everyone seemed to avoid the topic of the loss. Without asking or checking, friends just stopped talking about it. In fact, one sweet friend told me "I began calling myself the laughter killer. I could walk into a room full of people laughing over some joke, they'd see me, and the laughter would almost immediately cease, but no one would say or talk about why." So sometimes, it wasn't about what was said, but about the timing - while mourners will hear condolences thousands of times in the first few days, an average of seven short days after the loss, friends of mourners would avoid asking about or discussing the loss any further. This was jarring for my grieving friends. They didn't know what to say to get a discussion started, either - talk about a catch 22!

 

Having also been the person who did not know what to do or say when a friend was grieving a death, I empathize with both sides. It's awkward for both sides and I say, it's time we fight this unhealthy response. 

So, I think it's time for that third list - this is a list of things my friends did and said after my recent losses that I'm humbled and grateful for. 

List 3: Grateful For... (otherwise entitled: How to Fight Unhealthy Responses to Grief)

• The dear, dear friend that showed up at our door the day after I miscarried to bring us a small flower memorial (it had a butterfly on it! I love butterflies!) and give me a hug and laugh with me over silly things. (I still have the butterfly.)
• The friend that said 'You seemed panicked. What can I do to help?'
• The friend that helped me analytically evaluate the details of my particular medical condition.
• The friend that shared another woman's story with me and shared how she coped.
• The friend that told me her mother said "When you're delivering a child, you have contractions and pain, whether it's a miscarriage or a birth."
• The friend that said "I felt that too when I miscarried."
• The friend that said "It's OK to tell them you don't want to take the methatrexate."
• The friend that offered to get pregnant and carry a child for us. And really meant it.
• The friend that told other friends, when we just couldn't.
• The many friends that didn't shame us for not talking about it. The many friends that didn't shame us FOR talking about it.
• The friend that wanted to know if it would be alright if she just let me hold her baby. 
• The friend who said "Of course you're going to cry when you hold a baby, and it's totally OK to do just that!"
• The friend that sent me a text on Memorial Day to say "Thinking of your Dad and Tiny"
• The many friends that gave an hour of worry-free time
• The friend that said "This little angel was given to me by another woman when she miscarried. It comforted me a lot, and I'm passing it on to you thinking that it will comfort you and you can one day pass it along, too, if you'd like."

I cannot say how I got so lucky. I can only say how humbled and grateful I am for friends who try so hard to understand and show affection, despite my own failings in helping them through their grief. Examples and inspiration abound, dear Zuzu, and I can hardly wait to introduce you to these incredible people.

Love,

Mommy

Stories

Dear Zuzu,

I was in the midst of a panic attack yesterday and someone very kind said to me "So, what's the story you are telling yourself about this event?"

I was a little surprised by this and took a step back to consider the story I was telling myself... "Well," I responded, "I guess I'm telling myself the story that this event means I'll never be able to have children and this will make things difficult with my relationships because I will obsess too much about it so all my friends and family will get sick of me obsessing, and so, I'll lose everything for the rest of my life and then I'll die, childless and alone."

Then, the same someone said "Ok, that is certainly an option." (I give her great credit for not laughing at my ridiculous response.) She continued, "Now tell me, what is the reality-based story of this event?"
This question surprised me even more and I got my head and my heart involved in evaluating my 'reality'.
"The reality is," I responded, "B and I are surrounded by supportive people and this event, though tricky, is not catastrophic or life-ending. We're going to make it work and we will later look back on this time with gratitude for those who helped us through."

Isn't it weird how the simplest question can turn a story from unbearable to loving? I'm grateful to that someone for teaching me this question trick and thought I'd share it with you.

Love,

Mommy

PS - This question trick is applicable in other arenas, like work relationships and self-talk. How cool is that?

The Fertility Hope

Dear Zuzu,

I went to see a fertility specialist on Tuesday. It was a little bit nerve-wracking and altogether engaging. The OB I saw during Tiny's miscarriage recommended that I go see a specialist based on my numbers, my age, and the timing of everything.

I've been experiencing a very common phenomenon wherein I have a bunch of post-miscarriage, fleeting, and most-likely-imagined pregnancy symptoms. Daddy has been maintaining a stoic reaction to all of this, reminding us both that we need to be cautious about soaring through the roof over every little wave of nausea and backache. Many things cause early pregnancy symptoms that are not at all related to pregnancy (like the donuts Mommy craves all the time right now...)

So, when it came time for the fertility visit, I really hoped I would hear whether or not I was pregnant again without having to visit the OB. There are pros and cons to a soon-after pregnancy:

1. Women who've just miscarried have issues with their uterine lining being thin. This can affect implantation and can affect the resulting pregnancy. (Though stories to the contrary abound - as with any other medical category, reproductive and fertility stories, both academic and no, circulate through all communities.)
2. Waiting one cycle after a miscarriage can be a sign that the body is ready to conceive again.
3. While not eager to risk another miscarriage, Mommy is emotionally hungry for a baby now that she's experienced a recent, though brief, pregnancy.
4. Happiness does not depend on external circumstances and recovery from grief is not always dependent on filling the void left by a loss with another opportunity. 
5. Mommy is just plain tired - body, mind, emotions... it's exhausting to go through this amount of emotion and intense physical concentration in a short amount of time.
6. Mommy and Daddy's support system is unbelievably strong and positive and we believe that bodes well for our chances. How can anyone contend with an army of good thoughts?

The fertility specialist was recommended by Dana (one of Mommy's smartest friends, who is also a doctor) and the clinic itself was recommended by Kim (one of Mommy's favorite theater friends.)  The clinic is so nice and helpful. Mommy was introduced to all the Doctors on staff, just in case I ever have a question - I can contact anyone at the clinic. That's a good feeling. And then, dear Nurse Gia showed me to a room. Gia is one of my new favorite people - so funny and warm and engaging. She had me laughing through all the questions one has to answer in a visit like this.

Dr. Jessie Dorais is everything Dana said she would be and more. She's reaffirming without being condescending and willing to get emotional in the midst of the logic. We are very lucky to have her, dear Zuzu. During the visit, Dr. Dorais explained that they don't do blood pregnancy tests at that clinic and encouraged me to take a home pregnancy test over the weekend. After a quick trip over to the hospital to get blood drawn for a series of important tests, the appointment was done and the waiting started again.

The results of the test came in fast - we found out within hours that Mommy is immune to Rubella (hooray!), free of any interfering diseases, and the next day, we learned that Mommy's thyroid is right down the middle of normal range. This was great news.

The AMH test took a bit longer. 

During the wait, many of our friends offered to help us worry, since Mommy is so so mentally exhausted. Your Aunties and other friends all pitched in to help Mommy and give her a break by offering to worry for an hour so Mommy then felt obligated to NOT worry. A good idea, right? No, a GREAT idea. I felt so relieved at getting to put the worry down for awhile and it was good practice. I have a feeling that worrying comes with parenthood and practicing the 'letting go' will be invaluable in the years ahead of us.

Just this morning, I got two very emotional pieces of information: first, I am not pregnant and second, my AMH level is low for a woman my age. I read this info with great disappointment. AMH is such a vital part of conceiving and represents the reserve of eggs I have left. As old as I am, it's disheartening to believe that my chances are dwindling. Also, though there are cons to an immediate pregnancy after a miscarriage, it is the time when we are most likely to conceive. Feelings of despair overwhelmed me.

As I was driving to work, I noticed a small and bright feeling growing in the car around me. I was crying a bit and thinking ahead to the work I'd have to do today while feeling so despairing, and noticing that a warm, comforting hope was surrounding me. As Daddy has said at least a hundred times in the last month "It will be alright." I realized that all this up and down feeling could be resolved for the time being - we're not pregnant and there are options. I just feel it in my gut, dear Zuzu - there is a reason for my longing to have a baby join our family. And I just feel so calm now - I am not only meant to be a mother, I will be a mother. I will continue to go toward my children with all the hope my uterus and I can muster. The feeling in the car - call it what you will - reaffirming temporary insanity? Something to hold onto? I was there, though, and I call it a message from those children. Thank you, dear Zuzu, for reaffirming something important: we can do difficult things for worthwhile endeavors.

Some googling also revealed other news about AMH levels. They are not the be-all, end-all results to focus on. And re-reading Dr. Dorais's message helped me see that the though my levels are low, they are within the low-normal range. Meaning, I am not in a small percentile here. I have chances and options still and my levels are higher than literally tens of thousands of other women who have conceived and carried successfully. Those are pretty good odds in our favor.

Zuzu, we have some work ahead of us. And I'm going to continue to trust that I'm moving in the direction toward you and a successful pregnancy. Your Daddy's humor and my dogged determination combined with the army of good thoughts and willing worriers? I think we've got something more than hope, there.

With great hope and persistence,

Your Mommy and Daddy