Farewell to Lilly

Yesterday, exactly one month after we lost Jane Margaret, we had to say goodbye to our sweet Swiss Mountain Dog, Lilly.

My husband has had Lilly since she was a puppy, over 9 years ago. (He’s loved her longer than he’s loved me!) She has been a loyal member of the family, companion to our pug, Winston, and to C. Samuel, and occasional guest on this blog (for example, here and here).

Yesterday afternoon, Lilly had a seizure. She’d been having seizures and losing muscle control due to a suspected brain tumor. This was the second seizure since we started antiseizure meds in early July, and the first one that she didn’t come out of on her own. C loaded her, panting and non-responsive, into the back of my car, and we drove her to the veterinary specialty hospital, where they gave her phenobarbitol to break the seizure.

We knew we had pushed Lilly past the point of a good quality of life, but after so much recent sorrow, we had a very hard time letting go. The phenobarbitol made her sedated but responsive, which gave us an opportunity to say goodbye.

She will be deeply missed.😦

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Best friends. (Lilly was wearing the cone while recovering from an eye ulcer.)

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Our neighborhood 4th of July parade. Lilly couldn’t walk the route, so we pulled her in the wagon.

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The brain tumor made it hard for Lilly to get up to pee, so we did nighttime diapers, held up with ‘suspenders’ made from my NST-monitor elastic bands.

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Out for a walk. This was one of Lilly’s recent ‘good days’.

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Yesterday morning, C. gave Lilly a new haircut to make it easier to clean up after accidents. She was still giving us attitude even then.

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C. saying goodbye.

Decision 6: What to do with Jane?

Following the death of our sweet baby Jane Margaret, many of our most painful, frustrating, and morbidly humorous moments centered around decisions about what to do with Jane’s remains. (For Decisions 1-5, see this post.)

a) Autopsy or no?

While we were still in the hospital, Dr. R informed us that we had the option to do an autopsy on Jane to see if it revealed anything about the cause of her death. Dr. R believed Jane died from an accident in utero (either a cord accident or placental abruption), in which case an autopsy wouldn’t reveal anything, and Jane’s flawless appearance seemed to agree with that assessment. Data junkie that I am, I was somewhat surprised to find that this was one piece of information I didn’t feel like I needed. C felt the same way. We said we preferred not to put Jane’s tiny body through that.

b) Funeral home vs. hospital cremation?

When we met with the hospital social worker, one question she asked us is what we wanted to do with Jane. She said that the hospital could cremate her, in which case we would not get any cremated remains (or ‘cremains’ – yes, that is an actual word). This decision proved an easy one. My mind jumped to an image of Jane being tossed into a pile of medical waste for burning, and I reflexively and emphatically answered “Funeral home!”

c) Which funeral home?

At bedtime on Sunday, I realized that I needed to start taking action about Jane’s disposition and funeral. I emailed my two favorite priests and their pastoral associate, letting them know about Jane, and asking for a funeral home recommendation and guidance about how to plan Jane’s funeral.

Overnight, Fr. JP emailed me back, saying he had worked with EC Memorial before. I was in no mood for price shopping, and called EC Memorial first thing Monday morning to arrange for them to pick up Jane at the hospital.

It took another day for the Kaiser hospital to release Jane (during which I continued to be tormented by an irrational fear that Jane might somehow end up in the hospital furnace by mistake). Eventually, Nick from EC called and let me know that Jane was on her way to EC Memorial. Phew! We set up an appointment for Wednesday with representatives from both the funeral home and the cemetery sides of things.

I was hoping for a mom-and-pop shop of a funeral home, like the one where we took my Grandma. I pictured Dan Aykroyd from My Girl coming in to meet us…

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I so wish this was our funeral home director… (Source)

What we got was decidedly more corporate. Upon arrival, C and I were shown to a small meeting room with a tray of snack chips, cookies, candy and ‘Dignity’-branded bottled water. A man in a dark brown suit introduced himself as Sergio and gestured toward the tray, “If the family would like to help yourselves to some snacks…” He explained that he was the cemetery representative, and that Francisco – the funeral home representative – was running late, and would we like to take a tour of the cemetery? We said, “Sure?,” and followed Sergio to a golf cart.

Sergio drove us to a wall of niches, a man-made waterfall with holes where you can inset cremated remains, two “Catholic” burial areas, and a burial area for infants and children. At the second Catholic area, he informed us that all the visible sites toward the front were already purchased, but that there were some available spots towards the back near a “Madonna feature”. He asked “Would the family like to go see the available spots?” We again replied, “Sure?,” then immediately regretted it, as we saw Sergio crank the wheel a hard right and drive over the sloped curb and onto the grass. Ka-chunk, ka-chunk, ka-chunk. Over headstone after headstone! Ka-chunk, ka-chunk, ka-chunk. Live baby or not, I had still given birth three days prior, and was regretting my decision to leave the inflatable donut that my sister bought me in our car. Ka-chunk, ka-chunk, ka-chunk. Sergio drove diagonally across what seemed to be as many graves as he could hit, occasionally turning the wheel to dodge flowers. Ka-chunk, ka-chunk, ka-chunk. Finally, Sergio stopped, gestured in front with his hand, and told us that this area had availability…but only for double vaults (in case we decided we wanted to plan ahead for our burials). He could check and see whether all three of us (Jane, C and I) could be placed in one double spot.

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Wish I had brought my donut, purchased and lovingly decorated by my sister, for our fateful golf cart ride…

After our bizarre tour, Sergio drove us back to the little office, where Francisco met us.

d) To embalm or not?

Francisco proceeded with a series of uncomfortable questions. Did we want to embalm Jane or not? If so, the sooner we do it, the better the result would be. Wondering whether we wanted to put Jane through it, I made the mistake of asking what embalming entailed. “Well, you see, we make an incision behind the ear, and drain the blood, then replace it with a pink-colored preservative…” Ugh. Not what we needed to hear. He also made several references to “leakage”.

We decided to embalm Jane, if only so that we could have the opportunity to view her again. (We ended up being really glad we did, since it meant we got to have a private family viewing – during which we got imprints of Jane’s hands and feet – and a public viewing prior to the funeral. They also washed her hair, which was so soft and precious!)

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Taking imprints of Jane’s hands and feet during a private family viewing, made possible by embalming

When we resisted making any other decisions at that meeting, Francisco proceeded with some paperwork, asking C a series of questions that I tuned out, and then turning to me:

“What is your maiden name?

Date and city of birth?

What is your nationality?

When was your last menstrual period?

When was your first OB appointment?

How many OB appointments did you have?”

C got visibly irritated and asked, “Is this your form? Because these questions seem really impertinent!” Francisco looked flustered and explained that it was the State of California’s form, required for us to get a death certificate. He showed us the form, which was specific for stillbirths. (I can only imagine the quality of data coming from grieving parents filling out that form… Also, why in the hell didn’t Francisco just hand over the form for me to fill out, instead of asking me about my menstrual cycle?!)

e) Cremation vs. burial?

f) If cremation, what to do with her ashes?

g) If burial (whole or of her ashes), where?

These were harder decisions, and ones that we ended up postponing for another week plus. Considerations included (in no particular order):

  • Our off-putting experience with Sergio and the golf cart (see part c, above)
  • Our (relatively young) age, and uncertainty about whether we will stay in this city forever
  • A desire to have Jane be part of something big (like the ocean), or close to us (like in a pot or in the earth at our home), or incorporated back into nature (like under a tree)
  • A specific place to visit – on Memorial Day, and Jane’s birthday, and whenever
  • A sense of permanence – something that says Jane was here, that will outlast our home, us, even C. Samuel
  • Catholic Church teaching (Since Vatican II, cremation is allowed, but scattering the ashes is not)
  • Our reluctance to make any decisions (this probably influenced what we ended up doing more than any other single thing)

We decided to cremate Jane after her funeral. This decision bought us some more time to decide where we ultimately wanted to put Jane.

 

Today, almost a month after Jane passed and two weeks after her funeral, we interred Jane’s cremated remains under a tree in the infant and child section at EC Memorial, between two other babies.

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What happened next

After we arrived at triage and learned that our baby had no heartbeat, the hours and days that followed felt like a string of unpleasant and unanticipated decisions:

Decision 1: Vaginal versus cesarean delivery?By that point, my contractions were averaging about 2 minutes apart, so we knew our baby had to come out. Our first impulse was for a C-section. I was in a lot of physical pain, and the thought of pushing a lifeless baby out of my vagina sounded unbearable.

Our doctor – Dr. R – expressed her complete sympathy and support if I preferred to go with the C-section…but, she recommended a vaginal delivery. Dr. R explained that she really didn’t want me to have to go through recovery from surgery, and that we would most likely want to try for another child, which would be easier without two C-sections under my belt. She also promised to do everything to make me comfortable for the delivery.

We were fortunate that this was ‘our’ obstetrician, the same one that had seen me through this pregnancy. (With Kaiser you typically get whichever OB is on call, almost always a complete stranger.) Coming from anyone else, I’m not sure we would have listened. We certainly weren’t thinking about another baby at that moment, and I really really wanted the baby out immediately.

We told Dr. R we would go with her recommendation.

Things moved quickly after that. Shortly after telling us that our baby had no heartbeat, Dr. R checked my cervix and said I was about 1 cm dilated. Two hours later, I was fully dilated and feeling the urge to push…but still waiting for my epidural.  Dr. R’s best guess as to what had happened to Jane was either a cord accident or placental abruption (my wildly progressing labor supported the placental abruption hypothesis). With placental abruption, there is a serious risk of the mother bleeding to death, so we had to wait for my blood tests to come back before they could place the epidural. Eventually we got the results from both blood tests, and the nurse anesthetist showed up to place the epidural. Once it took effect, I became completely numb from the waist down, which was fine by me. (I’m pretty sure Dr. R told him to use the ‘adult elephant’ dose.) We did a few pushes, and then Dr. R got called away to an emergency C-section.

Decision 2: Whom to tell, and when?

C was the first to make this decision; he texted my mom, so she could try to get on an earlier flight. Then he texted his parents, his brother and my sister at our house, and they immediately drove to the hospital (leaving C. Samuel and the dogs at home with my sister-in-law). At some point he also told our friends S and Q, his business partner, and several other friends. Late Sunday morning, I shared with my local group of infertile mamas first, then texted the rest of my close friends over the course of the next few days.

This decision prompted another: When to let our family come in from the waiting room to see us? I didn’t want them in the room while I was in excruciating pain. But after the epidural was working, Dr. R’s emergency C-section opened up an opportunity to visit, and we welcomed our family back into the delivery room. We all hugged and cried together. My contractions had slowed way down, and the epidural was also making me sleepy, so I closed my eyes and rested for a bit while they were in the room.

Eventually, Dr. R came back from surgery, our family returned to the waiting room, and I continued to push Jane out – two pushes per contraction, one contraction every 5 or 10 minutes.

At 2:00 am precisely, I delivered our sweet Jane into the world. Seeing her beautiful face prompted a new wave of intense grief. C and I took turns holding her and gazing at her. I rocked back and forth with Jane, cradling her and singing James Taylor.

You can barely hear the ‘S’ at the end of James. Doesn’t it sound like he’s singing “Sweet Baby Jane” instead?

Our families came back in, and they each held her, and C and I held her some more. We examined her fingers and toes and arms and legs and back and bottom. Every part of her was so beautiful and perfect.

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We let the nurses weigh and measure her. She was so tiny! Only 5 pounds 8 ounces, and 17 1/2 inches long.

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We all took turns holding her until about 5 am, when we started dozing off and were afraid of dropping her. And so we sent our family home, and asked the nurses to come in and take Jane away.

Decisions 3 and 4: Photographer or no? Visit from a priest?

Some time early that morning a social worker came. She asked a series of questions, including whether I wanted a volunteer photographer from a charity called Now I Lay Me Down To Sleep to photograph Jane, free of charge. C and I said yes.

She also asked if we had a religious preference. I told her I was Catholic and she asked if I would like a priest to come and bless Jane. I said yes.

C’s family showed up with C. Samuel, followed by my sister with my mom, who came straight from the airport to the hospital.

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It was such a comfort to hold our precious little boy

The photographer arrived next and the nurses brought Jane back into our room for photos.

They had dressed Jane in the outfit I had brought to the hospital to take her home in: a sweet little onesie with gold letters that spelled “little sunshine”, the same striped leg warmers that we brought C. Samuel home in, and a pair of tiny socks. Everything was huge on her.

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The nurses had cleaned Jane up a bit, and rubbed some citrus-scented lotion or something on her, which I didn’t mind. She still looked perfect everywhere except for her lips, which had turned a crimson color. And she was so cold. When she was born, Jane had been warm – the temperature of my body – and she had slowly cooled off in the three hours that we held her right after. But now she was much colder – the temperature of the refrigerated room where they kept her tiny body. The cold had also turned her cheeks and arms a sweet shade of pink.

The photographer came in and photographed Jane in the hospital bassinet, and in my arms, and with C, and his parents, and his brother, and my mom and sister, and with her big brother, C. Samuel.

Then our dear friends S and Q (you may remember them and their generosity from this post or this one) arrived and cried with us some more and held our little Jane. Eventually we sent Jane back with the nurses.

C’s business partner came next. He had come straight from church in his suit and tie, and the nurse supervisor mistook him for the priest.

The priest came then, and the nurses brought Jane back into our room for the blessing. Fr. Danny said a prayer and sprinkled holy water on Jane’s forehead, and we cried some more and everyone held Jane again.

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Decision 5: When do I want to check out of the hospital?

As soon as possible.

As much as I hated to leave Jane, I had no desire to stay in that room any longer than absolutely necessary. The nurses mercifully had not transferred me to the postpartum unit to hear the cries of other peoples’ living babies, but since I wasn’t interested in staying another night, they also didn’t transfer me anywhere else. So we were still in the small delivery room where I had delivered Jane. C and I. And C’s parents, and his brother and sister in law. And my mom and sister. And S and Q. And C’s business partner. And the nurse. And our rowdy 2-year-old who had no idea what was going on. It was getting crowded.

I just wanted to go home and grieve in (semi) privacy.

For uncomplicated vaginal births, hospital policy was to let me check out as early as 12 hours after delivery…if I could pee on my own. This proved to be more difficult than I anticipated. While I was able to walk to the bathroom and sit on the toilet three hours after delivery (a stark contrast from when I had my C-section), I was unable to squeeze out more than a few drops during that bathroom visit, or during the one around 8 am. The nurse ended up having to reinsert a catheter just so I could empty my bladder (a process that was markedly more unpleasant sans epidural). Fortunately, my bladder eventually ‘woke up’ from the elephant dose of epidural meds, and I was able to pee on my own twice before 2 pm Sunday, at which point the nursing staff approved me to go home.

I changed into my clothes. Our entourage, including our friends M & M, who showed up just as we were packing up, gathered up all of our things and started down the hall. And C and I held Jane, and said our tearful goodbyes before making our way to the car.

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Saying goodbye to Jane before checking out of the hospital

Decision 6: What to do with Jane?

This decision – actually, this series of decisions, spread out over the next several weeks – proved the hardest for us. C and I were totally unprepared, the funeral home and cemetery staff seemed ill-suited to dealing with infant death, and each decision felt simultaneously rushed and high-stakes…I’ll save it for its own post.

My sister left today

My sister left today.😦

She has been staying with us since the first week of June.

She came to campus with me each day for the last 7 weeks of my pregnancy, doing data analysis for one of my projects.

She saw our Swiss Mountain Dog, Lilly, gradually deteriorate from a probable brain tumor, and took over more and more of Lilly’s care, as I became too pregnant to lift her and help her walk.

She stayed home with me when contractions led me to skip dinner with the in-laws, rode with those same in-laws to the hospital after C told them that we had lost the baby, and waited for hours in the waiting room while I was in labor.

She held our precious Jane in her arms, surreptitiously rubbed her tears on Jane’s forehead in a makeshift emergency baptism, and took cherished photos of our baby girl in the hospital.

She took over all dog care (including daily poop and pee clean up), most baby care, and shopping in the weeks following Jane’s death, when getting out of bed was hard and leaving the house unthinkable.

She notified neighbors and caregivers of what had happened to the baby, and handled returns of baby gear, saving us the same uncomfortable conversation over and over.

She wrote and mailed dozens of thank you cards – and addressed over 100 more – for flowers, food, and donations to Jane’s memorial fund.

She cried with us, laughed with us, drank with us, ate with us.

 

How am I going to do this without her here?

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My sister at the beach with my husband and little C. Samuel, 4 days after Jane passed

Sad news

I am so sad to share that Jane Margaret was stillborn on July 24 at 2 am. At 41 weeks pregnant, I was excited to go into labor naturally Saturday afternoon, but when we arrived at triage that evening, the doctor could not find a heartbeat.

We are at a loss, since everything looked great at the OB appointment and NST on Friday. Our doctor believes that I had a placental abruption, which combined with blood clots in the placenta deprived Jane of oxygen.

We held her for about three hours after delivery, and several more times before I checked out Sunday afternoon. Jane was beautiful. A full head of dark brown hair. My nose and fingers. A skinny little thing, under 5 1/2 pounds and 17 1/2 inches long.

We have been surrounded by family and friends, and have been holding our little C extra tight these past three weeks. (Have three weeks really passed?)

Here are some pictures of our sweet Baby Jane. I’m sorry if they are hard to look at.

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The 6th time’s the charm?

Well, despite my promise, I did take a home pregnancy test last Wednesday (at 11 dpo), and I did allow myself to get excited by a faint line. (I swear it looked darker than the one last month!) And like last month, I started bleeding a few hours later, and thought “Oh well!”

But then my period didn’t progress like usual. (Light flow of super dark blood, not much red, no clots.)

So on Friday, I tested again, and damned if that line wasn’t just a little bit darker.

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I got the nurse to order a beta hCG test, and it came back at 89 mIU/mL. Consulted betabase (which I was happy to see came back online since last time we went through this!), and saw that 89 is about right for 13 dpo, but I was still bleeding…

Tested again on Saturday (since I was leaving for a trip to DC on Sunday), and it came back at 131 mIU/mL, which corresponds to a doubling time of about 45 hours. A little high for the doubling time at that beta, but still in the ballpark…

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Still bleeding, and not feeling particularly pregnant, I was very hesitant to believe that this was real. But then my awesome husband reminded me that I bled when I was barely pregnant with little C. Samuel. He was totally right! I bled for six days and was convinced that I was miscarrying. How did I forget about that?

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I got back from DC on Tuesday night and went in for another beta first thing Wednesday morning. I figured if the 45 hour doubling time held, my beta should be around 600…

It was 1023. Which means the doubling time sped up to just over 32 hours…

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Is this really happening?

The IUI count, and Halloween cuteness

I’m deep in the 2WW of our sixth month of natural cycle IUIs. It’s only the third cycle that went according to plan (read: including trigger shot), and the fifth that included insemination. Unlike last month, I won’t make the mistake of testing too soon (or at least if I do test, I won’t mistake a squinter for a BFP…)

In the mean time, I’ll contribute to the Halloween cuteness going around. (Those of you who are sick and tired of kids in costumes might want to click elsewhere…)

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Oktoberfest party at a friend’s house the weekend before Halloween

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“Harvest Festival” at C’s daycare Thursday night

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Dressed as Daddy (including salt and pepper hair) for school Halloween parade on Friday

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Trick-or-treating with his bestie Saturday night

Can’t believe I forgot about that!

It hardly took any time after having our baby for infertility to become a distant memory. I first noticed it when I met up with wheresmywave and found that I couldn’t answer questions about my supplements, cycles, etc. without consulting my blog. But clearly, I underestimated just how much I had forgotten…

Today, at 10 dpo, I got impatient and decided to do an HPT. I distracted myself with Facebook for the requisite 3 minutes (since last time I got tricked by the disappearing early line), and then picked up the test and saw the faintest squinter of a line.

I took a shower, then checked again – still definitely a line.

I finished getting ready – still a line.

I got the baby, gave him his morning cup of milk, and checked again – still a line.

So I emailed Dr. Y’s office and asked his nurse to order a blood test for me.

I told C the news, dropped the baby at daycare, fantasized about a sibling for little C. Samuel on the way to the doctor’s office for a blood draw, drove to work and prepped for my class.

And my period started.

And then I remembered this.

How the heck did I forget about that?!

:/

I did it!

So…I did it!

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Here’s hoping the Universe sees fit to reward my bravery!😉

A new first

Tonight (well, technically tomorrow at 2am), I get to do my first trigger shot on myself! C is up in the Bay with the little guy and I can’t bring myself to ask a friend to do it at that hour, so…trigger shot in the upper thigh it is!

I’m a little terrified, but feel inspired to do it by our friend Willy. For the last trigger shot, in July, C was busy with a friend from out of town and asked poor Willy to do it! He works in construction, had no idea what it entailed, and was actually relieved when he found out the shot was only in my butt!:/ I talked him through it, “Just plunge it in, like a dart!” So I figure, I ought to be able to do it myself!

In case you’re keeping track, this will make only our second natural cycle IUI with trigger shot since we started trying for #2 back in May. That’s because I ovulated early twice, and traveled out of state at precisely the wrong time one time. As we come up on the three attempts that we had originally agreed upon, it begs the question of what we plan to do next… But I’ll save that debate for another night, and another post.

Wish us luck!

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