Post-op appointment: the end, and the beginning...

I had my post-op follow-up today. One week since the D&C. I should be grading papers right now, but I want to write this out. I've been told recently by colleagues that it's important to write about it. And I admit, writing here does purge and clarify. I have dreams that one day I may speak for millions of silent and grieving women, telling my story for a wider audience, but for now...

I hadn't expected today to end the way it did. But it began exactly how I'd expected.


I arrived. Woman in waiting room with baby carriage: my husband (who had arrived earlier) immediately made eye contact and waved me to the opposite end of the room (God bless the man). Then doc and his magic wand. I strip below the waist and sit waiting on the table of torture for the transvaginal ultrasound. I hate that thing anyway: maybe I'm not built for it, or maybe it's uncomfortable for everyone, I don't know-- but that thing really hurts me. And when he waves it inside and pauses to catch glimpses at certain angles... the whole experience is just really distasteful.

He found blood, which I guess I wasn't expecting. It looked like a narrow strip of dark on the ultrasound. Actually, it looked exactly like the gestational sac: a formless and inscrutable form on the screen. Seeing that blood bothered me, somehow. I've been spotting, and I have expected to be spotting a lot more, but somehow seeing a pocket of it still in my uterus was gruesome for me. The blood coming out of me seems right, normal, natural, and even expected: but seeing blood inside me feels like a wound, like something is sick. It's illogical, of course: if I'm spotting, then obviously there is blood inside to begin with. But seeing a large pocket of it... I guess I just thought there wasn't much blood there anymore. I was wrong.

Then he told me what I had expected: the results from the genetic testing weren't yet in and wouldn't arrive for several weeks. (My husband seemed to think Doc had told us otherwise, but I assumed it would take a long time to get those results back.) And we made the follow-up appointment for 3 weeks from today, at which point Doc will share with us the results of the genetic testing and do a series of blood tests. He didn't specify what tests those are, but he mentioned something about screening, so I think the testing that goes on for this sort of thing has far more steps to the process than I had assumed.

And yes, it was sad. I didn't cry when Doc was in the room, but when he left, I burst into tears. Because this was the end. I have so often watched the video I took on my iPhone at our first appointment-- which came, incidentally, precisely 6 weeks ago today (only 6 weeks!). That was The Beginning. The day we first saw Doc and did the urine test. The day he did the first ultrasound. The start of the journey. Today was The End. As I left the office and walked through the hall back to the elevator, I had that profound sense that the door on this pregnancy was officially closed. Today closed that door. It wasn't even the D&C that ended it, because that procedure brought with it a series of events which were traumatic in their own right (waking up, the recovery, reentry into the world). And everything related to the D&C surely relates to the pregnancy, so this whole week recuperating from the D&C has still kept me connected to the pregnancy. Today, the connection ended. All done. All loose ends tied up. The post-op check-up. Patient doing fine: recuperating. Blood, but it will pass. For all intents and purposes, this is behind us.

But all of that was what I had expected.

What I had not expected was that today also felt like the beginning. Because something has shifted, now that it's over. If what was is over, that we are now in the era of what is. I asked Doc when we can start trying, assuming he'd counsel us to wait until my next cycle or maybe even two (which he had told us before). So I had assumed to look at the next few weeks as a pause. Not quite still living in the last pregnancy, but in a holding pattern until we start thinking about the next one. In short, he told us we could start trying today if we wanted.

And that was something to think about.

Because suddenly I'm in the TTC stage. Suddenly I'm thinking about when I'm ovulating. Suddenly I bust out the prenatal pills and, God forgive me, I just took some. Suddenly I'm Googling "how long after a miscarriage do you start ovulating"? Suddenly I'm counting days when we might be fertile, although of course knowing I have zero idea how to calculate that because AF hasn't yet come. Suddenly I'm thinking, yes, I could get pregnant again. I think that's what I'm trying to say: suddenly I start conceiving of the possibility of being pregnant again. And soon. Women do conceive after miscarriage: it happens. Just because my first miscarriage ushered in a three-year era of mourning and bitterness as each month passed without a pregnancy, that doesn't mean it will be like this again. Indeed, I could see myself right now as not recuperating from surgery but rather as preparing my body for trying. Which is why I ate well when I came home (I included vegetables in my dinner, a sure sign that I'm trying to be healthy). Which is why I took my prenatals again tonight for the first time in weeks.

And it's scary. There's something very scary about opening this new phase of trying. First, it's sad and depressing: we just cleared this zone of anxiety with our BFP six weeks ago: not this again! Second, part of me doesn't feel physically ready. My incisions are still bleeding, for heaven's sake. It hurts to lay on my side so I'm still sleeping on my back. And there's still blood in my uterus. I know that isn't a sign of sickness or disease, but rather the natural product of my surgery or even remnants of the old uterine lining. But still, I don't feel physically well yet. And I think that is partly why I'm apprehensive at the notion of trying to conceive and DTD again. But there is also most definitely the fear that if we start trying again, I'll be flirting with depression. Because I'm assuming that I will not get pregnant when we start trying again-- I went three years trying and failing-- and I don't know that I can handle that disappointment anymore. I thought I had been absolved that. But God saw otherwise. He wants me to continue in the stress and anxiety of waiting to ovulate, then DTD obsessively, then the two week wait, then collapsing in a heap of my tears when AF comes again. So sensing that this is also the beginning of the next phase worries me more than anything because I worry that it's only going to lead to another crushing era of disappointment.

I feel better emotionally than I did last week, and certainly better than I did the week before that. I'm moving on in the sense that I'm able to integrate the pain and it doesn't debilitate me. Tears flood me at moments of vulnerability, though: this morning, driving in the car, I heard an NPR interview with Joan Didion as she discussed the death of her daughter. Clearly our situations are different, but the narrative of a mother losing her child struck a chord. I drove to school in tears. And then walking out of the doctor's office filled me with that profound and tearing sadness. But now, as I write this, I remark to myself how much stronger I feel than I did even Sunday night when I first contemplated returning to school. I couldn't even work that night until 10:30 because I needed to meditate and reflect in this blog before I felt ready to return to school. But now, I'm recording these thoughts in a more even temperament. I'm not crying, for one thing. And I'm about to sign off, even though it's still early yet (8:22 pm) and the depressed me would consider that still early enough to delay the work to do some more self-torture. But I'm going to sign off now. I don't need to torture myself tonight. I merely want to record that I feel ambivalent about entering the TTC phase. I'm scared of having sex with my body still healing. I'm sad that I have to go through all that TTC drama again.

And above all, I'm sad that we have to. That we're back here again, that the pregnancy didn't last. It was only 6 weeks ago that we found out, but that's long enough to give birth to a new dream child and have hopes for the future. To imagine January, February, March, and May. Now I look forward to an endless string of undifferentiated months, not knowing if I ever will conceive again. Sure, I could. A positive and optimistic woman would say to herself, I can still easily have my baby next year.

But am I that positive and optimistic woman? I haven't been for many years. I can't set aside my bitterness like a crutch or cane: it's a part of me, like a limb or a string of my DNA. But maybe I need to try. Because I could get pregnant again. It could happen, and even soon. This could be just the beginning...