Thursday, April 30, 2009

A big day

April 30, 2009

So today was a big day. Jeremy and I went to UMC for my OB appointment. On the drive in I was thinking about how, when I was in the hospital, I had no idea really what the drive there was like, but how Jeremy made the trek usually twice a day. My first drive to UMC from home was in an ambulance after five short (but very long) days out of the hospital. And then it dawned on me: that ambulance ride was one year ago today. That was the second time I seriously thought I was going to die. I was losing a lot of blood every time I went to the bathroom. I blacked out a couple of times and then passed out cold when I was on the commode in the ER room. I was in more abdominal pain than I had been the entire time, I could hardly keep from writhing in pain.

When I got to the hospital for my appointment this morning I walked past a spot that my family and I had sat to get some sunshine once when I was in the hospital. I was all big and bloated, slumped over in my wheelchair with my yellow mask covering my face so I wouldn't catch anything outside. I couldn't sit in the sun or look at anyone in the sun, my eye sight was all messed up from the medications. But I was happy to be able get some fresh air. It was one of the first times in a long time I had been outside of my room.

Anyway . . . it was quite a trip down memory lane this morning. I was keenly aware of the state of my health today - GOOD! I am thankful.

When I signed in for my appointment in the OB clinic I started to cry. Jeremy got a tissue for me. He asked what was wrong. "I don't know. I'm just emotional," I told him. There was just too much going on inside my head.

This was my first time meeting Dr. K. When she came into the room she said, "Well you have quite an extensive history here, don't you? Some of the doctors saw your name on the appointment list and one of them said to me, Oh, she tried to die on us last year. Something about her saying that validated my experience for me. I wasn't just a number. I was a person with a unique experience that people cared about and remembered. It would have been hard for me to be there and feel like they didn't know me. My experiences there, in that hospital, changed my life forever. I guess it's just another example of a way that I need others to be a witness to what I've been through.

So Dr. K was amazing and spent a lot of time (probably 45 minutes or more) talking with us and answering our questions. Here is what I recall:

*About getting pregnant: She said that because of my age and situation, she would recommend us trying for six months (if we decide to try again), and if nothing happens, to come back and see Dr. H, a specialist who could help us. She said that yes, scar tissue around my ovaries and fallopian tubes is the main reason getting pregnant might be difficult. However, when she did her oh-so-fun exam, she said that my uterus felt like it was not stuck in place by scar tissue, and that she could feel my ovaries too, which was good.

*If I were to get pregnant: She said that I would be considered high risk and that they would watch me "like a hawk." She said that there is a perinatal specialist (I think that was her title) she would suggest I see (Dr. M) if I felt comfortable doing so.

*About the medications: She said the antibiotics I am on are typically ones they avoid giving to women who are pregnant, especially in the first trimester of pregnancy. She said she would talk with Dr. T about other possibilities that would work for me. She said the same thing about the conscious-sedation drugs they give me when I have my dilations. She said not a lot of research has been done about the issue yet, and that we would really have to weigh risks and benefits. She said research shows that many pain medications can be okay during pregnancy so long as they aren't taken on a long-term basis.

*About the pregnancy itself: She said that she would do some research to see if there would be additional vitamins I would need to take since I don't have a colon and have a more difficult time with absorption. She said there were no guarantees about other issues arising like the UC did if I were to become pregnant again. We both understood that. She said the issues that I had carrying Harper were not issues that would carry over into this pregnancy though. She said from what she knew, the ultrasounds that I had with her showed she was developing normally.

*About the delivery: She said that she understood Dr. T's concern about pressure and trauma. She said that another option, other than a c-section would be to do an assisted delivery (I don't remember the exact term she used). Basically, she said my body would still do all the dilating, labor, etc. I would get an epidural and all the drugs to make me nice and comfortable. Then, when it came time to push, they would use forceps to take the baby out so I didn't have to do any pushing. She said that if after consulting with Dr. T we all felt like a c-section was the best option, then we could absolutely do a scheduled c-section, and that Dr. T could even be present to take a look inside while we were at it.

Other than that, she said my situation was unique and she wanted to do some more research. She took my e-mail address and said she would e-mail information as she found it. I liked that. Every doctor I've seen (GI, PCP, OB) have all said, "Well, you have a unique situation. I'll need to do more research." But I really haven't heard any follow-up. I guess it's time to start investigating more on my own too. I know one of my fellow j-pouchers at j-pouch.org (Redheadedmama) has done a lot of reading. I'll have to cyber-talk with her!

Boy, I can't remember if there was more that she said or not. All in all it was very helpful. I started crying when she did my exam. Jeremy did too. But he was there to comfort me and hold my hand. She was very understanding as well. So I came away from the appointment encouraged, but with more questions for Dr. T. Maybe at some point I'll try to see if it's possible to meet with both doctors together (since their offices are near each other).

Wednesday, April 29, 2009

What a mood I'm in

April 29, 2009

I just got an e-mail from an ostomy supply company, soliciting my business. I am trying so hard to live my life without fear, but sometimes I just fail. My mind gets tired of trying to process everything. I am terrified of having to live with an ostomy again. Terrified. I start thinking about it and I well up with tears.

I have had this box of ostomy supplies that I haven't known what to do with. I won't throw them out to the landfill. I put some feelers out there to see if anyone wanted them for free, but I didn't get any takers and I just haven't put much energy into calling other places to see if they want them. And so this damn box of supplies has sat in our hallway for a long time. And I hate it. I hate the box. This weekend we were taking some things to the Goodwill (that were also in the hallway), and my attention was drawn once again to that damn box.

Just writing about the box, I can feel myself getting angry and frustrated and scared. Right now I want to pick up the stupid box and stuff it in the garbage and then kick the garbage can a few times and curse at the top of my voice. Life was hell when I had my ostomy. I would not wish living with an ostomy on my worst enemy. It's not right and it's not fair that anyone would have to live like that.

And yet it hangs out there over me. My own little dark cloud. Dr. T's words, telling me that she will have to do surgery again and I will probably end up with a temporary ileostomy again, possibly a permanent one. And do you know where my thoughts go when I think about? I think about having a baby and holding him/her on my hip and having to worry that his/her little legs are going to mess up my ostomy bag. I don't even think about how happy I would be to have a baby; I think about how I don't know if I could find the will to live if I had to have one again.

Isn't that terrible? Today . . . Ugh, today I was wearing a long linen skirt that I bought when I had my ostomy. I bought the skirt 1) to hide the stretch marks that were on my legs; and 2) because it hid my ostomy bag well. But today as I looked down at my skirt, all I could think about was feeling the bag against me. I've gotten rid of a lot of the clothes I got to hide my bag because I couldn't stand to wear them again. But I kept some of them, because of the fear that I'll have to live life like that again. (Oh geez, we're out of kleenex and now I'm crying and have to use TP for my nose. Lovely.)

I don't know how to make peace with this. I feel like for some reason I need to be okay with living life with an ostomy right now. I also think that I'm a weak person because I would have a hard time living life with an ostomy. And am I valuing others who live full and meaningful lives but just so happen to have ostomies if I have these thoughts/feelings? Am I really being a colon-free bigot? Laugh if you want, but I really am beating myself up over these things. I really do feel like a failure as a human being because of this.

[Okay. I think I need to just take a step back here for a moment. Abby, get over yourself. You are taking yourself WAY too seriously here. You don't want to live life with an ostomy. NO ONE DOES and that's okay. (I think I just need to keep re-reading this paragraph over and over.) I think I've maybe been alone too much lately.]

I know this is going to be a really long blog today, but I'm not done yet. I'm also feeling anxious about my OB/GYN appointment tomorrow. I'm scared that being in the stirrups is going to bring back a flood of memories. (Sorry if that's an inappropriate visual to refer to, but that's what I'm imagining and it's freaking me out.) But as Christie reminded me, if I breakdown at the OB's office, so be it. I've earned the right to breakdown. (Thanks again Christie.)

I feel like there's a lot riding on this appointment tomorrow. This doctor, who I haven't even met yet, holds the answers to my future. Boy, am I being really melodramatic tonight or what? Just writing all this out is helping me see the error in my thoughts. But really, the doctor does have some important information for me. So here are some of the questions I want answered:

1) My surgeon is recommending a c-section if I get pregnant. Have you or other doctors here done c-sections on women with j-pouches (or other shaped pouches - same basic principle)? If not, would you be working in conjunction with my surgeon when it came time to deliver?
2) Would I be considered "high risk" because of my past experience? What does that mean for me as far as the pregnancy goes?
3) Studies I've read say 25% of women who have had a total colectomy because of ulcerative colitis end up being infertile. My understanding is that's because of scar tissue around the ovaries. Is that right? Does that mean that my eggs would still be there and we could possibly do IVF?
4) I'm having pelvic pain. Can you tell me if that's related at all to my reproductive organs? (And please don't dismiss this - the pain is pretty strong.)
5) We didn't have an autopsy done on our baby (big regret for me). Does that make a difference at all in how you would view a pregnancy of mine? [I don't know why I can't let it go that I don't have definitive answers as to what caused Harper's death. I feel like I need definitive answers. But would they make a difference for me at all? No.]
6) In your opinion, is it okay for me to have drugs such as Versed, Fentinal, Cipro, Flagyl, Mesalamine and Celexa during pregnancy? [Boy, for a woman who was eating as much organic as possible, not doing any caffeine and trying to avoid taking even Tylenol during my first pregnancy, this is quite a jump isn't it?]
7) I know that because I don't have a colon, my body is not able to absorb certain vitamins as well as before (or some possibly at all?). Are there supplements I would need to take even more of if I were to get pregnant again (obviously already taking prenatals into account).
8) My UC developed as soon as I got pregnant. Do I have higher chances of another autoimmune disease developing with the change in my immune system caused by pregnancy? (Don't forget to mention the joint pain that started with the UC - Are my chance of full blown arthritis developing greater? Chron's? Vitiligo?)

Okay. I think that's all I can come up with right now. If you've read this entire blog, I'm impressed. Even I'm bored with myself right now. (Do you hear the different tone in my "voice" tonight? What's up with that? What a mood I'm in.)

Tuesday, April 28, 2009

Not my first dream

April 28, 2009

Over the past weekend my mind went to all kinds of places. I usually spend a lot of time fantasizing about my future - a lot. I think I probably do that more than anything else in my alone time. I come up with all kinds of plans and ideas - all kinds.

This past weekend my thoughts turned to our home. After Jeremy and I scattered Harper's ashes last week, we drove through a stretch of the desert to get home taking the back roads. "Wouldn't you love to live out here?" I asked him. I can always see the fear in his eyes when I start asking him "wouldn't you like to . . . " because he knows if he agrees with me we could very well be full-steam ahead on some major life change. He's a good balance for me that way. Anyway . . .

I have this fantasy, I guess it's how I see our future. I picture Jeremy and I with a piece of land out in the desert, just behind the Tucson Mountains (on the west of them). The big backyard would be fenced in so we could have plenty of dogs running and playing back there. The house would be a hacienda style, with our own tiny little pool in the courtyard area, just big enough to jump in and get cool in the summer. The house wouldn't be that big, but we each would have our own room (him for his music, me for my writing), and then a guest room, or really a separate guest house is what is in my fantasy (because lots of places out here have guest houses - I'm not just trying to be fancy). We would wake up in the mornings and sit outside in the courtyard. Our home would be a sanctuary - a quiet, peaceful place. It would be a beautiful place, full of light and animals.

It's so real I can almost taste it. I started thinking through our budget and whether we could afford a move like that. I've already contacted our realtor in my mind and had this conversation with her, "Pat, would you be able to show our house with Django there? I mean, how do you deal with it when there are dogs in the home?" I've thought through all the sacrifices I might have to make living a little further outside of town than we do. I'm picking out tile in my mind (sautillo tile on the floors - tile roof). I'm thinking about what contractor we would use; what of the work we would do ourselves (we tiled all 3 of our bedrooms in our current house). I can picture friends coming over for dinner and sitting at our long wooden Mexican-style table, enjoying the food and the conversation.

So of course what do I do when a fantasy like this becomes so real to me? I start a movin' and a shakin'. I went on-line and started looking up real estate. I got as far as entering the search information on the MLS site and then stopped. I thought about all the energy it would take to do something like this. And I asked myself, "Is this what I really want?" Funny question, right? It obviously sounds like this is what I really want - I get all excited thinking through every little detail of it. But do you know what my answer to myself was? Nope. What I really want, what I wish I was putting all my energy into right now is a baby. I closed out the MLS website and shut down my computer.

I had told Jeremy about my fantasy on our drive back from scattering Harper's ashes. "I could see myself being at peace with something like that, couldn't you?" He said he could. Then he said, "That's a good thing that you can picture that Abby, because if we can't get pregnant, that might be what we end up doing." I guess it's good to have a back-up plan. But when your heart is so set on something, when you have come so close to such a sweet dream being fulfilled, second place feels like you are just trying to fill empty space. It's not a bad dream, it's just not my first dream.

An after thought: I suppose there is nothing saying we can't have both of my dreams, right? Maybe I just don't believe life could really be that good.

Monday, April 27, 2009

Off I go

April 27, 2009

I'm trying to get myself mentally prepared for an OB/GYN appointment that I have Thursday morning. I'm really dreading it. I'm afraid that I'm going to be flooded with emotion and I won't be able to control it. It's just one of those things I'm going to have to suck it up and do. Both Jeremy and I have a lot of questions for the doctor. This is a new doctor too, so that should be interesting. Because the OB who started following me when I was pregnant with Harper was associated with the first hospital I was at, I didn't really have a regular OB through the end because I had to go to UMC where they could treat my disease. This new doctor is associated with UMC. Jeremy and I decided that 1) if we decide to try to get pregnant and 2) are lucky enough to actually get pregnant again, I would want to deliver at the hospital where all my care could be coordinated - OB/GYN, GI, and surgeon. My surgeon has recommended that I have a c-section if I were to get pregnant, but it scares me to be cut open when the lay of the land has changed internally. Like I said, lots of questions.

The Flagyl Dr. T started me on has been helping a little bit, but I'm still having some pelvic pain that is really bothersome. I will probably call her tomorrow or Wednesday and ask about the results of the biopsy. I'm interested to know if I do in fact have pouchitis or not.

An encouraging piece of information, if it happens to be true: Dr. N told me when I saw him on Thursday that he had heard there was a new surgeon at UMC who specializes in pouches. That's something else I'm going to need to investigate. Wow, that would be awesome. Not that I don't already feel luck to have Dr. T who is a colo/rectal specialist. I've always felt really blessed with the doctors I've had.

This evening was a relaxing, enjoyable one. Jeremy and I went out to dinner with another couple who are good friends of ours. (A couple of years ago we took the train from Tucson to LA with them over Thanksgiving weekend - what a BLAST!) We had a leisurely two and a half hour meal. That's the way to do it! But now I'm tired - I don't usually do the weeknight get togethers any more. So it's time for bed. Off I go . . .

Sunday, April 26, 2009

The whole of my life

April 26, 2009

I've been thinking a lot about my blog lately. I started blogging as a way to keep people updated about how I was doing, as a way to process what I was going through, and in hopes of somehow helping other souls out there who may be struggling with grief and loss. I've been wondering how much I really need to do this for myself any longer. Don't get me wrong, I love writing and will continue to write and journal on my own (as I have since I was about six years old), but I wonder how much of what I'm thinking and feeling any more needs to be shared in this type of forum. I'm not exactly ready to stop now, but I'm thinking about it.

I was thinking the other day about how the loss of Harper is something that I think about every day. This has been one of my main outlets for those types of thoughts, and it could most certainly continue to be for me. I've thought, well maybe continuing to write about the thoughts that I have of her every day is a way to show people that the loss is always there. The amount of heartache changes from day to day, but regardless of that, the loss is always there.

I thought about how physically I'm doing pretty well these days. My weight is about normal now (which means I have to stop eating to gain weight - that's going to be tough and not as much fun). I may still have some health issues, but I don't feel sick any more. I feel like I have the same amount of energy I used to have (less a chronological year). While my body image is still somewhat of an issue for me (after all the poor thing has been through), quite honestly, that is an issue that I struggled with before all this happened too!

I guess what I'm trying to say is that life is back to normal for me. If you've been reading this blog waiting for that to happen (because so many people are reading with bated breath, right? smile), then you can stop reading now. I'm still gonna blog for now though. And if you chose to keep reading, just know that when I write about things like thoughts of Harper, or struggling with getting poked and prodded, that is not the whole of my life - that's just what I blog about. The whole of my life is right here in my living room with me, napping on the couch (and one part of the whole is napping on the floor). The whole of my life is setting up the coffee maker tonight so it will go off at 5:30 in the morning and I can wake up with a hot cup and sit in the backyard in the silence. The whole of my life is driving in to work on a Monday morning, looking forward to seeing the wonderful people I work with at a job I love. It's going out to dinner with dear friends in the evening, no agenda, just conversation and good food. That is the whole of my life.