Sunday, November 13, 2016

Letter to my infertile self

*Background* My husband and I eventually conceived our oldest daughter after just over 4 years of trying to conceive and with our 4th round of IVF. We have since been able to have 2 more children without fertility treatments. I am acutely aware that every fertility story is unique and many have a different outcome than ours. Nevertheless, amidst a crowd of my fertile, complaining, peers, I used to spend a lot of time panicking about whether or not I wanted to a mom, and whether I’d like it or even be good at it (I’m not very good at it, but I do like it…) This letter is what I wish someone had told me 8 years ago.

Dear Infertile Camber,

Stop panicking.

If parents are good at anything it’s telling horror stories about parenting. They relish horror stories. They try to outdo each other’s horror stories. 10 minutes in a room full of mothers is all the birth control anyone needs.

Having kids is about as hard as you think it will be. Of course it’s hard. Things that ACTUALLY matter are always hard.

It’s true that most of the things you hear parents griping about will be part of your reality as a mother. Tantrums in public. Messes. Expensive things getting broken. Sticky floors. Sticky chairs. Sticky door handles. Sticky EVERYTHING. Body fluids of all types. Sleep deprivation. Desserts you no longer get to yourself. Being late to everything.

But none of this surprises you. You probably feel depressed about it. “Why spend thousands of dollars to bring a miniature dictator into my life?” you ask yourself. And, “WHY does anyone have more than one child?” (The answer is free babysitting in 12 years).


Love will surprise you.

It’s real. It’s better than you think it will be.

When the screaming child is YOUR screaming child, it feels different. You know why she’s throwing a fit. You know she’s not always like that (unless she’s 3. Then she’s always like that. But really, stay calm). An hour ago she probably threw her arms around your neck and gave you a big wet kiss. Tonight you’ll check on her and she’ll look strangely angelic in her sleep (is this the same kid?)

You will find yourself savoring the little moments because they completely DWARF the bad ones. Like kids snuggled up on your lap to read books, kisses goodbye when you leave, a baby crying for you when you leave because they want YOU. Other people’s babies may seem a tad uninteresting, but you’ll find yourself happy to hold your own baby for hours at a time. Just looking at them. Just feeling their warm weight against you. Just staring at their face.

Being a mom is nothing like babysitting. Put all previous (and sometimes traumatizing) babysitting experiences out of your mind, because the truth is you don’t have to like babysitting to like motherhood. Frankly, you don’t actually have to like kids to like motherhood. Motherhood isn’t about other people’s kids. It’s about YOUR kids. Your kids, which, did I mention, you love more than your own life? More than your sleep or a decent sit-down meal or a whole dessert all to yourself? Motherhood isn’t like teaching kindergarten. Your kids will be different ages and you will love and dislike different things about each age. And they will be YOURS.

Obviously you’ll have to give things up. Forget reading a book for fun in the afternoon or sleeping in on a Saturday. Long, expensive vacations will be put on hold indefinitely. Hot dates become takeout and a cheap movie that’s over by 9PM.

So what? You’re making another HUMAN BEING. You teach them how to walk across a room, how to eat grapes, how to sing ABCs, how to start a movie by themselves or get their own cheese sticks out of the fridge. You will hear your voice in their voices because they will mimic everything you do (except picking up. They hate that. Probably because they know you hate it too.)

Keep on. Keep on trying. Keep on hoping. All of this lousy infertility nonsense--the temping and clomid and embarrassing procedures and mounds of negative pregnancy tests and feeling awkward in a room full of pregnant women and mood swings and painful shots and MONEY--all of it will fade away with those first moments holding your baby. It’s cliche, but there’s no other way to put it. It’s worth it. All this nonsense is worth it. In the end you will find that infertility gives you a present: perspective. Remember the infertility years on the hard days. Remember and be grateful.

Sunday, July 3, 2016

My year as a rookie

Last year, still new on the job as a nurse practitioner, I had a phone conversation with a patient's husband I will never forget.

He said, "This CT scan will cost us $730 out of pocket. My wife is feeling better after the shots you gave her. Are you SURE we need to do this today?"

I looked around desperately for someone to tell me what to do. No one did. Had this room always been so Hot?

I tried to sound confident. "Based on her lab results, I really do think she should have the scan done. I think there's a good chance she might have appendicitis."

Truthfully, I had never seen a patient with appendicitis before. She might be my first, and $730 were hanging over my head.

No one warned me about this kind of thing in school--the pressure of trying to keep costs down while also trying to keep my patients alive.

She had appendicitis.

Exactly one week later, I had the opposite conversation with a patient. He had similar pain but looked much less sick than appendicitis lady, and his labs were perfectly normal. I consulted with another doctor, and then told him he probably didn't need to do the CT scan (he also had a high-deductible plan and faced high costs for it).

"I'm already at the hospital and prepped. The pain is worse. If it's OK, I'd like to go ahead and have the scan done."

He had appendicitis too.

Thank GOODNESS he followed his instincts instead of mine.

Sometimes my job freaks me out.

One thing that is difficult for a new healthcare provider is to find the balance between thinking every patient is on the brink of death and thinking everyone is perfectly fine.

Most people with abdominal pain don't have appendicitis, most kids with coughs don't even need antibiotics, more sore throats are not strep throat than are, and most chest pain is not a heart attack.

BUT some chest pain IS a heart attack, and truthfully the only way to know (depending on symptoms), is to run the appropriate tests.

I've only seen one patient having a heart attack so far, surprisingly (out of a dozen or so that I've sent to the ER to be checked), and it wasn't the guy that showed up with crushing chest pain that radiated down his left arm, who looked sweaty and a little out of breath.

No, it was the lady that showed up with one complaint: excess burping. I'm serious.

Sometimes my job FREAKS ME OUT.

Although the majority of what I see is upper respiratory illnesses (sinus infections, coughs, ear infections, and sore throats), I'm often surprised at the variety of what comes through the door.

I have told 2 girls they were pregnant.

I diagnosed someone with type 1 diabetes.

I have pulled an ear bud out of someone's ear, a popcorn kernel from a toddler's nose, and sticks too large to be called splinters from arms and feet.

I have seen quite a variety of broken bones, treated migraines, backaches, stomach aches, rashes, pink eye, burns, eye injuries, abscesses, STDs, and on and on and on.

I have sutured eyebrows and shins, chins and fingers, knees and bottoms of feet. Sometimes I suture under perfect textbook circumstances, and sometimes I just really wish someone else would come in and rescue me from my job. The most miserable I've ever been at work was suturing the bottom of a toddler's foot while his dad held him. It was a bad angle to work from, he kept kicking his leg, and I bent 3 needles trying to get that thick skin pulled together. Zero fun. Maybe negative fun.

Some of my interactions with patients are funny. Like the time a fully-grown, obviously athletic man was terrified of getting swabbed for strep throat. ("How far back do you have to put that thing?") Every time I came near him with my swab he dodged me. I told him to hold still. "I'm trying!...Please don't tell the nurses out there about this..."

Some of my interactions are heart-warming. Kids that are SO excited if I let them listen with my stethoscope, or that try to comfort their siblings when sick or scared. Grandparents that light up when I ask about their grandkids. Patients that come in terrified of a procedure that leave saying, "That wasn't so bad."

There have been diagnostic wins, such as finding whooping cough or mono, suspecting aspiration pneumonia or urosepsis and being right about it, or basically any time I figure out what someone's rash is.

There have also been diagnostic FAILS, which are inevitable but discouraging. I have sent patients to the ER thinking they had something serious going on which turned out to be something minor. Something I could have treated, saving them an ER visit. Sometimes I think someone has appendicitis and they don't. Sometimes I treat people for an illness and they don't get better.

Sometimes I just have NO IDEA WHAT'S WRONG. This is just as discouraging for me as it is for my patients.

Sometimes I go to bed at night worried about patients I've seen that day. I question whether or not I did enough for them. Sometimes they even find their way into my prayers. Inevitably the kids are the ones I worry about the most. I recognize the look of worry on their parents' faces as the same look on MY face when MY kids are sick, even with all my training.

More than a year and a half into this business, the misdiagnoses and treatment failures remain deeply disheartening, but I've also learned that they continue to happen even to seasoned providers. Turns out none of us will ever know everything. But we all keep learning. All the same, I'm sure the wonderful, truly kind doctors I work with tire of my incessant, "rookie" questions.

But at least they're less incessant than they used to be.

I'm making progress.

Sunday, February 21, 2016

Two Kids

I still need a little practice at this "2 kids" thing. (Moms of 3+ kids, kindly hold your fire).

I think of having kids as a little like learning to play the piano. Students can play the notes separately just fine, but the first time I ask them to play two notes at the same time they look at me like their brain might explode.

That's what 2 kids feels like to me.

I have faith that I will get better at this, but there's this thing called "leaving the house" that leaves me feeling exhausted by the time I make it to the driver's seat. Mary requires extensive negotiating at each juncture. Putting socks on. Putting shoes on. Keeping the shoes on. Putting on a jacket ("But mom! I like being cold!") Getting IN the car. Getting IN the carseat. Getting in the carseat with bum down instead of out. Last-minute delays: "I need WAAAAAATER!"
One of Mary's cuter delays: "I giving myself a hug!"

Matthew is too little to require negotiating, but inevitably I'll forget something crucial on the looooong list of stuff to remember when leaving the house: diapers, wipes, binkies, blanket, extra outfit, nursing cover, water for me, burp clothes, and so on.

Sometimes I successfully pack it all and then leave the diaper bag by the door as we drive away. Leaving the house FAIL.

And mealtimes are always a crisis. Not one of us is very cheerful when hungry, and at lunchtime we all seem to be hungry at the SAME TIME. Poor Matthew always wears part of my lunch on his face. (I'm not that good at eating left-handed while nursing him).

A 3-year-old and a 3-month-old are easy and hard in opposite ways. Mary eats when I do, takes only 1 nap a day, can feed herself if I provide the food, and doesn't need to be carried anywhere. But she has OPINIONS and her OPINIONS rule my life. Matthew has almost NO opinions, but requires hours of my day immobilized on the couch feeding him, while trying to read a book to Mary that she is balancing on Matthew's head.

In the middle of all this, we just bought a home and moved into our new house. Three days in a row I haven't unpacked a single box during the daytime. THREE DAYS. Isaac is a tactful husband but I can sense a little confusion in his carefully worded, "So, um, what did you do today?" Fed the kids, gave them baths, and made dinner, thank you very much. So what if that took ALL day?
Bad memories of packing...

I keep telling myself that in the history of the world probably billions of women have had 2 kids. (Pull yourself together Camber!)

Then I tell myself most of those women didn't have to get their toddlers into carseats.

TWO kids! And yet, sometimes I feel kind of awesome. Like when I successfully carry a wobbly-headed baby and a 30+ pound 3-year-old down the stairs at the same time. Or when I manage to get all three of us taking a nap at the same time. Or when I catch Mary taking a binky to her crying brother and telling him, "It's ok! Your sister's here!"
At Matthew's baby blessing

There was a time when I doubted whether we'd have one kid, let alone 2. Ungraceful as I am at handling both of them I feel blessed beyond measure. And, though I admit that some days I want bedtime to come an hour early, the kids are no sooner in bed than I start thinking affectionately on them, no matter how hard the day. I'm pretty in love with my 2 kids.

Thursday, January 7, 2016

Gift of God

I am happy to report that the numerous fears catalogued in my previous post have proven to be unfounded.

Our baby boy is here.

He is healthy.

He has a name.

And, it turns out, I can love a boy. (Actually, I'm smitten.)

Meet Matthew Dennis
His arrival started on his due date, as Mary's did. My doctor stripped my membranes and by that evening, my contractions were coming stronger and more frequently than the braxton-hicks I'd been having for weeks. I warned my sister-in-law about this before we went to bed, in case we needed to bring Mary over in the middle of the night.

A few sleepless hours into the night, with contractions continuing, I went downstairs to watch Home Improvement reruns and pace around in between contractions. When Isaac came to check on me, I told him to go back to bed and sleep some more, but he wanted to stay with me. So we watched Tim Taylor break stuff and timed contractions. An hour later we called my doctor, dropped a sleepy Mary off with my sister-in-law, and drove to the hospital, where I was 4 1/2 cm dilated. I was admitted and my doctor broke my water.

Then I had a dilemma. I didn't get an epidural with Mary, and Sarah was an emergency C-section. Since I was hoping for a VBAC (vaginal birth after cesarean), my doctor had previously recommended getting an epidural in case of uterine rupture, which would require another emergency C-section.

To this end, I didn't plan for an unmedicated birth, and looked forward to a nice, relaxing labor with an epidural when the time came. When I showed up at the hospital, however, my doctor told us that in almost 30 years he's only had 2 uterine ruptures, and with an IV in they could always put me under if an emergency C-section was needed. So I didn't HAVE to get an epidural.

Well, shoot.

It's one thing to get an epidural because, darn it, my doctor made me do it.

It's another thing to get an epidural because I "couldn't handle the pain."

And as I lay there in my hospital bed, watching yet more Home Improvement reruns (a movie seemed like too much commitment), contractions getting stronger, I kept thinking of how soon I could ask for the epidural.

When I get to a 6? When I get too tired? If they have to start pitocin?

As it happened, my contractions started stalling a little, and they did have to start pitocin. But I still felt a little sheepish asking for the epidural. I told myself over and over again--next contraction FOR SURE I'm asking for one.

Finally, at 8:30 AM, only 6 cm dilated, and with the decision made to up the pitocin dose again, I meekly said, "Would it be bad if I got an epidural?" With such slow progress I was envisioning labor lasting well into the afternoon, and I hadn't slept a wink all night. I wanted a break.

Isaac said, "Well, sure, but I think you've got this!"

My nurse said, "Honestly, once we up the pitocin again, you're going to progress really quickly. I predict you'll be done in an hour, hour and a half tops. I think you can do this."

My spirits soared when she said this--I could be DONE in an hour? I decided to go for it unmedicated. What choice did I have, with that kind of peer pressure?

The problem was, I knew what was coming. In childbirth, things only get progressively worse as you go. I remembered from Mary that the baby only comes after you've already reached the point of pure despair, suffered the loss of all dignity, and wished for a swift death.

I tried to put such dark memories out of my mind. My nurse suggested having Isaac put pressure on my knees during contractions, to give my mind another sensation to focus on during contractions.

Believe it or not, it worked. The contractions were still intense but somehow the knee trick made them bearable, along with the deep relaxation and controlled breathing I was already doing.

I'll spare you the details of the final, ugly moments of childbirth. A nursing student came in for the birth and I told her, "I'm about to show you how unglamorous natural childbirth is." And it was terribly unglamorous. The final moments were just as despair-inducing as I'd remembered.

But he came, and despite a brief tense moment when it looked like his shoulders might get stuck, I was able to push him past that and out he came. The first comments I heard were, "Wow, he's chubby!"

Out of pain. And in love.

And he was--all 8 pounds, 2 ounces of him. We were, honestly surprised by this--I measured small my whole pregnancy and never showed all that much. Mary was 7 pounds even. To this day I don't know where I was keeping that baby.

He was crying, he was chubby, I was out of pain, and everything about it was different than Sarah's birth. I snuggled him right up to my chest and just loved him and his healthy self.

As the birth approached, I found myself leaning towards the name Matthew, because it means "Gift of God." I could never commit, though. Perhaps I was waiting to see if he would be okay. But moments after birth, when Isaac asked if we could pick a name already, I just wanted to name him Matthew. Our gift from God.
Proud Daddy.
Proud sister.
Feeling profoundly grateful.
And smiling because NEXT time I'm getting a dang epidural.