Ready or Not

I go back to work in less than 5 days. I'm nervous. Really nervous.

I'm nervous because I'm going back to a job where no one knows what happened. No one will walk on eggshells around me, no one will know that if I seem distant and sad, it's not because I'm a bitch or normally that way, it's because my baby died and that's just how I am these days. I'm going back to a new job and it's a job with a lot of responsibility. I'm afraid I'm going to do something crazy or stupid or forget something that just cannot be forgotten. It's hard being a nurse. You have so many lives hanging in the balance. You fear doing and saying the wrong thing all the time. I've read a lot of blogs and every time someone mentions the uncaring or stupid or thoughtless things one of the medical personnel said or did, I cringe inside...because what if that's me? What if I do something that makes life worse for someone else? I know as a nurse people count on you to be strong, to hold them up, to make things better, to say and do the right thing. But what if I'm the one that needs holding up? What if I can't take it?

I have this big secret that I'm carrying around. I haven't really talked about it much on my blog. No one really knows how bad it is, except maybe my husband and my mom, but I think I need to get it off my chest. Maybe I really will feel better.

In the 9 months or so before I got pregnant, I wasn't doing very well. I was stressed. I was stressed all the time. I was worried about getting pregnant and how it would affect my health. I was worried about having to continue to work while pregnant and how was I going to manage feeling even MORE tired and dragged out doing shift work? My heart functions well on a day to day basis...but I'm pretty sure I live with a *teeny* touch more breathlessness than other people. Would that get worse? Would I get worse? I was worried about something bad happening to my baby because of my heart. I was worried about dying if I put my body through a pregnancy. What would my husband do? Would he feel like he killed me? Would my family ever forgive me if something bad happened to me because I wanted a baby so badly? I was worried I wouldn't get pregnant. That I would have to spend time, money, and energy in fertility treatments. I was worried it would never happen. I was worried that it would.

I worried so much, I couldn't sleep before I had to go to work. Now when you work shift work sleep is VERY important. I ended up calling in 'sick' quite a few times just because I couldn't sleep and I was worried that if I went into work on only an hour or two of sleep that I would screw up and end up making mistakes. You can't make mistakes in the NICU. You just can't. I don't know why my worrying seemed to come out at these times, as I would lay there and toss and turn for hours, but it's probably because I just couldn't cope with the stress of work on top of my already stressed out background thoughts.

I worried so much that I think I may have actually caused the hormonal imbalance that MAY have contributed to Aidan's death. Now, now, I know you're thinking "Oh Emily, of course you didn't have anything to do with your son's death...etc, etc." But hear me out.

Prior to getting pregnant, right around the time that I started having these major anxiety attacks my periods started becoming weird. I started spotting for 3 to 4 days prior to EVERY period. The first few times it happened I just kind of blew it off, no biggie, just an odd cycle. But then it happened prior to EVERY period...and we weren't getting pregnant. I finally had my hormone levels drawn and my prolactin came back at 40. Normal for a non-pregnant female is 0-20.

My family doctor suggested that I may have a small tumor on my pituitary. These benign tumors can cause increased prolactin levels. Prolactin, in case you can't guess, is the hormone that causes lactation...and generally stops a woman from menstruating and hence from ovulating. My prolactin levels were not nearly THAT high, but they were abnormal. My doctor said that while we could do an MRI to confirm the pituitary tumor, the blood test was actually more sensitive and she suggested that I just start taking the medication to bring my levels back down to normal. My doctor told me at the time, that these tumors are generally for life, so I might need to take this medication indefinitely when not pregnant. So I started the meds in August or September of last year and was pregnant by November. But my periods never really evened themselves out. I was still getting pre-menstrual spotting even up until the day that I got my BFP.

I thought at the time: oh well, problem solved! Take that, pituitary tumor!

But then my placenta was weird, my blood work was weird, I had a lot of bleeding, I had no fluid.

Then he died.

Dr. K. at my follow up appointment suggested that it could have been the pituitary tumor that caused the hormonal imbalance and led to a build up of 'endometriotic tissue' in my uterus. Not the best place for an embryo to grow. He says I should follow up with my family doc about restarting the medication to ensure that I'm back on track.

Flash forward three months from Aidan's death and I'm at my family doctor's office. She redraws my prolactin levels and both of us are fully expecting a high level and a need to restart the meds.

Only now my levels are normal.

There may have never been a tumor at all.

The only difference in my body between now and last fall is that I'm not stressed, so I'm sleeping. I'm sad, I'm grieving, but I'm sleeping. I'm sleeping well, because I'm not under the pressure of work.

So now I have to wonder...did worrying kill my son? Did the fact that I stressed myself out so much cause me not to sleep, which threw off my hormones terribly, which caused a build up of crappy tissue in my uterus, where my son's little embryo implanted and got chewed up, that caused all the bleeding, that caused the preterm premature rupture of membranes, that caused his death?

Would it really have been all okay if I could have just stopped stressing? Would I instead of being 15 weeks past Aidan, be anticipating his arrival in just a matter of days?

Could the 'power of positive thinking' really be that powerful?

This really started out as a post about how stressed I am about going back to work. And I am...I'm afraid of slipping back into that routine. Of being nervous and stressed and not sleeping and trying to keep it all together. I can't go back to being that person. I can't. It will kill me.

It may have already killed my son.