Wednesday, August 4, 2010

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.


  1. Oh, dear Emily, I am speechless. Did it feel good, cathartic, to get all this out? I don't know if I can offer reassurance, and I don't know if you want reassurance.

    I guess all I can really say is this: I love you - be kind to yourself - I'm sorry.

  2. Oh Emily,

    If I could find a way to shrink and ride around in your pocket all day shouting words of encouragement on your first day, I would.

    And you're not the same person, because no one can be after this. Just take a deep breath and embrace that person starting with this moment.

    Thinking of you and Aidan...

  3. i don't know what to say to make you feel better about this, because i don't think anyone could.

    but i can tell you this - whether or not the hormone imbalance had anything to do with aiden's death, you did the best you could at the time. that's all anyone could do. even if there were anything you could have done to make it all turn out differently, you just didn't know.

    thinking of you as you head back to work, and i hope you find some peace in your new position.

  4. I wish I knew what to say to make you feel better, but I don't think there are any words that can. I have known some women who were really stressed out in their pregnancies and their babies were fine. You didn't cause Aidan's death. He knows that and he knows that you would have done anything to save him.

    You did everything you could, everything you and your doctor thought you should have. You couldn't help having the symptoms and sleeping issues that you did last summer. Sure, you had them, but they weren't your fault.

    I certainly have gone over everything I did during my pregnancy and have beat myself up about this thing or that thing so many times. Then I say it out loud to someone and realize that it really wasn't that bad, that tons of women do that and worse when pregnant and their babies are fine. Tons of women have done what you did, what you experienced, and worse and their pregnancies didn't turn out the same way. How can we explain the crack addicts who keep having healthy babies, when we didn't do anything nearly as bad, if we did anything bad at all, and our babies died.

    I know this is easy to say, but don't blame yourself. You did your best. You did a great job. IT IS NOT YOUR FAULT!

    I hope that work does well. I hope that you continue to get good sleep. You deserve so much more than you have gotten and I bet you have made a positive difference in so many lives during your nursing career.

    If Jacob had lived, he would have needed some care at Sick Kids because of his leg. I would have been happy to have you as his nurse.

    I think of you and Aidan often.

  5. what julie and dana said.

    i hope you're ok.

  6. To echo what others have already said, it's very clear that you did the best you could with the information you had. You worked hard to take care of yourself and Aidan. You *did.*

    I'm wishing you all kinds of luck for your first day.

  7. The "what ifs" will drive you mad. You have to think in terms of "what was". The facts.

    And the facts are that you did the absolute best in your ability. You are a good mother. Your doctors did their best. Honestly, you had no control over the loss of your son.

    But, I completely understand about fearing what stress can do. It's a horrible cycle: you stress out, which messes up your sleep, makes you feel awful, and then you start stressing out about what stress is doing to you. So you stress some more. I struggle with this myself.

    I'm not a nurse, so this might not be practical advice - but DO NOT go in to this new job expecting to be stressed out as badly as you were in your last job. That job was then, this is now.

    Stress is unavoidable. Unfortunately, in your line of work it is commonplace. Don't feel bad about needing to take a day off to catch up on sleep.

    I'll be thinking of you ((Big Hugs))

  8. I'm so sorry..I hope it brought you some peace to release those concerns, try to let go of them as much as possible. I know that is hard...I too go round & round with all the what if's and whether I had something to do with my daughters death. In the end it is impossible for us to know so we have to do our best to make peace with that.

    Thinking of you & praying for you as you prepare to go back to work. Be kind to yourself and know when to get yourself out of a difficult situation. I also work at a hospital and went back to a new area within the same hospital after our loss. The other social workers in the hospital knew & were amazing, but the staff in my new area did not. Some things have been difficult, especially with all the pregnant co workers in this area, but I've gotten good at casually leaving situations when discussions turn to a difficult topic. Also if you need to mention what happened to a co worker to help them understand it might help things, this way they can help others to understand why certain situations may be difficult for you. I too had an extremely hard time sleeping when I went back to work, the first night before I barely slept, but with time it gets easier. Sending love:)

  9. Oh, Emily, honey, sweetie, darling. You did not kill your baby. You did NOT. You did NOT. I know you'll worry about that no matter how many people tell you otherwise, but you did not. I want to hug you and cry with you in person. I've come to love you so much through this blog, weird as that sounds, and you did NOT DO ANYTHING. Aidan loves you. You loved Aidan. You LOVE Aidan. It was not your fault.

  10. I'm so sorry you were having these thoughts. It seems like we all go through something like this, or have these thoughts. The what if's. I know I have moments where I feel like I killed my daughter with the decisions I made. But at other times, I can see the facts and rationality. We loved our babies, and really had no control over what happened. I hope putting this out there on your blog helped a bit, I know it did for me.

    Also hoping your new job goes smoothly, and is way less stressful than the NICU.

    Thinking of you and Aiden

  11. This is so, so hard. I had my own version of this yesterday ... and it's even harder now that I am pregnant again, walking on my own eggshells, feeling like I could do anything wrong and kill yet another baby. But the commenters above have it right ... we could spiral into the what ifs forever. But if we want to live, we have to take the risk of believing in ourselves, the risk of believing that we've done the best for our bodies and our babies. Please be kind to yourself.

  12. I just found your blog through LFCA.

    I'm so sorry for your loss of Aidan. So incredibly sorry. My experience isn't the same as yours, but I can relate to the feeling of having a secret. I often feel like a sham when I meet people or "catch up" with someone I haven't talked to in some time. I worry about how it will impact my job and how it will lead me to come across. I don't want to be viewed as a flake or unstable. I'm not a nurse (and that pressure can certainly only magnify things) but I'm a teacher and often I feel as though we're suppposed to check our personal lives at the door, which is next to impossible.

    Good luck with your new job. Share if it feels right and dont' share if you aren't comfortable. Perhaps people not knowing will help you feel "normal" again? I don't know.

    I hope that it helped you to get your feelings out. Please know that you didn't kill your son. There was nothing that you could do. (((HUGS)))