Letter

Hello,

I would like to report a recent appointment that I had with Dr. T in the Fertility Clinic.

I was scheduled for an ultrasound in the clinic, with her there to read the results.

A little background-in 2009 I was pregnant with twins and suffered premature delivery and both were born at almost 24 weeks and they passed away in the NICU. Since then I have had a successful pregnancy, resulting in my daughter who is now 18 months old. I am back to try for another pregnancy, but as an intervention I have an ultrasound to check how my body responded to the medication (I do not ovulate as a result of poly-cystic ovarian syndrome) and see how many follicles are growing, in order to avoid a higher risk of conceiving twins again.

Dr. T :

1. Did not introduce herself. I had no idea she was even a doctor. She walked in and seemed to be in a rush.

2. She had obviously not familiarized with my situation/read my chart before hand and had no idea the reason for which I was even having an ultrasound.

3. She acted as though she was angry that she even had to be there as she “had no voice.”

4. She did not explain anything on the ultrasound.

After the ultrasound, I waited for answers. She said, “Well, it looks like you have one or two follicles.”

I needed to know if there was one OR two-that was the whole reason I was paying for that ultrasound.

She was very short with me. She was rude. She was demeaning and derogatory in how she spoke to me. She wrote a note in my file that was EXTREMELY demeaning, simply because I had teared up while watching the ultrasound. She implied that because I had teared up while looking at the ultrasound, that I "must need counseling" and that "a doctor cannot control how many eggs a woman produces."

I think most people are familiar with something called post traumatic stress. I have it. After holding two of my babies while they died, there are several triggers, specifically in the hospital setting, that cause me to feel anxiety, and even fear. For her to comment in a demeaning way because I “teared up” is unfeeling and cruel. I am SHOCKED that XX Hospital would employ a doctor (specifically in the fertility clinic, in which I’m positive there are others who have had situations similar to mine) is very, very sad to me.

After I explained my situation she replied, “Well there are no doctors here. We cannot control how many eggs a woman produces. Just don’t have sex this cycle then.” She then turned around and walked out of the room. She acted like she had NO time for me, and seemed to think an appropriate answer to my question was to “just not have sex”.

I left that appointment feeling horrible. I did not have any answers to help me decide about my next steps. In a situation when you are dealing with time sensitive issues (i.e. a menstrual cycle/ovulation) immediate feedback is essential. Thankfully, K, a nurse from the clinic who is extremely kind and helpful called me back, and my doctor, Dr. R, also called me back immediately the next day. I am a teacher and it’s extremely difficult to talk to a nurse during the day-especially when I had a doctor right there who wouldn’t answer any of my questions, so noe of this should have been necessary. I was also contacted by Dr. B, who had seen my note come through and was concerned.

I then was called by Dr. K, who asked for me to share about the incident. The ultrasound tech had informed others about the situation. She also apologized to me after the appointment was over. I appreciated the concern and the time they took to listen to me.

During my time at XX, I have had so many knowledgeable, efficient, caring and kind nurses and doctors. My family doctor is the most amazing person and treats me with the most respect. However, I have had many cruel and hurtful comments made to me since losing my twins. In a business that deals with so much loss, I would hope that doctors are educated on how to treat those who have gone through these big life changing events However, this time was by FAR the worst. I don’t expect extra special treatment because my twins died. What I do expect is to be treated humanely, to have my questions answered, and to be treated with respect.

I believe that patient safety involves patient emotional safety as well. I think that my safety was compromised. I am very seriously considering moving to XX for the fertility part of my journey, because it will be very difficult to schedule around NOT having Dr. T ever again.

I would be more than happy to explain more or answer any questions. My number is xxx-xxx-xxxx.

Thank you for your time and consideration,

Christy

All I once had

So, we decided that we wanted to have another baby. A living sibling for Avery. I mean, we've probably always known, but we decided we were "ready." Whatever that means.

I am not one of those people that you read so much about; I didn't suddenly become fertile after having a baby. I still don't ovulate; I still need help. Thankfully, the help I need is "minimal," meaning I take a pill and I ovulate.

It still means a trip to the RE. Which I did.

We decided to take the same plan of action as before. Get period, take femara (like clomid, but has a decreased chance of multiples) have a mid-cycle ultrasound to check and make sure there is only one follicle, timed intercourse, pregnancy.

I knew I needed to keep my head into perspective, not let it get lost in the clouds. I wanted to tell people right away, but I wanted to keep it to myself. The twins and Avery were both conceived on our first round of medication. I seem to be the "most fertile infertile." I am lucky. But I didn't want to convince myself that would happen, for fear of the letdown.

Anyway, the only way I get a period is to take birth control, which I did. Days 3-7 I took my femara. Mood swings, bad headaches, nothing awful.

Yesterday I went in for my mid-cycle ultrasound. DH couldn't go, it was the first day of the semester and he got all new students and I went before school.

The tech inserted the good 'ol va-ja-jay wand, and I watched her measure one follicle in my left ovary at 16 (mm? I don't know what measurement it is). Then I watched her turn her wand, and measure one follicle in my right ovary. 16 again.

I lost it. I freaking lost it. First of all, I had a TERRIBLE doctor's office visit. The doctor was extremely rude to me. She said and did so many things that I don't want to go into (but I did report to the clinic) but after the u/s she did not explain a single thing to me. She said, "Well, it looks like you have one if not two follicles. Great."

Um, excuse me. Is it one OR two ? You see, that's why I'm paying $150 for this ultrasound.

Anyway, she didn't answer any of my questions, but a nurse did later on the phone.

TWO large follicles. One in each ovary. Ready. Waiting.

I am showing other signs of ovulation, which I never have. Cervical mucous, slight cramping.

I cannot believe how hard this is. To skip a cycle. To know that I could make a baby (and quite probably two) right now, but I can't. I have to wait. I have to sit and wait and go against EVERY fiber in my being.

Because, you see, having twins would be too dangerous.
But it's all I ever want.
It's all I had.
It's all I'll never have.

Having twins won't replace Aiden and Sophie. Of course it won't.

But I feel SUCH extreme jealousy when I see twins. That's supposed to be me! ME! That was me, you see. I sat in a restaurant after my ultrasound and I called everyone I knew and screamed in the phone, "TWINS! OMG! YOU GUYS! TWINS!" and I sat in the teacher's lounge with a smug look on my face when someone new would come in and I'd be introduced as the "Twin Mama."

And I bought every twin book I could find. I memorized what I would do to tandem breastfeed. I came up with a gameplan about how I would get two babies in and out of the minivan we had just bought, just for them. I joined the local Moms of Multiples club, and made plans with my mom to go to their huge consignment sale to get ready.

I made their nursery. I watched my husband put up two cribs and two gliders. I carefully chose the paint for their room. I painstakingly picked out two outfits for their coming home outfits. One a size newborn, and one a size "preemie" because, you know, sometimes twins are born early (no one mentioned 16 weeks early, which they don't seem to make a size for at Target.)

I was (am?) a twin mama, but they're not really anywhere to be found. They seem to have vanished. Sometimes, when I'm brave enough, I'll go and touch their urns. It seems so strange to sit there, holding the cold urn, turning it in my hand. Is this really it? This is all?

So, yeah. I want twins again. I WANT TWINS AGAIN.

But.

BUT.

BUUUUUUTTTTTTTTTT.

What if the whole thing happened all over again. What if my water broke and I had to do the whole.damn.thing.over.again.

And what if I could have avoided that, by skipping this cycle?

So, skip we will.

Even if there's nothing in the world I want more. I will move on and try to forget and hope my body will figure out that I just one want follicle, that's all I can handle, I don't know why my babies died and I can't chance it. I have Avery now and I can't be on bedrest. And so even though I'm on the lowest dosage, "You know we can't control how many eggs a woman produces" says the rude doctor with venom in her voice.

Well, excuse me for being upset about it. But I can see on that screen, the chance. The future. All within my grasp. And instead, I have to turn and walk away, and tell my husband that, "No, honey, I'm sorry, it won't be this month for us." And he'll say back, "It'll be ok. It's always ok."

Except it always isn't.

Weaving

It feels like everytime I say their names, I brace myself. I say them, and then flinch-wondering what will swing my way. I post something on facebook, then immediately delete it. I mention them in a conversation that's NOT about death or pregnancy or baby loss and I slur my words, trying to move on to the next topic in such a hurry.

"She really needs to just move on."

"She needs to get over it."

"She must be depressed."

These are, of course, what I imagine they're thinking, instead of what they actually say. Well, they probably actually say it to each other.

I want to talk about them ALL THE TIME. I want to go outside and SCREAM their names. I want everyone to always remember that they were here. They were inside of me, and then they were born, and then they wrapped their little fingers around mine, and they EXISTED.

I think of them all day, long, still. Almost 3 years later. I wonder when it changes. I wonder when a day will go buy, and I'll be making dinner and I'll realize that I haven't thought of them.

Do you guys remember that I am my mom's rainbow baby? That my sister, Mary, was stillborn over 30 years ago, in between my sister and me? I want to ask my mom. I want to ask her when it stopped. When she stopped thinking of my sister every day, all day long. But things were so different with her. She grieved SO differently than me. She also had a totally different experience than most of us-she never got to see her, or hold her. She was whisked away. When she arrived home from the hospital, my grandmothers had gone over and taken down the nursery, taking the stuff to an undisclosed place. There was a statue of the Virgin Mary in my house, though, all my life. I remember it very clearly when I was a little girl. It moved with us, and with my mom once she and my father got divorced.

I always wondered a little about the statue. My mom is Catholic, and went to church every Sunday, but we didn't have any other religious figurines, or bibles, or anything in our house. But I never thought to ask. I recently found out that that statue is in memory of my sister, Mary. That my mom got it as a gift after she passed away and it is all she has. The ONLY momento. No hospital bracelet, no blanket, no lock of hair, no photos. So she did what she had to do-she chose something. A symbol.

But when was I told that I had another sister that had died? I don't know. How was I told? I don't remember.

Somehow, my mother has weaved Mary's existence into our lives.

This is what we do. We are expert seamstresses. We weave in and out of grief. We take the needle and pull the thread through, trying our best to wrap up and pull in those memories. Their names. Their entire, short, existence.