We had our appointment with the fertility specialist yesterday, and it went much the way I expected.  The doctor is testing for a few more things, and we meet again in three weeks to go over the test results.  The doctor was pretty great; he spent over half an hour just going over my charts from the other doctors and talking with us.  I have every confidence we are in the best medical hands we could be in, so I trust that we’re in the right place.  If there is anything to find and fix, this man will find it.

Based on our history and previously healthy test results, the doctor more or less said there wouldn’t really be anything else to look for if these blood tests are normal.  This round of tests will look for more antibodies and clotting factors than have previously been tested for.  If anything does show up, then we should be able to treat it in future pregnancies.  If nothing shows up on the blood tests, then we are faced with trying again and having the new doctor follow us through the pregnancy from the beginning.  He would monitor everything more closely than is really possible in a regular OB office.  Then, if things go south, he would do a d&c so they could do chromosome testing on the embryo.  My interpretation is bleak at best, I know, but we are faced with the same circle of gloom and despair with every test: I am always hoping to find something wrong with me so we have something proactive to do next time; finding nothing but healthy normal ranges means that all we can do is try again and hope for the best, which hasn’t really worked for us yet.

More than a few times, when reporting a good test result, I have been faced with holding back the rant I’d like to let loose on the unsuspecting commenter.  Usually the person says something along the lines of, “Well,  that’s good – you’re healthy, and now you know that’s not the problem.”  There is nothing wrong with that line of reasoning, except it frustrates the hell out of me: if that’s not the problem, then what is?  I know how messed up it is to hope for some bizarre disease or structural malformation to treat; it is not sane to wish for a health problem (although I think we may all do it at some point in an effort to avoid something else we see as far worse).  I’m not sure how much more sane trying again is at this point.  I keep hearing the quote, “The definition of insanity is trying the same thing over and over again expecting a different result.”  Am I not the walking definition of insanity, then?  The ugly truth is that, in this situation, I would rather find a problem because then I would have a circumstance I could control.  There, I said it: I want to have some control over the process and outcome.  I want to know going in that I have bettered my odds at a successful pregnancy.  I want to know that this time, statistics are on my side.  Bizarre medical condition = discernible and treatable condition.  Thus changing the current equation, healthy parents + pregnancy = miscarriage.

But the flip side to my desire for control is the effect it would have on my faith.  If I could control any part of the equation, would I still be trusting God?  I think so, but usually my desire for control reflects a lack of faith and trust in some part of the system.  Finding nothing on the blood tests would mean continuing in faith through another pregnancy, which I would do, but I would not be happy about it.  I know the pain and devastation another loss would wreak on our lives, and I’m a little exhausted and more than a little depressed about the prospect of yet another miscarriage.  Before you feel tempted to reply with some affirmation of God’s power, I know that God could provide us with a successful pregnancy.  I know it could happen because God can do anything, but those of you who are still tempted to encourage me on this point have to realize that blind hope in a possible success means it hurts that much more to fail.  Statistically (and I know that statistics are meaningless to God), I have less than a 50% chance of a successful pregnancy, even if no cause is found (this link shows the average of the stats I’ve read online, and they actually cite their source material: http://miscarriage.about.com/od/riskfactors/a/miscrates.htm).  Based on that, I’m doing really well right now to have more than 50% hope of success when we try again; that rate will improve with time and distance, and I recognize that rating my hope possibly indicates that my faith is woefully lacking.

A side bar on the statistics, or all the things you never wanted to know but are reading right now anyway (I can’t recall all of the sources, but a general overview of well-vetted stats can be found on most sites like American Pregnancy Association or What to Expect, etc.): only about 1% of the population experiences recurrent miscarriage, defined as 3 or more pregnancy losses.  Of those 1%, less than half ever find a diagnosis.  On the positive side, women with two or fewer miscarriages are really no more likely to miscarry in their next pregnancy, and some sources even say that women with recurrent miscarriage who have no medical explanation for it have a 75% success rate in their next pregnancy, making them only slightly more likely to miscarry.  Of course, there are some sources who put my success rate at 5% or less after more than four miscarriages.  The bottom line is, often the doctors are as clueless as we mere mortals are, and if you try anything enough times, you might succeed.  Or go completely insane.  I’m still waiting to figure out which direction I’m headed.

Lest my statistical rant or my morbid desire to find an actual problem in the blood work have left you terrified that I require constant adult supervision, here’s my bottom line.  We will wait for three weeks before seriously thinking any more about tests or trying again or anything related to it.  There is no point in discussing options without all of the facts.  I will try my hardest not to think about it until we have actual results and the good doctor’s opinion.  If our only option is trying again with close observation, I’m sure we will, but it will likely be at least five months before I want to think about that.  I pray everyday that God will “help my unbelief,” and I still believe we might have our own children.  And I’m sure we will pursue other options when we’re ready for that step.  In the meantime, we wait some more.

Bargaining is one step in the grief process, and I’ve certainly done my fair share of it.  While I didn’t really bargain much during the pregnancy this time, I have before – begging God to let us keep the baby in exchange for never having another one or for losing something else, anything else.  I have bargained after the loss in a futile attempt to find answers.  Yesterday, I was reminded of another kind of bargaining I’ve done.  There is no reasonable explanation for anyone to experience five miscarriages.  For that matter, there is no reasonable explanation for any miscarriage.  But somewhere after our second or third loss, I began telling God that my losses were acceptable if it meant that someone else didn’t have to experience it.

Yesterday, I found out that an old friend lost her baby, and it hurt me more deeply than my own recent loss did.  I had been telling God for days that he couldn’t take her baby; he had taken enough of mine to more than make up for my friend.  My bargain didn’t work.  I am devastated for her and more than a little confused by God.  I echo what a friend at church recently told me while speaking about our miscarriages: we know that God is in control, but I can’t imagine his purpose in this situation.  He was genuinely as much at a loss as I am in this situation.

I obviously don’t take the news of anyone’s miscarriage very well, as if their losses are somehow added to my own.  I take each friend’s or acquaintance’s loss like a personal affront, a revocation of the deal I made with God.  I would gladly take loss after loss – I have experience in dealing with it, after all, and no one else really needs to learn that skill – if it would spare the pain of someone else.  I want to erase my friend’s hurt and carry it for her.  I know I can’t, and I know that no human could take the pain of the entire world.  But I know that I would try, if it were possible.  I have tried to make that bargain, but it is not a bargain anyone but Christ can make.

I do not wait well.  That is a giant understatement.  Most people who know me would assume that I don’t worry all that much, but I am a closet worrier.  While I may never speak most of what runs through my head, my inner dialogue on waiting days is enough to turn any sane person into a paranoid schizophrenic patient.  People who can worry out loud at least have the courage to express the seedling of doubt that caused the worry in the first place.  I, on the other hand, let it run free until I feel stretched beyond my tensile strength.  At multiple points throughout any given waiting period, I have to force myself to sit still and repeat out loud that God is in control, not me, and there is nothing I can do while I wait but trust him.  Sounds easy enough, right?

On Thursday this week, we go to our first visit with the fertility specialist.  Having done more research than any well-adjusted individual ever should, I doubt there will be many surprises at this first visit.  I have no idea exactly what will happen, but I expect it to be like any first consultation.  The new doctor will look at our records and see what’s been done to date, and then he will present the options and that will determine the new plan of attack.  What can there possibly be to worry about until we know what the options are?  Let’s see…  What if he says nothing can be done?  What if he finds something almost impossible to fix?  What if our odds of success aren’t any better under his care?  What if our insurance won’t cover this?  And maybe the most terrifying, what if he’s confident he can help us?  Am I really ready to try again?  That last question is more fairly stated as, am I really ready to hope against all odds and then have that hope smashed to pieces – again?

What can I possibly do about any of those things by worrying?  Absolutely nothing.  Worry is clearly the expression of the fear of the unknown.  Spiritually speaking, it is unbelief.  Above all, I believe that God is in control; whether or not children are in his plan for us falls under that control.    We may not ever have children, which is something I can accept as beyond my control.  I firmly believe that I will have a successful pregnancy if that’s what God wants; my particular unbelief lies in the experience of repeated loss.  I know every day what it feels like to live the story of the father begging Jesus to heal his son.  There had been repeated attempts by people in his village and by the disciples to heal him, and then Jesus showed up and asked the father if he believed his son could be healed.  The father’s response: “Lord, I believe, help my unbelief.”  (Mark 9: 14-29)

In any given situation, God can intervene; things can go the way that we hope they will.  It’s easy to believe then.  What we do when God says no is not so easy.  Sometimes, we just have to wait for the right time.  Sometimes, we have to change our plans and hopes completely.  It’s hard enough to change your own heart – changing the hopes that our friends and families have for us is monumentally difficult.  They tend to be the voices advocating for the wild pursuit of a single outcome, and in my life, they have a harder time letting go of the baby dream than I do.  It shouldn’t really even be my job – to change someone else’s dream for me – but it becomes just another piece of the giant boat you attempt to turn with the tiny rudder that faith provides.  I worry more when I’m thinking about what everyone else wants from me.

I’d say about a quarter of my worrying over this week’s appointment is not being able to answer all of my questions right now (I really hate waiting).  The other 75% is worrying that the outcome will be a positive step forward.  It’s unlikely to be determined in a single visit on Thursday, but trying to conceive again means hoping for a positive outcome.  If that’s not the direction I’m supposed to be going, it will be another body blow, if not a knock-out.  Am I supposed to hope for something that I’m not supposed to have?  And, if this works, what was the point of all of that pain?  What did I do to deserve this?  Those are the real questions underlying the worry.  That last one is nothing but selfish indulgence, and I know it, but I am currently helpless to get rid of that particular unbelief.  Thursday is only two more days, and then I’ll have something new to worry about.

Everyone knows the old saying, “Misery loves company.”  Obviously, I agree, or I wouldn’t be such a pill to deal with right now.  But I know there’s a much deeper truth in that maxim, and I call it “The Sisterhood of the Traveling Pains.”  To be fair, it is more like a fraternal order, as there are plenty of men who face pain and loss, too.  Alas, “The Fraternal Order of the Traveling Pains” lacks the pun and the catchiness of my title, so the guys get to join the Sisterhood.  There is great innocence in those who have never experienced shattering loss, and I envy them in a way.  Can you imagine what I would give for my first pregnancy to have been perfect, to never worry about every pain or hormone fluctuation, to have heard just one of my babies’ hearts?  I will never know the innocence of pregnancy without the fingerprints of loss and devastation.  I only envy that innocence to a point because I now know a depth of emotion and strength in my heart and soul that I never imagined existed.  I think that’s what Steven Curtis Chapman was expressing when he said, “I have met the God I never knew,” in an interview after his daughter was killed.

There is a bond that doesn’t need to be fully spoken between people who have suffered through devastation; we have all met a depth of loss that brought a new depth of life to our experience.  While I may never have an “innocent” pregnancy, if I ever do carry a child to term, I know I will cherish every moment, every ache and pain.  Beyond that, I know the sadness of the other women who have lost a pregnancy, and God has endowed my spirit with new levels of empathy through my struggles.  A dear friend of mine who lost his sister described it as “the worst best friend you can have,” meaning that you now have a friend who can understand and comfort your soul, but only because they had to experience it, too.  There develops a shorthand for expressing the range of emotions that follow grief that someone on the outside can’t understand.  For instance, you don’t have to feel ridiculous admitting that you’d like to take your boxing gloves to work or church and clock the people who say ridiculous things to try to comfort you.  That sounds like overreacting or inappropriate behavior to someone who has never experienced a miscarriage (or any other loss, for that matter), but if you’ve been there, done that, and have the t-shirt, you’re secretly rooting for someone to actually do it, and you’d probably join the ensuing brawl.

As further proof that misery indeed loves company, I have found great comfort in other people’s survival.  Though miscarriage is not often talked about, it is more and more acceptable to discuss it or admit to it, which means that more people feel comfortable seeking help and offering help to others.  I am astonished at the sheer volume of women that I know well who have experienced miscarriage and infancy loss.  The more amazing thing to me is that those who have walked through it before me are beautiful, resilient women in spite of (or because of) their tragedies, and they give me hope that I will walk in their footsteps.  To know that kind of pain and to survive and grow past it is to learn a new depth of love to share with others who have lost, whether it is a child, a parent, a spouse, a sibling, or a friend.  It is the courage to share your battle wounds so that you can help others bind up theirs.  It is the inspiration of hope, and I hope it is a lesson I am putting into practice.  To the angels in my life who have had the courage to share their losses with me, there are no words to thank you for what you’ve shared and no words to comfort you except, I love you.   And to the angels in my life who haven’t walked this path but have chosen to share it anyway, you make every day easier knowing that I have friends like you to support me – you are honorary members of the Sisterhood, and I hope you will never have to become official members.

As loss becomes more reality than surrealist thought experiment, the pain creeps in.  The physical pain is fleeting, but the emotional pain sneaks up, inches in through cracks you can’t see until it flows out at some inopportune moment.  For me, this is usually at work, where I will spend the next two weeks (okay, maybe it’s more like a month) trying to keep my cool.  I will alternately want to fly into a near homicidal rage, laugh like a maniac, or weep like a tiny, lost little girl.  Mostly, I will be angry at everything for no explicable reason.  The cost of maintaining some semblance of sanity is usually a build up of stress that physically manifests as a migraine and enough tension in my shoulders to raise them to ear level even when I’m “relaxed.”

I have so far not discovered any magic bullets for dissipating the anger, and I’m sure that dealing with it and moving on is part of the process.  I just wish I could short-circuit this part.  I don’t like who I am during this phase; I have a mean streak that turns vicious, and I pick stupid fights.  I have amazing command of four letter words you can’t say on television (that part is mostly in my head).  The worst part to me is that I tend to dump a lot of that frustration on my husband, which is wrong in so many ways.  Although we feel it differently, I know he’s hurting and disappointed, too, and he’s trying with all his heart to support me, even when I’m this prickly.  As an armchair psychologist, I think anger is the easiest emotion to give in to, and it’s the hardest one to get out of because it’s less vulnerable than the raw pain and disappointment.  I have vowed to deal with this miscarriage at least a little differently; if nothing else, I am trying desperately not to punish my husband for something beyond our control.  I’d like to conquer the anger before it conquers me this time.

This will seem like a ridiculous comparison, but the story is a little funny if you have ever met our cat Clarence.  In the animal kingdom, injuries and wounds are seen as weaknesses to be exploited by other animal further up the food chain, so most animals will mask an injury to avoid becoming someone else’s dinner.  In one of the more hilarious examples of this behavior, our cat pulled a muscle while playing with one of the dogs.  The second he hurt his leg, Clarence started hissing and slapping at anything close by (the other cat, my husband, the bed spread…).  Every time he moved the injured leg, he hissed or growled, even if there was no other animal in the room.  Of course, we laughed after we checked him thoroughly and he was given a clean bill of health from the vet, but it’s not so funny to realize that I am doing the exact same thing right now.  It will be hilarious in a few months when I can laugh at this, but right now it’s entirely frustrating and embarrassing.

Unlike my cat, I have tried various methods of dealing with the anger.  One of the most physical outlets is the punching bag in my basement.  I don’t feel the need to put anyone’s picture on it; just punching the crap out of something is extremely satisfying, and the physical exhaustion releases a lot of the shoulder tension.  While deep breathing and meditation techniques are helpful, they’re not completely practical in the heat of the moment.  Maybe when I can perform the Half Lotus Toe Balance pose without using my backside for balance, I will have developed the meditation skills necessary for anger eradication.  This is unlikely to happen in my lifetime.  The two things I do best are write and retreat.  If I stop and write the feelings down, I acknowledge them, and I have time to think about why I am really angry.  I am slowly learning to let it go once it has been expressed; otherwise, I run around like a crazed duelist demanding satisfaction.  Letting go is not easy, so my other option is retreat.  Maybe I’m just tired, or getting older, but I have found no shame in retreat.  A time of escapism is an occasional necessity.  Books and television, even Facebook and Farmville, provide temporary distractions that can help you start going through the motions in other parts of life.  I have to be careful that this doesn’t turn into all out antisocial behavior.

This is likely to be somewhat controversial, but it has been my reality: I haven’t always been able to turn to Bible study or prayer to combat the anger and frustration; sometimes it has only added insult to injury.  This is not to say that my faith hasn’t underpinned my entire journey, but there are verses that cannot be explained away that still give me fits.  I have also experienced that a lot of modern Bible studies either lack the depth to truly address errant emotions, or they refuse to acknowledge that doubt is part of everyday existence.  I read through a Bible study book devoted to mothers who lost children at infancy or through miscarriage that provided so many contradictions and shallow expressions of loss that I would never recommend a study like that to another grieving mother.  That’s one reason I keep going back to solid writers like Charles Spurgeon, C.S. Lewis and Oswald Chambers.  I prefer straight shooters, even if the subject material is difficult; I may not like the answer, but I can deal with truth.  Fluff, not so much.

While I’m not disciplined enough to study like I should, I try to read several chapters of the Bible every day.  Right now, I will be reading through Psalms over and over again.  I have two favorite things to do while I study a psalm.  One is to rewrite the psalm in my own words and in my own situation.  A lot of psalms were written by David while he was under siege – I am not facing death by homicidal king or advancing army, but that doesn’t mean that God doesn’t hear my prayers.  The other is to take a psalm and turn it into a madlib.  We did this a few times in English as a Second Language (ESL) classes at church.  It may feel a little sacrilegious at first, but here’s the point I shared with our ESL students: the Bible is applicable to our daily lives, the psalms are a great format to use for prayers, and God certainly has a sense of humor, or we wouldn’t be able to laugh.

Shortly after my first miscarriage, I felt compelled to write. I wrote anything and everything that popped into my mind; I practiced creative writing exercises I hadn’t done since college. The writing obsession has followed every miscarriage and has been accompanied by a weird compulsion to buy pretty journals in which to put all that writing. I have battled a lifelong addiction to school supplies (nothing is quite so appealing as an untouched notebook and freshly sharpened colored pencils), so journal collecting became my new school supply shopping spree hobby. I found hand-bound journals, leather journals, floral printed journals, spiral notebook journals (insert Forrest Gump shrimp joke here)… I now have a shelf of about twenty unique and blank volumes waiting for copy. I have used, though not completely filled, about ten other journals.

I also have them stashed in assorted places; there is always one in my bag, there are two at my office in case of cathartic emergencies, and the great multitude of pages resides at home in my library. In spite of my school supply fetish, the truly nerdy part is that I planned out what I would write in each journal based on what the cover and binding and pages looked like. For instance, the black leather cover with the golden gilt-edged pages and snap closure was (or is when I remember to write in it) an event journal. The antique map cover with the magnetic flap closure was for my writing exercises; I was working my way through a photography magazine and writing whatever came to mind with each photo. In a fit of irony, my rant journal is the deceptively pretty cherry blossom printed cover with the Chinese symbol for happiness. It is also mostly pink, which further deepens the subversive irony given that I am not a very frilly girl. For some reason, I thought that the pretty pink outside might soften the venom that has been poured onto those pages. That journal will never be public because it is the one place that I have written anything and everything ugly that I needed to vent. It still gets opened on occasion, and it remains the most used journal I have ever written in. I’m not sure what that says about my anger level, but one secret to its success is that I have never dated a single entry. The anonymity of the dates in that book make it impossible to pinpoint exact times, and for whatever reason, that makes it easier to pour out the emotion and never look back at it. I don’t want to remember the hurt expressed so graphically in those pages.

Most writers use their journals as source material later, but this one will most likely be permanently shelved once it’s full. I allowed myself to spill out anything painful that needed expression without audible utterance; no one but God ever needs to hear most of what I think in my basest moments. I am learning to appreciate stripped-down honesty, but there are some things that move through your head that are so transitory that they are not a complete reflection of who you really are. I have dear sweet friends who can and will curse like sailors and angry Yiddish women or Irishmen briefly and privately when faced with seemingly insurmountable situations. Those all too human and weak moments do not define them or their true reaction to the situation at hand. My subversive, cherry blossom pink, Chinese happiness symbol (did I mention it has pink velvet ribbon trim?) journal is a record of all those horrible first reactions that you don’t really mean but you’d really like to say if there were no consequences for unfiltered speech. The true reason to edit those thoughts is that we should be speaking truth in love in order to edify ourselves and each other. Speaking without thinking is not a loving or commendable action. I wholeheartedly believe that we speak out of the overflow of our hearts (see Luke 6:45), which means my pretty pink journal is full of terrible things that were/are in my heart. But two things have happened with that journal: it has been a purge valve for the evil things stored up in my heart, and, as I have grown past the anger, I have written in that journal less and less. Now to find a more suitable journal for the rest of the journey…