Tag Archives: family

So Long, 2017!

I’ve rarely been happier to say goodbye to a year, but the flip side is that I’m looking forward to a fresh start in 2018.  Here’s the Cliff’s Notes version of 2017, and what I’m looking forward to in 2018:

The Good

  • My son.  He continues to delight and amaze me every single day of his life.  This week at home with him has been truly lovely.  He’s starting to have the patience for longer books (Dr. Seuss’s ABC, Angus and the Ducks, and Do You Speak Fish? are three current favorites), and his sense of humor is just wicked (this week it’s all about the yes/no questions and giggles: Is this hairbrush your dada?  NO!!!!  Is this pillow your dada?  NO!!!!  Is that doggie your dada?  NO!!!!  Totally cracks him up every time).  We have a Solar System rug in his playroom, and he loves running from the Sun to Jupiter to Neptune upon request, and playing Solar System Twister by trying to stand on as many planets as possible at the same time.  He likes to play hide and seek, mostly by hiding in plain sight and dissolving into giggles as we pretend to search for him (Is S under the table?  Is he in the bathroom?)  I could go on and on, but I’ll stop. 🙂
  • Work stuff.  My first postdoc got a job offer!  This was a huge deal, since I have been worried that he would not get an academic job and would be forced out of academia after which I would have been convinced that I ruined his career by bringing him to my rinkydink little college for a non-traditional postdoc opportunity.  Instead, he was offered a potentially permanent job that he would most certainly not have been qualified for before working in my group for four years.  I am so happy for him.  And I shouldn’t jinx it, but my year of supervising three thesis students isn’t going as badly as I feared, and I think they’ll all have high-quality theses come May.  There’s also a light at the end of the tunnel for a really big invited review paper that I’ve been working on for about a year now — it should be done by the end of next week.  It’s a ton of work, but will have high impact, and I’m pretty proud of it.  And as I wrote a few days ago, I totally rocked my 5th-year pre-tenure review and am optimistic about the tenure process that will start next fall.
  • My support network.  Having difficult years really makes you notice all the wonderful people in your life who are around to help you through the crumminess.  First prize goes to my amazing husband, of course, but I’ve also got prizes to hand out to other relatives and friends as well — the list is long enough that it makes me feel good about where I am in life right now.  Having a kid hasn’t totally squelched my important relationships as I feared it might.  I’ve been leaning on them a little more than usual of late, though, so I’ll have to make sure I’m giving back in the new year.

The Bad

  • Two miscarriages.  Recurrent Pregnancy Loss diagnosis.  Ongoing testing with no answers yet.  Coming up on a year of TTC living baby #2.  Oh, and the due date for my first post-S pregnancy is coming up this week.  Blargh.
  • My father died.  I had a complicated relationship with him, which has made it tough to sort through my feelings about his death, but the short version is: it sucks.  I think my grieving process has been largely focused on morbid thoughts about the mortality of my son and husband (also myself), which is not fun.
  • My mother had major surgery two weeks ago (a hip replacement).  Recall that I am ruminating on mortality, so it freaked me out emotionally right from the start.  My mom also lives a two-hour drive away, which is better than a plane flight away, but since she lives by herself she really needed help.  I made three round-trip drives in a week (one overnight stay the day she came back from the hospital, plus two day trips).  Thankfully, she’s on the mend now and I can relax a bit.  But I’ve really been feeling the whole “sandwich generation” thing this year.
  • Work-wise, this fall was a survival semester, in the sense that I phoned it in on a lot of teaching stuff and was kind of a crappy collaborator on a couple of projects.  Mostly I managed not to be too crappy at any one thing, which I feel like I can be at least a little bit proud of when you consider how my semester went.  Another part of my grieving process seems to be occasional irritability, which is out of character for me, and there are a couple of emails I wish I hadn’t hit “send” on — although I have to say that the people on the receiving end did basically deserve them, even if I am usually more diplomatic.  Oh, well…. I don’t think I burned any bridges too badly.  And I did an OK job of circling my wagons and prioritizing critical stuff like my research group and paper drafts, so hopefully I managed to mostly insulate my professional list from my personal problems.

The New Year

  • Getting back on the TTC wagon.  In a way, it feels good to have a fresh start after this most recent miscarriage, and to know that I’m back with the RE who will keep a really close eye on everything and do whatever she can to help us conceive the living child that we’re dreaming of.  I had visions of being a normal pregnant lady at my local OB’s office, but the silver lining of being abnormal is that I get more support and reassurance and can work on developing a plan.  I’m optimistic about our chances of success, since S is proof positive that my body is capable of carrying a baby to term.  I wish I could see the future and know how long it will take and what we’ll have to go through to get there, but I’ve been through enough at this point that I’m also feeling relatively calm and confident that I can just go with the flow for a while.  I am definitely in a much better place than I was three years ago after the loss of our daughter.  It seems like I shouldn’t be, since I’ve had three times as many losses by now, but for one thing I have S, and for another thing I’ve developed a certain amount of resilience.  I have hope for 2018.
  • The push to tenure.  There’s a certain narrowing of focus that happens when you’re less than a year from putting in your tenure packet. I’m in a good place right now: I already have a really solid portfolio of work, and I have a bunch of things in the pipeline, and I know what I need to do before next fall.  I’ve already done most of what I need to do, and the rest is in process.  Some of it is dependent on other people (like my students), but not too much.  I’ll be working hard this year, and I’ll have to prioritize like crazy, but the tenure process is another thing that I’m optimistic about for 2018.  I am so looking forward to submitting my tenure packet next fall and knowing there’s nothing more that I can do.  I think I’ll feel good about the body of work that I’ve accomplished on the tenure track.
  • The adventure of parenting.  I know people say the twos are terrible, and plenty of people will tell you that threenagers are worse, but you know what?  I’ve loved every age and stage of S’s life so far, and while there are certainly challenging moments/days, the thrill of seeing this little person growing up into himself more than outweighs the difficulties.  I am more crazy in love with this kid than I ever knew I could be, and I am looking forward to seeing what new skills and interests and ideas he develops in the new year.  I’m looking forward to getting more insight into his odd little mind as his communication skills improve.  And I’m looking forward to more snuggles and giggles as the toddler years wear on — I know that all too soon he’ll be too grown up for mama snuggles, so I’m soaking up every moment of it while it lasts.  I also love watching my husband surprise me with his parenting ninja skills, and I fall in love with him again every day as I see him growing into an amazing father.  He is so creative and funny with S that it just melts my heart.  Our family is so beautiful right now, and I hope that it will always stay that way — or perhaps even grow in love with a new member on the horizon.

And that’s the year!  Happy 2018 to everyone.  My hope for you all is for a brighter year full of love, laughter, new memories with your loved ones, and wishes coming true.


Testing Cycle and Tenure Ruminations

OK, quick update for the people who care about pregnancy/RPL, and then longer rumination for people who care about tenure.

I’m now about halfway through the testing cycle that my RE had recommended.  I had my second SHG last week, and have gotten the results of most but not all of the blood work she ordered.  The short news is: everything looks pretty much normal.  Of course, I have mixed feelings about this.  On the one hand: yay, no obvious problems!  On the other hand: if I have no obvious problems, then there are no obvious solutions to help me stop having miscarriages.  The SHG did show that the lining on the posterior wall of my uterus was noticeably thicker than the anterior wall, and they said that it was slightly unusual but might not be clinically significant.  So my RE recommended an endometrial biopsy, apparently forgetting that she had already recommended an endometrial biopsy, which I already had scheduled for December 29.  So, endometrial biopsy it is!  Now I’m just waiting for that test date to roll around, and after that, we can presumably start trying again.  My follow-up appointment with the RE isn’t until later in my next cycle, so perhaps technically we should hold off for another cycle in case there’s more testing or treatment she recommends, but we probably won’t.  Since there’s been no significant abnormality so far, there seems no reason to wait.  Plus, it probably won’t matter anyway, since I ovulated on my “good” right side this month (two follicles, apparently!  Blargh, I was bummed to miss the opportunity…) and next month I’ll probably be ovulating on my “bad” left side, which means all attempts at conception are likely to be futile.  Oh, well… but one cycle of missed opportunity still seems worth it, just in case they can find a treatable cause of our recurrent miscarriages.

Now, on to the tenure rumination.  If you don’t care about tenure, feel free to skip the rest of this post.

First, some context: Friday was the deadline for my department to submit its letter for my 5th-year review to the administration.  At our university, the 5th-year review is the last check-in before the big tenure review one year later.  It’s a department-level review, but the administration wants to see the letter before they give it to me, basically to cover their a$$ses legally and make sure there’s nothing controversial in there that could come back to bite them if I get denied tenure in the future.  My chair tells me that usually this administrative rubber stamp doesn’t take too long, and he hopes that we will be able to have our one-on-one meeting about the review before the end of the calendar year (though obviously at this point the timing is out of his hands).  Which of course means that I’m freaking out a little, so keep that in mind for the rest of this discussion.

The other context has to do with parental leave and the tenure clock extension policy at my university.  Since these policies vary from place to place, it’s worth a bit of explanation about how it works here: these days, the parental leave policy is that you get a full semester of leave at full pay if you are the “primary parent” (usually birth mother) of a child.  (If you’re not the primary parent, the leave policy is less generous.)  Then our clock extension policy is that all parents have the option of taking zero, one, or two semesters of tenure clock extension for each child born/adopted while on the tenure track.  I agonized over whether to take the clock extension and how much clock extension to take, but in the end my (previous) chair made the point that at least in theory there’s no down side to taking the full two-semester clock extension, since there’s no penalty for going up early for tenure at my university, which means that even if I take the full year of clock extension, I can still go up for tenure at the normal time if I am ready.  So, that’s what I did, and I have been discussing with my department all along that my plan is to go up “on time” according to my original clock (which would be one year “early” with the extension that I got because of the birth of my son).  So according to my current plan, I would submit my tenure materials next fall, around October or November.  This review is therefore an important final check-in about my progress towards tenure — if there are any red flags, I can delay the submission date of my tenure materials by up to a year, but I’m hoping to just get it over with and submit on time.

Yesterday when I checked in with my chair about the progress of my 5th-year review, he said a few things that made me think that he was going to encourage me to take the extra year, which freaked me out a bit, and I’ve been ruminating on it ever since.  The caveat here, of course, is that he didn’t actually say “I think you should take the extra year,” and I’m probably reading way too deeply into offhand remarks, but I actually think it’s probably not a bad thing for me to do some thinking through the issues so that I will be prepared for our official 5th-year review conversation.

If he asks me, “Why do you want to go up early for tenure?” … what will I say?

I think my answer breaks down into two major professional and personal answers, and two minor but still valid supporting answers.

Professionally: First of all, I want to remind my chair that I’m not going up early.  I’m going up ON TIME according to my original clock.  Basically, I don’t want to spend an extra year on the tenure clock unnecessarily even though I am grateful to my university for giving me the option.  Because I think I’ve earned it, darn it.  And because I don’t think there’s any substantial deficit in my tenure packet that an extra year would fix.  My reviews so far have been glowing.  Advisors inside my department, outside my department at the same university, and outside my department at other universities have told me that my department would be nuts not to give me tenure, and a few of the people outside my department at my university have told me I should *actually* go up early… like submit my materials now.  And when I look at the evidence, I think they’re right.  My university requires “excellence” in three categories: teaching, research, and colleagueship (this last category is also known as “service,” and even though we are technically supposed to be excellent, nobody ever gets denied tenure because of colleagueship, and my colleagueship is just fine).  As a liberal arts college, the emphasis is a bit more on teaching, and the research expectation is a smidge lower than at a research university.  My teaching evaluations are consistently the highest in my department, and comfortably above average for the university and my division within the university.  I’ve taught every level of course that we offer, multiple times.  I will have supervised six theses, an average of one per year, by the time I go up for tenure, which is consistent with my department’s number of majors per faculty member (and I’ve never turned a student away from my research group who wanted to work with me).  My thesis students have gone on to be very successful, both in and out of academia, even when it wasn’t a priori obvious that they would be (and my first postdoc just got an offer for a permanent job this week, woohoo!).  As for research, here I also think I’ve clearly exceeded my department’s expectations.  My department expects that we should publish 1-2 papers per year.  In my five years on the tenure track, I have been an author on 33 papers, with 8 originating directly from my research group (where I or one of my students or postdocs is the first author).  There will be at least three more from my group in the next year (one already in revisions, one to be submitted this week, one drafted and to be submitted next semester; in my field it’s rare for a submitted paper to not be published within six months, as in, it has never happened to me).  Anyone in academia knows that h-indices are fraught with all kinds of issues, but as a blunt instrument they’re commonly used to indicate research impact.  My h-index is essentially identical (+/-1) to the next two most senior members of my department.  Let me be clear: it’s not identical to what theirs were when they went up for tenure.  It’s identical to their current h-indices, even though one is 8 years ahead of me post-PhD and the other is a full professor who is a couple of decades ahead of me post-PhD.  For them to deny me tenure on the basis of research quality or quantity would be absurd.  External letters matter too, but I am well known in my field and have received several high-priority invitations in the past year that will get me significant visibility in my final pre-tenure year — and I’ve been networking and inviting senior people in my field to my university for talks to make sure I have enough exposure.  There’s no official guideline about external funding (just that we should seek it as needed), but I’ve brought in almost $1 million in grants during my time on the tenure track, which is a typical milestone for tenure at a research university (which ours is not).  Professionally, when I look at my case objectively, I just don’t think there’s a reason to wait.

Personally: I think I probably shouldn’t bring this up with my chair, but there’s one huge personal reason that I want to go up for tenure this year: I do not want to be worrying about tenure when (assuming we’re lucky enough to get there) our second child is born.  I really hate that I put pressure on myself to be productive during my first parental leave, and to come back to work and start traveling again before I would have if I hadn’t been worrying about tenure.  I don’t blame my university, but it is an unassailable fact of my personality that if I have tenure hanging over my head, I will be worrying about my productivity while I am on leave.  I know that no matter when our second child is born, I will need to worry about some professional things: I will still have a responsibility to my research students and collaborators to help move projects along.  But I want to remove the tenure pressure from the equation.  I’ve worked so hard to earn tenure, and so hard to have kids, that I think I’ve earned a parental leave that is on my terms.  I also have the feeling that if I take this one tenure clock extension, and have a second kid during the clock extension, that I’ll have no choice but to take the additional clock extension, and that means I’ll spend nine years in pre-tenure purgatory, which just sounds miserable.  We’ve been trying to have a second kid for almost a year now, and if it had worked out, I most definitely would have used this clock extension — but in my mind, the silver lining of two miscarriages in a row is that now my second baby definitely won’t be born before next fall so I can get tenure out of the way before baby #2 comes along.  While I think a year is a reasonable long-term approximation of the impact of a child on one’s career, the impact is extremely front-loaded, and in the short term, a year is not enough.  I can’t shake the feeling that the more clock extensions I take while my kid(s) is (are) young, the farther behind I’ll fall as tenure approaches, though I am quite confident that in the long term I will be an asset to my department (and in the short term as well, as I discussed above).

In addition, the two minor issues that I mentioned are:

(1) The feminist in me wants to get tenure on time because I see how parental leave and clock extensions put women behind men and I think it sucks.  The last successful tenure case for a woman in the sciences at my university took nine years (two parental leaves) and a bunch of controversy before it went through.  Meanwhile, the guy in her department with three kids and a stay-at-home spouse sailed through early — and in fact, her department encouraged the woman to delay her tenure case so that she wouldn’t go up for tenure the same year as the man.  So now she’s less senior than him (and paid less!) even though he started after her, and even though they both had kids on the tenure track.  I think it sucks.  I don’t want to delay my seniority, and I want to show other women in my university that they don’t have to be scared to go up when they’re ready.  I think the clock extensions are a good option to have, but I don’t think anyone should be putting pressure on pre-tenure women to use them for any reason other than their intended purpose.  Not to avoid going up in the same semester as the hotshot young guy, and not (in my case) for no clear reason other than that it’s expected.  One question I would like to ask my chair (but probably won’t) is: if you pretend that I don’t have a baby, but that my record is otherwise identical, would you still be sitting here now at the end of my 5th-year review telling me that if I only had an extra year on my tenure clock it might make or break my ability to meet tenure expectations?  I am really quite confident that the answer is no.

(2) Money.  With tenure comes an 11% pay raise.  One of the main reasons that women’s salaries lag behind men’s salaries is that they advance more slowly in the childbearing years.  I don’t have any interest in being part of that statistic, thank you very much.  I did a sketchy calculation yesterday about the difference in lifetime earnings between getting that boost one or two years from now.  It’s definitely in the tens of thousands and approaches the hundreds of thousands of dollars (depending on what you assume you do with the extra money).  My husband and I are not strapped for cash, thankfully, but I want fair compensation for the work that I do, including timely raises when I have earned them (like now, I think).

Of all of these reasons, I think I’ll have to focus on the professional reasons when I talk to my chair.  But I think the other reasons are important, and I wish I could talk about them.  Particularly the personal one about wanting my next baby to be post-tenure.  I get a little weepy when I think about how I might have spent more time with little baby S if I hadn’t been pushing myself to get back to work and not fall off the tenure track.  I still get weepy every time I think about being away from him while he’s so little.  After all I’ve been through for S and the future sibling we are hoping for, I want to take the professional pressure off a little and just be there for them while they are small.  Possibly this is exactly the kind of thing my university dreads when it considers the institution of tenure — that it provides a license to take a step back from professional responsibilities.  But I’m not that kind of faculty member.  Believe me — I don’t have a dead wood bone in my body.  I have every confidence that over the course of my career I will be an enormous asset to my department.  I’m just a human who wants to shift priorities a bit for a few years and not jeapordize my entire career as a result, which is the nature of the up-or-out tenure system.


Bad Luck Math

Because I’m me, I’ve been doing the math on my bad luck.  And because this is my blog, I figured I’d share it with you.  If you hate math, this might be one to skip, but I find it to be a helpful perspective.

My question: Among all women who have been pregnant four times before, what is a typical outcome, and how common is my type of outcome?

Assumptions: I’ll assume that first-trimester miscarriage has a ~20% probability, since that seems to be in the middle of the 15-25% estimates.  It depends a bit on week of gestation, but mine have been in the 6-8 week range, and I think 20% is probably about right for that gestational age; I also think first-trimester miscarriages at that gestational age are pretty typical. As for 2nd trimester losses, it depends a little bit.  The overall risk is something like 1%, but the risk of losing a chromosomally normal fetus like I did is about half that, or ~0.5%.  If I were being totally self-consistent, I’d make the probability of live birth ~79% and first-trimester loss ~19% to account for the ~2% of pregnancies that are lost in the 2nd and 3rd trimesters, but it won’t change my answer much so I’ll keep using round numbers for at least these initial back-of-the-envelope calculations.

What is a typical outcome for a woman with four pregnancies? 

The highest-probability event in any pregnancy (other than mine, that is) is a live birth, with a probability of ~80%.  The probability of having four live births in a row is (0.8)^4, or about 41%.  So, fewer than half of women with four pregnancies will have all live births.  That jives with my experience — most women I know with three kids had one miscarriage along the way.  So let’s explore the probability of three live births and one miscarriage.

There are four ways to have one miscarriage in four pregnancies: either your first pregnancy can result in a miscarriage, or your second, or your third, or your fourth.  So the overall probability of having one miscarriage among four live births is 4*(0.8)^3*0.2 = 41%.  That means that just according to the typical probabilities, 80% of women who have been pregnant four times will have either one or no miscarriages, and it’s more or less a coin toss between those groups.

What about the other 20%?

The other 20% are women who are less lucky.  They might have had two or three or even four miscarriages, typically in the first trimester.  But which fraction is which?  The easiest to calculate is having four miscarriages in a row: (0.2)^4 = 1.6%.  So, how unlucky do you have to be to have four miscarriages in a row, just by chance?  Unluckier than 98.4% of other women.  If you somehow manage to collect 100 women who have been pregnant four times in a room, you would expect about 2 of them to have had this outcome by chance.

But what about the other 18 women who had more than one miscarriage?  Most of them will have had two miscarriages.  There are six ways to do that (1st and 2nd pregnancy, or 1st and 3rd, or 1st and 4th, or 2nd and 3rd, or 2nd and 4th, or 3rd and 4th), so the probability is 6*(0.8)^2*(0.2)^2 = 15%  So a whopping 3/4 of the 20% of women who had more than one miscarriage had two miscarriages, and there are only 5 women in our hypothetical room of 100 G4 women who had three or four miscarriages out of four pregnancies, just by chance.

That’s actually more than I might have expected.  I mean, I don’t know very many women who have had four pregnancies, but of the ones I know, they mostly had one or two first trimester miscarriages along the way.  I think the largest total number of pregnancies I know of in my normal everyday life (not counting blogland, which is a very biased sample), is a grad school mentor of mine who once shared that it took her six pregnancies to have her three kids.  (I was appalled at the time, but now I’m 2/3 of the way to her total number of pregnancies and I only have one kid to show for it, so there’s that.)  But the point is that if you somehow collect 20 G4 women in a room — this is the size of a typical seminar course that I might teach at my college — you would expect only one of them to have had more than two miscarriages just by chance.

What about later losses?

So far I’ve ignored 2nd and 3rd trimester losses, because they are so improbable that they make up a pretty tiny fraction of all pregnancy outcomes.  For example, the chance of having one late loss out of four pregnancies is 4*(0.98)^3*0.02 = 7%.  That’s not nothing, unfortunately, but it’s also fairly small — it’s about the same as the chance of having 3 or 4 first trimester miscarriages out of four total pregnancies.  The more times you get pregnant, the more likely you are to have an improbable outcome like a late loss, alas.  The good news is that for a typical woman, even if she gets pregnant four times, she has a 93% chance of never experiencing a late loss — and probably it’s actually significantly better than that, since I’m assuming that all pregnancies are equal, whereas the research shows that women who have had one late loss are more likely to have another, so in reality it’s almost certainly skewed so that women with generally poor reproductive outcomes account for a larger-than-chance share of the late pregnancy losses, and a truly typical woman is less likely to ever have a late pregnancy loss.

So, how unlucky am I?

Let’s explore the probability of my particular reproductive outcome: four pregnancies, one late loss, two early losses.  We’ll assume that the order is random, although it might not be — for example, the adhesions from my first pregnancy could conceivably have contributed to my early losses in later pregnancies, or I could have some sort of weird immune-mediated thing that got worse after a live birth.  But those are fairly speculative possibilities, so I’ll just assume that the order is random.  In that case, the probability of having an outcome like mine (one late loss + two early losses, random order) is something like 12*0.02*(0.2)^2*0.8 = 0.8%.  So, if you got 100 G4 women in a room, maybe one of them would have a history like mine, but maybe not.  You’d need a thousand to get me some buddies for sure.

And I’ve also been generous in defining what “like mine” means.  If you narrow the definition to the loss of a chromosomally normal fetus in the 2nd trimester (plus two early losses), that brings the numbers down by a factor of 4 to 0.2%, which means that I’d need a room full of 1000 G4 women to maybe have one friend who’d been through something similar.  This thought experiment is also interesting because it brings the probability of having an outcome like mine below the threshold of 0.3%, which means that my outcome is 3-sigma bad, or that there’s a 3-sigma probability that my obstetrical history is not just due to bad luck, but rather to some other contributing factor that predisposes me to poor pregnancy outcomes.  That’s significant enough to get you publication in a journal in my field (though not in all fields).

Now, of course, when you get down into the weeds of these small-number probabilities, there are a lot of outcomes that look similar.  Another outcome that has a probability of 1-2 women in a group of 1000 G4 women is having two late losses and two full-term births, and you can add a bunch of different permutations that also give you similar answers.  But the point is, by the time we get into the land of both late losses and multiple losses, we’re down in the tenths digits of the percentages, which is a fairly lonely land to be in.  It’s also increasingly absurd to be told that your problems are due to “bad luck” and told that you should just try again — when you’re out in 3-sigma land, while it’s certainly true that your outcomes could be due to bad luck, the probability is low enough that it seems like any reasonable person with at least a slight grasp of statistics would want to do more investigation.  It’s easy to say that investigation is a waste of resources when you’re talking about two first-trimester losses out of four pregnancies (roughly a 1 in 5 chance), but not when you’re talking about an outcome that only a few in 1000 or even 10,000 women will experience (since most women don’t get pregnant four times and therefore aren’t even represented in the above numbers — you actually expect overrepresentation of poor pregnancy outcomes in G4 women for exactly this reason).

So there you have it.  I am so statistically significantly unlucky that it seems unlikely that my issues are due to random chance (i.e., they are probably more than just “bad luck”).  However, I’m not as dramatically unlucky as I guessed going into this exercise (I guessed that I’d be 4-sigma unlucky, but I’m not that unlucky).  So, that’s good news, I guess?  The other good news is that I live in a time when the internet exists to connect me to all the other women having a tough time out in 3-sigma land, so it doesn’t feel as lonely as if I’d been a prairie mama trying to deal with this all in isolation, never knowing another woman who had been through something similar (waving at you, blog friends!).  Though in that case I’d probably already be dead and/or completely infertile from the infection I contracted after my 2nd-trimester loss, or from hemorrhaging due to retained products of conception before the infection — huzzah for 21st century medicine!  It’s keeping me alive, even if it’s not telling me how to keep my babies alive.


Pregnancy #4

So, remember how I said in my last post that I was just getting my period on Wednesday?  I was pretty sure, because it was the day my period was due, and I was cramping and I think spotting a little.  But then, it just… stopped.  My period never started.  This morning I took a test, and, yup. Pregnancy number 4.

But with cramping and spotting (which has mostly stopped), so, yeah.  I’m not counting any chicks just yet.

But at least for today, I’m pregnant again!  End of June sounds like a nice time to have a baby. Kind of in the same way that the moon Europa sounds like a nice place to visit.  (They both seem very far away and hypothetical at the moment.)

Here we go again!  Wish me luck!


Day 3 labs and my dad’s memorial service

I swear I’m not as much of a grumpy gus in real life as I am on my blog, but I sure do feel like I have plenty to be grumpy about these days.  I thought I had left most of the bitterness of pregnancy loss and infertility behind me, but we’re now six months and one miscarriage into trying to conceive our second living child and I just today saw the second pregnancy announcement from a friend/acquaintance who is five months pregnant (which is how pregnant I would be right now if I hadn’t miscarried), and my dad’s memorial service was last Saturday, and we’re heading into midterm season which is no more fun as a professor than it was as a student, and I am GRUMPY about it all.

As part of the conversation with my OB about how to go forward with trying to conceive after my miscarriage in May, she offered to repeat my Day 3 labs, which I haven’t had done since before my daughter was conceived — I figured that if they were normal, I’d be more comfortable trying on our own a little longer, but if they indicated low reserve I’d want to head back to the RE sooner rather than later.  The results came back this week, and my FSH and estradiol are both normal (8.8 and 49, respectively).  My FSH was 8 before, so things don’t seem to have changed much there (although I do always worry about inter-cycle variability).  My AMH was a bit on the high side — good for egg quantity/quality, but apparently a potential indicator of cysts or PCOS.  Which makes total sense to me, because it seems like every time I get an ultrasound someone tells me I have a cyst and they’ll “keep an eye on it” and then they never do and then I mention it whenever they do another ultrasound and they’re like, “oh, huh, you do have a cyst… well, it looks normal, but we’ll keep an eye on it,” and then nothing happens.  I also wonder if my borderline high AMH levels are related to the fact that I get wicked ovulation pain these days — I don’t even really need OPKs anymore, because I can tell 2-3 days before the OPK turns positive that I’m starting to ovulate, and by the time I get to ovulation day it hurts to sit down.  Anyway, who knows?  My OB mostly just brushed it off (I didn’t actually get to talk to her; she left a message and said to call if I had questions and I haven’t gotten around to it).  But at least my eggs aren’t rotten, which was my main concern.  So that leaves us in purgatory of trying and trying and wondering when to go back to the RE.  I think I’ll probably wait it out until January — that would be seven cycles of trying post-miscarriage (since it took me >2 months to get my period back after the miscarriage), 10 months since we started trying after our son was born, and it would also be past the window of inconvenient due date timing (since I’m planning to submit my tenure materials next November).  Seems like a good time to step up our efforts.

In the meantime, I held my dad’s memorial service last Saturday.  It was so strange.  I still don’t really believe that he’s dead.  Most of the family got together, and it was nice to see everyone.  In a way, it was one of the more pleasant family funerals since nobody was really all that sad, since nobody was really that close to my dad — sounds weird to say it that way, but it’s the silver lining of my dad’s depressing life during which he worked hard to alienate himself from pretty much everyone in the family.  My uncle is a minister, and he planned most of the service.  He did a nice job — told some stories about my dad that were funny but didn’t totally whitewash the seedier sides of his personality.  It’s got to be disconcerting for my uncle that he’s now led funeral services for his parents and two of his three siblings, but you’d never know it from the way he was up there talking and laughing and playing Grateful Dead songs (which my dad definitely would have appreciated).  My son, S, was the star of the show, if that’s a thing that one can be at a funeral.  He was dancing along to the Grateful Dead songs, peeking over my shoulder at a family friend and saying “Boo!” during the service, and when I got up to give the eulogy he held out his arms yelling “Mama, mama, mama!” until I just picked him up and let him sit on my hip while I spoke and he tried to disassemble the microphone.

I had some really nice moments with my dad’s old friends who told me stories about the good old days when my dad was actually a functional human being and did some really important welfare reform work — like, welfare reform that influenced policy decisions across many states and also the platform for one presidential campaign that my dad worked on.  It was all before I was 5 years old, so I don’t really have any memories of those days, but it was nice to hear about how he used to be really driven and dedicated to helping other people.  I don’t know what happened — part of it was being diagnosed with Multiple Sclerosis, although that’s clearly not all of it.  As I mentioned before, there were drugs and alcohol and abuse involved, and I’m pretty sure there were some undiagnosed mental health issues too.  Not depression/anxiety so much as narcissistic personality disorder with perhaps a touch of sociopath, if I may armchair-diagnose my deceased father.  Anyway, it was good to hear his friends remember how he used to be, and to hear stories about him that I hadn’t heard before.  Since he died a lot of my sadness has been related to the empty life he led, particularly towards the end (I won’t elaborate on some of the things I found while cleaning out his apartment, but they were incredibly depressing) and so it was nice to hear that there were other parts of his life that were more fulfilling than the parts that I had the front row seats for.

So, that’s where we are now.  Making arrangements for the funeral and my dad’s affairs has been eating up my life since he died ~3 weeks ago, and with traveling back home on the weekends and my phone ringing off the hook I’ve been very behind on work and it’s been very stressful.  I’ve still got a stack of grading to be done, but I’m keeping up on the essentials, and now I finally feel like I might have a tiny hope of catching up — not that any academic is ever truly caught up, but at least I hopefully won’t feel that I’m constantly dropping balls and letting people down.

One sort of interesting thing that happened this week is that on Monday I was apologizing to one of my masters students for not answering an email that he had sent on Friday — I said that I didn’t want to play the sad card, but I did want to explain that my father’s funeral was Saturday so I just didn’t look at my email all weekend.  He said, “Wait, your father’s funeral?!” and I realized I hadn’t actually told him that my father had died, even though it had come up with all the other members of my group at one point or another.  But after that student found out, nice things started happening all week — the grad students in our department all signed a sympathy card for me and chipped in on a gift certificate to a local restaurant, and then “the students” brought surprise baked goods to our research group meeting today.  When I walked in and said, “Well, this is nice!  What’s the occasion?” they said, “We just wanted to do something nice since you do so much for us,” and it just about collapsed me into a weeping puddle of goo right then and there!  I have strong suspicions that this masters student who found out late goaded the other students into action — it fits his personality, and he’s a non-traditional older student, already married, so he’s significantly more mature than the other students in our program.  But it is clear that all the other students eagerly piled on once someone initiated, and I am grateful to all the students in our program — and my research group — for their kindness this week.  Even though it’s a little awkward, it’s nice to be treated like a human with feelings and shown a bit of appreciation occasionally (not that that’s why I do what I do, but it’s still nice when it happens!), and at a time like this it means even more than it otherwise would.  Our tiny department has all the pros and cons of small town living, but the way people support each other is one of the biggest pros there is.


Bad news

It seems like there’s a lot of bad news these days.  Destruction in Texas and the Carribean.  The increasing threat of nuclear weapons.  The government rolling back protections under Title IX and DACA — one of my handful of freshman advisees this year admitted to me that she is a DACA student, and she is scared stiff.  She’s an amazing kid who had a tumultuous childhood first growing up in Guatemala with her grandparents, and then being sent to live with her parents in the US when she was in elementary school.  She was a shining star at her US high school, and is now a freshman at a top liberal arts college who is studying to be a pediatrician.  She loves working with young kids, and used to take care of toddlers at her church growing up, and is applying to work at the campus daycare where my son goes.  THIS is the kind of truly amazing young woman our President wants to deport?!  I am so angry on her behalf, and on the behalf of all of the kids who did nothing wrong, often everything right, and find themselves rejected and under threat by the only country they have ever known.

On top of all of that, I got some personal bad news yesterday morning: my father died.  It was very sudden and unexpected; he’s had multiple sclerosis for almost 30 years but was healthy otherwise, and it seems that he just died in his sleep sometime Wednesday night.  I’ll apparently never get answers about what really happened either (i.e., was it a heart attack or stroke or what?), since in cases like this they don’t do an autopsy unless there’s suspicion of foul play.  So, I spent yesterday afternoon on the phone with everyone: the paramedics, the police, the funeral home, my father’s landlord, the county probate office, my entire family, and the few of my dad’s closest friends that I knew how to contact.  Yesterday was a total blur, and today I have a bit of a breather before traveling home this weekend to start making arrangements for his funeral and figuring out what to do with all of the financial stuff and his physical belongings.

I have really complicated feelings about this loss.  My father and I weren’t close.  He abused drugs and alcohol when I was a child, sometimes in my presence, was verbally abusive, and made me feel unsafe on a number of occasions.  I had occasionally wondered what his end of life would be like, what I would do if he wound up needing more intensive long-term care than the disability services he had used for decades.  In a way, it’s a relief that it ended this way, although I feel guilty for feeling that way.  But I also know that he would have wanted to die in his sleep rather than have a long, slow decline to death.  And, I do have some good memories of him when I was young.  I know that he was always very proud of me and my accomplishments, and that he was delighted by the birth of his grandson.  He’s my father, and while over the years I’ve already done a lot of mourning for the father I would never have in my life, I’m finding that, surprisingly, there’s still some mourning I’m going to need to do for the father I did have.

For the moment, I’m just taking it from one day to the next, with the practical side of me figuring out what needs to be done while the emotional side of me wrestles with the aftermath (particularly at 2am last night, alas).  Since my parents have been divorced for 25 years and I have no siblings, it’s clear that I’m the next of kin and it is my responsibility for making decisions and arrangements.  My mom has already offered to help however she can, of course, but legally it’s my responsibility.  I feel very unprepared, and wound up googling various iterations of “what to do when someone dies” and “checklist for when a parent dies” yesterday just to even get a sense of the scope of what happens next.  And today, with nothing concrete to accomplish, I’m sitting in my office not focusing and writing a blog post while pretending I’m going to be able to keep up with the crushing workload of the start of the semester (oh, and with a major deadline for my research next week too).

Anyway, I do take solace in the fact that this I know that this is the way my father would have wanted to die, even though he would probably have preferred that his death be later in life (he was 68).  I’m doing my best to respect his wishes and the needs of my family as I make arrangements for his funeral and what to do with his body.  I’m feeling grateful that I have so many wonderful people jumping to support me, including my husband, mom, and cousin, a couple of my wonderful colleagues at work, and friends (even though I haven’t really told any of them yet — I’ve got a couple of rock-solid awesome friends who I know will have my back once I can muster up the energy to pick up the phone again).  I’m also grateful for my snuggly, goofy toddler, who is still totally oblivious to grown-up sadness.  Playing with him last night after daycare was the best medicine by far.  I am lucky enough to have a village that will help me get through this difficult time.


Plan G

I think I’ve written about 5 or 6 blog posts by now about our newest fertility plan developed with the help of our doctors, so I think we’re on about Plan G by now, right?

This week marked two important appointments in our family life: (1) the 3-month follow-up visit with the OBGYN after my miscarriage in May, and (2) an official evaluation of S’s speech by our state Early Intervention program.

With the OBGYN, basically it was just a discussion of whether or not my periods have resumed normally since the miscarriage (answer: yes, although it took a while so I’ve only had one), and discussing a plan for moving forward.  Since I got pregnant so quickly last time around, my husband and I are a little more relaxed about trying on our own for a while.  But, also since I got pregnant so quickly the last time around, we didn’t have time to do the tests the RE had suggested to check my hormone levels to help figure out a course of action.  Since I’ve still got at least two conditions potentially affecting my fertility (irregular periods, which I’ve had for a while and have now gotten pregnant with three times so they don’t seem to be that much of a problem, and my scarred fallopian tubes, at least one of which is clearly still functional), it’s a little hard to know how to balance trying on our own with upping the ante on the infertility side of things.  Our fertility history is neither the greatest nor the worst, so it seems likely that I’ll eventually be able to carry another pregnancy to term… but I’m also approaching 35, so we don’t want to mess around too much.  The OBGYN said she’d just run the Day 3 labs herself, and I thought that sounded good because assuming they’re normal I’ll feel a little bit more relaxed about ovarian reserve and might be more comfortable trying on our own even as I cross the magical age 35 line into Advanced Maternal Age (gasp!).   Since we’re traveling to visit our in-laws this week and I’m expecting my period sometime in the next couple of days I might have to wait until next month to do the labs, but no biggie there.  So, at least for now, the plan is for us to try on our own for 6 months assuming the Day 3 labs are normal, and then if nothing happens head back to the RE for a new plan.  We’ll see how it goes.

The Early Intervention evaluation also went well.  The two evaluators who showed up at our house Tuesday afternoon were lovely — clearly experienced, comfortable with each other and with kids, and very thorough.  They ran S through a whole battery of tests checking every area of his development.  Other than a brief intervention from me when S decided it would be a good time to chug-chug-chug his train into the dog who was minding her own business sleeping on the living room floor, he behaved very well and wasn’t too shy with the evaluator even though he’s usually shy with new people.  The upshot is that he has a mild speech delay, something to keep an eye on but not bad enough to qualify for state services.  The tests confirmed what I’d thought, which was that there’s an enormous gap right now between his comprehension and his production.  He scored 95th percentile in receptive language, but only 9th percentile in expressive language.  The evaluator told us that there’s some evidence that having good receptive language skills is one positive predictor of a kid who will just outgrow a speech delay with time, although of course it’s not guaranteed.  They are sending us some materials in the mail about how to help encourage his speech development, but she said we’re already doing a lot of the big things like encouraging communication with sign language, reading to him, and exposing him to the rich environment of daycare where he’s around other kids who are talking more.  They also recommended that we talk to our pediatrician about having his hearing tested — the evaluator said that even though his receptive language suggests that he’s hearing just fine, she’s seen other kids that “fooled” them in the sense that even though they understood a lot, just a little tweak in their ability to hear got them to distinguish much better between different speech sounds and really set them off on a language spurt.  So, we’ll work on getting that set up when we visit the pediatrician next week.

Otherwise, we are having a lovely visit this week with my in-laws in the Midwest.  Traveling with S this year is just infinitely easier than traveling with him as a 6-month-old last summer — seriously, after our visit last summer I wasn’t sure we’d ever come back, but now that he’s a curious toddler who just wants to soak up every bit of attention from his doting grandparents and play with all the toys that Grandma has been scrounging off of Craigslist and enjoy zoos and parks and other such outings… he’s having a blast, which means I’m much more relaxed too.  I still find it really hard to let Grandpa and Grandma take charge, especially where safety is concerned.  They wanted to take him for a ride on the train this afternoon, and I just couldn’t stand seeing Grandma holding him up quite *that* close to the tracks while the train was pulling into the station, and then when we were walking through a really crowded place later I just didn’t want to be more than arms reach away from him because I was afraid he would get lost in the crowd, and I couldn’t help but grab his hand anytime he wandered more than a couple of steps away from them.  I know Grandpa and Grandma are very careful with him, but somehow I just can’t keep myself from worrying all the time.  I mean, I worry about leaving him at daycare, but (a) I do it every day so I’m kind of used to it, and (b) usually I don’t have to watch other people take care of him while I hang back.  I also know Grandpa and Grandma aren’t as quick or steady on their feet as my husband and I are, and they don’t know all the ways that a toddler can be quick and wriggly, so I hover.  They freak out about all the wrong things (like when he’s walking in a goofy way down the sidewalk and Grandma thinks he’s going to fall over when he’s clearly not), and don’t know to worry about the actually dangerous things (like the fact that he has zero sense of self-preservation and is liable to fling himself out of their arms when they hold him out to see the train, or dash into an impenetrable crowd of strangers with no warning).  I try to control myself, but I can’t help it.  That’s been the hardest part of this visit, honestly.  But it’s still a major improvement over last summer when nobody was sleeping and S cried the whole time and then Grandma cried because she was so sad that he was so sad while visiting her.  Looking back, I’m pretty sure he was getting like four teeth at once and going through a sleep regression on top of the travel stuff, but at the time I was afraid we’d broken our baby and that this cranky miserable sadness was going to be his personality forever.  Ha ha, first time parent kookiness. 🙂 This year he’s back to being my sweet little boy, and I love seeing him so happy with his grandparents.

One thing that helps is that he is finally saying “mama” (which is basically his only recognizable word other than “uh-oh,” “up,” and “yeah”) and it’s the sweetest sound in the whole world.  I mean, I know that seasoned moms can get annoyed by constant cries for “mama, mama, mama!” but for me, it’s still very new and incredible.  When he reaches for me and says “Mama!!!” it just totally melts my heart.  He knows who his mama is, and he makes it clear that I’m his rock (with Dada as an acceptable substitute most of the time).  Being his mama has been the most special relationship of my life, opening a completely new dimension into my understanding of love, and to hear him call for me and know that he feels towards me at least a little of what I feel towards him is just pure magic.  This is such a special time of life with our little boy.  Even as I navigate spending time with in-laws and plodding down the long and winding road to completing our family, every so often I step back and just marvel in amazement at the wonder of this little human we created.  He’s incredible.  He’s just a normal toddler, but to me, he’s the biggest miracle of creation.  Parenting seems to be an exercise in turning the most mundane things — diaper changes, snack time, waking up at 4:30am with a jetlagged ball of energy — into the most miraculous parts of being alive.  I know some moms are bugged by the old ladies who tell you to “enjoy every minute of it,” but when a checkout lady at Home Depot gave me that line last week, I was able to reply honestly, “Oh, I do… almost every minute!”  I really do.