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Bringing the cute, right here, right now.
Liam, 9 month Philosopher from Myg on Vimeo.
And it’s moments like these that make me ache to be younger and not infertile so I could have two or seven or nine more.
Then, maybe mother nature knows what she’s doing.
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I forgot my 7 year quit anniversary, which was back in June. This is the first year I’ve forgotten this, and I suppose I’ve got the perfect excuse but, being a mom, I’ve also got the perfect reason to get on my knees and thank the almighty that I’m no longer pwned by the nicotine demon. So to celebrate, however belatedly, I’m going to share how I did it. Oh and yes, I did it WITHOUT GAINING WEIGHT. In fact, I LOST WEIGHT. (This fact is so monumental, it seriously deserved the cap lock.)
First of all, let me tell you that my smoking habit was intense. I began smoking in 1984, when I was just 15 – a freshman in high school. Sad, I know, but true. I worked my way into a pack a day habit by college, which I pretty much maintained until I quit when I was 33 years old. That’s a lot of cigarettes, a lot of time, and a lot of feeling like shit.
I wanted to quit and managed to quit successfully for two years during that period, from when I was 25 until I was 27. At 27, a serious bout of depression led me back to cigarettes and though the depression got better, the addiction stayed steady for five more years.
During those five years I tried quitting many, many, many times. And I just couldn’t do it. I tried cold turkey and behavior modification approaches, always with the same result – I was a fucking wreck, and I continued to smoke.
Nicotine is, unfortunately, an excellent stress management drug. When I was stressed – and working in psychiatry and juvenile justice, when wasn’t I? – I could have a cigarette and the chemical reaction in my brain was all “Aaaahhhhhh.” Nicotine has the damning effect of being both a decent sedative AND a stimulant, so while helping to ease my frazzled neurons, it was also giving me a much needed lift. In fact, smoking would be perfect, if it wasn’t slowly killing me, and possibly those around me, and maybe even you.
I didn’t really want to die or get sick from smoking, so I had to do something. Maybe you’re in that place now and you have to do something too. If so, I offer the steps below and a whole lot of hope that you can get this done.
If I could do it, I’m telling you now, you can.
And I have to say this. I am NOT a doctor or a medical professional. I am a licensed clinical social worker, which qualifies me to do psychotherapy. This is not psychotherapy. Hell, it’s not even advice. My advice? QUIT SMOKING. What follows here is simply the story of how I quit, and why I believe it worked so well. If you want to try this, you will need the blessing and assistance of your own physician, which you should be able to easily obtain.
That said, I offer the following steps to get you off your butts.
Nothing, nothing happens in this world without us being motivated to make it happen. Some of us are motivated by fear, some by rewards. On this occasion, I was motivated by a combination of fear and guilt. I had promised my husband I would quit smoking before our wedding, which was about 4 months away at the time. I love my husband, but my love for him and my own desire to quit really were not enough to get me through the agony of nicotine withdrawal. I needed something drastic to shake me loose, and as life would have it, something drastic did happen. My brother got very, very sick.
My brother was extremely disabled from the time he was 6 months old, and at this point he was in his mid thirties. He had a bout of pneumonia, something that happened to him all to often as he got into his adult years. But this episode had him in intensive care, on a respirator.
I recall going into the hospital to visit him. He wasn’t aware of my presence at all, and I’m glad because I was hysterical at the sight of him. I can still see that alarming image of him, unconscious, on that respirator. I thought myself some special kind of asshole to treat my body the way I did, especially my lungs, when there he was, trapped in a very disabled body, now fighting for his life, having his breath drawn for him by some cold medical appliance.
It was my moment of clarity.
Now, I pray that you don’t have this kind of experience. But I do hope that you have something in your life that gives you that perfect view of reality and gets you motivated to change. Maybe it’s wanting to be around for your kids. Maybe it’s a person you love or simply know who is now fighting cancer. Maybe that will be enough for you to think, hey, I’m really an asshole** for smoking and I’m going to do something about it. For real.
**Calling myself an asshole over and over again helped ratchet up my guilt, which helped me quit. This may not work for you, I realize. No, I don’t think you are an asshole for smoking. I think you are addicted to cigarettes, like I was. Thinking it was my fault, however, helped me realize I could actually do something about it.
Nicotine is a drug, that’s all. When you smoke, you are administering a drug whose only purpose is to get you to keep using it. This realization pissed me off, which was a big help. When I would smoke, leading up to my quit date, I would think “I’m taking a drug that’s going to eventually kill me.” It was the truth, and it helped me de-symbolize what smoking had become to me. It was no longer a comfort, an old friend, a peaceful moment. Smoking was me slowly killing myself. Once I saw it that way, I had to decide that I wanted to live.
Go ahead and get dramatic with yourself in this situation, because you know what? It is a life or death situation. It’s just usually a long-term threat to your life, not an immediate one, which is what makes it such an evil thing. When you want to smoke, you want to smoke NOW and shit. When you get lung cancer or a stroke, you probably get it years from NOW and shit.
If the effects of smoking were immediate, like say, a bullet to the head from a loaded gun, you probably would never smoke.
Aren’t cigarettes a bitch?
It’s human nature that we are more likely to succeed at something when we make a commitment to someone else. It’s all about ego, which I have plenty of, and the need to save face. You can totally use this to your advantage.
That promise I made to my husband really helped me in this regard. I also told everybody – I mean EVERYBODY – that I was quitting smoking. I told all my professional contacts, including my boss, my adolescent clients, parents of my clients, in addition to family, friends, strangers in the grocery store, just to help up the schmuck factor should I try to back out. I also joined NJquitnet.com (terrible name, I know, but a decent online community), so when it was 2am and I was freaking out, there would be a place and people to turn to.
After so many failed attempts at smoking I was desperate, and I understood that my army of supporters and will power alone would be no match for the chemical party smoking threw in my brain and in my body. I needed something to help me fight the chemical fight, not just the mental fight. So I also turned to my physician for help. She was an excellent ally, and worked with me on a plan and gave me a prescription for Wellbutrin. Which brings me to the next ingredient in my quit smoking pie:
You might be thinking, Wellbutrin? Isn’t that an anti-depressant? And you’d be right.
Wellbutrin is a trade name for bupropion, which happens to be the same exact medication as Zyban, which is marketed as an anti-smoking medication. It’s the same shit, only my insurance would cover the anti-depressant and not the anti-smoking drug. Stupid ass insurance companies.
Wellbutrin worked very, very well for me because it does something, and I don’t understand what exactly, but something with the part of your brain that deals with compulsive behavior. My smoking was very compulsive – meaning the second I thought of having a cigarette, I had to have one. It would take an enormous amount of will to NOT have a smoke as soon as I thought about it. I couldn’t do that 10-20 times a day succesfully without serious help.
This here is the key: it is/was my compulsive behavior that was the almighty bitch for me – NOT the nicotine. I was addicted to the nicotine, yes, but once I was able to get help with the behavior part, I could simply titrate the nicotine down until I was off of it.
When you quit with bupropion, you simply take it for about a week while you still smoke. After two days on it, you up the dose. The worst part? This increase in the dose may give you anxiety symptoms – bad ones. Heart palpitations, sweating, racing thoughts, feeling scared. They all happened to me, but, since I knew they were side effects of the medication increase, I just dealt with it. The good part is that those side effects typically only last about a day or so. It was very worth it for me, however uncomfortable I was weathering them for the 24-36 hours they endured.
Then after a week on the medication, on a pre-chosen date, I just stopped. That was it. No agony. No crying. No hysteria. Wellbutrin magically made this compulsion problem disappear for me.
It was, no lie, a fucking miracle.
I stayed on Wellbutrin only short-term, like about 8 weeks total. Why? Well, the drug is not without side effects. One of them is complete ditziness, which got sort of pronounced at around the 8 week mark. Also? It lowers the seizure threshold, meaning you are at higher risk for seizures if you take it. This was almost a deal breaker for me with Wellbutrin until my doctor put it in perspective. She said, hey, seizures won’t usually kill you. Cigarettes will. And, the risk of seizure at the dose you take for this is quite low, certainly much lower than your risk for all kinds of terrible health problems with smoking. Anyway, once I was not smoking for seven weeks, I felt like I had patterned my new non-smoking behavior enough, broken the curse, so to speak, that I was safe to come off it. I did, and all was well.
Wellbutrin was not the only drug I used to quit. I also used badass old nicotine itself.
I did not use “the patch,” and I really don’t know why anyone would. I’m not a physician or any kind of quit smoking expert, per se, but anecdotally I can think of 5-10 people I personally know who tried quitting with the patch, but not a single person who actually quit for more than a few weeks.
For me, smoking was not just about getting nicotine – it was also about having something in my mouth (insert crude joke here). Simple consistent delivery of nicotine through my skin was not going to give me any kind of replacement for smoking behavior, and it wouldn’t come close to mimicing the way I administered nicotine with cigarettes either. With cigarettes you don’t get a steady dose of nicotine for 12 hours, like with the patch. You smoke, you get the hit. The closest thing to this was nicotine gum, which I used with great success, if I do say so myself.
But here’s the catch – I did not use it as directed. I used far less.
When you start to use nicotine gum, they typically tell you to take one every hour, etc. etc. etc. depending on the amount you smoked. My personal opinion is that this system is designed to get you to use too much of it, keeping you on the gum for far too long.
Instead, I waited until I got a nicotine craving. Then I used one piece of gum. My GOD the rush I got was enough to really cement the “nicotine is a drug” concept. One little piece of gum would keep me craving-free for hours – far longer than a cigarette would have. In the beginning I was chewing maybe 3-4 pieces a day. I gradually spread the time out between gum chewing – much easier to do than with cigarettes. Then I stopped craving the gum. I was off it entirely in about six months. For another six months I kept a few pieces on me – just in case. But I never needed them.
Please keep in mind, you should not try nicotine gum of any sort without first talking to your doctor. There are real side effects and long term risks associated with the gum and you need to be aware of them before you make a decision try it as part of your quit plan.
If you have any familiarity with 12 step parlance, you’ll recognize “People, Places, and Things” which really refers to minding the things that trigger your addiction. You can’t avoid all of your triggers, but if you can avoid major ones it can really help.
Back when I was in clubs seeing bands, something I did every weekend for many years back when you could smoke indoors in NYC and NJ, I was constantly smoking. And when I would drink, which wasn’t all that often, I would definitely be smoking. So for about a year I avoided both clubs and alcohol, with the exception of my wedding, wherein I did drink many Cosmopolitans. But, I didn’t smoke. I didn’t miss alcohol, really, and I didn’t miss the clubs much either. In fact, I got the side bonus of my tinnitus getting better. And really, not smoking felt so good after the first weeks I just became more and more committed to it.
The best piece of advice I ever got about quitting smoking came from someone unspeakably dear to me who has been in recovery from alcoholism/drug addiction for over 25 years. When I asked him how he did it, he had a very simple, elegant explanation.
He said, If I fight against my urge to drink, I’m going to lose. The only way I can win is to not fight. I just have to get out of the ring.
Get out of the ring.
How does one get out of the ring, exactly? Your best bet is distraction. Think about something else. It needs to be something that can really engage you. For me? I couldn’t really type or play guitar while smoking, so those things helped. I wrote a lot (I had a blog in 1998, and I updated that bitch by hand, yo). There are plenty of activities you can’t very satisfactorily do with one hand. Find something that you really get lost in. Be creative. Or dirty, perhaps. Hey, whatever it takes.
Who was it, Winston Churchill? He said If you’re going through hell, keep going. Well, same thing here. There will be rough times, and you must keep going. The longer you go, the easier it gets. It’s that simple. Your mind needs a little time to practice the new behavior, to carve new neural paths in your grey matter, for real. Keep practicing and never give up.
To help keep me going, I kept reviewing the benefits of quitting smoking:
When smokers quit — What are the benefits over time? (from the American Cancer Society)
- 20 minutes after quitting: Your heart rate and blood pressure drops. (Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification, Mahmud, A, Feely, J. 2003. Hypertension:41:183.)
- 12 hours after quitting: The carbon monoxide level in your blood drops to normal. (US Surgeon General’s Report, 1988, p. 202)
- 2 weeks to 3 months after quitting: Your circulation improves and your lung function increases. (US Surgeon General’s Report, 1990, pp.193, 194,196, 285, 323)
- 1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection. (US Surgeon General’s Report, 1990, pp. 285-287, 304)
- 1 year after quitting: The excess risk of coronary heart disease is half that of a smoker’s. (US Surgeon General’s Report, 1990, p. vi)
- 5 years after quitting: Your stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting. (US Surgeon General’s Report, 1990, p. vi)
- 10 years after quitting: The lung cancer death rate is about half that of a continuing smoker’s. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease, too. (US Surgeon General’s Report, 1990, pp. vi, 131, 148, 152, 155, 164,166)
- 15 years after quitting: The risk of coronary heart disease is the same as a non-smoker’s. (US Surgeon General’s Report, 1990, p. vi)
That’s a pretty good deal, if you ask me. Nevermind the obvious things like all that damn money you don’t have to spend on cigarettes in the first place. Another good list of benefits is here and there’s a mention of how quitting helps increase your fertility, for those of you struggling to conceive. I won’t even mention smoking and pregnancy, which you already know is bad news. If you’re thinking of quitting when you get pregnant, then consider that quitting might help you get pregnant faster.
It’s good to find ways to reward yourself for quitting. Setting your smokes money aside for awhile and using it on something you enjoy is not a bad technique – I did this back when cigarettes were in the $5-6 a pack range and stuck the money in a jar on top of the refrigerator every day. Seeing all that cash accumulate really did help keep me smoke free.
Here’s my quit plan, in a nutshell.
So, that’s it. That’s how I did it, and I’m certain that you can do it too, if not by following my quit plan, then by devising one that will work even better for you.
When I was in therapy myself during most of my twenties, I often lamented my inability to quit. I felt like a major asshole, a loser, a weak minded git for being unable to stop. I was afraid and I felt out of control. My therapist, who said many helpful things to me over the years said probably the most powerful thing to me of all at this time. He simply said, “When you’re ready, you’ll quit.”
He was right.
So I say that to you now. If you want to quit and have tried and failed, please, please don’t think all is lost. Don’t believe you can’t do it. Just know that you’ll do it when you’re ready.
And, you will know when that is.
I know, as a woman who gave birth to twins six months ago and is still hanging onto way too much preggers weight, that’s not a small consideration.
I did lose weight, that is no lie, in the weeks and months after I quit. I lost about ten pounds. The reason is twofold. First and foremost, I worked out. This was something I did for a short time in the months leading up to my wedding because, hey, I was having a wedding and I needed to fit in my wedding dress. Talk about motivation. And there’s no doubt that working out also helped me feel the benefits of quitting much sooner – I was rapidly increasing my physical abilities while also lowering my stress, well, as much as one can lower one’s stress in the months leading up to a wedding. I can just imagine how batshit I would have been if I didn’t have that outlet, given the insanity of quitting smoking in the months before my wedding.
The reason my weight loss was at all possible, I’m certain, is because I did not replace cigarettes with food. And the only reason I didn’t replace cigarettes with food is because I didn’t have that compulsive behavior problem, thanks to the Wellbutrin, and because I used the nicotine gum when I had cravings.
Given the same techniques in your unique context, please be advised your mileage may vary.
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A note of caution: If you are currently pregnant, this story is one you may want to wait and read after you’ve delivered. By reading further you agree that neither the author nor Wiser Mom nor anyone connected with the blog may be held liable for contact PTSD symptoms, nightmares, hysteria or other undesirable effects incurred from reading the following account.
There is a huge backstory leading up to this, some of it was documented in real time on this blog. But for those of you who need a refresher or are new to the story, this post drops into it when Myg was exactly 35 weeks pregnant. She had been in the hospital for a week with mild preeclampsia after a third trimester filled with ER visits and two other hospital stays—one overnight and one five days long. Unexpectedly—we had been told a few hours earlier that it would be another week—the OBGYN team decided on the morning of week 34 and 6 days that it would be best to induce labor immediately and not let Myg’s condition deteriorate. The babies were healthy in utero and would most likely be fine after delivery, whereas Myg would only get sicker and not begin to recover until afterward. We catch up with our protagonists at 4 a.m., January 22, 2009:
Myg is being rolled into the operating room for delivery and I am right behind her in disposable scrubs and surgical mask. Twins are considered high risk, so all twin deliveries are done in the OR, just in case. A Pitocin drip to induce labor was started about nine hours earlier, and she was given an epidural at 11:30 p.m. that worked just as you’d want—she has gone through transition smoothly with not too much discomfort and is now 9 cm dilated. She has also been given magnesium sulfate—known in the medical parlance as “mag”—to control her preeclampsia symptoms. Mag will keep her blood pressure, already high and spiky, from getting out of control. It also has a host of nasty side effects, including the possibility of hot flashes that some recipients have said feel as if you’re burning from the insides and your eyeballs are melting. The other effect is that it is a powerful muscle relaxant. Exactly what you don’t want when you’re about to deliver a couple of babies.
The last belly pic
My previous experience with operating rooms is that they are cold. But as Myg is wheeled into the OR to deliver our twins, I don’t notice the temperature. I notice the table. The scene is like something out of David Cronenberg’s Dead Ringers, which should put a chill into anyone who has seen the film and anyone who doesn’t get the reference should be thankful they don’t. The operating/delivery table has padded swivel legs and stirrups that my memory says are stainless steel, but that sounds unnecessarily cruel, maybe they were just worn leather. Like the straps you’d find on an electric chair in Texas. Overhead, a large array of klieg lights dangle at the end of an articulated arm looking oddly like a female mantis with the severed head of her lover held in the caress of her deadly mandibles. A wall made of monitors and other machines that go bing! stacked about twelve-high is teetering dangerously close to the table. The only man in the 11-person delivery team sits next to them in oversized glasses holding a clipboard or notebook or tablet computer. He is unmistakably Hell’s bookkeeper. Other odd apparatus are arranged about the room but my attention is focused on Myg as she is helped onto the table, still strapped in, and her feet are arranged in the stirrups and a flimsy sheet is arranged over her.
Once again, Myg explains to the doctor and the nurses that we’ve had no birthing classes, no Lamaze, nothing, because she’s been on bedrest since week 26 and no one at the hospital could find any resources that would come to the house, other than the midwife/dula team we can’t afford because I’m in grad school and Myg’s on disability and frankly, we’re as poor as we’ve ever been and thought that it was the best time to have twins because we plan everything and it always works out—just not how we plan it, or we would have gone to birth classes in the second trimester when Myg felt well enough to go on vacation—therefore, we’ve only read about delivery. Yes, in a book. Oh, and online, too. (This works for me, give me a book with instructions and I’m golden, not so much for Myg, and she’s the one that has to do it, so I’m nervous but keeping a good attitude.) No, Myg hasn’t watched A Baby Story, because she’s terrified. (Five months after delivery she still can’t bring herself to watch it.) We need some coaching, please. The staff says not to worry and explains that when she feels a contraction she needs to take a deep breath and hold it and when they tell her to push she needs to push like she’s shitting a watermelon and keep pushing as long as she can—they’ll count to ten—and then she can relax until she feels the next contraction or like she wants to push.
And that’s it. Ready for your skydive/bungee jump/moon launch? Good, me too.
I sit at my wife’s head, looking down at the part in her hair. I want to kiss it, but my mouth is covered by the mask. The delivery team sees a contraction begin on the monitors and they all say in disjointed unison like a girls’ rugby scrum: take a deep breath, now PUSH, hold it keep pushing don’t let it out one … two… three… four… don’t let it out keep pushing and Myg lets it out and stops pushing around seven.
She looks at me with a holy shit expression that says this is not fun I do not want to do this but I have no choice oh fuck…
I whisper sweetly into her ear and she tries to relax for the brief couple of minutes before the next contraction. I try to say encouraging things. I hold her hand. I feed her ice chips. And it goes on and on and on. Myg gets tireder and tireder but continues to labor. Labor. The word in its most radical form. She labors.
Of all the things I am in relationship to Myg, at this moment I am nothing but an ice machine.
I am an ice machine.
I am the best ice machine.
That is all.
The iceman. I’m good with a Styrofoam cup and chips of ice. See? I can get them out of the cup and put them into your mouth where they melt and soothe and if I knew where the crushed ice machine was I could refill the cup all by myself. And when you stop to think about it, what else does one need in life but some ice chips? All your needs can be met with a foam cup full of ice.
With every contraction the routine is the same. It goes on and on. The mag has made it next to impossible. Myg gets tired. I just want to sleep, she says. Can someone else take over for a bit? She tries not to think about the fact that this is Baby A, nicknamed “Doot” in utero, and that after she gets this done she has to do it all over again for Baby B, “Bing.” She’s ready to be a mother. Or, she really wants to be done with pregnancy and wants these kids out of her, at least.
The team all cheer her on with every contraction and it’s annoying. If it’s annoying to me, I know it has to be irritating her. Myg, amazingly diplomatic, says, okay, I only want one of you to count. She points to the resident. You. You get to count. Everyone else has to be quiet.
I know inside she is thinking along the lines of: Shut up, you dumb fucks, I know the routine now. It’s not complicated. I hold my breath, I push for an eternity, the kid doesn’t budge. I do it again. You had to go to med school for this? If you have any suggestions besides “push” and demonstrating that you watched enough Sesame Street to count to ten as a group, then please enlighten me. Otherwise, I’m coming off this table and there will be carnage that will require a SWAT team and weeks of forensic analysis.
The diplomatic tack works for about two more contractions. But now it’s clear that Doot is moving, they can see his head, everyone is more excited and seems certain that he is about to come out on the next push. Everyone but the bookkeeper starts shouting “encouragement” again. Myg looks at me and says, we’re done with this. I nod and agree. If we want more children, adoption, as we have often discussed, will be the way to go. We’re finished with the biological imperative. The Team tells me to come around to look from their angle. Doot is nearly here.
I walk around and look up between my wife’s legs at the mystery of mysteries, the holy of holies, the place I like to think is my playground and not anything that involves spectators. I’m a guy, I love sex. But I’m also a pretty waspy guy who was brought up right and went to church as a kid. Sex works best in the bedroom. Without a team of specialists with instruments and years of expensive training. And I know, I know, this is not sex—this is the end result of sex when all the pieces of the biological Rube Goldberg contraption fall into place. And we’re in a hospital. Everything is sterile and clinical and has nothing to do with my sex life with my wife and OHMYGODWHATTHEFUCKISTHATTHING? An angry red maw of engorged flesh has replaced Myg’s lady parts, and it’s being stretched wide by a red playground ball with wet black hair that I can just see a crescent of—no way is that thing coming out of that hole. It’s not happening. Meanwhile, the Team is grinning at me like they’ve just shown me the fountain of youth.
I admit, the miracle of life and childbirth are beautiful things, perhaps the essence of beauty—but it’s this as a concept, as an abstract. All the great and mysterious things about the universe, they are summed up by these moments but only metaphorically. In reality, it’s a gruesome visceral experience. It’s difficult, painful, and fraught with a lot of danger that modern hygiene and medical technology have mitigated but not eliminated. Sure, I love the primality. Put someone else’s spouse there and I’ll come in with a camera crew and wax eloquent like David Attenborough and win the Palme d’Or. But when it’s my beloved and my immanent offspring, I’d take no pain, no blood, and no risk if it were offered. Something antiseptic and external—stork delivery, even. I back away from the Team trying to appear nonchalant and not like I’m retreating from the mob at Bedlam.
Back around at Myg’s head, I smile and hold her hand. I lie. Just a couple of more pushes, babe. He’s almost here.
Myg pushes again. She has stopped paying attention to the cheering section. They’re doing it wrong. She has figured out that when she lets her breath out during the contractions and pushes not just with her stomach and bowel muscles, but even with her chest and neck, that they scream more encouragement and the baby moves better.
And I am also happily wrong. In just a few pushes, Doot arrives at 6:52 a.m. and gives a little cry as they hold him up and I look at my son—a weird red lizard dripping stringy white mucous, with what appears to be a version of Winston Churchill’s head run through a Play-Doh Fun Factory. They put him on the heat table and begin wiping him off and sticking his feet onto ink pads and making footprints. They put him in Myg’s arms for just a second and she is overjoyed and I’m choked up and she cries a little and then they take him back to the table where they swaddle him up and at the same time the doc is telling Myg she needs to get ready for round two.
Doot chilling on the warming table, 30 minutes old
They break Bing’s water and ask Myg to give a push just to get him down into position. Myg is in a daze. She has successfully delivered a baby. She knows she can do it again, how about in 18 months? It’s about 7 a.m. The doc has her hand inside Myg, a contraction comes and Myg pushes and I see a slight look of surprise on the doctor’s face. I felt the cord, she says. She looks up at the monitor and says, okay, Myg just give me one more push, and I’m going to see if I can get his head into position. Myg pushes. No, I feel the cord. The doctor shakes her head and she gives some unseen unheard command.
The operating room, already burgeoning with attention to Doot’s birth, blossoms. The 11-person team moves in complex synchronous harmony about twice as fast as they had been. What’s going on? Myg asks. The anesthesiologist begins turning dials and jams a mask over her face. Are we doing a C? There is worry in her voice and I realize something has happened, something with Bing and they’re going to do an emergency C-section.
A nurse flags my attention calling me “Dad” and it seems strange but I know it’s me. Follow me, Dad. She leads me out into the hallway with some rehearsed reason for why I can no longer stay in the room with Myg. You might faint, she says. Wait here. She points to a spot on the carpet in front of the delivery OR doors and leaves me there. I do as I’m told. After five minutes I begin pacing. I am worried but have faith in the Team that the C-section will go smoothly. I call my mother and tell her about the arrival of her grandson and let her know that the second is on his way. The doors slide apart and someone notices me as he moves past carrying arcane medical devices. The second baby is out, he says. I am relieved. He doesn’t say anything about Bing’s condition. I assume everything is fine. A manx cat appears pushing a small cart bearing Doot. The cat speaks. Do you want to come with me to the nursery? Apparently, it’s a nurse.
It’s not until hours later that I understand that when Myg pushed and the doctor felt Bing’s umbilical cord that it was a fairly rare and serious situation known as a prolapsed cord. The monitors showed his heart rate had dramatically dropped to 80 bpm when Myg had pushed. He would not have survived a vaginal delivery. Now I go cold when I write those words. On that day, I was supremely confident and ecstatic.
What they did not tell me and part of the reason I was in the hall during the emergency C-section is that because Bing’s heartrate was dropping they had to open Myg up immediately. As in before the anesthesia was in full effect. Myg apologized later to the surgical team for all the screaming. I didn’t hear a thing two sets of doors away in the hallway. Are you numb? The doc asked. You’re numb enough. Myg says the cut wasn’t painful, but that having her guts moved out of the way in a hurry was like having a wild animal pawing at her insides. The doctor knew she’d survive that trauma okay—the important thing was to get the baby out.
Bing joins his brother in the nursery after escaping the womb via a window
Both of our sons arrived healthy and whole. Neither required any time in the NICU. They even made it through the bilirubin spike without needing light table treatment. As of this writing, they’ve quadrupled their birth weights. They smile and laugh and roll over. They grab hold of fingers and toys and eat solid-er food. They’re delighted to see me every time I enter the room. Because of my wonderful sons, these five sleepless months full of diaper changes and spit up and two babies crying in tandem at a 4 a.m. that lasts forever have been the greatest five months of my life.
Husband becomes Dad
First snuggle
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I swore I wasn’t going to blog the Jon & Kate divorce. Then I read this:
Jon and Kate Plus Health Care – Would better insurance have saved this marriage?
If the Gosselins, whose efforts to raise eight kids have been chronicled over five seasons on cable television, had enjoyed, and availed themselves of, ready access to IVF — the most sophisticated, controlled and expensive form of fertility treatment — they almost certainly would not have had six children at once. “Just one more baby,” is how Kate described their goal after twins. Without the added stress of sextuplets, they would have had a fighting chance at not fighting nearly as much as they did.
That’s a quote from Liza Mundy, the brilliant author of Everything Conceivable: How Assisted Reproduction Is Changing Men, Women and the World
She’s right, of course. But being right, fair, or rational will not spare her or anyone from the wrath of the insensitive and uninformed internet. I’d love to take on her trolls, which she does herself with aplomb and no small amount of tact. If you really want to get pissed off, please click through that there link and steel yourself for a genuine SOMEONE IS WRONG ON THE INTERNET experience.
Otherwise, I’ll sum up the troll talking points in my favorite way – with bullets! Alas, not real ones.
I don’t need to argue all of these points, because Mundy does it so much better, and much more level headed than I can. I will impose the moral fine on your troll asses though. For all ya’ll out there who think fertility treatments are an elective, selfish vanity procedure, I require that you surrender your ovaries or testicles before commenting on any more infertility related articles. And, I’m putting all your children up for adoption.
How’s that feel?
Okay, now you’re allowed to comment again.
And another thing, about the poor Gosselins? They were SUCH ASSHOLES to each other, every damned episode, how did anyone not see a divorce coming? Seriously.
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Okay, so it took me until just now to find out it actually IS National Infertility Awareness Week, but now that I DO know, I want you to know too. Because before I got pregnant, I could not get pregnant. And I haven’t ever known an agony quite like that one. I’ve known agony, sure, but infertility agony is visceral, existential and beyond explaining to the fertile.
My infertility story had a happy ending. I’m hoping, if you’re dealing with infertility, one way or another your story will too. In fact, I’m certain that eventually it will, however you decide to persevere.
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Let me begin this way:
I am an ass.
Now, some history.
If you’ve read much of this blog before, then you may already know that I had IVF in order to get pregnant, and maybe you know that’s because I have blocked fallopian tubes after an ectopic pregnancy (naturally conceived) I had last year. You might even know that I’ve been trying to get pregnant since January 2005.
And you may recall me saying that infertility sucks balls. Before infertility, I was the kind of person who’d look at someone undergoing treatment like IVF and say, “there are so many kids already born who need homes – why would anyone go through IVF?” Oh yes, I did say that. And I meant it, working with a lot of homeless kids in shelters at the time. I mentally stab myself in the leg with a fork for that now.
So. For the past 3+ years I have been as avoidant of any baby-related social event as I could be. I was extra specially hyper avoidant of the dreaded friend/extended family member’s baby shower. Just. Couldn’t. Do. It.
Because I have an ego, early in my pregnancy I’d made an announcement to those I thought needed to hear it – no baby shower! I did not want to ask my family and friends to participate in an event I had willfully (maybe even spitefully) ignored for the last 3+ years of my life. I just couldn’t face those people or look at how poorly I’d handled my feelings over being infertile in the social context. So more avoidance had been my plan.
How was I going to get the hundreds, or perhaps thousands of dollars worth of gear I was going to need? Hell, I thought these babies would be more like puppies. A cardboard box and some sheets would do, right? They don’t do anything but eat and sleep for awhile – how much could they possibly need? (Hey, I might be 39 years old but what did do I know about babies?)
Six weeks ago or so, someone let it slip that a surprise shower was in the works. I won’t say who. Actually, no less than five someones let it slip. I was told out of kindness, so I would be able to either stop it or prepare myself for it. When I found out, I cried. I was angry, frustrated, a little humiliated and damn it, here was another thing about this pregnancy that felt out of control.
Then I mentally slapped myself. Because I suddenly understood clearly that this baby shower wasn’t about me, and this was something I was going to have to get used to if I was going to be a Mom.
See, the masterminds of the dreaded affair were my stepmother and her daughter, my stepsister, “A”. A has been battling cancer for almost five years. She’s been recovering most recently from lung surgery ever since April. She is still on oxygen and has dialysis three days a week (from the damage previous cancer treatment has done to her kidneys).
There is nothing – nothing – like a loved one’s cancer to make you understand what is and what is not a big deal in life. My ego? SO not a big deal. Even though I couldn’t see that at first, my stepmom could. And she understood that my babies needed stuff, and that I was going to need help no matter how reluctant I am to admit it or accept it.
While my stepmom was booking the restaurant and paying the bills, A was in charge of all the details – from the invitations to the decorations to the shower games. She put that shower at the center of her free time for over a month, painting custom made centerpieces and hand rolling adorable little favors between dialysis and schlepping into the city for experimental chemo treatment. “I loved doing it,” she said. I know she did, too.
If that realization wasn’t humbling enough, all of my extended family came out. All of them – even those whose RSVPs I never returned when they had showers of their own, to whom I’d never bothered to send a card or gift of acknowledgment of any kind when their own kids were born. They were all there and they outfitted my two kids better than NASA equips the shuttle.
I told you I am an ass. Did you think I was kidding?
To top it all off, would you believe that it was A’s best day since her surgery in April? She didn’t use her oxygen for most of the event, despite the fact that she was running around, handling gifts and guests and wait staff. I haven’t seen her with that kind of energy since before her operation.
When I stood up to thank everyone, I cried. I’ve done my share of crying over the last few years, but somehow these pregnancy tears are different. Yeah, I still get those snot filled migraine styled headaches when it goes on for too long. But I’m not in mental anquish when the tears come.
I think I’m just experiencing the literal awesomeness of what the whole thing means.
You know, the life cycle and the continuation of our very existence. The way love in a family can transcend any one member’s social transgressions and promote the healing of a bitter past and maybe thensome.
That kind of thing.
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Do you know what’s weird?
Waking up at 2am to pee, getting back in bed after you struggle to make room next to the dog, and staring wide eyed at the shadows on the ceiling in stark realization that your life is ending. I imagine if you knew the approximate date of your death it would feel somewhat like this. Only, granted, much worse.
This is me circa 2am, most nights.
And this is me in general: nary a good thing can happen without a moment of intense grief for what’s lost.
But to step back a bit, truth is I have been done with this part of my life for awhile now. Seriously, good bye. The last five years have been mostly too much work that was too hard combined with too much cancer and death in my family. Very little of the real work of my life got done because all I could do was trudge through another day of just making sure, in all seriousness, that nobody on my professional watch was going to kill themselves or get beaten, and if I wasn’t the world’s most miraculous therapist, so be it. Happily, everybody was left standing by the end of my clinical tenure this past March. Yeah I know. Go, me.
From January 2005 I’ve been trying to get pregnant, knowing full well that there was no way my body would bring forth a baby while I was under that kind of stress. It looks as though science is backing me on this one – there’s a study that says stress plays a role in up to 30% of infertility cases. To prove my point, about six months after my father-in-law died I got pregnant. I thought, yep, see, now that I’m not in acute grief I can conceive.
But just to keep me in the theme of depressing life shit, my pregnancy was ectopic. Stuck on the off-ramp, so to speak. And for a further dose of cruel poetic irony, I had to be treated with Methotraxate – a popular cancer drug – to end the pregnancy, otherwise it ran the risk of ending me.
With the ectopic pregnancy so went my chances for any kind of natural conception. And then it was onto the IVF ordeal, which began in July of 2007 and finally worked in June 2008. That was – holy crap in a handbasket – five months ago.
In any case, you know what I have say to the past five years of my life? SEE YOU IN HELL, BITCHES!
Sitting here thinking about all of this, on the eve of the most important election of my lifetime, I am realizing that if life-as-I-know-it changes as radically as I believe it will, I’m very much okay with that.
And so are Doot and Bing.
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Week 18 – which I haven’t posted yet (I’m working on it!) had one full day of “Oh My God I’m Gonna Die” agony. It had to do with that gross extra breast tissue under my arm (which I go on about in Week 17.) I actually went to my doctor’s office and saw the nurse practitioner (NP) for it. This was the second time I had this armpit evaluated. The first was back in April before I was pregnant, because it was swollen and it hurt. My previous OB/GYN announced it was nothing to worry about, and then he proceeded to not worry about it. No follow up. Fucker. Another reason I’m glad I changed docs.
This lump under my right arm sometimes swells up and really, really hurts. It used to happen during my period, and there was a smaller, harder more painful lump inside. Since getting pregnant, it has been fairly consistently swollen, and now there are two smaller, harder lumps in there which last week after examination, the NP stated were palpable nodes. Lymph nodes. I was referred that day for an ultrasound on my armpit to take a look. (As an aside, I must note that when I used the medical term for armpit (axillary) with the scheduling person at the Radiology department she asked, “What’s that?” How confidence inspiring, really.)
“If there’s an issue with the lymph nodes we’ll follow it. If they get worse, they may have to come out, though I’m not expecting that.”
Right.
Like a lot of people, I have a whole ton of cancer in my family so talk of swollen lymph nodes without any obvious infection symptoms made me go pale. Tell me not to worry all you want. It just. doesn’t. matter.
I had the ultrasound and the tech said, “Okay, place your finger exactly on the spot where you think there’s a lymph node.” I found the spot – it’s the most painful place on my body, so not terribly hard to miss. She put the machine over it. “I see nothing – no nodes.” We looked all over that engorged lump of fatty tissue and still, no lymph nodes.
“What is it then?” I asked.
“I have no idea” she said. Comforting, right?
Apparently there was no difference between the larger lump of fleshy tissue and the harder smaller lumps inside of it, according to the ultrasound. It was all the same gross stuff. The tech left the room and showed it to the doctor, and he said “I dunno either.” She said it doesn’t look like breast tissue either – just some other fatty tissue.
“It doesn’t look bad,” she said. “You look upset! Don’t be upset! There’s nothing scary we’re seeing here. Just tissue.”
Okay, great. That’s easy for someone to say who has one iota of medical or biological know-how. I do not. Strange fatty tissue masses appearing randomly in my body do not make me happy.
I’m glad nobody is worried, sure. But I have to ask – why don’t the doctors want to find out what it is? Our medical system is mind boggling with its inexplicably bad communication with patients. If you had random fatty lumps growing in your body, even if they were not cancerous nor in any way dangerous, would you not have the curiosity to find out how the hell they got there?
I had a massage a few weeks ago and the massage therapist felt those two little hard lumps and said, “you have a couple of serious knots in here that are causing you this shoulder pain.” I let her work on them (and it hurt so fucking bad I can’t even describe it), and my nagging persistent shoulder pain did indeed decrease. But not the armpit pain.
So when the Nurse Practitioner announced they were nodes, I wasn’t happy. All kinds of things went through my mind.
I really wish I’d had the wherewithall to ask a ton of questions but I was so anxious my mind was blank. “What could this mean? What are the possible causes of this? How likely are they? What are some common reasons this could happen?” Etc, etc, etc. I didn’t ask any of those, and I take responsibility for that. But the nurse said virtually nothing other than, “Go get it looked at.”
So in the hours before I could get the ultrasound I combed the internet. Mistake! Why? Cancer, cancer, cancer. That’s why. Try googling “swollen lymph node” and “axillary” or “armpit” and see what you get. Lymphoma, breast cancer, Leukemia. These are not the things you should be reading about at 18 weeks pregnant if you don’t absolutely need to. Especially if you are like me, and in your immdediate family there’s one person who’s had breast cancer before age 40 and another who had Leukemia before age 30.
When I’m anxious I NEED information. Need it. But without doubt it would have been better to get real information from a real medical professional, instead of from the internet. Probably better to call the doctor back and ask the questions. Maybe next time I’ll be smart and do that.
Today I’m not worried. The lump has ceased to be painful for now, and what testing I’ve had doesn’t indicate any reason to worry. I know that elevated levels of stress are not good for the little guys inside and I’ve nothing to hang my worry on anyway.
A mammogram would totally rule out any scary cancer related stuff here, but obviously I can’t get that now. I had a baseline done when I was 37 because as I said, I have a lot of cancer in my family. It was perfectly normal. My breast exam last week was perfectly normal too.
When it’s all said and done I’ll get another mammogram anyway, given that some studies have shown an increased risk of breast cancer among women undergoing IVF treatment. But I’m not going to worry about it. No, really.
I’ve got maybe 19 weeks to go now before the little ones are here, and it seems if I’d like to worry, there are a great many other worries to choose from.
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