Four Years Later...

This Saturday is the four year anniversary of my ectopic pregnancy. For some reason the anniversary is particularly raw for me this year. I have theories on why that is, but I think a lot of it has to do with our ability as nurses to think "things could always be worse". We minimize our own struggles because we see so much pain and struggle every day. Our situation can't really be that bad. I did this a lot in the days, weeks, and months after my ectopic. I explained it away, and told myself and anyone I talked to that it happened for a reason.  A couple months later, my hair was falling out, I lost some of the hearing in my left ear (it has never come back, and they never found a cause), and my SVT (abnormal heart rhythm) was flaring up regularly. I'm certain that the mind-body connection and the emotional stress contributed to these things. I would say it was at least a full year before I really dealt with things emotionally... I would also say that I continue to deal with this loss and I likely always will, as anyone in my situation does.

Here is what happened in 2010 in my words:
I found out last week that I was pregnant. We have two beautiful, amazing children. Lately, we have been enjoying the fact that our youngest is becoming more and more independent at 4 years old. We hadn't planned on a third, but apparently that plan was going to change. I selfishly thought about the things that I would put on hold for a few years. No triathlons in 2011... "Ok, I'll shoot for 140.6 when I turn 40" (that would give me 6 years). No more disaster medical team.... "Ok, that can be put on hold. I can still attend the trainings and keep up my skills." "We can't afford three kids in childcare...Ok, we will revise our schedules to eliminate before and aftercare for the two older kids." In a week, I had come up with a potential plan. It was a rough week. A lot of crying. A lot of guilt, for being shocked by this pregnancy when I know there are so many people who are trying so hard to have children. I felt tired, and nauseated, but tried to push through. Of course I started to become attached to this new little one.

On Monday, I started to feel uncomfortable. Pregnancy can make you uncomfortable, so I prescribed myself a dose of "Suck it up". Hours later, the pain was intense. (It should have been a sign when I put my jacket on the floor of my office and lay down for a few minutes trying to get comfortable). Eventually, my OB sent me to the ER. I was an emotional and physical disaster. I always feel fortunate to work with such amazing people, but even more fortunate to experience their skill and compassion when I needed it most. It took a ridiculous amount of pain medicine to get me comfortable, but they did. Tests showed that the pregnancy was ectopic (it was taking place in the fallopian tube rather than the uterus). This can be life-threatening, but thankfully they caught it in time. They were able to give me medicine and avoid surgery. It took an overnight stay to get the pain and nausea under control. The medicine (methotrexate) is a chemotherapy agent. It stays in my system for over a week, and causes nausea and other symptoms. I still have a fair amount of discomfort, but it gets a little better every day.

Three days later, I don't think I've begun to process it all. I went from thinking about how life would change with a baby, to not being pregnant in a week. I know I need to grieve, but I think I am too emotionally exhausted to be there yet. I do know that I don't have control over when it will happen, and just have to let things come as they may. 

Above all, I am thankful for the love of my family and friends. Tommy has taken time off to take care of me, the kids have kept their fighting to a minimum, and everyone has been so wonderful with their offers for help. I couldn't ask for more. I am sure there is some lesson in all of this for us, I just don't see it yet.

Four years later, I still haven't figured out that lesson. What I do realize and appreciate so much more is the loss experienced by those who lose a pregnancy. While Tommy and I weren't trying for a third child, it was still a loss, and it catches me off guard at unexpected times. Perhaps the lesson is that the loss has to be acknowledged. Sometimes we have to sit with it, no matter how hard that is, and let it be felt. And we don't always have to live in a world of "could be worse" and "things happen for a reason". Sometimes, things can just suck for a while... and then we have to pick up and give thanks for the amazing things that balance out the loss.

Sometimes You CAN Ask for Help

Those who know me well know I don't keep much to myself....

I do worry that sometimes I over share, but then I get positive feedback on a blog post from an unexpected source. My hope in sharing this story is that I explain the past 6 months of my life and perhaps help someone along the way. This May, I had the opportunity to hear Brene Brown speak about vulnerability. In a room full of 6,000+ nurses, I felt like she was speaking to me. I have often tried to "do it all", and do it on my own....without asking for help or admitting to vulnerabilities. Tommy and my family have always been an unwavering source of support for my endeavors (whether it was Hurricane Katrina relief, or school, or professional endeavors), but I never really relinquished control or asked for help. While I have a longtime love of Wonder Woman, when people have jokingly called me that I think to myself "if only they knew what a mess I can be". After hearing Brene Brown, I felt permission to share more of my vulnerabilities and to acknowledge that I am by no means perfect. 

Yes I do a lot...and am involved in a lot, but so many times I feel like I have dropped a ball. One of my greatest challenges is feeling like a good and supportive friend to some of the amazing women in my life... I don't think I show some of them nearly enough how important they are to me. This resulted this Spring in the loss of a friendship that I had always considered dear. 

This February, I tried an antidepressant (amitriptyline) to treat my migraines. I asked my headache specialist what the side effects were if I wasn't depressed. It turns out that irritability is the big issue. I made it about a week before my co-worker held an intervention. I was downright nasty at times on the med. (Some might say it wasn't the med...)

The following month, I developed really significant PMS symptoms. I have had hormone issues before, but I felt downright depressed. Every month, it got a little worse, until I had 3-4 days of feeling clinically depressed  and anxious every month. By July, I was feeling very distraught about it. While depression carries with it a stigma for some people, I felt surprisingly unthreatened by the idea of asking for help. I just wanted help. I did research and realized it was probably Pre-Menstrual Dysphoric Disorder (PMDD). Literally PMS on crack. Over the course of a few days, I melted down to Tommy and my family, and made an appointment with my MD. I went into the appointment with the goal of describing my symptoms, but not self-diagnosing. My MD is very well respected among staff in the hospital, but I have never loved her more than I did that day. She immediately said "I think it is PMDD". I cried with relief when she said "You have been trying to deal with this for months..do you want to try a medication?" I'm not a fan of throwing medications at every problem, but I knew that is what I needed. Zoloft (sertraline) is indicated for the treatment of PMDD, so we went with that. She told me that it wouldn't eliminate the problem, but significantly improve my threshold for dealing with the symptoms. When I thanked her profusely for her help, she said "You did the hard work by showing up, I just wrote the prescription." This is my doctor but also a colleague whose patients I care for on a regular basis. To leave there feeling just as competent and respected as I did when I walked in meant the world to me. 

One month later, I weathered my hormones in much better fashion. I know that I am getting off easy in comparison to people who struggle with depression every day of the month. I also know that there may be more difficult months ahead. This will certainly be a journey, but being able to ask for help was a HUGE first step. A pivotal moment for me came this week when a patient's family member asked "Are you always this perky?" I'm glad to have my perkiness back. 

This concludes my oversharing, but if you are one of those "balls" I dropped along the way, or one of the people who put up with me through some of my least desirable moments, I'm Sorry, and THANK YOU for sticking around. 

"I don't know how you do it"

This is an absolutely true story. Yesterday, I was walking through the hospital lobby in my lab coat and stethoscope when a man in his 30s started walking next to me. Out of the blue, he said "I don't know how you all do this. I could never do it."
Me "You mean work in a hospital?"
Him "Yes. My Mom died here a month ago and now my girlfriend is having surgery. I know you all save lives and stuff, but how do you deal with all the other stuff?"
Me "Everyone has something they are really good at. For a lot of us who work here, this is the thing we are really good at"
Him "I still don't know how you do it"
Me "There are days this job is really, really hard... but then there are those moments when you know that you have helped someone, either by saving their life or easing their suffering. You carry those moments that touch you and rejuvenate you forward, to help you deal with the bad days."
Him "That makes sense, but I still don't know how you do it"

We talked for maybe a moment more, and then went our separate ways. Obviously he was a young man who needed someone to talk to. As I read all the Nurses Day posts this morning, I thought of my conversation. Being a nurse is a calling. It can be thankless, and exhausting, and emotional... but at the end of the day, week, or month, you have absolutely touched someone, and made someone's life easier.


Happy Nurses Day!

Key to Keys 2014

It is hard to put the experience that is Key to Keys into words. Take 8 days of the best summer camp you could ever go to, with amazing friends, and add more laughter and tears than you could imaging packing into that time frame. Everyone on the journey has a story. This year we had three volunteer drivers, all with connections to cancer, the Ulman staffers who all have their own stories, and 25 riders. There were survivors, and many who had lost loved ones to cancer. Some days we laughed a lot... using levity to get through the day. Other days, we would ride in our SUVs and someone would say to a rider or support staff "tell me your story". You cannot hear the story of someone losing a child, spouse, parent, or loved one to cancer, and not be moved. Every day, I was surrounded by people who picked up the pieces of unimaginable loss and moved forward to help others. I was humbled to be with these amazing folks. I also know that we touched people at every stop along the way.

Having completed the ride last year, I definitely had a different focus. The aspects of the ride that brought me the most joy (aside from that moment when you peeled off your bike saddle at the end of a long day), were those in which I could help someone achieve a new distance. Several people rode longer than they ever had on Day 1, and continued to shatter their personal records on subsequent days. This trip is truly about the journey, and I am so thankful to Tommy and my kids for supporting me on this journey once again.

How it Works

Each day, we woke up and were split into 5 riding groups. To me, the beauty of Key to Keys is that we never know where we are riding until that morning. We were assigned our groups, and each group rode 25 to 70 miles each day (one group pulled a century on their longest day). The shorter rides were associated with visits to cancer centers along the way (6 in all this year). We had business cards with information about the ride, and used them to help people follow along with the journey. The challenge was to give out as many cards as you could.

Each morning starts with a dedication circle. Everyone who wants to speaks about who they are riding for that day. It is powerful and emotional and inspiring. To have a purpose and a person in mind each day provides focus. It also provides insight into what is motivating your fellow riders on that day.

Dedication circle in Charleston, SC

SUV selfie...Chris and the ladies

The ride itself was not about being fast, and I feel like we saw amazing sites along the way. Some days were back country roads and avoiding being chased by dogs, while others were more well-traveled roads and beach towns. We stopped and saw the sights, including the Navy Seal museum, a Revolutionary War era church, and even the Oscar Meyer mobile.

Riding with the boys, Day 2

In 8 days, strangers become family, random people on the street donated cash when they heard what we were doing, and we laughed and cried on a regular basis. As a group, we raised enough to fund the cancer navigator position at Walter Reed Military Medical Center. Meg is that navigator, and her program will provide services to young adults (ages 18-40) in the military who are dealing with a cancer diagnosis. 

Riding into Key West

The most bittersweet part of our journey was the ride into Key West. You want to pedal backward, to delay the inevitable. Even though friends and family are there at the finish, you want to enjoy the ride just a little longer. Inevitably the Southernmost point arrives in the distance, and we pedal to the finish of our journey. While Key to Keys 2014 has ended, there is still much to do in the young adult cancer fight. We ended our dedication circle every day with the UCF slogan: 

"Cancer Changes Lives....So Do We"

Many thanks to all of you who supported me on this journey, and to those who were support staff or riders, thank you for sharing those 8 days with me. If you would like more information about the Ulman Cancer Fund for Young Adults, click here.

Riding the bridge into Savannah (much steeper than it looks here)

We had just passed Kennedy Space Flight Center and seen a rocket launch.

No one can ever pass up an amazing photo op!

Day 8... Getting ready to saddle up for our ride into Key West.