Father's Day

Dear Ellie,

We've been through one Father's Day previously, but this past Father's Day I think was the first in which I've actually felt like a father.  One year ago, we were too busy running around to doctors appointments and physical therapy appointments for me to pay much attention to made up, second tier holidays like Father's Day.  Ever since you became a toddler though, we've had the sort of "mental space" necessary to enjoy and observe "the little things" of parenthood.  And the timing was perfect.

You are changing so quickly its hard to get a grasp on it.  Now that your teeth are finally coming in, you spend all day experimenting with new sounds and tones.  This tends to be handy, because you rarely want to ever stay still.  Should you happen to sprint away from our field of vision, your persistent toddler babble acts as a sort parental sonar.  What's more, your babble encodes information, too.  Loud and boisterous means you are on the move.  Quiet and contemplative means you are either flipping through a book or petting the cat.  Silence means mischief.

I don't have to worry about silence while you

are pounding on the piano.

Everything is interesting now, especially

stuff that you can wear

Your comprehension has grown quite impressively, too.  You understand a fairly broad range of instructions, including requests for a kisses.  I'm not sure why I'm surprised, but you seem to rather enjoying dolling out kisses, though for some reason, kitty cat seems to get the most kisses (as is evidenced by the allergenic bumps and cat fur stuck on your face).

I used to complain that you hated snuggling, but as you've grown older, that's changed rather quickly.  Now, whenever I carry you around, your little hands grip my shirt like talons and the side of your head is buried in my shoulder.  I suppose its no coincidence that its around this time that many people start to think about having more kids.

After the long crisis of the prior year and a half, that's not a thought that crossed our mind very often, though perhaps it did more than others.  Not long after you were born, your mother and I went to the doctor to ask about our prospects.  It might seem strange to be thinking about baby number two with a preemie that was fresh out of the NICU, but a year before you were born, we were told we had a very narrow window to have children, and we assumed that that window could only be narrower.  At that more recent appointment after you were born, the news was even bleaker than before.  Not only was your mother's remaining Fallopian tubed 100 percent blocked by scar tissue, IVF was unlikely to succeed either.  We asked whether it was plausible to open up the Fallopian tube with surgery, and the doctor said it would be such a misguided idea that he refused to do it.  That left adoption, which wouldn't be a financially viable option for a long time given all of the expenses that were associated with your pre-maturity.

After that depressing analysis, we reminded ourselves that we should be grateful and that having just one child might not be so bad.  It was a simultaneously intimate but glum thought.  How close we would be, I thought, with all the time we'd have to spend with you, and just you.  But then I thought of all the adventures I'd been on with your uncle and aunt.  About how close we were, and are to this day.  When I think of what my life would have been without them, it feels like reading a book where entire chapters have been torn out.

Sadly, there just didn't seem to be any options, even while the biological clock was ticking.  Despite this, we still held out for the possibility that your mothers eggs might somehow magically teleport around her blocked tube and we might still have a baby naturally (we've had the talk by now, haven't we??)  It was a naive hope, because we knew that if your mother did get pregnant again naturally, it would be a repeat of she experienced a few years ago: a dangerous, life threatening pregnancy inside of the Fallopian tube.  

So you can imagine our concern when, just days after our conversation about having more kids, your mother told me she didn't feel right.  She felt bloated, nauseated, and a pinch dizzy.  She felt... pregnant.  What was even more concerning was the fact that she was bleeding: a telltale sign that an embryo was burrowed into her Fallopian tube, pushing and stretching the tissue while it grew.

So with great fear and trepidation, she took a pregnancy test and sure enough, it was positive.  While most people who want more children would jump for joy upon seeing a positive test, we felt instead a perverse sort of grief.  It's bad enough knowing that you can have no more children, but to then know that you have one growing inside of you, destined only to die and threaten your own life in the process?  It's literally insult to injury.  The worst part was that some part of us hoped that maybe, just maybe it wasn't in the tube after all.  That it might instead be snuggled up in the womb where it was supposed to be.

Not being the type of people to harbor a fool's hope, your mother immediately began calling doctors because a tubal pregnancy is not something you want to leave alone for very long.  A day later, we were on our way to the OBGYN.  The feelings that felt so distant just a day ago--- those feelings of grief and stress that gnawed at us during our years of infertility--- were suddenly fresh in our minds again as though they'd never left.  Once we got to the doctor's office, a receptionist and nurse congratulated us, unaware that we had come to end an impossible pregnancy, not examine a healthy one.

Then, just as we'd found ourselves so many times in years past, we were in a waiting room, surrounded by happy women with bulging bellies while your mother and I quietly, and nervously, held hands.  Still, it didn't sting as badly as it had before.  We'd brought you and your grandmother with us that day, and you bumbled around with her in the waiting room with your clonky shoes, flashing grins and nearby mothers-to-be.

Eventually, I followed your mother into an exam room for an ultrasound, so that we could find where exactly the embryo had lodged this time.  During the previous tubal pregnancy, the location of the embryo was initially unknown.  In fact, the shots that were supposed to stop its growth didn't work at first, at which point surgeons went in to find it and remove it themselves (but still failed).  In the end, a second shot finally did work, and we eventually determined that the embryo had made it all the way to the end of the Fallopian tube, just centimeters from where it needed to be.  That, basically, is where the scar tissue was at, and we informed the ultrasound tech that this would be the most likely place to look with the new embryo.  Even then, as your mother and I both assured the ultrasound tech that she should be looking for a tubal pregnancy, I kept thinking: "Maybe not.  Maybe its where its supposed to be.  Maybe Ellie might have a sibling after all."

I remember right then wondering how I would explain this whole episode to you in a letter.  What would the moral of the story be?  I came up with two possibilities in my head, depending on the outcome.  The first?  "Sometimes, good things happen when you least expect them."  The second?  "Happiness goes to those who learn to be satisfied with what they are given."

As I  pondered these two possibilities the ultrasound tech swiveled the wand toward the uterus.  Both veterans of ultrasound screens at this point, your mother and I searched the screen anxiously.  We saw the gestational sack, a little black blob on the screen.

"Well," the said the ultrasound tech, with some confusion in her tone.  "It looks like this is a normal pregnancy."

And then we heard the heartbeat.  Your mother and I took a deep breath.  I'm not sure whether we even so much as shared a smile.  We sat silently as the ultrasound tech finished her work.  The woman must have thought we were disappointed.

At first, I don't think your mother and I could understand our subdued reaction.  Is this how someone would respond upon winning the lottery (and hadn't we done just that)?  We would quickly understand just moments later.  After the ultrasound, your mother started bleeding again.  The truth is, we were happy, but that happiness was smothered beneath layers and layers of worry and managed expectations.  When we spoke with the OBGYN afterward, she informed us that we fit into a special category of extra high risk.  Not only did our only successful pregnancy result in a micro-preemie, but the current pregnancy began with persistent bleeding.

What followed after the appointment was a flurry of activity.  Trips to special pharmacies for progesterone and prenatal vitamins, old pregnancy books dusted off, and lots of planning.  Your mother immediately went on to limited bedrest.  No straining and no lifting anything over 20 pounds.  We kept the news on a need to know basis.

That night, your mother and I talked for a long time.  We choreographed what our reactions would be to a negative outcome before hand.  "Before we got the news, we were happy with Ellie," we reasoned.  "If for some reason the pregnancy doesn't work out, doesn't it make sense that we should go right back to being happy again?  Even with a miscarriage, nothing more would be gained or lost.  We would just go back to the way things were before."

While it helped to accept this perspective, what followed were tense weeks.  The bleeding continued, the cause of which is as yet still unknown (and to be clear, bleeding even once during pregnancy is not a good thing.  Bleeding persistently is an even worse thing).  Every cramp or twinge made us wonder whether the end was near.  And what's more, the specter of delivering at 22 weeks was on our minds once again.

A few days ago, we took a trip to the our high risk OBGYN: the same one that attended to your mother during her 2 weeks of bedrest.  The questions on our minds?  How do we prevent another premature delivery, and why did it happen last time?

We weren't expecting to learn much given that your mother's uterine region has been a black box of mysteries, but as has happened often lately, we were pleasantly proven wrong.  As to the question of how your mother became pregnant with a completely blocked tube?  The doctor seems to think that the test we ran to see whether it was blocked may have partially blown the blockage open.  And as to the unsolved mystery of what caused you to be born early?   It appears as though there may have been a cervical malfunction, and once the cervix was open, the bulging of the gestational sack out of the opening caused the placenta to tear from the uterine wall.

With this suspicion to work with, the doctor came up with a course of action to hopefully prevent a repeat scenario: he decided it was best to stitch your mother's cervix closed.  In fact, as I'm writing this, the surgery just ended and your mother is back at St. Mary's Hospital, sitting in the very same recovery room she was in after you were born.

It's encouraging to know that we've taken measures to improve the outcome, but as of now, I still don't know what the "moral of the story will be."  For now, it appears the fetus is in tip top shape, and just like you, is described as "unusually active."  During the ultrasound at our high risk appointment, she was spinning around in circles inside the gestational sack like one of the three stooges.  Oh yes, and in case you missed that last pronoun I just snuck in there, the genetic test informed us recently that you'll be having a sister if all goes well.

Our fingers are crossed.