Here is this week's Objectivist Round Up, presented by Titanic Deck Chairs.
And with that, I'm signing off for the weekend. Thank you so much, readers, for all of your support.
Thursday, October 15, 2009
Logistics and Statistics
So tomorrow I go to the hospital for a procedure called "dilation and curettage," which is a type of abortion. This is my second unwanted abortion, and I'm not happy about that. Since it makes me feel better to write about all of this, I'll tell you what I know about this process. (And thank you all for your kind comments.)
In a case like this, where it is discovered that the fetus is not developing before there are any symptoms of miscarriage, there are two choices: have the D&C, or let things happen naturally. Eventually, my pregnancy hormones would adjust and my body would naturally expel the contents of my uterus. The problem with that option is that you don't know exactly when it will happen, it can be very painful, and it is very bloody. The doctor emphasized, "a lot of blood." The risks of a D&C these days are minimal, the most common major problem being infection, which could lead to perforation of the uterus and infertility. But I trust the doctor who advised me yesterday that this risk is very small. I will be on prophylactic antibiotics anyway, and I've never been prone to infection. Many times, even if you let things happen naturally, you need the D&C anyway to be sure all the tissue has been expelled. The other benefit of the D&C is that a genetic analysis can be performed to possibly find out what went wrong. I'm not sure if my insurance will cover this, so I'm not sure we'll have it done, but it would be nice to know if possible, especially given my history.
The biggest cause of miscarriage is genetic defect. If the problem is bad enough, the fetus can't get beyond a certain state of growth. When we are amazed at how well DNA builds such perfect human beings even with all the problems we see in living people, we shouldn't forget that there are a lot of errors - these are the miscarriages. I read last night that up to 75% of a 40 year old woman's eggs may contain genetic defects. Unfortunately, the book I have does not include footnotes and this figure sounds ridiculously high. (The book is also one of those types where pregnant women are encouraged to take no risks whatsoever so I don't completely trust it. Another source put the percentage of defective eggs at 50, with the caveat that this figure was arrived at by studying only infertile women, so it is probably still high.) But one hard fact is that the miscarriage rate for 40 year old women is about 1 in 3 and it goes up dramatically as you move towards 45.
These figures can be depressing, and it is certainly possible that we'll never have another child. (Here is an interesting personal anecdote from a woman who tried to have a second child in her mid-forties - she eventually did fail.) But I look at these figures as a way to understand and cope with this miscarriage. As I said before, it can be seen as "normal" at my age of 39. And I have to be prepared for it to happen again. But for now, this is no deterrent.
Tomorrow is going to be a terrible day, and from what I gather, I'm going to be in pain through the weekend at a minimum. But I want to get it over with. I've spent the past 24 hours worried sick that things would start happening on their own. I hope I make it through the next 24.
In a case like this, where it is discovered that the fetus is not developing before there are any symptoms of miscarriage, there are two choices: have the D&C, or let things happen naturally. Eventually, my pregnancy hormones would adjust and my body would naturally expel the contents of my uterus. The problem with that option is that you don't know exactly when it will happen, it can be very painful, and it is very bloody. The doctor emphasized, "a lot of blood." The risks of a D&C these days are minimal, the most common major problem being infection, which could lead to perforation of the uterus and infertility. But I trust the doctor who advised me yesterday that this risk is very small. I will be on prophylactic antibiotics anyway, and I've never been prone to infection. Many times, even if you let things happen naturally, you need the D&C anyway to be sure all the tissue has been expelled. The other benefit of the D&C is that a genetic analysis can be performed to possibly find out what went wrong. I'm not sure if my insurance will cover this, so I'm not sure we'll have it done, but it would be nice to know if possible, especially given my history.
The biggest cause of miscarriage is genetic defect. If the problem is bad enough, the fetus can't get beyond a certain state of growth. When we are amazed at how well DNA builds such perfect human beings even with all the problems we see in living people, we shouldn't forget that there are a lot of errors - these are the miscarriages. I read last night that up to 75% of a 40 year old woman's eggs may contain genetic defects. Unfortunately, the book I have does not include footnotes and this figure sounds ridiculously high. (The book is also one of those types where pregnant women are encouraged to take no risks whatsoever so I don't completely trust it. Another source put the percentage of defective eggs at 50, with the caveat that this figure was arrived at by studying only infertile women, so it is probably still high.) But one hard fact is that the miscarriage rate for 40 year old women is about 1 in 3 and it goes up dramatically as you move towards 45.
These figures can be depressing, and it is certainly possible that we'll never have another child. (Here is an interesting personal anecdote from a woman who tried to have a second child in her mid-forties - she eventually did fail.) But I look at these figures as a way to understand and cope with this miscarriage. As I said before, it can be seen as "normal" at my age of 39. And I have to be prepared for it to happen again. But for now, this is no deterrent.
Tomorrow is going to be a terrible day, and from what I gather, I'm going to be in pain through the weekend at a minimum. But I want to get it over with. I've spent the past 24 hours worried sick that things would start happening on their own. I hope I make it through the next 24.
Wednesday, October 14, 2009
The M Word
I had an ultrasound today. There is no heartbeat. The fetus stopped developing a couple of weeks ago. I had a miscarriage. On Friday I'll have a D&C. I'll write more about that later.
It's ok. I mean, it's horrible, but I'll be ok. This is nothing like losing a 24 week pregnancy. When that happened, I really resented people who equated my experience with a miscarriage, but I wasn't sure if my feelings were just, because I had never experienced a miscarriage. Well, I was right. This is hard, but I don't feel like I've lost a baby. We didn't know the sex yet, we had never heard the heartbeat or seen the baby on ultrasound, and we hadn't bought anything for the baby. My belly hadn't grown. I hadn't felt the baby move. We hadn't bonded with it. We don't have a huge context to disintegrate. We just have to start over.
I do have one similar feeling: the feeling that I have lost time. When our first child was stillborn, I felt like I had lost a year of my life. We had spent 4 months getting pregnant, 5+ months being pregnant, and then we had to wait 3 more months before we could try again. I'm sure I'll be told that we should wait 3 months again, but I might not heed that advice. I started planning and thinking about it within 10 minutes of finding out, and Adam agrees: We're getting right back on that horse!
I'm also thinking about the things that will be easier. We have some travel plans that will be much easier now. Next time, I'll be better prepared with the right drugs for my psoriasis, which has gotten totally out of control since I had to suddenly stop my medication. Well, that's about all the positive stuff I can think of right now. As for the negative, I think the thing that bothers me the most is that when we do have SS, there will be that much more of a gap between our children's ages. That, and the fact that, the older I get, the less likely we are to successfully have a child at all. But, at least right now, I'm not feeling as stressed out about that as I was when we first decided to try for another child. For some reason, I was really afraid that we wouldn't be able to conceive at all. A miscarriage is almost par for the course at my age, so I don't feel like this doesn't bode well for the future. We might have another miscarriage, but we're still fertile, and we've had one healthy child, so there is no reason to leap to worries about ultimate failure.
And that is one of the reasons I decided to announce my pregnancy to the whole world immediately. I knew this could happen, and if it did, I wanted people to know. I can't tell you how shocked I was after our first, failed pregnancy, to find out how common miscarriages, infertility, stillbirths, and other problems really are. Once you are a part of "the club," the stories come out of the woodwork. Miscarriage is common enough that I would call it normal. If you don't know how common it is and you have one, you will not have the right perspective, and you might become afraid. It might seem like there is something wrong with you, or that you did something wrong like eating the wrong food or exercising too much. Many women even feel ashamed, since it is just never, ever talked about (except in those internet chat rooms, and you should not go there--trust me). I don't want women to have to go through that. I mean, I hate thinking about all the pity people will feel for me, and even the sympathy. I hate to cause other people those negative feelings and I hate to be the object of them. I could have spared all of us that by just keeping my mouth shut. But now that this has happened, I can confirm what my gut told me in the first place: We need to stop hiding early pregnancy and miscarriages. It's one thing to learn the miscarriage rate as an abstraction. It's another to know that 5 out of your 6 best friends have had miscarriages, fertility problems, or a stillbirth.
I've only known that I miscarried for about 8 hours now, and I've had to tell 5 people. Telling people is difficult and painful (although writing this blog post is cathartic). I understand the desire not to have to go through that. But I think that telling people is an important part of facing up to what happened. I can't imagine having been pregnant this whole time, losing the baby, and having the whole thing be invisible to all of my friends and family. I think it would prolong the pain. I don't mean that I want to "share" the pain, like spreading it out would lessen it or something. I just don't like keeping secrets from people who are close to me. (And once you tell those people, the cat is out of the bag and you might as well tell everyone.) It's important to note that I absolutely do not think that it is dishonest to keep an early pregnancy a secret--it is nobody's business but the parents' and there are plenty of situations where it is rational to keep it hidden. What I'm saying is that this default practice of waiting 3 months to announce a pregnancy does not do anybody any good. Ignorance is not bliss.
I'll write more about this in the days to come, but now I have to go have a good cry.
It's ok. I mean, it's horrible, but I'll be ok. This is nothing like losing a 24 week pregnancy. When that happened, I really resented people who equated my experience with a miscarriage, but I wasn't sure if my feelings were just, because I had never experienced a miscarriage. Well, I was right. This is hard, but I don't feel like I've lost a baby. We didn't know the sex yet, we had never heard the heartbeat or seen the baby on ultrasound, and we hadn't bought anything for the baby. My belly hadn't grown. I hadn't felt the baby move. We hadn't bonded with it. We don't have a huge context to disintegrate. We just have to start over.
I do have one similar feeling: the feeling that I have lost time. When our first child was stillborn, I felt like I had lost a year of my life. We had spent 4 months getting pregnant, 5+ months being pregnant, and then we had to wait 3 more months before we could try again. I'm sure I'll be told that we should wait 3 months again, but I might not heed that advice. I started planning and thinking about it within 10 minutes of finding out, and Adam agrees: We're getting right back on that horse!
I'm also thinking about the things that will be easier. We have some travel plans that will be much easier now. Next time, I'll be better prepared with the right drugs for my psoriasis, which has gotten totally out of control since I had to suddenly stop my medication. Well, that's about all the positive stuff I can think of right now. As for the negative, I think the thing that bothers me the most is that when we do have SS, there will be that much more of a gap between our children's ages. That, and the fact that, the older I get, the less likely we are to successfully have a child at all. But, at least right now, I'm not feeling as stressed out about that as I was when we first decided to try for another child. For some reason, I was really afraid that we wouldn't be able to conceive at all. A miscarriage is almost par for the course at my age, so I don't feel like this doesn't bode well for the future. We might have another miscarriage, but we're still fertile, and we've had one healthy child, so there is no reason to leap to worries about ultimate failure.
And that is one of the reasons I decided to announce my pregnancy to the whole world immediately. I knew this could happen, and if it did, I wanted people to know. I can't tell you how shocked I was after our first, failed pregnancy, to find out how common miscarriages, infertility, stillbirths, and other problems really are. Once you are a part of "the club," the stories come out of the woodwork. Miscarriage is common enough that I would call it normal. If you don't know how common it is and you have one, you will not have the right perspective, and you might become afraid. It might seem like there is something wrong with you, or that you did something wrong like eating the wrong food or exercising too much. Many women even feel ashamed, since it is just never, ever talked about (except in those internet chat rooms, and you should not go there--trust me). I don't want women to have to go through that. I mean, I hate thinking about all the pity people will feel for me, and even the sympathy. I hate to cause other people those negative feelings and I hate to be the object of them. I could have spared all of us that by just keeping my mouth shut. But now that this has happened, I can confirm what my gut told me in the first place: We need to stop hiding early pregnancy and miscarriages. It's one thing to learn the miscarriage rate as an abstraction. It's another to know that 5 out of your 6 best friends have had miscarriages, fertility problems, or a stillbirth.
I've only known that I miscarried for about 8 hours now, and I've had to tell 5 people. Telling people is difficult and painful (although writing this blog post is cathartic). I understand the desire not to have to go through that. But I think that telling people is an important part of facing up to what happened. I can't imagine having been pregnant this whole time, losing the baby, and having the whole thing be invisible to all of my friends and family. I think it would prolong the pain. I don't mean that I want to "share" the pain, like spreading it out would lessen it or something. I just don't like keeping secrets from people who are close to me. (And once you tell those people, the cat is out of the bag and you might as well tell everyone.) It's important to note that I absolutely do not think that it is dishonest to keep an early pregnancy a secret--it is nobody's business but the parents' and there are plenty of situations where it is rational to keep it hidden. What I'm saying is that this default practice of waiting 3 months to announce a pregnancy does not do anybody any good. Ignorance is not bliss.
I'll write more about this in the days to come, but now I have to go have a good cry.
Monday, October 12, 2009
Rationally Selfish Radio
I've become a regular and enthusiastic listener of Diana Hsieh's podcast, Rationally Selfish Radio. Although many of my readers are probably already aware of it, the podcast is so good I that I wanted to encourage those few who haven't listened yet to give it a try.
Dr. Hsieh speaks on a wide variety of topics, which keeps things fresh and interesting. In her 13 podcasts to date, she has included segments on:
What I really like about Dr. Hsieh's podcast is her clarity and precision in discussing ideas. I've gone into a few podcasts thinking, "I already know what I think about this topic and it doesn't sound all that interesting," but I always come out feeling like it was time well-spent. Most of the time, Dr. Hsieh does have some insight that is new to me, but even when she does not, her methodical, rational analysis is just a joy to experience.
If you've never listened to podcasts or books on tape, I recommend listening while you drive. I find it impossible to sit still and listen to anything at all, with both my overflowing inbox and dirty living room staring me in the face. Of course, if my daughter is around, it's not going to happen. But listening to a podcast in the car is a great way to multitask. Even Sammy likes to listen sometimes. And now, she recognizes not only Dr. Peikoff's voice, but Dr. Hsieh's as well: MOMMY! THAT'S DI-NANA!
Dr. Hsieh speaks on a wide variety of topics, which keeps things fresh and interesting. In her 13 podcasts to date, she has included segments on:
- Philosophy in Action (Respecting property rights, how to choose a career, is accepting an inheritance moral, etc.)
- Book Reviews (The Count of Monte Cristo, Change Your Voice; Change Your Life)
- Teaching Files (An ongoing analysis of the arguments for the existence of God, other topics from her teaching experience to follow in the future)
- Interview (With Craig Biddle, editor of The Objective Standard)
- Explore Atlas Shrugged (Her newest segment, which is like a virtual Atlas Shrugged reading group)
What I really like about Dr. Hsieh's podcast is her clarity and precision in discussing ideas. I've gone into a few podcasts thinking, "I already know what I think about this topic and it doesn't sound all that interesting," but I always come out feeling like it was time well-spent. Most of the time, Dr. Hsieh does have some insight that is new to me, but even when she does not, her methodical, rational analysis is just a joy to experience.
If you've never listened to podcasts or books on tape, I recommend listening while you drive. I find it impossible to sit still and listen to anything at all, with both my overflowing inbox and dirty living room staring me in the face. Of course, if my daughter is around, it's not going to happen. But listening to a podcast in the car is a great way to multitask. Even Sammy likes to listen sometimes. And now, she recognizes not only Dr. Peikoff's voice, but Dr. Hsieh's as well: MOMMY! THAT'S DI-NANA!
Friday, October 9, 2009
Thursday, October 8, 2009
Objectivist Round Up
You can find this week's Objectivist Round Up at Trey Givens' blog. I'm looking forward to reading Kate Gerber's Is there a "Work-Life Balance?"
Mysteries
Since we had Sammy, I've been running a lot more plastic through the dishwasher. It seems obvious now, but I couldn't figure out why the ceramic and glass would come out dry and the plastic would always be wet. Answer: Ceramic and glass are better heat conductors and therefore stay hot longer and get drier than plastic. Duh!
Since that mystery was solved, here's another one. Why doesn't anybody make a lightweight children's step stool taller than a measly 8 inches? We have stools all over the house, but have yet to figure out a good solution for the bathroom sinks. Right now, this is what we have to deal with in our tiny powder room:
If you look closely, you can see that the stool blocks almost half the doorway. It is a tiny space and I can't imagine keeping it like this as long as Sammy needs a stool. She has to stand on the 2nd step and she can just barely reach the handles to turn on the water. She cannot reach the soap because of that completely non-functional sink. (For the life of me, I cannot understand why anybody would ever buy a pedestal sink. There is no storage and no countertop space. But that's another mystery altogether.)
Anyway, this is a mystery I haven't been able to solve. Any ideas out there?
Since that mystery was solved, here's another one. Why doesn't anybody make a lightweight children's step stool taller than a measly 8 inches? We have stools all over the house, but have yet to figure out a good solution for the bathroom sinks. Right now, this is what we have to deal with in our tiny powder room:
If you look closely, you can see that the stool blocks almost half the doorway. It is a tiny space and I can't imagine keeping it like this as long as Sammy needs a stool. She has to stand on the 2nd step and she can just barely reach the handles to turn on the water. She cannot reach the soap because of that completely non-functional sink. (For the life of me, I cannot understand why anybody would ever buy a pedestal sink. There is no storage and no countertop space. But that's another mystery altogether.)
Anyway, this is a mystery I haven't been able to solve. Any ideas out there?
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