About a half an hour ago, it was exactly one week since my sweet Maggie died. The heartbreak and the intensity of the loss has not subsided in the least. I think of her tiny body and her sweet face and I weep. And I remember pieces of that time. I remember the physical feeling of delivering her. I remember screaming in panic and fear when she was born "Please. My baby. Please." - begging the doctors, the universe - someone for a miracle for my second born child. But I didn't get that miracle. My daughter died in my arms hours later.
Now I sleep with the stuffed animal we gave her and stare at her pictures and weep. I think of the things we would have liked to do with her as she grew up. She looked like she would have been petite and maybe a bit shy. She would have had fun playing with EllaGrace - or maybe tired of what I'm sure would have been EllaGrace's bossy, big sister tendencies.
I'm so sorry Maggie... and I love you.... My Maggie......
Thursday, October 31, 2013
Wednesday, October 30, 2013
Patrick's Story
Patrick, my first son, although born so early was doing surprisingly well. He responded to all treatments being administered. In fact, in his first days his oxygen levels were close to room air. But, par for course, his needs varied hour to hour as he adjusted to life outside the womb. Given Maggie's passing, I did not actually meet my little Patrick - about 800g - until later in the day. We placed Maggie in his isolette so we could have photos of our children together. The image of them together was heartbreaking - these are two children who were meant to grow up together.
Patrick gave us hope. I touched him on the day he was born and he reached our and gripped my finger - one of those magical moments. He might be tiny, but he was clearly a little person. My littler person. I would fight tooth and nail for him. Over the following days I began expressing milk which he was given in small doses. We would watch him sleep or squirm around in the isolette. His movements were so easily linked to what I felt while I was pregnant. The nurses and doctors were always supportive and informative as we hoped for Patrick and grieved for Maggie.
Routine scans at that point had been going well. His brain looked healthy, his lungs were responding well to treatments and although his heart had an open valve, he was being treated.
On Wednesday morning the nurse and I noticed that Patrick was moving around more than usual, as though he was agitated. It was later discovered that his hemoglobin appeared to be low which the doctor explained may be a sign of internal bleeding in the brain. We sat on edge, watching his heart rate, oxygen, and blood pressure all change. He was given two transfusions and a platelet transfusion. Later that evening a doctor came to explain that severe bleeding could be seen on Patrick's brain. She explained that it was in both hemispheres and that this could affect speech, mobility and cognitive processing. Lee and I wept and spent the night discussing what our options may be for our dear Patrick. Dignity, comfort were paramount.
The following morning, October 28th, we went to see Patrick. He was receiving increasing doses of narcotics to ease his irritability. We met with a specialist who explained that she had seen that there was grade 4 and grade 3/4 bleeds in his brain, as well as swelling in the surrounding ventricle. We discussed palliative care but agreed to reconvene once she had a full report about his ultrasound. Later that day that doctor came in and explained that he had actually had a second bleed, which had moved down into other areas of the brain as well as caused swelling so much as that the placement of his brain had shifted. She indicated that given his high heart rate she was uncertain that this was a reaction to discomfort and that he may not live through the night.
We phoned my family members to come with EllaGrace. Patrick came out of his isolette and was cradled in my arms while he continued to received breathing support and pain medications. EllaGrace held his hand and kissed his head and talked to him. She gave him one of this toys. It was such an important moment for us as a family. She then left with my sister so that Lee and I would be alone with Patrick when medical interventions were removed. The moment of unhooking him, and loss of all hope and miracles, was an awful one. We sang him our goodnight song, and told him many of the same things we had told Maggie. He continued to breath on his own. He sucked on my finger lightly. I placed him against my skin to keep him warm. Given that he lived for so long on his own (30 minutes, perhaps), we allowed family in to see him. His grandparents, great aunt and aunt were there, surrounding him with love and tears as he exhaled his last breath in my arms. Patrick was then held and cried for by each person in the room. We wept and wished him well. He and Maggie are together again. Our family left, and after one more visit from Auntie Christie who gave him so much love and reassurance, we were left alone - parents and child - to say goodbye. We kissed him and gave him to a nurse, our last moments so precious.
Now, we are left with nothing but blankets and photos of our daughter and son. We were a family of 5 for two hours and a family of four for four days. Now we are a family of three once again, but with broken hearts and memories that will be with us always.
I weep for my children and my heart breaks for them both every moment of the day.
Patrick gave us hope. I touched him on the day he was born and he reached our and gripped my finger - one of those magical moments. He might be tiny, but he was clearly a little person. My littler person. I would fight tooth and nail for him. Over the following days I began expressing milk which he was given in small doses. We would watch him sleep or squirm around in the isolette. His movements were so easily linked to what I felt while I was pregnant. The nurses and doctors were always supportive and informative as we hoped for Patrick and grieved for Maggie.
Routine scans at that point had been going well. His brain looked healthy, his lungs were responding well to treatments and although his heart had an open valve, he was being treated.
On Wednesday morning the nurse and I noticed that Patrick was moving around more than usual, as though he was agitated. It was later discovered that his hemoglobin appeared to be low which the doctor explained may be a sign of internal bleeding in the brain. We sat on edge, watching his heart rate, oxygen, and blood pressure all change. He was given two transfusions and a platelet transfusion. Later that evening a doctor came to explain that severe bleeding could be seen on Patrick's brain. She explained that it was in both hemispheres and that this could affect speech, mobility and cognitive processing. Lee and I wept and spent the night discussing what our options may be for our dear Patrick. Dignity, comfort were paramount.
The following morning, October 28th, we went to see Patrick. He was receiving increasing doses of narcotics to ease his irritability. We met with a specialist who explained that she had seen that there was grade 4 and grade 3/4 bleeds in his brain, as well as swelling in the surrounding ventricle. We discussed palliative care but agreed to reconvene once she had a full report about his ultrasound. Later that day that doctor came in and explained that he had actually had a second bleed, which had moved down into other areas of the brain as well as caused swelling so much as that the placement of his brain had shifted. She indicated that given his high heart rate she was uncertain that this was a reaction to discomfort and that he may not live through the night.
We phoned my family members to come with EllaGrace. Patrick came out of his isolette and was cradled in my arms while he continued to received breathing support and pain medications. EllaGrace held his hand and kissed his head and talked to him. She gave him one of this toys. It was such an important moment for us as a family. She then left with my sister so that Lee and I would be alone with Patrick when medical interventions were removed. The moment of unhooking him, and loss of all hope and miracles, was an awful one. We sang him our goodnight song, and told him many of the same things we had told Maggie. He continued to breath on his own. He sucked on my finger lightly. I placed him against my skin to keep him warm. Given that he lived for so long on his own (30 minutes, perhaps), we allowed family in to see him. His grandparents, great aunt and aunt were there, surrounding him with love and tears as he exhaled his last breath in my arms. Patrick was then held and cried for by each person in the room. We wept and wished him well. He and Maggie are together again. Our family left, and after one more visit from Auntie Christie who gave him so much love and reassurance, we were left alone - parents and child - to say goodbye. We kissed him and gave him to a nurse, our last moments so precious.
Now, we are left with nothing but blankets and photos of our daughter and son. We were a family of 5 for two hours and a family of four for four days. Now we are a family of three once again, but with broken hearts and memories that will be with us always.
I weep for my children and my heart breaks for them both every moment of the day.
Maggie's Story
Our sweet Maggie, named after her Nana Pom, was Baby A. She had had ruptured membranes since 15 weeks gestation. This meant that her lungs had very little opportunity to grow. Moreover, at our 24 week appointment we had decided not to have steroids, which help lung development, in hopes that the pregnancy would continue and that they would be more effective later in the pregnancy. This decision, although based on fair information at the time and unlikely to have changed the outcome, will be one that I dwell on for years to come, I am sure.
Once I was stabilized we asked to see our children. It was at that time that a member of the Neonatal Intensive Care Unit (NICU) team informed us that both babies were still being tended to and that Maggie did not appear to be responding to their attempts. I was helped into a wheelchair and we were taken to the small table where Maggie was. The doctor quietly explained that they had administered several doses of medications to help her lungs but to no avail. She indicated that she was concerned that after two hours of attempts to save Maggie, that she would have sustained brain damage. We decided to end the doctors' attempts. Maggie was placed into my arms, nestled against my chest, where she died. I have never known such sorrow or heartache. She was wrapped up in a receiving blanket that we had purchased for her while I was pregnant and we gave her a small stuffed bunny toy. We spent quite a bit of time with her in my hospital room. She was held by her aunt Laleah and by her honourary aunt Christie. I sang her our goodnight song. I tried my hardest to memorize every inch of her body and the feel of her tiny body - about 400g - against my own. I knew at that moment that I would never be the same person again, nor would our family every be what it was prior to such a loss.
I have no words to explain how I feel when I think of my Maggie. I physically ache through my body for her. I will love her forever.
Once I was stabilized we asked to see our children. It was at that time that a member of the Neonatal Intensive Care Unit (NICU) team informed us that both babies were still being tended to and that Maggie did not appear to be responding to their attempts. I was helped into a wheelchair and we were taken to the small table where Maggie was. The doctor quietly explained that they had administered several doses of medications to help her lungs but to no avail. She indicated that she was concerned that after two hours of attempts to save Maggie, that she would have sustained brain damage. We decided to end the doctors' attempts. Maggie was placed into my arms, nestled against my chest, where she died. I have never known such sorrow or heartache. She was wrapped up in a receiving blanket that we had purchased for her while I was pregnant and we gave her a small stuffed bunny toy. We spent quite a bit of time with her in my hospital room. She was held by her aunt Laleah and by her honourary aunt Christie. I sang her our goodnight song. I tried my hardest to memorize every inch of her body and the feel of her tiny body - about 400g - against my own. I knew at that moment that I would never be the same person again, nor would our family every be what it was prior to such a loss.
I have no words to explain how I feel when I think of my Maggie. I physically ache through my body for her. I will love her forever.
The Beginning of the End: October 24th 2013
I am devastated to be writing this post. But, here is my account of the worst time of my life.
At about 4:20 a.m. on Thursday October 24th 2013 I awoke my in cousins home shivering. I had had the shivers once before during this pregnancy. But when I struggled to go to the bathroom and really struggled to get warm, despite having put on several layers I became worried. I took my temperature and it was normal. I decided I needed to wake my sister in order to go to the hospital. Yet another orange flag for me, I struggled to be able to go wake her. I did not want to call for help because my daughter and my cousin's daughter were both sleeping.
Eventually my sister and my cousin were both with me. My temperature had risen slightly and I began to have back pain. We arranged for an Aunt to take my sister and I to the hospital. The shivers would not stop, nor would the back pain which was migrating to my hips and legs.
I was admitted at triage by 5:30 and shortly thereafter my temperature had reached 40 degrees. My pain was coming in waves - likely contractions - but the back and leg pain persisted. I informed the team that I did not have steroids on board for the babies. The nurse and my sister noticed that I had developed black eyes and that my pain was worsening. A doctor checked my cervix and indicated that it was only open "a finger tip". My pain, contractions and illness continued. In a two hour time span I dilated completely and was preparing to deliver Baby A.
Lee, luckily, made it to Ottawa in time to support me through the hardest part of my labour and delivery. I was hooked up to fluids and magnesium for the babies' brains. We were told that I could not have steroids because it would risk my own health, which was obviously quite poor at the time. All of a sudden I felt something, Baby A, so small, was coming out without much pushing on my part at all. A beautiful baby girl, Margaret Laleah Lynn (Maggie), entered this world at 07h45. She was taken away so quickly by the doctors that no one was actually able to confirm if she was a girl or boy.
Our hope had been to have a delayed interval delivery. I was exactly 25 weeks pregnant and we knew this meant grim outcomes for our Maggie but also for Baby B. The OB supported this attempt. However, she noted that as my contractions continued, Baby B's heart was dipping dangerously low. She indicated that the Baby was telling us it was time. She broke my waters and I delivered a perfect baby boy, Patrick Lee Brian at 8:04 am. He was whisked away by the neonatal team just as quickly as Maggie had been. But we were told shortly thereafter that both babies were doing well.
The team then turned their focus to me. Having delivered the babies much of the pain and even the fever began to subside. They explained that this is common, as the infection is like an abscess that must be removed. However, upon further investigation it was discovered that I had an infection throughout my blood - sepsis. They explained that this was quite dangerous and Infectious Disease was consulted in order to treat me appropriately. Over the following days the specific infection was identified. I was on an IV for five days while in the hospital and have been sent home with a 2 week order for continued IV antibiotics. It has been explained that if we had come to the hospital any later I might have ended up in the ICU or worse. Evidently, I was quite sick. And in all honesty, while I know it does matter, in the grand scheme of things my own health has been the least of my concerns since that morning.
No more Facebook Status updates, because I have no words that do justice to my experiences.
At about 4:20 a.m. on Thursday October 24th 2013 I awoke my in cousins home shivering. I had had the shivers once before during this pregnancy. But when I struggled to go to the bathroom and really struggled to get warm, despite having put on several layers I became worried. I took my temperature and it was normal. I decided I needed to wake my sister in order to go to the hospital. Yet another orange flag for me, I struggled to be able to go wake her. I did not want to call for help because my daughter and my cousin's daughter were both sleeping.
Eventually my sister and my cousin were both with me. My temperature had risen slightly and I began to have back pain. We arranged for an Aunt to take my sister and I to the hospital. The shivers would not stop, nor would the back pain which was migrating to my hips and legs.
I was admitted at triage by 5:30 and shortly thereafter my temperature had reached 40 degrees. My pain was coming in waves - likely contractions - but the back and leg pain persisted. I informed the team that I did not have steroids on board for the babies. The nurse and my sister noticed that I had developed black eyes and that my pain was worsening. A doctor checked my cervix and indicated that it was only open "a finger tip". My pain, contractions and illness continued. In a two hour time span I dilated completely and was preparing to deliver Baby A.
Lee, luckily, made it to Ottawa in time to support me through the hardest part of my labour and delivery. I was hooked up to fluids and magnesium for the babies' brains. We were told that I could not have steroids because it would risk my own health, which was obviously quite poor at the time. All of a sudden I felt something, Baby A, so small, was coming out without much pushing on my part at all. A beautiful baby girl, Margaret Laleah Lynn (Maggie), entered this world at 07h45. She was taken away so quickly by the doctors that no one was actually able to confirm if she was a girl or boy.
Our hope had been to have a delayed interval delivery. I was exactly 25 weeks pregnant and we knew this meant grim outcomes for our Maggie but also for Baby B. The OB supported this attempt. However, she noted that as my contractions continued, Baby B's heart was dipping dangerously low. She indicated that the Baby was telling us it was time. She broke my waters and I delivered a perfect baby boy, Patrick Lee Brian at 8:04 am. He was whisked away by the neonatal team just as quickly as Maggie had been. But we were told shortly thereafter that both babies were doing well.
The team then turned their focus to me. Having delivered the babies much of the pain and even the fever began to subside. They explained that this is common, as the infection is like an abscess that must be removed. However, upon further investigation it was discovered that I had an infection throughout my blood - sepsis. They explained that this was quite dangerous and Infectious Disease was consulted in order to treat me appropriately. Over the following days the specific infection was identified. I was on an IV for five days while in the hospital and have been sent home with a 2 week order for continued IV antibiotics. It has been explained that if we had come to the hospital any later I might have ended up in the ICU or worse. Evidently, I was quite sick. And in all honesty, while I know it does matter, in the grand scheme of things my own health has been the least of my concerns since that morning.
No more Facebook Status updates, because I have no words that do justice to my experiences.
Sunday, October 20, 2013
Sometimes I Play Pretend
Picture a beautiful fall day: the sky is blue, the leaves are turning on trees and crunching under your feet. My toddler walks ahead of me, commenting on all of the new fascinations of autumn in our small town. My husband walks just behind me, as though he is admiring his little family and I feel admired, loved, and lucky. And we both smile because we know our family is growing as we walk on that perfect day. I reach down and rub my big, round belly and send a quiet message of love to my unborn babies. I already love my family so much and I know that this is just going to bring more joy and laughter into our home. I picture putting up Hallowe'en decorations and getting ready for the first snowfall. Maybe we can decorate my belly before going Trick or Treating. I am reminded that I should start looking for warm things for the little babies who will arrive in the cold days of winter. What a beautiful life I have. I cannot ask for anything more than this.
Reality sets back in: the walk from the car to the front door is over in 30 seconds. I consider myself lucky for having left the house that week. That precious moment with my family existed, but only for a moment. It was not nearly long enough. And, truth be told, it was too far from reality. I imagined my dream, my wish. If I am being totally frank, I do this often enough. On a walk to the bathroom when a friend is visiting I imagine that we are having a visit talking about how to paint the nursery or my birth plan and then smile at myself in the mirror, thrilled to be in the midst of a happy, healthy pregnancy. I have these short moments of transition in my bed rest world that allow for me to imagine away the truth.
I reflected on this tendency recently with my midwife. In truth, I know that this pregnancy will end too soon for my children and that their fates, especially that of my beloved Baby A, are far from predictable. We spoke about milestones: 24, 26, 28 weeks. I shared with her that I have a vivid imagination. Prior to this pregnancy I loved imagining that I won the lottery. I would ask Lee to imagine with me. I would picture us showing our children the world, maintaining our life but without debt or worries. But since rupturing I have not thought of the lottery, I have my own personal lottery. I imagine maintaining my pregnancy until 34 weeks, to be precise, 33weeks and 6days: Christmas Day. Lots of folks will say that a birthday on Christmas is no fun for the individual who has to share 'his/her' day. But, in this situation, I cannot think of a more amazing gift than to have reached such a far point in a pregnancy. It would be my own little Christmas miracle. My midwife laughed with me, but it is nice to dream.
Facebook status of the day: What are the chances of winning the lottery?
Reality sets back in: the walk from the car to the front door is over in 30 seconds. I consider myself lucky for having left the house that week. That precious moment with my family existed, but only for a moment. It was not nearly long enough. And, truth be told, it was too far from reality. I imagined my dream, my wish. If I am being totally frank, I do this often enough. On a walk to the bathroom when a friend is visiting I imagine that we are having a visit talking about how to paint the nursery or my birth plan and then smile at myself in the mirror, thrilled to be in the midst of a happy, healthy pregnancy. I have these short moments of transition in my bed rest world that allow for me to imagine away the truth.
I reflected on this tendency recently with my midwife. In truth, I know that this pregnancy will end too soon for my children and that their fates, especially that of my beloved Baby A, are far from predictable. We spoke about milestones: 24, 26, 28 weeks. I shared with her that I have a vivid imagination. Prior to this pregnancy I loved imagining that I won the lottery. I would ask Lee to imagine with me. I would picture us showing our children the world, maintaining our life but without debt or worries. But since rupturing I have not thought of the lottery, I have my own personal lottery. I imagine maintaining my pregnancy until 34 weeks, to be precise, 33weeks and 6days: Christmas Day. Lots of folks will say that a birthday on Christmas is no fun for the individual who has to share 'his/her' day. But, in this situation, I cannot think of a more amazing gift than to have reached such a far point in a pregnancy. It would be my own little Christmas miracle. My midwife laughed with me, but it is nice to dream.
Facebook status of the day: What are the chances of winning the lottery?
Friday, October 18, 2013
Hello Viability/Update IV
We made it. We made it to the day that doctors told me we would not. At 24 weeks babies are considered to be viable. But, what does that mean really? Where are we now that we are on this side of viability?
So much stress and fear has gone into the time spent getting to this point. But, as I have said before, we are not 'there' yet. 26, 28, 30 weeks are all of our upcoming benchmarks. And after seeing our MFM specialist as well as a Neonatologist, we have been asked to begin making some really difficult decisions. For example, do we want to do delayed interval delivery (potentially sacrificing Baby A for the long term benefit of the healthier, Baby B) and if one or both of the babies arrive, do we want to see them resuscitated or to be given palliative care.
I do not know how one begins to make these decisions. My entire basis for refusing termination was to bank on hope and mother nature. If I did not offer resuscitation, then have I not given up hope and forgone the fight for the baby/babies? And, to pick one baby over another based on statistics? How cruel. And, how cruel to ask a mother to decide.
We are trying to take into consideration some logical information in making these decisions: A pPROM baby at 24 weeks is not the same as a healthy baby at 24 weeks. Chances of survival without complications are lower. On the other hand, the NICU staff are happy to attempt resuscitation if we so choose.
In the mean time, we are also trying to decide when to take steroids. It will help both babies, but works best within the first week after which the positive effects start to wear off. Many women have them administered at 24 weeks, but our doctor pointed out that if we are not confident we would take all measures to save the babies at this stage, that it might be more helpful until we reach that point. It is such a gamble and there continues to be no predictability in terms of the end of the pregnancy or the outcome for either child.
Facebook status of the day: Please mother nature, give us more time so these decisions are unnecessary
So much stress and fear has gone into the time spent getting to this point. But, as I have said before, we are not 'there' yet. 26, 28, 30 weeks are all of our upcoming benchmarks. And after seeing our MFM specialist as well as a Neonatologist, we have been asked to begin making some really difficult decisions. For example, do we want to do delayed interval delivery (potentially sacrificing Baby A for the long term benefit of the healthier, Baby B) and if one or both of the babies arrive, do we want to see them resuscitated or to be given palliative care.
I do not know how one begins to make these decisions. My entire basis for refusing termination was to bank on hope and mother nature. If I did not offer resuscitation, then have I not given up hope and forgone the fight for the baby/babies? And, to pick one baby over another based on statistics? How cruel. And, how cruel to ask a mother to decide.
We are trying to take into consideration some logical information in making these decisions: A pPROM baby at 24 weeks is not the same as a healthy baby at 24 weeks. Chances of survival without complications are lower. On the other hand, the NICU staff are happy to attempt resuscitation if we so choose.
In the mean time, we are also trying to decide when to take steroids. It will help both babies, but works best within the first week after which the positive effects start to wear off. Many women have them administered at 24 weeks, but our doctor pointed out that if we are not confident we would take all measures to save the babies at this stage, that it might be more helpful until we reach that point. It is such a gamble and there continues to be no predictability in terms of the end of the pregnancy or the outcome for either child.
Facebook status of the day: Please mother nature, give us more time so these decisions are unnecessary
Tuesday, October 15, 2013
Overwhelmed?
The welcome distraction of Thanksgiving is over: back to the ol' grind. It was so nice to be surrounded by family, laughter and storytelling that did not relate to my pregnancy. By the end of the weekend I was exhausted, though who knows why since my routine of sleep-shower-couch did not change much!
Now we are a couple of days from Viability Day. As recently as last week I thought that I would have some level of release once having reached V-day. But, now I am doubtful. As I have written before, that finish line just keeps moving. Yes, viability is better than having doctors say they can do nothing. On the other hand, when I look at others' stories of pPROM it seems that 26 weeks is proper viability and really, 28 and 30 weeks are where you start to have some proper luck. That's one month plus. The road never seems to end.
In the mean time, we are in the ethical dilemma/Sophie's choice boat. If I went into labour the professionals would recommend delivering Baby A vaginally in order to provide a chance for Baby B to stay in utero for as long as possible. But, if we wanted to give Baby A a chance at life, we would need to request a c-section. I am confident that as the pregnancy progresses, the more likely I would be to make the decision to have the c-section. But, until we get to a point where the chance of survival is pretty high, how does one make that decision? After all this time on the couch, begging the universe and having others do the same, how do I give up on Baby A? How do I choose A over B? But, how can I risk having to bury two children? It is such a crazy thought process and decision to make. I loath the moments it crosses my mind.
Alas, I cannot spend all of my time dwelling on ethical dilemmas and the like. I am now in the throws of yet another difficult, heartbreaking change. We made the decision that I should relocate to Ottawa so that I am closer to a hospital. I have only two more sleeps at home. Then I leave behind my young daughter and husband - the people that keep me going at the end of the day - in an effort to make the best decision that we can for the babies inside me. It brings tears to my eyes to think of not seeing my daughter regularly. I have been away from her for about 5 days before but this is indefinite. In fact, the longer I am away, the better it is for the babies. I will miss out on her funny stories and faces, seeing how she changes and grows in the span of one night, her snuggles and kisses,.... it does not even sound bearable. And my husband... I have lived separately from him before but certainly not under these conditions. It is my late-night conversations with him that have helped me cope with so much of this pregnancy, and helped me to fall asleep at night. What will I do without that?
Facebook status: I may cry less frequently, but it is not any easier.
Now we are a couple of days from Viability Day. As recently as last week I thought that I would have some level of release once having reached V-day. But, now I am doubtful. As I have written before, that finish line just keeps moving. Yes, viability is better than having doctors say they can do nothing. On the other hand, when I look at others' stories of pPROM it seems that 26 weeks is proper viability and really, 28 and 30 weeks are where you start to have some proper luck. That's one month plus. The road never seems to end.
In the mean time, we are in the ethical dilemma/Sophie's choice boat. If I went into labour the professionals would recommend delivering Baby A vaginally in order to provide a chance for Baby B to stay in utero for as long as possible. But, if we wanted to give Baby A a chance at life, we would need to request a c-section. I am confident that as the pregnancy progresses, the more likely I would be to make the decision to have the c-section. But, until we get to a point where the chance of survival is pretty high, how does one make that decision? After all this time on the couch, begging the universe and having others do the same, how do I give up on Baby A? How do I choose A over B? But, how can I risk having to bury two children? It is such a crazy thought process and decision to make. I loath the moments it crosses my mind.
Alas, I cannot spend all of my time dwelling on ethical dilemmas and the like. I am now in the throws of yet another difficult, heartbreaking change. We made the decision that I should relocate to Ottawa so that I am closer to a hospital. I have only two more sleeps at home. Then I leave behind my young daughter and husband - the people that keep me going at the end of the day - in an effort to make the best decision that we can for the babies inside me. It brings tears to my eyes to think of not seeing my daughter regularly. I have been away from her for about 5 days before but this is indefinite. In fact, the longer I am away, the better it is for the babies. I will miss out on her funny stories and faces, seeing how she changes and grows in the span of one night, her snuggles and kisses,.... it does not even sound bearable. And my husband... I have lived separately from him before but certainly not under these conditions. It is my late-night conversations with him that have helped me cope with so much of this pregnancy, and helped me to fall asleep at night. What will I do without that?
Facebook status: I may cry less frequently, but it is not any easier.
Sunday, October 13, 2013
A Thanksgiving Post
Today I am celebrating what I can and being thankful for what I do have. For now, I have this pregnancy - something to celebrate and be thankful for. I am also thankful for my amazing friends and family who are helping to celebrate this pregnancy and this Thanksgiving Weekend.
I do not know how long I will be pregnant and I do not know if either of these babies will get to survive past birth. For now, I thank the powers that be that I do have them now. With this in mind, we decided to do a little family photo session with those supporting me. Here are a few that we got.
(Note: All photos taken by Beckie Kenrick, dear friend and photographer extraordinaire)
I do not know how long I will be pregnant and I do not know if either of these babies will get to survive past birth. For now, I thank the powers that be that I do have them now. With this in mind, we decided to do a little family photo session with those supporting me. Here are a few that we got.
(Note: All photos taken by Beckie Kenrick, dear friend and photographer extraordinaire)
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| The people that keep me going on a day to day basis: my husband and daughter. |
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| My Darling Daughter - the person who can put a smile on my face on even the hardest days. |
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| My Sister and I: she has completely changed her autumn's plans in order to support me and my family while I am on bed rest. She is such a rock star. |
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| Another amazing friend pulled through: HB made these micro-preemie sized hats for the babies |
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| My family: endless support and love - something to be truly thankful for |
Friday, October 11, 2013
The Struggle to Stay Positive (Update 3)
Yesterday we attended our bi-weekly appointment with the specialist. Although far from "out of the woods" and still riddled with anxiety, I think we approached the appointment feeling pleased that we have reached 23 weeks. We have beaten the odds so far. We are preparing for my relocation to Ottawa so that I am closer to the hospital and went into the appointment equipped with questions about how to manage the pregnancy when/if I reach 24 weeks.
When we were given the information from the ultrasound we noticed that the approximate weight disparity between the two babies was larger than it ever had been. In the past the difference was about 3 days, or 2-3 ounces. However, this time the difference was 5 ounces. Unsurprisingly, this disparity was raised by the specialist who indicated that it may be indicated of growth restriction for Baby A. Can this poor child not catch a break? What can I possibly do differently to help it?? The doctor acknowledged that this may be because of the difficulty to see the baby on ultrasound but that it required weekly monitoring to determine if this is a pattern or a fluke.
The good news, is that Baby A has grown some. It has good flow from the cord, a good heartbeat, had some fluid in the bladder, a little pocket of fluid and had actually significantly changed positions and could be seen moving on the ultrasound. So, it is not all bad, but it sure is scary. That baby just does not need anything else going against it. Twin A is now breech, essentially sitting on my cervix with its head beside that of Twin B, who is still transverse. More than anything, I hope that stay in there for longer. Baby B continues to look healthy and happy.
Unfortunately, when we began speaking about the future of the pregnancy the doctor we saw yesterday was quite negative. She spoke often about forfeiting Baby A to try to protect Baby B. She kept repeating that no matter when I deliver, Baby A has very poor prospects for survival and high likelihood of disability if it survives. She essentially dismissed the 24 week mark as any type of accomplishment and said that really 27 or 28 weeks would be a better baseline. I am acutely aware of this, as I have tried to articulate in previous posts. But having a doctor who does not acknowledge any level of success was so disheartening.
She did say that she would recommend a course of steroids for the babies next week, contrary to our usual doctor's recommendation. She also indicated that if I relocate to be close to the hospital, they will send a nurse to my home a couple of times a week for monitoring and see me weekly at the hospital. I at least liked that.
Facebook status of the day: So exhausted and so filled with love. Let's keep going, Little Peas.
When we were given the information from the ultrasound we noticed that the approximate weight disparity between the two babies was larger than it ever had been. In the past the difference was about 3 days, or 2-3 ounces. However, this time the difference was 5 ounces. Unsurprisingly, this disparity was raised by the specialist who indicated that it may be indicated of growth restriction for Baby A. Can this poor child not catch a break? What can I possibly do differently to help it?? The doctor acknowledged that this may be because of the difficulty to see the baby on ultrasound but that it required weekly monitoring to determine if this is a pattern or a fluke.
The good news, is that Baby A has grown some. It has good flow from the cord, a good heartbeat, had some fluid in the bladder, a little pocket of fluid and had actually significantly changed positions and could be seen moving on the ultrasound. So, it is not all bad, but it sure is scary. That baby just does not need anything else going against it. Twin A is now breech, essentially sitting on my cervix with its head beside that of Twin B, who is still transverse. More than anything, I hope that stay in there for longer. Baby B continues to look healthy and happy.
Unfortunately, when we began speaking about the future of the pregnancy the doctor we saw yesterday was quite negative. She spoke often about forfeiting Baby A to try to protect Baby B. She kept repeating that no matter when I deliver, Baby A has very poor prospects for survival and high likelihood of disability if it survives. She essentially dismissed the 24 week mark as any type of accomplishment and said that really 27 or 28 weeks would be a better baseline. I am acutely aware of this, as I have tried to articulate in previous posts. But having a doctor who does not acknowledge any level of success was so disheartening.
She did say that she would recommend a course of steroids for the babies next week, contrary to our usual doctor's recommendation. She also indicated that if I relocate to be close to the hospital, they will send a nurse to my home a couple of times a week for monitoring and see me weekly at the hospital. I at least liked that.
Facebook status of the day: So exhausted and so filled with love. Let's keep going, Little Peas.
Tuesday, October 8, 2013
A Shot at Optimism - or maybe just Distraction
Over the past two - three years I have completed my graduate degree and moved to a small town in which it has proved difficult for me to develop new friendships. However, in that same time frame I have met some incredible women. I believe that I am at that stage of life in which the friends that I have wonderful people and that I am certainly a better person because I have them in my life. I should not be surprised then, that these same women have been unfailingly supportive of me through this pregnancy. They show up with food, they talk about the 'outside world', they let me cuddle their own young children, they remind me how to laugh and they shed a tear with me sometimes, too.
One such friend, BK, visited me yesterday. She came bearing food, interesting stories and then whisked away to have her hair done (insert my own enviousness of the latter here). She mentioned that she and her sister each follow my blog - which I had figured out about her since she always seems to know my latest update before even visiting (one more demonstration of her friendship fantastic-ness). She also noted that generally negative over-tone of my blog. And although I cannot say for sure, I do not think that she is the first friend or family member to say this. So, I brainstormed for a bit and came up with something that is less negative.
If I had not ruptured, but for some reason had started to blog about my twin pregnancy, I would write a couple of things at this point (22w5d).
- I am in belly button limbo. With my first pregnancy my belly button stretched out as I neared the end, but it never popped out. But last night my sister and I agreed that I no longer have an innie, but it is not quite an outie. The inner part is making it's way out, leading me to belly button limbo. My belly button, my sister says, is not longer a button! Identity crisis!
- My pregnancy 'bump' is larger than I realize. I have loads of maternity clothes from friends. I often take out shirts or camisoles and think to myself that it just looks too big. I cannot imagine my friend ever having worn this, but it is certainly too big for me. I put one on today: it's almost too small. And if I was expecting a full term pregnancy, I would only be just past halfway!
- My chest is so vein-covered. I know this happened last time, but I swear it is more, sooner, bigger this time around. I look like a water-way map of Canada when I wear a low-cut shirt.
- I am no expert, but my sister and I also measured my fundal height (size of belly) last night. Compared to the midwife's measurement a few weeks ago, I have expanded by about 5 cm. Eek! But, then I remember that I had been in a slouching position, not standing, when she checked. So, I assumed the same position: it only brought me down by about 1cm! I think I am measuring to the equivalent of a 35 week singleton pregnancy! No wonder I have heartburn.
I am sure there is more, but these were the fun things that I could think of. There you go, BK!
Facebook status of the day: Distracting self from the countdown - 9 days to viability
One such friend, BK, visited me yesterday. She came bearing food, interesting stories and then whisked away to have her hair done (insert my own enviousness of the latter here). She mentioned that she and her sister each follow my blog - which I had figured out about her since she always seems to know my latest update before even visiting (one more demonstration of her friendship fantastic-ness). She also noted that generally negative over-tone of my blog. And although I cannot say for sure, I do not think that she is the first friend or family member to say this. So, I brainstormed for a bit and came up with something that is less negative.
If I had not ruptured, but for some reason had started to blog about my twin pregnancy, I would write a couple of things at this point (22w5d).
- I am in belly button limbo. With my first pregnancy my belly button stretched out as I neared the end, but it never popped out. But last night my sister and I agreed that I no longer have an innie, but it is not quite an outie. The inner part is making it's way out, leading me to belly button limbo. My belly button, my sister says, is not longer a button! Identity crisis!
- My pregnancy 'bump' is larger than I realize. I have loads of maternity clothes from friends. I often take out shirts or camisoles and think to myself that it just looks too big. I cannot imagine my friend ever having worn this, but it is certainly too big for me. I put one on today: it's almost too small. And if I was expecting a full term pregnancy, I would only be just past halfway!
- My chest is so vein-covered. I know this happened last time, but I swear it is more, sooner, bigger this time around. I look like a water-way map of Canada when I wear a low-cut shirt.
- I am no expert, but my sister and I also measured my fundal height (size of belly) last night. Compared to the midwife's measurement a few weeks ago, I have expanded by about 5 cm. Eek! But, then I remember that I had been in a slouching position, not standing, when she checked. So, I assumed the same position: it only brought me down by about 1cm! I think I am measuring to the equivalent of a 35 week singleton pregnancy! No wonder I have heartburn.
I am sure there is more, but these were the fun things that I could think of. There you go, BK!
Facebook status of the day: Distracting self from the countdown - 9 days to viability
Saturday, October 5, 2013
A Scary Night
Disclaimer: this blog may have too much information for some readers.
Last night I noticed that I was bleeding while in the bathroom. I calmly (on the outside, freaking out on the inside) phoned my spouse and asked him to come home immediately. I paged an MFM Specialist and waited for a call back. In those few minutes that I sat on the couch alone I heard myself begging aloud. Please don't let this be it. Please, please, please don't be the end. Please...
The Specialist informed me that this may be the beginning of a late miscarriage and that I should attend the nearest hospital for confirmation and to determine if I can travel to the city hospital. Lee, my sister and I ensured that our hospital bag had everything we needed, including the little blankets and toys we'd purchased for the babies. We grabbed the camera and Lee and I headed to the hospital, trying to mentally and emotionally prepare ourselves for the end. Thanks to adrenaline, I was able to do all of this without crying much; I shook like a leaf, but got myself to the hospital and through triage.
One of my biggest concerns was that we could be wasting time in a hospital which is not equipped to support me during a miscarriage, which I communicated to the nurse. As minutes passed while we sat in our small room, we calculated how far we could have been in relation to the High Risk clinic. Unfortunately the staff did not seem overly familiar with their own procedures. They had us wait for the ER doctor for about 30-40 minutes at which point he paged the OB - which could take another 40 minutes. Luckily, this doctor did acknowledge his own limits. Who does not appreciate some humble honesty? I strongly discouraged a digital examination to determine if my cervix (to try to avoid infection) was dilated and he respected this and said it would be better to have an OB who has experience in this if there is risk involved.
Up to the OBS section of our small town hospital, we found ourselves the only patients. I do not mind that I did not have to hear others celebrate the safe arrivals of their full-term bundles of joy. They monitored babies' hearts and my bleeding and decided to keep me at the hospital for observation for the night. The bleeding seemed to generally subside over night, thankfully. The nurses were supportive throughout the ordeal and this morning it was decided that it was likely cervical bleeding for which nothing could be done. Before leaving one nurse assured me that I am never an inconvenience and that if I need some reassurance at any time during the pregnancy, I can attend the unit and have some monitoring done.
Am now back home on bed rest hoping, praying... that this is not the end.
Facebook status of the day: Thankful, desperate for another day
Last night I noticed that I was bleeding while in the bathroom. I calmly (on the outside, freaking out on the inside) phoned my spouse and asked him to come home immediately. I paged an MFM Specialist and waited for a call back. In those few minutes that I sat on the couch alone I heard myself begging aloud. Please don't let this be it. Please, please, please don't be the end. Please...
The Specialist informed me that this may be the beginning of a late miscarriage and that I should attend the nearest hospital for confirmation and to determine if I can travel to the city hospital. Lee, my sister and I ensured that our hospital bag had everything we needed, including the little blankets and toys we'd purchased for the babies. We grabbed the camera and Lee and I headed to the hospital, trying to mentally and emotionally prepare ourselves for the end. Thanks to adrenaline, I was able to do all of this without crying much; I shook like a leaf, but got myself to the hospital and through triage.
One of my biggest concerns was that we could be wasting time in a hospital which is not equipped to support me during a miscarriage, which I communicated to the nurse. As minutes passed while we sat in our small room, we calculated how far we could have been in relation to the High Risk clinic. Unfortunately the staff did not seem overly familiar with their own procedures. They had us wait for the ER doctor for about 30-40 minutes at which point he paged the OB - which could take another 40 minutes. Luckily, this doctor did acknowledge his own limits. Who does not appreciate some humble honesty? I strongly discouraged a digital examination to determine if my cervix (to try to avoid infection) was dilated and he respected this and said it would be better to have an OB who has experience in this if there is risk involved.
Up to the OBS section of our small town hospital, we found ourselves the only patients. I do not mind that I did not have to hear others celebrate the safe arrivals of their full-term bundles of joy. They monitored babies' hearts and my bleeding and decided to keep me at the hospital for observation for the night. The bleeding seemed to generally subside over night, thankfully. The nurses were supportive throughout the ordeal and this morning it was decided that it was likely cervical bleeding for which nothing could be done. Before leaving one nurse assured me that I am never an inconvenience and that if I need some reassurance at any time during the pregnancy, I can attend the unit and have some monitoring done.
Am now back home on bed rest hoping, praying... that this is not the end.
Facebook status of the day: Thankful, desperate for another day
Friday, October 4, 2013
Questioning Strength
Since beginning this blog friends, family, Facebook friends and acquaintances have praised the strength that I have had or demonstrated through this experience. I have challenged this once or twice with close friends and have otherwise expressed thanks. But last night, while I was not sleeping, I started wondering: what is strength? What is it that others are seeing in me that is identified as such? And really, why is strength important?
In one such discussion it was suggested that the mere fact that I have continued through with this, despite the odds against us, is a demonstration of strength. But I look back at the first days after Baby A ruptured - during which I was a complete basket case - and thinking about terminating the pregnancy. And in some sense, I guess I decided that I was not strong enough to make such a decisive decision. To open myself up to all that second guessing and uncertainty. Could I not argue that I have put my personal and family's well-being at risk because I was not strong enough to make that decision? Having said that, I do not doubt the decision to wait for mother-nature.
Looking outside the actual decision-making process, what is strength? I consider myself... surviving (not thriving!). I go day by day. My blog posts are largely filled with negativity, but more than anything, complete fear. Where is the strength in that?
I looked at some definitions of strength (physically strong) and emotional strength online. The Free Dictionary defines it as "emotional stability and resiliency, characterized by assertiveness, caring, coping, and stress-management skills" (http://medical-dictionary.thefreedictionary.com/emotional+strength). Maybe I have demonstrated this by researching pPROM, changing doctors, getting out of bed everyday despite the nightmare I am living,...? Maybe I am selling myself short, but that does not sound that strong.
I have read on other women's experiences of a sense of failure: a failure to have carried a child to full term, a failure to be fertile, etc. I have never considered myself as a person who holds this level of ownership. I generally have accepted that bad things happen to all of us and that I can only to my best to face or overcome those obstacles. I did not do anything to cause my infertility. Nor did I cause this rupture. BUT, then I look at my refusal to consider myself as demonstrating strength and it begs the question: do I believe that I deserve praise? Maybe not, if I have self-blame. Or does the language of being strong for the babies and fighting for them inherently entail ownership that I simply do not want to have? I beg the universe to keep me pregnant, not myself. So, do I blame myself for what is going on and count on myself to prolong my pregnancy or do I just view this as a nightmare that me and my family have been thrown into and I am just along for the ride? Am I powerless? Where am I in all this?
I do not have the answers to these questions. Something new to ponder...
Facebook status of the day: I am only sure of two things: complete fear and love
In one such discussion it was suggested that the mere fact that I have continued through with this, despite the odds against us, is a demonstration of strength. But I look back at the first days after Baby A ruptured - during which I was a complete basket case - and thinking about terminating the pregnancy. And in some sense, I guess I decided that I was not strong enough to make such a decisive decision. To open myself up to all that second guessing and uncertainty. Could I not argue that I have put my personal and family's well-being at risk because I was not strong enough to make that decision? Having said that, I do not doubt the decision to wait for mother-nature.
Looking outside the actual decision-making process, what is strength? I consider myself... surviving (not thriving!). I go day by day. My blog posts are largely filled with negativity, but more than anything, complete fear. Where is the strength in that?
I looked at some definitions of strength (physically strong) and emotional strength online. The Free Dictionary defines it as "emotional stability and resiliency, characterized by assertiveness, caring, coping, and stress-management skills" (http://medical-dictionary.thefreedictionary.com/emotional+strength). Maybe I have demonstrated this by researching pPROM, changing doctors, getting out of bed everyday despite the nightmare I am living,...? Maybe I am selling myself short, but that does not sound that strong.
I have read on other women's experiences of a sense of failure: a failure to have carried a child to full term, a failure to be fertile, etc. I have never considered myself as a person who holds this level of ownership. I generally have accepted that bad things happen to all of us and that I can only to my best to face or overcome those obstacles. I did not do anything to cause my infertility. Nor did I cause this rupture. BUT, then I look at my refusal to consider myself as demonstrating strength and it begs the question: do I believe that I deserve praise? Maybe not, if I have self-blame. Or does the language of being strong for the babies and fighting for them inherently entail ownership that I simply do not want to have? I beg the universe to keep me pregnant, not myself. So, do I blame myself for what is going on and count on myself to prolong my pregnancy or do I just view this as a nightmare that me and my family have been thrown into and I am just along for the ride? Am I powerless? Where am I in all this?
I do not have the answers to these questions. Something new to ponder...
Facebook status of the day: I am only sure of two things: complete fear and love
Thursday, October 3, 2013
An (un)Milestone
I am 22 weeks pregnant today. That means I have continued for 7 weeks after rupturing. Is this a milestone? Something to celebrate? I do not know. Much like my previous posts, it does not seem to mean much to have made it to 22 weeks. I have beaten the odds, yes. I am still pregnant, yes. But, I am not far along enough to have a chance to have the children I am trying so hard to grow. I am too scared to allow myself to think that because I have been alright thus far, that I will continue. So, on this (un)milestone day, I ask that others that have the capacity for hope without the fear of jinxing, to send that hope/wish/prayer/positive thought (I will take anything!) to my babies today and in the coming weeks.
In the mean time, without completely jinxing everything I hope, we have started to look at the October calendar. If I could make it to November, I would be past 26 weeks pregnant.... sometimes it looks not that far away, but then, it is. Anyways, we were looking at visitors, bed rest supports, etc. My Aunt, who has offered to request a leave from her work in order to support me/us (she's an amazing person, to say the least) and I discussed dates that she could visit. And it is in conversations like that in which time seems to fly - all the weekends are covered until the last one in October. We will get me moved to Ottawa/closer to the hospital sometime before then... crazy. It is so scary to try to plan ahead, but the little piece of me that I allow to hope gets excited that if we can just make it to the time we are planning for, then maybe, just maybe, these little peas have a chance.
Facebook status of the day: What's a milestone anyway? Only time will tell....
In the mean time, without completely jinxing everything I hope, we have started to look at the October calendar. If I could make it to November, I would be past 26 weeks pregnant.... sometimes it looks not that far away, but then, it is. Anyways, we were looking at visitors, bed rest supports, etc. My Aunt, who has offered to request a leave from her work in order to support me/us (she's an amazing person, to say the least) and I discussed dates that she could visit. And it is in conversations like that in which time seems to fly - all the weekends are covered until the last one in October. We will get me moved to Ottawa/closer to the hospital sometime before then... crazy. It is so scary to try to plan ahead, but the little piece of me that I allow to hope gets excited that if we can just make it to the time we are planning for, then maybe, just maybe, these little peas have a chance.
Facebook status of the day: What's a milestone anyway? Only time will tell....
Wednesday, October 2, 2013
I am a bed rest athlete
The notion of being on the wrong side of mercy has stuck with me since I first posted about it a couple of weeks ago. In fact, it had been on my mind so much that I forgot that I had posted about it before and began planning a blog about being on the 'wrong side of mercy'. Then I realized I had already done as much.
I have seen other pPROM mothers identify the first week post-rupture as the worst one. And certainly that week was filled with shock and grief. I never want to go back there. But I am not sure that the 20 - 24 week stress is any easier; they are both the worst! I have had time to adjust to our new reality, but I have invested six weeks in getting this far. I am so much closer than I was all those weeks ago to viability, but I am still far enough away that if I went into labour I would have the same outcome. My spouse and I have both talked about the anxiety that we are each feeling and the conversation keeps happening, night after night.
This got us thinking about the stressful nature of these weeks of gestation and we each found an athletically-based comparison most helpful to describe our current experience. I explained that it seems as though I am running a marathon in which the finish line keeps moving: it never seems closer and I know that as (if) I approach it at 24 weeks, it will move to 26 weeks. I am exhausted and have no idea how far I will make it in the marathon. I have never worked so hard while having no tangible finish line while simultaneously having the threat of complete loss hanging over my head. When and how will this end? I could never have prepared myself for such an emotional, heart-wrenching marathon.
My husband, on the other hand, explained it seeming like he is in a series of races. Perhaps this is slightly more optimistic. He described running a race which will end at 24 weeks but that he will immediately be thrown into the race for 25 or 26 weeks. Equally as exhausting, but at the very least, crediting the milestones he attains.
Either way, we are both exhausted by the prospect of having come this far but knowing that we might have only loss at the end of the journey. We want so desperately to have these two children.... sometimes I end up feeling like I cannot even see a finish line at all, I just feel lost, desperate and exhausted.
Facebook status of the day: Two hearts breaking without having even lost... the running continues.
I have seen other pPROM mothers identify the first week post-rupture as the worst one. And certainly that week was filled with shock and grief. I never want to go back there. But I am not sure that the 20 - 24 week stress is any easier; they are both the worst! I have had time to adjust to our new reality, but I have invested six weeks in getting this far. I am so much closer than I was all those weeks ago to viability, but I am still far enough away that if I went into labour I would have the same outcome. My spouse and I have both talked about the anxiety that we are each feeling and the conversation keeps happening, night after night.
This got us thinking about the stressful nature of these weeks of gestation and we each found an athletically-based comparison most helpful to describe our current experience. I explained that it seems as though I am running a marathon in which the finish line keeps moving: it never seems closer and I know that as (if) I approach it at 24 weeks, it will move to 26 weeks. I am exhausted and have no idea how far I will make it in the marathon. I have never worked so hard while having no tangible finish line while simultaneously having the threat of complete loss hanging over my head. When and how will this end? I could never have prepared myself for such an emotional, heart-wrenching marathon.
My husband, on the other hand, explained it seeming like he is in a series of races. Perhaps this is slightly more optimistic. He described running a race which will end at 24 weeks but that he will immediately be thrown into the race for 25 or 26 weeks. Equally as exhausting, but at the very least, crediting the milestones he attains.
Either way, we are both exhausted by the prospect of having come this far but knowing that we might have only loss at the end of the journey. We want so desperately to have these two children.... sometimes I end up feeling like I cannot even see a finish line at all, I just feel lost, desperate and exhausted.
Facebook status of the day: Two hearts breaking without having even lost... the running continues.
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