Surgery Day - Cerclage

On Wednesday, J² nudged me to semi-consciousness at 5:30 a.m. That’s a real time, right? People actually wake up before the sun rises? Like, that’s a thing, right? So I stumbled out of bed, tossed on some comfortable clothes and we headed for the hospital. We checked in to the labor and delivery ward. It was very quite at 6:30 in the morning. We were taken to our room which didn’t bring up the fondest memories. The last time we were here it was not a happy moment. This time is for a better reason, and one that should help me get to the moment I really want.

I slipped into the fashionable hospital gown. The nurse, Barbara, started an IV. It was interesting because she put it in on the side of my forearm. Usually they haven’t been able to get an IV in my forearm because they say I’m too “vavle-y.” Better than in my hand. I felt like I could move. Barbara went and retrieved a Doppler to check the baby. At this time, my doctor arrived to touch base with us. After both her and the nurse tried and failed to hear the heartbeat (although they heard the cord), my doctor went and got an ultrasound machine. She stated that it is difficult to hear anything with a Doppler at 12 weeks. Not like I was having a mini freak out or anything. The logic part of my brain was telling me that it was too early; the pessimistic anxious side was……..

Internally, of course.

I think you get the point. The ultrasound (praise Dr. Ian Donald and Tom Brown) showed my squiggly little worm doing just fine. See? Nothing to worry about. Who’s panicking?

A little while later I was wheeled back to the OR. I got up on the table and they had me sit up and towards the back of the table. Since I was nervous about the epidural, Barbara talked me through what the anesthesiologist was going to do. I curled around a pillow and the anesthesiologist rubbed iodine on my back. Next, the nurse said I would feel something akin to a bee sting. The longest bee sting of my life. It lasted for a few seconds. To me, this was the worst part of the whole thing. Then came some pressure from the threading of the catheter and cramp like feeling when the medication was first injected. After that my legs started to tingle. I was scooted down to the other end of the table where my legs were lifted into stirrups. As the nurses were prepping, my doctor spoke with me. She asked if I could feel anything. I said that my legs were tingling (as if they fell asleep). She touched my leg and then pinched my arm and told me that’s what she did to my leg. I did not feel the pinch. So I could feel touch and hot and cold, but not pain. When the catheter was inserted, the nurses said if the epidural wasn’t working I would have definitely felt it.

I was always under the impression that an epidural completely numbed everything. More of an assumption. So it seemed odd that I could still move my feet. Now, I do think they can numb it more, but there is no reason if you’re not in pain. Bonus, first time I didn’t feel the speculum.

The procedure itself took about 10 minutes. My little girl was all tied in.

Essentially

Back to the room I was wheeled with J² waiting for me. I spent the next three hours waiting for the anesthesia to wear off. Another ultrasound was done and she was still moving all about. Finally, around 11:30 a.m. my catheter and IV were removed. I was then able to get up to make sure I was okay to stand and walk. I received the all clear and was discharged.

I really thought I was going to be in more pain. Besides a little cramping (which was expected) and my back being slightly bruised (since I’m on blood thinners) I’ve been fine. Overall, I’m pleased I did it. I feel a little more secure in this pregnancy.  

Week 12(ish) Check-up

Today, we went in for a second check-up with my OB. I’m a day shy of 12 weeks. It’s been a very long month waiting for this next ultrasound. Even though there has been no indication of anything being wrong, I still held my breath when she pressed the transducer to my abdomen. In the past, my track record with ultrasound have been hit and miss. I’ve gotten the best news. I’ve gotten the worst new possible. This time was all good news. BIG sigh of relief.

There she is. In all her fuzzy ultrasound glory. Heart rate is just fine. Seems to be measuring right on track. It’s been over two years since I’ve been this far along. Hurray for the little victories. Of course, I don’t consider myself out of the woods until I can hold her (very much alive) in my arms.

The other purpose of this visit was to discuss putting in a preemptive cerclage. This type of cerclage is placed after 12 weeks gestation to help prevent the cervix from opening and starting preterm labor. Because this seemed to be the reason my second pregnancy failed, we decided this is the best answer to my problem. So I am scheduled for tomorrow morning (bright and freaking early) to have this surgery. I’m a little nervous, but I do believe it is the right action to take.

My doctor also talked to us about starting weekly progesterone shots at 16 weeks. It appears some studies are finding that these shots, from 16 weeks to 37 weeks, help prevent preterm labor in women who have experienced it before. This is only for singleton pregnancies. While we are leaning towards doing the shots, I’m going to mull it over for a bit. So much pressure to make all the right decisions knowing if anything goes wrong I’ll always blame myself.

For this visit I did the glucose test.

Doesn’t that look yummy. If you like things that are so ghastly sweet that it burns when you swallow it. And I failed. But looking at my results online it says that I’m within the normal range, even if it’s the tail end. Give a girl a break! So they want me to do the three hour test. I’ll probably talk to my doctor tomorrow.

So here we are – – 12 weeks and counting. I can’t wait until I get that bump and can feel her move.

2017 – A Year In Review

I’m sitting here, relaxing on my couch (as is my custom for the time being) and reflecting on what 2017 entailed for me in my infertile world. Roller coaster is pretty cliché, but the most accurate way to describe the up and downs and stomach-knotting feelings.

It started off as J² and I were finally able to proceed with fertility treatment once again after the tumultuous 2016 year. My RE wanted to perform a HSG. HSG stands for Hysterosalpingogram. It’s a procedure where a catheter is inserted through the cervix and dye is injected, x-rays are taken to see in the fallopian are opened. For most women, it will be mildly uncomfortable. If your tubes are blocked or if the shape of your cervix makes things like this difficult, you may experience more pain. I took some Ibuprofen and was fine. Many doctors offer Valium, but I didn’t take it. I’ve actually never taken Valium so I am unaware of how it would affect me. My doctor talked me (J² had to wait outside) through the whole thing and it lasted maybe 5 minutes. My doctor was very experienced in this procedure and that helped ease my mind.

My tubes were clear. Add that to the what’s not wrong with me category. So what the hell is wrong with me? It’s the stick that so many infertiles beat themselves with. Of that, I am not an exception.

We decided to try a few more IUIs. I would call at the start of my cycle and we were going to do Femara, FSH injections, and a trigger shot. That was the plan. Anyone else hear Mother Nature laughing?

We took a quick trip to Vegas to relax before being bombarded with hormones.

While there, I found out it was the Year of the Rooster. I was born in the 1981. So that meant it’s was my year, right? 

When we returned home I waited for my cycle. About a week later, I wasn’t feeling well. So I broke down and took a pregnancy test. Guess what? Serious! It was positive! I was pregnant! Without meds. That happens? After 14 years? It was my year! Hear that laughing again?

Well, maybe not laughing.

I won’t go into detail in this post but three week later, having both my RE and OB confirm it (on J²’s birthday no less). We lost this baby, also. I was scheduled for a D&C the following Tuesday (this was on a Friday).

The next couple of months as I waited for my body to return to, well, as normal as it could get, we decided to so some testing. First, J² and I had the karyotype testing done. The results came back as normal. So our chromosomes looked good. Next, I did the Recombine CarrierMap genetic screening. Those results showed that I was not the carrier of any tested disease (they test for over 300 diseases).

We weren’t ready to give up yet. In June we did an IUI. That failed. We had a discussion with our doctor about moving on to IVF. In the meantime, we did another IUI in July. That failed.

So….on to IVF.

I had more blood work done. Another OAR assessment. This showed my AMH had dropped from 9 to 6. Still high though. Because I was straight stimming, meaning I was not taking birth control to suppress my cycle, I had to wait for my cycle to begin. This was the end of August/beginning of September.

Between the egg retrieval and transfer, we took another short vacation to Vegas in October. I finally got to see “o.” It was nice to unwind and have fun and not think about what had happened and what was to come.

In November, the transfer was done. In November, I had a positive beta.

In December, I got to go to my family Christmas party, pregnant. In December, I had my first Christmas, pregnant. I celebrated (or chilled on the couch) New Year’s Eve, pregnant. I called J² my designated drinker.

Overall, 2017 was crazy. And as happy as I am to be carrying one of our embabies, I am also happy that 2017 ended on a better note than the past 3 years.

Ultrasound #2

This past Monday, J² and I went to our second ultrasound. Now most people are usually thrilled to get to see their baby. And we are no different, but for us there existed a slight apprehension. We don’t have the best track record for ultrasound. Too many times we have been dealt the blow of bad news. Not this time! With a room full of the doctor, nurses, and a phlebotomist, we got this little gem:

Isn’t that just the most beautiful sound? I want more than anything to hear that sound when I’m holding her in my arms.

On Wednesday, I had my first(again) OB appointment. So I had another ultrasound. I always seem to hold my breath until I can see that heartbeat. So at 8 weeks, here’s our little girl:

The mind-melting dichotomy between joy and worry makes me wonder if I’ll be sane at the end.

It looks like I will continue taking the Estradiol and Progesterone until 10 weeks. I will use Lovenox until about 36ish weeks then switch to Heparin. I’ve also discussed with my OB about putting in a cerclage (more on that later).

For now, I have to wait o month before my next appointment. I may lose my mind.

FET Update #2

Houston, we have a positive! 

On November 27, I went in for my beta. Which is just your first HCG test. After the longest hours of my life, seriously, it felt longer than the two week wait. 

The nurse finally called and told us that my HCG level was 775 mlU/ml. This is a really good number for 14dp5dt (or 14 days past 5 day transfer). I’m officially pregnant! My stomach had to untie itself. This is a step in the right direction. I am in a bit of disbelief that it worked the first time for us. Not every woman is so lucky.

We then set up a time for my first ultrasound. And that’s why I’m writing this later than I would have. Because I wanted to make sure things looked alright before sharing. We went in on December 7. Which put me at 6 weeks and 1 day. Guess what? Measuring in the correct range was our little girl.

This is what an early scan looks like.

Our little girl.

Can’t see much, huh? First off, she is at the top of my uterus, which means not as clear picture. And second, it’s too early to see much. Sometimes, you might see a little more, but I think the position makes it difficult. You know what else we saw? The tiniest flicker of a heartbeat. Again, still too early to hear it, but there it was. Our little girl’s heart.

A convergence of science and nature. I’m in awe of both. And, yes, in love with the result that has barely come to fruition.

Truth be told, we have a long way to go. I’ve been here before and know nothing is set in stone. We have my second ultrasound in about a week. Crossing my fingers that things continue to go well. It’s as if I’m on a teeter totter that falls between excitement and anxiousness. I am haunted by the past losses to ever be secure in the hopefulness of any pregnancy. No matter how happy I am, that cloud follows me like a pet.

I’ll continue taking the estrogen and using the progesterone. Oh, and also Metformin and Lovanox.  I’ll also be content in experiencing all the nausea, tiredness, and sore boobs.

FET Update #2 – - - PUPO!

The day has arrived! Transfer day. From the egg retrieval to now feels as if a decade has passed. All Monday my stomach and nerves would not settle down. I felt excited. I felt nervous. There’s a giddiness that comes with the knowledge that the following day you will technically be pregnant.

Tuesday morning, J² woke me up and tried to focus on getting dressed and not freaking out. The magnitude of what was going to happen fired every nerve I have. Now, some may be worried about the procedure itself, but this weighed little on my mind. All my understanding is it’s similar to an IUI so I knew at most for me there would be mild discomfort. No, all the anxiety came from the fact I was about to have one of my embabies put back in and the hopefulness of wanting her to stick.

So I chose a simple black dress, my new leggings, and, of course, my lucky socks.

Stylin'

Nice combination, right? A quick aside: can I tell you about those leggings? They are from a brand called LuluRoe. I had heard the name pop up now and again, but didn’t pay too much attention. Leggings have never really been my friend. For some reason companies don’t like to make leggings in a petite size. So whenever I would buy a pair they always go passed my feet. It’s ridiculous. Well, a couple of weeks ago J² and I attended a fundraiser event and a couple of ladies were selling this LuluRoe stuff. So I caved and bought a pair. Surprisingly, the leggings actually fit. They are very soft and have a wide waist band. Which is a plus in my book. So these leggings made a good choose to wear for transfer day. We’ll see how well they hold up. Now back to transfer day. . . . .

I was told by the nurse to drink water on the way down so my bladder would be filling up by the time I arrived. The main clinic with the OR is about 45-60 minutes away. Your bladder needs to be full (not bursting) so the doctor can see the uterus and where to implant the embryo. Off we went; with a minor detour because of a freeway accident that had the road completely halted.

After checking in, we were taken to a consultation room to go over the finer details. The nurse had us sign a consent form and discussed the post-transfer instructions. This includes upping my Progesterone to twice a day and continuing my other medication (i.e. Metformin, prenatals, and blood thinner). My clinic recommends resting the remainder of the day and abstaining from activities that will make the uterus contract for a few days.

Next, the doctor came in to explain the procedure. He wasn’t our regular doctor, but that happens if you fall out of your doctor’s batch. He offered Valium, but said it didn’t look like I needed it. And I didn’t. He realistically gave us a 40% chance of this succeeding. I’m not sure if he is low-balling it or it’s just the sobering fact how hard this is. I am 36 so I get the distinction of being of advance maternal age. Evidently, my uterus needs a walker.

We are then taken to the pre-op area and I change into one of those stylish gown. J² gets to don a paper gown and mask. He looks good.

As we were waiting, I looked at the clock and mentioned how the digital face didn’t match the analog. The analog was reading 11:13 and the digital was at 11:14. Yeah. So it took after the clock turned 11:14 to realize the digital wasn’t the time - - it was the date. Duh. I blame my nerves and not me being an airhead. Ha ha!

The nurse came and escorted us into the OR. I got up onto the table and the nurse helped put my legs in stirrups. She did an abdominal ultrasound to check my bladder. Nice and full and I’m starting to feel it. At this time, the embryologist comes in and takes us through her part. She gives a picture our possible future daughter. She tells us they thawed the best looking one. Finally, the doctor comes in and we’re ready to go.

First, the doctor inserts the speculum (awkward and uncomfortable as usual) and cleans the vaginal area. The progesterone gel and mucus need to be flushed. Sorry, TMI. Secondly, a catheter is threaded through the cervix and positioned where the embryo will be placed. On a T.V. to our left we could see the petri dish with our embryo. At this point the embryologist confirms the name on said dish and then uses a needle to pick it up. The fourth step involves the embryologist bringing the needle containing the embryo into the OR and inserting it into the catheter that the doctor is holding in place. And lastly, the embryologist checks the catheter to much sure the embryo passed through. After the all clear is given, the speculum is removed. And that’s it. I’m officially PUPO. Pregnant Until Proven Otherwise.

Baby's first picture

In the red circle is the baby. The rest is the placenta.

I got dressed and we left. I mentioned to J² that I feel like I should feel different when leaving than when we first came in. Maybe a big flashing sign above my head that says, “baby on board.” I literally have a growing embryo inside of me. And, yet, it seems so surreal. I’m pregnant, but maybe not. I have no control of the outcome, but I’m worry that any sneeze, or cough, or even sleeping wrong will make the embryo fall out. The two week wait begins. Then I go in for blood work.

I’m trying to be positive, but also pragmatic. Be hopeful (yuck), but not get carried away.  

FET Update #1

How about an update? Currently in the midst of my first FET. What is a FET? It stands for frozen embryo transfer. As opposed to a fresh embryo transfer which occurs days after an IVF retreival. I must say this feels like a breeze compared to the retrieval process. After my cycle started, I went in for a baseline ultrasound and blood work. Raise your hand if you’re shocked by that. Standard modus operandi for a fertility clinic. Everything looked good. Now I’m taking Estradiol, orally, to help thicken my uterine lining. Aren’t you glad you now know that about me? Because you do. I’m also on Lovenox. Again. My stomach looks a little like those athletes who use that cupping method. Except my bruises are more gnarled.

On Wednesday, I have my next appointment. You’ll never guess what they are going to do. Ha ha ha! Did you say blood work and ultrasound? Well, you would be correct.

As of right now, my transfer date is November 14^th. That can easily change though. I’ll know more on Wednesday.

A laughable moment happened. I ordered Progesterone from a compounding pharmacy. It’s a suppository that comes in gel form. Many women either choose or have to do the shot form. I opted for the gel because I figured I’m going to be doing enough shots throughout this process. I received the medication; it comes in a tube. The instructions say to measure 1 gram. I’m looking at this tube and thinking, “how in the hell am I going to measure and use it?” Nothing else came with the medication. Sooooo……

Nope. A part of this equation is missing. The next time I saw the nurses I asked. Apparently, applicators should have been shipped with the Progesterone. I contacted the pharmacy and they sent those to me. Got to laugh where you can.

The First

Because I digressed a bit in the last post, I’ll continue my story here.

After consulting with our fertility doctor, we decided to try an IUI. IUI stands for intrauterine insemination. A nice fancy term for artificial insemination. After receiving the sperm sample, the clinic washes it to help eliminate the poor swimmers and produce a good concentrated sample. It is then injected into the uterus. Like putting Micheal Phelps into a kiddie pool. We want the fastest going the shortest distance. It’s a decent option for women with PCOS and no male factor infertility (MFI). Less evasive, less expensive.

We did our first one in July 2014. It failed. I took this failure the hardest. Perhaps, I was more hopefully than I acknowledged. Perhaps, it was waiting 11 years for good news. I recall getting the negative pregnancy test that morning and felt like I was punched in the gut. The melancholy hovered about me the whole day.

August 2014. Second IUI. Negative.

October 11, 2014. Third IUI. Two week wait. I refuse to test until I’m a least a week late. So a that two weeks became more like three and a half weeks. November 5^th: I think I’ve given it enough time. My cycle hadn’t started. My boobs were aching. So, I tested. And there it was in digital form –-- “Pregnant.” Without the ‘not.” It was positive!!!!!!!! BFP! My first one ever. Little butterflies hatched in my stomach. My mind commenced spinning. Blood test confirmed it. I was pregnant. J² and I were finally going to be parents.

Two days later, I had an ultrasound. The baby was where it should be. We could see the gestational sac and yolk sac. Ten days after that we saw the tiniest heartbeat ever. I was amazed. The flicker of a heart in a white blob on the screen. I loved that blob. At this point we “graduated” to my regular OB. I must say that it’s somewhat humorous when I went in to schedule an appointment and they had to do a pregnancy test. Then the nurse comes into the room and say you’re pregnant. Yeah, all those records that were transfer to your office should have told you. Perhaps, OB offices need a protocol for when fertility patients are transferred. Anyway, I had my first follow-up with my doctor’s nurse practitioner. Everything is progressing nicely. Scheduled out the rest of my appointments for the whole pregnancy.

Tired and nauseous, I managed to make a couple pies for Thanksgiving that year. Did I mention I was tired? My brain was becoming numb. And I ruined the pumpkin pie. I forgot the sugar. Who needs that in a pie? J² said he liked it. But that’s because he’s not much of a sweets person. So don’t trust his word on that. The lemon pie was alright.

Over a week later, on a Sunday night, I started bleeding lightly. I spotted in the first few weeks, but it a stopped. I was trying not to panic. The next morning, I was still bleeding. It hadn’t increased in flow that I noticed. I called the my doctor’s office and they had me come in. We ended up sitting in the exam room for over an hour because the doctor had to deliver a baby. So we sat anxiously.

Finally, the doctor returned and I had a rock dropped on my chest. I was supposed to be eight weeks along. The ultrasound showed no heartbeat. After such a long time……..

She gave us the usual spiel that it wasn’t my fault. Most likely a chromosome issue. We are handed some papers that explain all about early pregnancy loss. The doctor went over our options if I don’t miscarry naturally. She mentions it can take up to a week or so. We set up to go back the following week. And we left. . . defeated.

During this time, I kept telling my work I was coming in, so as we left the hospital I told J² to take me there. He suggested we just go home, but I was adamant that I go to work. Then I would take the time off I needed to get through this. I think part of my brain didn’t want to handle what was happening. I had broad expectations of what was to come, but not any true understanding. I went to work, while J² played racquetball waiting for me. My job is at a recreation center. Midway through my main task I started cramping. At first, I could ignore it. Then quickly, the cramping intensifies to the point where I’m almost in tears. I tell my manager that I have to leave. I make it as far as the nearest restroom. It is there, at work, that I fully miscarry my first baby. I managed to keep myself together in order to get J² and go home.

I showered, curled up on the couch, and slept. And I just laid there. I struggled through a phone call with my mom. In between making sure I was okay, J² painted the utility room. Focusing on a project helps him deal with his emotions. He already feels helpless enough because he can’t make me better.

As much I mourned my loss, I also began to focus on moving forward. I had to. The biggest question was could I get pregnant again. I couldn’t give up, yet.

October – Pregnancy & Infant Loss Awareness Month and other rants

Purely coincidental, waiting for transfer day and October have synced together. With the next step in our IVF process a few weeks out, I wanted to write more on my infertility journey. And in my case that includes miscarriages. October has been designated as the Pregnancy & Infant Loss Awareness month. One in four women will experience such a loss. I won’t call myself an advocate. I can’t fit into that world. I’ll also leave the gentle posts to others that are better equipped to handle it. For many, a dark abyss forms, both in heart and mind, and you must contemplate the decision to let it consume you. And even if you fight it, that darkness still gets its piece and leaves an emptiness. All the while, as you face this struggle, majority of the world will be apathetical. I am not delusional enough to think that people who don’t know me would have any feelings about me. However, I, like plenty of loss moms, do know the sting of being dismissed by the people around you. I could be polite and say it’s because they don’t understand. Well, I call bullshit on that. We have all listened to the troubles and tragedies of others that we can’t relate to. Often we just want validation that our pain is real and is okay to feel. I fathom that the awkwardness of the conversation makes people hesitate, but I don’t find this the biggest issue. After initial sympathies are offered(if any at all), very rarely is there any follow-up. Why does this irritate me? Because I am inundated with constant melodramatic wailing about the importance of mental well-being and how people should support everyone. This is puffery in the sense that we have that kind of capacity. It is also dubious since I rarely see any action that accompanies all the Facebook and Twitter posts that boast about love.

One moment a women is being offered the promise of happiness. In the next, she essentially experiences a mini labor, her insides twisting and contracting,. That longingness she wished for has been expelled. She is left hollowed out. I do mean this both literally and figuratively. And too often she sits reeling from the catastrophe and the hormonal upheaval alone. Why is it now no one can submit a shoulder to cry on or bring food? Whether, these babies only lived in the womb or had the briefest of moments in their parents’ arms, they were our children and they were loved.

I know I’m rambling a bit. However, how you been in a room full of family members and not one comes up to you and express any kind of sympathy? I have. And it would kind of sucks, but I long ago came to accept that I’m not someone who people bother about. My mental and emotional state is dependent mostly on myself. This is just me, however, plenty of women need to connect with family and friends.

Each women experiences their loss differently. Each will tell (or not) their stories in their own way. Each will, hopefully, find a path to healing in their own time. But many would like to be remembered after life has seemingly returned to normal. Some need more support. Others would just like someone to ask: “How are you doing?” The acknowledgment that their child existed can do wonders. There’s a burden of feeling like you are the only one who remembers your baby. The arbitrary way your grief is treated isolates you.

Sentiments have a place. Pretty words might work for some. Actions. Making an effort. This is what I see as meaningful.

If we want to work on being more compassionate, then we should start by being aware of the people closest to us. I believe a more local focus helps us build a bigger picture. Otherwise, it’s just posturing.

Nope, not an advocate. I’m probably the jerk you think I am. Have a string of displeased people in my wake that agree. I’m just tired of people’s idea of “helping” is to do a fun run. Or whatever viral fad is making the rounds. We want the appearance of being a good person because we neglect to actually BE one. Not saying we’re inherently evil, but not as humanitarian as the facade we don.

Sorry, if this post became disjointed. When I witness the opposite of what I’m being forced-fed, well, my eyes are still rolling. And even though I don’t fit in with the specialty groups I’m a member of, I still want to see a better support bridge in place.

The PGS results

Technically, I received the call on Friday. We went on a quick trip and I didn’t feel like posting. Being in a hotel room feels like escaping reality. Your existence centers around that little room and it’s easy not to care about what is happening elsewhere. Sooooooo….we’re back home now.

Out of the eight embryos tested; five were cleared as “normal.” And—spoil alert—they are all girls. We now have five tiny female embabies waiting for us. Still, nothing is guaranteed. The chances of success do rise, but no certainties. We will be transferring just one embryo at a time. There are several reasons for this. First, I have previous have suffered from an incompetent cervix. So the smaller the gamble on multiples, the better. Second, due to the blood clots I had, again one baby is better. I will be on blood thinners my entire pregnancy. Third, it seems to be recommended for a normal, healthy embryo. This will give us five potential attempts.

It looks like the end of this month or the beginning of November we should be able to transfer. What of the other three? Two were male, one undetermined sex. One had trisomy (three copies of a chromosome) and two had monosomy (one copy of a chromosome).

I find it all surreal. Basically, we started with 20 maybe babies. Now we are down to five. I am very grateful to have them. It’s just astounding to see how fast they can dwindle away.

Can I go hide in a hotel again?