Right before I found out I miscarried, two people reached out to me about potential new jobs. A new job? I love my team, and I have a great boss. I came to my current company through an acquisition three years ago. Over these three years, I have been given tremendous growth opportunities that I would not have had in another environment. The first two years I felt like I was drinking from a fire hose, making it up as we went along, my learning curve as steep as I wanted it to be. It was fun. The last year has been more incremental, even though I have taken on and enjoyed new challenges like managing a development team.
So it seemed like a good time to get pregnant. With my job being in more of a steady state, I could take some time off. My previous pregnancy had turned out to be well timed - I would have given birth at the end of November, right before the holidays. So, my maternity leave would have been easy to manage with work.
But a new job. Hm. Could I do it? My husband encouraged me. He and I have had a shared attitude about work: prioritizing our career, and always pushing to learn more, do more. To him, staying in a job that was only "incremental" would not be fulfilling. I would have agreed a couple years ago, but now I was torn. I was concerned that while pregnant I wouldn't be able to perform in a new job to my expectation level, and then only for six months before I went on maternity leave. Not a great way to start, from my perspective. Also, I was still learning in my current role, and a couple of large initiatives were going to kick off over the summer.
In the end, my miscarriage decided for me. I didn't want to make a radical change for now.
But how will I feel in the future? What if I don't get pregnant again or soon: when do I make the decision to turn my focus from pregnancy back to finding that heady level of learning and excitement in my career?
It's a strange thing, not being in control, feeling like I don't have all the facts to make an informed decision. I don't even know why I miscarried. Most first trimester miscarriages are due to genetic issues, but there could be other issues including fibroids, collagen vascular disease (lupus), hormonal problems, and diabetes (http://www.medicinenet.com/miscarriage/page5.htm). During my D&C, they found a fibroid that they said was too small to impact a pregnancy, but who knows?
What I do know is that I will have to turn my focus away from pregnancy, and back to driving my career. For now, I'll give myself six months, and schedule a check-in for December.
Sunday, May 24, 2009
Wednesday, May 20, 2009
Patience
I have often said that patience is a virtue for others. Apparently, I've been missing some learning opportunities. Why patience is a virtue from WikiAnswers:
I love fast. I like the feeling of being somewhat overwhelmed, learning a lot on the fly, making quick decisions, doing minimal postmortems. I was like this as a child, and six startup years cemented it. Fast makes me happy and light.
Trying to get pregnant has been the antithesis of fast. It has required patience and much planning. We spend so many years trying to not get pregnant. In fact, our physical life cycle is not longer aligned with our societal life cycle. Teenagers can get pregnant so easily and don't want to. 30- and 40-somethings ready to have children have a hard, sometimes very hard, time.
Who knew that it's really only 1 or 2 days that you can get pregnant in a month? Yes, there are the stories of people who conceived a week after having sex, but those definitely seem to be the outliers at my age. And, who knew that modest business travel would get in the way of getting pregnant? There were three months last year where Ben had to go to conferences, and we missed my peak time each month. Those were the only times he had to travel those months. I'm not lucky, but what are the odds?
Starting to try a second time feels even slower. Right now, I'm just waiting, not even out of the gate. Waiting until my uterus has recovered. Being a type A, I can't help but compare where I am now to where I would have been. T-1 or 2 months before trying again, versus 4 months along. I'm competing with myself (or my alternate reality self?). Lovely.
Clearly I need to work on my attitude... Patience, please. I'll have a double. Straight up with a twist of optimism.
Patience is a virtue because it makes us better people. The definition of the word is to tolerate delay. This implies self control and forebearance as opposed to wanting what we want when we want it.
I love fast. I like the feeling of being somewhat overwhelmed, learning a lot on the fly, making quick decisions, doing minimal postmortems. I was like this as a child, and six startup years cemented it. Fast makes me happy and light.
Trying to get pregnant has been the antithesis of fast. It has required patience and much planning. We spend so many years trying to not get pregnant. In fact, our physical life cycle is not longer aligned with our societal life cycle. Teenagers can get pregnant so easily and don't want to. 30- and 40-somethings ready to have children have a hard, sometimes very hard, time.
Who knew that it's really only 1 or 2 days that you can get pregnant in a month? Yes, there are the stories of people who conceived a week after having sex, but those definitely seem to be the outliers at my age. And, who knew that modest business travel would get in the way of getting pregnant? There were three months last year where Ben had to go to conferences, and we missed my peak time each month. Those were the only times he had to travel those months. I'm not lucky, but what are the odds?
Starting to try a second time feels even slower. Right now, I'm just waiting, not even out of the gate. Waiting until my uterus has recovered. Being a type A, I can't help but compare where I am now to where I would have been. T-1 or 2 months before trying again, versus 4 months along. I'm competing with myself (or my alternate reality self?). Lovely.
Clearly I need to work on my attitude... Patience, please. I'll have a double. Straight up with a twist of optimism.
Sunday, May 10, 2009
Water babies
Going public with my miscarriage has been a surprisingly supportive and cathartic process. My husband and I decided to send the miscarriage news via email because we didn't want to end up in an awkward social situation should someone asked us how the pregnancy was going.
This "who do you tell" decision felt very similar to the decision I made about who to share my fertility issues with. Initially, I didn't want to tell anyone. I felt ashamed, and frustrated that I could not be successful at this in the same way that I was in my career, interests, etc. Then, I told a couple friends who asked me how "it" was going. The support and information they gave me was tremendous. I learned about acupuncture, heard stories about IVF, and I found out who among my friends I could talk to who had had similar experiences. Prior to that, I only knew two of my friends had had fertility treatment. This was only a fraction.
I ended up getting pregnant at the end of January right before starting fertility treatment. I didn't believe it so I ended up taking eight pregnancy tests. I'll save that story for another blog posting. Suffice to say that the sense of normalcy and shared experience helped me last fall and winter.
With my miscarriage, statistics give some comfort - 20% or greater chance of miscarriage in the first trimester, usually due to genetic issues. But, the stories are what have made me feel normal. I have been surprised at the number of my friends who responded to my email to say they had had a miscarriage, sometimes multiple. And they have beautiful children now.
One of my college girlfriends told me about water babies, unborn or not fully formed humans. In Japan, there are temples devoted to Mizuko kuyo, rituals for water babies. Zen master and teacher Robert Aitken writes, "[The water baby is] given a posthumous Buddhist name, and thus identified as an individual, however incomplete, to whom we can say farewell. With this ceremony, the woman is in touch with life and death as they pass through her existence, and she finds that such basic changes are relative waves on the great ocean of true nature which is not born and does not pass away."
We already had an in utero name for our bump. Ben named it Tex. Good-bye, Tex. I imagine Tex is surfing.
This "who do you tell" decision felt very similar to the decision I made about who to share my fertility issues with. Initially, I didn't want to tell anyone. I felt ashamed, and frustrated that I could not be successful at this in the same way that I was in my career, interests, etc. Then, I told a couple friends who asked me how "it" was going. The support and information they gave me was tremendous. I learned about acupuncture, heard stories about IVF, and I found out who among my friends I could talk to who had had similar experiences. Prior to that, I only knew two of my friends had had fertility treatment. This was only a fraction.
I ended up getting pregnant at the end of January right before starting fertility treatment. I didn't believe it so I ended up taking eight pregnancy tests. I'll save that story for another blog posting. Suffice to say that the sense of normalcy and shared experience helped me last fall and winter.
With my miscarriage, statistics give some comfort - 20% or greater chance of miscarriage in the first trimester, usually due to genetic issues. But, the stories are what have made me feel normal. I have been surprised at the number of my friends who responded to my email to say they had had a miscarriage, sometimes multiple. And they have beautiful children now.
One of my college girlfriends told me about water babies, unborn or not fully formed humans. In Japan, there are temples devoted to Mizuko kuyo, rituals for water babies. Zen master and teacher Robert Aitken writes, "[The water baby is] given a posthumous Buddhist name, and thus identified as an individual, however incomplete, to whom we can say farewell. With this ceremony, the woman is in touch with life and death as they pass through her existence, and she finds that such basic changes are relative waves on the great ocean of true nature which is not born and does not pass away."
We already had an in utero name for our bump. Ben named it Tex. Good-bye, Tex. I imagine Tex is surfing.
Saturday, May 2, 2009
Anemia and the Vegetarian
The doctors told me that although it would take me a month-and-a-half to rebuild my blood stores, I could resume my normal activities a few days after my surgery. It's been a week, and I'm exhausted! I was lucky to avoid a blood transfusion, but I had not fully appreciated how I would feel from the anemia caused by my blood loss.
I have had anemia often in my life. My parents say I was a precocious child. I could recite the alphabet when I was two years old. My physical talents were limited, however. So, I was excited when I became the tallest girl in my fifth grade class. This and needing to wear a training bra turned out to be indicators of early menarche at 10 years old. I was so young that my mom had not yet told me about the birds & the bees, much less a girl's "time of the month". I thought I was bleeding to death out of my bottom. My mom gave me a crash course on napkins and tampons.
From that time, I fought with anemia for many years. I had to be hospitalized when I was in 7th grade for passing out during a math test. I had had a period that ran for six weeks, and was very anemic. I got to stay at the Texas Children's Hospital for a week, and was very happy that I had my own TV to watch Dallas on, and that I could get popsicles from the nurse's station each day.
After that incident, I was put on the pill to regulate my cycle, but I still had migraines and fatigue each month due to the iron deficiency anemia associated with menstruation [1]. In my late-20's I discovered depo-provera, which was fabulous because I did not menstruate. Gone were the migraines that typically left me with no option but to turn off all light and sleep for several hours in the late afternoon. This was really life-changing for me. Being suddenly down for the count had been tough to manage with my start-up jobs, and my post-college social life.
Over the past 10 years, I have slid into vegetarianism. I have insisted that I will never become a strict vegetarian because of bacon (bless you, bacon, for your magical impact on hangovers). But, the reality is that I haven't had bacon in a couple years (unfortunately, no correlation with hangover frequency). Why vegetarianism? I love tofu (try it soft, raw with just a bit of ginger and soy sauce). I have lived with several vegetarians over the years, including my husband. So, cooking vegetarian food is natural for me. The health impact of eating meat versus vegetables has also swayed me. Finally, as I have learned about the significant environmental impacts of eating meat versus vegetables, it has become more firm as a way of life. It is how I am choosing to reduce my impact on the earth [2,3]. And, yes, I've become one of those somewhat opinionated but hopefully quiet about it West coast slow/local food folks. Quick plug for our organic produce box: Terra Firma Farms: www.terrafirmafarms.com.
How does this relate to anemia? I need to eat iron-rich foods, and meat contains more iron than vegetables. Happily, one of my surgeons at Kaiser is a vegetarian, and did not think I needed to eat meat to re-build my red blood cells and iron. She told me focus on eating iron-rich vegetables, and take the iron she prescribed. I have been taking 325 mg tablets of ferrous gluconate three times a day. Over the past week I have eaten broccoli, spinach, beans, and tofu. Vegetables have been steamed to retain their iron content, in our cast iron skillet to add iron. Vitamin C helps absorption so I have been drinking orange juice with the iron and vegetables. Each day I would get a headache starting at about noon, and continuing until I gave up and took a long nap in the early evening.
Getting enough iron from vegetables is not issue for healthy females. Healthy females 19-50 years old typically need 18 mg of iron a day. A 1/2 cup of tofu contains approximately 6.7 mg of iron, a cup of lentils 6.6, and a cup of spinach 6.4 [4,5].
That said, iron is more plentiful and more readily available in meat versus vegetables. Cooked beef contains approximately two times the amount of iron as tofu [5]. Generally, the redder the meat the more iron. So beef, more than chicken, etc. Interestingly, beef has 25% more iron than lamb [6]. The heme form of iron in meat makes it more readily available for absorption into the body. Also, meat preparation makes a big difference - shorter cooking keeps the iron in heme form [7].
So two nights ago, I decided to eat beef for one week, lunch and dinner. I have had tenderloin, beef burritos, and beef tacos the past couple days. I'm cooking a hamburger for lunch today - local, grass-fed organic beef, of course. I'm contemplating Blue Plate's meatloaf, though I guess that doesn't rate well on the cooking time scale... Looking forward to warding off those headaches.
References
I have had anemia often in my life. My parents say I was a precocious child. I could recite the alphabet when I was two years old. My physical talents were limited, however. So, I was excited when I became the tallest girl in my fifth grade class. This and needing to wear a training bra turned out to be indicators of early menarche at 10 years old. I was so young that my mom had not yet told me about the birds & the bees, much less a girl's "time of the month". I thought I was bleeding to death out of my bottom. My mom gave me a crash course on napkins and tampons.
From that time, I fought with anemia for many years. I had to be hospitalized when I was in 7th grade for passing out during a math test. I had had a period that ran for six weeks, and was very anemic. I got to stay at the Texas Children's Hospital for a week, and was very happy that I had my own TV to watch Dallas on, and that I could get popsicles from the nurse's station each day.
After that incident, I was put on the pill to regulate my cycle, but I still had migraines and fatigue each month due to the iron deficiency anemia associated with menstruation [1]. In my late-20's I discovered depo-provera, which was fabulous because I did not menstruate. Gone were the migraines that typically left me with no option but to turn off all light and sleep for several hours in the late afternoon. This was really life-changing for me. Being suddenly down for the count had been tough to manage with my start-up jobs, and my post-college social life.
Over the past 10 years, I have slid into vegetarianism. I have insisted that I will never become a strict vegetarian because of bacon (bless you, bacon, for your magical impact on hangovers). But, the reality is that I haven't had bacon in a couple years (unfortunately, no correlation with hangover frequency). Why vegetarianism? I love tofu (try it soft, raw with just a bit of ginger and soy sauce). I have lived with several vegetarians over the years, including my husband. So, cooking vegetarian food is natural for me. The health impact of eating meat versus vegetables has also swayed me. Finally, as I have learned about the significant environmental impacts of eating meat versus vegetables, it has become more firm as a way of life. It is how I am choosing to reduce my impact on the earth [2,3]. And, yes, I've become one of those somewhat opinionated but hopefully quiet about it West coast slow/local food folks. Quick plug for our organic produce box: Terra Firma Farms: www.terrafirmafarms.com.
How does this relate to anemia? I need to eat iron-rich foods, and meat contains more iron than vegetables. Happily, one of my surgeons at Kaiser is a vegetarian, and did not think I needed to eat meat to re-build my red blood cells and iron. She told me focus on eating iron-rich vegetables, and take the iron she prescribed. I have been taking 325 mg tablets of ferrous gluconate three times a day. Over the past week I have eaten broccoli, spinach, beans, and tofu. Vegetables have been steamed to retain their iron content, in our cast iron skillet to add iron. Vitamin C helps absorption so I have been drinking orange juice with the iron and vegetables. Each day I would get a headache starting at about noon, and continuing until I gave up and took a long nap in the early evening.
Getting enough iron from vegetables is not issue for healthy females. Healthy females 19-50 years old typically need 18 mg of iron a day. A 1/2 cup of tofu contains approximately 6.7 mg of iron, a cup of lentils 6.6, and a cup of spinach 6.4 [4,5].
That said, iron is more plentiful and more readily available in meat versus vegetables. Cooked beef contains approximately two times the amount of iron as tofu [5]. Generally, the redder the meat the more iron. So beef, more than chicken, etc. Interestingly, beef has 25% more iron than lamb [6]. The heme form of iron in meat makes it more readily available for absorption into the body. Also, meat preparation makes a big difference - shorter cooking keeps the iron in heme form [7].
So two nights ago, I decided to eat beef for one week, lunch and dinner. I have had tenderloin, beef burritos, and beef tacos the past couple days. I'm cooking a hamburger for lunch today - local, grass-fed organic beef, of course. I'm contemplating Blue Plate's meatloaf, though I guess that doesn't rate well on the cooking time scale... Looking forward to warding off those headaches.
References
- Anemia: http://www.webmd.com/a-to-z-guides/understanding-anemia-basics
- Environmental impact of meat versus vegetable consumption: http://en.wikipedia.org/wiki/Environmental_effects_of_meat_production
- Quantification of the environmental impact of different dietary protein choices: http://www.ajcn.org/cgi/content/full/78/3/664S
- Kaiser Vegetarian Meal Planning booklet
- USDA National Nutrient Database for Standard Reference at http://www.nal.usda.gov/fnic/foodcomp/search/
- New Facts about Iron in Meat: http://www.nutraingredients.com/Research/New-facts-about-iron-in-meat
- Heme, Ferritin and Vegetable Iron Absorption in Humans from Meals Denatured of Heme Iron during the Cooking of Beef: http://jn.nutrition.org/cgi/reprint/116/9/1720.pdf
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