Wednesday, November 20, 2019

Craptastic! The low down on what to expect for your colonoscopy

This September I turned 50. There are many wonderful things about hitting the big Five-O, but the “welcome to 50” colonoscopy is not one of them. As I am the kind of person who needs lots of information about things, I took to Google to search for other people’s experiences with the prep and the procedure. I wanted to know what to expect and how to make the best of the “prep” everyone says is horrible.

There was precious little information out there, and a dearth of detailed information. The lack of information on what to expect each step along the way is largely why people are so nervous and fearful about the procedure. So, in my traditional way of doing things, I will write the information I wished I was able to find prior to my colonoscopy adventure.

The initial consult

The journey begins with a consult with a gastrointestinal doctor, who my primary doctor referred me to. They actually called me with an appointment day and time, which I had to change. This is typically a quick face to face appointment where your vital signs are taken, questions about your medical history, medications, and bowel habits are asked, and a brief discussion takes place about what to expect for the procedure and what bowel prep regimen you will use. You are then scheduled for the colonoscopy at a future date, and given your instructions for the bowel prep, in a handout. Be sure to ask questions at this visit, in as much detail as you need, because you won’t really get another chance until the day of your procedure.

Anesthesia or no anesthesia?

You are given an arrival time around 1 hour before your actual procedure so they can get you ready.
The procedure itself is typically done in an outpatient endoscopy clinic setting or the endoscopy unit of a hospital. My doctor was in a freestanding clinic. The lobby was designed to look like a tropical Zen garden, which was interesting and soothing.

Most people elect anesthesia, which really means you are sedated for the procedure with an anti-anxiety drug that makes you feel a little loopy and groggy and that relaxes you and another that essentially gives you amnesia, so you don’t remember anything. Yet you are awake and able to converse with the doctors the entire time, you just won’t remember it. You are not really “asleep” or “knocked out”, although I’m sure some people probably do doze off if the meds are strong enough for them to do so. With this option, you have an IV, Oxygen in your nose, a little gadget on your finger to measure your oxygen levels, an EKG, and a blood pressure cuff, and you are given all drugs to sedate you prior to the start of the procedure in your IV.

After the colonoscopy, which takes 20-30 min or so, you have to stay an hour or so to recover. Then you cannot drive or work for the rest of the day, so someone has to pick you up and take you home.

I opted out of the anesthesia. She seemed surprised, but also said more and more people, especially women, are opting to undergo the procedure without any sedation. Everything I could find on the internet (which wasn’t much) and talking to others who had no anesthesia, led me to believe it’s not painful. Uncomfortable at times, maybe, but I had all my kids without pain medication and know I react horribly to any kind of anesthesia and am super sensitive to drugs of any kind, so a few minutes of discomfort was far better for me than being down for a day or two to recover from the drugs.

I loved my GI doctor. She was easygoing, funny, and had a great bedside manner. She did her procedures on Tuesdays, so I had no choice of day, but I could choose the time. Choose carefully, as your last prep is usually about 4 hours prior to your arrival time to the appointment and you’ll spend most of those 4 hours on the toilet. If you are doing a single prep, it may be 6-8 hours prior. If you don’t want to lose much sleep, choose a later time of day. I chose 10:15, not realizing that was the arrival time. When I later received an appointment confirmation I learned my procedure was actually at 11:15.

My plan was to work from home in the morning prior to my colonoscopy, and then either work from home or go to the office afterwards, depending on how I felt.

The “prep”

Preparation for your colonoscopy will probably begin with a somewhat restricted diet for a few days prior. Even if it doesn’t, it’s a good idea to avoid difficult to digest foods like nuts, seeds, whole grains, fruits, veggies, and leafy greens. I had to avoid them for 3-4 days prior. Stick to soft, easy to digest foods and don’t eat a ton. Everything you put in for those several days prior will come forcefully out on prep day, remember that.

The day before you are usually allowed a simple breakfast of scrambled eggs, crackers, or mashed potato (no skin) in a small amount, after which you are only allowed clear liquids until after the colonoscopy. I actually forgot to eat breakfast, but I’m glad I did. I think fasting from solid food for 36 hours probably helped a lot.

Pro-tip on clear liquids and hydration before and during your prep:

Hydrate, hydrate, hydrate! You are allowed only clear liquids. Think anything you can see through including jello, Popsicles, juice, tea and coffee, etc. You cannot have milk or cream in your tea/coffee, however. You can also have sugary drinks, so unless you are diabetic, I recommend drinking lots of water, but also drinks that have calories and electrolytes in them like a sports drink. Avoid red and purple colored beverages, though. You will lose tons of fluid, so start hydrating days before, and drink as much as you can the day before and the morning of your procedure all the way until you are told to stop liquids by your doctor.

So, the real “prep” is anything but pleasant. It is a mega dose of laxatives usually provided in a packet that you mix with water in a specific ratio and must drink in a certain time frame, usually 30-60 minutes. It’s either in one dose, or two doses separated by a number of hours, depending on which type of prep your doctor prescribes for you. The timing relative to the time of your procedure will depend on the type of prep the doctor recommends for you and what time your colonsocopy is scheduled for.

My doctor prescribed Plenvu, which is a 2 dose prep. It’s relatively new. It was about $60 at CVS. It requires you to drink a lot less of the icky tasting mixture than most other preps, but its concentrated. None of them taste good and none of them are pleasant from what I’ve gathered.

Dose 1:

Starting around 5 pm the night before, I was to mix Pouch A with 16 oz of water in the provided container, shake it up, and drink it in 30 minutes. It was supposedly mango flavored. It was essentially a mega dose of salt water. It tasted disgusting. I sipped it. After about 45 min I had only managed to drink half of it. It made me queasy, gave me shivers, and I felt a little spacey in the head. I took to the internet and started to read the reviews of this particular prep. I quickly learned that was very common. Some people reported vomiting, but feeling queasy, cold and shaky, and generally crappy (pun intended) seemed to be the norm. NONE of this was discussed in my visit with the doctor.

Pro-Tips for getting the drink(s) from hell down:
  • Make it as cold as possible. I added ice and it helped a lot.
  • Use a straw, it avoids getting the full on disgusting taste in your mouth
  • Sip it slowly, don’t chug it. It seems the faster you drink it the more likely you are to throw it up or feel queasy
  • Chase each sip with a tasty clear liquid. It helps with hydration and kills the salty aftertaste. Something sweet helps.
  • Stir it frequently. The powder will settle out of the water a bit which makes the last few ounces super concentrated if you don’t keep stirring it before each sip.
  • Most everything I could find on the internet written by medical professionals said if you feel nauseous or vomit to take a break from the drink for 20-30 min, and then sip it slowly. Taking longer to drink it is preferred to not drinking all of it.
  • If you feel queasy, or think you will (chances are high you will!), have some peppermint or ginger handy (teas, candies, aromatherapy oil), an anti-nausea medication, either a homeopathic, an over the counter one, or a prescription one - ask your doctor. You could also try lemon or lime flavors or even suck on a lemon or lime wedge between sips (pretend it’s Tequila?)

After about 60 minutes, my normally very low blood pressure was 140/93 (I run 100/60), I had a headache and felt lousy. If you have high blood pressure, talk to your doctor about preps that have super high levels of salt (most do) and if you should adjust your medications.  My BP was likely higher than normal because of all the salt. I still had about 2 ounces of the salty solution left to drink after 90 minutes but I just couldn’t do it. I never finished it.

About 30 min into drinking, I had my first trip to the bathroom. Over the next 4 hours, I made several quick trips to the bathroom, and passed mostly brown liquid. I had no cramping, but very little “warning”, so stay close to the bathroom!

Pro tip for comfort:

Purchase a diaper cream and flushable wipes prior to starting your prep. Use the diaper cream often to protect your skin. Having hours and hours of frequent, liquid stools is very irritating to your skin. Toilet paper can be uncomfortable, too. The cream will protect your bum from the discomfort of the irritated skin. Your derriere will appreciate it. We have a bidet and it was a godsend. Others have reported sitting in a warm bath or taking a warm shower helps, too, but depending on how frequently you are needing to have bowel movements, how quickly they sneak up on you, and how liquid they are, you might not make it to the toilet from the bath.

After about 4 hours, things settled down and I was able to have a good nearly 6 hours of sleep.

Dose 2:

My alarm was set for 5 am, but I woke up on my own around 4. I had to pee and had another liquid stool. I made myself some tea, mixed my second “prep” drink, this time two envelopes of powder mix into the 16 oz container with water, and brought that with my laptop to the bathroom. Everything I read said once the second drink starts to work, you spend the next few hours in the bathroom, so I figured I might as well be productive. Guess where I wrote this blog post. :-)

I started drinking it a little before 5 am, alternating with my tea. I put lots of sugar in my tea! I found the second drink to be marginally more palatable as it was a sweet berry flavor. It didn’t taste quite as salty to me as the first one. It took me about an hour to drink ¾ of it, all of my tea, and a bottle of Bai coconut water, and during that time I had about 6 trips to the toilet, about every 10 minutes. They were quick, painless, and essentially liquid in nature. The cat kept me company while I camped out in the bathroom.

Also about an hour into the second round, I started to feel a bit queasy, lightheaded, and shaky. Not as bad as the first time, but not pleasant. My heart rate was actually low, probably because of the dehydration. I normally have a resting HR of around 56 (I’m a runner) but it was in the 40’s. This happened with the first round and only lasted a few hours. It took me about 90 minutes to completely finish drinking the prep.

The bowel movements by the time you are well into the second round of prep become essentially all liquid and frequent, about every 5-10 minutes for me. For a while I literally just sat on the toilet while it poured/dripped out of me essentially non-stop for maybe 20-30 min. It feels like you are peeing out your butt. There is literally little to no warning, so if you are not planning to sit on or very near the toilet for a few hours, you might want to wear an adult incontinence brief or a sanitary pad to avoid “accidents”. It just runs out of you with no effort. When your bowel movements are all liquid, yellow, and fairly clear, your prep has been successful. You are “clean”.

You still need to finish drinking all the prep drink though, to be sure your entire colon is cleaned out. I literally easily lost the equivalent of all the fluids I took in within an hour or two of drinking them, and then some. I also got a low grade headache and dizzy when I stood up because of the fluid loss and dehydration. It was about that same time I ended up sitting on the toilet for a good 20-30 min because I was running like a faucet. It was at this time I was most grateful for the heated toilet seat but really wished it was padded!

I should point out that at no time did I have any discomfort or diarrhea cramps. The discomfort was all in trying to stomach the prep drink and dealing with the side effects of it and the dehydration. I drank a TON, and still ended up dehydrated. The saltiness of the prep does help make you want to drink though, so that helps with the hydration.

About 3 hours after I started drinking the second prep, the bowel movements let up significantly and I was able to shower, get dressed, have one last cup of tea and a glass of water, before 8 am when I was not allowed to have any more liquids, and get a little work done. I had two more small, pure liquid (watery) BM’s before I left my house at 10 am. By then, I was wicked thirsty and getting hungry again.

Overall, despite the horrible taste and how I felt after the first dose, the second dose was less offensive in every way, and I would probably opt to use this prep again in the future. That said, if we can send people into space, why the hell can’t they make a prep that is entirely in pill form or that tastes GOOD and doesn’t make you feel like you are going to puke?

The Actual Colonoscopy

I left my house at 10, having had nothing to drink since 8 am per instructions. I reminded my husband to keep his phone with him and on vibrate in case he needed to come get me unexpectedly, but since I was opting for no anesthesia, I was allowed to drive myself there and home. I was so thirsty and getting even more hungry.

Why arrive so early? Well, they have to check you in, have you sign papers, make copies of your insurance cards, give you your ID bracelet and then you wait. Everyone in the waiting area was discussing how terrible the prep tastes. It was a pretty jolly group, actually.

About 45 min before my scheduled time I was brought into a large room with curtained “bays” with a stretcher in each bay. Everyone having procedures was brought into this room. There I met an aide who had me put my clothes in a bag, change into the fashionable hospital johnny and she gave me slipper sox to keep my feet warmer. She also gave me a warm blanket. My belongings were put under the stretcher and were with me the entire time. Then the nurse asked a bunch of questions like when I last ate, what I ate, what kind of prep I did, when did I last drink, what I drank, if I had any medications, allergies, etc. She took my vital signs and started an IV. This is absolutely necessary if you are having anesthesia, because they inject the sedative and amnesia drug via the IV, but they also require it for those not having anesthesia so they have access in an emergency.

The anesthesiologist came in to tell me I’d sleep through the entire thing. I told her nope, I wouldn’t because I wasn’t having anesthesia. She looked at me with some combination of horror and disbelief. As if to say why would you ever do something so foolish when we have perfectly fantastic drugs? She asked the nurse if it was true, as if I didn’t know what I was talking about. I don’t know what it is about anesthesiologists, but I’ve yet to meet one who didn’t think I was insane for saying no to anesthesia. Not when I gave birth and not for this. Mind you, my chart had “NO ANESTHESIA” written on it in big letters, starred, and highlighted, so I don’t know how she missed it when she looked right at it.

If you are having anesthesia, the anesthesiologist will come by and ask you a few questions, answer any that you have, and let you know, very briefly, that they will give you “something” to “knock you out” or “put you to sleep” and you won’t feel a thing.

She went on her merry way and the doctor came shortly thereafter to take my stretcher and me into the procedure room herself! She was not the best driver, which she kidded about along the way! In the room there were 2 nurses and the doctor. If you have anesthesia, there will also be a nurse anesthetist. In addition to the blood pressure cuff and pulse oximeter on my finger, they hooked up 3 EKG electrodes to my arms. I didn’t need the oxygen since I wasn’t having the anesthesia. Upbeat pop music was playing and we easily fell into conversation.

The procedure itself took about 20 minutes. None of it was painful. The colonoscope is a tiny camera and light at the end of a long, flexible tube, about the size of a finger. At times, there was pressure and discomfort, especially while the advance the scope in the beginning all the way to the end of your colon, sort of like when you feel super bloated and have a stomach ache, or if you’ve ever been pregnant, feeling the baby flip around and push against your belly, but it didn’t last long. I think it’s mostly because they inject air through the scope so they can see, so you feel distended and gassy and the scope just feels weird as it moves around the bends. At one point the nurse pushed on my belly to help it round a bend, and that actually made it feel much better.

Once they were all the way to the end of the colon they slowly back the scope out and that’s when they take a good look around, and that’s what takes the most time. This part was more comfortable. I watched on the TV screen and found it quite interesting. She showed me my appendix, the inside of my small intestine (very cool), and the rest of the journey was all the same looking. She did find and remove 2 polyps. That was also fascinating. I didn’t feel a thing! She kind of used a lasso and lopped them off. And then it was done. A little pressure at the very end, but nothing compared to childbirth and a hell of a lot shorter! Not bad at all!

I did find this video and website by a GI doctor in the UK that talks about colonoscopy that’s pretty interesting, if you want to see what the colonoscope looks like and hear a little about the procedure from a woman who is a colon cancer survivor. .


I was wheeled into the recovery area, which was just the other end of the big room I started in, and encouraged to let out the air. If you massage your belly and move around a bit it helps. You feel distended and gassy for a bit afterwards, but that didn’t last too long. They offered me something to drink and some toast, gave me a paper with pictures of my colon (what a conversation piece one of those would be on the wall!), and information on polyps. Those were sent to pathology to be tested and she said since I had polyps, I should have my next one in 5 years instead of 10, just to be safe, since polyps grow slowly, and although most are benign, they are what can grow into cancer in some people.

The nurse took one set of vitals, then since I was driving myself home and didn’t have anesthesia, I got dressed and they walked me out to the front door and sent me on my merry way, with parting chocolates! Female MD’s are the best! I was so happy to be able to drink again, I was so thirsty! I also ate some eggs and a little bit of oatmeal when I got home. They advise a soft, “easy” first meal or two so as not to upset your system too much with something hard to digest. I wasn’t as hungry as I thought I would be. It took a few hours before the bloating and gas discomfort subsided completely, but I worked the rest of the afternoon and felt perfectly fine.

Final Thoughts

All in all, I think people fear colonoscopy because it’s a mysterious procedure and because it’s not talked about in detail by those who’ve had them, or by the doctors and nurses who perform them and work with the people who have them all day, every day. Because it involves your backside and it’s an invasive procedure, people are anxious and fearful it will hurt, embarrassed because it’s “down there”, think they have no “signs” so they couldn’t possibly have cancer and thus don’t need to do it, or simply aren’t given the option to do it without anesthesia, which feeds the fear it’s painful.

The prep sucked, and I don’t look forward to doing it again, but that said, after talking with others who did different kinds of prep, none of them were “good”. I didn’t have to drink a gallon of the icky stuff in 2-3 hours. I wasn’t up all night and got several hours of solid sleep, and it worked great. I liked the split dose and now that I have experience with it, I know the tricks to make it as manageable as possible. I would do this variety of prep again, if for no other reason than I now know what to expect with it.

I think it’s important to keep in mind the purpose of the prep is to clean out your entire bowel system so the doctor can see everything clearly. This is a cancer screening, just like mammograms, prostate exams, and skin checks, it's just more invasive because it’s your colon, so keep in mind all the hassle of the prep, no matter how often you have to do it, is way better than treating colon cancer. SO many people avoid colonoscopies because the mere thought of it makes them uncomfortable. Anyone who has had colon cancer can tell you they’d much rather endure the prep and the colonoscopy, than the treatment for cancer, or taking the risk a pre-cancerous or early cancer area isn’t caught until it’s spread everywhere. A few hours of unpleasantness is a small price to pay for your health!

I hope that sharing my craptastic adventure has helped to ease your anxiety and encourage you to have that colonoscopy, whether you opt to use the sedation/anesthesia or without it. The most important thing is that you do everything you can to keep your body happy and healthy. It’s the only one you get, so take care of it!

Saturday, October 21, 2017

Losing L'il bean... Lessons in life, loss, and intuition

October 21st.  A beautiful Autumn day, yet again.  Just another day for most people, yet one of tremendous significance for me.  16 years ago, I was 38.5 weeks pregnant with twins, certain I might be pregnant forever.

17 years ago, I was having a very different experience on this day.  It's not one I talk about often.  It's not a birthday, holiday, or anniversary. Well, it is an anniversary, but not one that is ever acknowledged or talked about.  But I remember.  I remember vividly.  It's an anniversary that changed me, my relationship with my then husband, and my perspective and understanding of something still considered taboo to discuss by many.

If you've met me or read my blog, you know taboo and "not appropriate to discuss" is not a concept I subscribe to.  :-)

October 21st is the day I officially miscarried "L'il bean", sometimes referred to as "the little peanut".  Now if you've had a pregnancy loss yourself, you probably already *get* the depth of that sentence.

Now, October is pregnancy and infant loss awareness month. How appropriate.

The thing is, a pregnancy loss is so much more than "just a miscarriage".  It's a profound loss.  The loss of a life.  The loss of hopes and dreams.  The loss of confidence and trust in your own body for some women.

One in four women suffer a pregnancy loss at least once in their life. Some, have recurrent pregnancy losses. No one ever things it will be them.  Yet we all know many women who have had pregnancy losses, even if they don't tell you about it. We need to break the silence.

For me, at the time, it was one experience that taught me more life lessons than I could have ever imagined, even though it took years more to fully appreciate and understand them.

Let me explain.

L'il bean was conceived in late July.  In Bermuda.  I *knew* I was going to get pregnant based on a combination of cervical mucus and intuition.  I had an almost 2-year old son, and was a childbirth educator, so I knew my body and what it's signals meant.  Sure enough, 2 weeks later I was exhausted, emotionally labile, and constantly nauseous.  Yep, pregnant with baby #2. I peed on a stick and it said so!  It was confirmed by my midwife via a blood test.

As you would expect, I was excited. It was almost too easy to conceive.  For the next several weeks, I had the typical early pregnancy fatigue (which for me is always pretty significant) and nausea and oh, the tender breasts!

Then, around 8 weeks, I suddenly started to feel much better. My energy came back and the nausea went away.  In my previous pregnancy, that lasted well into the second trimester.  I tried to shrug it off, as every pregnancy is different, but deep inside, I knew this pregnancy was no longer viable.  I absolutely knew it.  In fact, I was worried from the beginning it was not going to stick.  I was afraid to say it out loud though.  I remember writing it in my journal.

The words every pregnant woman fears

Fast forward to my 12 week well-visit.  As the midwife listened with the doppler, I hoped to hear that galloping whooshing sound, yet knew I wouldn't.  No heartbeat.  They sent me for an ultrasound.  Confirmed.  No heartbeat.  No 12-week fetus visible.  Then the questions.  They asked me a bunch.  I asked one.  "What happens now?"  It had been nearly 4 weeks since I started to feel un-pregnant.  Why had I not miscarried yet?

I got no definitive answers, other than "You will, probably very soon.  It will be like a heavy period and maybe some cramping more than normal."  I was given the impression it would not interfere with my day other than the usual inconvenience of a period would.

**Somewhat graphic description to follow, may be a trigger for some**

Another 2 weeks and change went by before I woke up on the morning of Oct 21st around 4 am, with what felt like mild contractions every 5 or 6 minutes.  Must be the day.  No other signs though.  I couldn't sleep so I got up and wandered around the house.  I tried to read.  I had some tea.  I watched TV.  The cat sat on my lap.  Sitting became uncomfortable.

I woke my husband around 7 and told him what was happening.  The discomfort was becoming significant enough I was seeking comfort on my hands and knees, rocking, and trying to do some relaxation breathing.  I asked if he could stay home/work from home to care for our 2-year old, because I had no idea how long this was going to go on and how physically challenging it was going to be.

He said no.

He went to work. Even though he completely had the ability to work from home and take any conference calls from home.  Seriously?  I felt like I was in freaking labor.  Of course when I was actually in labor with my son, he also went to work that morning...

I called our day care provider, our son went 2x/week, but today was not one of his days.  I explained what was happening and she said absolutely, she'd take him for the day.  It was a 5 minute drive to her house.  Ever try to drive while in the middle of a contraction or abdominal cramp that causes you to double over?  Well, I did.  Not. Fun. Walking doubled over was also a joy.  Not.

WTF?  No one told me a miscarriage feels like labor, although it makes a world of sense.  Except I wasn't miscarrying a 15 week baby.  At best, L'il bean stopped growing somewhere between 6-7 weeks, if not sooner.  I was quite surprised it was this uncomfortable.

I had begun bleeding, like a heavy period.  I took a long, hot shower.  That felt good.  I cried.  I cried because I was alone.  I cried because it hurt.  I cried because I'd never get to meet L'il bean.  I cried because my husband didn't care or couldn't handle dealing with me and my physical and emotional pain, so I was left to cope on my own.

One of my most vivid memories is kneeling in front of my picture window in the sun.  The cat was lying there.  He knew something was not right.  He was trying to give me love.  Cats are intuitive and sensitive.  I rocked back and forth.  I cried some more.  The contractions were 3 minutes apart and lasting maybe 30-45 seconds, but damn, it felt like labor.  It was around noon.

I called the midwife to explain what was happening and get reassurance I wasn't going to hemorrhage to death.  She assured me it was normal.  However, she downplayed my description of it feeling like labor. She said miscarriage is not labor, especially this early in a pregnancy.  It's "just cramping".

That pissed me off.  I'm sorry, but I've been in labor and this felt exactly the same.  I know how labor works, she knows how labor works, why the hell would it be any different?  Your uterus is trying to expel a baby, whether it's a teeny bean or a full term baby, the mechanics are essentially the same.  She said it could last several more hours, but once I "passed" the "contents" of my uterus, it would feel much better.  She asked if I was alone and I told her yes.  She told me I should have someone with me since I felt lightheaded and dizzy in case I passed out, especially since my blood pressure ran low and my son would be coming home soon. She said I should not be alone.

I called my husband and asked him to come home, relaying what the midwife said. I was going to have to pick up our son by 3.

He said no.  Call my mother or my sister. He had an important meeting and could not come home early.  BTW, that important meeting was one he could have conference called in to.

Bullshit.  Some would say he couldn't deal emotionally, but this was not new behavior.  He was never attached to L'il bean.  My needs and wants were never a priority.  How I felt was entirely my problem.  Pregnancy and thus, pregnancy loss, was my problem. My job was to accommodate him.  He was the one earning the income after all.  If I needed help, I should call on friends or family.

Looking back, this day was the beginning of the end of that relationship.  I didn't recognize it at the time, but his lack of care and concern for me that day changed something in me.  It woke me up to a reality I was not entirely aware of before that day.

I called my sister and she came by after school.  She was in college nearby.

Shortly after I called her, and just before I had to go get my son, I passed what felt like a golf ball.  Probably what was the placenta.  I held a tiny shrimp on my finger.  Was that L'il bean?  I was fascinated.  I had a one-sided conversation with the tiny shrimp.  Then said good-bye.  I cried again.  I cried a lot that day.  I cried for the loss of L'il bean.  I cried because my husband chose work over me.  I cried because the sibling my son was supposed to be getting was but a memory now.

Physically I felt much better.  Heavy bleeding and cramping continued, but the contractions were gone.  I was exhausted physically and emotionally. I was still lightheaded.  I lost a decent amount of blood, I hadn't eaten all day, and I was no longer pregnant.  Officially.

I picked up my son.  My sister arrived shortly after.  She didn't really know what to do or say.  I asked her to entertain my son and make him dinner.  Around 5:30 or 6 I told her she could go home.  I put my son to bed and went to bed myself. 

Funny, I don't remember the interaction with my husband at all that night.  I may have withdrawn to the point of just avoiding him because I was pissed.

Supporting a woman after a pregnancy loss (or any loss of a child)

There are no words that bring comfort.  "I'm so sorry" is the best thing to say.  This meme really sums up how women feel when offered platitudes.  It might make you feel better and make you think it helps the bereaved mom, but it doesn't.

Try again?

They tell you to wait 3 months after a miscarriage before you try to conceive again.  That's kind of stupid advice, because if you do wait, and you do conceive 3 months later, guess what?  Your due date will be very close to the anniversary date of your pregnancy loss.

Guess what?  One year later, I was 38.5 days pregnant with twins. Yes, naturally conceived. I was facing an induction.  I had to go in for a stress test on the 19th. They wanted to induce, for good reason, and were determining if I (baby B in reality) could wait the weekend.  The decision was yes, they could wait.  Unless I went into labor on my own, I would be induced on October 22nd.

I was hyper-aware of the significance of October 21st to me, but I was the only one.  Would giving birth to twins one year after experiencing a pregnancy loss on the same day be difficult or empowering?  Was one of those babies the same soul who tried to come earth-side a year prior, and this time came with another? Part of me wanted October 21st to be L'il bean's day.  Part of me thought it would be rather amazing to birth not one, but two babies on the day L'il bean opted to "move out" of my uterus.

As it unfolded, the twins were born on October 23rd.  At 39 weeks exactly.  I had hired a doula and had two midwives and an OB caring for me.  I did not rely on my husband for any sort of physical or emotional support.  I had learned that lesson loud and clear.  He did lend some support, and sang my praises after the fact, but emotionally, I was not connected to him.  I was fully connected with my babies.  I labored with many people around, but somewhat alone, lost in the beauty that is hypno-birthing.

Looking back, carrying twins to term, birthing them naturally, un-medicated, and with Meghan arriving feet first, was one of the most empowering experiences of my life.  To hold those beautiful babies in my arms at the same time, gaze into their eyes, and know that I... my body, they, did something amazing that morning, it once again, changed who I was.  It changed my perspective.

Lessons learned

Now, 17 years later, I look back and I am grateful for L'il bean beyond measure.  I never met L'il bean (or have I?), but s/he taught me so much more through the experiences s/he gave me than I could have imagined at the time.

L'il bean taught me perspective, resiliency, the power of loss and love, and the importance of trusting your intuition.  L'il bean opened my eyes to a reality I had previously not fully recognized.  L'il bean taught me the "experts" don't always have all the answers, sometimes we teach them.

Losing L'il bean taught me it's ridiculous to wait until 12 weeks to share your pregnancy, because then you have no support in your pregnancy loss.  People are uncomfortable with talking about loss, but that doesn't mean your pregnancy wasn't important, that your baby's life was not valued, and that you have not had a profound loss.  Loss brings grief.  Grief deserves support. If more people talked about it, it would become the norm, and moms and dads and siblings would not have to carry the burden of their grief alone.

Thank you, L'il bean.  I have this silly image of a bean with wings flying around, not unlike a butterfly.  You were loved and you are missed.  I am grateful for being your momma, even if only for a short time.  You deserve a kiss.  Hug.  And a snuggle.  I wish I had the chance to give you those in person, but perhaps your purpose in my life was to teach me the very lessons I did learn from you.

And for that, I am eternally grateful.

Saturday, June 17, 2017

Alaska Cruise Adventure: Day One - Embarkation on Radiance of the Seas!

It's here, it's here!  It's finally here!  It's sail away day!  

Today we finally embark on a cruise that has been nearly 18 months in the making, and although the day dawned cloudy and rainy, it turned out glorious, on many levels.  

We had rented a car from National in Seattle and drove to Vancouver, BC.  It turned out that the rental car return was in the parking structure at Canada Place, and all we had to do was drop the car off, walk a short distance to an elevator, and we were at the cruise port!  Easy peasy!  We arrived at about 9:45 am, anticipating boarding at 11 am.

There were agents there to direct us where to drop our bags. We then were directed to customs, where we had a short wait at several check points (way too many, really, it was quite redundant).  

First it was the cruise check in, where our sea pass cards were issued. Then on to security, just like at the airport.  X-ray machines and metal detectors and the first passport and boarding pass check. Then onto a self check in kiosk for U.S. residents for passport verification and customs.  The machine printed a voucher which we then waited in a short line, maybe 10 minutes, for a customs agent to once again check our passports and passes. He was a hoot. He figured out we were travelling in a suite, so he asked if he could join us.  It was a quick check and off we went to a holding "pen".  

It was here that the boarding process was unlike others we've experienced. Typically, depending on your level with the cruise loyalty club and type of cabin (suites), the higher level members and those sailing in suites get a private lounge to wait in and priority boarding. Not so at this port. Everyone was herded into a waiting area with seats.  But some were left to stand.  We sat there a good 45 minutes or so. 

There was no overhead PA system, so random agents said something we couldn't hear to folks on the ends of rows of chairs, and they began moving people by row of seats through a door. This magical door lead to another holding pen where we sat for another 15 minutes or so.  We were waiting for the ship to be cleared by customs.  It was not too long after that they began boarding.  It was a bit of a wait in a long line to make our way from the cruise terminal and onto the gangway and finally onto the ship. I think we finally walked on the ship at about 11:30 am.  

As we like to do, we wandered the ship to get a sense of her layout. She was small, but beautiful.  She was aptly named, Radiance of the Seas.   Most everyone went to the Windjammer, which is the buffet style resturant for lunch right away.  We headed there just before we were allowed into our cabins (1pm), after most people had gotten their lunch. 

We had booked a junior suite. One of the perks of booking a suite, and for a cruise tour (cruise plus land tour), is that we earn double points in the loyalty club called the Crown and Anchor society.  So for a 10 day cruise tour, we earned 20 points. This allows us to jump one full level with just one cruise!   When we arrived to our cabin, there was a Happy Anniversary sign on the door and decorations inside.  In a twist of fate, both my husband and I had the same idea to surprise each other with the Anniversary package! So we had two!  He also ordered us a cake, which we snacked on the entire cruise!  

Outside elevator

rock wall

mini golf

The Colony Club

Our cabn

Our door

Our bed, with anniversary decor

sitting area of jr suite

Sitting area of jr suite

Bathroom of jr suite (not shown, full size tub/shower)

Dessk/storage of junior suite

The main seating in the centrum ("lobby")

English Pub

Solarium pool

solarium hot tub

Solarium pool

sail away

Sail away

Vancouver, BC

Squeezing under the Lion's Gate Bridge

Sevens card/game room

cool globe

View of centrum bar and fancy stairs

Schooner Bar

Towel Elephant Surprise

The suite was gorgeous. Recently refurbished and much bigger than we expected. We were in cabin 1580, on deck 10, towards the aft part of the ship.  One of the benefits of booking a junior suite is instead of the tiny typical cruise ship shower, we had a tub and a larger bathroom overall. We also had  walk in closet with ample storage including shelves, top and bottom hanger space (bottom rods fold-able and storable if you do not wish to use them, a tie/belt rack on the door, plus ample storage in drawers and cabinets both in the bathroom and the main cabin.  The beds can be arranged as two twins or a king.  We also had a sleeper sofa and a chair and ottoman with two side tables.  

The balcony was smaller than others we've had, but more a function of the size of the ship overall.  There was a padded lounger and two chairs and a small bistro table.  Since we were sailing Alaska, we did not spend much time lounging on the balcony, but more sitting in front of the glass admiring the scenery as we sailed by.  

The muster drill (mandatory) was interesting. Instead of assembling at our actual muster stations (lifeboats), we were directed to Chops Grill.  Apparently, all suite guests were there. We sat at the tables and waited for the crew to demonstrate and explain what would happen in an actual emergency. Others had to stand in other common areas in the typical stand in line formation with children and women ahead of the men folk. I guess another perk of being a suite guest.  Once we were dismissed, most everyone headed up on deck for sail away.  

We sailed away at about 4:45 from Vancover.  The sun had come out and it was quite warm!  As sail away often is, it was an enthusiastic and exciting time. We chatted with several others around us, many of whom were cruising for the first time.  We had a lovely view of Vancouver a we sailed away.  As we sailed toward the Lion's Gate Bridge, it looked like we barely made it under!  In reality, I believe the Captain said we had about 14 feet of clearance! Eek!  It was pretty cool to watch.

We then retired to our cabin to actually sit on the balcony and watch the mountains go by for a while.  We then unpacked (we had gotten our bags before the muster drill!) and enjoyed our cabin until dinner time.  

We had chosen the late seating for dinner, which was 8 pm. The dining room was about 70% full for this seating, with most cruisers opting for the earlier seating or my time dining. We were actually quite surprised by the number of folks we talked to who never ate in the dining room at all.  Seriously, if you are going to cruise, at least try the dining room for dinner and lunch on sea days. It's so much better than the food in the Windjammer/buffet!  
the way finder, touch screen

from our balcony

Sun setting from our balcony

Very cool glass elevators overlooking the sea

Amazing self-leveling pool tables!

ahhhhh, balcony

We were seated at a table for 10, but there were only 3 couples assigned to the table, or the other 3 never showed up for dinner. We scored a window table for the first time ever and on two nights, we saw whales while we were dining! One pod of Orcas and a few humpbacks!   

Our table mates consisted of a couple who were Pinnacle members with Royal Caribbean. To reach Pinnacle, you must have sailed at least 700 nights on Royal Caribbean ships.  I'll let that sink in for a minute...  We are now Emerald, which requires 55 nights on a ship (we earned it faster by staying in suites, so in reality, we've only taken five 7 day cruises and a 3 day land tour that counts as cruise nights).  They were a lovely couple and were probably about the same age as our parents.  The other couple was interesting.  While nice folks, they tended to have a negative vibe, and did not really "click" with the rest of us.  This is the hazard of group seating and with a low # of couples. We prefer to sit at a larger table ourselves, as we like to meet new folks, but it also helps if there is an awkward or uncomfortable silence or presence in the group.  Still, we enjoyed our dinners and the company.  We learned from all of them.  

After dinner, we checked out the entertainment on the ship and did a bit of dancing. Then we headed off to sleep, as we were still mostly on east coast time.  Tomorrow is a sea day and I have a massage at the spa! 

Alaska Adventure: Pre-Cruise in Vancouver, BC.

It's 9:46 am EST on Wednesday, May 31, 2017.  I'm somewhere over the midwest, courtesy of Jet Blue.  

Our day began at o'dark thirty and our flight began at 6:44 am.  For those doing the math at home, that's a 4 am wake up call and we were staying at a hotel at the airport!   We live over an hour from the airport, and parking is outrageous, so it was as expensive or less to stay at the hotel and get an extra 2 hours of sleep instead of driving or taking a limo from home.

I dozed for about 2 hours of the flight, and now, 3 hours in, my neck is stiff, my throat is dry, and my body already tired of sitting, but I'm excited.  This day has been over 18 months in the making. 

Why a cruise?

My husband and I first took a cruise for our honeymoon, nearly 5 years ago. It was our first.  We were not sure if we'd like cruising.  We didn't. We LOVE it!  

This will be our 5th cruise.  All of our previous cruises have been to the Caribbean.  In talking to other cruisers and reading about destinations, everyone seems to agree cruising to Alaska is a bucket list cruise, and quite possibly one of the most beautiful one can take.  We've talked about doing it someday ever since our first cruise.  We decided life is short, so we'd make it our 5th anniversary cruise!

We are loyal to Royal (Caribbean) cruisers, so the cruise line was easy to decide upon.  We (mostly I) spent countless hours researching when the best time to sail was.  The Alaska cruise season is short, because, well, ice, cold, and darkness.  So late May through early September is the window.  Given our schedules, the kids' school and summer commitments, and the availability of my parents to be able to fly up from Florida to stay with the kids, we decided on early June.  

Planning the Alaska Adventure

I booked the cruise the day the Alaska 2017 itineraries went on sale for Crown and Anchor members (we get a one day jump on the general public), so we had our pick of cabins.  That was in February of 2016.  There was also a 30% off sale going on.  We chose a junior suite on the starboard side of the ship toward the back.  We also booked a 10 day cruisetour, so after the 7 day cruise, we have a 3 day land tour.  Royal awards double points for suite guests, and junior suites are not *that* much more expensive than a balcony cabin, especially on the smaller ships.  We'll make emerald status once we have completed this cruise!   I tracked the price of that cabin category from that day and there was never a lower price, in fact increased by over $1000 at one point.  Take home message:  Book your Alaska cruise as early as possible. 

I have spent a lot of hours researching and planning our trip.  Trying to decide what tours and excursions to take, what clothes to take, what flights to take, where to stay pre-cruise, what to do pre-cruise, and recently, potential weather we will encounter.  We will be on the 3rd cruise of the season. The range of weather we must be prepared to deal with ranges from the low 40's (with a relative wind chill on the deck of the ship) to the mid 70's.  Rain is also very likely, and looking at the 7 day forecast, very likely for much of our adventure.  Wtih highs in the low to mid-50's.  I did not expect it to be gorgeous weather every day, but I am hopeful it won't be cold and rainy every day, either.  This made packing a challenge in terms of having to pack for 13 days and two or three seasons of weather. We take far less to the Caribbean!!  

And today, it begins!  

We landed at Sea-Tac at about 10 am local time.  We rented a car from National, the only rental agency that allows you to pick up in the U.S. and drop off in Canada.  I had researched the direct vs. a more leisurely and scenic route, but we opted for the direct route.  It was less expensive to fly into Seattle and we wanted a rental car for a few days anyway, so this was how we planned it.

Driving from Seattle to Vancouver was about a 3 hour drive.  It was not terribly scenic travelling Interstate 5, and there was more traffic than one would have expected going around Seattle in the middle of the day, but we did get a nice view of the city without driving through it.  Mt. Rainier was hidden in the clouds, unfortunately.  

Whirlwind tour of Vancouver's gems

It was about 2.5 hours to the Canadian border.  The roads got increasingly more scenic as we approached B.C.  Lush, green trees and a gently curving roadway.  The border crossing was quick and easy.  More like a toll booth than anything else, but instead of paying a toll, you showed your passports, answered a few questions about the purpose of your trip, and you were on your way.  We waited maybe 5 minutes for our turn.

Mt Rainier?

The road to Canada

The traffic in Vancouver was also surprisingly heavy for 2:30 or 3 pm in the afternoon.  We stopped at Van Duesen Botanical Garden, which was part of the plan.  The afternoon was increasingly cloudy and threatening with rain.  We walked around the garden for about 90 minutes, which was just enough time.  It started to lightly rain just as we were leaving.  

From there we went to our hotel.  It was in an area of Vancouver that was being rebuilt. Many tall office buildings and hotels were under renovation or being built.  We stayed at the Marriott Residence Inn.  It was easy to find (the city is a grid).  There were 22 floors, it was quite large.  More than adequate for our needs, and one of the more economical mid-range hotels from what I've read. Breakfast, which was included, was surprisingly good.  Quite a variety of options despite it's continental/mini buffet feel.

Our only full day in the city,  Thursday, we drove to North Vancouver, to Capilano Suspension Bridge park. It was raining and we arrived shortly after they opened. They provide free rain ponchos if you are not prepared.  It was $80 CDN for two of us, but worth every penny.  What a gorgeous place. It's in a temperate coastal rainforest.  Redwoods abound. Damn, they are huge!  

The park is so much more than the suspension bridge, although that is spectacular.  You do need to cross it to get to the bulk of the attractions on the other side.  Those afraid of heights will find this a challenge to cross.  

Capilano Suspension bridge.  Yikes!

Cliff walk! 

Beautiful nature walk

BIG trees!

Look up, not down! 

We were there about 2 hours. We walked across the suspension bridge first.  Holy cow. If you've never walked across one before, they are narrow, high, and you can most definitely feel the movement as people traverse it.  Most people stopped for photos along the bridge. It spans the Capilano river.  

Once on the other side, there is a gorgeous and lengthy canopy walk. It involves stairs and mini suspension bridges with informative plaques/signs along the way and gorgeous, literally bird's eye views.  There is also a nature walk along trails and boardwalks at ground level.  The rain really gave it a unique beauty almost making the green pop.  

We went back across the suspension bridge (only way back), and then did the cliff walk, which is an arched narrow (one person single file) suspension arch (no movement) from a cliff.  It offers a different perspective on the river below and how nature prevails with trees that grow out of/around the rock.  Educational signs and exhibits about water conservation and geology of the area dot the pathways to and from the cliff walk.  

Of course there is a gift shop and three options for snacks, a light meal, and beverages on both sides of the bridge and park.  Parking is self-pay for the parking lot or it's accessible but bus from the city as well.  It's well worth your time and dollars, especially if you love being literally immersed in nature.  

From there, we went to Stanley Park.The rain tapered off, although it remained mostly cloudy the rest of the day.  Stanley Park is huge, 17 miles around the perimeter which is called the sea wall.  It offers paved bike and walking pathways on the seawall and many hiking trails through the middle.  There is also an aquarium, a few playgrounds, a beach, and several areas to grab a snack or light meal as well as a few gift shops. There are even totem poles.  We spent a few more hours there, walking and exploring.  

Stanley park sea wall and the Lion's Gate Bridge

From there, we went to Canada Place. Our intent was to check out where our cruise ship would be leaving from the next day.  Canada place is interesting as it is attached to the Convention Center. There is also a Fly Over Canada movie, which we did. If you've ever been to Walt Disney World, it was Soarin' over Canada.  It was well done.  We wandered around for a while, then watched sail away for the Seaborn ship.  Given it was now about 5:30 and we had not really eaten a meal since breakfast, I was starving.  There was a bevvy of food options and we settled on an Italian place. It was okay, but at least we had food in the belly!

Canada Place

By now, especially with the time change from the east coast, we were tired.  We walked a few blocks to to get a case of water for the cruise and sea bands.  Then we went back to the hotel and crashed.

In hindsight another day at least would have allowed us to see more of the sights in the city.  It is a lovely city, and there are parts of the city I had wanted to see, but we are not city people, which you may have guessed given our choice of how to spend our time.  :-)

If you are cruising our of Vancouver, it's definitely worth your time to spend a few days exploring and experiencing this beautiful city and all it has to offer.  

Tomorrow, we cruise!