Second Year = Life & Death

My second year of medical school was filled with drama (as if my 1st year wasn't dramatic enough). I had spent the summer between 1st and 2nd year doing research with Dr. Linda May and meeting with a local reproductive endocrinologist to assess the physical damage that had been done to my reproductive system during the ruptured ectopic pregnancy and resultant open surgery (where they removed one of my fallopian tubes, a procedure called a salpingectomy). While the break from classwork was fairly drama free; it wasn't exactly a vacation. I saw the REI doctor at least once a week and worked between 20-40 hours with Dr. May on the research project. Even though I was quite busy, I still found plenty of time to relax and enjoy my time away from books and exams.

Dr. May and I studied the effects of maternal exercise on fetal nervous system development using a special machine called a biomagnetometer. The biomagnetometer is a special machine used to record the electromagnetic waves that are produced by fetal movement. It is very similar to the special cortical cap that is used to record brain waves when doing an EEG (electroencephalogram). The results from our study suggested that maternal exercise was quite beneficial to a developing fetus. I was later asked to present our study findings at a conference at KCUMB and at a convention in New Orleans (this is a link to an article about the convention). Dr. May was featured in Fit Pregnancy and our manuscript was selected for publication a few months ago! So, I guess that my summer work paid off; I can now say that I have a publication!

Dr. May and I working on our research project!

As for my reproductive evaluation; the summer evaluation did not turn out quite as we would have liked it to. We found out that it would be nearly impossible for Brian and I to conceive on our own. We were also informed that if we were interested in having children we should consider doing so sooner rather than later. ...Well, that gave me something to ponder while starting off my second year of medical school.

Year 2 = Life & Death

Second year is similar to the first year in the fact that it is learning the basic sciences before we are allowed to go into hands on training during years 3 and 4. Our school teaches medicine by the "genesis" system, where we learn the body in systems. So we study the musculoskeletal system as a whole and all of the conditions and medications that are related to that system, and then proceed through the rest of the body in a similar fashion (GI, reproductive, cardiopulmonary......). The 1st nine weeks of 2nd year are spent focusing on the nervous system. This section is known to be the most difficult section of all of medical school. The brain and nervous system are incredibly detailed and very hard to learn about. So, we are told that we must devote all of our time and energy into this section and then we can relax a bit while finishing off the rest of the body and studying for boards. That is exactly what I intended to do. I had survived year one, and I was going to do all that I could to devote all of my energy into making it through year two. No more issues, or drama in my life until medical school was over.......

That was my plan anyway, but things rarely go as planned. Instead of being able to devote all of my attention to this incredibly difficult section, my beloved Grandmother got very ill and was diagnosed with end stage lung cancer during my 3rd week of neuro. So much for no more drama. I was very close to my grandmother, so watching her go through the last 2 weeks of her life in horrible pain was a nightmare. The only thing that made it worse was the fact that while I was sitting by her side I was trying as hard as I could to memorize all of the intricate pathways in the brain. My Grandma's last wish was to die in the comfort of her own home. We did everything that we could to get hospice to step in and get her there before her final hours. We were able to succeed and she passed away a few days after returning to her house. At the time of her death she was surrounded by her family, and it was a very peaceful experience. We were all sitting by her bed holding her hands and talking about happy times that we had all shared when she took her final breath. 

 She was an amazing lady and I loved her very much. I wish that she were still here today; I know that she would get a big kick out of my having twins and becoming a doctor. She was very proud of the fact that she was able to get a degree and participate in science fairs. She always said that "back in her day, women didn't do things like that." She often told people that I was going to school to be a nurse. It didn't bother me and I usually didn't correct her. I don't know if she didn't know I was going to be a doctor or if she didn't understand that females were able to become doctors now. I guess I will never know. I wish that I had a picture saved on my laptop to add to this post, but I haven't uploaded any of my older photos yet... 

Grandma was 93 years old and had been living on her own and doing very well until a few weeks prior to her passing. Her quick decline in health was quite a shock. It made Brian and I think about how short life really is and how we have no certainty about the future. At that point we decided to consider working with the REI to have a baby. One of my closest friends, who was in my medical school class was getting ready to have her 1st baby, so we decided that this year was as good a time as any. We didn't want to wait until we were ready and miss our opportunity and regret it later, so we made an appointment with the doctor to discuss IVF.

So, about a week before the neuro final, I started giving myself injections in the abdomen to start the process of creating a new Million. IVF is very expensive, but Brian's insurance covered it. That was actually the deciding factor as to when we would attempt to procedure. Since his insurance was going to pay for it and the job market was a bit insecure, we decided to do it while we didn't have to fork over 15-20K out of pocket. I remember going through the final exam and having hot flashes and chills from the medication. Looking back, I have NO IDEA how I passed that exam. 

The IVF process takes 4-6 weeks and it isn't the most pleasant thing a couple can go through. You have to REALLY want to have children in order to give yourself daily hormone injections, and undergo 2 lovely surgical procedures. We really wanted kids, so we suffered through. I will never forget toting my little lunch cooler around with syringes everywhere that I went so that i wouldn't miss a scheduled injection. I even allowed Brian to inject me a couple of times and two of my best friends gave me shots just so that they could say that they helped get me pregnant. After all of the drugs and injections egg retrieval was a welcome event, because it meant that I was done with the shots and hormonal shifts. 

Retrieval went really well. They put you in a twilight state and use an ultrasound guided catheter to suck the eggs out of your enlarged ovaries. We got 21 eggs. As soon as they remove the eggs the embryologist surrounds each egg with sperm and leaves them to do their magic. The eggs are fertilized while the mom is waking up and the dad is hanging out in the waiting room. The next day we got a phone call saying that 19 of the eggs had fertilized, which meant that the ones that had not were probably not mature enough when collected. On day 2 we were informed that 15 of them were thriving embryos and that we would be undergoing a day 5 blast transfer instead of a day 3. It was a Sunday when we went in to "get pregnant." We were excited and nervous all at the same time, but we felt comfort in the fact that we had so many embryos.

Unfortunately when we arrived at the hospital we found out that only 2 of the 15 embryos had survived to the blastocyst form. We were crushed, and so was the doctor. So, instead of putting one embryo back in as we had planned, we put in 2. It didn't seem very likely that they would survive, so we were already planning on changes to make in our next IVF cycle. Well, that was the case until we got a call on Wednesday that informed us that 2 of the embryos that had not made it to blast stage on Sunday had started dividing again and were in excellent shape. They wanted to know if we would like to have them frozen for future use.....We froze; if those 2 had survived, what about the 2 that they put back in me???????????????

The next 12 days were perhaps the LONGEST days of my life. We had to wait until day 14 to have a blood pregnancy test to see if the IVF worked. Thank goodness that I had so much studying to do for school, because I think I would have gone crazy if I didn't have something else to focus on. 

On day 13 we had decided that we couldn't handle it anymore and went out and got some pregnancy tests. I drank a bunch of water and used the test as directed. We waited in anticipation for 3 minutes until the bright pink line appeared in the test box and then nothing showed up in the control area. Hmmmmm, what does that mean? It must be a defective test kit; how can you screw up a urine pregnancy test!!!! So, we tried again & this time within seconds both lines were BRIGHT pink! The waiting game was finally over. We were pregnant!!!!

The next day I got my blood test done and later found out that my hCG levels were so high that they thought I may be having triplets. At that time I think I might have had a mild heart attack! So, it was time to wait again. We had to wait another few weeks for the ultrasound to confirm a fetal heartbeat and to tell us how many. During this entire process I was still able to go to school full time and focus on my medical education. I aced the reproductive section; I think that I only missed a handful of questions on that final exam!

The very 1st picture of Molly (left) and Benjamin (right). The sight of this left Brian speechless for a day or two...

Benjamin

Molly.....the fact that she is upside down & kicking Benjamin,
is proof that personality develops before birth....

By Christmas we had gone through enough ultrasounds to feel comfortable to announce to the public that we were going to have twins and that we were due in late July. However, it was not until a few months ago that we decided that it was okay for the world to know that Ben and Molly are "test tube babies." So, I must apologize to anyone who is involved in our life, who is just finding out that the twins were made in a lab and who are shocked by the revelation. We did not keep this a secret from anyone on purpose; we just weren't sure how many people we wanted to share it with and we didn't know if we wanted the twins to know how they came to be. We have decided that it is a good thing for the twins to know and we want them to know while they are young so that they don't find out when they are older and go through some strange phase of hating us for not telling them everything or resenting us for not letting them know. We even found a few children's books about IVF babies and got them for the twins. They don't quite get it yet, but they do understand that we loved them long before they were born and that they are very special. Besides, now that I will actually be practicing medicine, I want to be able to share my story with patients who might be going through the same thing that we went through. So, enough about IVF....

The rest of year 2 went by really fast. We started studying for Step 1, which is our first of many medical board exams, and we whizzed through the rest of the body sections at warp speed. Nothing too exciting happened, except for my trip to New Orleans with my mother, Dr. May, and Dr. Yagoda. That was fun, except for the fact that I was VERY big and pregnant at the time. New Orlean's has some amazing food! I ate my way through the entire city! When we got back from they conference we started putting together the nursery when I wasn't too busy studying or going to class (so, we might have spent 3-4 hours a week on it). And then, at about 27 weeks I started having contractions that forced us to go to the hospital and be monitored in labor and delivery for a few hours. I was given IV fluids and some medication and the contractions stopped so I was sent home and told to return to the hospital 2 times a week for fetal non-stress tests so that the babies could be monitored more closely. It was not fun to try to schedule three hours a week at the hospital on monitors around board studying and class work!

I LOVED these adorable cupcakes from one of my showers!!!

A few weeks later, I was put on strict bed rest, because I was going into pre-term labor and the babies were too immature to be out in the world yet. The school allowed me to watch lectures over the internet, and I was told to postpone Step 1 until after the kids were born. A few of my classmates (& best friends in the world) would come over in the afternoon to study with me and to set up the nursery while I laid on my left side in misery. They would bring me treats and try to make my imprisonment seem more tolerable. I was addicted to frozen custard with cheesecake in it; no wonder I gained 72 pounds! 

One day when I was laying on the floor watching my friend fold adorable little onsies, I got a phone call telling me that my aunt, who I had lived with at one point in my life, had been found dead in her apartment.  I started sobbing and asked to be taken to my parent's house since I couldn't drive. We found out that she had died from a heart attack in her sleep and that her dog also passed away around the same time, right next to her. I have been told that animals often die a sympathetic death, but this occurrence confirmed it for me. I had spent a lot of time with my aunt and my cousin and we were very close. I couldn't accept the fact that she was gone and that she would not be around to meet the twins. 

At that point I started looking back over the obstacles that I had encountered while attempting to go to medical school & I started to wonder if maybe I should give up... Maybe all of these things were a sign: the ectopic, my grandmother passing, a twin pregnancy, the death of my aunt. Brian and I actually talked about  my quitting school and staying home with the kids and teaching skating again. We went so far as to contact the school's financial aid office to find out what would happen if I dropped out. What we found, was that we would owe over 150K and therefore could not afford for me to quit. If the obstacles that I had encountered were trying to tell me something, then I would need to win the lottery in order to follow their guidance and drop out. I didn't win the lottery, so I continued to go to school. 

I was 3 weeks shy of completing 2nd year when the twins were born. They were born at exactly 33 weeks gestation. A bit too early to be strong enough to handle the world, but tough enough to make it with a bit of medical support. We contacted the school and informed them of their early arrival and told them that they were in the NICU and that they would remain there until they were stable. We also sent them a doctor's note stating that I would not be able to return to school for 4-6 weeks since I had to have a C-Section. 

Molly Kaye (named after my Grandma); just a few hours old.
16 inches long, and weighing under 4 pounds

Benjamin Christopher a few hours after arriving to the world.
19 inches long, and 5.3 pounds

A few weeks later I got an email from the dean of medicine granting me a 1 year leave of absence from medical school in order to spend time with my tiny babies and help them grow and get strong enough to face the world. At that point in time, I needed the break since I wasn't feeling much like facing the world either...........

Our family with Double Dan, the man who helped us make Millions!!!!