the thing about pain....

1 Peter 5:10: 

“And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.”

“Cast not away your confidence because God defers his performances. That which does not come in your time, will be hastened in his time, which is always the more convenient season. God will work when he pleases, how he pleases, and by what means he pleases. He is not bound to keep our time, but he will perform his word, honour our faith, and reward them that diligently seek him.” 

~ Matthew Henry

Ethan, summer 2012, age 10

The day finally arrived. On February 1, 2013, eleven days ago today, my infertility became obviously permanent. This has been an incredibly difficult topic for me and I have mustered bravery from some unknown depth to be able to write about this anywhere but in the comfort of my own private journal, but here goes. 

I have a son, Ethan, who is 11 years old as of January 31 this year. So what I have experienced is technically termed "secondary infertility." Although I was completely unaware of my condition until several years ago, I have suffered with endometriosis since I was 13 years old. The problem with my pain was that I was always told "I just have bad cycles." In other words, deal with it. 

Romans 5:3-5

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God's love has been poured into our hearts through the Holy Spirit who has been given to us.

I have lived the last 29 years in 28 day increments. Contrary to what you may assume by that description,  I was not waiting for the "bad week" every month. I was waiting for the one good week I would have each month. My cycles were one week of premenstrual pain, one week of menstrual pain and one week of postmenstrual fatigue and malaise. Each month was scattered with periodic flares of pain, frequent ovarian cysts which would inevitably choose to burst at the most inconvenient times.  I have existed on an alternating regimen of tylenol, ibuprofen, alleve, and most recently mobic, until I am certain I have done some irreparable damage to my kidneys/liver sometime along the way. I never traveled without heating pads, and self adhesive hot pads are one of the greatest inventions ever to reach the shelves of your local drugstore.

I took oral contraceptives for many years, and I had some relief then. I truly believe it was because of these pills that I was able to conceive when I became pregnant with Ethan. The oral contraceptives, in a way, suppressed the endometriosis for a while, and possibly lessened the toxic environment in my pelvis such that I was able to carry a pregnancy. 

8 months along...

Being pregnant with Ethan was one of the happiest times in my life. I had no idea of course, that it would be the only pregnancy I would ever get to experience. But I loved every minute of it. I cherished the kicks in my belly. I loved carrying around my big and expanding midsection, making room for Ethan to grow in my ever increasing maternity wardrobe. I even loved the heartburn....as it was the constant reminder that my abdomen was not just for me, but had to be shared with this miracle growing inside me. I fell madly in love with the creature inside me I had never even seen or touched. 

A big part of my appreciation likely developed early on at around my 11th week of pregnancy when I began to bleed one morning while making hospital rounds. I immediately sought medical attention and the initial Doppler failed to detect Ethan's heartbeat which had been present the week before. I spent about 4 agonizing hours mourning the loss of an early term baby, as the nurse practitioner told me I had certainly miscarried based on her assessment. She referred me for an ultrasound later that day - hence the 4 hour wait - that ultimately confirmed she was in fact completely wrong. Ethan was fine, had a strong heartbeat, and likely I was just having some benign spotting that later proved to be of no consequence. 

1 Peter 4:12-13

Beloved, do not be surprised at the fiery trial when it comes upon you to test you, as though something strange were happening to you. But rejoice insofar as you share Christ's sufferings, that you may also rejoice and be glad when his glory is revealed.

So my pregnancy continued and I ate and gained weight like I was in a competition. Food had never tasted so good, and for that matter hasn't been that good since then! 

When I went for my 16 week ultrasound I was faced with another potentially devastating finding...Ethan had a choroid plexus cyst in his brain. This is for the most part a completely benign finding, but according to my physician, the anomaly can sometimes be associated with a chromosome defect (trisomy 8) which is incompatible with life. Yes, the baby might survive the pregnancy with such a chromosome defect, but with trisomy 8 he could be severely deformed and have pronounced neurologic derangements, and would not live long after birth. I asked about a million questions and researched the topic for hours, as any new young mother-who-is-also-a-physician would do, and panic set in. The odds were overwhelmingly in Ethan's favor that he would be completely fine - in fact he had absolutely no other problems on his ultrasound - but my mind went to all the bad places you could imagine. An amniocentesis was offered - recommended in fact, so that I would have the "opportunity" to terminate my pregnancy should he have a chromosome problem. Of course, the amniocentesis procedure itself can cause spontaneous miscarriage, creating the proverbial "catch 22"...do this test to be sure the baby is ok, but the test itself may cause termination of the pregnancy. 

Ultimately, I knew there would be absolutely no chance I would terminate the pregnancy, regardless of the status of his chromosomes, and I opted against the amniocentesis. Therefore, I truly did not know until the day Ethan was born if he would be ok or not. Talk about an eagerly awaited delivery. Of course, for those of you who know us, Ethan is absolutely fine and amazing and had not a clinical consequence of the choroid plexus cyst. 

All these trials, I am convinced, strengthened the bond with my baby, and with God, and inevitably left me to cherish every moment of what I now know would be the only pregnancy I would ever enjoy.

Ethan age 2

Ethan's arrival into the world was one of the most amazing times in my life, and has continued to be a daily journey of happiness and gratitude. After he was born, I was unable to get pregnant again. 

Ethan age 9

My monthly pain over the years escalated, and ultimately I underwent a laparoscopic procedure which confirmed the diagnosis I had most feared, stage IV endometriosis. I immediately knew the impact this could have on my chances of ever getting pregnant again. I had an "endometrioma" on my left ovary which was quite large, and caused the ovary to adhere to the side wall of my pelvis. I went on to have three more surgeries, all in an attempt to surgically remove (by various methods) the endometriosis implants that were causing me so much trouble. I was unable to let go of the idea that one day I may be able to have another child, and furthermore, I did not want to be postmenopausal yet. I was only 36 years old when all of this was unfolding in my life. 

Deuteronomy 32:4
⁴ He is the Rock, his works are perfect, and all his ways are just. A faithful God who does no wrong, upright and just is he.

I spent many many many nights questioning God about this. Why why why did this happen to me? I hear about women all the time who get pregnant but did not want to. Women get pregnant who were not even trying! Women get pregnant with far worse medical conditions than I had, why can't I?? I knew I wanted another child more than anything....if the Lord didn't want that for me, then why did he put this so heavy on my heart? My life was so full - I have a healthy son, a wonderful marriage, a great job, precious stepchildren and even now I am a "step-" grandmother, but yet there was an emptiness that was palpable in my heart. Where was the Lord in all of this? And furthermore, on top of all of that, each month I was greeted with the evil monstrous pain that only served as the reminder of my failing reproductive system. 

Galatians 5:22-23 

But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness,  gentleness, self-control; against such things there is no law.

That saying, "no one thinks about you more than you do" is painfully true. When we are faced with any trial or tribulation, we feel like no one else could possibly have felt the same grief or anguish that we have. Of course, in my profession, I see the grief and anguish of many, and yes that has helped me keep perspective that my own troubles are really pale in comparison to what could be. But it is all relative isn't it? When we are in pain, we hardly notice anything else. Whether it is physical or emotional pain, or both, the pain takes precedence over everything else in our lives. 

As I have coursed along this journey of endometriosis and all that it brings with it, I have repeatedly tried to outsmart it, deny it, accept it, and then repeat the cycle. Nothing, however, made it go away. Over the following years, the option of hysterectomy was offered many times by my physicians, although carefully so. The doctors working with me - bless their souls - knew how tender my heart was for another child, and they gingerly stepped around the topic of the permanence of a total hysterectomy. I just could not accept that Ethan was the only child I would ever have. And I could not understand why God was letting me continue to suffer through all of those years. And if I was not to have another child, why did I have one in the first place? When so many other women with endometriosis are not so fortunate? 

with my step granddaughters, Phoebe and Rosemary
Thanksgiving 2012

Finally, this past November, I guess the Lord grew tired of my stubbornness...He is a patient God after all, but really enough is enough...I knew when I woke up with the most horrific pain just before Thanksgiving, that my decision was made. The mobic - tylenol - advil cocktail no longer worked and I was trying to function as a physician with uncontrolled pain. Narcotics are just not an option for obvious reasons, and so my journey was in the midst of a serious turn. I called my physician and scheduled my hysterectomy, and on February 1, 2013, the pain that haunted me for nearly 30 years came to an end. 

Perhaps the greatest miracle occurred in November on that very day when the decision suddenly came to me so quick and easy. My heart had softened and I suddenly had no remorse any longer about my inability to have more children. My God had heard my cries and felt my tears all along, but He also heard my pleas and felt my resistance to making that next step of having the hysterectomy. He gave me space and time, all along though carrying me in His grace and love. I had questioned, "Why are you letting me suffer like this?" When in reality, I was the very reason I was suffering. Had I listened to His words years ago, when I clearly remember Him telling me -- countless times in fact -- that more children were not in my future, I would have had this surgery long before now, and my pain would have ended. When I stopped fighting His plans for me and I conceded to His will, my suffering ended. Why is this so hard for us to grasp as human beings? 

Hebrews 13:5-6, 8 tells us "...be content with what you have, because God said "Never will I leave you; never will I forsake you." So we say with confidence "The Lord is my helper; I will not be afraid...Jesus Christ is the same yesterday and today and forever." 

God was with me through the entire journey, even in the days of my pregnancy with Ethan before I even knew the future plans he held for me. My pain lasted far longer than it needed to in many respects, all because I was stubborn to give in to what God was telling me. But in a way, my suffering ultimately is what brought me closer to Him at this very time in my life. 

The truth of pain is this exactly. In no way does God want us to suffer...indeed I see many times looking back when He told me the truth of what I did not want to hear. But in our suffering, we can draw close to Him. For in Him is the only place where peace can be found. In Him I have been freed from the anxiety of my future and the sadness of an inability to have another child. So while yes, my infertility became obviously permanent to me on February 1st, it had been permanent long before then and God walked the journey with me at a pace I needed so that in the end I could have comfort in only His love. Yes, He is the same yesterday, today and forever will He be my gracious, loving, patient, gentle amazing God.