My Inbox

My email inbox is a heavy place lately.
Email exchanges with the nurse practitioners at UCSF, asking dozens of questions - difficult questions - about birth anomalies, chromosomal abnormalities, congenital diaphragmatic hernia, amniocentesis, ultrasound.
Scary things like the deadline for terminating a pregnancy - which still just doesn't feel like an option, it feels screamingly wrong.
Emails with my sweet sister, Sharon, who is helping me get everything together to apply for emergency MediCal insurance for pregnant women and babies.
Emails with our accountant, getting us ready to file our 2007 taxes so that we can then apply to get Dahlia on Healthy Families for her own insurance, at a huge discount.
Emails with family about all the nuances of returning to the Bay Area.
Emails with my Dad about plane tickets to get home.

And my favorite emails - those of love, positivity, support, holding - from friends and family.
Reminders that prayers are being said, because as one friend reminded me, part of the healing power of prayer is in letting the other know that the prayer is being said.
Thank you for praying and letting us know, and thank you for praying and just holding us silently in your heart.

I realize that by this time each night for the past 3-4 days, I've found myself with incredible cramps in my belly.
Stress, tension, fear, grief, exhaustion?
I get really really tired of dealing, and yet I have to deal.
No matter how this unfolds, it's not going to wrap itself up nicely anytime soon.

Then there is the little one in my knotted belly, my Tikva.
When I think about her, she kicks.
When I write about her, she kicks.
When I talk about her, she kicks.
And when I'm doing everything else, she kicks.
She reminds me that she is there, strong, growing, moving, being her.

I just want to get home, to the Bay Area, to feel less alone than I do right now.
To feel less on the edge of losing it completely.
To feel less snappy, hopefully be more patient with Dahlia, maybe sleep better.
And be able to make all the calls I have to make in real time, rather than at night when it's daytime in CA.
But mostly just to be surrounded, to be held, to be in the familiar.

I can't believe how much has happened in a week and a day.
I can't believe the way my life has changed forever.
I can't even remember the pain of the shingles I had just a few months ago.
They seem so irrelevant now, just preparation for something much more difficult.
It's been one heck of a year... it hasn't even been a year since I miscarried my last pregnancy on the day before Passover started.
I'm ready to get on that plane home.
No more than 10 days and we'll make it happen.

Beautiful Girl

Tikva's first photo, in 3D ultrasound.
She's being a little shy and hiding her face with her hand.
But rest assured this kid ain't shy...
She's a little powerhouse in there in my belly, kicking and wiggling and punching.
It was incredibly comforting to see her face and to watch her little hand wave to us, during the same ultrasound where we got such life-changing news.
She is beautiful...
I pray that I am able to hold her, hug her, dance with her.
I'm holding that vision from a very deep and intuitive place in my soul.

Small Miracles

Dahlia experienced her first ever snowfall today... in Jerusalem!
It's incredibly beautiful and magical.
We went out and played in it and threw snowballs.
Then it began to rain hard so we came inside and warmed our fingers under hot water.
Small wonders... We need those right now.

Can't Sleep

It's hard to turn of my brain and emotions after another full day of wheels busy spinning and being productive.
We've made contact with the right people at UCSF.
As soon as my emergency MediCal insurance is in place - hopefully in no more than 3 weeks - we'll be able to see them and move forward.
In the meantime, I'm sending our ultrasound results so they have everything in advance, to save time.
And I need to get an amniocentesis here in Israel before we go, again to save time.
And we are changing our June plane tickets to sometime around February 10th.
And I can't believe the trippiness of it all - that we're actually leaving here, getting on a plane soon, and that we'll be landing back where we started, for an adventure we never could have expected or planned for.
How on earth am I supposed to fall asleep?
I don't know how Dave does it - he just turns it all off and nods off to dreamland in about 60 seconds.
Okay, it's almost midnight and another full day is ahead tomorrow, so I'll go try to get some sleep.

How Times Moves

Swiftly.
Evolving with everything we learn, every doctor we speak with, every emotion we share with each other.
We are growing - getting to know each other and our selves in a way we never have before.

When we took a class about energy and intuitive development while I was pregnant with Dahlia, I was presented for the first time with the idea that time does not move linearly on a horizontal plane, but rather that all time is happening at once, linearly in a way, but on a vertical plane.

At the moment I learned this in the class, I had a flash of the first time I noticed Dave during that summer both of us first found ourselves at Burning Man. Something about this guy intrigued me, and I just watched him from afar as he walked around and talked to people. I was busy trying to figure out why he intrigued me. He didn't look anything like the guys I'd been interested in until then - he was much bigger and buffer and more Jewish looking. I hadn't even talked to him yet, so I had no idea who he even was. But I was still intrigued.

Something inside me knew in that moment, even if I didn't know I knew. If all time was happening at once, then this moment right now was happening then. The moment we heard "There is a problem" in the ultrasound doctor's office was happening at the same time I was wondering about Dave at Burning Man in 1999. I felt something deep inside me in that moment because that something knew we would be going through this very experience together. I couldn't understand it with my logical brain, but intuition and time travel are not really logical things. I deeply believe my intuition, and I trust that it is guiding me, especially now.

Dave and I have been spending a lot of time together lately. We said we were looking forward to spending his last week of vacation before school started together, but we had no idea what life would present us with to make that possible. The last two days I've been accompanying him on the loop he's been walking every morning all these months. My personal trainer has been helping me exercise, and in spite of the exhaust fumes from Jerusalem's many cars, I have been happily taking in oxygen, thinking of Tikva and all that she needs to help her lungs grow as much as possible in spite of her challenges. This morning Dave said he feels like we're dating again, having those life conversations we used to have so many of in the beginning of our being together, and even before when we were friends and would sit at parties on the couch and talk.

It's been five days, and our lives have completely changed forever. Today we went to the supermarket and bought food with our minds on not overbuying, knowing that we needed to empty our cabinets, not fill them. I am waiting to hear from our travel agent on how soon we can get on the plane to San Francisco, but within two weeks we should be there. It's time to wrap up everything and move on to the next chapter. Time has let us know this, and we are doing what is necessary. We've started making the connection to UCSF and are waiting to hear back from them. I'm submitting my emergency Medi-Cal application for medical insurance. And we have to figure out a way to finish up the 4 bottles of maple syrup that Grandma and Grandpa brought us just a few weeks ago when they visited.

The head mamas at HUC are going to help set things up so that hopefully Dave can finish his year of studies from SF. Everyone has been so amazing at HUC, and in Israel in general. Wonderful, compassionate and bright doctors, all supporting us in returning to SF to get the best care possible at UCSF. Friends we've made and family friends of my dad's and our few cousins - all checking with us and ready to help with anything. The family of Dahlia's friend Noya from preschool, who had her over yesterday and said okay when Dahlia said she wanted to sleep over, then drove her home at 10pm when she got overwhelmed by her ambitious plan and wanted to come home.

Sometimes Dahlia forgets that she's just four years old. You should've seen her going to school today. She wanted a ponytail and for me to get her bangs out of her face, so I made the ponytail and then put a few barrettes to get her bangs out of her eyes. She was so pretty, you could see her entire face, uninterrupted. She looked so much like her. I could've eaten her for dessert. I feel sadness about taking her away from here, away from her little school and friends and the Hebrew she is learning. But I have to believe that she can handle it, and that she is going to something familiar, to her family and friends in the Bay Area. And that she chose our family to be born into, maybe knowing long before we did - before she and Tikva were even conceived, when they were baby spirits floating around together, already getting to know each other - that this would be part of how our lives would unfold. She's a tough cookie, and she is going to be an amazing big sister.

Today I remembered that it was our community of friends and family who gifted us the money for our plane tickets home from Israel. Little did we know then that they really would be plane tickets HOME - back home to the only place in the world that really has been our home for almost all of our lives. We are blessed that this happens to be where we can also get the best care for our baby. It's a strange bittersweet feeling - I'm not jumping for joy that we are leaving Jerusalem, in spite of how challenging some of the time has been. And yet I am comforted to know in some vague way where we are headed. And whatever is next after that, I have to trust that time will continue to move along that perfect spiral - forward and circular at the same time. All occurring all at once, just as it should.

Keep praying for us. And when you do, we have one request: Please think only positive thoughts. Energy follows thought, and we are staying positive and grounded in trust and hope. Tikva continues to kick and wiggle all day in my belly, letting us know she's doing all she can to continue to thrive for years to come. And reminding us that she's as tough a cookie as her big sister.

Surreal

This is so strange.
I catch myself amid all the thinking and possible scenarios.
The discussions about returning to the Bay Area to get Tikva and me the best possible care.
To be surrounded by our community.
Talking through the logistics of it all.
Planning, problem solving, thinking creatively and outside the box as if I were planning an event for work.
Then I pause, and I realize where I am, and I ask myself, "Is this real? Am I being grounded and reasonable, or is this spinning beyond me? Am I blowing this out of proportion, creating drama?"

Then I remember that the baby growing inside me needs a lot more than just for me to make sure I eat enough calories each day.
I remember that I am not having a normal pregnancy.
I remember that some really hard hard hard stuff is ahead.
Something impossible to truly comprehend in advance.
No matter how much we talk through all the possibilities, it's still so abstract.

I feel grief at what won't be.
Trivial things like the homebirth in water I was hoping for.
Bigger things like how amazing it is that Dahlia is learning Hebrew and feels happy here, and how that will soon likely be cut short.
The house in Cincinnati we were going to start looking for in about 7 months, the colors we were planning for each room.
You can't make plans... you really can't.
But even now we are making plans, because what else can we do except try to help this story unfold in the way it is meant to?

We're adapting, even in just three days - three days, to this new scenario.
Even while it feels unreal and strange.
We worked so hard to come to Israel, and now we are probably leaving.
Possibly... who knows?
I pray for a good night's sleep - this all makes me so tired.

Tonight we watched a totally stupid and funny high school comedy - Superbad.
We are going to need a lot of comedies to get us through this.

We also talked to a friend of a friend - Abeja - who went through the same thing with her son and husband two years ago.
Garnet is two now, and thriving.
He totally made it, and that gives me hope.
I asked Abeja to email me a photo of them, for inspiration.
I read a story on the UCSF website about another girl who survived this and is thriving years later.
Abeja told me about a woman she knows who survived this as an infant.
Survivor stories.

Dahlia was naked in the living room this afternoon before taking a bath.
I looked at her amazing little body, and got a glimpse of Tikva at her age.
Same vibrant beautiful little body, but with a few scars to show what she survived.
I've seen these two girls in visions since before Dahlia was born.
Seen them sitting in the front row at David's graduation from rabbinical school.
Swinging their little legs in white socks and Mary Janes, proud of their Daddy.
He's older, less hair, more grays, but he's being ordained.
It may not happen in 2012, but it's going to happen, and two little girls are there.
I've seen them.
May it be.

Sweet Gal

The most beautiful, profound prayer from my soul sister, kindred Gemini spirit, Amira...

Dear Sister,
My prayers are with you with each moment since I read your blog yesterday. Below please find my prayer with you today. In the profound silence, being and prayer that I feel with you in this moment--it is all that I have to say.
I love you,
Amira

my god
grant us peace
breathing calm
in the face of war, dis-grace

holy heart of oneness
release us from the personal
from our karmic bonds to all that is not free
realize through us supreme compassion

sweet sweet gal,

be free of the ancient shudderings--
the personal, the good, the bad, the blessing, the curse
know that your heart is luminous for no reason at all
be free in the wisdom of death's illusion
celebrate all passages
riding joy's edge with wild abandon
get out your surf board and ride the tsunami waves
your masterful know-how NOW
heart breaking open as the force moves through you
you get to be OK
you get to be WELL
you get to be SANE
you get to be ALIVE
you get to LET GO
you get to BE FREE
you get to RELEASE
you get to NOT TAKE IT PERSONALLY
you get to BE WISE
you get to BE the ancient shamaness of peace, presence and holy humility that you know you are

our suffering has taught us well, sweet sister
my deepest heart empathy, compassion and presence are with you now
i stand with you in fierce grace
in a peaceful place
committed to staying in the holy heart--no matter what it looks like
knowing thru the experience of my own road that attachment to the form is always futile

i am holding you as you cry
praying for the mercy of your own heart to be with you like feathers lining a nest of straw

you get to let it go--whatever that looks like
it's ok
it is all ok

let me know--whatever you need

love,
amira

Tikva

About a week ago, I had a dream that my baby was a girl, and that she wanted her name to be Tikva.
In Hebrew, Tikva means Hope.
I didn't know at the time what this dream meant, and I played around with how the name rolled off my tongue.

48 hours ago, three words came out of the ultrasound doctor's mouth which have completely changed our lives.
"There's a problem."
You never want to hear a doctor say those words, not ever.

Since then we have had a second ultrasound with a specialist, and talked to one of Israel's main pediatric surgeons.
Our 21 week old baby girl - she is a girl, and her name is Tikva - has a diaphragmatic hernia.
This means there is a hole on the left side of where her diaphragm should be, and some of her abdominal organs are in the chest cavity.

The stomach, part of the liver, and possibly the spleen, and others could move in there later.
They are taking the place of the left lung, and her vibrant, healthy little heart is pushed over to the right.
The major question is not whether it can be fixed - with surgery, it can - but whether the one lung will be able to develop sufficiently to sustain her long enough to get surgery after she is born.
And what the quality of her life will be afterwards.

There are more people for us to talk to - a geneticist to see if other things are at play; the doctor who heads the pediatric ICU to get a sense of what we can expect if I carry Tikva to term; and the other big pediatric surgeon in Israel, who worked with a family I spoke with in a similar situation - whose son is now a healthy 4 year old.
We are going to look into getting me into the Israeli social security and insurance system, and find out if my baby would be covered here even if I'm not (my private insurance only covers normal pregnancy costs).
And we are looking at whether it makes more sense to return to San Francisco, because UCSF specializes in this and so does Stanford, and I could probably get emergency Medi-Cal for pregnant women and their babies.
Interestingly, the other place that specializes is Cincinnati Children's Hospital.

These are not things you ever want to think about.
They are not decisions you ever want to have to make.
"There but for the grace of God go I" has become "Here I go."

I get tired wondering how much more pain and struggle I am going to have to go through in my life.
I wonder when I will reach my limit, when I will crack and completely fall apart, check myself into Happydale and be done with persevering.

Looking at my vibrant, healthy, loud and powerful spirit of a daughter, Dahlia, helps to sustain me.
My rock solid soulful partner, David, sustains me - he is on this journey with me and we hold it together equally.

But I still get tired, and my heart is broken in a way I have never felt before.
I don't know how you can heal from something like this, and I can only hold onto Hope at this point.

I'm terrified at the thought of possibility having to terminate the pregnancy.
Say goodbye to a child who is so alive inside me, who wiggles dozens of times a day, kicks to remind me she is not just there, but alive and growing.
The thought of delivering a baby who would not be alive upon delivery.

She is connected to me, my body is breathing for her and feeding her, so she must feel fine.
Though on a soul level I'm sure she knows what's up.
She's involved in whatever choices we make, and I have asked her to let me know what she needs and wants.
I'm not letting her go yet - she has not given me that message.
She spoke to me in my dream about Tikva, about Hope, so I am listening to that.

Please pray for us - all four of us.
Hold onto Hope with us.
Help us to trust this bizarre existence, and that clarity will come in the right time.
Hold us from afar, because we feel it deeply and we need it.

Navigating the System with Patience

19 weeks pregnant; baby weighs 8.5 ounces and measures 6 inches — about the size of a large heirloom tomato.

Now that little guy looks pretty smushed in there!
No wonder I'm feeling more and more movement.

This morning I spent time navigating the Israeli prenatal and insurance system, summoning up patience it's not the first time I've had to call on, and getting just a little bit frustrated.
I am trying to schedule my mid-pregnancy ultrasound, the one they do around 21-22 weeks to check the organs and make sure everything looks as it should.
I got a written request for it from my OB-GYN, and it's required by my midwife if I want to have a homebirth.
And it's something I want to do - I did it with Dahlia too and it was great to see her actually looking like more than a dot, moving around, hear her heartbeat.

So this mid-pregnancy ultrasound is one that all pregnant women do in Israel - even the homebirth midwives recommend it.
And yet it supposedly isn't covered by the regular Israeli insurance that women here have - they have to pay for this $300-400 procedure out of pocket unless they are having a problematic pregnancy.
All this means that my private Israeli insurance doesn't cover it either - although they will pay for 3 regular ultrasounds (they really like their prenatal tests and ultrasounds here).
What I learned today is that this particular ultrasound that I need doesn't count as a "regular" ultrasound because it's a more in-depth screening that's done by a doctor.
Fine - but it's still expensive.

So I have a call in to my doctor to see if he has any suggestions, maybe knows a doctor who can give me a discount.
And Amos, who owns the private insurance company that is covering me and who gave all HUC students and their partners his cell phone number if we ever needed anything, and who has a son who is an OB-GYN in Tel Aviv who happens to specialize in ultrasound, is going to let me know tomorrow if his son can help me, or recommend someone here who can.
And worse comes to worse, we'll just have to spend the money and deal with it.

I started to get frustrated with morning - ranting to about how ass-backward the system is here, how it's ridiculous it is (I actually used the words "that's bullshit" when I was talking to one of the insurance agents) that something that is required and which all women do is not covered by Israeli insurance for any woman, how much I miss Kaiser, etc. - I decided to stop making more calls, breathe deep, and take a shower.
And in the shower, hot water washing off all the frustration, I remembered that insurance in the US of A is completely messed up too.
That I've had a lot of challenges even getting insurance back home because of preexisting conditions.
That at least I have insurance here that covers prenatal care (everything but the birth), whereas I'm not really sure how that's all going to play out when we get to Cincinnati and before I get a job that will cover us.
That during my pregnancy with Dahlia I even considered not getting this ultrasound at all (or any ultrasounds, for that matter).
That my insurance here costs me less than half of what I was paying for Kaiser back home.

And I remembered the most important things:
That it will all work out.
That we can afford to pay for it if we have to.
That I'm resourceful and know how to navigate meshugas like this, stand up for my needs.
And that I have a healthy, thriving, happy little baby growing and moving around inside of me.
At times I wonder if it's me who's calming myself down for the sake of the baby inside me, or if it's the baby who helps to keep me calm.
Thanks Baby.

Movement

18 weeks pregnant; head to bottom, Baby is about 5.5 inches long, about the length of a bell pepper, and weighs almost 7 ounces.

On Wednesday night, the eve of 18 weeks, I felt Baby kick and move around for the first time.
For a few weeks now, I've been putting my hand on my lower abdomen a lot while lying down.
It could be that s/he was just having a good stretch, but as I held my hand on my belly, a little limb or knee or elbow or tush or head pushed against me.
It was really sweet, and I've felt a little more movement since.
This is a very vital, happy, calm little soul growing in body inside me.
I just feel it, know it, trust it.
I've wondered if it could be the same soul that more apprehensively tried to join us before I miscarried.
That soul felt just as sweet, but more shy, hesitant to inhabit the cells growing in my body.
Perhaps this little one has come back now that s/he's ready.
I felt like that soul had been a boy, and this time I'm feeling a boy too.
Last night Dave had a dream about a baby boy.
And Dahlia is 100% without a doubt convinced she's having a brother.
I guess we'll see.
I would be absolutely overjoyed to have a boy, and equally thrilled to have a girl.
A healthy happy baby and mama is all I ask for from the universe.

Psoriasis

I have had psoriasis, apparently, for my whole life.
For those who have no idea how to say this word, it's pronounced so-RYE-a-sis.
Unless you're French or Israeli, in which case you pronounce it sor-YAH-zis.
My mother confused the doctors a lot when she would ask them about my psoriasis with her thick French accent.

It's hard for me to think about my psoriasis without summoning up the image of my mother, who was quite anxious about it.
It clearly worried her, this persistent psoriasis that resided mostly on my scalp, and would occasionally pop up in little spots on my body.
We used to have our washer and dryer in the bathroom I shared with my sister, and she would sit down on one of them, me standing in front of her, and insist that I stay there for as long as it took for her to lather cortisone cream all over my scalp on the lesions.
She was diligent about it, and very serious.

According to non-Western medicine, cortisone is about the worst thing you can possibly put on psoriasis, because it pushes the ailment back down deep into the body - while its energy is clearly trying to come out, not in.
Of course when you're itchy as hell, like poor Dave with the spots of psoriasis on his leg that get bad during the winter, cortisone cream can help the itching... sometimes.
Energetically, it is a very annoying ailment; not dangerous in any way, but a real pain.
Luckily I'm past the point in my life where I'm self-conscious about the aesthetics of it.

So this interesting thing has happened over the last 3 weeks or so where the shingles blisters have been healing.
The blisters have been gone for about a month, and the skin where they were is healing, the scars lightening slowly.
The area is still incredibly itchy, and right where it's most ichy, many little spots of psoriasis have appeared.
To my homeopath, it is totally natural for the psoriasis to have replaced the shingles, and they do say that psoriasis comes out in areas of stress on the body.

The psoriasis and healing blisters - I'm sure also affected by the tired and healing nerves underneath - are itchy and I am ready for them all to heal and clear up.
What's funny, though, is that the fact that psoriasis has popped up feels natural to me, too, and it's not stressing me out.
My mom's energy around my psoriasis was so anxious - she wanted so much for it to go away.
As I grew up, I adopted that anxiety about it, and have had many times in my life where it has really stressed me out.

But right now, I'm taking the position of the observer, and just noticing what is making itself known now that the shingles are done presenting me with their bit of energetic information.
Is there a layer of healing, of forgiveness, I can do around my mother, thanking her for how much she cared, letting go of her energy around my psoriasis, and reclaiming this part of my body - yes, even this unpleasant part - as completely my own?
Is my psoriasis having one last hurrah before it is ready to clear up once and for all?
Or is this just a chance for me to accept that a body isn't a perfect thing, and that it doesn't need to be - that some itchy psoriasis on my scalp isn't the worst thing possible?

SKIN is definitely my place of challenge - psoriasis, acne in college, cholestasis during pregnancy, shingles - and skin goes hand in hand with large intestine and lungs.
All the more reason I'm thankful I never became a smoker, and all the more reason not to live in a place with too much smog, but to make sure there is a lot of greenery around me.
All the more reason to eat well and do yoga and meditate and BREATHE so that stress doesn't get stored in its usual favorite place - my colon.
Who knows what will happen on my skin as my pregnancy progresses and after Baby is born - it's always an adventure in my body.

I have a feeling that as soon as the warm sun comes out again and I'm able to wear tank tops and hold my skin out to the rays of the sun, it will all go away.
Winter is not my favorite season, and it is definitely not my body's or my skin's favorite time of year, either.
Again last night I reminded Dave that Hawaii really does have the perfect climate... Unfortunately, while there are (older) Jews, we can't say there's an incredibly vibrant Jewish life there.
Maybe that's where we'll retire, and then we can open our Jewish healing center where others can come and do some healing.

I'm going to get sushi today.
Nothing raw since I'm pregnant, but I have missed sushi these past 6+ months - I need to eat something wrapped in sticky rice.
Next week I am seeing my OB-GYN for a check-up, then having my first meeting with my midwife, Barbara.
Life is good, and baby is growing; the little one seemed really pleased when I did yoga this morning - afterwards as I was laying in shivassana, my uterus seemed to do a little lift.