I'm Just Scared: Dealing With Generalized Anxiety in Children

     Amani has been suffering from a lot of anxiety lately.  When we first moved into the house it was mostly nightmares and fears about being in a strange place. That has subsided some, but she still tells me she is scared a lot.  I've looked into ways to help her but it's a little tricky. Most books and websites I have looked at are for kids who are very shy, or are overly fearful. Amani is not shy in the least, and she is not really fearful. She is not anxious about anything. We could be driving in the car and she will suddenly say she is scared. She could be sitting on the couch playing pleasantly while I fold laundry, and all of sudden she is saying she's scared.

     Part of it is probably boredome and attention seeking, but I think at least part of it is anxiety. I have had little "anxiety storms" since I was about her age. They would come on the same way that hers seem to- unprompted, especially when I'm sitting quietly- and I said the same thing when I was little; "I'm scared".  Now I call them anxiety storms because they are not anxiety attacks, but I think they are still a manifestation of anxiety.  Anxiety attacks feel like a heart attack and last for around 30 minutes- I guess. I don't think I've ever actually had one. What I call anxiety storms are these little shudders of panic that are very intense for a few seconds, and fade after a minute or so.  I've always had them, but they are way worse now that I am an adult.  I think Amani is getting those, and she will sometimes have them all day, just like I do.

    So I have been looking for ways to help her. Whenever she tells me she is scared, I try to assure her that she is safe and that I sometimes get scared too. Sometimes I suggest taking slow deep breaths, or we turn on some music. At night we play the Indigo Dreams guided meditation from Lori Lite. Personally I like the Indigo Ocean Dreams stories the best, in case you are looking. They have been really helpful, not only to help her get to sleep, but also to have familiar terminology to talk about her feelings: "Remember how the octopus felt when he got mad?": that kind of stuff. 

     Today I saw this list in my Facebook feed. At first, I didn't have much hope for it, because, you know, Facebook forwards are usually pretty obnoxios. I'm glad I looked at this one though. The author suggests a lot of things I am already doing with Amani, but there a few new approaches to try. I think I will ask her to draw what she is upset about (#1). Although I think she just has generalized anxiety, it's possible she is fearful about something and can't explain it.  I also really like the idea of the Widdle Worrier (#35). Amani loves imaginary creatures and I could really see her get into calming a little imaginary creature. Outside of the new techniques, it is nice to see that someone out there can appreciates where I am coming from, and that I am generally on the right track.

I will shrink my own head, thank you very much.

     So I recently decided to try therapy.  Actually, I recently decided to try therapy, and then even more recently than that decided to quit therapy.  I am sure the therapist think I have commitment issues, but the truth is I just generally do not trust therapists.
     There was a combination of two things that were really the impetus for giving therapy a go.  The first was that my anxiety levels have been increasing gradually since baby number two, and have been reaching something of a fever pitch. My doctor insists that I go off my Cymbalta, and, as we all know, that is not my favorite thing for her to say. Changing medication is like playing reverse Russian roulette: all the chambers are filled with hormonal rage monsters except for one, and that one contains just a normal monster that causes some weight gain.
     Yeah, my doctor is going to need to pull my Cymbalta from my cold dead fingers.
     Anywhoo...I decided to try and manage the anxiety through therapy.
     The other reason I tried therapy is because of the little girl.  She has been having a lot of nightmares, and sometimes gets scared in the middle of the day for no reason.  We'll be in the car, and all of a sudden she'll tell me she's really scared.  I remember feeling like that when I was little, and it was terrible.  I actually still feel like that, only now, only I realize it's anxiety. So, I thought that if I learned some techniques to deal with my anxiety, I could help the little one when she is feeling scared.
     The problem is that I get really annoyed at when a therapist asks me questions, which, I realize kinda limits how much a therapist can help me.  It's not that I don't like being reflective.  I am Dr. Reflective Ph.D., but it has been my experience that most therapists ask presumptive and/or leading questions in hopes of discovering my "real" problems. When I was a kid I felt like my therapists were looking for a history of sexual abuse, or a fear of abandonment, as if I had experienced it, but didn't know about it; so annoying.  Often when I explain to therapists that my father is schizophrenic, their eyes light up and they practically start salivating.  I told my latest therapist that I had always been independent and she responded, "Is that because you schizophrenic father couldn't provide for you?" C'mon, for real?
     I am not saying that people should not try therapy, and I have had a good therapist at one point, but generally, I don't think its for me.
     One positive thing that did come out of my latest endeavor with therapy was that I began reading Mind Over Mood, a workbook that trains the reader to use cognitive behavioral therapy to cope with anxiety, guilt, phobias and so on.  Cognitive behavioral therapy (CBT) is a really focused therapy technique that uses concrete steps that help the patient deal with with distinct thought and behavior problems as articulated by the patient; articulate the problem, devise a plan, establish a goal. Follow through. Boom. Sounds good, right?  I had originally hoped the latest therapist could walk me through the process, but then she started trying to "uncover" the damage my parents had caused, and I couldn't handle it.  The book I ultimately feel is helping though.
     The problem I wanted help with was the endless stream of embarrassing memories that my brain perpetually harasses me with.  You know how sometimes you'll be lying in bed ready to drift off to sleep and all of a sudden you'll remember the time in elementary school when you laughed and shot snot all over the lunch table?  Or the time you were on a bowling field trip and partnered with a boy you had a crush on, and you were so distracted that you rolled the ball without any pins set up?  Or the time you were belting it out in the back of the band room and everyone heard you in the practice rooms?  Or how you're so stupid and incompetent and everyone thinks you're weird...gah!!!!
     This happens to other people, right?  Well, it happens to me endlessly.  Since I started reading the book, I've been timing how often this happens to me.  If I'm not actively engaged in something, my brain will torment me about every six minutes.  Usually I get so embarrassed and anxious about it, I have to say something out loud to relieve the tension, which makes me look like a crazy person.  The whole thing is very exhausting.
     So, the book is helping me with that.  I have this little chart that I feel out whenever I have an "anxiety storm" that has me describe where I was when I had the memory, what exactly I remembered and how it made me feel.  The I am supposed to find evidence that supports my interpretation of the memory, as well as evidence that might support a more balanced interpretation of the memory. I think it's kind of working.  I think I've been having fewer attacks, and when I do have them, my brain kind of automatically begins to analyze the memory, so I don't start to catastrophize what happened.  So it's good; it's a start anyway, and there is something refreshing about making progress.

Highway to the Danger Zone

     Do you always follow your doctor's advice?

I do not.  I am a little bit of a renegade when it comes to my medication.  On more than one occasion I have upped my meds, or changed them completely, without checking with my doctor, or even really letting her know.  So far it has worked out.  Maybe I am just lucky, or maybe I am like Maverick from Top Gun- except that instead of jets, I am use mood altering drugs.  Totally bad ass.


     And the analogy totally works because my doctor is pretty much Stinger.
     Seriously, she is.  She scares me a little.

     I am not saying that I endorse my behavior for any one other than myself, but sometimes, my doctor wants me to do something: try a new medication. lower a medication, add a medication, and I just don't agree.
     I actually really like my doctor, (everybody likes Stinger; he's doing what is best for his men.) but you don't really argue with her, or even really discuss things with her.  When I started to slip into a depression after the baby, I wanted to increase my Cymbalta from 60 to 90, but she thought it would make me too manic, so at first she just insisted I get more sleep.  Don't you hate that?  I mean- I had a six month old baby who had GERD and hadn't slept fore than an hour-and half-consecutively in two months.
     "You just have to.  You have to get more sleep.  Your ego is writing checks you body can't cash."  Blah, blah, blah.  Easy for her to say.
     Three weeks later I am back in her office, spiraling into despair.  She wants to put me on Seroquel, which I have been on before, and I hate.  But there's not debating it. Back in her office again within six weeks and she wants to up the Risperdone and lower the Cymbalta.  She wants to do this and that, and each thing takes at least three weeks to work through.  Every time I go in there I ask her to please just raise the Cymbalta and she looks at me like a disappointed grade school principal: "We could raise it up to 90mg, but I really think that it may make you manic, so I'd like you to try...".
     Ugh.  "Negative Ghost rider, the pattern is full."
      I even brought Erik with me once to try and convince her, and she didn't listen.
     So, I took matters into my own hands and went ahead and just started taking three of my 30 mg pills instead of 2.  I felt so much better.  I didn't even tell her until I run out of meds a few months later.  (Do not ask me how I managed to collect so many extra 30's.  I have no idea; I'm Maverick!)
     Now that we are going to have another kid, she wants me to taper down again. I was fine with tapering down to 60 mg, but she wants me to go all the way down to 40mg, and I don't know if I see that happening.  I understand why she wants to do it, but frankly, it's not her life we're playing with here.  What can I say?  "I'm dangerous."

Don't call me a liar

     Ugh!  I take it all back.  Months ago I wrote a response to an article regarding medication and the authentic self: it was all a lie.
     Okay, it wasn't a lie exactly; I still stand by what I said about your authentic self being the best version of yourself, even if that means your medicated-self.  And you definitely should look for a medication that makes you good because no one should have to feel drugged just to manage their daily lives.  There are way too many drugs out there that for anyone to have to suffer.  That's what I said and I really do believe it.
     Here's what I didn't say though: finding the right medication sucks.
     Right now I am on 90mg of Cymbalta and my mood is fantastic.  It is completely responsible for pulling me out of depression: a feat which Risperdol, nor Abilify nor Serequil could manage.  But it is not perfect.  Most notably, it gives me a really bad stomach ache about an hour after I take it.  I've tried taking it with food, I've tried taking it at night: nothing works.  So, each day we have a one hour period where I stalk around with the stance, temperament and vocalization pattern of a mountain gorilla, all while LO presumably licks the bottom of the dishwasher or something.
     If I were to follow my own advice I would be harassing my doctor to come up with something that did not force me to channel Animal Planet, and yet, the pattern continues.
     Because I DON'T WANT TO CHANGE MY MEDICATION.....
     Experimenting with medication means wrestling with all kinds of potential side effects including weight gain and mood swings, and headaches, and muscle tension, or insomnia, or exhaustion, ontop of which the darm medication probably will not work as well.  I mean, I have been trying to find the perfect medication since I was ELEVEN and this one works good enough, so...
Ugh.
Whatever.
I mean, if in three years LO begins beating her chest to warn her nursery school classmates that she feels threatened, then I suppose I'll look into what my other options are.

Medication and your authentic self

My friend Kaitlyn recently published this post from a guest blogger on her site.  It has to do with medication and whether or not it makes you your "true" self, another version of yourself, or someone else completely.  This is a question that I know a lot of people wrestle with.  After all, everyone wrestles with their identity to some degree, and when you are taking medications that fundamentally change your brain chemistry, identity issues are bound to pop up.  In the blogger's article, she tries to determine whether she *is* the woman she becomes when suffering from her ADHD , or if she *is* the woman she manifests when on medication.
Personally, I do not believe that I am the nasty, ill-tempered, dark human being I become when I go off my medication.  Depression is a disorder: not a personality trait.  Science has determined that depression is due to a chemical imbalance; so I think it would be inappropriate to say that my true self is the manifestation of that imbalance.  I wouldn't say that a person with epilepsy is most truly him/herself  when having a seizure.  I wouldn't say my father is most truly himself when have a schizophrenic episode.  I wouldn't even say that a person is most truly him/herself when they are really tired.  I guess I like to think that a person is his or her true self is his or her optimal self: who they are under the best conditions, not the worst.That is not to say that I do not believe that I am a complete and total nutcase.  I definitely understand that that cranky, misanthrope I become when I am depressed is me, it is just not most authentically me.
Additionally, I think that if your medication makes you feel anything other than the most authentic version of yourself, then you need to change medication.  There are a ton of medications out there, and if you feel stifled, or wired, or just inauthentic, there is probably a medication that can get you to a better place.  Medication should help you manage your day to day affairs, and help you accomplish the goals that your disorder is stopping you from achieving.  If anything else is happening, there is something wrong.

My Father the Star Wrangler

     So this week is national Schizophrenia awareness week. This hits particularly close to home foe me because, as a lot of people are well aware, my father is schizophrenic. For those of you who were not aware, that my father is schizophrenic, well, happy Schizophrenia Awareness Week. Consider your self aware.
 That's probably what one does for Schizophrenia Awareness, right? Become aware of someone who is schizophrenic, and maybe send them a basket of cheeses and cured meats? That's what I send my dad for Christmas and he really likes it.
     I can give you his address.
    Oh. Erik just pointed out that it is Schizophrenia Awareness, not Schizophrenia Appreciation Week.
    Guess I better make with the aware-i-fying.

      The whole awareness thing is good. It's relatively new, and it is good to be able to mention to people that there are schizophrenics out there who are not homeless or in prison. When we were kids, we were not allowed to tell anyone about my father's illness, which was fine with me, because I really had no idea what anyone was talking about when they said my dad was sick. He did not seem sick. I suppose he did things that I didn't understand, but adults were always doing things that I did not understand, and I never troubled my self with comparing adults inexplicable behaviors. My dad did talk to himself, but so did I; I still do actually, so there was nothing even remotely strange about that.      On the contrary. I have fond memories of falling asleep to the sounds of my mother working at her sewing machine and my father quietly mumbling to himself, and feeling as though everything was right with the world.

     I do remember the first time I was aware that my father was having a break down. My mother had gone to a family wedding in Texas and we children were left with my father, who was behaving in a very silly manner, shouting at the TV, marching around the house singing, praying at the top of his lungs. I wasn't scared. On the contrary, I think all of us kids were very excited to see my dad in such a fervor. We shouted along with him, danced in parade behind him and happily acted as a sounding board for some of his more precarious ideas.
     "What about this apple, Doll? You think this is good for eating?"
     "No Dad, that's a ceramic apple." I remember giggling, "You can't eat that."
      "No? That's not a good idea?" I laughed. I knew he was genuinely asking me, and I was delighted to be able to care for my father who very often was stoic and intimidating. "No, you can't eat that. Do you want a real apple?"
     I remember my father's face lighting up and him grinning ear to ear. "Yeah, that'd be great!"
     I was so happy to be helping, that my father's illness was more an opportunity to play and be close to him, than anything I ever would have considered a disorder. In fact, it feels strange even now to think of it that way.
      "My father's schizophrenia is a disorder."
      Yeah. That seems weird.

      As an adult, I have come to understand what schizophrenia is indeed a disorder. I know that it can be a terrifying disorder that can torture both the patient and their family. My father's path through his mental illness has been horrific at times, as it has been for my other loved ones who suffer from a similar disorders. I don't mean to make light of any of their suffering. Right now my father is working to promote awareness of the humanity of the schizophrenic. Isn't it sad that we need to remind people that though schizophrenics may behave a bit differently than the majority of society, they are still human? But it's true. Too often when we see a homeless person speaking fervently on the street, or when we hear of disturbed people committing crimes for what are clearly delusional motivations, we forget that these people are humans who are not only disabled, but who are suffering. We need to have sympathy for them.
(The sound gets better in the video after a minute or two)

Did you watch it?  Isn't my dad awesome?  Don't you want to watch the whole talk now.
Ah, then my job here is done.
Thanks Dad!  I love you!

NOT a New Age Hippie

As previously discussed, I trust TV way too much.  I am one of those people that believes everything commercials tell them.  Those "corn sugar" commercials: I totally bought it.  (Evidently they are quite bogus, if you can believe MSNBC, which, of course, is still television.)  Okay, I am not totally sold on EVERYTHING the television says to me, but I am pretty sensitive to suggestion.
This is why I thought I would be a perfect candidate for Hypnobabies.
I know, I know: you are rolling your eyes at me thinking "You ARE one of those gullible new-age hippies".
Well, okay, there may be actually a very strong case that I am a gullible new-age hippie, but hear me out.  Hypnobabies is basically just a form of deep relaxation that allows you to stay in control when you are giving birth.  This was important to me because I was really afraid of having an anxiety attack while delivering.  See, perfectly non-gullible talk.

Unfortunately, once we got to the hospital, I was too afraid the nurses would judge me, so I couldn't follow through on the program.  "Did you hear about the crazy hippie in room 2B?," I could imagine them saying, "She doing HYPNObabies.  I'll bet she even calls high fructose corn syrup 'corn sugar'.  Someone should call social services."
Despite the fizzled ending, the program was actually pretty helpful in dealing with some of my anxieties.  Before I started the program, I was becoming pretty disenchanted with the whole pregnancy thing.  As I became more and more uncomfortable, my perception of LO's movements in the womb changed from fun-loving and playful flips and squirms, to irritated and malicious kicks and shoves.  I actually would get angry with her, telling her to knock it off when she squirmed around inside me.  Obviously, not a healthy way to perceive your growing child.  Once I started the program though, I started noticing my response change.  The program suggests that you listen to the "Positive Affirmation" track daily.  It had me repeat things like, "I love my pregnant body" and "My baby is safe and healthy inside me now". When I first started doing it I thought the whole thing was ridiculous.  I was amused by my crazy antics, and the startled expressions of the shoppers around me."  My uterus is oft and supple" I said as I walked down the frozen food isle.
Okay, I didn't actually do it while shopping; I do have some boundaries.
Anyway, I was amused by doing the exercises, but I kind of thought the whole thing was ridiculous.  Please note how very sensible non-gullible I was in this.
Then, lo and behold, every time I would drive by the Dairy Queen, I could hear the recording's calming voice,"I eat healthy foods everyday for my baby".  I started feeling a lot better about the pregnancy; referring to LO as a "sweet little baby"; it was awesome.
Now, was it enough to keep me serene during an emergency delivery and five day stay in the hospital?  No, it's not Valium, but now that I not facing the prospect of people coming into my room in the middle of the night and jabbing me with needles, I am thinking of picking up some guided relaxation again.
Seriously, I just need to see one commercial for it and I think I would pick it up again.

If you can't say something nice...

Have you ever lied to a care provider because you are afraid of hurting their feelings?
I have.  I know it probably seems silly, but you know, I've never been good at break ups.
     I visited an acupuncturist for a little while during my morning sickness, and though it was nice to lay down for twenty minutes and listen gentle new age music, I am fairly certain it had no lasting benefits, especially considering that on one occasion I puked immediately upon leaving the office.  But the acupuncturist was so nice, and so confident in her methods, and I didn't want to seem close minded.  I would say things like, "I always love coming to your office.", or "I think its helping a little; I am sure it will build over time."
     That's not the worse case though.  Once I kept seeing this Indian doctor for a year even though I would only ever understand one in three things he said.  It was ridiculous, but again, he was this really cute elderly doctor, and I didn't want to seem like a jerk.  He would chat away, laughing at his own jokes, and all I could do was nod and smile, waiting for him to refill my prescription.  At one point I was considering going to see another doctor at the same time, but then I would have felt like I was cheating on him.  I would probably still be seeing him, but I moved out of state.  I loved that guy.

Sleeping on it

Hey, so you know what I did?  I went to a sleep clinic and had a sleep study done.  This is a big thing for me because, as with many things in my life, while I adore sleeping- seriously, like one of my top 5 favorite things to do- I am not very good at it.  I scream a lot, and kick a lot and thrash my arms around.  I am sure that this makes me a relatively unique bed partner, but being unconscious for the whole thing, I wouldn't really know; DH says he is used to it now.
     Anyway, I have basically spent my entire life really tired, and to some degree resigned myself to that reality.  I know I probably should have taken a sleep study earlier, but, well, you know how I feel about doctors.  So, I went on living my life, souped up on caffeine, pondering the possibility of  injecting coffee into my blood stream directly, and  insisting to people that I really I do not have high energy but I need to keep moving so I do not fall asleep.  Then my new psychiatrist tells me that I absolutely have to try this neurologist she saw for her sleep problems, that he is a genius, blah blah. And I was like, okay, maybe I can write a blog entry about it.
     It was fine.  The test itself was fine; the bed was super comfy, I could watch TV until I felt sleepy, and the little electrodes they attached to my head, face, arms and legs were not actually to uncomfortable.
The consult afterward was not terrible, but I am not sure that I agree that the neurologist is a genius just yet, and that in and of itself is a little disappointing.  (I always have such high hopes...)  So according to my doctor I have a few things going on, that are really common for people with depression.  First and foremost, I have RBD, REM Behavioral disorder.  It is a disorder that essentially means I act out my dreams in my sleep and the doctor suggests it may be a result of the medication I am taking.  This already started sounding a little questionable to me because I have always thrashed, cried and shouted in my sleep, even as a baby; it can't just be from my medications.
     Anyway, since I obviously am not going off my medications, (I have resumed my meds ever since the little incident during my potential miscarriage in January) the doctor suggested I try clonazepam.
Sigh.
     Yeah, that's not gonna work.  First of all, clonazepam is a big no-no for pregnant ladies.  Plus, clonazepam and I are not friends.  I tired it in high school and it really only makes me ridiculously tired; not the kind of help I am looking for.
     So, the other problem my doctor noticed was sleep apnea; a very mild one.  I think I stop breathing like every four times an hour.  In order to fix this minor problem, the doctor suggested I wear SCUBA gear while sleeping.  Okay, not actually SCUBA gear, its actually called a CPAP, but it certainly looks like SCUBA gear, and definitely makes sounds like Darth Vader.

My first question: does it come with accompanying lingerie?

      It thrusts air down your nose and mouth while you are sleeping, and though I know people who swear by it, I cannot even imagine wearing something like that and being able to sleep.  There is an alternative device that is a little mouth piece you sleep with, but it will cost us almost $2,000 after the insurance pays its portion, and then it is only likely to sure 70% of my apnea at maximum.  Ick.
     So, I need to go back and talk to the guy I guess.  I mean- is it really worth it if my big problem is the RBD?  We'll see.
     Anybody out there use the CPAP or the mouth piece?  What did you think?

I am seriously going to need to talk to the people at casting.

     Ugh, this is getting ridiculous.  I am not old; there is no reason I should be rapidly careening towards that stage of life wherein the majority of my time is spent complaining about health ailments or concocting conspiracy theories about the medical community. How is it that I find myself engaging in rhetoric fit for Gandpa Simpson?     It just seems like doctors were more trustworthy when I...well....trusted them more.  When I was a little kid I had this pediatrician who was so composed, collected, and spoke with such certainty that I suspect he got all his information directly from God.  He had steel colored hair, and these patient calm blue eyes; it was like he walked out of a Norman Rockwell painting.  If the man had told me that drinking Draino was my best course of action, I would have immediately done it, and I am sure that it would have worked.
     Then I grew up, as all of us do, and was confronted with the wonders of the college medical clinics, wherein any and all conditions are treated with condoms.
     Since leaving college, my doctor appointments more or less resemble episodes of House: no one knows anything, so they just going to shove things into me at random until I start bleeding anally.
     I didn't want this; I want a sane medical history where people in lab coats make sound, infallible diagnoses in calm, resonant voices, and give simple and effective treatments.  Does that happen anywhere?  Because if so, why can't I be on THAT show?  Why do I have to be on the show where medical staff shrugs their shoulders and wave their arms to the rhythm of set to the calliope music?

We can neither confirm nor deny our ability to give a straight answer.

I am fairly certain that the entire medical industry in America is hell bent on providing the American public with absolutely no answers what-so-ever.  For years I have had abnormal Pap smears.  After each scary result wherein they suggest I may have cancer, but can't be sure, "it's probably nothing to worry about", they tell me to definitely come back in six months so they can run more tests and tell me how abnormal I am.  Awesome.
Then, I bleed upon conceiving.
"That sounds serious.  We should definitely see what happens in a month."
I bleed more, and my HcG levels are dropping.
"This is a very bad sign.  Come back in six weeks and we will definitely tell you that we are very concerned."
Super.
Finally, Tuesday I go in, and everyone is very grim faced and sympathetic.  "Yes, we are concerned.  Come back next week for another test.  We will have more platitudes we can give you as we stall for answers."
I can't take it, my voice trembling, I finally get the balls to ask, "Is this typical period for a miscarriage?"
"Well, you know, we need to watch it closely and work with what we have..."
"Yes, but generally, how long does a miscarriage take?"
"Everyone is different.  If this continues for awhile we will investigate."
"How long would you say?"
"Well, we don't want to intervene unnecessarily..."
"But what if I am still bleeding after the next several tests?""I think it is important to let nature take its course."
For a moment I briefly consider lunging over the desk and throttling the lovely spiritely woman who is clearly determined to make me cry.  I decide to try one more time before settling on manslaughter.
"Do you think I will still be bleeding in a year?"
Her expression demonstrates she thinks I am being ridiculously over-dramatic.  Finally, a straight answer!
'So sixths months or less?"
She purses her lips and looks insulted, "I would certainly step in before sixth months."
I honestly feel a wave of relief.  I go for broke: "Two months?  Do you think it will be longer than two months?"
"Listen," her tone no longer compassionate or sympathetic.  She leans forward and looks me into the eye.  I feel as though she is being honest for the first time, "If after our test next time I don't see necessary progress, we will do an ultra sound and probably consider a D&C.  If your levels do fall, but you are still bleeding by the end of the month, we will need to intervene.
I would thank her, but the sense of relief has made me choke up; I can only nod.