I Heart Demerol

REFRAIN: [to the tune of “Wild Thing”]

Dem -er -ol

You make my cramps stall*

You make pain management … grooovy

Oooohhhh, Dem -er -ol

Dem -er -ol, I think I love you.

*I know that Demerol, unlike NSAIDs, doesn’t really stall the cramps. I know that it just interferes with the perception of the horrifically painful cramps, but at a certain point, I don’t really care what is happening biochemically, just that I am not in pain. Besides, it is difficult to rhyme words with Demerol.

D&C #1, Part A (October 2006):

I found out at 10weeks that I had a blighted ovum (i.e. anembryonic pregnancy = no baby but everything else). This was a Monday. On Friday, I was scheduled for a D&C. I came in on Thursday and cried all through pre-registration and the requisite bloodwork, and then came in bright and early on Friday for the procedure. The highlight was definitely the general anesthesia. Awesome stuff, especially the concoction they give you en route to the OR which is filled with sedatives and pain medicine. I woke up. I was no longer pregnant with a sac. I ate a cheeseburger. I went home.

D&C#1, Part B

Nine days later, I start really cramping and bleeding. Bleeding right after a D&C is normal but starting over a week later is not. I had nothing at all right after the D&C, so this was especially dramatic. I was sent to the ER, by which point I was in a considerable amount of pain and the bleeding was getting worse. Not knowing what to do with me, they did a ultrasound to rule out an ectopic and then pumped me full of NSAIDs (no Demerol this time, folks). I felt a little better. The bleeding slowed down. I didn’t have an ectopic. They sent me home.

D&C #1, Part C

Two days later, eleven days after the original D&C, everything really went downhill. What I thought were painful cramps before were nothing compared to what I had now and I was continually bleeding as well as passing golf-ball sized clots. Back to the ER. By the time we reaching the hospital I was really screaming/crying, and they took me right back to a bed this time instead of making me languish in the waiting room. After THE. MOST. PAINFUL. PELVIC. EXAM. EVER. (by a doctor I only remember as “Dr. Bighands”) and another ultra sound, the doctors determined that I must sill have placental tissue in my uterus that was missed in the D&C, Part A. The pain was agonizing and the three doses of morphine did nothing to help (yes, THREE doses of morphine didn’t touch the pain.) The ER doctors decide to call in an OB consult.

The OB surgeon, who was a tiny little woman with tiny little hands, told me that Dr. Bighands didn’t do any measurements, except to note that my cervix was dilated (NO! really??), and she would need to repeat the pelvic exam. I think my hysterical crying was her first clue that this was not going to be easy, so she told me she would give me pain medicine and make sure I was “comfortable” before doing the pelvic. She gave me a concoction of Demerol and Zofran (Demerol can cause nausea). (REFRAIN)

I was admitted, put on a Pitocin drip, and left to “expel” whatever was left in my uterus in the privacy of my own hospital bed. I could have pain meds whenever I wanted (REFRAIN) and I was promised that this would be the end of it. Some nurse sent something I had “expelled” to the lab that was identified as placental tissue, so I finished the course of Pitocin (just to be sure), walked around the maternity ward (where they put me) and looked at the happy mothers and their sleeping babies, and then went home.

I was told this was “bad luck” and that it had no bearing on any future pregnancies. Riiiiiiiiiight.

June 6, 2007. Miscarriage #1. Leave a comment.

Little Known Facts

Sour cherry Icees from Burger King, I have found, actually have antiemetic properties. A small costs $.99 and large $1.49.

Zofran, which is also an antiemetic, costs $316.00 for a 30 day supply as a generic fill with insurance coverage.

You can not adopt from China if you are on anti-depressants or if you have taken anti-depressants or seen a therapist in the last two years.

June 2, 2007. Little Known Facts. Leave a comment.

FHR = 54bpm

I went in Tuesday for my third trans-vaginal (i.e. “dildo-cam”) ultra-sound at 6w4d. Fetal Heart Rate = 74bpm. Ideally it should be between 120-160, but early on anything above 100 is good. 74 is not good.

I also had some bleeding in the sac, although it is impossible to know how long it had been there.

I knew it wasn’t good when my doctor called to tell me the news. Usually the nurse calls with the good news (“Your betas have more than doubled!”; “The ultrasound showed a gestational sac and egg sac that are exactly appropriate!”). When there is bad news, I guess the doctor calls. She was “concerned” and wanted me to come in for a follow-up u/s the next week to monitor the FHR (fetal heart rate). Doctor: full pelvic rest and progesterone suppositories. Me: hysteria and emotional meltdown.

Here’s what NOT to do in this situation: Google “low fetal heart rate.” Baaaaaaaaad idea. There are three types of information out there: anecdotal stores on pregnancy boards, websites filled with sourceless information, and medical journals that use obtuse language and are filled with statistics. I am an educated woman, trained to be critical of information. So, of course, I start with the scary medical journals. As my hysteria gradually builds with every ominous article, I find myself instead on the pregnancy boards reading wrenching stories from 2005 of other women who have gone through this same nightmare. I find them more comforting, even if the majority of them are in bad need of spell check. Here’s what everyone can agree on: low fetal heart rate (below 100) is not a good sign and the majority (68% I read somewhere that I am too drained to go back and reference) end in miscarriage.

I should mention that I have clinical depression and usually take 60mg of Prozac a day. While ttc I weaned off the Prozac completely and had a go at an SSRI-free existence. After that failed miserably, my doctor and I agreed to try 20mg a day instead. I found that I could function at this dose and the incessant crying and excessive lethargy had abated. Undermedicated, yes. Ideal, no. Workable, sure.

I should also mention that I had a “blighted ovum” (who comes up with these terms?) last October that was discovered at my 10-week ultrasound. But that is for another post ….

Lastly, I was also contending with severe nausea and vomiting — the “good” signs of any first-trimester pregnancy — so trying to process bad news in my ralphing, undermedicated, jaded-from-miscarriage #1 state was very difficult. My husband, who works in the same hospital as my OB’s office, went to ask if my doctor had any objections to me upping my Prozac dose to 40mg. The OB was out, but the nurse midwife, after being given the Reader’s Digest version of my medical history, thought that was an excellent idea. She also — bless her soul — moved the ultra-sound up to Friday, today, so perhaps I could find out something before the weekend.

Here is what I found out: FHR = 54bpm. Non-viable pregnancy.

The D&C is scheduled for Monday at 6:30AM, assuming that the little heart has stopped beating by then. (It is office policy not to do a D&C if there is still a heartbeat, I am sure for legal liability). If not, they reschedule the procedure for next Wednesday and I have another ultrasound. I am not naive: I know the heartbeat is not going to miraculously shoot back up into the normal range. It is slowing down and the embryonic heart is dying. I just feel like a horrible, horrible person for even thinking “I hope the little heart stops beating soon.” I don’t want it to every stop, actually. I want it to keep beating and grow as it should into a healthy baby. That, however, is not going to happen. So I guess, yeah, I do want it to stop beating by Monday, but I still feel for awful thinking and writing that.

June 2, 2007. Miscarriage #2. 2 comments.

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