Sometimes when I hold S or E in my arms, I mourn the babies that never were. I hold them close and tell them that they are very, very loved and very, very wanted.
I remember when Princess Diana gave birth to Harry and the media quipped that she had fulfilled her duty of providing the royal family with “an heir and a spare.” At the time, I thought it was a very odd thing to say but an even odder way of thinking.
I was talking to my friend the other day and she brought up her step-sister, who had a series of miscarriages before ultimately giving birth to her daughter.
The step-sister now wants another child because — and I am paraphrasing here — you don’t want to put all your eggs in one basket. She said something about never knowing what could happen and wanting to have more children because she lives in fear that something might happen to the one she had. My friend was horrified and said she just could not understand how a 21st-century mother could think like this.
But I do understand. Two miscarriages taught me to be this cynical.
I don’t worry about Baby S (who isn’t really a baby anymore!) constantly or obsessively, but I do know, first-hand, that shit happens. I want another child because I want another child; I want to have children that can grow up together and learn from one another. Yet I understand what this woman was saying. You lose a pregnancy and you see how fragile and delicate life is. You see how your hopes can be shattered in a minute. In my case, I do not think I will ever completely let my guard down. I try not to let this fear for Baby S overpower me or color how I raise him, but it is always there. Always.
To get to this point in my life, my heart had to break in half. Twice.
I had to have a D&C to remove dead embryonic tissue from my uterus. Twice.
I spent most of my third pregnancy terrified that it would end without a healthy baby. When I wasn’t worrying about that, I was throwing up.
I fall more in love with him every day.
Yes, it was worth it.
I am even considering doing it all over again eventually, which, although I am still a cynical bitch regarding all things pregnancy, I think is the ultimate gesture of optimism.
“Are you pregnant?”
I hated this question because I always wanted to clarify what was meant by “pregnant.” Do I have HCG in my system? Is there something in my uterus? Is there something alive in my uterus? Is there something alive in my uterus that will eventually grow into a healthy baby?
And, if one were to answer yes to all of the above, how long would it stay that way?
“Is this your first baby?”
Yes, Baby S is my first baby.
“Is this your first pregnancy?”
No, this was not my first pregnancy. It was my third.
If you have ever had a miscarriage, however, you know that being pregnant and having a baby are not the same thing.
“Is this your first?”
Well, it depends on whether you mean pregnancy or baby. When people ask me this, I usually just say “yes” because I assume they mean child.
“I am very sorry that you lost a baby.”
I don’t feel like I lost two babies. I lost two pregnancies. It was crushing and sad and awful but it is not the same kind of loss as a still-birth or a child that dies very young. I never got to hold or see my child; the idea of a baby was completely an abstract concept. I lost the hope, joy, and potential that a baby represents, but I did not lose a baby.
“You got the baby you were supposed to have.”
What do you say to this? I had two embryos die in my uterus, had the insides scraped out, bawled my eyes out, etc…, just so I could arrive at the “right” baby? Baby S is here, yes, because I had two miscarriages. The particular sperm/egg combination was unique to that month. Yet, without knowing why the other pregnancies failed, I do not know how to process the idea that those pregnancies were somehow wrong or “not meant to be.”
Anyone want to add anything else?
File Under Either: “Stupid Things That People Say” or “Wow, MC Has A Tremendous Amount of Self-Restraint”
I had to return some duplicate gifts to Tarzhay Boutique. The girl who was processing returns looked at my pregnant tummy and exclaimed, “WOW, I was told that being pregnant in the summer is like the WORST. THING. EVER!!”
What I wanted to say: “No, actually spending last summer bleeding heavily for several weeks after my second miscarriage was far worse.”
OR: “No, being pregnant in the summer is AWESOME compared to not being pregnant when you really want to be.”
OR: “Being hot, sweaty and pregnant is far, REALLY far, from the worst thing ever. In fact, it pretty much rocks compared to the WORST. THING. EVER. , whatever the heck that is (although I do have a few ideas).
Instead, I said: “Yes, a refund on a gift cards is just fine.”
What I really wanted to add: “You stupid naive idiot.”
My father, in an e-mail (the only way we really communicate because he is deaf, and refuses to learn sign language or use the TTD device on the phone) told me yesterday: “I LOVE YOU AND MR. MC AND HE-BEASTIE AND LOOK FORWARD TO HAVING HIM IN OUR FAMILY BUT WHAT YOUR MOTHER HAS DONE TO ME HAS TAKEN MOST OF THE JOY OUT OF THIS.” (Yes, he apparently also yells loudly when he types not because he is deaf, because he hasn’t figured out that all caps = yelling).
What I wanted to reply: What mom has “done to you” is, after 37 years of being unhappily married, to finally leave after living with someone who is bi-polar who refuses to see a therapist or take any medicine for the condition. He still, even after smashing many a house-hold object in fits of rage, spending through a chunk of their retirement during a manic episodes, and spending Christmas and New Years in the psychiatric ward (my mom had him committed when he smashed the second flat-screen TV when she cut off his credit cards) with the official diagnosis of “severely depressed/bi-polar,” doesn’t think there is anything wrong with him.
I also wanted to add: How does your wife leaving you possibly diminish the joy for your first grandchild, unless you are just wallowing in self-pity and a completely selfish asshole.
What I realized: He is just wallowing in self-pity and a completely selfish asshole.
[What I am also fervently wishing: He-beastie did not get the bi-polar gene in my family. Let’s hope that Mr. MC’s genes either dilute it or cancel it out completely. ]
But I didn’t say nasty things to either the little Tarzhay girl or my father, because apparently I have a tremendous amount of self-restraint even when I am hot, sweaty, and 8 months pregnant.
Yesterday, I was 8 months. I am today, officially, 9 months pregnant.
WARNING: This is a TMI post. You will not be able to un-read it, so if TMI-y things tend to bother you, do not keep reading.
I knew about the sore breasts, the fatigue, and the nausea. I did not know about the constipation. It is in all my books as a “symptom” but I thought with my history of ulcerative colitis that I would cancel out the constipation and end up somewhere around normal. I was wrong.
It turns out that the progesterone capsules I shove up my bajingo twice a day can cause constipation. Even more dramatically, Zofran — the drug that allows me to only dry-heave my way through the work day instead of barfing myself silly at home — also causes constipation. The two of them teamed up and it is not pretty.
The only other time I have had this happen was post-miscarriages when I was pleasantly doped up on pain medicine every four hours. I took Colace (a stool-softener) then, too, and while I was uncomfortable, I was not physically miserable. This time, I fear I started the Colace too late.
I blew out my boh-poh.* I can barely walk and can only lay down in certain positions. I am bleeding and I am seriously considering putting an ice-pack on my ass. Why was I not warned that this could happen? With colitis, I thought not going to the bathroom for a day (or two?) was good news; this was not good news. This is horrible. Awful. Painful.
I am now taking fiber, Colace, and drinking lots and lots of fluids. Prune juice will make me ralph, but milk-of-magnesia is looking better and better. Hopefully, something will work and my boh-poh can heal.
My third ultrasound is tomorrow morning. Did you know that when you are very nervous you tend to clench your boh-poh? Why, neither did I until today. I have been practicing “conscious muscle relaxation” that I learned years ago in yoga. I am sure this is exactly the situation my teacher intended it for.
*My four-year-old friend Maya taught me this word. Some of you may know the same anatomy by the terms “butt-hole” or “anus” but I prefer “boh-poh” — it has a nice ring, eh?
I intentionally booked all my appointments and meetings for this week. First, being this busy helps to take my mind off of the ultrasound next Monday. Second, if I get bad news at the ultrasound, I can fall apart and not have to reschedule anything.
I know. I am such a freaking optimist.
After two miscarriages, the best I can do is realist. Things might be fine but they might not, so it is best to just try and take things as they come.
It is amazing to walk around campus and realize that everyone I see, even if their mothers were not wanded, was at some point a healthy first-trimester pregnancy. They had a head, a body, and a strong heart. They grew and developed and grew and developed and were born. This process is such a normal thing — every child or adult you see is a testament to its success — but it feels like it is continually out of my grasp. I have never had a “good” ultrasound. I had an early ultrasound after I started spotting in pregnancy #2 to ensure that the sac was in the uterus. I also had a 5 and something-week ultrasound with pregnancy #2 that showed a sac and yolk sac, but it was too early to see anything else. Those were the “okay” ones; every other ultrasound I have had either showed an empty sac at 10+ weeks or an embryo with a very slow, non-viable heart rate. I think realistic is pretty good, all things considered.
My boobs are still killing me, the gaggyness is getting more pronounced, and if I don’t eat or if I smell something funny, I get hit with nausea. The Plan is still working, even though I freaked out this morning when the test line was a wee bit lighter than yesterday. I forgot, however, that I got up and peed in the middle of the night; when I took another one this afternoon, it was back to being very dark. How can a 6-week pregnant uterus make you have to pee so much? It must be the hormones more than the physical weight, right?
On a totally non-related note, I heard a rumor that tonight is the last “Office” recorded before the writers’ strike. (Sniffle)
I got the karyotyping results back today.
My husband and I are both chromosomally normal.
My doctor told me in order to explain the embryonic results that came back, she had to tell me the gender. It was female.
They were able to culture 20 embryonic cells. 19 came back as “normal female” cells; 1 came back as “abnormal female” with trisomy-20 (three copies of the 20th chromosome instead of two). This could be one of two things:
1) indicative of a complete trisomy-20 in the embryo where the other 19 cells (normal female) were actually my cells
2) a “confined placental mosaicism” (CPM) where the 19 cells of the embryo were normal and the one was just an “oops” (my term, not hers) that was confined to the placenta. 90% of fetuses with CPM are born perfectly healthy (this assumes no maternal contamination happened when she collected the sample during the D&C)
While either one is possible, odds are that the embryo was abnormal because there is often a high rate of maternal cellular contamination when taking the sample from a D&C. If it came back as “normal male” in 19/20 cells, they could establish it as a mosaicism; “normal female” does not really mean much. So, it was probably a genetic error, but since we do not know for sure, we will still treat as if it could be an autoimmune problem.
What I am not going to do: use the words “daughter” or “baby girl.” This is exactly why I did not want to know the gender. In order to preserve my sanity, I must only think of it simply as an “embyonic female” or “proto-baby female.”
Have you seen that ad? I hate that ad. People who have depression know that it sucks and we do not need some stupid ad telling us “depression hurts everywhere” and “depression hurts everyone.” You know what depression especially hurts? My ability to follow through on things.
I did not go to yoga today. Reasons: I am bleeding super heavily; I am exhausted; noon seemed really early. Reason I Am Focusing On So As Not to Exacerbate Depression: you are not supposed to do yoga the first three days of your menstrual cycle. See? I am not lazy. I am a good yogi.
The 90-minute hot stone massage got rescheduled for this weekend (scheduling problem with massage place).
The HSG has to be rescheduled for later next week (doctor’s office called, another sort of scheduling snaffu).
I was supposed to go to the library to research an article that is due in a week. I didn’t go. I am supposed to go today. I might go. I might not. I really should go. I am having a hard time caring.
I am planning to go to a support group tonight at Dr. SBS’s office for infertility and pregnancy loss. I am hoping for punch and cookies and a group of women who are not freaky. If they are freaky, I will sit silently and think snarky comments. If they aren’t, I can tell them all how depressed I am and assure them that “depression hurts everywhere,” just like the ad says. If that is true, is it the depression giving me monster cramps because they really hurt like hell?
Update: Nope, didn’t make it to the support group either. Instead, hubbie and I are going to eat Middle Eastern food, go the the library, and then go watch the new Harry Potter movie.
I had a very bad day yesterday. The kind of bad where you can’t stop crying so you just cry and cry until you either can’t breathe or you throw up. I had an asthma attack.
It is one thing to have horribly negative, terrifying thoughts swimming in your head all day. It is another thing to realize that those thoughts are impacting those around you and jeopardizing the one thing — your marriage — that you thought was going well.
I am taking my antidepressants. I am seeing a therapist. I try not to dwell on how terrifically scared and sad I feel, but it is very, very hard to not think about miscarriage. I am sad for what I lost and what I might never have. I simultaneously feel like giving up and boldly striding forward. I am terrified to be pregnant again and terrified not to be pregnant. I do not trust statistics, luck, or the laws of the universe. I wish I could make some sense of this but instead I have this petrifying fear that things are not going to ever work out the way I want them to. Ever.
I am ready to adopt. I am ready to plunk down an obscene amount of money for a baby that some other woman — who ironically probably considered herself unlucky to be pregnant — birthed. I am ready to be a mom and I do not trust that I am going to get there biologically. I do not see it as “just” adopting; it is something that I am very committed to doing. The question is in the timing, as it is not sane to start the adoption process while actively trying to get pregnant. I am 32 and by waiting, even 2-3 years, I increase my risk of miscarriage just by virtue of being older. If I want to have any biological children, this is the time to do it.
I stared researching adoption days after my second miscarriage. It feels very right to me. However, I do not want to stop trying to have my own biological baby. I want both.
I knew I was ready for a baby because I felt a hole or an emptiness in myself without one. The miscarriages seemed to rip that hole even larger, leaving it raw and exposed. The emptiness seems to follow me in everything I do and everywhere I go. I do not think this is an emptiness that is filled by antidepressants or therapy visits; it is filled with a child.
I have two sets of papers sitting next to me: the adoption information and preliminary forms for Korea and the information packet from the RE. We go to the RE this afternoon, but I do not have high hopes. Anything short of “I can guarantee you a healthy baby” is not going to be good enough to quell my anxiety and pessimism.
I start aikido tonight. Perhaps a little Japanese martial-art training is just what I need. At least I will not be surrounded by a bunch of happy, glowing pregnant women, which is usually the case at yoga. I am hoping to be blissfully in the company of those who rarely, if ever, think of babies: pimply teenage boys.
Update: And just because life is oh-so-fair, I now how colitis-y symptoms starting. It could be emotional fallout from yesterday, but I am not taking any chances. I started back on Colazal and Asacol, bringing my pill total up to 48 a day, if anyone aside from me is counting. I just can’t bear to have to delay trying to conceive because my colitis is flaring, not to mention that colits flares suck big time. I would rather swallow all the extra pills just to be extra sure it stays under control.
Update #2: Guess what arrived in the mail today? Well, Satan’s henchmen were hard at work, publishing yet another issue of Enfamil: Family Beginnings and making sure that it arrived on schedule in my mailbox. Inside are important articles that every depressed/anxious woman who just had two miscarriages needs to read: “See What I Can Do!” (um, live more than I few weeks?); “Finding the Perfect Babysitter” (… “For Your Animals While You Are Having Your D&C”); “Let The Games Begin” (… you mean like going to a specialist to find out what the hell is wrong?). My personal favorite, however, has got to be the closing essay, filed under “One Parent’s Thoughts” and subtitled “Extreme Makeover: From Party Animal to Proud Papa — A Changed Man Tells His Story.” If you are not lucky enough to be on Satan’s mailing list, here is just the last sentence of the last paragraph of the essay. “Our makeover transformed us from a couple to a family, a prize worth every minute of lost sleep, a gift I cherish every day. Of course, a new wardrobe would have been a nice bonus, too, but I’m already counting my blessings.” Need I say more?
I was at a conference this past week and a group of my colleagues decided to go out to dinner together. We all work in different parts of the country, but we have been attending these conferences for years and know each other personally. It was five of us: myself, three other women, and one man.
We went to dinner at a lovely sea-side bungalow restaurant in Southern California. The man, whom I will call Bob, got up to take a phone call from his wife, who is nearing the end of her second pregnancy. When he got back to the table, we all inquired how she was, and Bob said she was doing just great. I asked if she was huge and miserable, as she is 37+ weeks along. Bob looked at me — I have no idea if he knew about my miscarriages, but I really doubt it — and quietly said, “no, actually, she is just so happy to still be pregnant.”
The last three words hung in the air for what seemed like forever. Still. Be. Pregnant.
I tried to think of something to say. All I could think of was “I am sure she is looking forward to holding her healthy baby in her arms.” Bob nodded.
The look on my face or the tone of my voice must have suggested that I was empathetic to the situation, as he then explained to me that she has had a total of five miscarriages: two before their daughter was born; three before this pregnancy. I told him I had just had my second; he smiled understandingly. I have always liked Bob as he is a smart man and a gentle soul. This conversation, however, cemented out friendship.
None of the other women at the table had children or had ever been pregnant. You could see that they felt awkward as we talked so openly about miscarriage and physically squirmed, pretending to read their menus. I didn’t care. I told Bob that I thought the pain of miscarriage was something you could only really understand if you had been there. He agreed.
Sympathy is one thing; empathy another. I don’t want anyone to have to go through miscarriage(s), but it sure is nice to find someone you can talk to who has.
Warning: The Following Post Contains Information that is Exceptionally Vain and Selfish
I am overweight. My BMI is currently 29.4, and anything over 30 is considered obese. For my height, I can weigh 169 lbs. and still be considered “normal,” which is a BMI under 25. This is new for me. I was very athletic growing up and never, ever worried about my weight or what I ate. Youth is wasted on the young.
This whole weight issue started when I had to take Prednisone for my colitis in late 2001. Everytime I would wean down my dosage, my symptoms would come back, so I had to stay on it for over nine months. I gained over 50 lbs during that period and have the nasty red stretch marks to prove it. My doctors were sympathetic but not concerned: it was better to be in remission and have stretch marks than be dangerously ill without them. I really thought (which is funny now!!) when I stopped taking the medicine that the weight would just come right off. I didn’t realize that it would take me over a year to lose 30lbs and the last 20 just refused to budge. This was okay, though, because I was still at a healthy weight.
When you have a D&C, most women are given antibiotics prophylactically to prevent infection. I was and took the 3-day course of antibiotics without even thinking about it. This was early October. In mid-December, I was hospitalized because I had C-diff (click here for more info on C-diff), which as best we can determine, was caused by this three-day course of antibiotics. (I took antibiotics after D&C #2, but they were specifically chosen by my Poop Doc because they don’t tend to cause C-diff.) I had a huge colitis flare. I was miserable and sick and did not even really care that they put me on Prednisone because it helped me feel better so quickly.
Now, as I sit here though, I care. I gained all the weight back from the first time I was on the steroids. I feel fat. I am tired of not fitting into my clothes. I am tired of looking in the mirror and not recognizing myself. I am tired of feeling like my body is not my own. Sounds a lot like pregnancy, right?
Here’s the problem: I am already overweight and it is going to take me months to get back to my normal weight, even with diet and exercise, because of how the steroid messes with your metabolism. I am worried about starting out pregnant at this weight. Vain, I know, but if knowing how pregnant women describe their bodies at the end of their pregnancy, how will I feel then if I feel this now?
I got pregnant this last time and decided I would not let it bother me. Now that I am not pregnant again, it bothers me, even thought I do not want it to. Am I really this shallow? Would I put off trying to have a baby again because I don’t like the way I feel when I look in the mirror?
Can someone who has had two miscarriages even think like this? How can I be worried about my body image when I might not be able to have a healthy baby? If I am overweight now, will I increase my risk of complications later in the pregnancy?
My Diet Coke and I are going for a walk.
Maybe my internal angst will help me burn some more calories.
Hormones, it may be argued, are what help make us women. They regulate our menstrual cycles and, for some, they help ensure a healthy pregnancy. They can also be a bitch.
My hormone levels are out of whack. My doctor told me last time to expect this post-D&C, but I forgot how annoying it was. It is all the unpleasantness of adolescence combined with the post-partum blues. (At least with the post-partum blues you have a baby.)
I have horrible acne. Horrible. I am sitting here with a mud mask on my face, hoping this will help. I am also indulging in Dr. Hauschka products because even though they probably do not work any better than the other stuff, they are organic and smell good.
I am bloated. I am so glad we sprung for the “comfort” wedding bands, because even thought my ring is tight, it is not actually cutting off circulation. Yet.
I have bad headaches. I long for the days when I could pop some Excederin and feel better. (You should not take aspirin or ibuprofin if you have colitis.) FYI: Tylenol is a lame excuse for a pain reliever.
I have a yeast infection. Hormones do not cause yeast infections, they just make them worse. Considering that the antibiotics I took for the D&C probably started it in the first place, I still blame this on the miscarriage.
As most women know, out of whack hormones can make you moody or depressed. Having a miscarriage can also make you depressed. Whacked out hormones because of a miscarriage leave you really, really depressed and slightly crazy.
I know that hormones do not make you stare longingly at all pregnant women you see, but in my depressed/slightly crazy state, I feel like blaming the hormones. It is nicer than blaming the pregnant women, even though it is clearly their fault for being so insensitive and selfish, isn’t it?
Yesterday I got to deal with my favorite things in the world: sick cat and dog (both vomiting, dog had/has diarrhea) and an eye injury. I can deal with most gruesome medical stuff just fine, but vomit and eyeballs just do me in.
I was taking out my contact lenses Monday night and my eyes were very dry, making it difficult to get them out. When I took my right lens out, it felt like there was something still in my eye. I looked in the mirror, expecting and eyelash, but there was nothing, even though my eye was tearing. I went to bed and when I woke up, my eye really hurt, so I assumed (and this was confirmed by my husband who has had a scratched cornea before) that I must have scratched it with my fingernail. (Ewww!!, I know, I know, eyeballs are gross, so I will not get any more graphic than this, both for your sake and mine.)
I waited a few days, thinking it would heal itself, but it was still driving me crazy yesterday. My eye was spontaneously tearing and for the people who knew that I just had a miscarriage, I looked like I was falling apart mid-sentence in the middle of the day. (Please!! I do my falling apart in private, thank you very much.)
I went to the urgent care to have it looked at, and also because it had been a few days since I had had hospital bracelets on (ID and drug allergy information) and I was going through withdrawl. We did all the usual pre-medical appointment stuff: blood pressure, heart rate, height, weight, etc…. Then, because I had an eye injury, she tested my vision, which, thankfully, is fine. We went back in the room and she stared getting the drops and equipment ready for the doctor, when the nurse remembers she forgot to ask me a question. THE question. The one they always ask that always throws me, because who walks around with this kind of knowledge in the forefront of their mind?
“Date of last menstural period?”
I am sure she was expected a flustered, “uh, well, um, huh, well, it was a few weeks ago? I think? When was _________ [insert recent holiday]? Yeah, it started like 3 days after/before that.” Or even a matter-of-fact “Monday, June 4th.”
Instead I snortled loudly, which is something between a snort and a chortle (which is itself a cross between a snort and a chuckle). I know they need to ask this question because the don’t want to do any procedures or prescribe any medicines that are contra-indicated during pregnancy. Still, I was here for a scratch on my eye. Now I had to give this poor unsuspecting nurse the latest chapter in my woefully pathetic obstetrical history all because of said scratch on eye.
I assured her I wasn’t pregnant; she wanted a date “even if it was approximate.” I knew that once I told her, the whole dynamic between us would change. We would either have to endure that incredibly awkward silence when you tell someone you miscarried and they don’t know what to say, she would tell me all about her sister/cousin/friend/neighbor who had ___ [insert number] miscarriages and now has ___ [insert number] healthy kids, she would give me a pitiful look, assure me “these things happen” and that I am young and can try always again, or (this rarely every happens) she would confess that she too had a miscarriage(s) and that it majorly sucked.
I told her that technically my last menstrual period was way back in early April but that I had just had a D&C a week ago. I got the third option from the menu above.
4mm corneal abrasion. I should let it heal on my own and put anti-biotic ointment in my eye for a week.
Then I went home to clean up new cat vomit and dog vomit. I had to leave the dog diarrhea (I did put paper towels over it) for my husband because I almost threw up, even though I am quite sure the pregnancy hormones are either gone or very low by this point.
FYI: Any man who will clean up dog diarrhea, even begrudgingly, is a keeper.
I feel like I am finally able to write about my most recent D&C, although it has not even been a week. I am hoping writing about it will help me process things a little.
After finding out the heartbeat was non-viable (54 bpm) on Friday, we went in Monday for the D&C at 6:30AM. I woke up a little before 6AM only to find that I had already started bleeding, even with 5+ days of 200mg progesterone suppositories. We got to the hospital before the surgery center even opened, so we had to check in at the Emergency Room. I changed into the fashionable gown, had my blood drawn, and waited for the u/s technicians to arrive.
My husband went with me to the u/s and we got the worst possible news: the heart was still beating at about 54 bpm. I was crushed because I was really hoping that it had stopped by now, especially considering that I was bleeding and starting to really cramp. The nurse had told us that the doctors would not do a D&C if there was still a heartbeat. I was terrified and confused. On the one hand, the thought of having to leave the hospital and possibly miscarry naturally horrified me; the thought of having a D&C that actually stopped the heartbeat — even a very slow non-viable heartbeat — was also horrifying. I take comfort in the fact that both my doctor and my husband didn’t hesitate and decided to do the D&C right then. I just started sobbing. I was so upset that I didn’t even know what I wanted. I didn’t want a D&C because I wanted a healthy baby. I just remember telling my OB to do the genetic testing but that we didn’t want to know the gender, only if the embryo was genetically normal. I have never been so thankful for the pre-operative IV sedative as it knocked me out almost instantly.
When I woke up, I had bad cramping and the nurse in the recovery room gave me two doses of Demerol (REFRAIN). She told me, as my OB told my husband, that when a natural miscarriage had already started, the cramping is worse after the D&C. They also, in an attempt to avoid what happened last time, had done the D&C with an u/s in the OR and had a Pitocin drip in my IV just to make sure everything was expelled. When I got out of the recovery room, another nurse gave me two Percocet and told me I had to stay on the Pitocin for an hour. I have never been so happy to be drugged out of my mind, for both physical and emotional reasons.
I am not sure why, but anesthesia really makes me crave cheeseburgers, so when I awoke I had a cheeseburger from Burger King — none of the generic hospital burgers for me today!! — waiting for me courtesy of my awesome husband. It was honestly one of the best burgers I have ever had. I peed. The nurses were happy that I had peed and eaten, so I was discharged, given the sad look that nurses overseeing your D&C give you, and went home.
I was okay the first day, I think, because I was still groggy from the anesthesia. However, the guilt, if that is even the right word, of having had a D&C when there was still a heartbeat still haunts me. I know it was a non-viable pregnancy, but I just wished it had stopped on its own. The miscarriage had already started as I was spotting and cramping, so I like to think that my body had figured out the pregnancy was non-viable. I also know that embryonic testing is important and can only be done right after a D&C; this many give us clues as to why this miscarriage happened.
The blighted ovum was so much easier because I was just having the procedure to remove an empty sac that was still cranking out nausea-inducing hormones. No baby. No heartbeat. No guilt.
In the spirit of never doing anything the easy way, I had some complications from my most recent D&C. I am writing this a little (okay, a lot) hopped up on Vicodin, so please excuse any non-elegance.
Yesterday I woke up to cramps and bleeding. I re-read my discharge papers after the D&C and comforted myself with the knowledge that “YOU MAY HAVE SOME VAGINAL BLEEDING AND DISCHARGE ON AND OFF FOR 2 WEEKS. SOME WOMEN HAVE NO BLEEDING WHILE OTHERS HAVE CRAMPS AND MAY PASS CLOTS.” While the symptoms were unpleasant, I did not really think there was any cause for alarm.
Yesterday afternoon, I was still feeling crampy and decided that taking my umpteenth nap of the week was certainly the panacea. I think I slept for a few hours but when I woke up about 6PM, things were noticeably worse. The bleeding was heavier and full of clots and the cramps were now out of the menstrual cramp and into the “get me some &^%$ing pain medicine, please” realm. I called my OB’s office and spoke to the midwife on call. She told me to go to the ER. I cried and swore and went to get my husband, but he was already waiting and ready to go.
The good news is that sometimes women have a “slow bleed” after a D&C that doesn’t manifest itself until 72+ hours later. It builds up in the uterus, and then when the uterus rightfully decides that it is not happy about the situation, cramping and bleeding ensue. This is presumably what happened. My hormone levels had dropped into the 1300 range (down from 44,000 pre-D&C), so the OB on call was confident that there were no more “products of conception” left.
I was sent home with Methergine, a drug that helps contract the uterus and stop bleeding, and Vicodin, both to be taken every 4 hours. My husband set alarms so I got every dose of my 6-pill Methergine regimen right on time. It appears to have worked as the bleeding has slowed down considerably.
Things I have discovered in the past 24-hours:
1) Methergine and Vicodin both go down better when served with a cupcake (either vanilla with chocolate frosting or chocolate with vanilla frosting), hence the title of this post. Link
2) If you ever have to go to an ER and need a pelvic exam, you can request that only an OB/GYN do one on you. The midwife who told me to go to the ER told me to ask for the “House Doctor” (i.e. the OB on call) and after my experience with Dr. Bighands, I didn’t need a whole lot of convincing. The ER doc looked almost relieved when my husband stated I wanted an OB consult. OBs regularly do pelvics, know what to look for, and know what is “normal.” Whatever the extra wait time is, it is more than worth it.
3) Inter-muscular Demerol (REFRAIN) lasts much, much longer than IV Demerol. It will knock you on your ass (perfect for your pelvic!!) so be sure to have someone there who can translate and remember medical babble for you.
4) ER nurses who advocate on behalf of their patients for pain medicine are really angels in disguise. When I told her that morphine didn’t really do anything last time, she made sure to ask for Demerol (REFRAIN). When the IV Demerol wore off, she asked the doctor on my behalf (I was too busy writhing in pain) if it was too soon for an inter muscular injection. Then she gave me said injection the second it was approved. I love you, Becky.
5) It is just as painful to get an ultrasound from a male technician when you are cramping and bleeding than from a 5-month pregnant female technician when you are not: pregnant cervixes are tender; post D&C cervixes are tender; pregnant mothers of non-viable embryos are also tender.
6) I have the best husband in the whole entire world. He is my best friend, my best advocate, and the only person I want by my side when going through this kind of yuck.
There is another part to “I Heart Demerol” which will detail my most recent rendez-vous with my favorite pain med, but the D&C was just Monday and things are a little too emotionally raw. Never fear, though, it will be filled with wit, charm, and the ever-present post-D&C cheeseburger.
I have been laying around in bed a lot this week. I don’t even feel guilty about it. Not even a little. However, I can feel that it is starting to get old and soon laying around and wallowing in self-pity may run its course.
My follow up with my OB for my post-D&C appointment is on the 26th of June. Then we can talk about testing, genetic results, etc…. My husband thinks it is prudent to wait for any and all test results to come back before we try again, just in case there is something that we can do to avoid another miscarriage. My brain thinks that, too. My heart wants a baby NOW and emotionally I want to start trying again right away.
I plugged in the big fat old “MENSES” into my fertility software today to start my cycle over last Monday. The software doesn’t even have a little message that tells you it is sorry this is your second miscarriage in eight months. It doesn’t even know you had a miscarriage, only that you were pregnant (“Congratulations!!”) and now you have a period. They really need a “D&C” option.
We also are trying (because they will not call or e-mail me back) to get an appointment with an RE. Are you infertile if you can get pregnant but keep having miscarriages? It took us 5 months and 4 months, respectively, to get pregnant each time, which is not too awful. Our insurance will cover the RE visit, so I guess there is no harm in going for a consultation. I am not yet a “habitual aborter” (3 consecutive miscarriages) nor am I infertile, because I can get pregnant but, and here is the big, but, I still have no baby. What does that make me? Unlucky? Cursed?
Less than 5% of women have two or more consecutive miscarriages.
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.