Tuesday, November 23, 2010

The next chapter . . .

I apologize for my absence during the last week or so.  As a graduate student, I am extremely busy finishing up coursework this semester, and the kids have had loads of school related activities going on.  B has been sick with some kind of stomach bug as well, in fact, a trip to the pediatrician this morning resulted in an script for a stool culture.  As she handed me the sterile cup in a brown bag with orders to deliver the "sample" to the hospital within 20 minutes of collecting, I had to chuckle inwardly.  Ha ha ha . . .  humor that only an infertile can understand. 

I want to continue the story of my loss.  It is helping me to get it out, written down.  I feel like everyone else has forgotten about this pregnancy because it has been almost three years and  was able to conceive and successfully deliver another baby.  And while I am thankful every day for the miracle that she is, I still can't forget what that experience did to me.  It affected my entire family in more ways than anyone can realize.  But that is fodder for another post . . .

So I think we left off with the REALLY BAD ultrasound at my RE's office.  At this point, I need to point out that my RE's satellite office was across the hall from my OB's office.  Unfortunately, because it was his satellite office, he did not have the best equipment at this location.  We were sent downstairs to the hospital for a high resolution ultrasound.  The results of this ultrasound were inconclusive.  The sonographer's best assessment was that the pregnancy was located in the lower uterine quadrant but not quite in the cervix.  My RE took a look at the data and let me decide how I wanted to proceed, although he warned me that my prognosis was not good.  I chose to skip the methotrexate and see how things unfolded.

I contacted my OB's office and they recommended no heavy lifting and pelvic rest, as I was still bleeding, and weekly ultrasounds.  My decision to switch to my OB was mainly due to the fact that they had awesome equipment in their office while on the other hand, my RE's main office was almost an hour away.  Under other circumstances, I would have stayed with the RE, but it just wasn't practical with the kids or for my husband, and I had no reason to doubt my OB's care at this point.

On a side note, one weekend after that initial ultrasound and months before I knew I was pregnant, DH and I had actually lined up an all night babysitter so that we could see a concert downtown and spend a rare night in a nice hotel.  We were in DH's company's box seat with catered food and the whole nine yards.  It should have been a great experience. But it wasn't.  It was miserable.  I continued to bleed, and actually passed some black clots (which the nurse assured me was "old blood") that night in the hotel.  The pelvic rest eliminated any prospect of other recreational activities, too.  My next ultrasound showed that the pregnancy was till hanging on, however, so I tried my best to remain hopeful.

At home, I spent as much time lying down as I could with two young children to look after.  It seemed that the bleeding increased when I was more active, although I was not given specific instructions to go on bed rest.  I still wonder if I could have saved that pregnancy if I had remained flat on my back during this time.

The fool that I am scoured the Internet for any information regarding cervical ectopic  and pregnancies with low implantation.  Nothing I looked at was very promising, although many women carried close to full term pregnancies with low implantation.  I realized that if the pregnancy progressed, I was most likely looking at a placenta previa situation, which was both hopeful, as many of the stories I read had a positive outcome with bed rest,  and terrifying, in that I had NO idea how I would manage a 2 year old and a 4 year old on bed rest and many of the stories did not have a positive outcome.

Eventually, the nature made the decision for me.  At one of my routine weekly ultrasounds, we saw that there was no longer a heartbeat.  Ironically, earlier that week, I had a sharp pain in my abdomen and the bleeding stopped almost immediately.  The ultrasound tech noted that it looked like the heart had stopped several days before, as the measurements, which had always been right on for the gestational age, were a few days off.  I, again, was given a decision,  to  either proceed with a D & C or wait and see if I would miscarry on my own.  Given that I was only about 8 weeks along at this point, and I wanted to avoid another surgery, I decided to wait it out.

I could write an entire post on the significance of the decisions we make and how we will forever wonder if we made the right one.  I sickened myself over the decision to terminate this pregnancy with methotrexate.  In the end, I just couldn't do it.  Especially since there was a heartbeat, the pregnancy had not been formally diagnosed as a cervical ectopic, and at least one medical professional was giving me hope for  successful outcome.  Like I mentioned above, nature (or God, I guess, depending on how you look at it) ended up making that decision for me.  As sad as I was to no longer see that little flicker of life on the screen, I was and am eternally grateful that I was not the one who made the decision to snuff it out. 

Two days later, on a Saturday right before Halloween when DH happened to be working, I lifted M, who was two at the time, into his car seat and I felt a tug then a gush.  I looked down and blood had saturated my pants and was running down my leg.  Since I knew what was happening, I called my DH, who could not leave work at that time, but would be home as soon as he could, and my MIL,  who unbeknownst to me happened to be out of town on a shopping trip.  My  20ish BIL, who had no children of his own, ended up driving 30 minutes to pick up the kids and watch them for the day.  Since I was determined to miscarry on my own, without surgical intervention, I stationed myself in the bathroom and waited.

This was a BAD move.  It was a bloody mess.  My OB, who just happened to be on call that weekend encouraged me to call him if it got to be too much to handle but to otherwise come in on Monday morning.   I was bleeding and cramping a lot, and I kept watching to see if I was going to pass the products of conception, as my OB called it.  It concerned me that after spending literally all day on the toilet, I still hadn't passed anything that looked like an 8 week pregnancy, although I realized there wouldn't be much to see.  I called the OB again and he mentioned that it may have passed unnoticed inside a clot.  I foolishly believed him, and when the bleeding slowed down later that night, I assumed the worst was over.  Once again, I was dead wrong.

To be completed . . .

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