Life Behind the Curve

***This post needs much less of a warning than parts one and two of this story. No swearing, not particularly graphic and nothing specifically about pregnancy. Hope it’s a bit of an easier read. Thank you all, again, for your support.***

The doctor in the ER had warned that the bleeding may continue for a while but would taper off and eventually abate. Certainly it wouldn’t take more than a few weeks.
 
I bled for a month solid. At one point I bled so much I called the on-call doctor, who happened to be Dr. D&C, and I was prescribed Methergine, a drug to control bleeding from the uterus. It’s so powerful you can only take so much of it over a period of days. He said if the bleeding didn’t stop within 24 hours to call back and he’d have me come in for an emergency D&C. When I called back the next day, a different doctor was on call (this is a huge practice, perhaps 12 doctors or so). She said a D&C would not be necessary and to give the Methergine another day but no more than that. I did and the bleeding stopped.

But I continued to bleed off-and-on. I told my boss (not the married/no kids one but the married/mom of four boys one) that I wasn’t looking forward to seeing Dr. D&C again. She hooked me up with her doctor and friend who was, coincidentally, in the same practice as Dr. D&C. She called and left a message for this new doctor who called me on my cell phone to set up an appointment. On January 7th I went to see her.
 
OMG this woman was amazing. She’s one of the top OB/GYNs in the area. When I got there, she was sympathetic. I talked. She listened. I half-heartedly said I wanted a hysterectomy. She asked if we wanted more kids. I said I didn’t know. I was scared. I asked if I had to see that awful nurse practitioner I saw for my first appointment if I did get pregnant. She put her hand on my shoulder and said, “If you try, when you try, call me as soon as you get a positive test. I’ll have your hormone levels checked all throughout your first trimester.” I know that checking my hormone levels won’t prevent another miscarriage, but she was expressing concern. What a refreshing change.

We got down to more immediate issues. She explained that there was a chance my body hadn’t expelled everything though the ultrasound from my ER trip seemed to indicate that it had. She ordered an hCG level test (to see if there was any pregnancy hormone left) and yet another ultrasound. I told her what Dr. D&C had said about the chance that I’d need a D&C. She said she doubted that was necessary. She prescribed birth control at a low dose (I hadn’t been on any type of BC since a few months after our wedding) and said I’d get a call the following day to report the hCG test results. If my levels were normal (my body was no longer producing pregnancy hormone), I was to start taking the pill. It wasn’t so I did.

At that appointment, she also said something I knew but really needed to hear. “Your body needs a break.” She told me to take the first three weeks’ worth of pills and then, instead of taking the placebo, start a new pack, meaning I shouldn’t get another period for six weeks. Hallelujah! This is the kind of doctor I needed.
 
I went in for the ultrasound she had prescribed and, once again, found out that there was nothing left of this pregnancy.

I got a bill for my ER visit. Despite having decent employer-sponsored insurance, I had to pay more to miscarry my pregnancy on the floor of the ER bathroom than I paid to have one induction and two C-Sections, both with a five day hospital stay.

Two weeks after starting BC, I missed a pill. Despite taking two pills (as directed) the next day, I bled for two more days. A week later, as instructed, I started the second pack of pills. I think my body must have been on a hair trigger because the following week I missed one pill and bled for two weeks straight. It took me taking two pills a day for four days straight to stop.

A week went by. No missed pills. No bleeding.

Scoot and I went with my brother-in-law and his starting-to-show pregnant wife to Las Vegas around President’s Day. It was a Christmas present that she and I had given our husbands that year. While we were wandering around the southern end of the strip, my BIL noticed one of those exhibits like Bodies: The Exhibition (those human bodies preserved in silicone) and said he wanted to go. Scoot had no desire to see it and, I think my SIL already had. I don’t have a weak stomach. I’ve seen two autopsies, an organ harvest and a heart transplant. I’d heard a lot about the exhibit and thought it might be interesting, so my BIL and I went.

What I didn’t know was that they had an entire room dedicated to prenatal “specimens.” It was cordoned off in such a way that you came to a wall that said some feel-good thing about the beginning of life and warning that it was graphic. My BIL asked if I’d be ok. I took a deep breath and said yes. I turned the corner. The room was full of embryos, fetuses, babies of all gestational ages. My heart stopped. I couldn’t breathe. I feel like I absorbed every item in that room in one blink. I freaked out. I ran from the room crying hysterically. My BIL followed me out and asked if I was ok. Yes, I said while taking deep breaths and trying to convince him – and myself – that it was true. Please, go ahead and go in. I’ll wait on the other side. When he came out, I had calmed down somewhat. He apologized. I told him he didn’t need to. I felt bad for freaking. I wanted to be happy about pregnancy. I wanted to be amazed by it. But I just wasn’t.

Bleeding-wise, the Vegas trip was uneventful, but out of the blue, on February 26th, I had heavy bleeding. I kept taking the pills. It stopped. I took more pills. On March 3rd I passed a large clot and had light bleeding. OK, seriously? WTF is going on here? I mean, I figured out my body just can’t afford to miss pills but COME ON!

Sometime during this period, I remember shutting the door to my office and bursting into tears. It was not an uncommon occurrence by that point but I was starting to feel like I was at the end of my rope. I called Scoot. He was worried. “What’s wrong?”

“I don’t know, honey. But I’m not ok,” I told him.

He calmed me down. I called the doctor’s office. I told the receptionist that I was a patient, that I’d had a miscarriage, and that I wasn’t ok. (It was the only way I could describe myself.) She asked if something was physically wrong. No, I said, but the NP had told me at that first appointment that if I needed to talk to someone I could call for a referral. The receptionist wasn’t quite sure what to do. I told her to forget about it and hung up. I cried some more. A lot more. I never got help.

I went to my primary care physician for something unrelated and told her about the continued intermittent bleeding. She ordered yet another ultrasound and changed me from BC pills to Nuvaring so I wouldn’t have to worry about what would happen if I missed a pill.

She asked if I was ok. “No,” I told her. She said, “I know. I’ve been through it too. If you need someone to talk to, we can get you help.”

“No, it’s alright,” I replied. “When should I go in for my ultrasound?”

I never went. I knew what it would show.

Things turned up with the Nuvaring. I loved it. It was so easy and convenient and I didn’t have to worry about causing a two week bleeding spree by missing a single pill.

Later that month, I started to play soccer again. I needed to try to lose some of the weight that I had packed on while eating out nearly every night because I couldn’t bring myself to make dinner. At halftime of the first game I went to stretch my groin in the butterfly position (sitting down, feet together, knees out). I saw what looked like a pinkish stain on my grey compression shorts I wore under my soccer shorts. I went to the bathroom at the field. I had blood everywhere. I jerry-rigged a “pad” out of paper towels and toilet paper and returned to the field. When I got home I took the Nuvaring out and let yet more blood and yet more tears come.

I went back to the doctor. I was told to get a refill, use the ring for three weeks, then remove it and replace it with another. Again, I should have gone six weeks without bleeding. Again it failed. At $35 a pop, I was starting to fall out of love with my Nuvaring. I went back to the doctor. She prescribed a stronger pill. $5 a month. I’ve been on that pill every since. A year and a half later, I can finally say I’m back to normal. Well, mostly. If I miss taking one in the morning, I’ll bleed by 2 pm. When I exercise hard, like I do when I play soccer or when I was training for my first 5K last summer, I sometimes bleed. It’s all kinds of awesome. I want to stop taking it, but I’m scared of the blood. I’m scared of another pregnancy. I’m scared of another miscarriage. I can’t, I won’t, live in fear forever.

***I’ve been overwhelmed with the kind words I’ve gotten here and on Twitter and Facebook about my last post. Below I continue my story. Those of you who write know how writing can help you deal with tough situations, but for those of you who don’t, I just want to say thanks. This has been far more therapeutic than I could have imagined.

As a reminder, if you’re pregnant, you should stop reading now. Seriously. I went a little easier on the swearing in this post, but it still might not be for you. And if you’re grossed out by medical stuff, you just might want to come back tomorrow for the final(?) installment, because this is graphic. I’d apologize but it’s the truth, and it’s part of my story and I need to tell the whole thing. Again, no offense will be taken, I just wanted to give you fair warning.***

The ER waiting room was packed. I got myself checked in and joined Scoot and the boys in a crowded room with bad TV blaring from overhead. Everyone in that room had their own story, their own maladies that drove them there. Yet I felt like there were a million eyes on me.

Unfortunately, simply showing up in the ER did not take my symptoms away. The pain was still unbearable. The diarrhea continued to worsen. And to add insult to injury, thetoilet in the main restroom for the ER was backed up. I found another restroom back by radiology. Luckily I seemed to be the only person who needed it with any type of urgency and so had my run of the place. (Errr…bad word choice…sorry.)

Each time I went, I wasn’t sure whether I was losing fluid more from the diarrhea or the insane amounts of blood leaving my body. I had brought what would normally be a week’s supply of pads with me but ended up having to flag down a nurse and get a new supply from the hospital’s stock.

After a wait of more than an hour, I was called back by the triage nurse. He was a young man, no more than 25, likely a few years younger. He took my vitals and asked about my symptoms. I told him I was having a miscarriage but that I hadn’t passed the amniotic sac yet.

He sent me into a different restroom to give a urine sample. Clearly already suffering from dehydration, urinating enough for a sample proved challenging. After a few minutes I got what I thought was enough to make him happy. (OK, well, maybe not “happy” but you know what I mean.)

Another wave of pain hit. I just wanted to curl up on the floor and be done. I went to wipe with toilet paper and looked down to see a transparent object about the size of a golf ball. Oh, shit! What am I going to do with this? I remember all the books and websites I read that said to keep large clots or the amniotic sac itself so that it could be tested (for what I still don’t know). I stretched to reach to the paper towel holder above the sink, laid a few towels on the floor and placed the wad of toilet paper holding what was to be my third child on it.

I was defeated.

I walked out of the restroom with the cup of urine in a paper bag as I had been directed. The nurse asked if I was able to get a sample. I told him yes but could I have another cup, as I passed the sac and it’s now laying on the floor. He very kindly told me that he’d take care of it and sent me back to the waiting room.

I don’t remember whether I told Scoot what happened, I assume I did. But I was so shocked, embarassed, ashamed, brokenhearted.

As I sat there waiting, I thought to myself, huh, I wonder if that’s what real labor feels like. D was induced and I had a doctor who was liberal with the pain medications early on in my “labor.” I ended up with an emergency C-section so when it was B’s turn, I scheduled a C-section. No real labor. Even if I were to have a third, I’d already been advised against even contemplating a VBAC. I found it cruelly ironic that the only labor I was destined to experience would be this kind.

I waited for a short time in the waiting room and was then called back. I was put in the last room on the left. The boys, especially D, were confused and curious. As the nurse tried to get me situated, they were acting, well, like a four and one year old would in an emergency room. Scoot took them out to the waiting room and I was left alone.

Very very alone.

From the moment I found out I was expecting with all three pregnancies, there was always a feeling inside, sometimes psychological — that little reminder that there’s another life in you — sometimes physical — a hiccup or elbow to the rib that said, “Hey, mom, I’m here.” That feeling was gone.

Thank God Scoot’s sister arrived within minutes of me being brought back so Scoot quickly rejoined my side.

In my experience, every trip to the ER is about the same. You wait, you see someone, they say they’ll be back later, the nurse checks on you, you don’t really get the answer you want. And the cycle repeats. Such was my experience.

I had an IV. I got a couple (few?) bags of fluid. I was to have an ultrasound to make sure all the “pregnancy matter” was out, but they needed me to have a full bladder before they could do it and I was so dehydrated I wasn’t there yet. After what very well could have been hours, they gave up. Since I couldn’t fill up my bladder on my own they were going to do it for me.

How, you ask? Well, have you ever heard of a reverse catheter? If you’ve ever had a catheter, you’d know that a tube is placed in your urethra and, normally, the fluid from inside your bladder comes out. So reverse that. They put a catheter in and flushed my bladder with fluids.

O!M!G!

Oww! It still hurts to think about it.

The ultrasound showed that everything was gone. I had left it all on the bathroom floor.

I went back to my “room” in the ER, got some more wonderful pain meds (gotta love a doctor who is willing to dope you up before letting you loose on the world), and was discharged.

We were home sometime around 2 or 3 am. The boys were safely tucked in their beds. Their aunt and Papa had treated them to ice cream. They were there, two healthy boys, and come the morning they were going to need me.

I was beat. Little did I know, I had only taken my first step down the road to physical and emotional recovery.

***A few dear friends have noticed my lack of posting. While nine months out of the year, a gap in my writing is most likely attributable to laziness, the months between September and November are a little more complicated than that.

Every year, September marks my month of triumph. (I have two babies born in this month and it marks the anniversary of when Scoot and I started dating.) October marks my month of hope. And November marks my month of devastating loss. Oh, and my birthday. Awesome, no?

So to the few of you who have been coming here expecting to find something new, I apologize for the delay and offer the first part in my explanation about why this is such a hard time of year.

I want to point out, if you’re pregnant, you should stop reading now. Seriously. If you’re offended by swearing, this post might not be for you. And if you’re grossed out by medical stuff, you might want to check back later for a post full of sparkles and unicorns. No offense will be taken, I just wanted to give you fair warning.***

When we found out that our second baby, B, was a boy, Scoot and I reconfirmed our plan to have another child. My philosophy, at the time, was, “If I’m meant to have a girl, I will and if not, it’s because I’m meant to be the mother of boys.” And so we were decided. We’d work out timing later but we’d have one more. His/her name would be C (quite frankly the one name I’ve been coveting. I can’t explain how much I want to use this name).

Not long after I stopped nursing/pumping for B, I got my first post-pregnancy period (September 21, 2007). While I was always regular, my cycles were long so I wasn’t totally sure when to expect my next one. Five weeks later, after not menstruating again, I took a pregnancy test. Sure enough, I was pregnant.

Who what? We had just had a baby. Oh my God, they’re going to be less than two years apart. Poor B. D will be so excited. Let’s tell D. How are we going to pay for three of them in daycare when we’re already paying $1,600 per month now!?!?!? What about our contract on that house that we’re building? Will it be big enough? Oh sweet baby Jesus how am I going to tell my boss (who is married but has no kids)?

These questions bring me shame now.

I called and made my appointment to see a nurse practitioner (at a new practice because we had just moved from DC) for the eight week heart beat check. I started feeling nauseus. Woo hoo! Here we go again. Excitement replaced my initial fear. I couldn’t wait to finish making our family.

I went in. I should have been somewhere right around eight weeks. I reported that I’d already been feeling better, that the nausea had subsided a bit which surprised me because with my previous two pregnancies it just started getting bad at nine weeks. I wasn’t really clicking with the NP but we went on and did the sonogram to find the heart beat.

Huh, she said. I was measuring under seven weeks. Was I sure I had the right date? Well, I informed her, I track these things in my Blackberry so I’m quite sure, thankyouverymuch. Not to mention the fact that my last period came while I was watching the boys in a hotel in San Ramon while Scoot went out to celebrate his best friend’s last night before his wedding, which was held on September 22nd. And because I wasn’t expecting it, I had nothing with me and so had to pack up a four year old and a one year old in a car and drive around a town I’d never been to to find a grocery store open at 10 pm to get some *ahem* supplies. So don’t question whether I’m sure! I said I’m sure!

The NP said she couldn’t see the heartbeat. My pregnancy was either unviable or I had the date wrong. Yup, she said it just that casually. (Despite my lifelong exposure to the medical community, it took me a while to translate “unviable” to “miscarriage.” When I figured it out, well, it sucked.)

She set an appointment with a doctor for a week or so later. We’ll just see if that sucker grows in the next week. If not, I was going to miscarry. Oh, and a miscarriage starts with blood so if it happens between appointments just grab some pads and ride the crimson tide, she said in not quite that way. Oh but don’t panic if you experience some spotting because that’s normal after a pelvic exam. O.K. Sounded simple. Apparently. To her.

Confusion. Despair. Denial. Anger. What the fuck? I’m 28 years old. I’ve had two perfectly normal pregnancies. This isn’t a miscarriage. It can’t happen to me.

So I started rationalizing. Every day I’d refer to Dr. Google and every day I had some new explanation for what was going on. And the waiting, oh the waiting.

The waiting period included Thanksgiving weekend. My parents were out of town. We were to go to Scoot’s family’s house. Spending time there would include spending time with his brother and sister-in-law, two of my favorite people in his family and, frankly, two of my best friends. The only glitch? They were pregnant too, with their first, and we were to be due at exactly the same time.

It wasn’t so much that I didn’t want to see them, it’s that I didn’t want my presence to make anyone else uncomfortable. I wanted them to be able to rejoice with family, not walk on eggshells around us. So I had Scoot call our family and tell them that we weren’t sure if we were coming. After thinking about how awful sitting around the house for four days would be, we called back and said that we were coming but could they please, please not talk to me about it. The whole thing was about as uncomfortable as you’d expect but man, my sister-in-law earned my undying love and gratitude when she quietly asked if I was ok and let me know, in her always genuine way, that she was there for me. She was the only person there who could even come close to putting me at ease, and she tried her hardest.

When we went in to the doctor the following week, he confirmed my worst fears. The baby was still in there. And still measuring right around seven weeks.

“You know, my wife and I have been through this. I recommend you just have a D&C. That way you can get on with trying again.”

What the hell is a D&C? Oh, it’s a surgery that requires general anesthesia? Yeah, I’m in no state to make a decision about that now. What the fuck do you mean “get on with trying again?” I JUST FOUND OUT I AM CARRYING A DEAD BABY AROUND IN MY UTERUS.

Needless to say I was not blown away by this doctor either. So I urgently made an appointment for a second opinion with a different practice. On my birthday.

When I scheduled the second appointment, it was in part because I was still flirting with denial but by the time I got to the office for the appointment, I knew what was coming.

“Congratulations,” the nurse who took my weight said.

“Thanks, but I’m having a miscarriage.”

“Right now?” she panicked.

“Nope. Not yet.”

“Uh…[Extremely uncomfortable silence]…I’m sorry to hear that. Have you been here before?”

“Nope. First time.”

“Then how do you know?”

“Been to another asshole doctor. He says it’s inevitable and wants me to abort the baby.”

Yeah. I feel awful for the nurse that had to deal with me that day. Luckily the doctor was awesome. He agreed that I COULD have a D&C if I wanted but there was no medical reason to do so at that point. If, he told me, anything became worrisome, I could decide to do one then.

So I started asking the important questions: “Am I still officially pregnant? Can I eat sushi? Lunch meat? Caffeine? Alcohol?” He assured me that I could stop acting pregnant. Oh, and Happy Birthday.

We went out to dinner that night to “celebrate” my 29th birthday. I didn’t talk much. We explained to D that even though there had been a baby in mommy’s tummy it wasn’t going to survive. For a four year old, that boy sure demonstrated an amazing understanding of what was happening. And of course he was his usual empathetic self. He told me that it would be ok. I really wanted to believe him.

The next day I had some spotting, but like the NP said, it isn’t all that unusual after a pelvic exam. I went to work. That Friday evening, however, things started to change. Slowly at first. Bleeding. Some cramping. Diarrhea. More bleeding. And more. Bigger and bigger clots. And then pain so bad I was balled up on the floor crying hysterically, yelling for Scoot to keep D away so he wouldn’t have to see me like this. They were both panicked. We all were.

I called Scoot’s sister. She was in Palo Alto, a two hour drive from Sacramento. She dropped everything and jumped in her car, calling his aunt and uncle to watch her own kids and picking up Scoot’s dad on the way.

Thirty minutes later Scoot, my boys and I pulled up to the emergency room.