Monday, December 20, 2010

My Second Miscarriage: Unfamiliar Territory

(Part 2 of 3)
TMI warning: I've included some gory details and some people might be uncomfortable with my candor.

I prayed Sunday night and made the decision to call the OB's office in the morning and see if I could schedule an ultrasound. When I woke up Monday morning I felt peace about getting an ultrasound, so I made the phone call.

The receptionist never asked for my name or any personal information, only listened to my explanation that I was 10 weeks along and bleeding. She informed me that since their office hadn't seen me for this pregnancy and I didn't have any appointments scheduled, I would need to go to the emergency room. She said they would need to rule out ectopic pregnancy, which was something I wasn't concerned about at all, but she also said they would have access to everything I might need in any eventuality.

I wasn't very happy with this option, so I took some time to think about it. I realized how peaceful I felt about getting an ultrasound, when before praying about it I had been so conflicted. I realized it was what I needed, and that the ER was the only way I was going to get that. I didn't know why, but it felt right to me.

I called my midwife, thanking her for the offer to check with the doppler, but told her I'd be going to the hospital for an ultrasound instead. She asked me to keep her updated, and said that she'd be thinking of me.

I then called my mom and asked if she could take my kids while I took myself to the hospital. She had a full day scheduled but she rearranged her schedule completely so she could help me out. I was really glad she lived only a mile or so from the hospital, and I was able to drop the kids off and head over.

The ER was a mess. They had every bed full and it took quite a while to even get into a room. I cried uncontrollably while sitting in the waiting room. My emotions were so close to the surface, and I felt nervous and alone. The nurse who took me back to my room obviously saw my tears and didn't say anything other than to direct me where to go. Once I was in the room it was waiting, waiting, and more waiting for every step for everything the whole time I was there. My room was right next to the nurse's station and I could overhear them talking about how the doctor was facing his first shift in the emergency room with a full load to handle. They teased the doctor about it being the perfect initiation for him.

A different nurse was sent in to take my vitals and draw some blood. She explained that they'd do some blood work, which I was fine with, until I realized she was also inserting an IV into my arm! I said “I didn't know you were going to put in an IV!” She casually brushed it off, saying that it was there “just in case” they decided to give me fluids or medication. I thought “I'm here for an ultrasound, and I don't need any medication!” She left and I never saw her again.

There was a PR lady whose job it seemed was to keep everyone happy. She checked on me every once in a while, which turned out to be about three times in the several hours I was in the hospital that day.

It seemed to take forever for the ultrasound technician to come get me. I laid in the bed with my eyes closed, trying to tune out the chatter from the nurses just outside my curtained doorway. The tech poked her head in and asked if I had a full bladder. I didn't think so, and I offered to drink some water or juice to help the situation. I was really thirsty and had nothing to drink, but she didn't bite. She said she'd try and see what she could see with the ultrasound anyway.

The ride in the wheelchair to the radiology department was probably the best part of my hospital stay that day. It may sound odd, but it felt like I was being taken care of, and the chair was comfortable. I enjoyed the little bumps and bends along the way. It was almost like being a kid enjoying something so simple.

Then it was time for the ultrasound. It turned out my bladder was actually very full, which was good for the ultrasound, except that she still had a hard time finding what she was looking for. She located a cyst on my left ovary, which she assured me was a normal part of early pregnancy, as it served to protect the fetus as the placenta was formed. She measured my ovaries and then looked in the uterus and found... an empty sac. She wouldn't tell me outright, but I could clearly see that's what it was. She measured the sac at about 6 weeks, which was over 4 weeks shy of my calculated gestation. A big gap. She tried to reassure me by saying it could just be “too early to tell”, but in my heart I knew exactly what had happened, and I knew that the ultrasound technician wasn't legally allowed to tell me.

I was taken back to my room and sat alone for quite a long time. At some point the PR lady came in to talk with me. She said there was a possibility I could be miscarrying (no duh lady). I told her that I needed some juice and crackers, or something to eat. She said she would bring me some, and came back about 20 minutes later without anything. She explained that the doctor didn't want me to eat or drink anything in case they decided to do a D&C. I told her I didn't want a D&C and she very diplomatically left, never to be seen again.

I thought over everything and it was clear to me that the sac had stopped growing at about 6 weeks and my body needed to get it out. I prayed and asked “Heavenly Father, if I'm really to miscarry, then please let it happen quickly.” I didn't want to bleed continually or feel like this for days, and I wanted a resolution to the situation. I also didn't want any medical intervention for something my body should be able to do itself.

Shortly after that I started to bleed, and I mean REALLY bleed. It started and wouldn't stop. I was glad to have a chux pad on the bed under me to catch it, but soon I found I needed to run to the bathroom across the hall. I started passing clots and asked the nurses to check them. The main nurse told me that they were “only blood” and not tissue, so that was a “good thing”. I wondered who that was a good thing for. Certainly not for someone in my situation who NEEDED to get dead tissue out!

The doctor finally came in to discuss the ultrasound with me, and I informed him that my bleeding had increased and I was passing clots. He was extremely dry and had no bedside manner, but his diagnosis was exactly what I had expected. I was miscarrying. He was going to consult with my OB on what to do next. Thanks for the info doc, now get out of my room so I can get this over with!

I sat up in the hospital bed watching some TV to distract myself, but it wasn't working. My mind was on one thing only. I found if I changed my position ever so slightly it affected the blood flow, and I used these shifts in position to help encourage the flow to increase. I was getting my own chux pads from the cabinets and cleaning up my own blood because the staff were too busy to notice and I didn't want them sticking their heads in anyway. I got some blood on my sock and I was frustrated with myself for wearing my own socks.

I called the main nurse in and asked her if someone could assess my blood loss to make sure I wasn't losing too much blood. She said someone would come back in to take more blood to check my iron levels, but they never did. She hooked me up to the blood pressure cuff to check my vitals and make sure it wasn't dropping too fast. I told her I was weak and hungry, and that I needed something to eat. She said she would order me a lunch tray, which never came.

I was having cramps, and some of them were severe enough that I used focused breathing through them. They weren't regular, but they were definitely increasing in intensity. Then I felt something pass. I lifted my gown and looked at the bed under me, tore the blood pressure cuff off my arm, and I jumped out of bed in shock. I yelled “I need some help in here!” several times, and no one came.

It looked like a body! I grabbed a fresh chux pad from the cabinet and stuffed it between my legs and got some latex gloves from the box on the wall. I needed to look at this and figure out what it was! I was so shaky from exhaustion and adrenaline that I couldn't pick it up. I took the gloves off and walked into the hallway to the nurse's station and told the nurse I needed her.

I showed her the bloody tissue on the bed and she said she needed to put it in a specimen jar and send it to the lab to be analyzed. She must have sensed my hesitance because she then said “...if that's OK with you”. I told her I wanted to look at it more closely but I couldn't because I was too shaky. She put on some gloves and sat down to show me what it was I was looking at. She explained the round part was the egg sac which had never developed into a fetus. Attached to the sac was the cord, and on the other end of the cord was the placenta. I breathed a huge sigh of relief! The way it had been sitting on my bed, the sac had looked like a head, the cord like a neck, and the placenta like a body. I knew it was far too big to be a 6 week fetus, but until she explained it to me I didn't understand what any of it was. I was relieved, and the nurse left me alone with the sac and placenta. I was grateful for her sensitivity, and I let the tears flow. I prayed and after several minutes I calmed down.

I called the nurse back in to take the tissue and send it to the lab. I was no longer attached to it, and I was DONE. I told her I wanted to go home. She told me that I would need to follow up immediately with my OB and that they might want to do a D&C which “for you is probably a really good idea”. I said “I don't want a D&C” and she said something about how it was really my choice, but I would have to talk with my doctor about that. She went back to the nurse's station and I could hear her telling them about my refusing the D&C, laughing about it in a way that it seemed she thought my doctor would have the final say in the matter.

I called a few friends and family and told them what had happened.

It took forever to be discharged. I waited, waited, and waited, for over an hour just to get my discharge papers. I got dressed all the way to my bloody socks (which had dried by then) and shoes, opened the curtain so the nurses could see me, and sat on the doctor's stool with my purse in my lap. When I couldn't take it any longer I walked into the hallway and stood at the nurse's station until they got me my discharge papers. They insisted on getting another blood pressure reading, and then FINALLY let me go, with strict instructions to see my OB. I asked them to take out the IV and they refused, saying that my doctor might need to use it, and it was best to keep it in so they wouldn't have to poke me again, and that the doctor's office could remove it for me. I think they were assuming my doctor would order a D&C. My discharge papers said "Abortion".

The OB's office was in a building connected to the hospital, just a short walk away. I was grateful for that. It was the first time I'd gone to this particular office, and it was all shiny and new. There was even a camera crew in the lobby taking photographs of my doctor in his office with fake patients. “Very high profile”, I thought. I just wanted to go home.

The nurse took me into an exam room and took my blood pressure. The tears were flowing again, and I asked her why I was there. I told her I'd been in the ER for over 5 hours and I just wanted to pick my kids up and go home. She told me that the ER had said I wanted to see my doctor. I told her that no, the ER had told me the doctor wanted to see ME. I think the ER was trying to open up a bed. So, I asked the nurse why exactly I was there, and whether the doctor would want to do a pelvic exam. She said he might want to do one, and that she needed to talk with the doctor about what he wanted to do.

I heard chatting in the hallway and then a different nurse came in and talked with me. She asked more questions and told me she understood how I felt, and that she would need to check with the doctor as well.

The doctor came in with the second nurse. I recognized him from the one time I'd seen him when I had an ultrasound during my pregnancy with Liam. He didn't remember me. He sat down in his chair and just talked with me. He empathized with my situation, which was a relief. He understood that miscarriage was not to be trivialized. He mentioned the possibility of a D&C and I assured him that I'd passed everything in the ER and there was no need for it. He agreed. He also mentioned the possibility of giving me some medication which they sometimes use for miscarriage, and then quickly said “but you probably don't want that either”. I agreed, grateful that someone was finally listening to me. He asked if I had any questions, and gave me some information about recovery. He gave me a pamphlet about a study involving aspirin use in preventing miscarriage. I politely took the pamphlet with no intention of participating in the study. He also gave me a book about miscarriage, written by a woman who had gone through it herself. I was very grateful for that, and took it with plans to read it. The doctor then said goodbye, and as I walked out he told me that he wouldn't charge me for the visit. He said I'd gone through enough in the emergency room and that I didn't need to worry about another bill.

I was free! Exhausted and completely spent in every sense, I returned to my parents house and my sweet babies. They were just as happy to see me as I was to see them, and it was so nice to be somewhere familiar and comfortable. After I sat down on the couch I realized that in my rush to leave I'd forgotten to have the doctor's office take out my IV! It was still in my arm, pinching. It had never been used for anything except the initial blood draw. I asked my mom to get me a cotton ball and band-aid, and as I removed the tape from my arm the IV came right out with hardly a drop of blood. My mom got me some food and we talked about what had happened. She'd never had a miscarriage, so it was hard for her to imagine what it was like, but she was incredibly supportive. I spent a couple of hours there with her before returning home to the rest of my family.



8 comments:

  1. I am so sorry. It seems our concurrent journey continues. Two weeks ago I suffered a second miscarriage, although it wasn't traumatic like yours was or like my first one was. I never felt the presence of another little spirit with me and just felt like there wasn't really a baby forming inside me. Both my husband and I felt from the beginning that it probably wasn't going "to take." We know there is one more little girl to come but I can totally relate to you when you said in another post that you didn't know how much more you could take.

    I am so sad for your loss. I now understand how hard this is to go through and how real the grief is.

    PS I live in the valley and am curious which hospital you went to (yikes) although you probably don't feel good about revealing the name. That's okay. Take it easy and allow yourself to grieve. My thoughts are with you.

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  2. I"m so sorry you had to endure all that...you are incredibly brave. Thank you for sharing your story with all of us. ♥

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  3. Thank you so much Bonnie :) I'm so sorry you're going through this too. No matter how or when the loss happens, it's still loss and should not be trivialized.

    I'd rather not sully the name of the hospital. I had 3 very good birth experiences there, and I don't believe this particular hospital as a whole is a bad place to go. I really think it was a bad combination of circumstances, with the ER being completely full and a new doctor on staff. I knew from the moment they told me (as I sat in the waiting room) that every bed was taken, that things would go differently than I hoped they would. I actually felt bad for the doctor and nurses who had to handle everything, but they obviously didn't provide the attentive care they should have. I'm not mad and I don't blame the people involved, although when I wrote this there was some anger I felt about essentially being neglected and ignored. It definitely wasn't a fun experience.

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  4. Wow, I just wanted to cry about how callously you were treated in the ER. It is as if you needed a doula there for your miscarriage as you had no support from the staff. I am glad the OB was sensitive.

    Hugs!

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  5. Thank you for sharing this. It means alot to me today.

    I also have been thinking more about your piece "The Illusion of Control" about birth control and was wondering if you would be willing to write something up like that piece for the book I am working on called "The gift of giving life: rediscovering the divine nature of pregnancy and birth". I've been working on the section about family planning and i would love to have a personal story about someone who has made different sort of family planning choices and realized that God is in control. Your piece keeps coming back to me and I feel prompted to ask you if you'd be willing to share it. I thought a modified version of that blog post would be a wonderful addition to our book. Let me know what you think. My email is heatherlady at gmail.com and you can read more about the book at the.giftofgivinglife@blogspot.com

    Thanks and love your blog

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  6. Sheridan, I really would have loved having a doula with me. That was one thing I realized in retrospect: that I should have thought beforehand about making arrangements to have someone come with me to help me. Of course, I didn't expect to miscarry right there in the ER, and didn't think I would need extra support. I went in for an ultrasound, but if I'd known what I was in for I probably would have tried to find someone to come support me.

    I was pleasantly surprised by the sensitivity of the OB. My regular OB who had attended 3 of my children's births was on leave because he was out of the country on military duty, and the OB I met with is his partner. I didn't know what to expect.

    Heatherlady, thank you. I emailed you :)

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  7. Sorry to hear about your 2nd miscarriage, and so sorry you had to go through that while in the ER! Makes me realize how blessed I was to be at home on a weekend with my husband there to support me when I miscarried.

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