The Miscarriage – From Naivety to Reality: Part 3

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The two weeks following the misoprostol were difficult to say the least.  I smiled less, I cried often.  I did my best to put on a brave face at work, but on the inside I was broken.  My bleeding was a constant reminder of our loss.  I felt empty.  I was empty.

I had gotten up for work on a Friday morning, almost two weeks after the misoprostol, and felt like I was finally seeing a small light at the end of our hellish tunnel.  I had hardly bled at all the last two days, and I finally felt like I was getting back to “normal”.

That afternoon at work, I felt a sudden gush of blood into my underwear.  I had a diva cup inserted, so I was a little taken aback that I had filled all 30 mL of it and then some.  I carefully made my way to the bathroom to empty the cup and then carried on with my day.  I didn’t think much of it, until an hour later I felt another huge gush of blood.  What the hell was going on?!  I thought this nightmare was coming to an end.

I waddled my way to the bathroom and discovered I had filled my diva cup yet again and bled all the way through my panties and leggings.  I embarrassed and scared.

My clothes were too blood-soaked to put back on.  I still had to see another three patients that day, there was no way I was going to sit at my desk with no panties and blood everywhere.  I tried to maintain my calm, as my mind flicked through the various outcomes and consequences of what was happening.  The nurses at the fertility clinic said that if I soaked a pad an hour, for two consecutive hours, then that was cause for concern.  Maybe the bleeding would slow down and everything would be fine.  I didn’t want to jump to conclusions.  I put my diva cup in and found a bag for my bloody clothes.  I talked to my manager and explained the embarrassing situation.  As I explained to her what happened I started crying and she told me to do whatever I had to do.

I grabbed my purse and walked to my car.  The second I stepped foot out the front door, I felt blood running down both of my legs.

Oh my god.  I couldn’t believe that my miscarriage wasn’t over.  It was only getting worse.  I didn’t think that was even possible.

I sat in my car and broke down.  I had no idea what to do.  I couldn’t go anywhere because I had no panties and blood streaming down my legs.  I didn’t know if I should go to the hospital, but even still I had blood leaking down my legs under my dress.  I would have left a trail of blood behind me and who knows how long I would have to wait.

I called one of my co-workers from inside my car.  I don’t even remember what I said to her, I was just crying and hyperventilating.  She got me an extra pad she had in her purse and a garbage bag to sit on.  I called my wife and she talked to me in the kind and calm voice that she uses when I’m freaking out.  I started to breathe and get my head straight again.  I felt physically fine and I knew I could drive home safely.  I just needed some goddamn panties and a pad and then I could figure out what to do next.

I drove the hour from Regina back to Moose Jaw trying to convince myself that everything was going to be okay.  I pulled into my driveway an as soon as I got up out of the car, blood was leaking out from the pad and running down my legs.  I ran inside to my bathroom and took my diva cup out.  I had filled the diva cup again, completely soaked the pad I was sitting on and there was blood everywhere.  I went into full panic mode, sobbing and shaking uncontrollably on the toilet.  I knew I was bleeding too much.

My poor wife started cleaning up around me and asked if we should go to emergency.  I still couldn’t think straight.  Deep down,  I knew I had lost too much blood that afternoon, but I wanted to check with the fertility clinic before I went into emergency.  Being a nurse, I didn’t want to go to emergency without a good reason.  I got into the shower to wash the blood off my legs.

I called the clinic and the nurse confirmed that I should go to emergency.  I heard some worry in her voice as I told her about how much blood I had lost that afternoon.  We gathered our things and headed to the hospital for my first emergency trip ever.

The emergency room was like everything else in Moose Jaw: small and quiet.  I was thankful for that because as we sat there I started to feel dizzy. A nurse took my vital signs before admitting me.  My pulse was 134.

I had never been a patient before.  After being assigned a room in emergency, I sat at the edge of the bed, adjusting to my surroundings.  Somehow, laying down on the stretcher would have been admitting there was really something wrong.  I was feeling better now that we were at the hospital.  My wife and I talked lightheartedly, to distract ourselves.  My bleeding had slowed quite a bit in the last couple of hours, which was encouraging.  I felt a bit silly for even being there.  Maybe I wouldn’t need a D&C after all.

The doctor on call was actually my family doctor.  It was a relief to see a friendly face.  He said that we would do some blood work and a speculum exam and the decide what to do from there.  My blood work was drawn by an awkward lab tech and we continued to wait, listening to the buzz of the emergency department around us.

My doctor came back in to the room a while later for the speculum exam.  Ugh.  I knew it had to be done, but I was not looking forward to it.  I laid back and scooched to the edge of the bed, with a wedge pillow under my butt.  I made a joke about how many people had been up in my private bits lately that I really didn’t care anymore.  But that was a lie.  I did care.  It was invasive and awful.  I hated it.

The doctor saw what he thought could be blood clots or products of pregnancy, but he wasn’t sure.  He wanted to do an ultrasound to confirm what was going on.

I walked down the hall to the ultrasound room.  The tech did an abdominal ultrasound first.  She said I still had a bit of urine in my bladder and that I should empty it in order to do a transvaginal ultrasound.  Oh great.  My favourite.

I went to the bathroom that was attached to the room and peed.  I stood up to wipe and gushed blood all over the floor.  How much blood could I possibly have left in me?!  I tried my best to wipe up the floor.  I told the tech what happened and apologized profusely.  I was overcome with embarrassment.

The transvaginal ultrasound was bloody and awful.  I felt so exposed and there was nothing I could do about my bleeding.  I just laid there and stared at the ceiling wondering what I did to deserve this.  The tech was very kind and said that it wasn’t my fault when I kept apologizing for bleeding everywhere.  She said she couldn’t tell me anything she saw on the screen and I would have to wait for my doctor to tell me the results.

As I walked back to my room, I felt another gush of blood.  That continued for the next couple of hours as we waited for the results to come back.  I finally resigned myself to laying down on the stretcher.  I felt tired and defeated.  I just wanted some answers.  I just wanted this nightmare to be over.

The doctor came back into the room and shut the doors.  He told me that the ultrasound had shown some retained tissues from the pregnancy.  He said that though my condition was not emergent, it was urgent and that I would need a D&C the next day.  My worst fear was coming true.  I immediately asked if I would be under a general anesthetic and he said that likely I would be.  That made me feel marginally better.  I started to cry for the first time since being admitted.  I had done so well putting on a brave face.  But that all came crashing down when I knew that a D&C was inevitable.

Somehow we managed to sleep a little bit that night and then we headed to the hospital bright and early the next day.  After checking in, I put on a hospital gown.  It was then that I really felt like a patient.  I sensed all of my autonomy and confidence slowly drain out.  I suddenly had so much empathy and respect for patients I had looked after in the past.  I never truly realized how powerless and frustrating it was to be a patient, especially in a hospital setting.  In the whirlwind of crap that I was dealing with, I felt a small pang of gratitude to have had that experience.  The nurse in me knew that this experience would probably make me a better nurse down the road.  Maybe it’s strange to have felt that just from the folds of an uncomfortable, snowflake-patterned hospital gown, but that’s what I felt.

As an aside, who decided that snowflakes were a good pattern for like every hospital gown ever?  Ew.

The gynecologist who was going to do my D&C came in to speak with us regarding the surgery.  His smile was nice, but his eyes and body language said that he didn’t really care all that much.  He wanted to do another ultrasound, as I had bled a considerable amount last night, just to make sure the D&C was still necessary.

Sure enough, the abdominal ultrasound showed small patches of white in my uterus, indicating that there were still tissues present.

As I began to ask him questions about the procedure, I quickly discovered that he had no interest in informed consent.  I asked him when my period could be expected to come back and about the risks of the procedure.  He said he didn’t know when my period would come back and that there were no risks to a D&C.  I asked about Asherman’s Syndrome, which is a rare complication leading to infertility, and he just waved his hand at me dismissively at me saying that it was nothing to worry about.  He also said that I could just as easily take another dose of the pill and not have the D&C at all and that it was up to me.  He left the room for a few minutes to let us decide.

Well, great.

For the umpteenth time in this whole process, I was glad to be a nurse.  I was already decently informed of the risks of a general anesthetic and had done my own research on the D&C procedure.  But I kind of wanted to discuss it with a real live doctor who specialized in gynecology to make sure that I was making a good decision.  Apparently that wasn’t going to happen today.  It’s no wonder people regularly turn to “Dr. Google” and message boards on the internet.  If you get stuck with a doctor who doesn’t care about you, unfortunately you don’t have anywhere else to turn.

My wife and I talked about what we were going to do.  I was really scared of the D&C.. Though it was irrational, I kept having horrible thoughts of never waking up from anesthesia.  Any surgery is risky and I wanted to avoid those risks, if possible.  Still, but clearly the pill did not work for me the first time and I really did not want to go through all of that again.  Again, I was stuck choosing the lesser of two evils.

The gynecologist came back into the room and asked if we had decided because the anesthesiologist was on her way and if we weren’t going with the D&C then she wouldn’t bother coming.  His tone made it very clear that we were at the bottom of his priority list.  Apparently the schedule of the anesthesiologist was more important than this critical decision to have surgery or not.  I looked at my wife and then told him that I would have the surgery.

After an hour and a half wait, I was wheeled to the operating room.  The bright white lights and air of sterility greeted me, reminding me of my scrub nurse days.  All of the staff were women, which made me feel slightly more comfortable.  I walked to the operating room table and laid down as the anesthesiologist started asking me questions.  Through a veil of numbness, I felt the hustle and bustle of nurses attaching cardiac and vital signs monitoring to me.  I thought of all the times I had prepped a patient for surgery and realized how nervous they must have been, as I put a blood pressure cuff and a warm blanket over them.

I looked up at the ceiling covered with fluorescent lights, a sight that was becoming all too familiar to me, and the anesthesiologists face came into view.  Her eyes looked kind and I imagined what her face looked like underneath her mask.  She asked me if this was my first baby.  Hearing the word “baby” made me burst into tears.  Since the miscarriage everyone had referred to the “products of pregnancy”, which while medically useful, is a very dehumanizing term.  It was like everyone just wanted to pretend that my baby was never there.

I hurriedly explained through my tears that I really wanted this baby and that I was a nurse and that this was not how I ever imagined things would turn out.  The anesthesiologist wiped tears from my eyes with the flannel blanket and said that everything was going to be okay.  This happens to a lot of women.  You’ll have another baby, she told me.  I felt so ashamed of how my body had failed.

She announced that she was giving me a dose of midazolam, which I was so grateful for.  Everything got fuzzy and I felt wonderful.  All of my worries were suspended temporarily as I unknowingly drifted off…

The next thing I knew, I was flicking my eyes open in the recovery room.  The lights were dim and I felt the pressure of the cuff on my arm, as my nurse took my vital signs.  She said that my wife was waiting for me at the end of the hall.  I was so thankful to have woken up.  I felt relaxed and a little dizzy.

I dozed off and woke up to my wife coming in to the room.  I was so happy to see her face.  She read to me a little bit, as I slowly had some apple juice and the most amazing piece of toast with peanut butter on it.  Seriously, guys.  That toast was out of this world.

I walked slowly to the bathroom for the obligatory pee before I was able to go home.  I got my discharge instructions and felt like a princess as a porter wheeled me down to the front door.  I hoped that all of the kind staff I encountered was some sort of nursing karma for the compassion and care I’ve shown my patients over the years.  Either way, I was grateful to step into the sunshine and go home.

The next two days were full of sleep, tears, Netflix, cuddles and comfort food.  I was anxious about taking too much time off because I wanted to save my sick time for future fertility appointments.  I wish I could have taken more time off to really process what happened to me.

I let life whisk me away and I kind of left my emotional health in the dust.  I’m dealing with it as best I can now, with meditation and exercise.  Everyday is a little bit better, but if I’m being honest with myself I’m far from being in the clear.  I put on a smile because I’m pretty good at faking being happy, but I know deep down I have some healing to do.  I’ve been more gentle and compassionate towards myself than I ever have been in my life, which is an area in which I’ve been wanting to grow for some time.

People have said to me that everything happens for a reason and that this experience will make me a stronger person.  I’ve been told that it will happen when it’s meant to happen.  I’ve been told to focus on the positive.  I’ve been told that everything has a silver lining if you look hard enough.  But you know what?

Fuck that.

There is nothing good about my baby dying.  There is no positive thinking that will take away the pain of losing her.  I did not need this traumatic experience to become a stronger person.  I was already strong to begin with.

-K

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The Miscarriage – From Naivety to Reality: Part 1

Well, there’s no easy way to say this, so I’ll just say it.  We had a miscarriage.

I was diagnosed with a missed miscarriage at 8 weeks 5 days, and after confirming the diagnosis I had a medical abortion with misoprostol (brand name Cytotec) at 9 weeks 5 days.  After two weeks of bleeding from the medication, I started bleeding extremely heavily and was advised to go into emergency.  After some tests and an ultrasound it was determined that I had retained some products of the pregnancy and had to undergo a dilation and curettage procedure (D&C).

Needless to say, these last two weeks have been hell for me and my wife.  It’s hard to remember back to the days following that positive pregnancy test.  All of the joy and excitement we had when we found out we were pregnant is such a stark contrast to the devastation we feel now.  It feels like I was living a different life.

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I found out I was pregnant on my birthday and it was the best gift I could have received.  I could hardly believe that it had worked the first time!  It was a dream come true.  Sounds like the beginning of a picture perfect movie, right?  That’s what I thought too.

Truth be told, I actually had an inkling that I was pregnant the day before my birthday.  The two week wait was killing me and I really wanted to be prepared for the news from the fertility clinic.  At exactly two weeks, I was to go have blood work done to check my hCG levels (the pregnancy hormone) and then the fertility clinic would call me the same day with the results.  I decided to take a Clear Blue pregnancy test the night before the blood work, just to see what would happen.

I peed into a cup (much easier than trying to aim for the stick!), dipped the stick, sat on my bathroom floor, and started my timer.

The indicator window was blank for the first couple of minutes.  Of course.  It’s exactly what I thought.  It didn’t work, I’m broken, we’re gonna have to shell out another $2000 next month to do this all over again.  Ugh.  Nonetheless, I continued to stare and stare and stare at the stupid window right until my timer went off.  All of a sudden, the faintest, palest, shadow of a second blue line started to appear.  I stared at that silly pregnancy test from every angle, in every light, straining my eyes to make sure what I was seeing was correct.  I could hardly believe what was happening.

I was pregnant.

My cute Pinterest-y plans of telling my wife the good news quickly went out the window as I yelled her name from the bathroom and started freaking out.  When she came in, I was still sitting on the bathroom floor, next to my pee, waving the pregnancy test in the air like a crazy person and I kept asking her, “Is this real?!  What if this is REAL?!”.  It was all very romantic.

As an aside…who are these amazing women who set up adorable photo shoots and blindfolded taste tests to surprise their partners with their big news?!  I couldn’t imagine holding on to such exciting information long enough to plan something so delightfully elaborate.  My original plan was to give my wife a set of baby Converse shoes (so cute!) when I told her that we were pregnant (which I had wrapped and stored in my underwear drawer for the last couple months, because I’m a planner like that).  She loves Converse, it’s the only shoe she wears other than combat boots.  She even wore them at our wedding!  How cute would that have been?  I had imagined it all perfectly, and after I told her the precious news we would embrace and smile and be filled with joy.  Rainbows would shoot from the ceiling and doves would fly gracefully down from the heavens to mark our celebratory moment.

Yeah, that didn’t happen.  Like, at all.

The next day, after the blood test, I watched my phone obsessively waiting for the actual confirmation from the fertility clinic that the pregnancy test was positive.  I was secretly very excited, but I also wanted to make sure that it wasn’t a false positive.  I watched and waited, and watched and waited some more.  Unfortunately, despite leaving a voicemail for the clinic, no one got back to me with the results that day.  It was pretty frustrating, but I decided I would just take another pregnancy test (or two!) and get confirmation myself that evening.  I picked up a First Response dual pack (way better than Clear Blue, in my opinion) with a digital test and a line test.

The second I got home, my pants were off and I went straight to the bathroom with a cup.  I waited anxiously, but it didn’t take long for a very clear “Yes +” to show up on the digital strip and the brightest, clearest pink vertical lines to show up on the other strip.

Okay, I really am pregnant!!!

I could hardly contain my excitement and we immediately contacted our parents with the great news.  This was really happening.

I was just glowing for the next few days.  My heart was full and I felt incredibly blessed to have had our IUI work the first time around.  I think I was also equally shocked that it had actually worked the first time around.  I’m sure a lot of other couples weren’t so lucky.  I received a call from the clinic, that my hCG levels were excellent.  I had to go for a second set of blood work 2 days after, just to ensure that the levels were rising appropriately, as hCG should double every second day at the beginning of a pregnancy.

My second set of hCG levels were sky high and I was starting to feel all of the lovely first trimester symptoms.  My boobs were gigantic and I could smell EVERYTHING.  I felt like a superhero.  For anyone who knows me, I definitely do not need help in the bosom department, but it was nice to feel the changes in my body.  It made everything feel so real.

Around 5 weeks is when things really started to get fun.  I started having the worst morning sickness, that quickly upgraded to all day sickness.  I was exhausted and I hated all food.  Seriously.  I tried all the standard remedies for morning sickness like soda crackers and ginger ale, but nothing really helped.  I couldn’t imagine eating anything, but at the same time I was starving and having food in my stomach really settled the nausea.  As you can imagine, I was pretty miserable, but also knew that all of the symptoms were a constant reminder of the life growing inside me.

At 7 weeks and 1 day, we had our first ultrasound scheduled.  We had the familiar drive up to Saskatoon, but I was over the moon that we were about to see our little (very little) baby.  My wife and I chatted about the future and continued our plans that had been brewing for our little family since we received the news.  I was so excited to see our baby and maybe even hear a heartbeat!

In the clinic, I laid down on the table for a transvaginal ultrasound.  That early in the pregnancy, a transvaginal ultrasound is much more accurate than an abdominal ultrasound.  Within a few seconds our doctor found our little tiny baby.  He or she was really in there!  My heart just about burst with love for this tiny being that was only the size of a strawberry.  I asked if we could hear a heartbeat too, but the doctor said that she was having some difficulty finding it, but that it was probably nothing to worry about.

After the ultrasound, we had a brief consultation in her office.  Our doctor said all of the measurements looked excellent and right on track for how far along I was, but that the lack of a measurable heartbeat was “mildly concerning”.

My heart dropped.

Those were the last words we wanted to hear and though I was trying to focus on the positives, I was devastated.  What happened to our picture perfect movie?  I was supposed to see our little baby, hear their precious little heartbeat, smile loving into my wife’s eyes, glistening with tears and feel a deep sense of joy at the life being created inside me.

Instead, I felt scared and disappointed and cheated.

All of the wind was taken from my sails and we had a pretty quiet drive back home.  We had another ultrasound booked in a week, to confirm that everything was okay.  It was slightly early to hear a heartbeat, so I clung on to the fact that the measurements were good and we saw little flutters of movement on the ultrasound screen.  Maybe everything will be okay after all.

With the Easter weekend quickly approaching, we decided that we would go ahead with our plans to tell our family.  We don’t see everyone back home very often and we really wanted the chance to tell our loved ones in person.  Even though I knew miscarriage was a possibility, I just couldn’t believe that it would ever happen to me.

Miscarriage is one of those things that happens to other women.  Friends of friends.  The fertility nurse who did my IUI just had to look at me and I got pregnant.  Clearly, my body was ready to make a baby.  I wasn’t in a high risk group.  I was only 29 years old.  I had taken my pre-natal vitamin for three months before trying.  I slept well, exercised, went to yoga regularly.  We had minimal processed foods, tons of fruits and veggies.  I had cut out caffeine and alcohol long before our first IUI.  I had switched all of my cleaning and personal products to brands that did not contain phthalates and all of those other nasty chemicals that aren’t recommended during pregnancy.  I made my own deodorant, for god’s sake.

I had done everything right.  But I guess it wasn’t enough.

On Easter Monday, we drove back from Edmonton and stopped in Saskatoon for our follow-up ultrasound.  We were cautiously optimistic.

I laid down on the table for the trans-vaginal ultrasound and immediately my eyes were glued to the ultrasound screen for any sign of our little baby.  I still felt so very pregnant.  The doctor scanned and scanned and kept doing sweeps of my uterus.  The doctor was very quiet.  Deep down I knew that something was wrong. I felt my wife’s hand on my shoulder.

“I’m sorry.  I don’t see anything.”

“What do you mean?” I said, knowing what she meant, but refusing to believe it.

“I just don’t see anything.  Last time there was a fetal pole and now I can’t see anything.  I’m so sorry.”

She removed the ultrasound wand and I sat up.  She said she would meet us in her office down the hall.  I turned to my wife and said, “I guess this is why people don’t tell early” and burst into tears.

I felt ill. I could hear the blood pumping through my ears.  My throat hurt so much from holding back a flood of tears.  I just wanted to break down, but there were other patients around in the office, so I tried to keep my composure.

As we sat down in the doctor’s office, the first thing she said was that it wasn’t my fault.  That should have made me feel better, but it didn’t.  I was devastated.  I felt like everything was my fault.  How could it not be?

She presented our options.  I felt bad for her.  I’m sure this was one of the worst parts of her job.  I was only half listening, trying to process how our lives and future plans had just shattered all around us.  In that moment, I couldn’t imagine any sort of abortion procedure.  I said we would just wait for the miscarriage to happen naturally.  She said it may take a week or two.  I couldn’t think.

My wife drove home and I cried.  I couldn’t think of what to do except to start telling my close friends and family that we had miscarried.  I couldn’t speak.  I didn’t want to call anyone or answer the phone.  I just texted through my tears.

I miscarried.

I found out I had a miscarriage.

I just found out I miscarried.

Every time I typed that word, it looked more strange, as words do when you stare at them too long.  I think it helped me accept what was happening, in some small way.  With every person I delivered the news to, I felt another piece of my heart break.

I felt a deep shame and embarrassment.  Like I had let everyone down.  Everyone was so excited for us.  We had a trunk full of baby gifts already.  A bassinet, blankets, little toys, a diaper bag.  I felt stupid for having those things.  How foolish to start planning so early, when I knew full well this was a possibility.  I still haven’t taken those things out of my trunk.  I can’t.

I immediately understood why people choose not to tell anyone they are pregnant until the first trimester is over.  In that moment, I wished we had done the same.

When we finally got home, my wife and I collapsed onto our bed a cried together for a while.  I was upset that she hadn’t shown much emotion, as she was trying to hold it together for us, but as soon as she started crying I wished she would stop.  Her tears made this nightmare real.  Her sadness broke my heart almost as much as losing our baby did.  We held each other for a while and eventually the tears stopped.

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The following week was a confusing mess of hope and devastation.  As I regained my critical thinking and started to adjust to our new circumstances, I explored the options for handling the miscarriage.  My initial idea of allowing the miscarriage to happen naturally, was seeming more traumatic by the day.  With my hCG levels as high as they were and the pregnancy as far along as it was, it could take weeks to miscarry naturally.  I’m pretty tough, but I’m not that tough.  I couldn’t imagine dealing with all the pregnancy symptoms (which were still in full force at this time) and just waiting day after day for bleeding to start.

My other options were to take a pill to induce the miscarriage or to elect for a surgical dilation and curettage procedure where they remove the pregnancy products and lining of the uterus.  Both options sounded awful, but not as awful as waiting for endless weeks for the miscarriage to happen naturally.

In my next post, I will write about the next steps we took with our miscarriage.  There are no easy decisions and no “one size fits all” approach when it comes to a miscarriage.  I will go into detail about how we came to our decision and the resulting events, but I don’t think I can handle much more crying today.

My hope is that my writing here may provide some comfort for women and couples who are dealing with the same experience.  I personally found a lot of comfort in reading the various miscarriage discussion pages and threads out there, so I hope to return the favour.  I have found that it helps knowing that you are not alone.

I also hope that reading my experiences here will be a reminder that although pregnancy can be a very joyous time, it can also be very traumatic.  I think it’s important to remember that everyone has a story.

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This was our first ultrasound.  The little blip between the green crosses was our baby at 7 weeks 1 day.  At the appointment, I remember making the ultrasound joke from that Friend’s episode, when Rachel couldn’t see her baby on the ultrasound screen.  But I definitely saw her.  And I loved her.  And I was already imagining a life with her.  I know she was very small and brand new, but for a few weeks I was her mom.

-K