09 December 2012

My Surprise Abortion

Tuesday morning I went to my doctor's office for an ultrasound. Monday morning I had a beta HCG test drawn and instead of continuing a decline the result was over three times the value of a week before. One thought was I could have lost a twin, but the second embryo was growing. However, the ultrasound didn't show anything. She could see a lot of tissue, but nothing else visible in the uterus or tubes. She was concerned that there could be a molar pregnancy that was obscured by the vast amount of tissue. She said I needed a D&C this week. She looked at her schedule and said she had time the next afternoon (Wednesday). It was overwhelming. I was by myself, because it's Josh's busy time at work. Up until this point the only person who knew we had been looking at a potential loss was my sister. I knew I would have to tell my parents, because I would need a ride to and from the hospital. Part of me wanted to insist on waiting for more blood work or another ultrasound, but I let myself be carried along. It was hard to discuss much through all the hysterical sobbing.
The result was a 1:00 show time for a 3:00 surgery and the rest of the week off work. So in addition to my parents I would have to tell my boss something. While still at the office I texted my sister. Then as I was pulling out of the parking lot I called my parents. Despite an attempt to hold it together I broke down. (Over the past 4 years I've become very adept at the sobbing while driving). Once that was figured out I called Josh at work and told him that they were going to do surgery to remove the tissue and that my parents were available to drive. Back at work I waited for my boss to get back from meetings and I simply said, "I'm having outpatient surgery tomorrow and will need the rest of the week off." Usually he asks questions, but he didn't and I didn't want to get into it.
With food, water, etc all banned after midnight, I spent most of Wednesday morning in bed. I had started bleeding more overnight, so I put a call in to the doctor's office to find out if they still wanted me if I was bleeding. The answer was still a big yes. My doctor wanted to make sure all the tissue was removed. I was thinking about doing dishes, but decided I needed to stay out of the kitchen--so hungry, but mostly sooooo thirsty. Josh called a little before noon to say we should wait for him, because he was going to be able to make it home. My parents arrived with snacks for post-surgery, a new robe, and fuzzy socks.
At the hospital, my parents dropped us off at the front and then went to park the car. Josh and I walked into the admissions office and once I gave my name, we found our seats. Almost immediately I started feeling a sharp pain on my left side. It became progressively worse as I was checked in and led upstairs to the ambulatory surgery waiting room. Waves on nausea. I had Josh move the trash can close and find me a box of tissues. In the back of my mind I wondered if my parents would find us, but I couldn't focus between the nausea and the pain. My parents did show up. My mom went to find a nurse and my dad sat beside me with his hand on my back as I shook and sobbed. When my mom came back she went to the bathroom for a wet paper towel for the back of my neck. Eventually a nurse came out to make me trade the trash can for a shallow kidney shaped pan. A few minutes later they took me back to a room, so I could change and answer a million more check-in questions. The pain continued to worsen--spreading down my left leg to just above my knee and then up my back to the middle left side. My blood pressure was ridiculously low.
Almost as soon as they finished getting my stats (which included a domestic violence screening) the OR called for me to get prepped. A nurse brought my family back. It was hypothesized that the pain was simply miscarriage. It could feel different because molar pregnancies attach differently. When it was time for me to go, it was decided Josh would go with me for prep. We went down separate ways since the initial prep would have to be done before they brought him back. With each moment that passed the pain worsened. I cried as they wheeled me past the waiting area where Josh sat.
I don't remember the exact order of everything that happened next. There was the constant pain. Eventually an IV was started, Josh was brought back, pain meds were injected into the IV, more pain meds were injected into the IV, a nurse assisting my doctor's current surgery came out to find out what was going on so she could report back to my doctor. They had heard from ambulatory surgery that I wasn't well. My blood pressure was more reasonable. At some point my doctor came out of surgery with the nurse and another doctor. They did an ultrasound to check for fluid in my abdomen, which would have indicated a ruptured tube. There wasn't any. So the plan remained the same: D&C, look for "products of conception," if there aren't any then go looking for an errant implantation (starting on the left). Then more waiting. While we waited, I had Josh rub the pain in my leg. Then they took him away. And I was alone.
In the actual OR prep room I was moved to the operating table and the anesthesia was started. My doctor was there. She stood with her hand on my shoulder. I cried as I fell asleep. It was no longer from the pain in my side--the medicine had taken care of that. It was the realization that this pregnancy was over now. I had mourned it multiple times, and this was the absolute end. My doctor offered comfort, promising we would get this figured out. I heard them discussing the order of things and then I woke up.
It was 7:30 pm when I woke up. I had been under anesthesia for about 3 hours. After the D&C they froze the removed uterine lining, which took an hour. Then when no "products of conception" were seen they started laproscopic surgery. My left Fallopian tube was very swollen and was leaking blood. They were able to remove the offending cells and clots without removing the tube. When my doctor reported back to my family, she said there was a 10% chance of another ectopic and if that happened they would just removed the tube.
I"ll handle the details of my recovery in subsequent posts.

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