Sunday, December 9, 2012

The One Where She Has Emergency D&C After Waiting to Avoid D&C

Well, that was fun.

Ready to hear the tale of how this latest pregnancy finally came to its miserable end, with a spectacular display of pain and suffering that only someone like me, with the worst reproductive luck in the history of humankind, could incur?

Well, gather 'round, friends. Pour yourself a glass of something good. I'm ready to tell it.

So last weekend I was nearing the end of my threshold of patience for "waiting it out." Although my history of uterine scarring (Asherman's) gave my doctor much understandable pause about doing a D&C, I was nearing ready to try Misoprostol, despite my own personal really bad luck with it (during the first of my five pregnancies -- the pre-H miscarriage following my first IVF attempt). Because let's be clear: Waiting to bleed out a dead fetus is most definitely not like "waiting for a period" as myriad health care providers will try to convince you it is. I was sick of feeling pregnant without the benefit of shopping for cute baby outfits. Call me vain, but I wanted the ability to fit in pants beyond my one pair of acceptable borderline fat jeans I keep around in case of emergency.

So I'd called my OB's office to give me the medication, and I'd decided last Monday would be the day I'd take it. The thing about a plan to take medication that makes you bleed your girl parts out is that you have to find a time in your schedule where it's convenient to sit on the toilet bleeding your girl parts out all day long. My husband agreed to stay home on Monday and watch H so I could do the deed.

Except last weekend I started spotting and then Monday morning I woke up with period-like bleeding. I felt very crampy on and off for most of the day. The cramps were quite heavy at times, and I can't say I was having a great time, but it all felt very manageable. Until it didn't.

I went upstairs to take a shower around 3:30. When I got out of the shower, I felt a gush of something and I feared looking down, but I really didn't see anything. I thought it was kind of weird but there's plenty of weirdness going on when you're passing a pregnancy so I didn't dwell on it. I went back downstairs to my perch on the couch to watch a Christmas special where Giada and a house designer remake someone's house and then teach them how to cook. I was silently cursing Giada for being so adorable and yet so hatefully, enviably skinny, when I felt another gush.

I ran upstairs.

It was blood. So, so much blood. So much blood I don't even know how to describe it here.

You know how they tell you that you will know you're bleeding too much when you soak more than a pad an hour for three hours? I would like to know right now who the hell came up with that ridiculous measurement. Because when you're bleeding too much, it cannot be contained by a pad, your underwear, your pants or the seat beneath you. It gushes out of you in a way that actually feels uncomfortable coming out of you. It feels like it must be stopped. Right now.

I ran outside, where my husband was playing with H. I told him I needed to go to the hospital. He heard me, but he is a man, so he thought I was telling him I was going to the hospital, like "Ta ta! I'm off to the hospital!" You'd think after all we've been through he would know better. I told him he would be driving me, thank you, as I was not interested in blacking out behind the wheel if it came to that. Except I was really upset, so I'm not sure it sounded calm and reasonable, or even like English. But he got the message and ran to the car with H.

When I got out of the car at the ER door, I felt more gushing. I literally waddled into the door, where I was greeted by three women, thank God. I sat down and promptly bled all over their triage chair. I really didn't need to say anything, but I told them I was likely hemmorhaging and needed urgent medical care. And I got it. They wheeled me directly back. Apparently bleeding is one of those things that gets you a ticket out of a two-hour wait in the ER, in case you're ever wondering.

Also, if you're ever looking for a good time, or to test your ability to think swear words urgently but not scream them out loud, I highly recommend a pelvic exam during a miscarriage at the exact same time that they're trying to jam an IV into your arm. The good thing is, you're not sure where to direct your discomfort sensors. Is the feeling of having blood clots grabbed out of your lady bits more or less comfortable than a tube entering your vein? The jury is out, my friends.

After some waiting, I was then wheeled to an ultrasound with the Worst Ultrasound Tech in the History of Infertility and Pregnancy Care. I won't trouble you with the details except to say that she was slower than slow except when she needed to tell me something urgent like, "You have lots of fibroids!" or "Wow, you are bleeding a lot!!!!!"

Finally, I was wheeled back to my little ER room, H having been released to a very kind friend willing to come and get him and take care of him for the rest of the night. The ER doctor came in and told me -- newsflash -- that I needed a D&C. She said there was a good amount of tissue remaining and I'd probably just keep bleeding as I was until it was out. She said the OB (a partner of my own, who was not the one on call) was on his way in and he'd come and discuss it with me when he arrived.

Meanwhile, my one stroke of luck sauntered in: the best anesthesiologist on the planet. Not only had she gone through four D&Cs herself, but she actually said the words, "You tell me what you want for anesthesia." You know, I can't believe it's true that it's actually hard to find a doctor who is willing to be kind to you when you're going through something like a miscarriage, but it is. This doctor, thankfully, was one of them. I knew the D&C was going to suck, but I knew it would suck less with her near my head during the procedure.

Then, the OB walked in. With some hindsight, I think I understand why the conversation didn't go well. I think he thought he came all the way in to the hospital during his call to meet a patient who had presented with severe bleeding and that he would be hailed as a hero. Instead, he got a patient who was informed, hesitant and full of questions. Who dared suggest that he talk to her RE about her Asherman's case. Who asked questions about the way he would conduct the procedure. He didn't like it very much. He asked if my RE was the only one who could touch my uterus, why wasn't she on call 24 hours a day for me in case of this situation? He questioned the wisdom of waiting in light of the outcome. He was defensive and sort of generally not very nice to me, and since I was already fragile I broke down in tears immediately. I simply could not believe that I was in this situation, about to get the D&C I walked around with a dead fetus in me for three weeks to avoid, in a new care setting (because it felt like an emergency I went to the hospital near my new town, which is my OB's hospital but not my RE's), with a doctor who was not only new to me but who obviously hated me too.

Both of us sort of backed off after I started crying. I just sort of recognized the obvious, that I was in no shape to get up and go to a different hospital or wait for my RE to be available the next day, that I needed a D&C now and despite the doctor's attitude he seemed skilled (naturally I'd looked up his bio when I learned his name) and aware of the need to not go crazy with the scraping. I'd said my piece, he was aware of my concerns and I just needed to let him do his job. And I think he recognized he'd been overly defensive.

And so they wheeled me into the OR and I had the surgery. I was awake the entire time, with little more anesthesia than IV narcotic. I heard the tissue get sucked out of me. The whole time I was just thinking,

I never want to be here again. I don't give a crap about another kid. Just get me home in one piece to the one I have.

Recovery was quick. As I stood up from the wheelchair and got in the passenger side of my car, the fresh air against my cheeks brought me back to life. The streetlights had that muted glow of early winter and I had that sense of gratitude you have after being really afraid of something and then realizing everything was going to be okay.

I don't know where we go from here. I don't know why I have to be having another freak show nightmare miscarriage in the middle of Christmas. I don't know why this all has to be so hard.

All I know is, thank goodness it is Christmas, actually, because what would I do if it were just the dead of winter with the ice and the slush and without 10,000 sparkling lights all over the bushes outside my window? What would I do if I couldn't take this all away just by thinking about a boy upstairs right now who believes in Santa Claus with all his heart? A boy who reminds me what is possible if you just keep on pushing through all the pain, if you're crazy enough to keep trying even when a voice inside you says it may be time to stop?

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