Archive for October 11th, 2006

Protected: insult to injury

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Protected: suckiness

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insult to injury

I called to make an appointment with my fertility specialist. I trust my OB and I know he'll be very aggressive in trying to determine the cause of the miscarriage, but I also know RE's and OB's sometimes look at different sides of a problem, so I want to make sure they're communicating with each other. I don't want my OB running a battery of tests and then three months later having the RE say, "why wasn't this test run?" I don't want two rounds of testing. I want it over with. I want to know what the next step is, even if the next step is "do nothing." I love my fertility specialist. She always treats me like I'm the only person on her mind; she remembers random things about my life; she listens and considers her answers to my questions carefully, and she asks appropriate questions.

She is also, apparently, on leave for at least three months. I hope everything is okay. I don't know why she's on leave, but she didn't mention it when I saw her a few weeks ago, so I'm guessing it was rather sudden. I'm worried about her, but my selfish self is, well, being selfish. I want her, not some substitute!

I have an appointment with another doctor in the practice, a doctor I have a lot of respect for and whose opinion I trust. In fact, there's only one doctor at that office that I don't care for, so I really had my pick of a lot of really good doctors. Dr. S. has been in the business a long time, he's the best of the best in a lot of ways. He's funny and smart and he listens to me when I see him for monitoring appointments and I know he'll be a fine subsitute. I always knew if I hadn't been originally scheduled with Dr. T, that I would have been very happy with Dr. S. But he's not her. And he doesn't know me. And I'm a lot more than what's in my chart. So my selfish self is pleased to have such a fun, amazing substitute who knows the field as well as anyone else, but sad to not have Dr. T to turn to right now.

Mostly, I just want to know where to go from here, in as prudent a fashion as necessary, and I want input from both sides of the fence (OB/RE sides), so seeing Dr. S. is fine. I just hope I don't end up feeling like I'm starting from scratch.

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This sucks a lot more today than it did yesterday.

There's a whole lot of TMI to follow, so seriously… don't keep reading if you're squeamish, but I really needed to write this. For me.

Every time I close my eyes all I can see is all that blood. I remember that no one seemed concerned except me (and Seth). We walked into the ER and once we got to the registration desk, I fell to the floor in pain and couldn't get up for several minutes. I never should have gotten up into the wheelchair after the contraction (as I now know it was) passed. If I hadn't gotten up, they might have seen me sooner. It wouldn't have made a damn bit of difference in the outcome, but it might have meant fewer minutes of sheer terror. In the waiting room, I sat across from the triage desk literally bleeding on the floor and no one seemed to notice. Every contraction left me sobbing for relief and no one seemed to notice. No one, of course, except for Seth and the six year old who kept asking his mother why that lady was crying.

Finally Seth convinced them to take me into triage ahead of the queue and I was wheeled into a nurses station, doubled over and sobbing in pain, watching blood drip on the floor. "Are you in a lot of pain?" the nurse asked. I couldn't even answer her. Now I know what it's like to not be able to talk through a contraction. "Are you pregnant?" I wanted to say, Are you fucking kidding me???, but I could only wildly gesture. "Is she deaf?" the nurse asked my husband. "No, she's just in a lot of pain, and yes, she's pregnant." I kept pointing to the floor desperate to get someone, anyone to notice the blood underneat my wheelchair. No one seemed to notice. No one, of course, except for Seth. She took my blood pressure (163/85… not so great) and my temperature (100.5, not great, but not bad) and my pulse (113, not great, but not as bad as I would have thought). How on earth do I even remember those vitals? "My wife has had 12 kidney stones, so when she says she's in pain, she means it," Seth said sensibly. "Oh? Does this feel like a kidney stone?" No you idiot, I'm pregnant and bleeding on the floor!

The nurse wheeled me to a room, but the room wasn't ready, so I waited in the wheelchair in the hall, sobbing and doubling over with each contraction, bleeding ridiculously. No one seemed to notice. Finally, someone asked if we were being assigned a room. "I think so," said Seth. "We'll get you in as soon as we can, and someone's going to bring you something for the pain, okay?" Another contraction, another sobbing fit, a small prayer. I'm not sure why it took me that long, but that's when I knew there was no way that I was going to leave the hospital pregnant. I mean, I walked into the hospital knowing there was a good chance that I was miscarrying, but it was with that contraction that I knew I wasn't going to have a baby in April, or anytime before then.

Once I was in a room, they worked swiftly. The nurse got an IV line in, and drew blood. She left momentarily and I had a ridiculous contraction and finally, I felt something far too large to be a blood clot slide out of me. And that was it. "What if that's the baby!?" I asked Seth. It's the first time I'd ever referred to it as a baby. "Don't think about that. I know it's on your mind, but don't think about that," he said. The doctor came in to see what was going on and said she was going to do a quick internal exam and then send me to ultrasound to see what was going on while she called my OB. But she saw all the blood and she said she there was the gestational sac with the fetus intact. My cervix was still open. That was it. I was really okay. I was still in pain, but I had expected her to say the "m" word and it wasn't a shock. It wasn't the cathartic moment I would have expected. I didn't melt into pieces. I just said, "yup." She got me more pain medicine. 1mg of dilautid didn't work. 2 mg of morphine didn't work. Another 4 mg of morphine didn't work. But she said I could keep asking and they'd keep giving me more.

She called my OB to see if he still wanted to do the ultrasound, and just as a transport tech came to take me to ultrasound, my OB called the room. He said I could do the ultrasound, which would show whether there was still placental tissue requiring a D&C. "But this far along, it's extremely unlikely that you have gotten all of it out, and you probably need a D&C." Would I prefer, he asked, if he just came straight in to do the D&C? It would, after all, save a couple hours of wondering and get me home much sooner. Yes, that's really all I wanted. They cancelled the ultrasound order. A new nurse (shift change) came in to get some information. Sheri arrived with a new change of clothes for me since I knew there was no way I'd be going home in the clothes I came in. Seth asked for more pain medicine for me, but since I was going to be going to the OR soon enough, they didn't give me more. An hour later I was taken to the OR cursing the lack of pain medicine.

The OR staff was terrific. The anesthesiologist became my new best friend. My doctor arrived in jeans and a button down shirt, and talked to us for a little while. He told me he would be as aggressie as I wanted him to be in finding out why I miscarried. I told him I wanted more information than I needed and he said no problem. He was very sorry, and acknowledged that there was nothing I could have done differently. Everything was fine a week ago. Perfect heartbeat. Perfect fingers and toes. Perfect size. Perfect everything and no reason to worry. Things moved pretty swiftly and I was sent into an OR and drifted off into blissful sleep as soon as my doctor arrived in scrubs and a mask. Half an hour later, I woke up in far less pain and a few ounces lighter and I was sent into post-op with a bag full of pitocin dripping into my IV. It was very quiet in post op.. the only other patient was discharged just as I was arriving. My doctor told me my uterus was very large (not a surprise, given how far into the pregnancy I was), but that everything was okay and he'd saved a lot of tissue to send to the gentetics lab to do some testing. And I should see him again in a week to follow up and make sure I'm healing appropriately. Once the tests are in, we'll know more and he'll call me.

I know intellectually that even if I hadn't been waiting in the ER waiting room for so long that this would have turned out exactly the same. But there was such a stark difference from that frustrating time trying to get past triage and then once doctors actually became involved and how well I was cared for that I really resent having to sit there pointing stupidly at the floor. The ER doctor and my OB were both exemplary and I can't possibly ask for much more. I'm so grateful that I was in their care, even if the end result is a giant black hole of sucky suckiness.

And that's really all I have the emotional energy to write at this time. Thanks to all of you who left comments. I'd like to respond to them individually, but I can't right now, but I do so appreciate the people in the blogosphere are thinking of me. Somehow it's easier to be honest inside the computer than face to face with anyone. It's sort of ridiculous that that's how it is, but I hate crying in front of people… it's far too personal, and far too ridiculous looking. Anyway, thanks.

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