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Coming Back From Loss

2 Abdominal Surgeries, 1 Miscarriage, 1 D&C, 2 Rounds of Chemo, 2 Bottles of Narcotics and a Whole Lot of Pain.

NOTE TO READER - graphic and difficult material.

Before I dive into this, I just want to acknowledge that many of my friends and family will be hearing about this by reading this post and for that I'm sorry.  I didn't call, or text, or IM, not because I don't want or need to share my loss, but because I can't bring myself to call you up, say "Hey.  How are you?" followed by "I just had a miscarriage."  It's just not in me.  For whatever reason this is how I am able to share, heal and move forward.  But know that I know that if I did call, you would be there for me and for that I am grateful.

While I don't quite believe in luck, we were "lucky" with our first child. We immediately became pregnant. I had a generally low drama pregnancy. Granted, thirty two hours of unmedicated childbirth was not easy, but I did it. Life after baby has included immense joy, gut wrenching anxiety and a constant drive to always improve for myself and my family.

Our life paths are a series of peaks and valleys. There are many valley's that I have imagined during some of my high anxiety episodes, however, this was not one I pictured. It happened so fast that others around me were grieving before I understood what had happened. The nurses were supporting me through my miscarriage before I even understood that I was losing the life inside me.   

Here is my story...

Two years after our daughter, Stella, was born, I was still not ready to contemplate being pregnant again and I was having extremely heavy monthly bleeding. That compounded with low iron and vitamin D levels prompted my doctor to suggest an IUD.  I resisted.  The idea of implanting something in my body did not seem natural, but bleeding through my pants while in a meeting with my boss was a very stressful existence. (This happened multiple times)

Well, I was one of the 2% of people who will get a pelvic infection from an IUD. It was bad. It also increased my risk for a ectopic pregnancy (aka tubal pregnancy) if we decided to have another baby. At the time, I didn't think much beyond healing from the infection. 

Fast forward a year, and I'm finally in a mental space to think about another baby.  My OB warned us that I would need to have blood work and an early ultrasound as soon as we discovered I was pregnant to rule out an ectopic pregnancy immediately.

Getting pregnant the second time was not nearly as easy.  

After a few months, I decided I needed to have my blood work tested again and see if there was something we could do to better support my overall wellness.  I still had low iron and Vitamin D, as well as a low thyroid.  We supported my low

After another 4 months, I got pregnant. Then comes the hard part...

It starts with a blood test every 3 days to track my increasing hCG levels.  They should about double every every couple of days.

Additionally, they want to do ultrasounds starting as soon as 5 weeks and then every week until they can confirm the location of the pregnancy.

Unfortunately, I was not entirely sure when my last period was.  Shame on me; this made their job harder.  I thought I was abut 6 weeks when I first called them, but couldn't be entirely sure.

An ectopic pregnancy is rare statistically.  However, if you have certain factors, your chances go up drastically.  I'm old, had an IUD AND had a pelvic infection because of my IUD.  The cards were stacked against us, but we were still hopeful.

The first blood test had an HCG level of about 1,700.  They thought I was about 5-6 weeks along.  The next one was supposed to about double (over 3,000), it came back at 2,500.  Not a good sign.

The first ultrasound came back with no results.  Not good.  Not bad.  Just inconclusive.

The next ultrasound, I brought my husband, daughter and mother.

Yep, Stella (age almost 4) knew I was pregnant.  It was not easy to keep it from her, especially when I had to get blood tests and ultrasounds every few days.  We decided to tell her, even though the chances were not good, because she is part of our family, she has the right to know whats happening and she should have the opportunity to grieve the loss just as much as we do.  She was so excited.  It breaks my heart to disappoint her, even though it was beyond my control, but I believe she is better having known and grieved, even in her limited understanding than to wonder why we are sad and us hide it from her.

The second ultrasound and third blood test came back.  The ultrasound was inconclusive again and the blood test had not increased fast enough; a sign of a potential ectopic pregnancy. 

My husband and I came into the OB’s office that evening to discuss the game plan going forward.  It was a Friday.  On Monday, I needed to come back for a blood test and ultrasound.  Fingers crossed we would get an answer.  I was having some abdominal pain on the right side, which my OB said was a cysts and not something to worry about.

We live an hour from Portland and my OB is in Portland.  We stayed in Portland that weekend, my husband and daughter heading home Sunday in time for school and work.  Monday morning I had the tests done, then headed to a coffee shop to sit and wait for results. And wait. And wait.

Finally, I called the office and pushed them for test results.  My OB was off Monday, so I was waiting on the OB that was covering for her.  Finally, she came on the phone and said that there were no concrete answers and that I should come in to discuss options... again.

As I sat in her office, I still didn't quite believe that this was me, my life, my baby.  

She came in in a rush from the OB floor.  Sat down and told me that since they couldn't confirm a uterine pregnancy and my HCG levels were not multiplying, that it was likely an ectopic pregnancy.  After an examination, the concern about the abdominal pain on the right side prompted her to suggest immediate surgery.  When I mentioned that my OB said the pain was from a cyst, I was ignored.  I get it, she was concerned about me bleeding internally.  It is life threatening and 100% non-viable.

I called my husband an hour away and told him what the doctor said.  It was almost 5PM, Dave was home with Stella getting dinner on the table.  He fed her, got her in pajamas and started driving.  I called my parents, who live near the hospital and they came down immediately.  Meanwhile, I walked myself across the street to the hospital and up to the OB unit, where the babies are being born.

My OB was unavailable, and while this doctor was focused on the potential life threatening pregnancy, I really wish I had been able to speak with her.  It may not have changed the outcome, I realize that.  

The doctor came into my room, I was already in bed in a gown and the nurse was trying to find a vein.  At this point, I've had so much blood drawn that I didn't have many options left.  She reviewed my results with another doctor and still believed that immediate surgery was the right way to go.  We got my husband on speaker and she reviewed the procedure.  They would remove one of my tubes and use the same incisions created by my appendectomy 3 months earlier.  

My husband asked, "What happens if you don't find an ectopic pregnancy?"

Followed by the silence of the doctor.  She was not prepared for a diagnosis other than what she believed.  Her answer, "Good question.  I'm not sure." followed by, "we will close her up."  Not the strong answer you want from the doctor about to cut you open.  But, we were in a position that we had to make a potentially life threatening choice now.  Immediately.  So, off to the OR we went.

The first time I woke up, a nurse was saying my name while adjust a pad between my legs.  A pad that was not supposed to be there.  I was supposed to have abdominal surgery, why would there be a pad between my legs... I fell back asleep.

The brought me up to the room where my husband was waiting.  My parents had taken our daughter home.

I didn't understand what had happened.  My husband didn't understand what had happened.  And the nurse could only tell me what my chart said, which was not the entire story.  I started crying, then I started crying hysterically and asking "what happened?" over and over again.

The doctor never showed up.  Finally, the nurse got the doctor not the phone and she explained that she did a D&C, but only a partially sending the biopsy to the lab. She still never showed up.  She didn't adequately explain what had happened to my husband; he was at a loss.  It was a long night filled with tears, pain and drugs.

The next morning my doctor, not the one who did the procedure, but my own OB, came into our room to talk to us.

"The doctor didn't find the ectopic pregnancy."  
"The doctor did the D&C to try to confirm the pregnancy in your uterus."
"Your HVG levels are not going up as they should and they didn't find the ectopic pregnancy, this is most likely a non-viable uterine pregnancy, but we are still not sure."
"You're losing the baby and it's time to grieve."
"Because, no matter how far along you are, the moment you know you're pregnant the baby is in your heart and it is your heart that needs to heal."
"It's time to go home and heal."
"However, we also need to continue to watch for an ectopic pregnancy, just in case the doctor missed it."

It was more than just healing my heart.  I had abdominal surgery, a D&C and was going home with a bottle of narcotics and appointments for blood tests every 4 days until my hCG levels dropped to zero. 

I went home.  Hugged my daughter and tried to start the healing process.  But, this was not over.

My hCG levels continued to rise, but not at a normal pace.  The doctor called with the news that I would need a round of methotrexate (aka chemotherapy).  WTF.

What is methotrexate?  And why?  

It is a chemotherapy drug that essentially stops cells from multiplying, stopping an ectopic pregnancy.  It's scary shit.

Side effects include abdominal pain, nausea, vomiting, diarrhea and worse.

My doctor arranged for me to have the injection at our local ER.  The nurse was covered in hazmat gear. I got the shot in my ass and headed home back to bed again.

I felt numb.  This wasn't ending.  I was bleeding, miscarrying, but my hCG levels were not going down.  It's like living in a nightmare that had not sunrise, no stop time that I could count on.

I tried to keep moving forward.  Keep my business running.  Help my husband take care of us; though I was almost useless.  He has done everything.  Food, laundry, child care, driving... everything.  We had my parents helping us as well, but mostly, it was my husband.  My amazing husband.

It still didn't end.  After a week, my numbers were still not going down.  I had to have another round of methotrexate. 

I'm tired.  I'm numb.  And, I just want to move on, beyond this point in my life.  There is no desire to "live in the moment" right now.  It is all about getting beyond this, at least physically.

By the time my hCG reached zero, it had been almost eight weeks since discovering I was pregnant.  I miscarried for six weeks.

I'm trying to figure this all out.  While I've now physically healed, I'm trying to understand how to emotionally heal.  There are good moments, there are difficult moments.  

Now is the time to hold my family tight and be thankful for us; all four of us.

Thank you for taking the time to read this post.  It is long and it was hard to write.

In the coming months, we will be sharing the actuals nutrients, recovery and resources I've used, as well as, additional input from experts, to heal from surgery and loss.

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