Thursday, November 5, 2015

The Story of Our Miscarriage (There Is Blood)

Trigger warning: This post discusses blood and miscarriage. 

Hello, readers. As discussed in my previous post, BJ and I learned on the evening of Sunday, October 25 that we had lost our beautiful unborn baby at 9-1/2 weeks. This was ascertained at the emergency room, where we learned that my HCG hormone levels were unexpectedly low and an ultrasound confirmed that baby Hjarta was measuring 3-1/2 weeks too small and did not have a heartbeat. The reasons why I'm sharing the details of my miscarriage are three-fold. The first is that it helps me feel better. I've never been one to suffer in silence! The second, and most important reason, is that it might help someone who is going through a miscarriage. After I learned that Hjarta had died, but before my body began actively miscarrying, I had no idea what to expect in the coming days. Two friends of mine who had previously miscarried volunteered to share their details with me so that I might have some idea of what to expect. Reading carefully through their stories was very helpful for me, and I believe it kept me from panicking when the genuine gushing began. Then, when my experience began to significantly deviate from both of theirs, I knew it was time to seek medical help. The third reason is that my miscarriage went terribly wrong and made for a semi-interesting story. So, if you enjoy ER drama, this post is for YOU! I can promise you some action!

I had not had any indications that anything had been wrong with the pregnancy until I started spotting blood about an hour before we trekked to the emergency room for the first of four times. As I was discharged on Sunday night with the terrible news, the ER physician told me to contact my OBGYN (Dr. Brown) the next morning and schedule a visit with him by Tuesday, at which time a D&C might be necessary. My bleeding was minimal, and my body had not yet given any indication that it would pass the baby naturally. For some reason, I was hoping against hope that I wouldn't need a D&C. Any unnecessary interventions just seemed too much to handle at the time. How was I to know that it would later save my life? I woke up on Monday and scheduled my appointment with Dr. Brown for early Tuesday morning. Throughout the day my bleeding became heavier and I more frequently needed to change maxi pads. I also started passing some tissue, all of which I took to be a good sign. It seemed that my body was doing its job of flushing the pregnancy out, and a D&C might not be necessary after all.

In the shower late Monday night the bleeding began to intensify. BJ and I got ready for bed, and I asked him to get me a towel to sleep on just in case I bled through my pad. I anticipated a night of up-and-down, to the bathroom and back, because of the increased bleeding. Then all of a sudden at 11:45pm, I felt an absolute gush. I bolted out of bed and shouted BJ's name as I ran for the toilet. The blood was coming quickly, much more quickly than before, at what I counted to be 3-4 drops per second. BJ sat with me for a few minutes, but I began to realize that this wasn't going to slow down anytime soon, so I sent him to bed. He agreed to go, reluctantly, but told me to shout if I needed him. I knew there was a possibility that I would need him later, and he would need to be rested for that, so I decided to go it alone in the bathroom.

Three magazines later, the bleeding wasn't slowing down at all. I moved over to the shower and sat on the shower floor until the water ran cold, about 45 minutes later. Then I went back to the toilet. At times the bleeding would seem to slow down, and then I would pass a large clot. I reckoned that the bleeding wasn't actually slowing down because as soon as the clot would pass, the bleeding would resume. Somewhere in the middle of it I passed Hjarta into my hand. I knew it was Hjarta because it didn't look or feel like anything else I had passed, although it also didn't look much like a baby. The tissue was about the size of a walnut.

A friend of mine who miscarried naturally told me that she bled intensely for a couple of hours; after three hours of bleeding alone in the bathroom, I decided I had had enough. I called the women's floor of Baptist Hospital, and the nurse thought I should probably come to the ER. I woke BJ up and we agreed that the best thing was for me to drive there alone. I knew I was clear-headed enough to do it, and I didn't want to wake up our three small boys to take them to the ER for the night. So BJ stayed on the phone with me as I drove across the city. I arrived at the hospital at about 3:15AM.

This was by far the least helpful ER visit I think I've ever had. The physician confirmed with ultrasound that I had passed nearly everything, including baby, and only had a tiny bit of tissue left. The nurse gave me a bag of fluids and some oxygen, but didn't seem too concerned when I told her that I felt nauseated and lightheaded. She gave me IV Zofran, and they prescribed Methergine to contract the uterus and help the bleeding to stop. The nurse acted like I was an idiot because I refused to take pain medication with the Methergine. I told her I had a high pain tolerance, had birthed naturally, and didn't want to be under the influence of pain medications at this time. She told me I would "regret it." (I didn't. The contractions from Methergine were nothing like childbirth and were only mildly painful.) The physician told me that he spoke with Dr. Brown, who was not on call that night, and that it was okay for me to be discharged. (Dr. Brown later was extremely angry about this; he said that he told the physician that I should be discharged only if my bleeding stopped. The trouble is, the physician never checked on me again to make sure that my bleeding stopped, and it didn't.) So, the ER sent me home with BJ, who had arrived to pick me up, and they assured me that the bleeding would stop soon. They were wrong.

We stopped at CVS Pharmacy on the way home to fill my prescription and get some Depends so that I could go to sleep. It was now about 7:00AM, and I was desperate to go to bed. I knew that maxi pads wouldn't cut it though, as I was still bleeding just as heavily as I had all night. BJ left me in the car with the sleeping boys while he ran into the store. As he was in there, I suddenly began dry-heaving. The nausea was quickly overwhelming, and I was extremely hot and dizzy. I had been on the phone with my mom (who was out of town), but I hung up because I wasn't able to talk anymore. I rolled down the window and thought, "Maybe I can scream for help." But there was no one to scream to, and I didn't have the energy. I looked at the phone in my hand and realized I needed to call BJ and tell him to hurry, but I couldn't figure out how to work my phone. I suddenly couldn't move, and I wasn't capable of simple cognition. I finally pushed the "BJ" button on my phone; however, I couldn't lift the phone to my ear, so I clumsily moved my thumb to the speaker button. I lost my vision and could only see stars. Just before I passed out, I told BJ as he answered that something was very wrong and I needed to go to the hospital.

BJ came out quickly, and I regained consciousness. I was sweating profusely, so he took off my hoodie, and I passed out again. BJ was calm, but I think he was terrified. He quickly drove to the Moore Medical Center about a mile away, holding my head up as he drove and feeling for my pulse at stoplights. He said he couldn't find it, but he didn't think I had died. At the ER, I came to as I was being wheeled back to my room. The ER staff said that I collapsed from low blood pressure, with my reading at 91/67. The Moore ER got me stabilized for a couple of hours, giving me fluids and gathering the records from the previous ER (which, incidentally, took hours to send even though I had just left there. Seriously.) The physician at Moore decided to send me through a non-emergency transfer back to Baptist, and he told me they might monitor me there or they might just do the D&C. Bear in mind, the bleeding had not slowed down in the least.
"D&C!" I begged. "Please! I'm afraid I'm going to die if my blood pressure gets that low again." I was truly terrified and had never felt so awful in my life. Things got worse as I passed out once again, this time in the bathroom with the nurse. Blood pressure reading: 88/64. Honestly! Just before I passed out the second time, I had the same symptoms as I did in the car: nausea and dry heaves, light-headedness, loss of vision, and complete inability to do anything.

When I came to again I was in a thick sweat and was being carried back into the bed. The nurses were all around me and two of them asked me to help get myself back in the bed. As if. I was completely incapable of moving, and I couldn't see anything except darkness and stars. For the next six or so hours, I remained essentially paralyzed. I couldn't move at all for about two hours, and then regained enough to move just a little. I did regain my vision. I didn't have the strength to lift my own head, sign consent forms, speak above a whisper, or offer my arms when the nurses need to check my bracelet, IV needles (yes, one in each arm!), etc. My transfer was quickly moved up in priority, and the ambulance arrived in what seemed like mere moments after my second collapse. The medic who stayed in the back of the ambulance with me was named Mel, and I loved her. I couldn't move, but she stayed close with me. She told me she had also lost two babies, and to hang in there, and that I wasn't going to die because I kept asking her if I might. Believe me--it's easy to start feeling that way when you go from normal to paralyzed in a matter of hours.

Dr. Brown was waiting for us in the ER as we arrived by ambulance at maybe 12:30ish. BJ had never been so happy to see him, although I think I had (remember when he arrived late to deliver Van, my 9-1/2 pound child that I delivered naturally??). He explained that the little bit of tissue left was probably part of the placenta, and that my body had become fooled and would not stop putting out blood unless we did a D&C. He told me that he and I had "a date" in the operating room at 5:15pm (they actually operated at 6:30 because the OR was running behind), and he promised that they would closely monitor my blood pressure and keep me full of fluids so that I wouldn't crash again. Later that afternoon he decided that my hemoglobin, which was below 7.0, was low enough to warrant two bags of blood. I never imagined I would need a transfusion, and I now give heartfelt thanks to blood donors! I spent the rest of the afternoon miserable up in the MDU, gushing blood, unable to move, nauseated, and constantly fearful of my blood pressure. Each time my cuff tightened for a reading, I sent a hawk-eye to BJ, who religiously read me the numbers and told me to relax, that I would be fine. He was amazing. (A big shout out to Christa, my amazing sister, and Susan who kept the kids safely for us at home while we handled the big excitement all day!)

The D&C was a simple, painless procedure. When it was all over with, Dr. Brown said it took only two minutes of me under general anesthesia to stop the bleeding nearly altogether. Upon awakening, I was given the transfusions, but I still thought I might die. I felt that awful. My post-op nurse was awesome and gave me a lot of one-on-one attention, and after awhile I was the only patient down there. She raised the head of my bed slowly--it probably took a solid hour to get me to a sitting position--because I kept protesting that if I sat up I would pass out. She didn't push me too hard. I got nauseated again so I was given Phenergan, Zofran, and a patch behind my ear, and with that I was able to hold down a cracker and some water. Slowly, slowly, I eventually made it to the bathroom and I laughed in relief when I sat down on the toilet: there were no clots barreling out of me, and the blood spot in my maxi pad was only the size of a quarter!
"Kelsey!" I feebly whispered in excitement to my nurse! "Look!"
"I know," she smiled. She knew how much blood I had lost and how far I had come that day.

When Kelsey and I were confident that I could make it with just BJ's help, we were discharged. It was 11:00pm. It felt like an eternity since I had left home at 2:55AM the night before, and I had been in three emergency room visits during that time (one of them twice). I'd also had my first ambulance ride, my first transfusions, and my first fainting episodes. That's a lot of firsts! We drove home and I was hardly even sad about Hjarta at the time; I think I was just so exhausted and so happy to be alive. We got home and relieved my sister, who went home to her own family after generously entertaining my children all evening and getting them to bed. She did all this while getting updates from my brother, who stayed with us while we were in Baptist the second time. I slept hard until 10:30 the next morning, when BJ woke me up with breakfast in bed.

The sadness would settle in again that afternoon, after some of the commotion died down. For several days I felt hopelessly in despair, looking forward to nothing, and I cried at least 50 times a day (no exaggeration) in grief for my lost baby. I also bled lightly for six days after the D&C. Although the physical part of my miscarriage was difficult, I would call the emotional part of it the much more difficult piece. It's a nightmare to lose a child, even an unborn child late in the first trimester. I think that some people dismiss the loss as trivial, given that the loss is kind of abstract, and much of what a mom grieves is the hopes and expectations that she had for the life within her. The joy of being pregnant is suddenly robbed and replaced with the death of a baby and a dream. The grief is real, and I don't think it can be understood unless it has been experienced.

I hope this has been helpful for moms who regrettably might use the information (or, at least I hope it's been entertaining, depending on your needs!). Friends, I will always be willing to share my experience or offer help if you need help and are going through a miscarriage. Please know that you can always contact me through phone, text, or Facebook, should you find yourself in the awful position of a miscarriage. Without the help and support of my own little group of friends who have also miscarried, I would have been isolated and alone during my experience. Let me help support you if you need it.

A happy shot of my four kids and me, exactly one week before we lost Hjarta

2 comments:

  1. Jenny, you are a remarkable woman. So brave to share this so soon after loosing your precious Hjarta. Please know how much you are cherished.

    ReplyDelete
  2. Jenny, you are a remarkable woman. So brave to share this so soon after loosing your precious Hjarta. Please know how much you are cherished.

    ReplyDelete