Friday, 7 February 2014

The Second Ectopic Pregnancy

The bracelet I bought after my first miscarriage
Having had to wait 9 months to try again with my first pregnancy, I was happy that the doctor who did my surgery said that I could start trying again as soon as my period returned. It took 6 weeks for my body to get back to its regular cycle. In that time, I had a tubal patency test done on my right ovary to make sure that it was clear. It was a huge relief to find out that everything looked okay on that side.

We started trying again as soon as my cycle returned. I had my doubts about how long it would take as the average person in their early 30's has less than a 20% chance of getting pregnant every month. And since I am one tube down (if I ever start a band, that's going to be our name!), my chances are reduced to about 12%. That's not very high but somehow I managed to get pregnant after a couple of months of trying. The human body is a pretty amazing thing. A scan would reveal that I had ovulated from my left ovary (the side with no fallopian tube), and yet somehow, my right tube managed to pick up the egg.

For those who have suffered repeated losses, you'll know what I mean when I say that I felt so robbed when I found out I was pregnant again. Don't get me wrong - I was really happy, but that feeling of happiness was completely overshadowed by fear. When I got a positive on my pregnancy test, instead of screaming and shouting with excitement, my husband and I looked at each other with wry smiles as if to say, "here we go again." It shouldn't be that way. At this point we know better now than to get excited about a pregnancy. It's more of a "wait and see" situation.

I called up a specialist who dealt with difficult fertility cases and over the next couple of weeks I went through regular blood tests to check on my hCG levels. Unlike my last pregnancy, the levels looked really good and were more than doubling each time. My doctor even joked that he thought it might be twins!

Over the course of two weeks I began to have the familiar sharp gas pains that I had had with my previous ectopic pregnancy. I tried to tell myself that it was probably constipation which pregnancy tends to give me, but I was extremely worried. What I couldn't figure out was that the pains were on the left side again, just like the last time. I tried to reassure myself that it couldn't be another ectopic because I had no tube on that side.

On the day of my first scan, I suddenly began to have terrible abdominal pains, worse than I had ever had, and found myself on the bed, doubled over in pain. Standing up, I nearly passed out and decided that I needed to call my doctor. He managed to get me in for an earlier appointment and gave me an ultrasound. Once again, there was blood in my uterus and he wasn't able to see a gestational sac. He admitted me to hospital for more tests but I already knew the answer. One of the signs of an ectopic pregnancy is shoulder tip pain, and while I hadn't felt any with my first ectopic, I had now begun to feel it alternating in each shoulder. Another scan confirmed my worst fears - the embryo had implanted again on my left side, but this time in the STUMP of what was left of my fallopian tube. The chances of this happening are almost impossible. Almost.

One of the things that will stay in my mind forever is lying on the operating table right before they put me under. In my previous pregnancies, I had already lost the babies by the time I realised that I had miscarried, but this one was still very much alive. I closed my eyes and took a moment to say goodbye to my child who was about to be terminated. To the child whose birthday should have been the day after my husbands' and who I had so desperately hoped would be our rainbow baby.

The rest of the story is pretty much how the second ectopic went: laparoscopic surgery, an overnight stay in the hospital, and then sent home to grieve and recover. The chances of having a molar pregnancy followed by not one, but two ectopics, is literally a million to one. With those odds I feel like I should be playing the lottery.

Saturday, 11 January 2014

The First Ectopic Pregnancy

It took me only a few months of trying before I got pregnant a second time. Knowing that I was able to move forward with my life after being stuck in medical limbo for so long was such a wonderful feeling. I was finally seeing light at the end of the proverbial tunnel.

I had been taking pregnancy tests in the days leading up to what would have been my period, but each test was painfully negative. There was no line to be seen. On the day that my period was due, I took one last test in the hopes that I would see something but still nada. I put the test aside and got on with things, disappointed, but knowing that we would just have to try again.

A few hours later, I picked up the test to have another look, and low and behold, there was the faintest of faint lines to be seen. Shocked, I headed out and picked up a First Response pregnancy test to confirm my suspicions. This also gave me a faint positive!

I called my doctor straight away as he had told me that he wanted to closely monitor me the next time I got pregnant, and he sent me in for an hCG test. That came back at a level of 14 and my heart sank. I could tell that things didn't look great from the nurse's voice when she gave me the number over the phone. The level was too low for 4 weeks into a pregnancy. And from that point on, I told myself I wasn't going to get attached. I knew in my heart that this pregnancy probably wasn't going to make it and so I didn't even let myself calculate my due date. I couldn't bear the thought of counting down to another birthday that should have been.

My heart leaped however, when a second and third blood test over the following days showed appropriate doubling of  hCG levels, although they were still really low. I tried desperately not to get my hopes up, but when you're carrying something so precious, it is almost impossible not to get emotionally attached. 

Over the next 10 days or so, I would experience sharp pains in my abdomen. I was a little concerned, but a quick internet search showed that gas pains were very common in pregnant women, and so I didn't think too much about it.

At about 5 weeks, I had a small amount of spotting which then progressed into painful cramps on the left side of my abdomen, similar to the ones that I had when I had taken cytotec. I waited through the night and then went to the hospital to find out if I had miscarried. It was too early to do an ultrasound and so more blood was taken to see where my hCG levels were at. Surprisingly, they looked ok. The nurse told me not to worry and that bleeding in early pregnancy was common.

The bleeding tapered off, but over the next four or five days, the pain in my left side remained. It wasn't a terrible pain - hell, we moved house during those few days so it definitely wasn't crippling, but I just knew in the back of my mind that something wasn't right with this pregnancy. With the hCG numbers being so low and the fact that the pain was only on one side of my body, I was starting to get concerned. 

I finally decided to go to the ER. It was a public holiday and everything else was closed. After being there for 5 hours and having an ultrasound done, they determined that they couldn’t see a gestational sac in my uterus but that I had a lot of blood in my pelvic area. They were unable to see my left ovary on the ultrasound because of the amount of blood and it was decided that I had an ectopic pregnancy that had ruptured my left fallopian tube which had resulted in internal bleeding. Within an hour of that diagnosis, I was on the operating table.

I have never felt more incapacitated than I did after the surgery. My D&C was a cakewalk compared to that. Not surprising considering they cut three holes in my abdomen. Unfortunately, they were unable to save my fallopian tube and so it was removed.

I was released from hospital the next day. As I was wheeled out, I passed a very pregnant woman in her 20’s puffing away on a cigarette. I was totally shocked but it made me so angry as well. I wanted to go up to her and shake her and ask her if she knew how lucky she was? That she was able to get pregnant and have a successful pregnancy. And how many women would kill to be in her shoes?  Instead, I went home to grieve the loss of another baby.

Saturday, 28 December 2013

The Loneliest Road

I actually had to laugh when I saw this card because it captures how perfectly I have been feeling over the past year and a half.

After my PMP, I was thrown into 9 months of medical limbo. During that time, a number of my friends gave birth to babies, and it seemed like an even bigger number were getting pregnant.

There is nothing that makes you feel like more of a failure than watching so many people succeed where you could not. It's a wretched situation and one that I would not wish on my worst enemy.

To add insult to injury, a woman at work had her due date the day after what would have been mine, and so I got to spend the next 7 months watching her get bigger and bigger and trying not to measure her milestones against those that I would never have.

Having a miscarriage is probably one of the loneliest roads one can travel which seems strange to me because for something so common, it is so rarely discussed. It is such a taboo subject that no one ever speaks about because it makes everyone feel uncomfortable. Nothing kills a conversation faster than talking about your dead baby. People are scared to bring up your loss because they are afraid that it will remind you about what happened. What they don’t realise is that not a day that goes by when I don’t think about what happened.

A miscarriage is a life altering experience and the truth is you’re never the same after having one. A piece of you dies along with your baby. Society recognizes the grief of losing a parent, a grandparent, a brother, sister or friend, but it doesn’t look upon losing an unborn child in the same way. It’s a loss that most people aren’t able to understand and so many women are left to grieve silently.

Recovering from a miscarriage in the physical sense is a lot easier than recovering emotionally. Those scars run deep and are reopened regularly. My miscarriages destroyed my confidence in my own body which I used to think was pretty dependable until it failed me horribly over and over and over again. There is no joy in the thought of trying once more to get pregnant - only fear. Fear of losing another baby, fear of the physical and emotional pain, and the fear that the next time might kill me. And yet I will try again. I have to. There really is no other choice if I want to be a mother.

Hello, Rock, meet Hard Place.

Wednesday, 25 December 2013

And in time, this too shall pass...

I picked the name of this blog to remind myself that
everything ends at some point.  Both the good and the bad. I have never been one for tattoos but lately I have been considering getting this phrase inked somewhere on my body to take it with me always. Just another way that a miscarriage can change a person.

Christmas has come and gone. These days, I sort of dread holidays and celebrations. They always seem tainted by sadness and bitterness. My birthday this year was awful - just 10 days after my third miscarriage and I couldn't wait until it was over.

I tried very hard not to think about how this should have been baby's first Christmas. How I would have had a special stocking and ornament hanging on the tree to commemorate the occasion, and how wonderful it would have been to have been able to share this holiday with a child, even one that didn't yet know what was going on. Some days are harder than others.

Monday, 23 December 2013

Molar Pregnancy

I had my D&C nearly a month after I had found out that I had first lost the baby. At the hospital I was given a mountain of medical paperwork to fill out and led to a waiting room which, cruelly, was right next door to the labour and delivery ward. Sitting in the lobby with a bunch of women who were hours away from holding their healthy babies in their arms while I was waiting to say goodbye to mine must count as cruel and unusual punishment.

The nurses were lovely and held my hand while I lay on the operating table and cried. I cried because I was scared, I cried for our baby that we never got to meet, and for the life that we had planned out as parents but never got to experience.

And maybe that's half of my problem. I plan too much. I love structure and knowing how things are going to go because there is safety and security in that. And perhaps this is why I have such a hard time dealing with all of this; because there is no plan on this journey to motherhood. Nothing is a guarantee and I am powerless in all of this. I have learned the hard way that I can't plan my life. If I could, I would have had my first baby at 28, followed by a second one a couple of years later. Instead, I had three losses under my belt by the time I was 30 and I'm still trying to become a mother.

A few days after my D&C, I got a call from the doctor asking me to come in to see him because he thought that I may have had a partial molar pregnancy (PMP). If you're wondering what the heck that is, you're not alone. I had never heard of a molar pregnancy until I had one. The doctor explained that there had been a tumor that had been growing around the fetus which causes severe deformities and eventually kills it. One of the signs of a molar pregnancy is extremely high hCG levels and that would explain why the first pregnancy test I took showed up so clearly despite it being so early.

The doctor said that I would need to be closely monitored to make sure that the tumor didn't grow back. If it did, I need to be treated with chemo. Few words have the power to strike pure fear in people's hearts; tumor, cancer, and chemo are definitely up there as some of the most terrifying.

There are two types of molar pregnancies: a complete molar pregnancy and a partial molar pregnancy. You can learn more about the two types here. Regardless of the type of molar pregnancy, the treatment is the same. I was told to get a weekly blood test to monitor my hCG levels until they returned to zero. After they had remained at zero for 3 consecutive weeks, I would have to have 6 more months of monthly blood tests in order to make sure that the levels were not rising. Only once the doctor was sure there was no chance that the tumor would grow back, would I be allowed to  try and conceive again.

From the time I was diagnosed with my PMP to the point that I was given the all-clear took nine of the longest months of my life. Ironic, isn't it? I could have had a baby in the time that it took to get better. And while I healed physically, the fact that I wasn't able to jump back into the proverbial saddle (and sack!) made it almost impossible to heal emotionally. I was stuck in medical limbo - not sick, yet not well enough to try for another baby.

Tuesday, 17 December 2013

Of Missed Miscarriages and Cytotec

A week after having being told that I lost the baby, there was still no sign that my miscarriage was going to happen. Everything carried on heartbreakingly as normal. My boobs were still sore, I still had that bloated feeling, and the line on any pregnancy test that I took showed up painfully clear. That's the cruel thing about Mother Nature; she has a sick sense of humour.

The nurse told me that I needed to either take the cytotec or have a D&C because the risk of getting an infection was getting higher by the day. I chose what seemed like the lesser of the two evils and made an appointment to get the cytotec. I was warned that if the first dose did not work, I would have to have a second dose a couple of days later.

The night before the procedure, I read up on what other women had to say about the drug. The reactions were mixed - some said that it was just like having a heavy period, while others said that it was the worse pain that they had ever experienced in their life, complete with vomiting and passing out.

Knowing that I would one day want to be able to properly share my experience of this drug, I documented it as I went through the process.

4:15 pm
Was give 4 cytocec pills. It was a quick procedure - a little uncomfortable because of the speculum, but far more emotionally painful. I cried through the whole process. She gave a prescription for vicodin which I hope that I won't need but I would rather have it just in case.

5:15 pm
I am beginning to have a weird, churning sensation in my stomach and ever-so-slight amounts of pain. I also made myself eat a bowl of cereal so that I will have something in my stomach if I do need to take the vicodin. I am tossing around the idea of taking 3 Advil instead but it might not be enough. Also, I am not sure at what point do I take the painkillers? When the pain gets really bad? Or beforehand to ward off the pain before it really begins to hurt? These are the things that I wish I had thought to ask the nurse.

7:05 pm
I'm a little worried that things aren't progressing properly. I would have thought that I would be in the throws of cramps right now, but I just have some light pain that are similar to period pains. The nurse said that it can take up to 48 hours to work but I really don't want to have to go in again on Monday for a second dose.

7:10 pm
Just started bleeding. Not exactly the huge gush of blood that I had read about (just a small amount), but at least there is something. In some sick way, I want there to be a lot of blood and pain so that at least I know that it is working. Just like I wished that I had had morning sickness so that I would know that the pregnancy was okay. I am worried that this miscarriage may not finish 100%.

7:30 pm
The cramping has increased a little. It's still not unbearable, but definitely worse than any period pains that I have had. I have a hot water bottle which is helping a bit but I am wondering when I should take my pain killers. If this is as bad as it gets, I don't think I will need them.

8:35 pm
I passed my first blood clot. It was pretty big but it didn't hurt and my cramps don't seem to be any worse. So I am feeling relatively lucky at the moment that I haven't needed to take anything. I think I will take a few Advil before going to bed so that I am able to sleep without too much discomfort. 

9:45 pm
Heading to bed now. The pain is about the same but I haven't passed any more large clots - just small ones.

A blood test a couple of days later revealed that my hCG was not dropping as quickly as the nurse would have liked, and she told me that there was probably still a lot of pregnancy tissue inside my uterus. She suggested that they do another round of cytotec in the hopes that this would clear the rest of it out. And so a week later, I was back at the hospital getting another dose and going through the same process once again.

And like some horrendous Groundhog Day scenario, I still did not bleed as much as I should have. This left me with one other option - the one that I had been trying to desperately avoid. A D&C was the only way that I would finally be free from this pregnancy. From starting as something that I had so desperately wanted, this zombie pregnancy (dead, but not dead) was draining me physically and emotionally. I just wanted it all to be over and I couldn't help but see the sick irony of it all. For something that wasn't mean to be, it really wasn't easy to get rid of.

Tuesday, 26 November 2013

"I'm sorry, I can't find a heartbeat."

Getting pregnant for the first time was an amazing feeling. Even though it was planned, I still felt like I was in shock for a couple of days afterwards. I took a pregnancy test a couple of days before my period was due, waiting the regulation three minutes with bated breath, and not daring to look and see what was happening. I took a deep breath, looked at the test, and found two bring pink lines! There was no doubt I was pregnant! I couldn't believe how strong that line was and I hadn't even missed my period yet! In retrospect, that should have been my first indication that something wasn't right.

I spent 9 weeks walking around blissfully pregnant. I only told a few people including my parents who thrilled. Knowing that I had a tiny little secret growing inside of me was a wonderful feeling and I never had any problems during  my pregnancy. No pain, no bleeding, and no morning sickness. I felt really lucky, but also a little concerned.

"Surely I should feel something," I thought. After all, I had to take low-dose birth control because the high amount of estrogen in The Pill had made me sick in the past.

A friend of mine who was six months pregnant at the time assured me that she had not had any morning sickness her entire pregnancy and told me that I was probably one of the lucky ones. That reassured me a little.

A few days before my first ultrasound, I went to a baby shower for that friend. I remember being excited that in a few months, I would be celebrating my own baby shower. I couldn't wait! I had had boy and girl names picked out already, having chosen them carefully several years ago in anticipation of one day having a baby.

The day of the scan came - two days before my 4th wedding anniversary, and I anxiously sat in the waiting room with my husband. After asking what seemed like a million questions, it was time to see our baby for the first time.

The Nurse Practitioner squeezed out a blob of cold blue gel and began to move the ultrasound back and forth over my stomach. For what seemed like an eternity, she moved the ultrasound around, left and right, the same concentrated look on her face never changing. Then she handed me a tissue to wipe off the gel.

"Let me try the transvaginal ultrasound. That one can usually pick up more."

She kept the screen turned away from me, maintaining a poker face that I have now come to associate with bad news. After trying some different angles with the ultrasound wand, she said those words that no pregnant woman ever wants to hear: "I'm sorry, I can't find a heartbeat. It looks like the baby stopped growing at 7 weeks."

She must have been an expert at delivering bad news to mothers-to-be because she didn't flinch. I suppose it was just another day at the office for her. When you see these things all the time, I would imagine you start to become numb to other people's pain. You have to in order to effectively do your job, but it is a moment that will haunt me for the rest of my life.

She told me what my options were - wait to see if I miscarried naturally, take a dose of cytotec (misoprostol), or go in for a D&C. I said that I wanted to wait a few days to see if nature took its course. The nurse sent me on my way with an order to go and get a blood test to measure my hCG levels. It would be the first of many blood tests that I would get over the following months.

Walking out of the hospital, I felt like my world had shattered. Minutes ago I had been anxiously waiting to see the tiny flicker of my baby's heartbeat; a baby that was going to change our lives and the start of our new family. Now, all those hopes and wishes had been extinguished along with my baby's life. All that I had left of this dream was an ultrasound of the baby who was never meant to be.

Friday, 22 November 2013

From the top...

I find myself creating this blog more than a year after I first had the idea to do so. After my first miscarriage in 2012, I desperately needed an outlet where I could release my emotions, And there were so many: anger, sadness, despair, guilt, shame, rage...the list goes on and on. For some reason, I couldn't bring myself to start something public. Part of me wasn't ready to share such a personal experience; instead, I poured my emotions into my private journal. And the other reason was that I figured that I had only had one miscarriage - does that really warrant creating an entire blog? After all, how much can I really write about?

Now, just over a year later, and having recently gone through my third consecutive miscarriage, I feel as though I definitely have "enough to write about." Awesome - I can finally put that writing degree into action. 

During my search for answers to the many questions that come with having a miscarriage, I found a number of helpful blogs written by women who had gone through the same thing as me. I hope that by starting this blog, I am returning the favour in some way. I hope that this blog will serve as an outlet for my own healing, a place to share my struggles and my journey to become a mother, and a resource for others who are going through the same thing.

There are a number of things that I have learned through the process of failed baby making. The biggest lesson (and the most distressing for an avid planner/list maker/Type A personality like myself) is that with pregnancy, you are not in control. You relinquish control of your body for nine months, cross your fingers, and hope for the best. Most of the time, things go according to plan. Your body does what it is supposed to do and you end up with a beautiful baby at the end of it. But sometimes, for one reason or another, it just doesn't work out. 

I have been pregnant three times in the last 14 months. My first pregnancy was a molar pregnancy. A partial molar pregnancy, to be exact. Never heard of it? Yeah, I hadn't either until I had one. The second pregnancy was an ectopic. I lost my baby and my left fallopian tube. This was followed by my third pregnancy - another ectopic. Each miscarriage was very different. Even my two ectopic pregnancies were almost polar opposites of each other, but all three have left me shattered. 

I have been down this road three times now, and I wish I could say that it gets easier the more times you suffer a loss, but it doesn't. There's a process and a routine that I have come to know well. You grieve, you cry, you scream and throw things. And then you pick up the pieces and move on. Because you have to. Because there is no other choice. And because at the end of the day, there is no other way but forward.