Saturday, June 9, 2012

Misoprostol Miscarriage: My Story

READER DISCRETION ADVISED

I decided to write out the story of my experience with using Misoprostol to miscarry. In preparation for yesterday, I scoured the Internet for stories so I was aware of the types of experiences real women have had with this drug. I found many from years ago, a few from more recently, and none with a comparable experience to mine, at least in some of the details. Doctors do relay information, and mine is wonderful, but details are lost in the shuffle too often so I needed to educate myself. If you choose to read this post, please be aware that I'm not going to hold back on details in hopes that my story will help others going through the same thing.

Kimberly

You can read about the beginning of my journey here, and an update in this post.
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Friday, June 8th, 2012

The dreaded day was here. We dropped B off in Hudson early in the morning and headed up for the doctor appointment. It hit me about 30 minutes before we got there that this was really happening. I was nervous, anxious, scared, and wished for temporary amnesia so I wouldn't remember any of what was to come.

My blood pressure was on the rise and I knew it. The nurse seemed concerned since it has never been that high in my past visits, but understood that I was very stressed and would test it after seeing my doctor. We waited for about 15 minutes before she came in. She expressed her condolences once more, and all I could think about was how it's so much easier to keep myself together around people who don't know, and who aren't about to administer a pill to shed the tissue in my uterus. She went over what was going to happen (by the way, I had to go to the pharmacy to pick up the Misoprostol the night before and bring it to my appointment) and offered some advice on symptoms that would send me to the ER (fever, immense bleeding, intense and unbearable pain). She informed me that she would administer the first dose and I would need to administer the next three myself every 4 hours, two pills at 200mg each (400mg a dose total). I was also prescribed Vicodin for pain and Ondansetron ODT for nausea. I was ready to get this over with.

The first dose hurt slightly; I mean it's someone else pushing up behind your cervix. That's where the pills needed to go, and she explained that the cervix has the same density as the tip of your nose so I would know where to find it, but the furthest I could get it up would be sufficient. I had to lay there for about 15 minutes to let the pills dissolve, and the nurse checked my blood pressure again (it had gone down only slightly). J and I left to pick up the prescription and headed home to do some more waiting (Dear God, is this about patience?).

Four hours passed and I hadn't had a single symptom. I was convinced that this wasn't going to work for me, just as expectant management (miscarrying naturally) hadn't. All we did was sit and watch TV (well, J vacuumed) and wait. Wait, wait, wait. At 1:45pm I had to administer the second dose. I was concerned about how far I had gotten it up, although I found my cervix pretty easily thanks to my doctor's description. I laid on my back, again, for 15 minutes, then back to the couch I went. Shortly afterwards, maybe 20 minutes, I started getting cramps comparable to menstrual cramps but a little longer lasting. This went on for the next 3 hours, coming and going. 

At 5:45 pm it was time for my third dose, so as I prepped for that I noticed some spotting. I had mixed emotions. The blood indicated the process was starting and the Misoprostol was working, but at the same time I had the realization (once again) that I was losing my baby. As I administered the third dose, I could feel that one of the pills from the second had not yet dissolved. I sat on the nurse's after hours line for much too long before talking with an RN and being directed to let it be and continue my doses so long as I was experiencing cramping and seeing blood.

At about 8:15pm, the cramps started getting more intense and were constant. I was sitting on the couch so I just kept adjusting to find a position that was bearable. J suggested I take the Vicodin (I haven't had good experiences with the drug in the past so we were hesitant to take that route) so I went to the kitchen to make some food before taking it just to avoid any stomach mishaps. The pain that I experienced in the short time waiting for water to boil was comparable to labor. I walked in circles, breathing through them and stopping to bend over when it became too much. Suddenly, at about 8:45pm, I felt a gush and went hobbling to the bathroom. My water had broken.

I spent the next half hour on the toilet, unable to get up for just a minute because blood and clots were pouring out of me constantly. Had I not read about one woman sitting on the toilet for over an hour I would have rushed to the ER. I didn't look at the clots when they came out, afraid of what I might see, but there were some that I would have to relax for and push out. I knew this was happening when the stream of blood would stop because the clot would be blocking that pathway. I probably passed six or seven clots that were large enough to make a "plop" sound in the water. I also experienced diarrhea during this time.

Towards the end of that 30 minutes (of which I spent 26 minutes bawling my eyes out), I started experiencing a few things that I had not read about in stories about Misoprostol. I began feeling very lightheaded and dizzy and asked my husband for prenatal vitamins to replenish my body. Suddenly I felt extremely nauseous, so J brought me a bowl to vomit in (obviously since the toilet was occupied), and right as that was happening I felt as though I was going to faint. I have never felt like that before in my life...I was swaying and I could feel my eyes rolling into the back of my head and just as that was passing, my hands went completely numb and cramped up. The numbness tingled from halfway between my wrist and elbow to the tips of my fingers. They were so numb that I couldn't pick up the bowl or glass of water J had brought me. My fingers would cramp completely straight, then they would cramp into a claw. I was terrified. J got on the phone and was waiting to talk to a nurse to see if I needed to go to the ER, but as he sat on hold I started to feel less panicked and slowly the numbness started to subside, so I told him I was going to be OK for now. I also noticed that the bleeding had decreased significantly, so I cleaned up and went back to the couch, spending a few minutes shaking away my anxiety and controlling my breathing.

After that, I became very, very tired. My eyes were so heavy and my whole body felt as though it was shutting down. I must have fallen asleep for about an hour before my husband decided we should both go to bed. By that time, I was an hour late for my last dose and debated even taking it since I felt I had already experienced the miscarriage. However, both of us were concerned that there might be some tissue left, which would lead to having a D&C, so I quickly administered the last dose before bed.

Throughout the night I didn't feel any cramping and only woke up twice to go to the bathroom, with bleeding very similar to a menstrual cycle. This morning I had a headache, but no cramping and the bleeding is steady and slightly heavier than a normal period. I hope that the worst is over, and that the gestational sac was discarded during that half hour nightmare. It's an odd thing to hope for, but knowing it wasn't a viable pregnancy for nearly three weeks has made my outlook on this split down the middle: a part of me was still in denial and the other part just wanted this over with.

I hope anybody looking for information on using Misoprostol for a miscarriage finds something helpful in my story. I read 70+ stories on experiences, but none had the numbness and cramping of hands or the extreme faint feeling. Expect the unexpected I guess...although I can't confirm if those reactions were from the Misoprostol directly, the immense amount of blood that was leaving my body, or even the emotional toll that time took on me. Regardless, that's my story. I would never wish to have anybody go through this, but if trying to avoid a D&C, using Misoprostol is the least of two evils.

Good luck and God bless.

Kimberly

*Update 6/11/12: The last two days I have had bleeding that is less than a normal period, but no other symptoms. This afternoon, however, I started having cramps stronger than menstrual so I was concerned I had more tissue to pass. Since I was at work, I ended up leaving and took ibuprofen, which helped take the edge off but didn't make them go away entirely. The bleeding has been a little heavier in the last couple hours, and after speaking with my doctor I was told that it could be my uterus contracting back to normal size, which would typically take six weeks following a full term birth. I stopped in for a lab appointment to have my hCG levels measured and will have results tomorrow (my birthday...boo). Hopefully the levels are at or near zero to confirm that I did have a complete miscarriage and can avoid surgery.

**Update 6/12/12: Received a call this morning from my doctor's care team with the results from my hCG level test. On May 24th it was at 181,000, had dropped to 87,000 on May 30th, and my last check on June 4th indicated a drop to 36,000. As of yesterday it was at 1,400, which in comparison to the last few weeks is nothing. So in that half hour disaster on Friday night, I fully miscarried. I go in once more for blood work so they can document the levels at or below zero. Then I wait. I wait and we decide if we are going to attempt another pregnancy and risk another miscarriage. Physically, my doctor told me I'm young and there isn't any reason we can't try again. Emotionally is another story...although it's easier to talk about, I still feel depressed and hope that I can find a way to get through this in one piece. As far as how things are going days following the Misoprostol experience, my bleeding is much less than a normal period still and I was told that it's OK for it to be that light (I was afraid it meant things were moving slowly and there was still tissue left). Nothing hurts, the cramping from yesterday subsided pretty quickly as it had made its appearance. Overall, it wasn't a terrible experience in comparison to having a D&C and I consider myself pretty lucky for only having an hour of full on pain and "shedding". That half hour was torture though, and I am so grateful that my husband was there helping me through it otherwise who knows what might have happened.

***Update 6/20/12: Nearly two weeks into it and still spotting/bleeding...however it isn't as steady or predictable as it has been. Some days I will bleed for a couple hours (less than a period) and other days I won't have anything but a tiny bit of spotting. I had my hCG levels measured again on Monday and received a call from my doctor this morning with the results. She told me they were at 208, which is "encouraging", but was concerned when I told her I would still bleed a bit heavier every now and then instead of it slowing down. Personally, I am surprised it has only dropped 1200 when previously I was dropping tens of thousands within a week. I'm not a doctor, so I'm not educated in what's "normal" but to me that seems like an immense halt in the process. If the spotting/bleeding continues for the next week or so she wants me in for an ultrasound to make sure all the tissue is out...so a D&C obviously isn't out of the picture quite yet. All I can do is pray, although my faith is severely shaken after all of this. How fair is it that children born out of wedlock are healthy, but those trying within marriages struggle with infertility and loss? What kind of biblical lesson is that for anybody? This feels like a never ending experience and I am so beyond words of how I feel about it I wouldn't even know where to start. I'm on the edge. Of what? That I'm not sure. I just feel like I'm teetering on something, so an edge it is.

****Update 6/29/12: I haven't talked to my doctor since last week; I guess I'm afraid that if I do and she finds out that I am still spotting just a little (not enough by any means to fill even a liner), that's a sign that the shedding has halted and she will order an ultrasound. I am so ready to be past this...maybe I will call next week.

*****Update 7/27/12: Oh boy. Check it out here.

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