Miscarriage: It Wasn't Over Yet

It's been 7 weeks since the medically induced miscarriage, and we thought we were in the clear...well, we thought wrong.

WARNING: Graphic details ahead!

I had spent a few weeks bleeding but mostly spotting following the miscarriage. When I finally stopped, I was so excited and just in time for the Fourth of July! However, July 8th I found myself with my first menstrual cycle. Go figure, right? It lasted a week, which is two days longer than normal, but I attributed the immense body changes to that issue. I had a week's break and was eagerly peeing on a stick every morning to define my ovulation days, when all of a sudden on Tuesday I started bleeding again. Are you kidding me? I was more upset that my cycle was off than thinking anything was wrong. Wednesday I had no signs of even spotting, so I thought that was strange.

Yesterday, however, I woke up at 7am feeling like I was gushing blood again. I went to the bathroom and it was bright red and thin, and I had to push out clots. Immediately my mind went back to June 8th and the half hour in hell and it was too similar for comfort. I told J that something was wrong, and that I would call my doctor at 8am when the office opened. Panic washed through me...was this another miscarriage? Could I have gotten pregnant already and not known? Or is this remnants from the first miscarriage that never made it out? My doctor stopped testing my hCG levels after they were at 208 and I didn't have any follow up appointments, so I was scared to death that seven weeks later I would have an infection of some sort.

When I talked to the nurse on my doctor's care team, she confirmed that I should wait one more hour and if I fill a pad (I had already filled one in the hour waiting) that I needed to go to the ER and would likely need an emergency D&C. SHUT THE FRONT DOOR. That's what I had been trying to avoid this entire time! I cried. And waited. Sure enough, not even a half hour later I had to change pads. I called my husband and he came to get me since I was instructed not to drive with the amount of blood loss I was experiencing.

By the time we reached the hospital, I was experiencing cramping that went from just uncomfortable to a steady pain, about a 5-6 on the scale. Of course an ER visit is never quick, so it was about two hours in which they talked with me, took note of my recent history, performed a pelvic exam (I'm sorry, but men should not be involved in those...I was in so much pain during that) where they found big clots and lots of "pooled blood", sent me in for an ultrasound (which also hurt immensely, but let's face it, I was at the point where if I didn't suck it up they wouldn't be able to get the information they needed), and determined that I would in fact need an emergency D&C.

The OB doctor came in and confirmed that there were "products of conception" from the previous miscarriage that had not expelled in the seven weeks since the miscarriage. The only way to ensure I wouldn't get an infection and stop the bleeding (by this point it was still intensely heavy, worse than when I was admitted) was to get all of the tissue out with a D&C. She explained the procedure - they would dilate my cervix if it wasn't (which we knew from the pelvic exam) and use a vacuum-like tool to scrape the sides of my uterus and remove whatever was left. The risks included infection, possible punctures to the uterus and / or bowel lining (if that happened I would have required more surgery and a longer, likely overnight hospital stay), and of course scarring. Since this was from an actual pregnancy, my uterus lining would be softer and more sensitive so her plan was to use a partially aggressive approach, enough to get what she needed out, but definitely be gentle at the same time.

Honestly, I was scared and I could hear it in my voice when I asked her a couple questions. This was what I had been avoiding from the beginning yet here I was in the ER on a random Thursday weeks after my miscarriage had been induced. It didn't seem fair. I was in pain and hungry and sick of the gushing blood so I agreed to the procedure and signed. Immediate they began the prep, I overheard that the operating room would be available for me in 25 minutes. They told me that from start of prep, through the procedure, and recovery it would be a half hour. That wasn't so bad. I would be sedated so I would be breathing on my own and wouldn't feel anything, thankfully.

They made necessary preparations which included an IV, notes on my medical history, and started wheeling me off to the OR. It's just as scary as I thought it would be, only having been in an OR when B had tubes put in her ears back in August 2008 but of course I was just there until she was sedated. The lights, the number of people running around to move me, strap me down, hook up my monitors, the contraptions they had...I knew my blood pressure was still through the roof (most of the morning it was about 160-180 over 120...way too frickin high!). After a few breaths of the gas, I was out.

I don't know how I woke up, if they did or if it was on my own, but I felt extremely tired and just wanted to see my husband. I cried a lot in the recovery room because it hit me how long I have been mourning this loss and everything I have physically gone through for this. I wanted so badly to have already been mended and ready for another try, yet here I was months later...one step forward and two steps back it seemed. They gave me one dose of an antibiotic to prevent infection and some extra-strength ibuprofen to ease any pain. When they brought me to my private recovery room and J came in, I found out that I had been gone for two hours, not the half hour we were initially told. It wasn't explained to either of us why it was so long, but at least everything went well. By 3:30pm I was discharged and heading out, really sore when walking but the bleeding had subsided by a landslide and I wasn't really feeling pain. I was hungry as hell for some greasy food though...

After eating at DQ and heading to pick up B, I laid on the couch the rest of the night. My arms and legs would feel tingly whenever I stood up or sat a certain way, so I was careful about that. I was told I could go into work if I felt better, so here I am today trucking through. I have no pain but am sore. I am weak and tired but I am sure it's because I only ate once in 36 hours. My arm is severely bruised from the IV, and I've had plenty of IVs but never this much bruising. Luckily I have a job where I can sit in my cubicle all day and not have to walk around if I don't need to so it's kind of like resting I suppose.

I still need to be cautious of vomiting, nausea, pain, or heavy bleeding. Next week I have a follow up appointment with the OB who performed the D&C and she is going to take the extra precaution and order an ultrasound so she can verify that the tissue is out as well as see how my recovery has been. Part of me is so frustrated that I had to go through everything else when I could have done this D&C sooner, but I know that at the time I was terrified of taking that step and this was a last resort. It is what it is. Now hopefully this truly is the end of this ordeal and we can move forward without a doubt.

*Update 8/14/12: Well, after seeing my doctor on the 2nd for my follow up, she told me she was concerned that I developed Dysfunctional Uterine Bleeding (DUB). Essentially, in non-medical terms, that's like having a spontaneous/continuous menstrual cycle. All. The. Time. As if once a month isn't enough... We have to wait it out until after I get my next cycle just to make sure since it's expected soon. If I am still experiencing bleeding we will need to go to medication for resolve. Lucky me, I know you're jealous. Also, it feels weird to admit this but I think talking about it will help, she feels that I am on the border when it comes to postpartum depression. I can't imagine why... (maybe because I've burst out crying about six times in the two visits I've had with her?). It's a scary thing and I definitely don't feel like hurting myself or anybody, but I do feel like I let my family down, let myself down, and basically am just wallowing in self pity and "whys". I hate that about myself right now, but it's how I'm feeling so I might as well just own up to it. Pity party at my house. I kid. She said she wouldn't prescribe me anything yet, as it could very well get better soon now that the D&C is complete. I believe her...I've spend much less time crying the last couple weeks over what happened so maybe the finality of it all is allowing me to move on. Fingers crossed and prayers prayed.