Part 2 – Dates with Doctors

***Disclaimer***

I think it’s safe to say that we all know that while our situations may be similar, they are not the same. If you are reading this in hope of finding answers or comfort, I am so glad you’re here. I am glad we can be in community with one another and love on each other through a dark time. That being said, I am not a doctor. My story is my own. My symptoms are my own. My diagnosis is my own. Please do not take my words as medical advice or diagnosis. Please, please, please schedule an appointment with your doctor immediately if you think you are pregnant and something is not right. Bleeding and cramping during early pregnancy are common, but not normal. If you are worried something is wrong, do not ask Google, speak with your doctor!

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Because I have never been good at “long story short,” and because I feel like the tiniest detail in our story might be what helps another woman or couple wade through their own story, this is the second part of our loooooong story leading up to where we are today. It was my intention to write more frequently, and as things happened, but life has been like the scene in Moana where she falls out of her boat, gets her foot caught in the coral, and the waves keep pushing her under. I’m Moana when the waves won’t give her a chance to breathe, except I don’t have a beautiful tan and I’ve never been on an adventure with The Rock (but I wouldn’t mind if I had to!). So, I’m playing a bit of catchup now, and sharing our story that started on April 14, when I found out I was pregnant. I’m not one to steer away from topics that might be uncomfortable, or unsavory for those with delicate constitutions, because this is how life happens, and this is what bodies do. I am choosing to speak out about a topic that is painful, and heartbreaking, and still a bit taboo in our culture. If you can’t stomach a little blood and guts, then you might want to avert your eyes now…

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Life doesn’t stop happening when you’re having a miscarriage, so the morning after Easter Sunday, we got the girls ready for school and put them on the bus, as our daily routine dictates. But this time, we headed straight to the ER after. The whole way there I practiced what I would say to them when they asked the reason for my visit. I felt awkward and ashamed of so publicly declaring that I was having a miscarriage. Do I whisper it so as not to make others feel bad for me, or awkward for overhearing such a personal situation? Do I pronounce it boldly and matter-of-factly so they know I know what’s happening in my own body? Do I sob and sniffle to prove that I’m sad and scared? No matter how much I tossed my options around, nothing seemed right. So, I did what I often do when I’m at my most awkward, and said it nonchalantly to the nurse, followed up by some awkward self-deprecating humor about not really having any clue about how far along I am because we were only just practicing and didn’t even mean to get pregnant this quickly. I guesstimated that I was only three or four weeks, because I just had a period that long ago, so it couldn’t be more than that.

We were quickly given a room and assigned a nurse, and I was asked to change into the blue gown laid out on my ER bed. While waiting, we continued to do what Bryan and I do best when we’re freaked out, and that’s make awkward jokes and touch stuff we’re probably not supposed to touch. Bryan did everything he could to make me laugh and lighten the mood, including taking a page from Bart Simpson’s handbook and giving all my white board attendants ridiculous names like Seymour Butts, Eileen Dover, and Buck Nakad. And at that time, when neither of us had much hope for any good to come out of the visit, his goofiness worked, if just the smallest bit.

Our nurse, Steve, didn’t find the joke very funny, which made it funnier to us. It was all the joy we had in that moment, so we took it. Steve began asking me the routine questions about what was going on, took some blood, and got me a blanket from the magical blanket warmer outside my room. He, too, asked how far along I was, to which I answered with the same haphazardly formulated answer. He explained what to expect during our visit, which would be three things: 1. blood work (including a pregnancy test); 2. ultrasound; 3. pelvic exam. The thought of a pregnancy test horrified me. What if it came back negative, and I really did waste everyone’s time and energy for a stupid false alarm? What if it’s positive and everything is normal and I stressed everyone out for no reason? What if they find out that my brother has been right all these years and I am, in fact, heartless and that’s why I’m always cold? Steve took my blood, asked if I was warm enough, and then went to check on the doctor’s whereabouts. He came back a few times to check on us (probably to check on his white board), and let us know each time that our process would be moving along shortly.

The few times I’ve imagined having my first ultrasound done, I thought of the anxious excitement of meeting our baby for the first time. I did not think it would be to confirm a miscarriage. But that is where we found ourselves. Eventually, the ultrasound technician showed up at our room with a wheelchair to roll me down to her office. She was an adorable woman who had graduated from UCF in recent years, and was in the process of planning her wedding. As she prepared her space and got me moved out of my wheelchair and onto the bed, we talked excitedly about the plans she and her fiancé had pulled together so far, and Bryan and I shared our own excitement for our wedding that had happened less than three months before. But as soon as she was ready to get the ultrasound underway, our conversation quickly changed directions. We went from “did you splurge on a videographer?” to “is this your first pregnancy?” Why yes, it is, and I’ve done a terrible job with it so far; also, I’m really sorry I just bled all over your clean white sheets.

The first ultrasound was a standard one. She smeared the cold gel under my belly button, rolled the probe around for a few minutes, and, in strained reassurance, let us know that sometimes ultrasounds don’t show anything in early pregnancies. She moved on to the transvaginal (read: via the vagina, not atop your cute little pregnant belly) ultrasound, where (we’re about to get intimate here, fair warning), she surprised me with instructions on how I would be responsible for inserting the lightsaber of a wand they use to do them. What?! Seriously?! You want ME, to put THAT, in THERE? Well, here goes nothing. I did it, and it was bizarre, but I did it, and I had a strange sense about it. Who can say they gave themselves a transvaginal ultrasound?! Not me, in all honestly, but I like to give myself some credit. She spent some time looking around, sending little stabbing pains from my reproductive organs all the way down to my ankles. I’m not very squeamish or easily embarrassed, but this was the grand kickoff to a lot of uncomfortable situations in which I never imagined myself in.

Through all of this though, my sweet, precious, stoic husband is still by my side, encouraging me, comforting me, and never flinching or acting like he would rather be anywhere in the world but here. In fact, at this point he has already, with his bare hands, changed two bloody Chux (that’s what those in the industry call the puppy pee pads they put under you in medical settings), and acted like it was just normal newlywed stuff. Part of me felt guilty for showing this young bride-to-be just how messy marriage can be, but a bigger part of me was proud to be able to show her what marriage should look like. That the vows you take are not just sweet words you say, but intentional acts of love that you show each other every single day.

The tech let us know that she would not be able to tell us what she found while during the ultrasounds, nor could she show us the images. We would have to wait for the doctor to review them, along with the bloodwork, and then they would be able to tell us more. I was wheelchaired back to my room (they meant business with the fall risk socks and medical bracelet), and we resumed our wait. All the excitement of lightsaber ultrasounds and blanket warmers had worn me out, and I was able to sneak in a nap, which my husband documented with a photo he swears is “cute.” Shortly after, the doctor came in, and I waited for her to scoff at my silly need for attention. She had an entourage with her: a person to take notes, someone to assist with the pelvic exam, and Steve, to write her name correctly on the white board. I wish I could remember her name, because she was unbelievably kind, and her compassion and concern toward me finally validated my feelings of grief and fear. She never made me feel like we were anything but reasonable for being there. The first thing she told us was that the pregnancy test had come back, and I was, in fact, pregnant. The moment she confirmed that, I started sobbing. I had held myself together until then, but at that moment I felt powerless, and hopeless, and so sad. I was pregnant, and I was bleeding, and I was never going to meet that baby. But she was reassuring, telling us that there wasn’t one outcome to this situation, that there was still hope, and she was going to take care of me.

She did the pelvic exam next. I’m not easily embarrassed when it comes to my body or gynecological appointments, not even the time when the doctor I was scheduled to see was the husband of a client I had just met with a week before. We can thank my momma for the lack of shame that the Rodriguez children have. Being raised by a pediatric/labor and delivery nurse just normalizes those things. But for the first time in my life, I was humiliated because of my body. I felt inconsiderate for bringing my bloody mess to the ER, for making someone pull the short straw and forcing them to poke around in the disaster zone that my body had created. But no one hesitated in the slightest. It was a quick exam, not unlike a regular annual exam. She was checking for cervical dilation, major bleeding, and uterine abnormalities, among other things I know nothing about. Other than the bleeding, things were normal. She gave me time to sit up and readjust myself onto my puppy pad, and relay the blanket over me.

At this point, the layman’s terms were out of the way, and our months long lesson in human biology and the female reproductive system had begun. She had one last bit of information to share with us, and that was the more thorough results of the bloodwork, which told a more detailed story of what was going on in my body. My bloodwork was not just simply a yes or no pregnancy test, but to identify my hCG level. Human chorionic gonadotropin, or hCG, is the pregnancy hormone produced by the placenta after an egg has implanted itself in the uterine wall. There are two types of hCG tests: 1. Qualitative – detects the presence of hCG, but not its exact level; 2. Quantitative (beta) – detects hCG and tells its exact level. Home pregnancy tests are qualitative – they tell you if you are, or are not, pregnant. Bloodwork, however, will yield a quantitative result, and the beauty of the ER, is that you can get your results almost immediately. My bloodwork included a quantitative test, showing us that my hCG level was currently at 1,902 mIU/mL. I was undoubtedly pregnant, and very much so. They say there is no such thing as being a little bit pregnant, but I feel like hCG levels would say otherwise. My levels were fairly high for only being 3-4 weeks along and experiencing a miscarriage, but that was only part of the story. The doctor continued explaining that even more important than knowing your hCG level at one point in time, is seeing how it changes over the course of several days. Typically, but not always, hCG levels will double every 48 hours. I say typically, because in some cases it takes more time to double, or it doesn’t exactly double, but a pregnancy can still be found to be healthy despite the hCG working at its own pace.

The doctor explained that each procedure performed that day was a piece to a puzzle that remained very incomplete. Both ultrasounds were inconclusive, showing no evidence of pregnancy, but my hCG levels were proof of implantation, but the pelvic exam was visible proof that my bleeding surpassed that of normal implantation bleeding. They needed more information, more observation, to see if my hCG was increasing or decreasing, and at what rate. So, they developed a calendar of bloodwork every 48-72 hours, and corresponding visits with my OB/GYN. The doctor looked at me, shook her head, and said “I’m sorry, we can’t give you an answer today, but we will continue to work towards one, and we want to focus on taking care of you first.” And then she handed me a packet of papers for us to take home and read, and when I looked at the cover of the papers, I knew what they were anticipating for us.

The papers were titled “Threatened Abortion,” and the first line read “You may be having a miscarriage.” Thanks, glad we got that out in the open. The doctor has probably seen the look on my face on a million other women’s faces, and knew exactly when to intervene. She told us that they were diagnosing me with a threatened abortion, which is fancy medical talk for the presence of bleeding in the first 20 weeks of pregnancy, indicating possible miscarriage, but that I was not actively miscarrying and there was still hope. She suggested I follow the home care suggestions, which included no alcohol or caffeine, no tampons, no sex, and lay in bed until the pain and bleeding stop. I was crushed that such simple things could save my pregnancy, because, in my mind, it made it equally simple that those same things caused its failure.

Despite the doctor’s attempts to be positive and hopeful, she was also realistic, and I had already resigned to the fact that I was losing this baby. But part of me wanted to stay hopeful, because they were, and Bryan was, and I had faith that God knew how much I already loved this little baby. She gave us our follow-up instructions and did all she could to instill a bit of peace by telling us we did the right thing by coming in, and that no one knew for sure what was going to happen. She and her gaggle of medical assistants left us to get dressed and gather our things, and we left, sans wheelchair, and sans answers. We went home, where the girls were waiting for us, clueless to where we had been and why. Not being previously established with an OB/GYN, I called the office we were originally referred to, and made our follow-up with their doctor for Wednesday. And then I stole away to our bedroom every few minutes to obsess over the papers from the ER, Googling everything I could about threatened abortions and all the statistics that went with the hazy diagnosis. I don’t remember much of the rest of that day, except that hope would slowly well up in my heart, but anxiety would quickly and aggressively squash it.

Wednesday came hurriedly, but the emotional exhaustion from Monday was still lingering, refusing to let go of us. To add insult to injury, I was still bleeding, but, per my instructions from the ER, I could only use pads. If I ever wanted to relive my awkward middle school days, where changing in the gym could only be made more horrifying by being on my period and trying to hide the equivalent of a pre-teen diaper from my classmates, this was my opportunity. The day before wasn’t so bad, because I didn’t leave the house, allowing me to hide my awkward predicament with sweatpants. But this day, I woke up at the crack of dawn, slapped a fresh maxi pad in my underwear, and Bryan drove us to the hospital so I could have my blood work done in time for our follow-up that afternoon. I felt like there was a banner above my head, announcing that “This woman is miscarrying!” and “Yes, that squishy sound you hear IS a maxi pad!” Bryan swore no one else could hear the swishy, parachute pants-esque sound coming from my jeans, but I would have bet my life that he was just saying that to make me feel better.

Knowing that the small bit of blood they took held so many answers for us, the rest of the day dragged on. Our appointment time finally rolled around, and we were introduced to Dr. C. Again, I never thought that the first time I would sit in front of an OB/GYN with my husband, would be to find out if I was miscarrying our baby. I felt robbed of that experience as I sat on yet another bed, with another soaked Chux underneath me, another stupid exam gown over me, and cold toes. But Dr. C came booming into the room, a cheerful presence despite the circumstances. He had been made aware of the situation, and read the reports from our ER visit. I’ve not had many hospital experiences, so it wasn’t until this visit that I truly appreciated hospital networks. Our ER was part of Florida Hospital, so was the hospital we went to for bloodwork, and so was Dr. C’s practice. Everyone could access all my information and everyone else’s reports and tests, so I didn’t have to try to regurgitate what we’d been told previously. It took a weight off our shoulders. We were immediately at ease with him. He showed concern, but hope, and said his priority was making sure that he put my safety above all else. While that provided some comfort, it left a pit in my stomach knowing that he was anticipating protecting my life above baby’s.

He did a quick pelvic exam (this is the third person poking around in my vagina in a 48-hour period, if you’re keeping count), and then began discussing the findings from the ER, and what he wanted to do moving forward. As luck would have it, he had not received the results of that morning’s lab. Not having a new round of hCG levels to compare to Monday’s, and not having any usable information from the ultrasounds, he, too, was unable to tell us anything conclusive at that time. He continued to encourage positivity and relaxation, as well as insisting my health and safety be of top priority. And then he mentioned something we had not heard before, something that had not crossed our minds – the possibility of an ectopic pregnancy. He mentioned it ever so briefly, like it was something that had to be mentioned, just as a formality. And as soon as he mentioned it, he said we would hear from them soon with updated hCG results. And then he gave us a huge smile, reminded me that he was going to take the best care of us, and left the room.

I got dressed and we left. The moment we walked out of the building, I fell apart. We stood in the parking lot and I sobbed. I wailed about having an ectopic pregnancy and how all the directions in the world couldn’t save our baby. I was devastated that we were left without answers again, and scared that the situation could be worse than we thought. Bryan, always my voice of reason, tried to calm me by reminding me that no one knows if this is ectopic, and that the chances of that being the case are slim. To say I’m useless after an emotional breakdown would be an understatement. For the rest of the day, like two days earlier, I was in a daze. The only things I could bring myself to do were cry, and research everything the internet knew about ectopic pregnancies.

The next morning, we got a call from Dr. C with the results of the second beta hCG test. It had increased from 1,902 mIU/mL to 2,559 mIU/mL. My heart sank.  It increased, but it didn’t double. Not even close. And I could tell from his voice, that he wasn’t happy with that either. He asked me to go ahead with the bloodwork scheduled for Saturday (round 3), and arranged another (round 4) for the following Tuesday. Our next step would be a follow-up appointment on Wednesday, and creating a plan using the information we had gathered throughout the course of the week.

On Saturday I woke up bright and early to get round 3 of bloodwork done. My mother-in-law came over to watch the girls, and I smeared on my best smile to say goodbye to them. The girls were my saving grace through much of this, but it was also hard to hide from them. They are like magic seers who can smell emotion. Putting on a happy face in front of them all the time was exhausting, but we weren’t ready to tell them what was going on. Even if we were ready, we didn’t know what to tell them at this point anyways. My swishy maxi pad and I arrived at the hospital, where we (me and my pad) were directed to a medical building attached to the main hospital. As if someone thought I needed another challenge to overcome, I walked into an empty building. The reception desk was vacant, all the valet parking signs were piled up in front of the automatic doors, and the lights were off. When I tried to escape, what seemed like the beginning of a cheaply produced horror movie, all the doors were locked, from the inside. I was trapped inside an empty building, as my lab appointment ticked by. At this point I couldn’t help but laugh, while also losing my mind. I found a phone to call the front desk of the main building, and a very confused operator said she would send someone to lock the building properly. Eventually, I pried open the automatic doors and found my way to the correct location for weekend lab work (in the main building, of course), was in and out without even feeling the sting of the needle, and on my way home. 72 hours later, round 4 of bloodwork would proceed with no commotion, and then we would wait again for results.

We started recalling our days by which medical appointment we went to, what hCG results we received, and how many pads I went through. It had been 11 days since I found out I was pregnant, and as many since I started bleeding and knew something was wrong. It would be just a couple more before we would finally have answers.

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Just to reiterate – I am NOT a doctor. For your safety, do not take my words as medical advice. These are my words as an emotional woman processing loss and heartbreak. They are not a diagnosis for your symptoms. Please see your doctor immediately if you feel that something is wrong.

 

 

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