Saturday, December 21, 2013

Am I having an ectopic pregnancy? My personal story.

Ryan and Maddy, planting Olivia's memorial tree.
 
 
 
If you are reading this blog, you probably fall in 1 of 2 camps:

1) You are my friend, and read my blog. (Hi friend!)

2) You stumbled upon my blog because you are researching ectopic pregnancy -- either thinking that you may be having one now, or you are looking for stories of people who have had one. (In that case, welcome new friend! Although I'm sorry you had to find me.)

I know how hard it is to interpret symptoms -- to know what is normal, and what requires medical attention. I know it's easy to second guess yourself. I know what it's like to wonder if you are just overreacting, or if something is really wrong.

Since many of the symptoms of ectopic pregnancy can mask themselves as a lot of other issues, I thought I'd share more in depth about my story of my ectopic.

If this post sounds a bit clinical or devoid of emotion, I'm sorry. Trust me, going through this experience is probably one of the MOST emotional I've ever had. I've got LOTS of other resources on this blog if emotional support is what you are looking for. (If you are new in your loss, you may want to go through the archives in my blog to December of 2011 when my ectopic was.)

For the rest of you, I hope that somehow you will be helped by reading my story. And since yesterday was the 2-year anniversary of my rupture and loss of our baby (who I named Olivia), I think now is just as good of a time to share as ever.

So here we go . . .

Pregnancy tests and symptoms:

My period was a week and a half late. I had no other pregnancy symptoms, but maybe very, very mild smell sensitivity and a teeny weeny bit of queasiness. The pregnancy tests were negative (I took several), up until I was 5 1/2 weeks along. And I got a very strong positive.

(Now, I also tested positive "late" With Maddy. But I was having way more symptoms, mostly nausea, with her.)

This time, I had hoped the lack of nausea was a good thing. I thought, maybe this one's a boy... Or "every pregnancy is different."

I knew in my heart the lack of symptoms wasn't good news, but I only thought maybe a possible miscarriage. I had no reason to suspect ectopic... Yet.

Cramps:

I joked with my friend that this time my uterus was "cranky." I don't remember exactly when the cramping started. I remember having cramps one day, and I had to lay on the bathroom floor for about 15 minutes. They were sudden and made me stop everything. They were over quickly, but still made me late for work.

I researched cramping in pregnancy, and couldn't decide what to classify this as. Mild? Moderate? Severe?

"Severe" was probably what it correctly should have been labeled, but since it was over so quickly, "mild" seemed to make more sense.

Plus, I was kinda convinced I'm a wus when it comes to physical pain. So maybe the cramping felt severe to ME, but if someone else had felt it, it probably would have been mild, I figured.

About a week after we found out, I had about 1-2 hours worth of cramping. Same scenario. I remember posting on FB "So glad for a daughter who occasionally sleeps till 10.) Well, that was because I couldn't get out of bed from cramps.

I chalked it all up to "normal" stretching and growing of my uterus. I did not tell anyone seriously about the cramping, other than the "cranky uterus" joke.

One day while I was at work, the cramping came back. From the time I got a positive, to the time my tube ruptured, I was having more cramping at greater intensity, duration and frequency. And this particular day, it was so bad I could barely walk.

I was taken to my parents. My dad, who is a PA, did a quick abdominal exam to see if he could locate the pain. Ironically, I felt the most pain when he pushed on my right side, even though we later learned Olivia had implanted in my left tube.

He thought that either I had an obstructed bowel, had an ectopic pregnancy, or I think, appendicitis.

I was hoping for appendicitis.


Ultrasounds:

My parents took me to the ER. They did a urine pregnancy test, which came back negative. I insisted that I was pregnant, and they did a blood draw.

My HCG was around 500. They told me to get my blood drawn in two days to compare the numbers.

They did both an external an internal ultrasound. They did not find anything... No sac, no heartbeat. Nothing.

The only thing was that my lining was thick which would be consistent with being pregnant.

The ultrasounds took forever, and were emotionally excruciating. The technician couldn't say anything, but I knew there was no baby on the screen. I was at the ER for about 4 hours, and most of the pain had actually subsided before I was seen. My dad had insisted I get seen anyway.

I was sent home being told I had either an ectopic pregnancy, a threatened miscarriage, or I was just earlier in my pregnancy than I thought I was. I knew the last option was NOT the case, but as that was the only option that gave me hope, I clung to it.

I was 6 1/2 weeks at the time of the ER visit.

HCG:

My HCG seemed to bounce around. That is the only explanation I can think of as to why a urine pregnancy test was not showing up positive when my HCG was at 500. Two days later, when they retested, my HCG was 850.

The increase was encouraging, but because my numbers didn't double -- they were worried about the placement of the baby.

Bleeding:

I didn't start spotting until I was at the ER I had some slight pinkish spotting.

It picked up a little that day, but not what I would consider to be as heavy as a period. The next day, I barely had any spotting. The nurses seemed encouraged that the bleeding had slowed, although they told me they were still concerned about the placement of the baby.

The next day, after news that my HCG had gone up, the cramping and bleeding picked up. I knew I was miscarrying.

After about an hour or two after everything started, I felt the need to push. I pushed out tissue. It was grayish and covered in blood, but was not a clot. It was about the size of what my ring finger and thumb make when I put the tips of my finger together in a circle.

I saved the tissue. My mom came over, and having experienced miscarriage herself, told me that this was the placenta and baby. We wrapped up the tissue sanitarily, double bagged it in
Ziploc, and put it in the fridge to save for the doctors.

The next morning, we were scheduled to go on a vacation. I called the on-call doctor that night, and asked if I should go.

They informed me that I could go, but must stay close to a hospital and must go in if my bleeding increases or I'm in pain.

The bleeding did not increase, and was about the same as a period. I went on vacation (though it was all very stressful and emotional.) Strangely I felt more pregnant during this time, but I just thought it was from my hormones trying to go back to normal.

Rupture:

For 3 days, I was for the most part pain free. I might have had some period-like cramps to go with the bleeding, I honestly don't remember. Those 3 days were honestly a fog of shock and grief, of believing I was no longer pregnant.

I had "miscarried" on Friday, and my post-miscarriage appointment was scheduled for 9 am on Tuesday.

As I was putting on my coat to go out the door for my appointment, I felt something like a pop, and very, very intense pain on the left side. It quickly radiated throughout my entire abdomen.

I would not classify this as a cramp. It was more like feeling like I had been stabbed in the gut.

I expected it to go away, but it did not. I did not want to be late to my appointment. I couldn't really walk very well. I could make it a few steps, then had to squat down to try to catch my breath. I called my parents and let them know I was in a lot of pain. They offered to come pick me and Maddy up and take us to our appointment, but I was afraid of being late. I insisted I was OK.

You, the reader, should know that I was NOT OK. And honestly, I knew I wasn't OK.

I simply didn't want to be a drama-queen. I didn't want to inconvenience anyone. I wanted to be superwoman, I guess. I just wanted to take care of it on my own.

Getting in the car and driving myself is probably one of the stupidest things I've done. Deep inside, I knew my tube had ruptured. I knew it.

I was in so much pain, it took me 30 min to drive 15 minutes away. I passed a fire station, and debated whether I should stop there and ask them to take me by ambulance. Again, not wanting to be drama (and also wondering if we could afford an ambulance ride), I opted again to try to cope with the pain instead.

I was dry-heaving in the car. The pain was so intense, it was causing me to throw up. I was also bawling. Maddy was in the backseat, and kept telling me not to cry, and that I would be OK. I also kept telling myself I would be OK. The whole drive, in between dry heaves, I was repeating aloud, "I'm OK. I can do this. It's just a drive. I'll be fine."

When I got to my parents, they met me outside. My dad pulled me from the driver's seat, as I could no longer stand on my own. My mom grabbed Maddy and took her inside, then quickly came back out to help my dad move me to the back seat of his car, where I curled in the fetal position. My parents debated which one should take me in. My dad decided that he should since I might need to be carried. My mom then called the doctor to let them know I was in bad shape, and to bring me a wheel chair when I got there.

She also called Ryan to let him know what was going on.

When we arrived at my OB/GYN, they got me in right away. Dad helped me in the wheelchair, and brought me back to the exam room. I couldn't stand or dress myself. So a nurse took off all my clothes, and got me in a gown, while completely supporting my body weight.

I did not want to be moved to an ultrasound room as everything just hurt too much. The dr did an internal exam (excruciating) where she determined that my cervix was open and everything seemed to be cleared out. Then she wheeled in the portable ultrasound machine, where she could see fluid and a mass by my ovary.

She said that the tissue I had passed was likely my uterine lining all rolling up and coming out in one clump.

She told me I had an ectopic pregnancy, that my tube looked like it ruptured, and I needed emergency surgery. The nurse got me dressed, and I called Ryan to let him know to meet me at the hospital as I would be having surgery right away.

It was hard to talk as I hurt so much. To Ryan, it sounded like I was dying. He came to the hospital expecting to say "good-bye" to me forever.

Surgery:

The nurse got me dressed again, and wheeled me out to my dad's car, where he took me 5 minutes to the local hospital. He wheeled me back in to the hospital, where they receptionist was trying to check me in. They briefly left me alone in the lobby for my dad to move the car to a parking space. I began dry-heaving again, and shaking uncontrollably.

They moved me to a room, where I had to go over my medical history several times. The anesthesiologist came in several times to make sure I wasn't allergic to anything. The nurses stayed in my room. They FINALLY gave me a shot (I don't know what it was) to help control the pain. As soon as they gave me the shot, I started throwing up bile. They told me it was the strongest pain medicine they had.

I remember them putting a band on me with my blood type, and told me I may need a blood transfusion.

After a few minutes, I felt some pain relief. The shaking stopped.

It only lasted about 10 minutes. After about 10 minutes, everything (nausea, shaking, pain) would come back, and I'd have to get another shot.

Everyone in our family came to the hospital. I only saw my dad, Ryan and my mother-in-law. The doctor came in and told me what happened. She said the baby died when my tube ruptured. I was 7 1/2 weeks at this time.

By the time I was wheeled into surgery, I was crying from pain again. The shot had worn off. My doctor told me she didn't know what my insides would look like. She said I might have to have a hysterectomy, but she would save everything she could. She said "I'll take care of you baby girl. I'll take care of you."

She gave me the comfort I needed at that time.

I briefly felt fear as they put me on the operating table, and everyone had masks. The anesthesiologist told me he was giving me the medicine. I was afraid to go asleep because I wasn't sure I would wake up. But I was so ready for relief, I gave in readily when sleep took over.

Recovery:

I had a hard time waking up from surgery. It was nighttime (maybe 7 pm) when I woke up in recovery. I kept having dreams that they moved the baby back to my uterus, and I was still pregnant.

 My mom and Ryan were with me. Apparently the nurses had been trying to wake me up for a long time.

I asked if I had anything left in there, and Ryan told me they saved my tube.  I asked if I had had a transfusion. Ryan said they took out the baby and tissue, and a softball-sized blood clot. I had lost a 1/2 liter of blood.

My doctor had (unbeknownst to me) gone out to my family after recovery, and showed them pictures of the pregnancy and clots. She let them know that the baby had implanted in my fimbrials (the fingerlike part of the tube that "catches" the egg from the ovary, and draws it into the tube.) Because that's where she implanted, my tube literally just split down the side when it ruptured, as opposed to worse damage that would have happened if she were in the middle of the tube.

Because of that, they scraped my tube clean, suctioned out all the blood, and were able to cauterize my tube back together.

I had the key-hole surgery, so I have 3 small scars. One in my belly-button, one on my left side by my hip, and one right above my C-section scar.

They discharged me before I felt ready. I had to get my clothes on (which didn't fit after the bloating from the surgery). They packed me up in our car (even though I couldn't walk on my own), and Ryan took me home.

I can't remember how long it took to feel normal. But I felt very weak for a LONG time.  I was bloated, and had horrible pain from the gas they pumped in me. My tube hurt for a long time. One of my incisions got infected and needed some extra TLC.

2 years later:

As a result of my ruptured tube, I still get lots of pain in that area. It usually comes on suddenly, and makes me gasp a little in pain, or suck in my breath till it's gone. The pain is less frequent than it used to be. When I first started trying to conceive, I had panic attacks thinking that I was having another ectopic.

The last two pregnancies I've had have been in an undetermined location. It appears as though I have just miscarried -- but since my HCG was slow rising, and they could not locate anything on ultrasound, I'm not 100% convinced they also weren't in my tubes. But we'll never know for sure. I just refer to those pregnancies as miscarriages.

My periods were also messed up following my rupture. My periods became more frequent, with more clotting and more spotting. My periods interfered with my daily life. Just recently, I had my FIRST (FIRST!!!!) normal period in 2 years.

My scars are barely noticeable. I had a test done on my tubes this summer, and my tubes are clear. However, there is scar tissue on the one that ruptured.

I have a higher risk for ectopic now.

I'm still waiting for a rainbow baby, and hope that one day, we'll have a baby in-utero that is healthy!



I hope that this has helped you. As always, if you want to share your story (ectopic or other pregnancy loss), please email me at renyeart@gmail.com.

Monday, December 9, 2013

Going back to work

Just before Olivia, I was working part-time at an advertising agency, and was also building my own home-based business. Just weeks before we found out we were pregnant with her, I had promoted in my business and had replaced my income at the agency. And so, two-week-notice it was for my work! I couldn't wait for this new journey to start. Life was just falling into place, and I was so excited.

That feeling that everything was so perfect did not last long enough.

A few days before my last official day at work, I was sitting in an office party when the cramping I had been feeling suddenly became awful. After about an hour of me crying on the bathroom floor, trying to get on top of the pain, a friend told me she was taking me to the hospital.

A very long story short -- exactly a week after that ER visit (where nothing was conclusive), my fallopian tube ruptured. I was internally bleeding, and required immediate surgery.

They were able to repair my tube. But nothing could repair my broken heart.

I was grateful that I did not have to go back to my work right away -- as I had just quit! However, I did go back after a few weeks to collect my things and have lunch with my friends.

I was so nervous about going back. It was if I were a WHOLE new person entering that building. I was a broken, shattered soul with a put-together exterior. Normally outgoing, I was afraid of seeing anyone! I was afraid any wrong word would break me, but hearing no words that would speak to my pain would be infinitely worse.

I was also concerned about the trigger just being at that building would be. The very last time I was there, I was pregnant.

My friends were beyond gracious. The set up a table in very quiet corner of the building where no one would bother us, and ordered take-out for all of us. We caught up -- but I was feeling that internal pressure to just SPEAK about what just happened to me. I know they all were afraid of bringing things up, but I finally just said, "It's ok to talk about it and ask me questions. I WANT to talk about it."

They proceeded to let me speak, and asked gentle questions, and the whole thing went so much better than I could have anticipated. I ran into a few people I wasn't planning on. Some I told what happened, and others I just smiled on the outside. I think having such amazing, thoughtful co-workers made coming back, even briefly, pretty amazing.

My business, however, was a whole other story.

After we lost Olivia, I did not want to work at my business. I had no emotional or physical energy to pour into it. Not surprising, our numbers dwindled, and I became concerned that I wouldn't keep the promotion I just received for very long. But our rising bills just added pressure to the grief.

A few weeks after our loss, I had a few home parties coming up. I didn't WANT to do them, but I felt like I should -- especially with the bills! My sponsor, who has had a miscarriage, told me she absolutely understood and supported me in whatever I decided. Then she asked me a key question. "Rachel. I know you don't want to do the parties, and I wouldn't either. But I just want to ask -- at the end of the month, what would it feel like to have DONE them, and have a nice paycheck and some activity behind you?"

I thought about that a lot, talked with my husband, and decided to do the parties.

The first party I was a mess, absolute mess, the night before. I thought I was crazy for trying for the party --- but with a ton of help from my husband -- I did it! And it felt good to do something "normal." Sure, I made a ton of mistakes. I dropped things during the presentation, forgot names, and left half of my stuff that I needed in the car.

But -- I took one step.  And eventually, that led to another, and another and another.

We have now had two subsequent losses since our ectopic pregnancy with Olivia. Ironically, both times I had a large presentation scheduled on the same day as the heaviest bleeding.
Both times I went ahead and did the presentation. Both times I was uncomfortable, myhormones were EVERYWHERE, and I couldn't help but tear up often. But I gave myself tons of grace, and rested a lot once I was home.

For me, getting through that FIRST step after a loss is the hardest. And the sooner I was able to do it, the easier it was for me to keep going.

Another thing that helped was feeling "normal." When the nurse called to let us know our hcg had dropped and would miscarry (with our second miscarriage), I chose to follow through with my work that night. I could have cancelled. But I just wanted something that would distract me from my pain for a few hours.

I don't think there's any "right" way to go back to work. But I have found that being able to surround myself with supportive people, take that first step, let myself have a few hours of "normal," and listen to and voice what I really needed was immensely helpful.

Tuesday, December 3, 2013

What I didn't know

 
 
Two years ago, I knew I was expecting a baby. I knew life had changed. I had changed. I was changing.

A new start. A new beginning.

But there were a few things I didn't know.

I didn't know she was ectopic.

And you know what? I'm glad I didn't know. Because I didn't know, I got to experience tremendous joy for the few short weeks she was in me. Because I didn't know I'd lose her, I got to share with excitement to friends and family. I could celebrate. For those I hadn't shared with yet, I got to revel in the tiny little (big) secret I was carrying.

Her life only lasted a few weeks. We were just nearing 8 weeks when we lost her. Each life deserves some joy. And I filled that time with the joy of knowing her.

If I had known she would die, I may not have celebrated her life.

I didn't know we'd lose more babies.

Honestly, if you had told me that two years ago today would start the worst two years of my life so far, I wouldn't have been able to handle it. If you had told me that not only would I not keep her, but I wouldn't keep another baby 9 months later, and then ANOTHER baby another 9 months later, I would have lost it.

If you told me we would deal with infertility, divorce, death, cancer, accidents and unemployment in the last two years, I really would have lost it.

As it was, I almost lost it just losing one baby.

Gosh, I'm so glad I didn't know.

I didn't know we wouldn't have an answer.

Of course, the answer I assumed we'd have to our pregnancy test was a live baby. But we didn't get that answer to our prayers. The doctors don't know why we had an ectopic. The only "risk" factor was that I had a prior cesarean. (Bet you didn't know that was a risk factor, huh? Funny what they don't tell you.) But even then, at surgery the doctor said my tube had no scar tissue on it.

And it's the same for our last miscarriages. As far as they can see, I'm healthy. I'm the peak of healthy. A very healthy person with recurrent pregnancy loss.

I didn't know how much of an impact she'd make on me.

OK, so yes, assuming she'd lived, of course I knew what an impact she'd make on me. And I had assumed she'd lived. So I had dreamed of all the years ahead.  I dreamed about her first Christmas and First Thanksgiving. I thought about nursing, birthing plans, what kind of sport or hobby she'd love as a high-schooler, what she would look like, what her personality would be like, what the girls would look like playing together.

She had my dreams. She had my love. And I couldn't wait to share my life with her.

When we lost her, the world says "It wasn't meant to be." "Some babies just die." "This just happens." "This is your 1 in 4." "Maybe she would have been deformed, and you wouldn't want to deal with this." "This is nature's way." "This is God's will." "You are strong enough to handle this loss -- I'm not." "You will move on." "You can always try again." "It will be better next time -- I know it."

But in my heart, she was meant to make a mark on this world. Her life has value. And purpose.

She was supposed to be the one to share her presence. But since she's gone, I'm determined to make her life count still. I want to give her a voice.

I don't know how long I will write about her anniversaries. I don't think I will ever forget. But for now, I need to spend the day remembering her.

I didn't know I'd survive.

I never thought I'd survive the loss of a child. Now, some of you might be thinking -- a miscarriage is not REALLY the loss of a child. But, you need to know, it is.

Not that I think every loss is exactly the same. It's not as though I'm trying to compare myself to any other baby or child loss mom. Because I'm not.

But I'm just saying -- I didn't think I'd survive loving and losing.

But I did.

Not only have I survived, but I'm growing. I'm stronger, more resilient, more compassionate, more REAL, than I was before Olivia. I wouldn't say my faith is stronger, but I would say it's more personal. It's different. It's weaker AND stronger at the same time.


I didn't know the tears wouldn't always be there.

For a very, very, very long time, I cried. I cried for hours, I cried for days, I cried for months.

I didn't know the tears would slow.

But they did.

The tears still come. They came today. But they are not the harsh, bitter tears of despair. They are beautiful tears of memories.


I didn't know that the women who went through loss are some of the best friends I have, and the most beautiful, strong people I've ever known.

I didn't know that with the loss of my relationship with my daughter, how many other relationships I would form! That there is a whole crowd of women who had been there and were there to support me. And that there were women I was meant to support. I didn't know that, in spite of none of us wanting to be a part of this "club," we really were better together.

I didn't know how amazing people would be to me.

Strangers I've never met face-to-face. Church friends, old and new. Small group friends. Family. Our agency and those we've met through foster care. Friends from junior high, high school and college. People from all over -- supporting me and my family in our losses. By dropping off food, sending cards, taking care of Maddy, praying with us, reading our blog, hoping for the best with each successive pregnancy . . . All of it. Amazing. YOU have blown me away by your love and support.

I just didn't know how amazing you all would be.

I didn't know that I would grow, laugh and love again.

I didn't know if I could move forward without her. But I can, and I have. Not by choice, but by necessity. And God has given me the strength, grace and perseverance to just keep putting one foot in front of the other. To move forward with an adoption of precious little miss. To move my business forward. To keep writing my blog. To keep my faith, and keep trusting in His goodness.

I didn't know I could live with loss.

But here I am. Two years out. Missing her always. Excited to meet her in heaven.

But knowing that somehow, I'm better to have known her, even for such a short little while.


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