Tuesday, April 18, 2006

The Twins

It's eerie even writing that....it seems like a lifetime ago...but it was just over a year...

We found out I was pregnant one weekend in mid-February 2005. We couldn’t believe it, we were floating in the clouds for a week since we'd been trying for a year at this point. That next weekend, we told my parents and my grandmother…gosh how they needed some good news because we were all still grieving so hard for my grandfather (we had lost him just before New Year's). Then that Monday, something happened…I can’t explain it, but I was just filled with this overwhelming feeling that something was wrong. I had some minor cramps, and my mom convinced me to call the dr. Wednesday (March 2) we went into the dr. Patrick wasn’t going to go (they were supposed to just be checking me for a bladder infection), but he surprised me and was there at the office when I got there. My dr. did a quick ultrasound, and I could tell she was worried. She saw no pregnancy sac in the uterus. She said it could depend on my levels, they would need to be over 2000 to see something on ultrasound. I asked her about the chances of everything being fine, her response “It’s possible”. She asked if I was going to be home alone that day, and I said no, Patrick would be with me…but I knew the fact that she had asked wasn’t a good sign. They drew my blood, and we left. Patrick and I drove home in separate cars, and I was crying so hard I could barely see the road. I remember my dad calling me on the way. Patrick had called mom, mom had called dad, and he had called (he’s better with these things than mom). He said some wonderful things, and it helped to calm me down.

Patrick and I sat at home for a couple of hours, he was doing research on ectopics and I was staring at the TV not really knowing what to do. Then at 2pm, we got a phone call. It was the nurse wanting to know where I was and how fast I could get to the hospital. My levels had come back at 3500, and they needed to do an emergency ultrasound to see what was going on. After all was said and done, the radiologist said “I don’t see a pregnancy in the uterus, but I do see one in the left tube. I’m sorry.” The rest of the night was kind of a blur. I’ve never seen Patrick so upset and worried. We were told to go to a treatment room, and before I knew it they were taking blood, asking me to change, putting more armbands on me, I didn’t understand what was happening. And then they told me I was being admitted. They didn’t want to take the chance of me rupturing the tube at home, and I had eaten that day so they wanted to wait to do the surgery the next morning. My dr. came and talked to us. She was as upset as we were. She said that they had to get it out…if they didn’t, I could die. It was that simple.

By the time I was settled in my room and had almost run out of tears, my mom was there. It gave Patrick a chance to take care of things at home…and to deal with his feelings. Later I would find out that when he had gone outside to call my mom about the surgery, he had lost it and was crying with her. Mom and Patrick went through a lot together those few days. The next morning I had laparoscopic surgery. We didn’t really know what they would need to do: excise it from the tube, take out the whole tube, even take my uterus. The incision could be the three small incisions that are common in lap surgery or it would be the type of incision they do for a C-section.

When I got back to my room, Mom and Patrick both looked pretty happy given the circumstances and they told me what had happened. I only needed the three small incisions. My tube was saved, and while they were in there, they found something else. I have endometriosis. We had no idea. It was pretty mild. Stage I maybe Stage II, but while they were in there, they got rid of it. In essence, I came out of the surgery more fertile than when I went in. I felt good, and except for the puking spell from the morphine, it wasn’t so bad. The next few days were annoying because I needed help going everywhere and doing anything, but all in all I felt lucky.

This is where the story changes. ….there is no happy ending.

One week later, we went for my follow up. The dr. said I was healing great, and that we would just need to monitor my levels. On the way to work the next morning, I got a phone call. It was my dr. They were very worried, my levels had not gone down, they had doubled (somewhere around 7000). They thought something was left in the tube and that it could be getting big enough to rupture. I was to go home, get Patrick (luckily he was on Spring Break), not eat or drink anything else, and head back to the hospital for an emergency ultrasound… again. I packed my bag at home, and we were fully expecting that I would be back in surgery having my tube removed by the end of the day. Once in the ultrasound room, the tech was really sweet. Then she says, “Well, I can’t say anything until the radiologist comes in, but I can tell you that it’s better than last time.” Patrick and I didn’t know what to think. Then my dr. comes barging in, and in the middle of saying hi to all of us, she looks at the screen and blurts out, “Is that a pregnancy in the uterus?” The tech smiles and says yes. My dr. is freaking out she’s so excited, punching Patrick in the arm even, Patrick is standing there stunned, and as usual, I’m bawling uncontrollably. The radiologist comes in and confirms that there is a gestational sac with a yolk sac. When I ask how it’s measuring, she says 5.5 weeks. I immediately start to panic. I should be 6.5 weeks. No one else seems concerned….but I know again, something just isn’t right. But everyone else is just saying what a miracle it is...a heterotopic pregnancy (one in the tube, one in the uterus)...a 1 in 40,000 chance...

Over the next week, my parents, the dr, Patrick, everyone tells me not to worry about my chart, that things just happen sometimes, that this isn’t an exact science. But I look at my chart, I see when I ovulated, I see the last time we had sex, and I see when I got my positive test…and I know…something isn’t right.

One week later, we went for another ultrasound. There we saw a pregnancy sac, a yolk sac, and an embryo with a heartbeat. But when I asked what it measured, they said 6.5 weeks…I should have been 7.5 weeks. Again, everyone said this was good progress, and not to worry about it. We were sent home with our first ultrasound pictures. So I stopped worrying about it, but in the back of my mind, I couldn’t help feeling that something was still wrong. Over Easter weekend, that feeling got stronger. My mom would talk about someone else that was pregnant or complain about wanting to tell people, and I would snap at her. My grandma would ask about names, and I would tell her I didn’t want to talk about it. Patrick tried several times to rub my stomach, and I would pull away instinctively...something wasn’t right.

On Tuesday (March 29), I woke up to a tiny bit of light spotting. I freaked out. Called Patrick. He called the dr. and met me at the office. We went through all the motions of a first prenatal visit, but all I could concentrate on was the ultrasound…I needed to know. I could tell from my dr.’s expression that it wasn’t good. Based on her measurements, the baby was a little over 6.5 weeks, meaning it had stopped developing shortly after the last ultrasound. I should have been 9.5 weeks. There was no heartbeat. I needed to go to the hospital for my third emergency ultrasound in a month to have it confirmed….but we knew what had happened. The ultrasound at the hospital confirmed it. It’s called a missed miscarriage. Patrick called my family and told them, and let them know that I wasn’t ready to talk to anyone. Apparently Mom left Dad a message that he couldn’t understand, so he ended up calling me while I drove home. Again, he said all the right things…instead of the consoling things he said the first time, this time he was angry. He was flat out mad, and I appreciated that so much. I didn’t need to hear that “God has a reason” or “It wasn’t meant to be”. I needed to hear him rant about how some women do drugs and have a baby and here I was not even eating peanuts or drinking Coke.
The dr. called the next morning and gave me my options: wait for it to happen naturally or do a D&C. The natural miscarriage could take weeks, and could lead to a D&C anyway, so she chose to do the D&C for both my physical and emotional well-being. Thursday morning (March 31), we were back at the hospital. The D&C was pretty easy compared to the previous surgery. I felt good enough to eat Freebird’s that night, so it really wasn’t so bad. I was out shopping by the weekend, and back at work that Monday.
In the recovery room after the surgery, they drew my levels. I found out at my appt that week that they were 29,000. The numbers were good, we’re not sure what happened. But both my dr. and I ran across the same statistics in the medical journals. In heterotopic pregnancies, the uterine pregnancy has a 50% chance of miscarriage.
Two months later we found out the real reason for the miscarriage. One of the radiologists had mentioned that she saw evidence of a uterine septum on the ultrasounds. An HSG in May 2005 confirmed it. In July 2005, I had laparaoscopic and hysteroscopic surgery to remove (resect) the septum and they also removed more endometriosis. We hoped that the septum was the cause of all of the problems (the endo, the ectopic, the miscarriage), but my journey wasn't over yet....

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