Thursday, May 29, 2008

Nothing Inside

I'm having a miscarriage.

Tuesday was my first prenatal appointment. Aaron and I arrived at the medical commons and were told upon registering that the doctor (who I hadn't met yet) was running quite late and that we were in for a bit of a wait. No problem, I thought...Grace didn't need to be picked up from day care for a couple of hours yet and there were plenty of magazines to read, so we made ourselves comfortable in the waiting area and enjoyed some quiet reading time.

After waiting 20 minutes or so, a nurse came out and called us back to a room. She told us that she would be asking me a bunch of questions to get information about my medical history since I was a new patient. Afterwards, I would need to wait some more and then I would be able to meet with the doctor. We went through all of the medical history questions, discussed family genetics for both my family and Aaron's, and then the nurse gave us the prenatal nutrition speech (diet, exercise, etc) and told us a little more about the facility where I would be delivering the baby. Standard first prenatal visit stuff.

We were sent back out to the waiting room, and after waiting a bit more, my doctor's medical assistant came out to us and told us that unfortunately the doctor was delayed a bit more. She suggested that I head down to the lab to have my prenatal blood tests drawn while we wait. She gave us the clinic's thick "Information for Expectant Parents" binder to read while waiting and sent us down to the lab. We paged through the binder while we waited and then I had my lab work done, peed in a cup, and soon we were heading back upstairs to the clinic.

Finally, about an hour and a half after our scheduled appointment time, we were called back to see the doctor. The medical assistant weighed me and said, "Let's get your blood pressure before we take you back to the ultrasound room."

Huh? Ultrasound?

I asked the medical assistant why I was having an ultrasound so early (I didn't have one with Grace until I was more than 12 weeks along), and she says that they typically like to do them on the first prenatal visit, but that they don't always have the space or availability to guarantee it for each woman, so it's not something that they don't tell patients when they make their appointment. Cool, I thought. We can see the baby today!

Then, suddenly, something inside me said, "No. I do not want to have this ultrasound." In fact, when the medical assistant took my blood pressure, she asked me, "Are you nervous?" I told her that I was, and she told me my blood pressure was high, something like 140/86. She joked and told me that she would let it slip this time. We walked to the ultrasound room, and waited for the doctor.

While we were waiting, I told Aaron how nervous I was feeling. He asked me why, and I told him that I was nervous that something was wrong. He told me that I shouldn't worry, that everything was okay, and that if it wasn't, that he would be here for me. I remember feeling so nervous that I could have jumped out of my skin. I even toyed with the idea of running out of the room and canceling the appointment. I just had a horrible feeling that something was wrong and I wanted to avoid finding out what it was.

The doctor came in and apologized for our long wait, explaining that she was on call and that she had a patient in labor over at the hospital who was getting ready to push. And then she got paged, excused herself to take the call, and eventually came back in. She quickly scanned the medical history information that her nurse had taken earlier, asked me some questions about my last pregnancy, and noted that I was vomiting earlier this week. She asked me if I had a fever when I was sick and I said yes, I had a low grade fever while I was throwing up. She told me that she thought that the vomiting was not related to morning sickness at all, because of the fever, and that it was probably just a fluke and a coincidence and that hopefully I would escape the morning sickness monster altogether. She also did some quick calculations and confirmed that I was eight weeks pregnant and that my due date would be January 5th. She was excited because I was to be her first '09 mom.

January 5th. I will never forget that date.

And then came the pelvic exam. Aaron stepped out briefly, at my request, because for some strange reason I wanted privacy during this part of the appointment. Over the course of the appointment, I had started to warm up to my doctor. She was young, knowledgeable, and had a good sense of humor. We talked about all of the great restaurants that there are in Bayview, near to our home, and talked about all of the great shopping that there is around my office in Brookfield. The pelvic exam went without incident, and Aaron was called back into the room for the ultrasound.

Aaron and I watched the screen intently, not really knowing what we were looking at, and there was silence in the room for several seconds. Then the doctor said, "Huh." Several more seconds of silence, and then, "I don't see anything inside your uterus." She said it like she was saying, "Huh, I didn't think it was supposed to rain today," or, "Huh, I thought I put my car keys in my purse." Just a tone of mild surprise and wonder.

I closed my eyes, and my stomach dropped. I grabbed Aaron's hand.

Please, look harder, I thought. And she did. She looked harder, showed Aaron and me both of my ovaries, my cervix, and my empty uterus. She showed us where the baby should be, and all that we could see was nothing. Everything looked perfectly normal, except for the fact that our baby was gone. She mentioned a slight dilation of something, and I wish now that I had the presence of mind to ask her what she meant, but I didn't, so that comment remains a mystery. I remember being slightly conscious of the sound of Aaron shifting his weight back and forth on his legs and chewing his gum faster and faster.

All that I could think of at that moment was Aaron. No one deserves to be a dad more than this man. He has loved and accepted Grace as his own daughter, he is a good, good man, he DESERVES this baby. God, I know I have screwed up in my life and if you want to punish me, fine, but DO NOT punish Aaron. Please, God. I couldn't even bear to look at his face, because the disappointment and sadness that I knew I would see in his expression would have been enough to make me lose my shit.

The doctor stood up and told us that there were three possibilities to explain what we saw, or rather, what we didn't see. The first possibility was that this was a normal pregnancy but our dates were off and I wasn't as far along as I had thought. This was a remote possibility because I hadn't had a period for eight weeks and I'm healthy and have relatively regular cycles. The second possibility was that this was a tubal pregnancy and that the doctor was unable to see anything because the ultrasound machine she was using was not super high-tech and she didn't have a good view of my tubes. Again, this was not a very probable explanation, because if my pregnancy was ectopic, chances are that I would have had bleeding or some strong pain by now, and I hadn't had either. The final, most probable explanation was that I had had an early miscarriage and it was just starting so I hadn't had any symptoms yet. The doctor told me that she would order some additional tests on the blood that I had taken earlier in the afternoon and that she would call us that night with the results. If my hCG level was 2000 or more, she would order another ultrasound for the next day at the hospital and take a closer look. If the level was less than 2000, she would have me come back every couple of days for repeat blood tests to follow the levels. Either way, she said, this was most likely not a normal pregnancy and we are losing the baby. Then she apologized because her staff gave us the parenting binder earlier and said that she wished they could have done the ultrasound first.

No shit.

The doctor told us to take as much time as we needed, and left the room. We sat there for a long time, and I let myself cry for a while, and Aaron cried, too. After a few minutes, I realized that we needed to pick Grace up from day care and briefly thought that exactly four years ago, at that moment, I was receiving a call from my obstetrician in Oshkosh telling me that they would be inducing my labor the next day because my blood pressure was too high. Four years after hearing the exciting news that I would be meeting my first baby in less than 24 hours, I learn that my second baby is gone.

Aaron offered to pick Grace up, since I was a mess, and I headed for home. As soon as I arrived, I quickly jumped on Google to look up miscarriage and tubal pregnancies, but soon lost the strength to read the information. I sobbed and sobbed, and then I heard Aaron's truck pull in the driveway. I pulled myself together as best as I could, and got ready to put on a happy face for Gracie. She came in the door and immediately gave me a big hug--Aaron had told her in the car on the way home that Mommy was sad and needed a hug. This was not the first time in my child's life that she has been an immense comfort to me. Seeing her took the edge off of my grief.

I made a call to my parents to tell them what was happening and promised them that I would call back as soon as I heard back from the doctor. I went through the rest of our nightly routine as best as I could, and put Gracie to bed. Just as she was falling asleep the doctor called. She told me that my level of hCG was near zero, and that (thankfully) ruled out a tubal pregnancy. She told me that what was happening was that I had an early miscarriage and that many women in my case would not have even known that they were pregnant, but I took the pregnancy test early enough for the little hormone that I was producing to register. She apologized, told me that there was nothing that we could do, and told me that I should expect to start bleeding and passing tissue over the next week or so (she said she was actually surprised that I hadn't started bleeding yet). She said that the pregnancy was young enough that I should miscarry without any complication, so there shouldn't be any intervention (such as a D&C) needed. She told me to make an appointment to follow up with her in the next couple of weeks and that if I hadn't completed the miscarriage by then, she would give me some medicine to help it along.

So, now we are waiting. Waiting for the end of all of this. My doctor made it seem as though passing the remains of the baby was going to be a bloody and painful process, but after doing some research on my own and talking with some people who know something about this, it's possible that my body absorbed the tissue and that I won't actually need to pass it. I guess that remains to be seen. My appointment is a week from today and as I said, if I haven't at least started spotting by then, my doctor will give me the medicine to help things along.

I am numb. I am devastated. This is quite possibly one of the most difficult things that I have had to face and I'm not sure what to do to make it better. I know that I wasn't pregnant for very long, but we HAD a baby, and now it's gone, and I am grieving. We are grieving.


Carrie said...

Oh, Sara. I'm sitting here at the computer weeping for you. I'm so sorry.

Please don't think that you could have ever done something to deserve for this to happen to you. No one deserves this and you and Aaron are both wonderful people and great parents.

I know it probably doesn't help to remind you this at this point, but just because you had one miscarriage does not mean by any stretch that you will not be able to have a baby together.

I've been reading the blog of another mom in your situation, It might help to take a look. She's pretty depressed, so it won't exactly cheer you up, but I thought you might want to know about it.

Hugs! Epu and I will be thinking about you.

Anonymous said...

Ditto on Carrie's comments. Sending hugs your way...

Angie said...

I'm thinking of you guys....and sending you positive love vibes.

when you're up to it, i'll take you for a glass of wine to cry in.

Bert said...

Sara, I just read this. We've been away from the internet. I'm SO sorry to hear about you and Aaron's loss. It makes absolute sense that you would feel such strong grief for the loss of a child you very much wanted.

But, as Carrie said, this doesn't mean that you can't have a child (or several) with Aaron. You are both wonderful parents and deserve wonderful things.

I know it hasn't been long, but keep in mind that it won't always feel this way. And someday, you'll hold a lovely new baby together.

My thoughts are with you both.