Wow, haven’t been on LJ for ages. I’m posting here because my personal blogs are experiencing technical difficulties. Will repost there when things are cleared up. Anyway, this is a huge updatish post for everybody that I meant to talk to but haven’t been able to yet. Hope it explains things a bit and that I’ll get to chat with you soon.
PS. Because the majority of you are female, you probably won’t mind but I suppose I should warn that there are references to all sorts of medical-related stuff behind the cut.
Right. So the last half year has been something of an emotional roller coaster, among other things. I know I have a tendency to clam up and go into hiding when stuff goes down, which works okay when my friends live close enough to come by and poke me with a stick until I start talking again. Since most that would do so now would have to go to extraordinary lengths given my halfway-around-the-world head start, I owe them at least an explanation for why I disappeared for a while. So here we go.
I am currently typing this on my Kindle while lounging on the living room sofa. It’s a sunny spring day – a bracing 5°C or so – but it still feels tropical after the -20 mornings we were having just last month. Just being able to open the windows for some fresh air is a treat. The giant piles of snow outside are finally getting the message and starting to melt. Which would be great except that they then solidify into neck-breaking sheets of slippery death overnight when the temps drop again. But that won’t be something I will be worrying about for a while because doing a few shuffling laps around the downstairs rooms of our house every few hours is about the limit of my ambulatory efforts for now. I had surgery on Sunday (3/24) after massive abdominal bleeding, y’see, so exploring the newly thawed Finnish wilderness is kinda off-limits for the time being.
Actually, that’s near the end of the story, so let’s rewind to… late October 2012. That was when the hubby and I celebrated our 1 year wedding anniversary and decided that we were probably stable enough to tackle the next big project in our lives. That being the whole business of trying to spawn a child or two so that the parents would stop with the really unsubtle hinting every time we talked on the phone. Well, that and we actually want kids, of course, but the halt to nagging would have been a bonus prize. So, being the practical sorts that we are, I drew up a game plan, did my research, collated my personal data from the past several years, and bought a helpful electronic test kit. What can say, we were efficient. A few weeks later, we were staring at a positive home pregnancy test.
There was a lot of excited flailing at home. Then I went to work and excitedly flailed at selected colleagues. It was nice to have that period of innocent excitement. We knew better than to make an announcement before the first trimester, in case anything happened, but that had the same vague precautionary feeling of stewardesses showing us the emergency flotation devices before a flight. We didn’t really think anything would go wrong, after all the successful births that had been going on around us, after we already got a positive on the first try. I got a smattering of symptoms after a few weeks and went about my daily work schedule without too many issues. During the big family Christmas dinner, when I was around 9 weeks along, we decided to tell everybody since I had been eating/drinking suspiciously anyway and we figured it was close enough to the end of the first trimester. There was general excitement, everything was great. In retrospect, I am thankful that I was able to have a happy holiday season. It was pretty cool.
About a week later, I had some light spotting and called my nurse at the maternity clinic to be reassured that it was a fairly common occurrence. I did extensive Googling to calm myself and tried not think too much about it. The spotting got worse over the next few days and turned from brown (old blood) to pink to reddish. I started getting worried and asked to have a scan scheduled with a private ob/gyn ASAP, since my clinic scan wasn’t supposed to be for another couple of weeks. That Tuesday, the doctor took a look inside with the wand and was unable to find a live embryo. She dated the size of the amniotic sac to around 5/6 weeks, which was when it stopped growing. I realized that was corresponded to the dip in my symptoms, which had been slowly tailing off through December. I had a missed miscarriage. A typical miscarriage would have naturally expelled a week or two after the growing stopped, but my body seemed to be on the stubborn side.
The doctor scheduled for me to get a shot at the hospital the following week, with the hopes that it would take care of itself before that, since natural means tend to be less traumatic. Waiting the rest of that week for something to happen still rates as one of the most emotionally draining experiences of my life (and hey, I’ve had a handful of really sucky ones now to compare to!). There’s nothing you can do but wait and in the meantime, you’re stuck knowing that the giant pile of elaborate plans you were making are scrapped, plummeting hormones are screwing with your brain in all sorts of weird ways, and that little person you’d been talking to for the past three months no longer existed. Yeah, the suck just did not seem to end. On Saturday, January 12th, I managed to have the miscarriage by natural means, several weeks later than would have been expected. Which basically meant I clung to the walls of the downstairs bathroom while clammy, pale and only able to speak occasionally between bouts of escalatingly painful cramps, hoping that things wouldn’t get too messy because there was no way in hell I’d be able to even stand upright, let along clean anything up until it was all done. While I always knew I had a reasonably high pain tolerance, this was perhaps the first time it had been truly tested and I must say, I was impressed with myself.
Well, it eventually happened. I flushed before I could see what came out because I just didn’t have the heart to look. I wiped down my face, downed some painkillers, and stumbled to bed feeling empty but with some sense of closure. A few days later, I had another appointment with the ob/gyn to get probed some more. She confirmed that most everything was out and that we just had to wait a cycle or so for things to reset before trying again. Although I was pretty depressed by then, I definitely did want to get back on track right away because that’s just the way I deal best with things. The hubby was mostly just surprised, then in shock, through most of these proceedings. Can’t blame him.
Fast forward through the subsequent month of hormone-induced crazy-making in my head. I cried and moped a lot, all the while knowing that it was kinda stupid to be doing so. I went back to work, then got more time off because being crazy at work was not so hot. Found an English-speaking counselor, who patiently talked it out with me and helped to calm things down a bit. (I’m sure she’ll be pleased that I’m writing this.) Made valiant attempts to be social and sane. Then discovered a month and a half later that part of why I might have been all muddled in the head was because I had ovulated again and (surprise!) we’d managed to score another positive test.
We were more careful that second time. The people I most interacted with were told right away because I needed the support. We decided not to think too far ahead or hope for too much until we could get a positive confirmation of heartbeat, at least. I scheduled a scan as early as I could with the clinic, to make sure that we’d catch anything that went wrong. Funny thing, how I was able to be both ultra paranoid and yet willing to believe any scrap of hope at the same time. Lessons learned. The home tests I took were showing steadily climbing hormone levels, I started getting a decent range of symptoms, and looked forward to a successful scan, bolstered by the statistics that it was likely to be a successful pregnancy, following so closely on the heels of the m/c.
Come time for the scan, the doctor was unable to find anything in the womb. She could tell that “something was going on there”, though, and checked the surrounding fixtures as a precautionary measure. Nothing was detectable. She asked for more bloodwork and suggested a scan in another couple of weeks. The blood test numbers came back showing close to 18K, which should have been our first hint that something could be going wrong. It is one of the classic signs of an ectopic, to have high levels with nothing showing where there should be. I talked myself instead into believing that it was just too early and everything would be easier to see with just a little more time. Since nothing dangerous was showing on the scan, the doctors went along with it.
On Saturday March 23rd, a few days before that second scheduled scan, a sharp abdominal pang hit me. It felt like the worst of my period cramps, with a bit more bite. It gradually lessened over the next hour to a more bearable soreness, however, so I took a Panadol and attributed it to growing pains. I had similar cramps (though not so strong) during my first pregnancy when ligaments started stretching, so didn’t want to be too alarmist. I made it through the rest of the day with just a bit of tenderness in the general belly area and went to bed early, figuring a good nights’ sleep would fix everything.
I woke up a few hours later, a little before midnight, to the return of the cramp from hell. Only this time, it didn’t lessen after the initial stabby feeling, but kept right on going. I managed to stumble out of the bed and to the stairwell, where I tried to shout down to the hubby that something was seriously wrong. Funny thing about projecting your voice, it uses a lot of abdominal muscle when done properly, and suddenly that wasn’t an option. With that general area hurting like it did, the best I could do was wheeze loudly a few times and thump on the wall. On the plus side, I can totally sympathize with people squeaking after being kicked in the gut now.
Luckily, I made enough noise to alert the cats and the hubby, who came upstairs to find me pretty much crumpled against the side of the bed and no longer able to move. My shirt was already soaked with the gross sort of cold sweat you get when something horrible is going down, but changing clothes was not an option when I couldn’t even uncurl myself from fetal position. The mother-in-law (a nurse) was called, soon to be followed by a request for an ambulance. Trying to answer questions was rather difficult, since my jaw seemed incapable of unclenching for any length of time. I don’t know whether it’s a good or bad sign that the hubby could tell exactly what I was trying to say when most of it came out as irate hisses.
Fast forward through the agonizing wait for people to arrive. Two lovely paramedics showed up and managed to trundle me down the stairs clinging to a carrying chair. Quick transfer to a stretcher and out the door we went. Vague alarm over the fact that it was freezing cold outside and they were rushing me out in nothing but a wet t-shirt and underwear, but then I reasoned that hey, going numb from cold didn’t sound so bad, did it? We were in the ambulance soon enough though and between the heating and the blanket, I was warm enough to feel every damned pothole in the road between our house and the hospital. I might have squawked about it a few times. It was about a 40 minute drive or so, since they were advised by dispatch to take me to the neighboring city’s hospital which had a proper maternity/gynecology wing. The nice lady paramedic who was sitting with me gave me a shot of something that was supposed to help with the pain and really didn’t – I think they were still skimping on the dosages at that point in case the baby was viable. I mentally gave myself another pat on the back for not being a blubbering mess. Because really, there are probably several wartime torture methods that hurt less.
Minor digression here to recommend that if you do not have a medical alert app on your phone, you should really get one. It saves a lot of fuss and trouble when you’re too miserable to make any coherent sentences. All I had to do was point at each well-defined tab on my patient history and they could read all about my medications, conditions and allergies, leaving me to fade in and out of consciousness in peace. Quite convenient for anybody filling out forms for you. I also have a second app that keeps track of my monthly cycles and pregnancy details, which seems to make the doctors pretty happy. Of course, it helps if you fill out all the blanks in painstaking detail and update on a regular basis. Yay, paranoia.
We arrived at the hospital and I was wheeled into this tiny exam room where they wanted to do another ultrasound and some blood tests. I agreed and tactfully mentioned that stronger painkillers would be awesome thankyouverymuch. They sadly chose to not get the hint until they could figure out what was wrong with me. Fair enough but still disappointing. Also? Having a wand ultrasound when everything there is going wrong? Ow to the fifth degree. They ascertained that there was bleeding of some sort going on and I helpfully added that it was probably a ruptured ectopic based on the previous scan and they said they guessed as much as well. Then they gave me drugs, yay. There was more squawking and ungraceful flopping, then I was in a rolling bed and being reassured that I didn’t have to be moved again. Which was a huge relief because movement was evil and painful and really, I was fine with never moving a muscle again. Ever.
The drugs kicked in and lying down made things more bearable. They hooked up a drip and got some LRS going. They said something about monitoring my blood levels and scheduling a surgery the next day accordingly. The hubby and in-laws paced for a while then went home to sleep. Aside from being impossibly thirsty all the time and asking for refills of my plastic sippy cup every hour or so (huh, that’s a sign of significant blood loss, I mentally noted) I was able to finally sleep a bit. Sippy cups are wonderful for bedside use, by the way (and especially if you’re as clumsy with unlidded beverages as I am), and I am tempted to buy one for home use now.
The next morning was pretty much a waiting game, since they had to rearrange surgery schedules to accommodate me. Which would have been fine except that it meant I couldn’t drink any water for most of the morning in case they needed to wheel me in right away. Well, I kind of cheated a little on that since nobody took away my cup or the little metal flask (used strictly for water, tsk) I always have in my bag. I stopped as soon as they confirmed the time, so my stomach was empty enough to keep them happy. No harm no foul.
They finally came back to get me early in the afternoon, which gave me plenty of time to write a few just-in-case draft emails, delete anything super embarrassing from my browser history, and compose a short will. While I knew that statistically this sort of surgery was pretty low-risk, I figured it was best to cover my bases. Massive internal hemorrhage does not equal disorderly conduct, after all. And let’s face it, I’d already managed to beat the statistics enough times in the past few months that I wasn’t too sure where the bad luck streak would end. I gave the hubby what I hoped was a fairly cheerful see-you-soon and was wheeled off to the other side of the hospital. I read all this stuff about people being nervous or frightened of operations, but honestly, I was just looking forward to general anesthesia with something approaching fervent zeal at that point. Blame it on a general fatalistic attitude towards life, or perhaps (more optimistically), on a decent amount of trust in the medical establishment. Surgeons were greeted happily (though it might have looked more like a grimace by that point) and I tried not to make too many displeased noises about being moved to the table. I remember remarking that it seemed the walls were the same particular shade of green in nearly every hospital I saw, and that it probably had something to do with color balancing the unavoidable amount of red they had to deal with. (Given that all these nice people were Finnish, they probably were just ignoring my babble at this point.) I apologetically explained that I would not be able to move any further or actually lie down (curled up in an upright ball was pretty much the position of least resistance for most of the day) without a bit of chemical aid. The anesthesiologist injected something lovely into my drip and a few seconds later, everything thankfully went blank.
And hey, wouldn’t you know it, waking up in recovery really DOES look like what they show on TV. You know, that part with the faces looming over you and everything being in bleary soft focus with wonky sound controls for a while. Also, you really are just out and then conscious again with no memory in between. Yay for induced comas. Everything was much less painful, though I was shivering like crazy from the ridiculous cold. (It really wasn’t that cold, but the combination of lower temps in surgery and blood loss just amplified things.) Another friendly blonde nurse (they seem to come by the dozen out here) tended my blankets and poked at various plastic tubes for a while until I was deemed stable enough to go back to my room. Fast forward through napping and waiting and napping some more. The doctor came by and explained about my stitches (laparoscopy, so minimally invasive with just a couple of smallish scars) and the drainage tube sticking out to the left of my belly button (slightly more visually disturbing). The hubby came by and explained that they’d removed 2 liters of blood from my abdomen along with the ruptured Fallopian tube, and had spent an hour or so more than they’d expected trying to clean everything up. No wonder it’d hurt so much, with all that sloshing around inside. The aches and twinges from moving around whilst healing were nothing in comparison.
Roughly calculating, I probably have about 5-5.5 liters in me on a normal basis, so a 36-40% loss in blood volume put me in class III hemorrhage territory well on the way to hypovolemic shock. The wonky blood pressure, general parchedness and looking like I’d slapped on makeup meant for a mime? Yep, that pretty much lined up with the symptoms I’d been having. Good to know. One symptom that I found particularly interesting, especially since I couldn’t find much on it through Google but could tell it was probably related to blood pressure, was that I could distinctly hear a thudding sound halfway between a timpani and a jackhammer in my ears for most of that day. It abated as the transfusions continued (I guess the heart has to work extra hard when there’s less to go around) but it was fascinating just how loud the sound was considering nobody else could hear it. I got three units of packed blood over the course of the day (well, at least that’s how many I counted. not sure about when I was out) and lost count of how many bags of Ringer’s I’d already gone through. Between the various cannulae being employed at any given time and the blood tests every few hours, I ended up with an impressive collection of needle puncture marks up both arms and hands. Hopefully they’ll all heal cleanly and I won’t have to be explaining away track marks to any future employers. Also, it somewhat amuses me that for at least the next couple of months, I’ll be walking around with a sizable percentage of Finnish blood in my system. I suppose this is only funny to those of us who come from less homogeneous cultures. I’ll repay the favor in a year or two, when I’m topped off again, with a stop at the Red Cross donation office. Hopefully they’ll be okay with my asthma medications, because I got turned away once before during a university donation drive due to my inhalers.
Fast forward through a couple days of assisted bathroom visits (awkward), lots of napping and really bad hospital food (the horror, the horror). Good grief, it really deserves the reputation it’s gotten, eh? I’ve seen better spreads in economy class airplanes and elementary school cafeterias. It was the one thing that my roommates and I could sympathize over without uttering a single word (at that point I was sharing with another youngish woman who I occasionally chatted with and an older lady who didn’t speak any English). I still have nightmares about the horrific plastic-tasting banana “pudding” from one of those lunches. The nurse who brought around our trays seemed disappointed by how little we were eating, but I really have to wonder if there was anybody who actually had the stomach to clean their trays. (And if so, they probably would have needed a hospital afterwards anyways.) Happily, the hubby showed up with a large bag of juice boxes (I developed an obsessive need for apple juice during the thirsty hours leading up to surgery, and had made him promise to bring tons of it when he next visited) and chocolate early on, so I had a stash to draw from for the remainder of my stay.
That’s pretty much it up until release. Oh, except for the evil nurse. There’s always one in the bunch, I swear. So by the end of the second night after surgery, I was able to hoist myself out of bed and shuffle a few yards unassisted. Feeling quite pleased with myself, I was getting back into bed when EvilNurse rushes over and shoves my shoulder down when I’m halfway in, nearly toppling me head-first into the pillows. This was followed by a stern lecture on the proper way to enter and exit the bed, delivered mostly in Finnish so somewhat lost on me. Both my roommate and I had this look of “OMG did that just happen?”. I never did really figure out what the correct procedures were, but I did learn to sneak in bathroom visits when she wasn’t around. They discharged me Tuesday afternoon, figuring I’d probably be more comfortable and more likely to eat at home. Two days after a laparoscopy is within the average, I think, and our living room couch is way more comfy than a bed with metal rails. The big bag of prescription meds I brought home with me took care of the rest.
And that’s pretty much that. For those that are wondering about the whole emotional side of losing pregnancy #2, I can say that while I’m disappointed by what happened, I’m not nearly as upset as I was the first time around. Maybe because it was more inevitable with the given conditions, maybe because I’d been more careful about not thinking too much about it until we could declare it viable, maybe because the hormonal influences were tempered by other physical and pharmaceutical factors. Maybe because I felt that I’d hurt enough this time without adding more to it. Whatever the case, I’m pretty much at peace with the whole thing. I’ll rest for a few months, then we’ll start thinking about trying again when everything’s healed up — there are still plenty of scenarios where things could work out well and I’ve chosen to focus on those rather than what could go wrong, since that’s stuff I don’t have much control over.
I guess I’m writing this all out the way I am for multiple reasons. Because, as I mentioned earlier, I owe several friends an explanation for my silence. Because I want to have some sort of record when I look back on it later. Because it’s hopefully a way to prove to some other people that I am of sound mind (the rest will catch up) and was so for the majority of the time, so they don’t have to worry. Better to explain thoroughly once and just have something to point to than repeat bits over and over again. Also, because I found comfort in reading the stories of other people who went through similar experiences on various forums online, so thought I’d return the favor.