Monday, September 13, 2010

Ruptured Ectopic Pregnancy- Bloody hell, not again!

If it weren't for bad luck I'd have none at all.
Not true actually, I'm being a tad melodramatic there. I am actually pretty lucky. For the second time this year, I'm looking back over the previous week and thinking: "Geeze, I'm lucky to be alive!"
So it started with two pink lines on the pregnancy test. Well, actually, it started with a feeling. I just felt pregnant. I sensed all those little tells that there are when things are happening, and this lead me to take the test. Andrew was very excited right off the bat and I was was terrified. I could only think of all the things that went wrong last time. He said "It's a cautious yay. We will just do everything the doctor tells us and be very careful."
So I made an appointment to see the Obstetrician who did my surgery in April, after I lost the first baby. She had said to call her the second I got a positive home pregnancy test. I saw my GP as well, who sent me for test straight away; Blood work and an ultra sound. He put me at five weeks dating from my last period. I saw the Obstetrician went for the blood work a couple of days later. She said to me that at this point the was no reason to assume anything was wrong, and that the chances were 85% everything would be just fine. She would be in touch when she got the blood tests back, which would be before I went for the ultra sound.
So the blood test came back, and yes I was definitely pregnant. Three weeks pregnant.
But wait a minute, shouldn't I be at least five weeks?
We start counting from the first day of the last menstrual period. That was August first. I know for sure it was August first because it was my first day back at work after getting home from the cottage. I don't usually keep track, being so irregular, but this time I knew for sure. So I was worried. But the Obstetrician says , maybe you're not as far along as you think. She doesn't know if it's a good idea to get the ultra sound because at three weeks, nothing will be visible yet. She is worried that if they don't see anything it will really stress me out. I tell her I'm already really stressed out. And we come to the conclusion that, if I am five weeks and ectopic (which there is not really any reason to worry about) and the technician sees an ectopic pregnancy, she will tell me and send me right to the ER. But don't be worried if she doesn't see anything, cause three weeks really is too early. She wants me to redo the blood work on Monday to see where the levels of HCG are and make sure they are in line with where I should be. She leaves me with these words: "You know what to watch out for. You know what the warning signs are. If you have any of them go directly to the ER. But everything is probably just fine, so just try not to worry."
But, but, well, okay. I'll just see what the ultra sound shows.
The ultra sound was the next day. They are not supposed to tell you anything at all, (and there's good reason for that,) but, since the test was on Friday and the office wouldn't get the result until Monday, and given my history......She did tell me. She did tell me that she didn't see anything at all. But by five weeks, there should at least be a yolk sack, there should at least be something in there. But no, nothing at all there. Which is consistent with 3 weeks, which is be far too early to see anything thing. Well at least she doesn't see an ectopic pregnancy either. The technician said "I think you just came too early, come back in two weeks."
But I know, I know I'm five weeks.
And I was always afraid, from the moment I saw the two pink lines, I was afraid, but now I'm terrified. And she asks when did I have my blood work done? In her opinion I should have my levels tested again soon, and see how they are progressing, and that's what your doctor said? So go home and relax, enjoy your weekend and don't worry about it until Monday.
Andrew is waiting in the waiting room, and I tell him in the hall way on the way back to the elevator that there was nothing at all, not even a yolk sack, and I'm really really worried. And he says, but we're doing everything thing we should be doing, we getting everything checked out early and we're staying on top of everything. So try not to worry too much.
So we go home. I go and get Ben from daycare, and we have a bit of a difference of opinion, but such is life. We read some, play some, and just generally hang out together.
The I get this pain.
Just like last time.
I tell Andrew I'm not feeling well and I'm going to lay down for a bit. I'm really hoping that it's nothing and in a few moments it will turn out it was just gas.
The boys go to watch a video.
I rest for half an hour and don't feel any better.
Andrew says we should go to the ER but I don't want to.
He says it's better to be sure, it's better to go when it's not necessary than to not go when it is necessary. And I hear the last thing the Obstetrician said to me echoing in my mind " You know what to watch out for, you know what the warning signs are. If you have any of them go directly to the ER." And while I'm not in agony, this is exactly what it felt like at the beginning last time.
So I say to Andrew, okay, but eat dinner first because we could be there pretty late. He thinks I should eat too, but I can't, and I know this is another bad sign.
We leave Ben with my Mum, not saying much to her, because we haven't told her I'm pregnant, in case something were to go wrong. We just say I'm not feeling well.
We decide to go to the Scarborough Hospital, where I was taken last time.
While he is driving Andrew says "It's much better to go ourselves then wait until you're in agony and have to go in an ambulance." And I'm trying not to cry, I say "I think it's just psychosomatic because of what happened last time. We'll be there all night and then they will send us home saying I'm fine." And Andrew doesn't answer, and I think maybe he's not listening but then he says "Given your history they will say it's a good thing you came regardless of what they find."
He drops me in front of the ER doors and go to park the car.
I make my way over to the triage nurse and she asks me why I'm there, and it takes all the strength I have not to breakdown and burst into tears. I say "I have abdominal pain. I'm five weeks pregnant. I suffered a ruptured ectopic pregnancy in April. It felt like this." She asks me question which I don't remember and I answer her. A woman sticks her head into the room and she says "It WAS gauze!" and is holding a piece of gross looking gauze between her latex covered fingers. And my nurse says "That's what I told her! I said it really looks like gauze!" And they both think it is funny. I can see Andrew standing outside and he's glaring at these women, if looks could kill they would have burst into flames. And she says to me "Oh sorry, it's just this woman came in and she thought she has a growth in her mouth, and it turns out it was a piece of gauze, which is what I thought, but she insisted they hadn't put any gauze in there." I can appreciate that this must be funny to her and I lamely say "Oh, had some dental surgery did she?" And the nurses say "Yes, she did, and she must have just been really groggy when they put it in, she thought it was some kind of a growth!" She prints out a little red ER ID bracelet and snaps it on my wrist, she's putting a folder together. Someone walks by the window and she grabs him in and they have another little chuckle about the gauze. Then she sends me out to the waiting area.
I try to get comfortable but it's getting more and more difficult. The pain is getting worse. Andrew is outraged about the gauze and the laughing. I tell him not to worry, it's just a strange thing that happened for them this evening.
I don't know how long we are waiting but the waiting room is pretty empty, not many people there at all.
They call my name and I'm taken to RAZ again (Rapid assessment zone). This is where the paramedics left me last time. Last time I was in so much pain every breath hurt. This time, it hurts, but I can sit, I can stand, I can walk. It seems like ages before I'm seen, but it's not actually that long. She looks far too young. She's pale and has black hair, her name is Jennifer and she asks me why I'm there. It's harder and harder to keep calm, but I tell her, about the pains, and she's writing everything down. I tell her that I went for an ultra sound today and that there was nothing there. She says, "They are not supposed to give you the results." And I say I know. She asks where it was done, and says they are probably closed and she won't be able to get those results now. She says she'll be back soon.
Andrew leaves to go and call my Mum, see how Ben is doing.
Jennifer comes back asks how I'm doing. I tell her I'm really really scared. She tells me that we have a lot of tests to get through and it's going to take a long time to get to the bottom of this. She says "You've got to try to keep it together." I tell her I'll try.
Andrew comes back.
She wants to take blood samples but she can't find my veins.
She's tied off my arm and she poking and prodding but she can find it. She says she doesn't want to try and miss, so she's going to go and get someone else. She comes back with an RN who also has some trouble finding it too. She asks the other one where she tried, she says she hasn't.
They have both found the place where the blood was taken for the original blood work a few days ago. The RN wants to put a lock in "just in case". I know what that means, it means that she thinks that I will either be getting more blood drawn or need an IV, or other various injections. She pokes at the back of my hand. She manages to fill a tube and then says, "Ah, forget the lock here it's not working, I'll put it in your arm for now." And she puts it where the original blood work was taken. She fills up many long tubes and then leaves with them. A few moments later she comes back to make sure it's the right names on the tubes, because it was the other girl who stuck them on. A bottle in a bag has been left on the table. I'm pretty sure I'm supposed to pee in it, but no one has asked me to, so I don't.
We don't talk much.
I say to Andrew "This is all just in my head, I was so traumatized by what happened last time, I'm imagining that it's happening again. They'll come back and tell me it's all in my head and everything is fine." Andrew says "Yeah, I guess, probably." But he doesn't look at me.
After what seems like hours of "keeping it together" The ER doctor comes in and asks me some more questions, mostly about bleeding and shoulder pain, but this time there's no bleeding or shoulder pain. Then she says they are just waiting for the blood test, but that I will need to see the Gynecologist. She notices the bag with the bottle, she gives it to me and asks me to pee in it. Says she'll be back for it.
By now I am bleeding.
I didn't bleed at all last time.
Andrew goes to tell someone.
It's getting later and later eventually the gynecologist comes, and he say it could be one of three things, ectopic pregnancy, appendicitis, or a ruptured ovarian cyst. He says,he has to make a judgement call on how to proceed at this point because He doesn't have any conclusive evidence. There is an ultra sound machine that could detect an ectopic pregnancy, or ruptured cyst but the technician who knows how to use it has gone home for the night and won't be back until 8am. If he does surgery to rule out ectopic and it's a ruptured cyst then it will end the pregnancy. If it is an burst ovarian cyst it should get better on it's own, however if it's ectopic and it ruptures, I could die. He tells me "I have to make a judgement call here and I really don't know what to do."
Andrew is silent.
They are both looking at me.
I know I'm bleeding, and the pain is getting worse.
I say "If there's a chance for this baby I want to take it even if it's only one percent. I really really want to keep this baby." He looks and Andrew, and Andrew nods. The doctor says "Okay, that makes my decision much easier. We'll get you admitted. You'll go upstairs as soon as there is a bed for you. Do you want some morphine and some gravol for the pain and nausea?" I say "Uhhhhhhh." He says "It's completely safe during pregnancy." So I say yes. He leaves and things seem to happen pretty quickly after that.
Someone comes to ask me about medical coverage and I'm told I'll be going to a ward room.
When I'm all settled in up stairs in a room on a bed, Andrew leaves, says he'll be back at eight am.
My night passes in a painful anxious haze. Even through the drugs the pain is getting worse. People come and go, take my blood pressure, temperature, and check my pulse. I keep asking them if it's morning yet. More morphine and finally the sun rises. The Gynecologist comes back and says he's going home. I'm going have the ultra sound as soon as the technician gets there and a different doctor will decide how to proceed.
The rest is just waiting.
Andrew comes back. He looks tired.
And we wait.
Finally I go down for the ultra sound.
It gets sent to the doctor.
I go back up stairs and there's more and more waiting.
We don't talk much, just hold hands. His hand is warm and comforting.
Andrew says he's going to go for a coffee. I can tell the waiting is getting to him.
While he's gone the doctor comes.
The doctor is a lady and she says that the pregnancy is ectopic in the right tube and it has ruptured. There is blood in my abdominal cavity. I am on the list for the next surgery and I will go in as soon as possible, I am next in line unless an emergency comes in a I get bumped.
I don't say much. I listen to everything she has to say.
She finally leaves and I'm through keeping it together.
I knew that something was wrong, because somethings you just know. Pain like that isn't normal or healthy.
I can't stop crying.
It feels like forever until Andrew comes back. He has his coffee in hand.
I can only shake my head.
I'm just crying and crying. He asks what's wrong but he knows. He forces me to say it anyways.
And he's holding me and we are both crying.
The moment stretches out into a lifetime, the life time of the second baby I am losing this year. For these few moments, it's still alive and within me. But the moments don't last long enough.
I say: "It's just not meant to be."
Andrew says: "At least this time I'm not worried about losing you too."
I say: "I want to see Ben."
And Andrew goes to try and find out how much time we have and figure out if he can go and get Ben in time.
First the nurse says I'm going right now, get ready they are getting everything ready. So we say oh well so much for that.
She comes back a few moments later and says I've been bumped and I won't be going for at least four hours. So Andrew leaves right away.
The nurse comes back after twenty minutes and says I've not been bumped after all. Has my husband gone to get my son already? Do I want to go now? I say I want to go, because I just want it over with. She goes to set everything in monition.
Twenty minutes later Ben walks in with my Mum, and I say "You're just in time to see me! I'm leaving right now!" And behind him they wheel in the bed. There is time for a few quick cuddles and we all go down the hallway together and get into the elevator. Ben asks about my IV. He asks me why the bed is so big. He asks me if it hurts. He says he hopes that they can help me feel better. I tell him that I love him and I'll be home as soon as I can but probably not until tomorrow.
I go through the door and down a long hallway.
Andrew leaves to take them home. He'll come straight back and see me in recovery.
The wait in the operating room is very hard.
Last time I was in screaming pain and everything was happening so fast, they put me under right away, I was just screaming and screaming. This time I'm just crying. I can hear the clinking of the instruments they are getting out and I wonder why it's taking so long. I can help but remember a program I heard about people who aren't affected by anesthetic.
Finally they put me under.
The next thing I know It's all over an I'm in recovery.
They take me upstairs and Andrew is there waiting.
He says I look good. Much better than last time.
We are back in my room. He holds my hand. I drift in and out a lot. Around 9pm he has to go home. Says he'll be back first thing in the morning to take me home.
The night is long and hard.
I'm lonely and drugged.
I'm hallucinating and it hurts.
The worst is over, physically I'm out of danger.
The rest, what's left, it's all emotional.
It's still hard to think about.
They say no, in no uncertain terms there will be no pregnancies. The "good" tube is gone, and the other one is full of scar tissue. The doctor said it was not viable.
All I can do now is look to the child I already have.
And be grateful and thankful for my husband, who loves me so much and has stood beside me through this hard time. I know it's not easy for him either.
I have to keep reminding myself, it could be much much worse. I could have no children at all. And for the second time this year, I could very easily have just died.
But as long as I am alive, and I have this one beautiful amazing boy, and this wonderful husband, plus the rest of my family, I will try to remember my blessings and concentrate on what I do have. Doesn't mean I'm not mourning what I lost, that I'm not totally and utter devastated. I am. But I also know that my heart still has the capacity for joy and happiness and that things won't be this sad forever.

So there it is.

1 comment:

Rosemary Cottage said...

Oh darling girl, you know I don't really do all that crying stuff but I really am in tears reading this.

You are so brave and amazing, to go through all this twice and still be able to count your blessings at the end of it. Very strong.


I'm so sorry. It just isn't fair. But I am glad you got there quickly and they were able to look after you.