A Guide Through the Morass of Miscarriage

My husband, Paul, and I waited, for one reason and another, to start a family. We wanted to hit 30 before even thinking about baby-making time. And, when we got to 30, we thought, “Crap. We’re still a bit too young to start this nonsense.”

In the autumn of 2007, we started trying. And, just like that I was pregnant. This is not a story about how we struggled to conceive. This is a story of how we struggled to keep a pregnancy viable (to use a hated doctor term). I am apparently a Fertile Myrtle. I can get pregnant just by willing it to be so. Unfortunately, I can’t will a baby to stay inside.

Step One: Keep Mum

Like anyone who is newly pregnant, we were super excited about the entire thing. And, even though we weren’t that far along, we let slip the news to family and a few friends during the holidays. Big mistake. Rule number one: No matter how flipping happy you are, don’t blab until later. Because if something goes wrong, you have to tell everyone how you’re not pregnant. Then, you have to wade through all of their baleful, sympathetic looks. Eventually, you end up comforting them rather than the other way around. If you limit the number of people you tell, you also limit the stupid crap people say. Now, I had some friends who were amazing and said/did exactly the right things at the right times. I had other people in my life who just kept putting their foot in it. If I hadn’t been such a blabbermouth, I wouldn’t have had to find out who in my life was a colossal idiot and who wasn’t.

January 2008: First D&C

The year of hell begins with my miscarriage in the bathroom of Target on a Saturday. Yeah, it was that great. I called my doctor on Monday, and was scheduled for a D&C at the end of January. Since my miscarriage was bordering on the 10 week mark, my doctor suggested that I have one. You don’t necessarily have to have one if your pregnancy is miscarried early enough. You can let it go naturally—waiting for everything to pass through. But to me, that just seems like a horrible thing to do to someone. Better go in and get it done. (Of course, you have to weigh your personal risks and advice from your doctor. I’m just relaying what I was thinking at the time.) I had mine at Prentice Women’s Hospital (Northwestern Memorial’s ladies hospital), although you can have it done in a surgical center. It’s usually an outpatient procedure (which means you get to go home the same day). Let’s talk D&C, shall we?

D&C is short for dilation and curettage (basically enlarge and then scrape or suction). It’s best not to think about it. For this procedure, I was under that fun anesthesia where you’re not really out of it, but you’re not all together there. And, afterward, you’re really drowsy and hazy on the whole thing. But, if you’re a bit scared, this is how it goes (more or less depending on your doctor):

• My doctor’s office made all the arrangements for time and checking that my insurance would cover the procedure. They also sent over my medical record to the hospital and made sure my pre-admission forms were filled out.
• I get to the hospital with Paul. He gets to come in to the surgery prep area while I’m waiting for an OR, but then he waits in the surgery waiting room while I have the procedure.
• I get to wear a sexy gown with really fabulous socks and a hair cover.
• They hook me up to a saline IV and heart rate monitor. (HINT: Don’t wear dark nail polish as the monitors are sometimes fingertip varieties and the nail polish can cause issues.)
• Your doctor may or may not stop by (mine did every single time) to go over the risks and answer any last minute questions you might have.
• Then, they put me in a wheelchair and took me over to the OR. I got to meet the nurses and anesthesiologist in the room as well as have a second “calming down” convo with my doctor before they hooked me up to a few more monitors and set the IV drip to drowsy fun.
• The whole time, my doctor asked me if I felt this or what this feel like to make sure I wasn’t in any pain and to probably make sure nothing crazy was going on. The unfortunate part of this twilight anesthesia thing is that you can hear the vacuum sucking noise as tissue is removed. Again, it’s best not to dwell too much on this.
• Afterward, they strap on some of the biggest hospital-grade maxi pads and sent me over to recovery where I promptly fell asleep. I woke up to Paul reading in the corner and a nurse checking my bleeding. (Yup, it’s that much fun, folks.)
• I got my choice of snack items from the CNA. And, I must say that Prentice has some fine hot chocolate. It may have been a combination of the drugs and my empty stomach, but man was it good.
• Once I’m feeling less woozy, I get to go home. Where I promptly fell asleep again.

Now, for the next week or so, you have the worst period you’re ever going to have in your life. And, you can’t wear tampons or have sex (not that you’re feeling very randy at this point). But there is a huge not nice feeling going on in your nether regions. My procedure was scheduled for Thursday and I took Friday off of work. I felt well enough on Friday that I could have gone to work, but why push it?

And, then you can’t do the trying to get pregnant thing until you’ve had another period and gone to your doctor for a post-op check-up.

May and June 2008: Pregnant Again

Yes, that’s right. I waited for a month and half to get my period, and then hopped right back on that horse. At this point, I am hopefully optimistic as is Paul, but we aren’t planning to tell anyone. My sister and my best friend figure it out, but that’s it. Unfortunately, this time the ultrasound showed that the fetus hadn’t grown past eight weeks. I opted for another D&C so I could have genetic tests done to see if there was a pattern. (I didn’t really want to collect samples in my own home. Call me a sissy, but that’s just a bit too much to ask.) So, by the end of June, I was having my second D&C.

Genetics came back that there was an extra chromosome somewhere. Incompatible with life is the official term. But, my doctors assured me that it was random.

November 2008

You guessed it. I’m pregnant again. By now, I have absolutely no joy in this situation. I am not elated or giddy, just full of dread. I have blood work that comes back pregnant, but off. My first ultrasound shows the fetus’ heartbeat is irregular. I cannot see my regular doctor, but I get in to see another doctor in the practice. This woman, quite frankly, is the biggest douche bag I’ve ever met. She says to me, “Well, this one’s not going to make it. It’s up to you whether you want to have the D&C now or later.” Um, thanks for the hope, Doc, as well as the wonderful bedside manner.

I decided to wait, going in every week for three more weeks to have a vaginal ultrasound. Every week watching the heartbeat get more and more irregular until on the fourth week it just stopped. And, now I could have the D&C knowing that there really was nothing else that I could do.

This was the worst experience of the three. Due to scheduling, Dr. Douche had to perform the procedure. I was supposed to be first up in the morning, but she was late. So, I got two IV drips instead of one pre-surgery (which caused massive water retention and a strong desire to pee for the next day). She also decided midway through the procedure that I was too much of a hassle to deal with and put me completely under. This lead to me vomiting out the car window on southbound Lake Shore Drive as we drove home after recovery. Fabulous. Absolutely fabulous.

Genetics were done. It was different missing or extra chromosome this time. Incompatible with life, completely random. Merry Christmas! Of course, by now I was so old hat at this D&C thing, I actually went to work the next day. Yes, I am a corporate drudge.

Time to Start with the Specialists

After three miscarriages, you are officially deemed RPL (or recurrent pregnancy loss) and if you’re anything like me, you’re not too keen on seeing pregnant ladies walking around being all fabulously pregnant. I was just angry and bitter and didn’t want to talk to anyone about it. Chances are your regular doctor doesn’t treat RPL so you’re punted over to fertility doctor. Mine was amazing. I have nothing but lovely things to say about the people at Fertility Centers of Illinois. They took me by the hand and walked me through the steps.

After my initial consult with FCI, I went to get a second opinion at another hospital just to see if they had anything else to say. This doctor’s office was a bit inept and the doctor was rude. The technician who did my ultrasound must have been inexperienced. It was the most painful 30 minutes of my life (yes an entire half an hour for a vaginal ultrasound). Rule number two: Shop around for your specialist. If you don’t like the one you have, go someplace else. Even if it means a longer drive, or more difficult office hours, it is worth it. You may be spending a lot of time with these people.

You should have all of your medical records sent to the specialist. Better yet, get copies and bring them yourself. Make sure to include any genetic testing that you or your partner have had done. A quick note about medical records: If you see another specialist outside of your OB/GYN (like an endocrinologist, bring those files with you). The more information your doctor has, the better sense he/she can get of your current medical state.

Having said that, your doctor will probably want to do a bunch of his own tests. (From now on, I’m referring to the fertility specialist as him because mine was a man. A very nice, sweet man.) For me, this included a number of blood tests (vials and vials and vials of blood) plus weekly ultrasounds to track my inside during the course of one cycle. Paul had to have a few vials of blood taken as well as whack off into a cup. I think he got off a bit easy on that one.

Saline Sonogram: How Bad Is It Really?

One test that is regularly done (and much discussed on blogs) is the saline sonogram. You might hear it referred to as a saline ultrasound, a sonohysterogram, or a hysterosonogram. In layman’s terms it’s a test to see what’s going on inside your hoo-ha. It’s a vaginal ultrasound that involves the doctor and technician pumping your uterus full of saline using a thin flexible plastic tube. (The tube is inserted through the cervix into the uterus.) The ultrasound probe is rotated to look for abnormalities in your uterine walls and vaginal lining as well as fibroid or polyps.

The whole thing takes, at most, five minutes. Mine was pretty pain free, just oddly uncomfortable. (But when have you ever been comfortable during a pelvic exam?) Some women have said that their saline sonograms were the worst pain they’ve ever experienced. I’m not an expert (as I’ve only had one), but it seems if you have blocked fallopian tubes (because they jet the water through the tubes to look for blockages) or if your doctor doesn’t do too many of them, that it could cause pain. I popped a few Tylenol beforehand and was fine. The worst part for me was when the technician gave me a roll of paper towels and said, “Put this between your legs and stand up.” Whoosh. What goes up, must come down, I guess.

Again, I took the afternoon off of work after the procedure, but could have gone back to work. The only issue I had was the desire to go to the bathroom every 10 minutes.

Results

So, after months of tests and monitoring, what did we learn? Not a whole lot. Neither my husband nor I had any genetic predispositions that would cause the miscarriages. My uterus looked healthy. I had a few polyps but nothing out of the ordinary. My fertility doctor even proved that I didn’t have an endocrine condition for which I had earlier been diagnosed. Unfortunately, I fell into that 50% category of women that never figure out why they have RPL. Great, what do I do now?

Let’s Get a Little Alternative

Well, I had gone to a dermatologist for an unrelated issue (my hair is falling out and thinning like you wouldn’t believe). She found that I was seriously Vitamin D and iron deficient. I’m guessing it has something to do with the fact that I can’t do the dairy, but whatever. She put me on a shitload of extra vitamins for a while to get my levels back up. I also started going to see an acupuncturist specializing in miscarriage prevention. I did a spot of yoga when I thought about it and waited.

Meanwhile, my husband and I took a break from trying to figure out if we wanted to do IVF (still a crap shoot given our history) or if we wanted to spend the IVF cash on adoption. I was bummed at either option. I get really pissy when I see people neglect or abuse their children and I couldn’t even have one. And, here I had to pay a bazillion dollars to take a chance at getting pregnant or basically buy someone else’s child. It just didn’t seem fair.

That’s when we got pregnant again. When I was drinking and eating raw fish and not caring because I was convinced I would never have children. Was I happy when I found out? Honestly, no. Did I cry when my fertility doctor sent me back to my regular physician saying I now had a 95-98% chance of a regular pregnancy? Yes, I cried a little. When people ask me now how excited I am? I smile, and lie and say yes. But inside, I’m just waiting for something to go terribly wrong. We’re into month four and we haven’t discussed names or anything baby related. We’re just a bit too scared. I can’t tell you when this feeling will go away, but I hope soon. I don’t want to spend my pregnancy in fear that something bad will happen.