Tuesday, August 16, 2011

Loss & Looking Forward {My Ectopic Pregnancy} Part I

I had gone back and forth trying to decide if I wanted to share my unique story. While I teetered toward keeping things private, ultimately I decided to share our experience of sadness, strength & blessings. While my situation is rare, I know there are other women out there searching for stories like mine. Ryan and I discussed how sharing the details of our loss may help others looking for personal accounts of ectopic pregnancies to find solace.
I have been so amazed and blessed with numerous emails, texts and messages of prayers and love. I appreciate everyone that has been there for us, and I wanted you to know the whole account of what has been going on. Again, I thank you so much for your kindness.

One thing I have decided is that I am good at rough times. Through my teenage and adult years, I have seen my fair share of struggles and pain, but with the help of my loved ones I have learned to chin up, stay positive, and always keep sight of my blessings.
I feel as though the experiences we go through as humans, no matter if they are happy, sad, painful, or joyous, are what makes us who we are.

This is an experience that will be with us forever.

{Please bear with me through the details - if womanly medical issues make you uncomfortable, feel free to skip this post. I will be sharing all the procedures that were involved in my situation.}

Let me rewind a bit. While a woman is pregnant, they have no menstrual cycle. It is a glorious hiatus in the monthly annoyance that we all experience as women. Then, if the baby is breastfed, some mothers will continue to not ovulate or have periods. The hormone Prolactin will continue to stay elevated, and your reproductive hormones stay low. This is called lactation amenorrhea. Through my pregnancy and until Dylan was 11 months old I had a nice long break. I had heard and read stories that the return of your period was different from a normal period. Many women experienced strong cramping and a very heavy flow but mine seemed normal, and I had no cramps. While somewhat disappointed that my period was back, I accepted its return and was happy that I had gone so long without it. From what I had read, it also was a sign my body had recuperated and was ready to make another baby once Ryan and I were ready to add to our family.

Fast forward a bit now. On July 5th, I had a short three day period. It came and went in a hurry and I didn't think much of it. Then on July 22nd I started again. How odd that it was back so quickly. This time I was moaning to Ryan about the cramps, and I was passing strange blood clots. I know this can be normal for some women, and since it only happened the first few days, I let it go. Then the cramps subsided, and just left me with light daily spotting. The strangest part was how long it lasted. One week passed by, then another. I wasn't too worried, but it went on long enough for me to point out to Ryan several times about how different this period was. Different things popped in my head, but I mostly convinced myself that this was my body getting back into the swing of having periods - it had been 20 months after all!

Tuesday, August 2nd, I started having mild cramps while continuing to spot. This period was just plain annoying. I popped a Tylenol and went about my fun with Dylan.

Wednesday, August 3rd, I woke up with cramps and a headache. Something felt very strange. Throughout my years as a young woman I had never really had to battle with cramps, so any time I get them I make a big deal out of it - they really are no fun! Ryan gave me a kiss and high hopes that my day would get better. Dylan and I shared a bowl of Cheerios and I drank a big glass of water - maybe I was dehydrated? A few hours passed and the pain got worse. Before I knew it, I could barely move I was in so much pain - I curled up in a ball on the bedroom floor while Dylan played around me. At first I thought I could just breathe through it and it would pass…then I started panicking that something would happen to me and no one would know, and Dylan would be alone and scared. I called Ryan trying to sound somewhat calm - he saw right through it and headed home. I insisted that it was just severe gas pains, but he said there was no way I was talking him out of taking me to the doctor.

He and Dylan dropped me off at a walk-in clinic by our house. We had been there just a month ago, both of us sick with sinusitis and laryngitis. The clinic was very busy, so a physician's assistant saw me. I told him about my pains and he immediately chalked it up to gas pains. He had mild concerns that it was appendicitis, so he sent me down to see the x-ray tech. I stretched out on the cold table while the tech took a few shots of my belly. Finally the PA came back with the results. He patted me on the knee and said "Yep, it's gas! Don't worry, we all need a little help in that department sometimes." He said the x-ray showed that I was "filled up with gas everywhere he could see." He scribbled down some OTC meds and sent me home. I sat in the lobby and waited for Ryan and Dylan to come back to get me. Ryan was dumbfounded that it was just gas and seemed very hesitant with the outcome. I didn't care - I just wanted to be home. The pain was getting worse every minute. I stood up when I saw the car outside the office, and I saw sparkles - I shut my eyes and steadied myself then slowly made my way to the car. The ride to Wal-Mart to get my medication was agonizing. Every bump, every turn, made me wince in pain. I held my breath to keep from crying - I didn't want to scare Dylan. Through gritted teeth I told Ryan that this was the worst pain I had ever felt in my life next to childbirth. We finally made it home and I crumbled onto the bed. The PA had recommended I get laxatives and suppositories. While both of those were the last possible thing I could imagine doing at that moment, Ryan insisted I try them; anything to get me feeling better. The next few hours were miserable to say the least. Neither of the medications did what they were supposed to, but the pain had somehow lessened - that was good enough for me. I put Dylan to bed and then did the same for myself.

Thursday, August 4th, we all woke up bright and early. I still felt awful, but it was manageable. I lay in bed with one groggy eye open, watching Dylan play with Ryan as he got ready for work. Ryan left and D and I went about our morning routines; share breakfast, play in the living room, listen to some music then nurse and morning nap. We woke up after an hour nap, and this time the pain was not manageable. I begged Dylan to stay in bed with me just a little longer. He sleepily nursed, but nursing a toddler is no easy feat. The usual adorable acrobat act that I love was now painful - I grimaced as he crawled on my belly. Every tiny touch was so painful. I crawled off the bed and got on all fours. I couldn't even stretch out to stand or walk without a terrible pain in my abdomen. A few new symptoms had shown up too, the scariest was that I could barely breathe when I lay down or rolled to my right side. I called Ryan and he was in an important meeting. I called my mom and told her about my abdomen. She talked to an OB doctor she trusts from her work, Dr. Gills. He had rattled off many different things that came to mind based on my symptoms, and when she called me back she named a few. The one that stuck out to me was possible miscarriage. She said it quietly and quickly as to not put emphasis on the scary prospect. In the beginning of this two week period it had crossed my mind - I told her about my bleeding, and she said she wanted to make me a gynecologist appointment with my OB, Dr. Howerton. We hung up and I hurried to the bathroom to take a pregnancy test. Sweet Dylan followed me, wondering what all the commotion was about. I peed, and waited, and there it was - positive. Just as the first time I saw those double lines, my hands began to shake. This time instead of Ryan by my side I had my sweet little boy, and worry had replaced my giddiness.

I called my mom and through a mix of excitement and wonder I told her the news. She was shocked and happy. She talked me though the possibilities both bad and good, then I hung up and waited for Ryan to call me. He and my mom had been talking through email all morning about my symptoms, and when he called her to see if she knew how I was feeling, all she told him was to call me immediately. I hesitantly told him the news and quietly muffled my crying as I shared with him that I thought I was having a miscarriage. He immediately canceled his second meeting and headed home. While I was still aching, my pain had again subsided by the time he got home. I called my OB to see if they could move my appointment to that afternoon, and they told me they had no ultrasound openings and Dr. Howerton insisted I head to the ER. We thought the nurse told us that simply because they couldn't get us in until Monday. We started calling nearby OB doctors trying to make an appointment. Doctor vs. ER is $30 vs. $200. Not one single office could get me in, and on top of that they all recommended the ER. Reality set in and we decided to go. Grandpa Smith showed up at a moment’s notice to take care of baby D. I called Dr. Gills, on the way and he went through all my symptoms with me as we pulled in the parking lot of St. John Broken Arrow. The moment I said “shortness of breath,” he told me to go inside. He quickly explained that symptom could possibly mean internal bleeding and pressure on my diaphragm. I thanked him for everything and we headed for the door. The brand new hospital was clean, friendly, and quick too! They got us in a room in no time, and an RN named Gary started asking questions and preparing me for the doctor.

They took my blood and put an IV catheter in my arm. I knew this meant to prepare for lots of tests. I took a urinalysis pregnancy test, and then they covered my belly and took x-rays of my chest. A friendly young man named Dr. Matloff introduced himself and told Ryan and I that I was definitely pregnant and my chest x-ray looked great. He was still concerned about my shortness of breath. I could barely breathe as he laid me down for my ultrasound. Ryan helped roll me to my left side every few minutes so I could catch a full breath. When I was newly pregnant with Dylan, I had many intrauterine ultrasounds - while not comfortable, they were absolutely tolerable. This ultrasound was different - it was unlike any I had experienced before. This time it was extremely painful. The notions kept stacking up, I knew something was wrong.
With a kind but solemn face, Dr. Matloff explained that he believed I was suffering from an ectopic pregnancy. An ectopic pregnancy is one that does not grow in the womb. In a normal pregnancy, the fertilized egg enters the uterus and settles into the uterine lining where it has plenty of room to divide and grow. About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb, and of these 98% occur in the Fallopian tubes. These are usually called "tubal pregnancies." Ryan and I were both shocked to hear the news. While the term wasn't completely foreign, I knew next to nothing of what that meant in terms of me - in terms of our baby. He explained that my HCG hormone levels were showing that I was pregnant, but there was no visible cell growth in my uterus. Therefore, he was concerned that the pregnancy was growing somewhere else in my body - he couldn't tell me where or why. He wanted us to see an OB doctor immediately, and he insisted I be taken by ambulance. Shocked by the dramatics, we said I would be fine in Ryan's truck. A serious look came across his face as he said "I need you to understand how serious this is." Ectopic pregnancies are 100% life threatening, and there was high risk for internal bleeding or blood clots. We agreed, and waited for the ambulance to arrive.

I finally got a break from the pain, just before the ambulance came to pick me up. They gave me a shot of morphine - my first of many throughout the weekend. In a numb and fuzzy state, I kissed Ryan and he assured me he would follow close behind - he would be there right when we arrived. He could tell I was getting more nervous.
Tony, a paramedic and driver of my chariot, kindly helped me onto the stretcher with his sweet partner. The partner, a young girl not much older than me, took care of me on the ride. She noticed my anxiousness and asked if she could calm me down with the oxygen tubes. I agreed, and I made small talk with her while I tried to keep my mind off the pain. She told me all about her exciting job, and quickly put me at ease. The ride was over before I knew it, and Ryan welcomed me off the ambulance as they wheeled me into St. Francis' ER.

Leaving the quiet new hospital and arriving in this one was quite a shock. Sick and injured patients dotted the hallway as we waited for my room to be cleaned. My mom appeared in the doorway and I was so happy to see her. She hugged me and assured me that everything would be okay. It was now 2:00 am, we had been waiting, testing, & waiting some more for nearly 8 hours now.

The three of us passed the time with stories and laughter, only the occasional twinge of pain to remind me why we were really there. Finally, what felt like hours later, we met Dr. Curry, the St. Francis ER doctor. She apologized to put me through it all again, but wanted to see the tests for herself. She ordered more blood work and another ultrasound. I cringed at the thought but welcomed moving things along. A sweet nurse named Janelle arrived to take me to radiology. She made jokes and we switched stories about our little boys as she wheeled me to my destination. She introduced me to the radiologist and told me she wouldn't leave my side. Nerves turned into tears, then quickly into sobs as we started the painful ultrasound. Janelle sat close and held my hand through every wince and cry. She wiped my tears and talked about the ocean and beautiful blue waters, doing her best to distract me. Finally after what seemed like an eternity, it was over. He squeezed my shoulder and told me how sorry he was. Janelle helped me clean up and took me back to my room. Ryan and mom looked shocked as I was wheeled in looking worn and bleary eyed. Janelle told me she would be back to visit and sent the nurse to give me more pain medication.

Dr. Curry was kind but honest. She agreed with my first prognosis. She believed I had an Ectopic pregnancy and clarified that my ultrasound showed mixed density liquid in my abdomen. She believed it could have been blood. She wanted my OB doctor to see me just as soon as possible. It was 4:00 in the morning, but she said it was important enough to wake her. I gave her doctor Howerton's information and she went to call immediately. A visit from the on-call doctor that represented her office would've been a few hours, so, Dr. Howerton kindly got up and headed my way.

Dr. Howerton was with me every bit of nine months when I was pregnant with Dylan, and got me through my long, tedious 22 hour labor without the C-section that the nurses told me I needed. Seeing her face was comforting to all three of us. She listened to and touched my abdomen, and gently scolded me for not coming to see her sooner. Then, while rattling off the information about possible ectopic, she threw us for a loop. She said that a healthy baby was still possible. My mouth dropped open and I looked at Ryan's confused face. She explained that I was only two weeks pregnant, therefore the baby was too tiny to be seen on an ultrasound. The fluid could have been both blood and liquid from a (common) ovarian cyst. She gave us all the possibilities and I clung to the tiny bit of hope. Dr. H. ordered several blood tests to monitor my HCG levels, and told me she would see me the following afternoon. Ryan and I had a moment of quiet, and for the first time we spoke of the "what if's" of adding a new life to our family. From the moment my pain had begun, it had been about me - but the reality was that I had a life growing inside of me! We discussed how completely off our plans for the future this timing was, but how wonderful it could be. The conversation ended with a kiss, hope, and prayers that it would work out.

Dr. Curry came in and wished me luck, said she would keep an eye out for my prognosis, and kindly had me admitted to the hospital so we could get comfortable.

As we arrived to the Labor & Delivery floor, we met a handful of amazing nurses; all of them attentive and eager to get me relaxed. I ordered a pump, as it had now been 12+ hours since I had fed Dylan. This was the longest Ryan and I had ever been from him. Sherry and Bob sent us a few pictures and updates of Dylan, who was now sound asleep in his crib.

My mom offered to stay the night and sent Ryan to sleep at her house. She and I tried to catch a few winks, but failed miserably. Between the nurse checks, phlebotomists drawing blood and needing pain meds, we were up to see the sunrise. I remember finally falling into a deep, comfortable sleep, only to be woken by a nurse whispering “how much do you weigh?” C’mon now! I about threw a shoe at her when she came back minutes later to ask how tall I was. Ryan appeared back in my room around 7:00, happy to have gotten a bit of sleep, but still exhausted. My Grandma came to visit looking worried but loving. I was happy to have her there with me.
The room went quiet when Dr. Howerton came in around noon to tell us what my tests had shown. She sat on my bed with me and tenderly squeezed my leg. She looked me in the eye and said “The tests confirm that this is an abnormal pregnancy.” I swallowed a lump of tears as Ryan put his arm around me. My mom quietly sniffled at the sadness of the news. She explained our options to us; without surgery she couldn’t tell exactly what had gone wrong or if it was indeed an ectopic pregnancy, but she could tell that I had fluid in my abdomen and that the baby was not surviving. The blood would be reabsorbed into my body. There was a shot that I could take called Methotrexate. The potent drug, usually used as a type of chemotherapy, would end my pregnancy. The only other option to my life threatening pregnancy was surgery. Ryan and I decided I would take the shot.
A nurse met me at the door with a wheelchair and took Ryan and I across the hospital to Dr. Howerton’s office. I was happy we didn’t have to travel far. Her office was closed when we arrived, but they opened the doors and led me to a room where I curled up on the table. The sweet nurse split the giant dose into two shots. One poke into each buttock left my hips burning – it was done. I hugged Dr. Howerton and thanked her for being there for me through everything.
Ryan took me home – finally, I got to see my baby. I wasn’t allowed to nurse Dylan for 72 hours. That was quite the challenge, but with help from all the family that surrounded us, and a bit of patience, we made it through it. We were all happy that I was on my path to recovery. I couldn’t believe all of this had turned out the way that it had! What an absolute whirlwind. I was thankful to be in good health and to be home with my family – we counted our blessings, knowing I was lucky in so many ways.

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Anna@Directions Not Included said...

I'm so very sorry for your loss and that you had to go through that experience. Lots of hugs and good wishes headed your way.

smithpeasinapod said...

Sweet Anna I appreciate your kindness so much.

Christine said...

Gosh I can't imagine how scary that must have been! You are so strong! Thank you for sharing your tough story, I'm sure it will help so many people! You're a rock!

theBlessedLife said...

TONI! I happened upon your blog once and check it every so often. My heart went out to you when I read the title! After reading your terrifying story(not terrifying to read, but terrifying to imagine being in your shoes) I am overly impressed with your courage and strength. I will be praying for your little family! God is good, so I know what he has in store for you will be magnificent!

smithpeasinapod said...

Thank you ladies so much for your kind words!
Courtney I had no idea you had a blog - so happy to be a new follower! You have no idea how important your prayers are to me - thank you dear. I believe you are right - I have faith for our future too!

Jessi Mayfield said...

Toni, you are truly good in tough situations. You told your story beautifully, though I know it must have been very hard to write. Thank you so much for sharing your experience. You truly are an inspiration. Love you, sweetie.

Meggie said...

Thank you for sharing Toni, my heart was mourning for you. I am glad God has blessed you with such a loving husband and momma to help you through such a hard and challenging time. You are a strong woman.

smithpeasinapod said...

Meggie I appreciate your empathy and prayers so much. Your words mean so much to me!