I would like to take a minute to say thank you to everyone who has supported Chad and me over the past few months. Thank you for reaching out. Thank you for the love, the kind words, the hugs (both virtual and in person), the cards, the flowers & plants, and possibly my favorite, the margarita delivery.
It’s been a rough time for both of us, and while I can’t speak on Chad’s behalf, I can tell you about me.
I’ve had days where I couldn’t get out of bed.
Days where I watched Netflix through multiple “are you still watching” pop-ups.
Days where I wanted a stiff drink at 10am.
Days where I had that drink at 10am.
Days where I didn’t read or reply to any incoming messages.
Days where I had to force myself to make my orders—several pregnancy announcements and baby onesies.
Days where I hoped I could get through this, somehow.
Days where I thought I would be okay again.
So. Many. Days.
I had this grand plan to stick with the numbers theme, to post an update 41 days after finding out the bad news. That day would have been February 8th, the day after I turned 32, but also the day we found out we were FINALLY no longer “clinically pregnant”. You heard (okay, read) that right. It took FORTY TWO days, SIX FREAKING WEEKS for my body to finally be “normal” again. Like that’s even a thing. But I wasn’t ready, and I’m getting ahead of myself here, so let’s go back a bit.
On December 29th, on what would be 9 weeks + 3 days, we received the worst news we could have expected. That fun extra view of our little shrimpy baby turned out to be the end of that chapter. Or not, because nothing about this journey has been that easy so far.
Still waiting for the official word, I cried through one last PIO shot.
The next day, it was confirmed. Dr. Wu said we had options. Either come into OHSU that day and take some medications to help pass the “tissue” at home, over a few hours or days, or schedule a dilation and curettage (D&C) with Kaiser.
Why Kaiser? Well, during open enrollment, Chad and I had decided to switch insurance providers, from PPO to HMP, in hopes of saving some bucks during labor and delivery…well that sure didn’t work out, did it?
Dr. Wu recommended, because of the gestational size, that we go with the D&C. We were told that should also help speed things along, allow us to test the “tissue” for any genetic abnormalities, and try again.
This also meant OHSU couldn’t help us with the next steps, as they were now out of plan. We were stuck until business hours began again in the new year.
I spent the next few days in a fog, counting down to 8am Monday, and trying to put the fact that there was now “something dead” inside of me out of my mind. That wording came from another IVF “friend” … again. The last group of friends I would expect that kind of comment from, and it happened AGAIN.
Originally, during the first week of December, I had called and scheduled our first OB appointment for Monday January 4th via video chat, with an in-person appointment and ultrasound the next day. Instead, at 8am Monday morning, Chad sat with me while I called Kaiser to ask about cancelling my appointment, and instead scheduling a D&C. We were told a doctor would call us back. A few minutes later, we received a call from Dr. Dorius. She was sympathetic and informative. She took a brief history, asked some questions, and explained our options, in detail.
Option one: D&C with her, in office, where Chad could be in the room with me. I would have some local anesthetic, pain pills and some valium, but I would be awake and lucid for the procedure.
Option two: D&C with whoever was on that day, in day surgery/ambulatory care. Chad couldn’t come back with me, but I would be under anesthesia and unaware of what was happening.
I just needed this to be over, and I didn’t want to risk seeing the “tissue” after the process, so we chose Option #2. We received a call an hour or so later with an appointment time for Tuesday the 5th.
My pre-op instructions were different than others in the past. No food after midnight, but I could have clear liquids up until check-in at 10am, and the last thing they wanted me to drink was 16oz of full sugar Gatorade and take a massive dose of doxycycline to help prevent infections. Oh, and I needed to get a Covid swab ASAP, and they were available at the Cascade Park location.
I was given a 1:30 appointment. After arriving 15 minutes early, I ended up sitting in my car in the drive through testing line for almost 2 hours as we snaked around the building, and keeping some friends informed about the woman in the car in front of me being completely oblivious throughout this time.
Kaiser doesn’t use the same testing service as OHSU.
That meant we had less than 24 hours to get an Igenomix testing kit from OHSU so we could send the “tissue” out to try and get some answers. After some back and forth with my nurse, Dani, we were told they had ONE kit left, and we could pick it up on the way to Kaiser in the morning.
After a quick detour to OHSU, we got to Kaiser a little before 10, parked and sat in the car for a while, while I choked down my Gatorade (blech) and popped my doxy. We masked up and headed inside. Both of us were screened and temperature checked for Covid symptoms, and sent to the check-in desk about 10 feet away. She checked the paperwork and told us we were a little early, check-in time wasn’t scheduled until noon. *eye roll* Not a great first impression with a new healthcare system.
Did we want to sit in the car for 2 hours? Drive back home and have half an hour at home to turn around and come back? At this point, I was starting to feel SUPER sick. Was it all the sugar or the doxycycline? Some odd combination of both? I’ve taken it before as part of the IVF protocol, but always with food. We decided to go home so I could try to sleep it off with the kitties.
At noon, things went a little smoother. I was given a paper mask and sent downstairs. Chad would get phone updates, and I would keep my phone with me for entertainment until it was time to be rolled into the OR.
The nurses were friendly (I had 3 different pre-op nurses, including the supervisor at one point), I felt well taken care of, and there was some much-needed humor sprinkled throughout my 2 hour wait to go back at 2pm. I was visited by the anesthesiologists, who asked some questions, looked at my throat and all that jazz.
Dr. Traynor came and introduced himself, inquired about the Igenomix kit, and after my explanation of why we needed that particular kit, opened it to familiarize himself. The testing kit had some paperwork to fill out (including lots of OHSU info that Kaiser wouldn’t know), an instructional brochure (Dr. T said “I love a good book, but this isn’t one of them”), a specimen cup, a blood vial and a cheek swab. The instructions said to include either a maternal blood or saliva sample, but my nurse and Dr. T decided to give both. The kit appeared to be missing the parafilm (used to seal the specimen cup) so a search for some spare began. Finally it was time to get this over with.
The last time I was in an OR (and the only other time) was for my hysteroscopy and ERA, and I remember staring at the ceiling and getting asked if I felt anything because it seemed to take forever to go under. Not this time. All I remember being slid onto the table and then waking up in recovery…fine by me.
When I woke up, I was told that they would have to send the kit home with us to fill out the paperwork and then drop off at FedEx. I didn’t feel so great about this, so Chad assured me he would take care of it. What a guy 🤍
When we got home, Chad helped me upstairs and into bed and readied the kit while I filled out the paperwork. Curiosity got the better of me, and I looked while he was labeling the specimen cup. I’m happy to say, all I saw was pink tinged water, because I would have lost my shit if I had seen what I was expecting.
The next day I had several follow-up calls. One from a nurse. One from Dr. Traynor. One from Dr. Dorius and one from my OHSU nurse.
And then we waited. If our journey had a theme, that would be it. Wait, Wait Wait. Hurry up…and wait.
Eventually, we got the call. Our “tissue” was confirmed a genetically normal female embryo, which opened up a whole new can of worms. 85% of miscarriages are caused by an abnormal embryo…so what happened here?
The only changes we had made from the last good scan was stopping the dexamethasone—a steroid meant to help prevent the body from rejecting the embryo, but isn’t recommended late first trimester. The last day I took it was on December 18th, when the baby measured 7 weeks + 5 days. The final size was 8 weeks + 2 days. Dr. Wu mentioned it could be one of two things, or just a fluke. Do I have an autoimmune issue? A clotting disorder? Is there an underlying cause, or were we just being dealt more crappy cards in this shitty game of baby-makin’ poker?
Dr. Wu recommended we do some more testing:
First up, the Recurring Pregnancy Loss (RPL) panel. Technically I don’t qualify because we’ve only had one loss, but more info can’t hurt. This involved NINE vials of blood being drawn, and more waiting on results.
Second, another Saline Infused Sonogram (SIS). A catheter is inserted into the uterus, the balloon is inflated, and several syringes of saline solution are injected while an ultrasound is performed. This was my 3rd and wouldn’t you know, all three have been at different locations. I don’t remember the first two being so painful though.
Last, but certainly not least, another consult with the Maternal Fetal Medicine (MFM) doctor, aka Perinatology. I had one of these with Vancouver Clinic last Spring, but that was BEFORE the pregnancy and miscarriage, and we had new information after the RPL, and now they are outside of our plan anyway.
This brings us to results.
The RPL was MOSTLY normal. The only “flag” was on the Lupus Inhibitor Panel. “Consistent for Lupus Like Inhibitor affecting SCT arm. Repeat testing in 12 weeks is recommended to exclude a transient Lupus anticoagulant.”
With all of my medical knowledge (practically zero) I was left to consult Dr. Google. I know, I know, but I already did it *shrug*
My SIS was normal, no scarring from the D&C. I also did not swear, even though it hurt like a bleep, so go me.
My MFM consult was done via video chat. Dr. Brass asked some questions about my medical history and went over the results of the various tests. She then explained that even if I do test positive for this Lupus anticoagulation thing, I don’t technically meet the criteria for treatment, because you have to meet both clinical and lab requirements, and again, I’ve only had one miscarriage.
She went on to explain that because I’m in this grey area, she would err on the side of caution and have me on blood thinner injections after the first ultrasound confirms a viable pregnancy, since there wouldn’t be any harm. Studies show this can help with clotting issues in pregnancy, but only in cases that qualify, and I don’t really meet the qualifications. I’m TOTALLY okay with not having multiple miscarriages though, just to make that clear.
We talked about the dexamethasone not being recommended in late first trimester, and that in some studies it showed an outcome of cleft lip and palate. She recommended I defer to OHSU, and depending on their decision, stay on the lowest dose possible if they deem it necessary. She put in a referral for an echocardiogram, as well as orders for the repeat blood draw after May 11th.
….and we’re back to waiting.
P.S.
Medical terms suck.
I now have a “missed abortion” on my medical record.
Way to throw salt in the wound.
Everyone knows where it really belongs; on the rim of a margarita.