No More Baby

***Warning!  May not be for the faint of heart.***

My third beta was scheduled for today.  I woke up early this morning to take my mom and sister to the airport by 7:00 a.m. and then headed to the lab.  Right before I left my house, I inserted my morning MVP and noticed a slight amount of red blood on the applicator after I removed it.  Given my bleeding experience last week which still resulted in more than doubling HCG levels, I tried not to be too concerned especially since I was going to be at the clinic in less than an hour for bloodwork anyway.  I dropped mom and sis off at the airport and made my way to the clinic.  The clinic is located downtown in the midst of a large medical and university campus and it is a bit of a walk from the closest parking garage to the office itself.  While I was walking there, I felt a substantial warm gush and just knew I was bleeding.  I made it to the clinic receptionist to check-in for the bloodwork, but asked to see a nurse first since I had started bleeding again.  My favorite nurse greeted me with empathy, suggested I have the bloodwork done first and that they would call me as soon as it came in.  She gave me the standard instructions ("if you start bleeding heavily or feel sharp pains, yadda yadda, call us right away").  I had my blood drawn and was heading back home by 7:30 a.m.  (extremely thankful that today was my day off and I would be able to come home and just lay on the couch without having to call in sick).

I was home by 8:00 a.m.  I changed into my comfy sweats and went to the bathroom (warning, TMI ahead) and that is when I felt the first chunk of something pass.  I couldn't bear to flush the toilet full of blood.  I called my husband, who was already at work, in a panic and he immediately came home.  I never felt large clots passing with my other two miscarriages - they were both just like longer and heavier periods with lots of cramping and dark red blood.  So then I thought, maybe it was the MVP I had just inserted less than 2 hours before that came out.  But about an hour later, I went to the bathroom again and felt two large clots pass that time.  I was still bleeding bright red, but otherwise felt okay.  No cramping, no nausea, not dizzy.  My husband wanted me to call the clinic back, but I, probably foolishly, said no and that I would wait until the nurse called with my beta results and then let her know what had been going on since I was home.  Well, that wasn't a good plan.  Next thing I know it, I bled to the point where it soaked through my thick maxi-pad, through my underwear and favorite sweatpants and right onto our couch.   I ran up to the bathroom, sat on the toilet and passed 3-4 more large clots.  I thought for sure the baby was in the toilet.  Heeding my husband's earlier suggestion, I yelled to him to call the RE's office.  He did and they told us to come right away.  I put a new thick, maxi-pad and a pair of old jeans on and we were on our way. 

The walk from the garage to the office was not fun.  Half way there I could feel another large clot coming out.  They were expecting us when we got there.  I told them I needed to use the bathroom and then the nurse's had a quiet conversation on whether or not they would want/need to see whatever I deposited in the toilet.  The consensus was no, because it was early, 5w5d, and they suspected that whatever it was apparently wouldn't be worth viewing.  In the bathroom, I passed another large clot and discovered that I had bled through the maxi-pad I had put on less than 30 minutes earlier.  After I used the bathroom, I was taken to an exam/ultrasound room.  My vitals were taken and the doctor quickly came in.  He seemed to be shocked by the amount of my bleeding and the clots.  He said that he was glad that we came in and that if I had waited much longer, I would have probably needed an ambulance.  To my surprise, the vag cam revealed that the sac was still there, but it was not attached to the uterine wall any more and was making its way down and out.  Because the bleeding was significant, we were given two options: (1) transfer me for surgery under anesthesia, which could take 1-2 hours before it would begin, with the possibility of passing the sac on my own before we got there; or (2) do a suction curettage, an outpatient procedure, right there in the office which should stop the bleeding within 15-20 minutes assuming no other complications.  We opted for the second choice.  I wanted it to be over sooner and I knew the sac was still there and if they got it all out then they might be able to test the tissue.

Of course, the RE had to discuss the risks with us and I had to sign a consent form (although I know this is standard procedure, I wonder if the RE was also remembering that my husband and I are both attorneys).  Two nurses and a medical fellow came in to assist the RE.  They numbed my cervix, waited a few minutes and then inserted a small vacuum to remove the sac.  The fellow was controlling the abdominal ultrasound to help the RE guide the vacuum.  There was some cramping, but it wasn't as bad as the HSG I had done.  And just when I thought it was over, I heard the RE say something about still being concerned by the bleeding and that he needed to make "a second pass" to make sure most of the tissue was gone.  I think that part of the reason he did that was in the hopes of retrieving more tissue so that there would be enough for pathology to try to test.  Before the procedure started, he never mentioned the possibility of needing to make a second pass.  I cried and I laughed throughout the procedure.  I wasn't really in control of my emotional reactions.  It all seemed to happen so fast.  Somewhere in the midst of all this, I heard them reviewing my HCG levels.  They were at 10,956 today.

After the procedure was done, I stayed in the room to rest for a bit with my husband.  I was given wash cloths to clean myself up.  After awhile, I got dressed.  The RE came in to talk with us for a bit and gave me a prescription for an antibiotic and explained the risk of a potential infection.  Unless I experience anything out of the ordinary, I go back in two weeks for bloodwork again to make sure my HCG is dropping.  The pathology and genetic tests may or may not work and we won't get results for at least a month.  We are now back home, possibly in need of a new couch.  Just flipped the cushion over for now.

This is miscarriage #3 so I can officially be diagnosed with recurrent pregnancy loss (RPL).  It's completely boggling to me how RPL is not a diagnosis after two pregnancy losses with no live births ever, but who am I to say?

What I do know is, I have an absolutley AMAZING husband.  This is so hard for him, too, in so many ways.  He's grieving our losses and was very scared for my well-being today.  But through everything today, he remained strong and calm and loving and supportive . . . like he always is.  He's shared the news with our family members because I just couldn't do it.  He called our friend to cancel the plans we had with him tonight.  He bought me a big ass Diet Coke from Mickey D's (something I have been denying myself from the moment we found out I was pregnant).  I truly have no idea what I would do without him.  And I truly hope that one day I will be able to give him the family we both desperately want.