Friday, August 26, 2011

A Really Bad Movie

Last I wrote, we were due to go back for a fancypants ultrasound on Thursday to confirm ectopic or confirm something abnormal that was hiding in my uterus. Last I wrote, we were still stuck in the awful limbo of uncertainty and things were definitely not looking good. I was still holding out the tiniest amount of hope that this could all be a big mistake and we could still be the miracle story that I so desperately wanted to be. A lot has happened since last I wrote. I could probably write forever on everything that happened, the background, my feelings, etcetera, but I am fairly exhausted and feeling somewhere vascillating between completely numb and a complete hysterical disaster, so I am going to write about what happened since Tuesday the way that it has felt. Like I am watching a bad Lifetime movie where I am playing the part of Valerie Bertinelli playing the part of me, because shit this bizarre and bad can't really happen in real life.

Tuesday we got the call with my HCG beta from Monday. It was 1161. This is a number that would have had me doing cartwheels down the street had I not already seen that my uterus was empty. They were very concerned. A number that high should have yielded something visible and definitive if the pregnancy was in my uterus. The chances that it was elsewhere were much higher now. I was to come in Wednesday for the special ultrasound and we would meet with our doctor immediately after at the clinic. There was a sense of urgency that made me nervous, very very nervous. I was asked if I had any one sided pain or bleeding. I had neither. I felt better.

Tuesday evening I got up from sitting with Bryce and experienced sharp localized pain on my right side. I couldn't ignore it, but I didn't feel that it was severe or anything--I could breathe, talk, I didn't feel like passing out. I waited to call until Wednesday morning, figuring if it got worse I could always call the on call doctor and if it went away, well then it was obviously my brain playing tricks on me because I can't possibly have an ectopic pregnancy. That has been my fear all along. Since starting fertility treatment and learning it's more likely in my new demographic. But it's an irrational fear, because it is so rare, especially with IVF.

Wednesday morning I woke up and still had the pain. I was going to do some work and be productive about the house but quite frankly wasn't feeling up to it and spent most of the morning in bed, reading and watching TV and spending quality time with my phone. I called about the pain and was told that my doctor would definitely be there with us at the special ultrasound. I got up from bed to eat lunch and discovered that I was bleeding vaginally. I started to cry, because this was not good, and it added to the uncertainty. Was I bleeding because there was something abnormal in my uterus that was leaving me now? Or was I bleeding because of the pain I was still experiencing and I was facing the scary chemo drug therapy for an ectopic pregnancy? Either way, bleeding was not a good sign of a miracle.

We went in for the ultrasound and it was impressive--definitely a much higher-tech machine than I'd ever seen, anywhere. I got my first abdominal ultrasound for this pregnancy. It was my last. They saw nothing. Well, they saw my uterus with nothing in it. My doctor walked in as this first part was happening and said, "Hi, how are you guys doing?" and I said "Still empty." Sounds sad when I write it now but it was actually borderline hilarious at the time. They switched to transvaginal ultrasound, which is how they actually do all the follicle monitoring so I am most familiar with that obscene-looking magic wand of interior illumination. It really is like it is in the movies and TV shows. They talk about what they see that is normal, and as soon as they find something abnormal everyone is deathly quiet and the ultrasound tech won't answer any of your questions (like, "Um, what IS that???") with anything other than "that's concerning but I need to talk to my doctor first." This is where it was fabulous that our doctor was there. He explained that that ugly balloon-circle-fluid looking thing we saw was my ectopic pregnancy. Which was why the probing hurt like hell. I was officially entering the nightmare.

We had two options: try the methotrexate (I think I've been spelling it wrong), which would take at least 4 days to wait and see if it worked and then either get another dose or end up going in for emergency surgery, or go for the gusto and have the surgery. I liked that we were given a choice, but it really wasn't one. We had to do the surgery. We weren't willing to wait any more, and I was in pain, and it was apparently fairly sizable already, and the idea of nurses in hazmat suits injecting me with toxins that may or may not take care of the problem sounded horrible to me. Our doctor said that with surgery they could get a better idea of what was going on and also look for other possible issues such as endometriosis, and remove the tube. Because chances were the tube was defective anyway if it was sucking my baby up into it. And if it was defective it was possible that we could have the same problem in the future, so we were all about getting rid of it. I don't need tubes for IVF.

It was about 2:30 at this point and we had gone from being pregnant (my numbers were up to 1350) and uncertain about whether it would be viable or not just a day or two before to being pregnant and knowing without a shadow of a doubt that by the end of the day I would not be pregnant anymore. This is where I think I truly numbed up and decided that this was something happening to someone who looked an awful lot like me but wasn't. Because everything went super fast from here on out. My doctor and the adminstrators at our clinic got all the paperwork together and called the hospital and had us all set for surgery between 8-9 pm. I had eaten that stupid BLT with my tomatoes that I grew myself (proof that I actually can grow something correctly) around 1:00, so it limited where we could go and it made it much more possible that we'd get delayed. How was I supposed to know it would turn into such a whirlwind? The BLT was only one of my ill-timed mistakes. The other was that I had stopped taking my asthma medication the Monday we left for the Boston area last week, when I forgot it one day and our numbers went up. I of course, using all my intensive medical studies and experience as a doctor, chalked this up to Advair=bad for baby developing. By the way, this is totally not true. It was just a fluke but meant that I was going into surgery without my asthma under control. I felt fine but was a ticking time bomb. More on this later.

We got to the hospital at 5:30, got shuffled around due to some admitting issues between the surgery department and the emergency department, and ultimately ended up spending a lot of time in the emergency department, where we really were not supposed to be. They were very nice and rushed us through, but we were unable to avoid three very pregnant women who came in to deliver their babies, not remove them; a woman who was clearly a frequent visitor having a psychotic break; my having to tell the story that yes this was a diagnosed ectopic and yes this was my first pregnancy and yes this is certainly something to be very sorry about. When we got a bed at around 7:30ish it was on the other side of the curtain from a gentleman who had apparently shot his finger with a nail gun and they were in the midst of cauterizing it when we were shown to our gurney. That smelled nice. We had wonderful nurses who did the fastest blood draws and most painless IV insertion I've ever experienced, and who were very sympathetic to the horror of our situation. I finished The Book Thief despite the hubbub around us. Bryce tried to nap, unsuccessfully, but he did manage to remove the outer layer of his hand skin due to obsessive purelling. I had no idea that he was so uncomfortable in hospitals. The things you learn when you have to have surgery to remove your pregnancy.

We did get down to surgery by 10:40 and I was under by 11:00. We sat with pre-anesthesia and Bryce went white as they explained how they would calm me with drugs and then knock me out completely, then stuff a breathing tube down my throat and another tube down to empty my stomach and another tube up my urethra (ahhhh, the catheter). Luckily all tubes would come out while I was still out of it. The nurse anesthetist was very soothing and looked and sounded like the Drug Fairy. It was surreal. The drugs they gave me to "calm" me actually caused me to hallucinate and my knit blanket that was around my knees undulated like a stormy sea and freaked me out but also was weirdly meditative at the same time. I got lots of goodbye kisses from Bryce, especially after he freaked me the fuck out by telling me what a trouper I was and how scared shitless he would be if he were the one going in for surgery. That was nice, because he was genuinely proud of me, but then I was like, "oh shit, I am going under general anesthesia and this IS scary as hell." So lots of kisses and then crying as I realized that the body under the waving serpent sea blanket was pregnant going in and would be truly empty and not quite whole coming out, and that this really was a life-threatening situation and it was happening to ME. Thankfully I was out like a light shortly after that and I didn't have to think about it as though it was me for much longer. The one funny thing was that my doctor told me he caught Bryce in the hall and assured him I was in good hands, and Bryce told him to "Kick some ass in there." So my doctor said "So we're here to kick some ass!" Have I mentioned how much we love our doctor?

I came out of surgery minus my right tube, minus the mass of cells that would have been a baby had it not had a terrible sense of direction, and with the peace of mind of knowing that this was absolutely the right decision because it had already started bleeding and had we waited it would have been a very, very bad situation. They found endometriosis on my uterine ligaments, which was cleaned up. They inspected my left tube and found it physically fine. My uterus is physically fine, which is a relief. In all the bloodwork I did finally find out my bloodtype, which is O negative. Great because it is the universal donor, which is guilt-inducing because I cannot give blood (having donated buckets to my own cause through blood draws, I have learned that my veins are crappy. I did try to donate blood twice during college and was unsuccessful both times due to anemia and crappy veins. Sorry, blood centers. Not happening.) However, this whole negative thing meant that I had to have a Rhogam shot, because of the whole RH negative mother positive-father thing where I will create antibodies that seek to destroy my baby's blood the next time. So even though my baby didn't look like one at all and probably wasn't making its own blood cells, I got the shot anyway as a preventative measure for next time. Which was lucky and I am grateful, but it just seemed like one more thing to add to my oddities.

Oh, and the asthma thing. After they removed my intubation tubes and I was coming out of anesthesia, I had a whopper of an asthma attack due to my idiocy in stopping the Advair because I thought it was having some kind of impact on HCG levels. I had to be nebulized twice and I vaguely remember the sensation of drowning in the gunk in my lungs. I am still chesty and it does not feel good on my incisions or very sore belly to have a deep cough. I wonder if I am so sore because of all the deep coughing so soon after coming out of surgery. I just couldn't believe that I would have such an issue after coming out of such a bizarre surgery to begin with. I was monitored tightly for oxygen and had more adhesive and cords coming from me than I knew what to do with because they were making sure I was oxygenated. I also vaguely remember feeling like I needed to pee in the worst way either before or after the asthma attack. The nurses thought the sensation was because of the catheter, but that I probably had nothing in there, but I was insistent so they gave me a bedpan to lay on (no walking to the bathroom for me, apparently with the heavy narcotics and my breathing that was not a good idea). I can't pee lying down. Or I just didn't have to go. But I did apparently promptly fall asleep on top of the bedpan and snored super loudly, so they took it away.

I woke up at 3:45 and couldn't find my call button. So I said "helloooooo" for about 10 minutes until someone heard me, because I had no voice (thank you, tubes) and no lung capacity to make it louder, and plus I am a generally considerate person and I didn't want to wake anyone up. I did make it to the bathroom but then realized how sore and painful I was, and then I asked for my book. So sad. When Bryce left at 3:00 because he was exhausted and the nurses pretty much forced him to go to bed at home (I was not lucid anyway), he was going to leave my book but the nurses mistakenly told him I wouldn't be able to read it. I would be too loopy and tired and I would read the same page over and over again. There was TV in the room, I would be fine with that. Bryce thought that wasn't the case, but they were adamant and he had to go and so no book for me. I can tell you this--I wanted that damn book in the worst way possible. I am not a TV watcher. And nothing is on at 4 in the morning. And by 4:45 I could totally immerse myself in my book. It was so sad. Another weird thing--there was apparently a severe and dangerous electrical storm at 3 a.m. -- Bryce had to call the nurse to let them know he got home safely it was so bad. Really? All at the same time as everything else?

That pretty much brings us up to now. If you have made it this far I really appreciate your dedication, because this is a really long post. I am recovering and grateful that we have compassionate, talented medical professionals working with us. I am grateful for the family and friends that have flooded us with sympathy, empathy, offers of help, and hugs. I am very high on Percoset all the time because my pain levels are ridiculous even now. I think that this physical trauma is making it difficult to focus on anything but my physical recovery. Although as time passes it is becoming more clear that this was not something that happened to someone else. That it is me that was pregnant and then through a very rare but dangerous situation had to go through surgery to become not-pregnant. It is a lot to take. I have a lot of positives that have come out of this cycle and I will write about those separately. I am grateful for the things we have to look forward to. I am grateful that we are not out of this game. I am especially grateful that I have an amazing husband who is here for me and patient with me as I flit in and out of psychosis and depression and physical agony. He loves me so. But right now I am just kind of sitting in the physical pain and the slow emotional awakening to the fact that I have lost an awful lot in a very short and confusing period of time. I think I liked it better when I thought it was just a bad movie.

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