Monday, October 22, 2012

The whole story, part 1

I keep meaning to come post the full story of our loss, but it's overwhelming.  This morning, I'm back in my office for the first time, which is overwhelming in its own right.  So, heck, what better time to catch up.

I'm not sure where to rewind to.

I guess back to the anatomy scan.  Looking back, here are the things that should have concerned me.  And maybe they did, to some extent, but not in a way that would have ever led me to believe that the baby would die soon afterward.  First, I ate candy and drank a Dr. Pepper (neither typical for me) the morning of the ultrasound, to perk up the baby for a good show.  But the baby did not perk up.  He didn't move at all during the scan except for one slow arm wave.  Also, his weird, folded up position just seemed off to me.  And finally, looking at the ultrasound report after the fact, he was measuring 18w2d, when we were 19w.  Not a huge concern, except that he had never measured behind and none of the babies have ever measured behind-- they've all been 50%-ers.

Before the ultrasound I had (finally) started to fel some big movements/kicks.  I had eagerly awaited those kicks-- my favorite part of pregnancy-- and celebrated them.  I might have felt a few more in the weekend after the ultrasound.  I honestly don't remember.  But I know for sure by the Thursday after that (so, 19w6d), I was telling Rick that I hadn't felt movement and I was worried.  I tried laying on my stomach and would feel tiny little somethings, which I tried to tell myself was the baby.  But no more kicks.  I tried laying upside down (supported headstands), in case he was in a strange position.  I drank Sonic iced tea, which had sparked a big dance party in the week before the ultrasound.  But I still didn't get any big kicks. 

I spent another week listening to Rick and other people's reassurances that everything was ok.  "Your placenta must be anterior."  (It wasn't-- I'd asked specifically at an early ultrasound, and knew it was posterior.)  "The baby must be in a funny position."  (Possible.  But I'd tried so hard to move it.)  "This happens every time."  (Said by Rick, but not true.)

On Thursday morning (20w6d), I finally resolved to go get checked out and either end the paranoia or confirm that something was wrong.  I drove the midwives' office after the kids went to school and sat in the driveway, waiting for someone to show up.  The "someone" was Debra, and as she got out of her car, I told her "I'm sorry I don't have an appointment, but I need a heartbeat check."  She asked why and I explained I hadn't felt the baby move for about a week.  She took me inside and to an exam room right away.

She got the doppler and started checking for a heartbeat.  Nothing.  She went slowly, over every inch of my lower abdomen.  Still nothing.  She had someone go out to her car to get a different doppler.  Still nothing.  She said it was possible that the baby was in a funny position, but that it didn't look good.  She asked if I wanted an ultrasound with Dr. Berry and I said yes and asked her to call for me.  Dr. Berry did not have an appointment until 2.  She asked if I would call her when I found out anything and I said I would, which was also the first time I started crying.  I walked out and to my car, where I lost it and bawled on the way home.

I called N to tell her something was wrong with the baby.  I was crying so hard that she didn't understand everything I said, but I think she and Rick talked too.  She didn't tell M at first, since there wasn't anything to do but wait for more answers.  By about noon, they had told him and he called me, supportive and positive as always.  Rick was at work, but I called my mom to come over and she spent the day with me.  I texted my good friend, Eve, who agreed to meet me at Dr. Berry's office.  Having to wait until 2 did seem cruel, when the doppler had been at 8 in the morning.

At 2, I got to Dr. Berry's office and Eve came in just a couple of minutes later.  We talked about non-baby stuff, at my request.  Eventually, we were called back.  A sonographer (not the one we'd seen before) did the scan and confirmed that the baby had died-- there was no heartbeat.  I think she also told us that it looked like it had been a while (it's a bit of a blur here).  She left us with tissues.  I cried just a little bit.  I felt numb.  I giggled about her assuming Eve was my partner.  What's the right way to react?  How do you hold it together in the face of that kind of news?

Dr. Berry had been in surgery, so we had to wait for him to get back to the office to discuss next steps.  It took a long time.  30 minutes maybe?  an hour?  Gosh, I have no idea.  When he got there, he did another scan and said yes, it did look like the baby had been dead quite a while.  He seemed disbelieving that we had been there just 13 days before.  The baby was measuring smaller than he had at 19 weeks (17w6d, I think without looking), which is a natural part of decomposition, but made it clear that he had not grown at all since the ultrasound-- he must have died within no more than a few days of the "everything looks great" ultrasound.

Dr. Berry said our options for delivery were waiting for my body to go into labor naturally, which would likely take 2-3 weeks, or inducing.  Most people induce, since the wait is intolerable (and there are some risks to waiting).  I was glad he didn't suggest a D&E, which I knew was an option, but not one I wanted to take.  We agreed I would talk to Mary to figure out exactly what our plan was.

He also ordered a slate of lab tests (bloodwork), to rule-out some of the more common causes of late miscarriages-- clotting issues, infection, etc.  When I left his office, I went straight to the lab for the tests (all of which came out normal- to skip ahead).  Then I talked to Mary, who told me I had the option of inducing at home with Cytotec (misoprostol).  I was glad that was an option, since I didn't want to be admitted to the hospital and spend the night there.  That's what I decided to do.  Mary wanted to do more research, so she said she would get back to me with specifics.

I can't remember talking to M that night.  Maybe I did.  I had texted them from the appointment, to confirm the bad news, and I know Rick and M talked a couple of times.  I asked Rick to cancel our plans to go to Houston that weekend-- we'd long-planned to go to the Rice Centennial and stay with M and N.  M pushed us to reconsider and, with the girls and Rick pushing me to, I eventually did.

This whole time, I was still feeling very numb.  Sad, but not as sad as I would have expected.  I was doing things like being careful not to put my ipad on my belly (I never do if I'm pregnant, in case there's a risk to that) and waiting for movements, even though I knew it was over and I had a gin & tonic on my nightstand.  There was definitely a disconnect between the intellectual reality of what had happened and my emotional reaction to it.

By Friday, Mary finished her research and had Dr. Berry call in my prescriptions (misoprostol and vicodin).  Since we were going to Houston, we decided we would induce when we got back-- Sunday night or Monday morning.  Rick picked up the prescriptions, and I spent most of my day watching Law & Order SVU-- which is what I would end up doing for most of the day for the next week.  Rick picked up Mariela from school, we packed in a whirlwind, and then left to go pick up Andie and drive to Houston.  In lots of traffic.

The weekend was ok.  We spent some time at the Rice festivities, though I did not feel festive.  I laid around a lot.  I still felt mostly numb-- moreso than sad.  M and N were gracious hosts as always, despite their loss.  The kids all had fun together, which was a good distraction.  That and our Saturday night drama.  My girls took a shower and when Andie went to open the shower door, it shattered, filling the bathroom with tiny crumbles of glass and prompting blood-curdling screams.  Andie jumped out in her panic, cutting up her feet and causing a crime scene (blood everywhere).  But eventually, everything got cleaned up and everyone put to bed.  On Sunday, after a huge breakfast, we headed back to Austin.

I guess that's as good a place to end this chapter as any.  Up next: induction, delivery, emotions catch up.

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