The day started out ok even though the flu was kicking my butt. I had breakfast at Bread Co with my former coworker, MS. She gave me a beautiful snow globe with Greyson's name engraved on it.
Throughout the course of the day I spiraled down, down, down. Emotionally and physically. Emotionally, I'm very close to wishing I wasn't even on this earth right now. Physically, I'm miserable.
Second follow up with Dr. H today but it's not even worth recounting my questions or his answers. It's all still the same. We don't know what causes this or if it could happen again. Again, he said something about it being fortunate that this doesn't happen very often and again I said it wasn't fortunate for me. I really tried to push him to give me real answers. I cried multiple times and was terse with him. It was a bad scene.
I think he could sense how much I was searching and dissatisfied with his answers, he encouraged me to take my information back to Dr. AA or to a high risk OB and ask them all my questions. I tried to get a definitive answer out of him about trying again. He said I had to decide if emotionally I could handle another loss but that physically he was comfortable recommending trying again.
And he did give me something for this flu. Speaking of which...I have to throw up now.
Showing posts with label stillbirth. Show all posts
Showing posts with label stillbirth. Show all posts
Monday, January 17, 2011
Monday, January 3, 2011
Fractured Thoughts
First day back to school after vacation. Brutal. I wasn't 30 minutes in the door before someone else announced their pregnancy. I spent lunch crying in my classroom. All the people wishing me happy new year and asking how my break was. Acting surprised when I just say that I survived it. They've already forgotten.
I visited the grave site on the way home. It's the first time I've been there since the Yas took me the day after the funeral. The fresh turned ground over his grave was sunken into the hole. It didn't really look like that much dirt was covering him. I had the thought that I should dig him up and take him home so he could be where he belongs. With me.
I glad he's buried with my grandparents but I really regret having him buried there now. It's so difficult to get there on that steep hill. I nearly fell on the way down there. I know the logistics will keep me from going there as often as I want to or need to. And I'm having trouble with the drive to and from work. My usual route takes me right past the cemetery. So if I take my usual route, I want to stop and visit or get upset if I drive past, if I take an alternate route, I can only think about why I'm going a different way. Plus, I'm not sure where I'll be buried and I should be with Greyson after I die. I wish I'd been capable of thinking about these things when I had to make this choice.
Now the drywall finishing guy is here and will be until 9 or 10. So I can't really go to bed and cry.
I HATE MY LIFE.
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Aunt L, who is a nurse, came by last night and read through all the autopsy and pathology reports with me and listened while I talked on and on about the doctor, the support group leader and what happened. She was very loving about it and I know she told me the truth. She said that the 6cm clot formed after the placenta tore away. It was my body's way of trying to heal from the tearing. The clot was not on the ultrasound because it formed after the abruption.
I did not tell her the secret I've been keeping. I know what caused the abruption and my baby to die. It is something I did. I wish I hadn't done it.
She was mad that the busybody support group leader said all that about Dr. H. She works in a pediatrician's office and said they get alot of Dr. H's babies and she's never heard a complaint about him and that she's never heard of a doctor spending an hour with a patient like that. My mind is my worst enemy. After she left, I thought, of course they haven't heard a complaint at the pediatrician's office, those people have living children.
Mom told me that she and Aunt L talked today and spoke of how well I'm doing and how much I've accomplished since the stillbirth. I don't know. Sometimes I do think I'm functioning ok and getting over it awfully quickly. Shouldn't I still be crying heart wrenching sobs like I did for most of the first week? My baby boy is dead! How can I get over that or even act like I am? Sometimes I start to cry and then stop myself, thinking oh well, it's in the past, nothing I can do can change it now. Sometimes when I cry I realize it's not about the baby but about me and feeling sorry for myself and wondering what's going to become of me. Sometimes I have a thought about trying again, and I think, your baby is barely cold in the ground, stop thinking about that.
I've experienced this before on a much less traumatic scale. Getting over bad breakups, thinking I'm over them fairly quickly and then later it hits me full force and as a result it actually takes me much longer to move on. It's like I fool myself into believing I'm ok and everything is fine.
I'm not really fine.
I'm not really strong.
On the topic of strength:
I'm NOT strong, or brave, or courageous. People have their opinion, of course, but I sort of wish they'd stop saying that. My body wasn't strong enough to keep my baby safe and I'm still not sure my soul can survive life without him. Strong people don't have crazy thoughts about digging up their dead babies or obsess the way I do about what happened. The only reason I'm still physically alive is because I'm half dead on the inside not because of any type of bravery.
Really fractured....am I getting over it too quickly or not strong enough to survive. I wish I could turn my brain off.
I visited the grave site on the way home. It's the first time I've been there since the Yas took me the day after the funeral. The fresh turned ground over his grave was sunken into the hole. It didn't really look like that much dirt was covering him. I had the thought that I should dig him up and take him home so he could be where he belongs. With me.
I glad he's buried with my grandparents but I really regret having him buried there now. It's so difficult to get there on that steep hill. I nearly fell on the way down there. I know the logistics will keep me from going there as often as I want to or need to. And I'm having trouble with the drive to and from work. My usual route takes me right past the cemetery. So if I take my usual route, I want to stop and visit or get upset if I drive past, if I take an alternate route, I can only think about why I'm going a different way. Plus, I'm not sure where I'll be buried and I should be with Greyson after I die. I wish I'd been capable of thinking about these things when I had to make this choice.
Now the drywall finishing guy is here and will be until 9 or 10. So I can't really go to bed and cry.
I HATE MY LIFE.
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Aunt L, who is a nurse, came by last night and read through all the autopsy and pathology reports with me and listened while I talked on and on about the doctor, the support group leader and what happened. She was very loving about it and I know she told me the truth. She said that the 6cm clot formed after the placenta tore away. It was my body's way of trying to heal from the tearing. The clot was not on the ultrasound because it formed after the abruption.
I did not tell her the secret I've been keeping. I know what caused the abruption and my baby to die. It is something I did. I wish I hadn't done it.
She was mad that the busybody support group leader said all that about Dr. H. She works in a pediatrician's office and said they get alot of Dr. H's babies and she's never heard a complaint about him and that she's never heard of a doctor spending an hour with a patient like that. My mind is my worst enemy. After she left, I thought, of course they haven't heard a complaint at the pediatrician's office, those people have living children.
Mom told me that she and Aunt L talked today and spoke of how well I'm doing and how much I've accomplished since the stillbirth. I don't know. Sometimes I do think I'm functioning ok and getting over it awfully quickly. Shouldn't I still be crying heart wrenching sobs like I did for most of the first week? My baby boy is dead! How can I get over that or even act like I am? Sometimes I start to cry and then stop myself, thinking oh well, it's in the past, nothing I can do can change it now. Sometimes when I cry I realize it's not about the baby but about me and feeling sorry for myself and wondering what's going to become of me. Sometimes I have a thought about trying again, and I think, your baby is barely cold in the ground, stop thinking about that.
I've experienced this before on a much less traumatic scale. Getting over bad breakups, thinking I'm over them fairly quickly and then later it hits me full force and as a result it actually takes me much longer to move on. It's like I fool myself into believing I'm ok and everything is fine.
I'm not really fine.
I'm not really strong.
On the topic of strength:
I'm NOT strong, or brave, or courageous. People have their opinion, of course, but I sort of wish they'd stop saying that. My body wasn't strong enough to keep my baby safe and I'm still not sure my soul can survive life without him. Strong people don't have crazy thoughts about digging up their dead babies or obsess the way I do about what happened. The only reason I'm still physically alive is because I'm half dead on the inside not because of any type of bravery.
Really fractured....am I getting over it too quickly or not strong enough to survive. I wish I could turn my brain off.
Friday, December 31, 2010
My Big Little Guy
In my wildest dreams, I never thought that one of the last things I would do in 2010 would be to read autopsy and pathology reports on my son. It feels wrong in the very deepest level of my being. How can this have happened? How could my beautiful pregnancy have ended this way? Why is my beloved baby boy dead? Why am I still here on earth without him? No matter how long I think about these things or how hard I try, there is no answer. I will never understand.
There was one thing in the autopsy that made me smile:
"Appropriate for gestational age.
1. Weight: 319 grams (normal expected 174-452 grams)
2. Crown-Heel Length: 27 cm (normal expected 22.6-27.2 cm)
3. Crown-Rump Length: 19 cm (normal expected 16.0-20.0 cm)
4. Head Circumference: 16.5 cm
5. Foot Length: 3.4 cm (normal expected 2.7-3.9 cm)"
My boy was big and tall! He would have been a big, little guy.
Below this was the placenta pathology. It said: "Large blood clot, 6 cm in largest dimension, adherent to maternal surface."
6cm! I was appalled when I read that. This seems huge. I actually got out a ruler and looked at this measurement. That thing must have been about the size of a baseball. I was angry. How was something that large not seen on the ultrasound two days before? It seems impossible that something that large could grow in the short amount of time between the ultrasound on Thursday and the abruption on Saturday.
I have, the support group leader, Robin's words ringing in my ears. I spoke to her the day after the support group and I asked her more about her thoughts on Dr. H. She's a labor and delivery nurse and works with Dr. H regularly. She said she wasn't sure he was a liar really but that he had so many patients and always seemed in a hurry and maybe cut some corners. I couldn't get that phrase out of my head today. "cut some corners"
I was so alarmed and upset that I called Robin back today and told her about this 6cm clot. I also emailed my aunt, who is a nurse. They both said the same thing. A clot this large really could grow in a very short amount of time. My aunt said it could have been formed in minutes. My aunt said there is no way to know which happened first. The abruption causing the clot, or the clot formed first and caused the placenta to start separating. Robin said that even a full term baby would have struggled to survive this even if it happened in the hospital and was delivered immediately since the placenta tearing away would have taken the baby's oxygen supply.
I told Robin that her words were nagging at me. She apologized and said she should not have said that. That Dr. H. was a good doctor. That his medicine is solid but that she did think he rushed sometimes. She assured me that if he had seen something on the ultrasound he definitely would have done something. I wonder if she said that just to ease my mind. I doubt what everyone says now.
I know I'm desperately looking for some answers and probably seeing trouble where there is none. Could he have rushed through looking at our ultrasound and missed something? This thought haunts me.
I want to believe Dr. H is a good doctor and that there wasn't a thing he or I could have done to save Greyson.
I have to believe that.
I want to believe that this was all out of our hands. I loved my baby so much and did the best I could to care for him. I wish it had been enough or that the doctor had seen something or that it just wasn't part of our story.
2010 ended with the 4 worst weeks of my life. I never knew there could be this much pain in one person's heart. I'm not sure how I survived it and sometimes wonder how I will continue survive it.
But 2010 also gave me the 20 happiest weeks of my life.
I became a mother.
My fairytale really did come true in 2010,
only it was far too brief
and there is no happy ending for me.
There was one thing in the autopsy that made me smile:
"Appropriate for gestational age.
1. Weight: 319 grams (normal expected 174-452 grams)
2. Crown-Heel Length: 27 cm (normal expected 22.6-27.2 cm)
3. Crown-Rump Length: 19 cm (normal expected 16.0-20.0 cm)
4. Head Circumference: 16.5 cm
5. Foot Length: 3.4 cm (normal expected 2.7-3.9 cm)"
My boy was big and tall! He would have been a big, little guy.
Below this was the placenta pathology. It said: "Large blood clot, 6 cm in largest dimension, adherent to maternal surface."
6cm! I was appalled when I read that. This seems huge. I actually got out a ruler and looked at this measurement. That thing must have been about the size of a baseball. I was angry. How was something that large not seen on the ultrasound two days before? It seems impossible that something that large could grow in the short amount of time between the ultrasound on Thursday and the abruption on Saturday.
I have, the support group leader, Robin's words ringing in my ears. I spoke to her the day after the support group and I asked her more about her thoughts on Dr. H. She's a labor and delivery nurse and works with Dr. H regularly. She said she wasn't sure he was a liar really but that he had so many patients and always seemed in a hurry and maybe cut some corners. I couldn't get that phrase out of my head today. "cut some corners"
I was so alarmed and upset that I called Robin back today and told her about this 6cm clot. I also emailed my aunt, who is a nurse. They both said the same thing. A clot this large really could grow in a very short amount of time. My aunt said it could have been formed in minutes. My aunt said there is no way to know which happened first. The abruption causing the clot, or the clot formed first and caused the placenta to start separating. Robin said that even a full term baby would have struggled to survive this even if it happened in the hospital and was delivered immediately since the placenta tearing away would have taken the baby's oxygen supply.
I told Robin that her words were nagging at me. She apologized and said she should not have said that. That Dr. H. was a good doctor. That his medicine is solid but that she did think he rushed sometimes. She assured me that if he had seen something on the ultrasound he definitely would have done something. I wonder if she said that just to ease my mind. I doubt what everyone says now.
I know I'm desperately looking for some answers and probably seeing trouble where there is none. Could he have rushed through looking at our ultrasound and missed something? This thought haunts me.
I want to believe Dr. H is a good doctor and that there wasn't a thing he or I could have done to save Greyson.
I have to believe that.
I want to believe that this was all out of our hands. I loved my baby so much and did the best I could to care for him. I wish it had been enough or that the doctor had seen something or that it just wasn't part of our story.
2010 ended with the 4 worst weeks of my life. I never knew there could be this much pain in one person's heart. I'm not sure how I survived it and sometimes wonder how I will continue survive it.
But 2010 also gave me the 20 happiest weeks of my life.
I became a mother.
My fairytale really did come true in 2010,
only it was far too brief
and there is no happy ending for me.
Thursday, December 30, 2010
Dead Baby Appointment
How I was dreading this day and looking forward to getting past it at the same time. I wish I didn't have to go to that place for this reason. This should have been my 24 week check up, I should still be pregnant, Sweet Pea should still be alive and kicking on that ultrasound. I should have been happy to see Dr. H, not dreading what he has to say. I'm strangely a little sad to see this appointment come and go too because it will be the last appointment for Greyson and take me a little further away from the halcyon time when he was with me.
It was a mini-walk through hell within the bigger walk through hell my life has become. First of all, after I signed in the bouncy little girl at the desk asked if I was there for an ultrasound. I said, "No, I lost my baby 3 weeks ago." To which she responded, "Oh, I'm sorry. Did they still want you to have an ultrasound?" Umm...really? The physician's assistant who called me the week after it happened said she would take care of switching my folder. Further, I can't believe they don't train these children better. My GOD, what a thing to have to deal with. And the waiting...it was horrible. I nearly lost it several times but knew that if I did I wouldn't be able to listen or learn anything. I texted with MB and kept thinking...Stay focused, focused like a laser beam and learn as much as you can. The nurse, who I consider my nurse, did seem upset for me when she called me back for blood pressure and weight.
Dr. Hottie was genuinely kind and I might even say had a loving attitude toward me during our time together. In a doctorly way, not a creepy way. Intermingled with the medical stuff, he acknowledged everything I'm feeling. He said he knew how hard it was to come in there today and that it was a tough time of year to have something like this happen. He admitted up front that he doesn't really have the answers or know everything and that what he tells me today is his best guess. He took his time answering my questions, and was with me for over an hour.
He talked about how nothing could have been done by either of us to save the pregnancy or the baby. This is just something that sometimes happens. He was adamant that it was nothing I did that caused it. That there was no way I could have known an hour before when I felt the weird pressure what was happening and that even if I had called him when I felt the pressure it would not have changed the outcome. I asked him if he knew when I called him that it was over or soon to be over. He said he was very worried when I told him what had happened considering the amount of fluid and blood and that I was in the 20th week of pregnancy. He said he wanted me to have copies of everything related to the loss because he knew I was intelligent and a reader and researcher.
At one point, I commented that I was holding it together pretty well for our appointment. He said he was wondering about that. That he hadn't seen me show much emotion in the hospital and that had him very concerned and was why he had the assistant call to check on me the next week. I assured him that I wasn't doing very well with the emotional side of things at all but that I was a private cryer (In my head I'm thinking, he wasn't there the whole time in the hospital, what does he know about it). Later, I as I talked to my mom about the appointment she said she had been worried about the same thing, that I was so still in my body and my face was like granite in the hospital and I couldn't or wouldn't let go with emotions. I'm still not sure myself what was going on there. I think the idea of what was happening was so big and terrifying that I just couldn't get my head around it or maybe I was holding it in so tightly I was afraid of what letting loose would feel like.
We talked about antidepressants and I told him I thought I needed to be feeling what I'm feeling right now but how do I know when grief turns to depression? He said when it keeps you from functioning in your daily life. He said it was ok to cry everyday, I told him I cry a lot every day and he said that was to be expected. I told him there wasn't much I enjoyed, he said it was totally normal to feel like that after something like this. Later, I told him I was still bleeding lightly and he asked if it was ok for him to examine me in two weeks and we could revisit antidepressants then. I told him I'd probably have two more pages of questions for him by then. He said to bring them on, he'd answer anything he could.
I left feeling a tiny bit less tight in the chest, if that makes any sense. I still have some niggling worries and would perhaps want to change doctors in the future. This whole experience of losing Greyson has left me so unsure of everything, everything in the world.
Let the overanalyzing of every word the doctor says begin.
Questions for Doctor:
What exactly is what happened to us called: preterm labor, ruptured amniotic sac, PPROM? He walked in saying he thought it was an abruption so I didn't ask this one.
Death certificate says “abruption”? What is this and why wasn’t it seen on ultrasound? He walked in saying that he doesn’t really know, but his best guess is that it was an abruption. A clot or a vascular weak spot formed somewhere along the area where the placenta is attached to the uterine wall causing the placenta to detach. Once it detached the sac ruptured causing preterm labor. But really there is no way to know what happened.
Causes: None of these had anything to do with the abruption.
Age and weight? It was a donor egg so age was not a factor. I have no medical problems with weight such as diabetes or high blood pressure so that was probably not a factor.
Viral or bacterial infection? Gardnerella? Test? We were tested for these and it was negative.
Donor egg/Donor sperm? This is a more risky situation but probably did not cause the abruption.
Laptop use daily, sometimes actually over my abdomen? Not a cause.
Strenuous and long day a few days before and an activity where I had to reach up many times?
Not a cause.
My female donor has no knowledge of her father, could something in his background have led to this? Most likely not a cause but can't say for sure because we don't know what information we're missing.
Two days before at our 20 week ultrasound, you said you couldn’t see the bottom
of the heart and wanted us to have another ultrasound. Could this have something to do with it? Not a cause.
Greyson’s autopsy? The baby was totally normal. And all my blood tests came back normal as well.
I had a large gush of bleeding 12 hours after my four week internal ultrasound with Dr. A. They said it was caused by cervical irritation, old blood pooling at the bottom of the uterus and looking for a way out. Could this somehow be related? This could be related. There could have been a very small abruption at this time and then it healed itself but continued as a weak spot as the placenta and uterus grew. Again no way to know for sure. There was a lot of medical mumbo jumbo about blood in the uterus. He stated that any bleeding at all was considered not normal.
Is there something wrong with my uterus or cervix that it can’t hold things in? My uterus and cervix seem fine. On my 4 and 6 week ultrasounds with Dr. A my cervix was “long and closed”. Everything looked normal. I’ve read about something called “incompetent cervix” How do you know? Same answer as above.
Was there anything at all on the ultrasound indicating a problem of any kind? No, the ultrasound looked completely normal. It could have been on the ultrasound but they are in grayscale and you can’t always tell because even these days the quality of the picture is not good or sometimes the area with the abruption isn’t shown during that particular ultrasound.
I know the first gush of clear fluid was amniotic fluid, where did the blood come from?
A lot of medical mumbo jumbo on this one. What he said I think boils down to when the placenta pulled away from the uterine wall, some blood vessels tore loose with it, my and the placenta's? blood vessels are intertwined at this point. It could have been part my blood, part baby’s.
I was usually able to feel him move while still in bed in the mornings but I didn’t feel him the morning of the 4th. Was something already happening then? It is possible, the abruption could have already been pulling away or it could have been just one of those days he didn’t move. There is no way to tell.
If I had gotten to the hospital when I’d first felt the odd pressure an hour or so before, could something have been done? No, it was an acute case early in fetal development and happened very quickly, nothing could have been done even at this point.
Why was no medication given to stop labor when I got to the hospital? More medical mumbo jumbo. Something about it only being the 20th week and if labor did stop he probably wouldn’t have been able to keep the baby inside for as long as needed to become viable. And something about even if he could have miraculously kept him inside for that long, there would have been a high probability of the abruption causing a serious infection which could be dangerous or fatal to the baby and to me.
If I can gather my shattered soul for another try, when would be the soonest? Physically six months, only if I’m emotionally ready.
Is there a scan or test to tell if my insides are ok to try again? An internal ultrasound.
In, January you removed a polyp from my uterus, is there a chance that could have grown back by now? Yes, an internal ultrasound can see if there are polyps.
Do you think my periods will come back normally? Can’t be sure. Pregnancy sometimes causes periods to come back regularly for people who’ve had irregular ones before. (I've never had irregular periods.)
Considering that Dr. A. diagnosed me with diminished ovarian reserve a year ago…what does this mean concerning my periods and early menopause? It could be a concern, we'll wait and see what happens and take care of any problems as they arise.
What does this mean for trying again? My uterus is healthy and fine so pregnancy is possible with donor egg. A similar hormone protocol would probably be used to simulate a cycle. With medical protocal, technically a 100 year old woman could theoretically get pregnant if the uterus was healthy. I told him I feel 100.
What are the chances something like this happens again? Donor egg and IVF in general is more risky. No one can say what the chances are but it is fortunately something that this doesn’t happen very often. I told him it wasn’t fortunate for ME.
Is it MORE likely to happen again? Not more likely, probably less likely but can’t say for sure.
What are the chances I can survive it if it happens again? Didn’t ask it.
Are there precautions to take if I’m lucky enough to get pregnant again? Early and more frequent ultrasounds and consults with perinatologist/high risk OB.
How can you help me manage anxiety if I get pregnant again? Medication only if needed.
Would you be willing to see me as often as I need to reassure me of a safe pregnancy? Yes, he’d see me every day if I wanted. He has an “open door” policy and I could drop in any time for reassurance. He was sure to tell me not all places are like that.
What is the difference between you and a high risk OB/perinatologist? Perinataologist has more knowledge of high risk cases and the statistically odd things that can go wrong. While Dr. H. reads and researches only gyno and ob stuff, Periguy reads and studies only high risk research and articles and sees only high risk patients.
It is my understanding a high risk OB would work with you, do you think I need one? Dr. H would work with the periguy on a consultation basis. Dr. H would still be my OB and deliver baby. Yes, seeing a perinatologist would be a good precaution to take. Then he talked on about some doctors at SLU who would be the best to see.
Would I see the perinatologist before trying to become pregnant again? Yes, a prepregnancy consult would be advised. Sometimes the specialist can see things that might have been wrong that the regular OB can’t see. (I'm wondering why I wasn't sent there with this pregnancy although I know it probably wouldn't have changed things.)
Dr. A put two embryos in me, would this have happened earlier if there had been two? No way to tell, twins sometimes grow from the same placenta, sometimes they each have their own.
Should I have two put in if I try again? Yes, that is standard practice and very much increases the chances of getting pregnant.
Less chance of getting pregnant with frozen embryos, right? No, he thought it was still about the same with frozen embryos considering the newer technology and quick freezing.
Records of pregnancy and loss sent to Dr. A. Yes, they will be sent and a copy given to me as well.
Anxiety attacks? Normal to have these and will get better with time, he prescribed Xanax.
Raging headaches when I wake up? Again normal, probably stress related and will get better with time.
How do you know I don’t have PCOS?
--heavy esp. on top, infertility, weird hair growth, you removed some cysts 5-6 years ago during a D & C.
He thought I did have a very mild form of it but that I didn’t have the metabolic portion of PCOS that would affect pregnancy. (I don't remember hearing of this before.)
I've already begun a new list including:
Why wasn't I sent to the periguy to begin with?
Would you have been able to see the abruption with a 3-D ultrasound?
How do I know if I'm emotionally ready to try again?
Would it have changed things if I didn't have the 6 week internal ultrasound?
Should I have internal ultrasounds in the future?
It was a mini-walk through hell within the bigger walk through hell my life has become. First of all, after I signed in the bouncy little girl at the desk asked if I was there for an ultrasound. I said, "No, I lost my baby 3 weeks ago." To which she responded, "Oh, I'm sorry. Did they still want you to have an ultrasound?" Umm...really? The physician's assistant who called me the week after it happened said she would take care of switching my folder. Further, I can't believe they don't train these children better. My GOD, what a thing to have to deal with. And the waiting...it was horrible. I nearly lost it several times but knew that if I did I wouldn't be able to listen or learn anything. I texted with MB and kept thinking...Stay focused, focused like a laser beam and learn as much as you can. The nurse, who I consider my nurse, did seem upset for me when she called me back for blood pressure and weight.
Dr. Hottie was genuinely kind and I might even say had a loving attitude toward me during our time together. In a doctorly way, not a creepy way. Intermingled with the medical stuff, he acknowledged everything I'm feeling. He said he knew how hard it was to come in there today and that it was a tough time of year to have something like this happen. He admitted up front that he doesn't really have the answers or know everything and that what he tells me today is his best guess. He took his time answering my questions, and was with me for over an hour.
He talked about how nothing could have been done by either of us to save the pregnancy or the baby. This is just something that sometimes happens. He was adamant that it was nothing I did that caused it. That there was no way I could have known an hour before when I felt the weird pressure what was happening and that even if I had called him when I felt the pressure it would not have changed the outcome. I asked him if he knew when I called him that it was over or soon to be over. He said he was very worried when I told him what had happened considering the amount of fluid and blood and that I was in the 20th week of pregnancy. He said he wanted me to have copies of everything related to the loss because he knew I was intelligent and a reader and researcher.
At one point, I commented that I was holding it together pretty well for our appointment. He said he was wondering about that. That he hadn't seen me show much emotion in the hospital and that had him very concerned and was why he had the assistant call to check on me the next week. I assured him that I wasn't doing very well with the emotional side of things at all but that I was a private cryer (In my head I'm thinking, he wasn't there the whole time in the hospital, what does he know about it). Later, I as I talked to my mom about the appointment she said she had been worried about the same thing, that I was so still in my body and my face was like granite in the hospital and I couldn't or wouldn't let go with emotions. I'm still not sure myself what was going on there. I think the idea of what was happening was so big and terrifying that I just couldn't get my head around it or maybe I was holding it in so tightly I was afraid of what letting loose would feel like.
We talked about antidepressants and I told him I thought I needed to be feeling what I'm feeling right now but how do I know when grief turns to depression? He said when it keeps you from functioning in your daily life. He said it was ok to cry everyday, I told him I cry a lot every day and he said that was to be expected. I told him there wasn't much I enjoyed, he said it was totally normal to feel like that after something like this. Later, I told him I was still bleeding lightly and he asked if it was ok for him to examine me in two weeks and we could revisit antidepressants then. I told him I'd probably have two more pages of questions for him by then. He said to bring them on, he'd answer anything he could.
I left feeling a tiny bit less tight in the chest, if that makes any sense. I still have some niggling worries and would perhaps want to change doctors in the future. This whole experience of losing Greyson has left me so unsure of everything, everything in the world.
Let the overanalyzing of every word the doctor says begin.
Questions for Doctor:
What exactly is what happened to us called: preterm labor, ruptured amniotic sac, PPROM? He walked in saying he thought it was an abruption so I didn't ask this one.
Death certificate says “abruption”? What is this and why wasn’t it seen on ultrasound? He walked in saying that he doesn’t really know, but his best guess is that it was an abruption. A clot or a vascular weak spot formed somewhere along the area where the placenta is attached to the uterine wall causing the placenta to detach. Once it detached the sac ruptured causing preterm labor. But really there is no way to know what happened.
Causes: None of these had anything to do with the abruption.
Age and weight? It was a donor egg so age was not a factor. I have no medical problems with weight such as diabetes or high blood pressure so that was probably not a factor.
Viral or bacterial infection? Gardnerella? Test? We were tested for these and it was negative.
Donor egg/Donor sperm? This is a more risky situation but probably did not cause the abruption.
Laptop use daily, sometimes actually over my abdomen? Not a cause.
Strenuous and long day a few days before and an activity where I had to reach up many times?
Not a cause.
My female donor has no knowledge of her father, could something in his background have led to this? Most likely not a cause but can't say for sure because we don't know what information we're missing.
Two days before at our 20 week ultrasound, you said you couldn’t see the bottom
of the heart and wanted us to have another ultrasound. Could this have something to do with it? Not a cause.
Greyson’s autopsy? The baby was totally normal. And all my blood tests came back normal as well.
I had a large gush of bleeding 12 hours after my four week internal ultrasound with Dr. A. They said it was caused by cervical irritation, old blood pooling at the bottom of the uterus and looking for a way out. Could this somehow be related? This could be related. There could have been a very small abruption at this time and then it healed itself but continued as a weak spot as the placenta and uterus grew. Again no way to know for sure. There was a lot of medical mumbo jumbo about blood in the uterus. He stated that any bleeding at all was considered not normal.
Is there something wrong with my uterus or cervix that it can’t hold things in? My uterus and cervix seem fine. On my 4 and 6 week ultrasounds with Dr. A my cervix was “long and closed”. Everything looked normal. I’ve read about something called “incompetent cervix” How do you know? Same answer as above.
Was there anything at all on the ultrasound indicating a problem of any kind? No, the ultrasound looked completely normal. It could have been on the ultrasound but they are in grayscale and you can’t always tell because even these days the quality of the picture is not good or sometimes the area with the abruption isn’t shown during that particular ultrasound.
I know the first gush of clear fluid was amniotic fluid, where did the blood come from?
A lot of medical mumbo jumbo on this one. What he said I think boils down to when the placenta pulled away from the uterine wall, some blood vessels tore loose with it, my and the placenta's? blood vessels are intertwined at this point. It could have been part my blood, part baby’s.
I was usually able to feel him move while still in bed in the mornings but I didn’t feel him the morning of the 4th. Was something already happening then? It is possible, the abruption could have already been pulling away or it could have been just one of those days he didn’t move. There is no way to tell.
If I had gotten to the hospital when I’d first felt the odd pressure an hour or so before, could something have been done? No, it was an acute case early in fetal development and happened very quickly, nothing could have been done even at this point.
Why was no medication given to stop labor when I got to the hospital? More medical mumbo jumbo. Something about it only being the 20th week and if labor did stop he probably wouldn’t have been able to keep the baby inside for as long as needed to become viable. And something about even if he could have miraculously kept him inside for that long, there would have been a high probability of the abruption causing a serious infection which could be dangerous or fatal to the baby and to me.
If I can gather my shattered soul for another try, when would be the soonest? Physically six months, only if I’m emotionally ready.
Is there a scan or test to tell if my insides are ok to try again? An internal ultrasound.
In, January you removed a polyp from my uterus, is there a chance that could have grown back by now? Yes, an internal ultrasound can see if there are polyps.
Do you think my periods will come back normally? Can’t be sure. Pregnancy sometimes causes periods to come back regularly for people who’ve had irregular ones before. (I've never had irregular periods.)
Considering that Dr. A. diagnosed me with diminished ovarian reserve a year ago…what does this mean concerning my periods and early menopause? It could be a concern, we'll wait and see what happens and take care of any problems as they arise.
What does this mean for trying again? My uterus is healthy and fine so pregnancy is possible with donor egg. A similar hormone protocol would probably be used to simulate a cycle. With medical protocal, technically a 100 year old woman could theoretically get pregnant if the uterus was healthy. I told him I feel 100.
What are the chances something like this happens again? Donor egg and IVF in general is more risky. No one can say what the chances are but it is fortunately something that this doesn’t happen very often. I told him it wasn’t fortunate for ME.
Is it MORE likely to happen again? Not more likely, probably less likely but can’t say for sure.
What are the chances I can survive it if it happens again? Didn’t ask it.
Are there precautions to take if I’m lucky enough to get pregnant again? Early and more frequent ultrasounds and consults with perinatologist/high risk OB.
How can you help me manage anxiety if I get pregnant again? Medication only if needed.
Would you be willing to see me as often as I need to reassure me of a safe pregnancy? Yes, he’d see me every day if I wanted. He has an “open door” policy and I could drop in any time for reassurance. He was sure to tell me not all places are like that.
What is the difference between you and a high risk OB/perinatologist? Perinataologist has more knowledge of high risk cases and the statistically odd things that can go wrong. While Dr. H. reads and researches only gyno and ob stuff, Periguy reads and studies only high risk research and articles and sees only high risk patients.
It is my understanding a high risk OB would work with you, do you think I need one? Dr. H would work with the periguy on a consultation basis. Dr. H would still be my OB and deliver baby. Yes, seeing a perinatologist would be a good precaution to take. Then he talked on about some doctors at SLU who would be the best to see.
Would I see the perinatologist before trying to become pregnant again? Yes, a prepregnancy consult would be advised. Sometimes the specialist can see things that might have been wrong that the regular OB can’t see. (I'm wondering why I wasn't sent there with this pregnancy although I know it probably wouldn't have changed things.)
Dr. A put two embryos in me, would this have happened earlier if there had been two? No way to tell, twins sometimes grow from the same placenta, sometimes they each have their own.
Should I have two put in if I try again? Yes, that is standard practice and very much increases the chances of getting pregnant.
Less chance of getting pregnant with frozen embryos, right? No, he thought it was still about the same with frozen embryos considering the newer technology and quick freezing.
Records of pregnancy and loss sent to Dr. A. Yes, they will be sent and a copy given to me as well.
Anxiety attacks? Normal to have these and will get better with time, he prescribed Xanax.
Raging headaches when I wake up? Again normal, probably stress related and will get better with time.
How do you know I don’t have PCOS?
--heavy esp. on top, infertility, weird hair growth, you removed some cysts 5-6 years ago during a D & C.
He thought I did have a very mild form of it but that I didn’t have the metabolic portion of PCOS that would affect pregnancy. (I don't remember hearing of this before.)
I've already begun a new list including:
Why wasn't I sent to the periguy to begin with?
Would you have been able to see the abruption with a 3-D ultrasound?
How do I know if I'm emotionally ready to try again?
Would it have changed things if I didn't have the 6 week internal ultrasound?
Should I have internal ultrasounds in the future?
Wednesday, December 29, 2010
Questions for Dr. Hottie
Am I completely insane for going into our postpartum appointment tomorrow with this huge typed list of questions? Will he even take the time to answer them all? I'm intelligent and know how to use google but I have to hear it from his mouth. My head knows there are no answers and never will be and that I could have been standing next to the doctor when it happened and nothing could have been done. My heart has to ask.
Let me know if I've missed any....
Questions for Doctor Hottie:
What exactly is what happened to us called: preterm labor, ruptured amniotic sac, PPROM?
Death certificate says “abruption”? What is this and why wasn’t it seen on ultrasound? Why the discrepancy with what I was told in the hospital?
Miscarriage or stillbirth?
Greyson's autopsy results?
Causes:
Age and weight?
Viral or bacterial infection? Test?
Donor egg/Donor sperm?
Laptop use daily, sometimes actually over my abdomen?
Strenuous and long day a few days before and an activity where I had to reach up many times?
My female donor has no knowledge of her father, could something in his background have led to this?
Two days before at our 20 week ultrasound, you said you couldn’t see the bottom
of the heart and wanted us to have another ultrasound. Could this have something to do with it?
I had a large gush of bleeding 12 hours after my four week internal ultrasound with Dr. AA. They said it was caused by cervical irritation, old blood pooling at the bottom of the uterus and looking for a way out. Could this somehow be related? Is there something wrong with my uterus or cervix that it can’t hold things in? I’ve read about something called “incompetent cervix” How do you know?
Was there anything at all on the ultrasound indicating a problem of any kind?
I know the first gush of clear fluid was amniotic fluid, where did the blood come from?
I was usually able to feel him move while still in bed in the mornings but I didn’t feel him the morning of the 4th. Was something already happening then?
If I had gotten to the hospital when I’d first felt the odd pressure an hour or so before, could something have been done?
Why was no medication given to stop labor when I got to the hospital?
If I can gather my shattered soul for another try, when would be the soonest?
Is there a scan or test to tell if my insides are ok to try again?
In, January you removed a polyp from my uterus, is there a chance that could have grown back by now?
Do you think my periods will come back normally? Considering that Dr. AA diagnosed me with diminished ovarian reserve a year ago…what does this mean concerning my periods and early menopause? What does this mean for trying again?
What are the chances something like this happens again? Is it MORE likely to happen again?
What are the chances I can survive it if it happens again?
Are there precautions to take if I’m lucky enough to get pregnant?
Would you be willing to see me as often as I need to reassure me of a safe pregnancy?
What is the difference between you and a high risk OB?
It is my understanding a high risk OB would work with you, do you think I need one?
Dr. AA put two embryos in me, would this have happened earlier if there had been two?
Should I have two put in if I try again?
Less chance of getting pregnant with frozen embryos, right?
Anxiety attacks?
How do you know I don’t have PCOS?
--heavy esp. on top, infertility, weird hair growth, you removed some cysts 5-6 years ago during a D & C.
Let me know if I've missed any....
Questions for Doctor Hottie:
What exactly is what happened to us called: preterm labor, ruptured amniotic sac, PPROM?
Death certificate says “abruption”? What is this and why wasn’t it seen on ultrasound? Why the discrepancy with what I was told in the hospital?
Miscarriage or stillbirth?
Greyson's autopsy results?
Causes:
Age and weight?
Viral or bacterial infection? Test?
Donor egg/Donor sperm?
Laptop use daily, sometimes actually over my abdomen?
Strenuous and long day a few days before and an activity where I had to reach up many times?
My female donor has no knowledge of her father, could something in his background have led to this?
Two days before at our 20 week ultrasound, you said you couldn’t see the bottom
of the heart and wanted us to have another ultrasound. Could this have something to do with it?
I had a large gush of bleeding 12 hours after my four week internal ultrasound with Dr. AA. They said it was caused by cervical irritation, old blood pooling at the bottom of the uterus and looking for a way out. Could this somehow be related? Is there something wrong with my uterus or cervix that it can’t hold things in? I’ve read about something called “incompetent cervix” How do you know?
Was there anything at all on the ultrasound indicating a problem of any kind?
I know the first gush of clear fluid was amniotic fluid, where did the blood come from?
I was usually able to feel him move while still in bed in the mornings but I didn’t feel him the morning of the 4th. Was something already happening then?
If I had gotten to the hospital when I’d first felt the odd pressure an hour or so before, could something have been done?
Why was no medication given to stop labor when I got to the hospital?
If I can gather my shattered soul for another try, when would be the soonest?
Is there a scan or test to tell if my insides are ok to try again?
In, January you removed a polyp from my uterus, is there a chance that could have grown back by now?
Do you think my periods will come back normally? Considering that Dr. AA diagnosed me with diminished ovarian reserve a year ago…what does this mean concerning my periods and early menopause? What does this mean for trying again?
What are the chances something like this happens again? Is it MORE likely to happen again?
What are the chances I can survive it if it happens again?
Are there precautions to take if I’m lucky enough to get pregnant?
Would you be willing to see me as often as I need to reassure me of a safe pregnancy?
What is the difference between you and a high risk OB?
It is my understanding a high risk OB would work with you, do you think I need one?
Dr. AA put two embryos in me, would this have happened earlier if there had been two?
Should I have two put in if I try again?
Less chance of getting pregnant with frozen embryos, right?
Anxiety attacks?
How do you know I don’t have PCOS?
--heavy esp. on top, infertility, weird hair growth, you removed some cysts 5-6 years ago during a D & C.
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