Thursday, February 20, 2014

My experience with cytotec

Warning: The following post contains detailed information regarding miscarriage. I decided not to hold back but share openly about my experience. I'm giving you the option now to stop reading.

After receiving confirmation that I had miscarried baby #2, I was given options on how I could proceed. The decision was completely mine to make. I could either wait for my body to miscarry naturally, I could take medicine to try and induce the miscarriage, or I could opt for a dilatation and curettage (D&C).

The waiting option was pretty much out the window for me because, in my opinion, I'd already done that. I was 11w6d based on my LMP but carrying a baby that seemed to have passed at 6w0d. Initially, I wanted to go straight to the D&C. I have heard horror stories about cytotec (misoprostol) causing terrible cramping, severe bleeding, and heard that some people go through all that and still end up needing a D&C. Plus, I wasn't sure how I was going to manage cramping and bleeding while taking care of Owen.

I received a phone call Friday (the day after confirming our miscarriage) and the date for my D&C was set for first thing Wednesday (February 19th). I lined up childcare for Owen and was fully prepared to go that route. Then my dad called. We got to talking and he seemed to think that I would handle cytotec well. Because I was already starting to have spotting, he thought that if I took the medicine when I got off work Sunday morning that I could be "done" within 12-24 hours. The idea of avoiding surgery was appealing to me. Plus, Patrick was basically off Sunday afternoon and evening which meant that he would be around to help. I started to think that it would be a good option to at least try. Plus, if it didn't work, I was already scheduled for the surgery. It seemed like a win-win (well, not really given what we're actually talking about but you know what I mean).

Long story short(er). I did it. I took 800mcg of cytotec Sunday morning at 7:45 as I was preparing to leave work. I was bleeding by the time I got home. Maybe I'd get through this rather quickly. I went to bed for a while only to wake up around 1:00pm and discover that I wasn't bleeding anymore. At 1:30pm, I took 600mcg. By 7:30 that night, I was discouraged. However, I went ahead and took another 600mcg dose before heading to bed. I was exhausted from working the two nights prior.

Around 9:00am on Monday I took another 800mcg dose. I had a talk with my dad a little before that and he said that he saw no reason why I couldn't give it another try. Apparently, sometimes it takes a while. Patrick decided to head out and get some work done. I promised him that I'd call if I needed anything but I really didn't think that I would. Then, around 1pm, I began to feel some mild cramping as I was preparing lunch for Owen. The cramping stopped but then I felt a gush. It felt like a lot of blood. I left Owen in his high chair and went to the bathroom. I sent a text to Patrick at 1:19 that said, "Yep. Come home." I thought this was it.

The rest of the afternoon went along rather calmly though. I would be fine for about thirty minutes, experience a gush, run to the bathroom to change my pad, and then I'd be fine again. Sometime around 3:30, I went ahead and took a 400mcg dose. I decreased the dosage because I thought that the heavier bleeding meant that I was close. I even got a call from my doctor's nurse around that time and she scheduled me for an ultrasound for the next morning since we really couldn't be sure if I'd passed everything. I was pretty certain that I was headed for a D&C. I was thinking that maybe my body just doesn't respond to cytotec. Then things made a sudden change.

My phone records show that I called my Dad at 5:31pm. I called him from the bathroom to ask if my bleeding was an acceptable amount or if I should be concerned. I had been sitting there when I realized that I had gone through 4 overnight pads since 1:00. I knew I didn't qualify for the "no more than a pad an hour rule" but I was starting to think I might be bleeding too much. My dad told me that he thought I was probably close. He said that the bleeding usually picks up right before you pass everything. He also said that taking another 400mcg dose might help my body complete the process. However, he ended the conversation by reminding me that sometimes it can get stuck in the cervix. I've actually seen that happen before so I knew what he was talking about. He said that if my bleeding didn't slow down or if it picked up that I should probably get checked out.

I hung up the phone and took another 400mcg dose. I went back to the living room to sit down. Patrick was fixing us dinner. Owen was in his highchair eating. Then I felt it. Blood felt like it was pouring out of me. Without saying a word, I rushed back to our bathroom. The pad I had just put on was soaked. I was officially bleeding like a faucet. There is just no other way to describe it. I called my sister first and asked her to please pack a bag and come over. I told her I was bleeding too much and needed to go to the hospital. My phone records show that I called her at 6:05pm. As soon as I hung up the phone with her I felt my vision fading. I was about to pass out. I quickly got down on the floor. Through my blurry vision I dialed the number to the hospital. In the back of my mind, I was wondering if I should actually be calling 911. At some point in the conversation I was put on hold. I took the opportunity to yell for Patrick. I told him that we needed to go to the hospital and that Caroline was on her way over. I told him he should go ahead and scarf some food down and that I would be okay on the floor for a bit. After he left, I began to realize that I really wasn't okay.

I called Frances (at 6:13pm), our youth pastor's wife, to see if she could come over. I knew she would be able to get to the house faster than Caroline. I then sent a text to Patrick (I didn't think I could yell to him) saying that Frances was now coming. He quickly appeared in the bathroom again and began asking me what he needed to grab. I could tell that he was running around quickly. I was trying to mumble out various items but I really don't remember what I told him to get. I was laying on my side with my cheek pressed up against the cold hard tile. I was trying to stay with it and felt like I was hanging on to reality by a couple of threads. I began praying that God would give me the strength to get to the car but also thinking that Patrick might need to carry me. I even told God that if this is how he wanted me to go then it was okay because he is God and all. However, I also told him that it really wasn't what I'd prefer. I heard Frances arrive and heard Owen begin to scream in protest to having a stranger take over.

I began to feel like I was with it enough to get up. I knew that this was my window of opportunity. I pulled myself up by the counter and began making my way down the hall. Patrick saw me and said, "You look really pale." I said, "I know" without slowing down. I had caught a glimpse in the mirror already. I made it to the car and to the hospital by 6:54. Patrick got a wheelchair and got me upstairs where my nurse friends could take over.

They got my weight, I went to the bathroom to change into a gown, and then I put on one of those gigantic postpartum pads. By the time we were finishing with my orthostatic blood pressures I was not only passing out, but I remember telling the nurse, "My pad is already soaked." I knew we needed to control this bleeding fast. My blood pressure was low... like 60's/30's? I just remember the nurse saying, "Yep, we need an IV." She also called for help.

I really thought I might be headed for an emergency D&C. Luckily, I began to feel better as I laid flat on my back. It seemed that as long as I didn't sit up, I could stay in touch with the world. I was able to talk with the doctor somewhat clearly and explain what had been going on. She was able to assess me, perform an ultrasound, and then start with the pelvic exam. I remember telling her, "I'm hoping that it's just stuck in my cervix and that's why I'm bleeding so bad. If you can get it out then maybe I'll be okay."

I was right. Our little baby was just stuck. I was actually surprised by the size of it when she got it out (yes, I'm a curious nurse that wanted to look at it). It looked like an egg-sized clot at first but when I looked closely I could tell that it was tissue. The doctor seemed to think that she got everything including the placenta. She performed another ultrasound and could tell that I still had some clots in my uterus so she ordered methergine.

It worked. My bleeding slowed down. I passed three large clots (like the size of my fist) the next time I went to the bathroom, but my bleeding really slowed after that. I just had to wait for my body to stabilize. I kept getting dizzy every time I sat up. The doctor estimated my blood loss to be between 500mL and 1000mL. She said it was probably closer to the 1000mL since she felt confident based on her observation that I lost 500mL while at the hospital. She said that there really was no way to know how much I bled before I got to them.

After three bags of fluids, methergine, a midnight snack of chicken fingers and fries (shared with Patrick), a little mini bag of magnesium, and a shot of rhogam, we were able to leave. We got home around 2am. It really wasn't until the next morning that it set in. It was over. I was no longer pregnant. I never really cried through the whole process. There have been brief moments here an there that I have felt more emotional and raw. For the most part, however, I think Patrick and I both feel bad that we don't feel that bad. Sounds crazy, I know. Part of me is just happy to be alive after the whole experience.

Everyone grieves differently and I believe there is no right or wrong way to do it. Our faith has played a large role in our outlook. I long for God to take these ashes and create beauty. I've seen God do it over and over again in my own life and in the lives of others around me. I know that he can take the ugliest and most painful things we go through and bring glory to His name. This is why I've chosen to be honest about our loss. Maybe God can use my honesty to help others.

I take comfort in knowing that this is not the way the world was intended to be. I'm not angry with God. As a Christian, I truly believe that evil hunts us. We are to expect hardship and pain. I feel like Joseph after he was sold into slavery by his own brothers. After years of hardship, he rose in power in Egypt. When he was reunited with his brothers he later said, "As for you, you meant evil against me, but God meant it for good, to bring it about that many people should be kept alive, as they are today." (Genesis 50:20)

What evil meant for harm, God meant for good. In just one week, I have seen my marriage strengthen as my love for Patrick has deepened. I have been in awe as the extra down time has sent me to Scripture. I have been encouraged by fellowship as people have sent loving texts and comments, and as food has arrived in our home. None of these things fix what has happened. However, they have made our burden lighter. We have no doubt that God's heart toward us is loving and gracious.

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