Monday, February 24, 2014

The Diagnosis

Last Thursday afternoon (February 20th, 2014), I received a phone call from my doctor. I immediately felt cold when I realized who was on the other end of the line. Something was wrong. Normally the nurse calls. "Your pathology report came back and you had a partial mole," were some of the first words out of her mouth. I almost couldn't believe it. As if the miscarriage wasn't enough to deal with. Her words were like a punch to the gut. I listened as she explained that I would need an ultrasound prior to my follow-up appointment next Thursday and that if there is anything left (like tissue) in my uterus then I will need a D&C next Friday. She also reminded me that this meant weekly blood draws for a while until my hcg level drops to zero. Plus, I will be monitored for the next 6-12 months once my levels drop. Being a labor and delivery nurse helped me absorb this information quickly. I was thankful for that. However, nothing prepares you to hear this type of news.

Molar pregnancies are just random flukes. They are genetic accidents that occur in about 1 in every 1000 to 1500 pregnancies. Tissue that should have become a fetus instead develops into an abnormal uterine growth (trophoblastic tissue). There are two types of molar pregnancies- complete molar pregnancies and partial molar pregnancies. Complete molar pregnancies occur when an egg with no maternal DNA gets fertilized by a sperm. Obviously, there can never be a baby in that instance. A partial molar pregnancy occurs when an egg is fertilized by two sperm. Because all of the information is there, a baby can develop but it usually has severe chromosomal anomalies and therefore doesn't live very long (as was the case for me). Unfortunately for me and other women who experience partial molar pregnancies, a partial mole can be difficult to detect on ultrasound because they present rather normal.

So what does this mean? Probably nothing. However, some molar pregnancies can lead to gestational trophoblastic disease. Basically, the abnormal placental tissue continues to grow after the miscarriage is thought to be "complete." This is why it is very important to ensure that everything has been expelled from my uterus. For a partial molar pregnancy, about 50 in every 1000 women develop trophoblastic disease. Even more rarely, the trophoblastic tissue can become cancerous. Fortunately, because women receive such careful monitoring, the cancer is caught early and is usually cured with one treatment of chemotherapy.

A molar pregnancy does not mean that I can't get pregnant again. It also doesn't mean that when I get pregnant it will happen again. There is about a 1-2% chance that it could happen a second time. However, because of the recurrence and cancer risk, I am advised not to become pregnant for 6-12 months after my hcg level reaches zero. If I were to become pregnant before the "all clear", I would be putting myself at increased risk for missing a potential problem.

I have had a few days to absorb this information. At first, I was really upset. Patrick walked into the bedroom as I was hanging up the phone with my doctor and I just cried. I didn't know how to tell him. I didn't want what I was saying to be true. I didn't want to tell him that I couldn't offer children to him for a while. I didn't want to tell him that I was carrying around this "disease".

The odd thing is that I had actually discussed molar pregnancy with him a month earlier so he had a vague idea of what I was talking about. About a month prior to finding out about our miscarriage, Patrick had asked me why it was so important that my hcg level get checked and was there really any harm in waiting a while to find out if our pregnancy was a "good" one. I pointed out that there can  be risks involved by not seeking medical care when a miscarriage or problem is suspected. I used molar pregnancy as an example. However, I told him that it was highly unlikely that I had it. I had already had one ultrasound. However, I had almost completely forgotten about partial moles which are hard to detect on ultrasound.

How ironic. It's bizarre that I had a bad feeling about this pregnancy from the start. I knew in my gut that there was a problem. Now I have the diagnosis. I feel somewhat like a sitting duck. I'm going to be waiting to find out what this potentially malignant tissue decides to do inside of me. I feel damaged and unhealthy. I feel helpless and hurt. These have been some of the hardest emotions and feelings to deal with. Thursday night I couldn't sleep. I got up and began cleaning the kitchen. I cried and cried as I scrubbed everything clean. It was my therapy. I couldn't control whether or not I was "clean", but I could scrub the heck out of my kitchen. I cried out to God. I prayed. I cleaned. Sometime around 2:00am I went to bed.

I'm feeling better now that I've had some time. I know that I will be well cared for. I know the risks that I fear are rare. I'm starting to feel okay with this year long "sentence". I'm even starting to get excited about things that I can do with this next year now that baby making is out of the question. Patrick and I are hoping to take a nice vacation (without Owen). I've got some plans in the home renovation department. I've even got plans for Patrick and I to work on our own health. There is a part of me that wants to do everything in my power to be healthy. It's not that we aren't healthy right now, but I figure eating well and exercising more can't hurt.

I'm choosing to focus on the positives. I have more time to spend with just Owen and he is awesome. I have more time to enjoy being a mommy to one sweet baby. There is a lot that can be done in a year and this is going to be a good one. I'm going to continue to fight. I'm going to hold on to the truths of God. I'm hanging on now more than ever to the fact that God wins. I've said it before on this blog. It's so true. It's become my mantra. God wins. 

"So do not fear, for I am with you; do not be dismayed, for I am your God; I will strengthen you, I will keep you, I will uphold you with my victorious right hand."- Isaiah 41:10

Our God is victorious. Regardless of what happens in this life, whatever curve ball gets thrown, we know that God reigns in victory over sin and death. Let us hope and rejoice in that.

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