Saturday, June 6, 2009

Utter terror = visit to ER

First - I'll just get this out there so you can stop reading if you just want the bare bones and no details. Baby is ok, measured 8w3d, which is exactly 2w3d since our u/s dated us 6w even two weeks and three days ago. Heart rate was 182 bpm.

Background, or why I went to the ER in the first place: After taking a nap and feeling perfectly normal, I laid in bed reading. Completely out of nowhere, with absolutely no warning whatsoever, I felt a warm gush of fluid into my vagina. Went into the bathroom and saw red blood. I passed something into the toilet, wiped, found a lot of red blood. Wiped up, yelled in a panic for my husband, stood up and saw a very large clot in the toilet. It was triangular, about the size of a square of toilet paper folded diagonally, or a little smaller. DH saw that, and we talked about what to do. I checked internally, and found that my cervix felt about the same as the last time I checked - a little open, but low and mushy.

We called my mw, who advised that we go to the ER. By this point, there is just a little pink or brown spotting, even internally. No real sign of bleeding. She said we could wait until Monday if we wanted to, but that for my peace of mind, given it was out of nowhere and I said my symptoms had declined some over the previous week, and given my history, she strongly advised just going and getting the ultrasound, so we would know for sure.

I hung up and called my mom and started crying. Then we drove to the hospital across the street and found the ER and got in, at which point I was visibly shaking. They were very kind and triaged me immediately and sent me back immediately to a room with a bed. Things seemed to move fairly quickly, and they drew blood (had a lot of trouble though, had to try both arms and only barely got enough for the quantitative beta). Left an IV port in and holy hell, that hurt a lot. Jason called a couple of friends for me and then got pulled out to do paperwork and they took a history and did a pelvic exam. The PA immediately said there was some 'old blood' around my cervix but no active bleeding. She also said I was a fingertip dilated, but only at the opening, not all the way through. I was worried about that, but she said it's not uncommon in women who have had cervical dilation, as I have had. She was surprised that the clot was red and that it was out of nowhere, but it totally was - no cramping, no spotting, no nothing. I asked about the size of my uterus and she said she could feel a fullness, but didn't check for anything, preferring to wait for the u/s.

They got me in fairly quickly for the ultrasound. The tech asked a few questions and I told her I was really nervous and why. She said she understood and hoped things would be ok. She started with an abdominal u/s, and the screen was turned away from us. After a quick look, she said, "I am not allowed to tell you anything or interpret the results for you, a doctor has to do that. But there is nothing wrong with you watching if you'd like." And she turned the screen towards us. DH had a good view, but I didn't. She was moving fast. I got to see the baby a few times, and it was definitely a lot bigger than the last time, but I couldn't see a heartbeat and couldn't ask DH if he did. There was one point that she was clearly checking for a heartrate, but I couldn't tell whether it was there or not or what it was, partially from not knowing exactly what we were looking at but also because of the angle, I couldn't see the entire screen or anything she typed. She then said she wanted to do a vaginal u/s to double check.

I honestly felt like her allowing us to watch was based on reassuring us, that she wouldn't have turned the screen if there was no h/b. But then I was afraid she was gently trying to let us know that. And I was worried that she wanted to do a vag u/s (the last time we started with one and switched, it was with Chickadee and that didn't go well). Unfortunately, due to the position I was in, she couldn't turn the screen for me to see, but turned it so DH could. I squeezed his hand and gave up a thumbs up/thumbs down sign. He just shook his head and watched. He was concentrating pretty hard, and I was getting nervous. After what seemed like forever, he squeezed my hand and gave me a thumbs up, tapped his chest and mouthed 'heartbeat' - he told me after it was clear as a flashing Christmas light. The tech said she would review the images, send them to the ER doc and he or she would come talk to us.

We went back to the room, and about 45 minutes later - during which time DH told me that he saw the heartbeat and saw her type 182 bpm and that the gestational sac measured close to 10 weeks and he was sure all was well - they came back and told me I could get dressed again (thank goodness, I felt gushy after the pelvic exam and the u/s goo) and took out the devil IV port. The PA came back, handed me labwork (beta was a little under 97,000) and said all looked well. Baby was fine, yolk sac was fine, gestational sac was fine. Heartrate was 182 bpm, which was normal, baby measured 8w3d. She asked me about that, since I'd said I was nearly 9 weeks when I first went in and I said that matched the last u/s to the day. She said total pelvic rest and rest with my feet up as much as possible. She said there was no clear or obvious cause of the clot or bleeding and no signs of further bleeding. She said while all looked good and normal now, they couldn't say everything would be ok, given my history, but that for now, all looked well. Follow up with my OB, and take it easy.

I feel pretty reassured after the terror, because my miscarriages have never been totally spontaneous abortions - they've been mostly missed miscarriages, where development stops and we find out weeks after the fact. So given that there is clearly a healthy baby in there now and that according to u/s, my cervix looks ok (though I'm going to take it very easy and ask Jackie to check up - though I'd previously read about cervical dilation potentially causing an opening at the vaginal end and that being ok), I am feeling pretty good. I'm crampy now, but between a pelvic exam and two u/s, that is to be expected, as is some spotting over the next week.

I should probably change my tickers, which still say 9 weeks, based on ovulation, but honestly? 9w has sort of been a benchmark and it sucks, and I refuse to relive this again. I told DH I'd be happy to relive 11 weeks or 13 weeks, but I'll just leave things as they are, with a disclaimer it may be a little ahead. Don't care. Just happy the chicken is ok, even if we don't know why it happened.


Alyssa said...

I'm so glad you baby is okay and is measuring great (to your last u/s) and has a great heartbeat :) My heart warmed when you said that your DH mouthed "heartbeat" and said (later) it was like Christmas lights. :) I hope everything continues to go well, and that the blood was nothing, and never comes back this pregnancy :)

aLLie said...

oh Lord, I am so happy everything is okay!!! I panicked when I first started reading so thank you for putting the bare bones up at the top! But after reading the whole thing oh man I can't imagine what that did to you and your H's hearts!! Thank God your DH was able to see the heartbeat! And that God your little babe is okay!!!!

jess said...

I'm so glad everything seems to be okay - I wish nothing but the best for you. After all of my experiences working with obviously unwanted children and their mothers (AmeriCorps ftw), it always warms my heart a bit to read about a baby that is so wanted and loved. I have to believe, and I hope you do, too, that things will work out.

Much love from this end :)