I wanted to wait until the worst was behind me, before sharing my feelings on this miscarriage. My body, on the other hand, had no intentions of playing along. As always, I have no control over any of this, and so much has happened (yet so little has developed), that I just need to write it out.
After the confirmation scan on Wednesday, my plan was to use the medication Friday morning. My husband would work from home to be there for me if I need it, and in my mind it all seemed straight forward. After all, I’ve been there twice before.
This being my pregnancy that ended the earliest, the sac measuring less than 6 weeks and without an embryo, I thought it would be over quickly. I imagined inserting the medication around 8 o’clock in the morning, then laying down and watching a movie to distract me. In a couple of hours, the excruciating pain and heavy bleeding would start, and I even thought it might be over whithin 4 to 6 hours. Then, I would take a long, warm shower, eat the lasagna my husband had prepared the day before and rest, finally starting to heal emotionally, since most of the physical pain would be over.
It began like I envisioned. Got up on Friday at 7 a.m., had breakfast and by 8:30 a.m. I was ready to have the treatment. I took the little bag of pills and looked at the painkiller. Distrusting doctors is my new norm, so I thought to double check that drug on Google, since I never took it before. The problem is, I’m severely allergic to aspirin, which makes me allergic to any NSAIDs (Nonsteroidal anti-inflammatory drugs, which includes several types of painkillers). I’ve had anaphylactic shock twice in my life, and been lucky to survive them.
On Wednesday, when the RE confirmed the fetal demise and recommended me to manage the miscarriage medically, I specifically reminded her of my allergy and asked that she made sure I got the right painkiller. So googling the medication on Friday should have been completely unnecessary; only it wasn’t. The medication she gave is a NSAID.
If I wasn’t overly cautious, this could have ended very badly. My husband was spitting fire with anger at this point, and wanted to make a formal complain about this doctor. These past 3 years, however, have taught me to let go of the smaller things and keep my eye on the important goals. And as much as I’m angry with the RE right now, I need to maintain a good relationship with her so she will refer me to the RPL specialist, which is my primary goal at this point.
The treatment was still waiting for me, so I called my GP instead, to get a different prescription. It took over an hour to get hold of the doctor and go fetch the new medication in the pharmacy, but finally around 10 a.m. I was ready to start. By this time I thought it was all falling into place and it would be over soon. I couldn’t have been more wrong.
I watched a movie, then read a book, then watched some more TV and the bleeding had hardly started. I felt very mild cramping with the occasional sharp pain, but nothing compared to the pain I had with my other two miscarriages. Something just didn’t seem right, especially the very light bleeding. At 4 p.m. I finally decided to call the hospital and ask if they had any advice.
On weekends (which starts at 3 p.m. on Friday) the gynaecological department is closed down, so I’m always told to call the maternity ward. Calling the midwives and telling them I’m having a medical abortion for a missed miscarriage is always hard. They don’t understand why I’m calling over there and are often rude. They keep transferring my call from one nurse to the other, forcing me to repeat my history of losses again and again. It’s just too painful. At last, a nurse told me to wait until the morning, that maybe the treatment just needs more time and every pregnancy is different.
I took the nurse’s advice and decided it was time to have that shower and that lasagna, because nothing was going to happen any time soon. At night, I was afraid to go to bed and wake up in the middle of night in excruciating pain, the memory of blood clots the size of oranges and contractions getting stronger and closer together being too fresh still. I finally managed to fall asleep around 3 a.m., without much pain or bleeding.
In the morning, I called the hospital again and spoke to a doctor. She wanted to scan me, so off I went to the ER. We talked about my history, the fertility treatment and my symptoms, and shortly after I had my legs up in the stirrups, as usual. The sac was not visible anymore, but my lining was still pretty thick, around 27 mm, so she agreed the drugs were not working. I was given 4 more pills and sent home to try again, with the recommendation to call the next morning in case the bleeding didn’t get stronger.
Another day of mild pain and light bleeding went by, with the hours dragging on and no closure in sight, only anxiety to get this over with. Sunday morning came along and I called the hospital again. Several insensitive nurses later, I spoke with the doctor, who wanted to proceed with a D&C immediately. At this point, having had countless doctors frightening me off about the high risk of developing Asherman’s syndrome from this procedure and how that would negatively impact my already damaged fertility, I asked to try and wait a little longer. After meeting him at the hospital, having another scan and confirming that little had changed in my lining thickness (around 23 mm, after 2 rounds of Cytotec), he agreed to try the medication once more.
This waiting for the miscarriage to start is hard and I know I can’t let go emotionally until the worse is over. The D&C could have ended it all quickly and with little pain, but I’m too afraid to damage my womb. I don’t need more issues reducing my chances of getting pregnant, my one and only tube and recurrent miscarriages are enough. Moreover, going through the physical miscarriage process, as painful and horrendous as it is, brings me some closure. The physical pain matches well how I feel inside and legitimates my suffering, making the loss more real. No one can say this life was only a few insignificant cells when so much is involved in letting it go.
Now, I’m still sitting here, waiting for the hours to pass by, waiting for the freeing pain to show up, after the third 0.8 mg dose of misoprostol (Cytotec). Realistically, it’s more likely that I’ll have the operation on Tuesday, on my next appointment at the hospital. Tuesday is the deadline they gave me for the medical treatment, so I can hope for better days from Wednesday on…