Thursday, October 1, 2009

Closure and Remembrance

I was about 7 weeks pregnant. The fertility center's protocol is that at 6 weeks you have an ultrasound. My friend Clare, who is my age (gasp, we're past our 40th birthdays) had been in to see her doctor at 6 weeks and was told there was no heartbeat on her ultrasound but there might be and she should come back in a few days. Later, at the return, she found that her embryo had already died. Remembering that experience, I delayed my own ultrasound for one week so there would be no dilly-dallying about growth of a fetus.

I flippantly and cheerfully gave my husband a pass and encouraged him to stay at work instead of coming to the second ultrasound. I had seen the embryo on a previous ultrasound, firmly implanted in my uterus at 5+ weeks, so we knew that the pregnancy was proceeding normally. I hopped in the minivan and dropped the children off at my parents and zoomed off for the hour drive to the Fertility Center.

As I drove, I was struck by a sudden sense of gloom, an almost tangible grey cloud, and I began to pray out loud for relief. I asked Heavenly Father to help this horrible feeling to leave me so that I could enjoy my pregnancy, and had the most immediate feelings and impressions. I felt comforted, but the gloom did not leave me.  My prayer changed and I asked Heavenly Father to help me to be cheerful and enjoy this experience for however the pregnancy lasted. I then saw in my mind's eye a fat little baby with a sweet baby face looking at me. I smiled at that baby, because the baby was a little smaller than my Andy and Sarah, who were 10+ and 12 lbs. each, and the baby was also bigger than Emma who was 5-11 when I brought her home from the hospital. I felt some relief to be seeing a live birthed baby because this feeling of gloom was so strong as I drove. And yet I felt comforted.  I put it all aside to cheerfully greet the receptionist.

I went in and got ready for my ultrasound and chatted with Dr. H who was there to perform it. She scanned my abdomen and a momentary flicker led me to say Oh There's the heartbeat, and she said no.. that's not.

Oh. A sick feeling of dread overwhelmed me. Shock and puzzlement filled my soul. How quickly I forget what I had been warned.

She scanned over to the actual fetus and said "I'm sorry Honey, the baby has no heartbeat". I sucked in air abruptly.

There's no heartbeat - how can that be? Oh.

She measured and recorded her medical information for my file, the baby made it from embryo to fetal stage, but had stopped growing one week previously.

I want my mama!

How am I going to tell my husband? He's at work, and this is going to hurt so bad.

She hugged me and left me to dress into my street clothes, indicating I was to meet her in the office across the hall from the ultrasound room. I texted my husband to call me. I sat in her office and heard the clinical explanations of what happened. Probably chromosomal damage. An incident of the interaction between one particular sperm and one particular egg. Not uncommon over age 35, but not a portent of everlasting doom either. That helped, somewhat. FarmBoy called as I sat listening, and I told her I'd take my husband's call. He took the information calmly, and Dr. H was able to answer his questions as she had mine.

How do you recover from that? How do you take that same rounding belly home, and wait for your body to recognize that the baby is dead and expell the fetus? Why does morning sickness make you barf on the way home, even though you just found out the baby is dead. Darn those hormones! How do you reconcile the joy you felt at having a new family member join your family with this sudden gloom? There are no simple answers. Here's where I found peace.

I was given three options. I could wait and see how my body handled a miscarriage within the next two weeks and it might take care of everything on its own. I could use misoprostol, a drug that dilates the cervix and gives one contractions which will encourage the expelling of a dead fetus - but with a risk of incomplete miscarriage. I could schedule surgery, a dilation and curretage which would scrape out my uterus and end this process quickly and surgically but with a risk of uterine damage or scarring.

I opted to wait at home with my family. It gave me days to ponder my family, my hopes and our dreams, and to feel and process my grief in privacy. I cried, I was comforted, and I continued through stages of grief. It was good for me. However, as the 2nd week approached without resolution, I opted to take misoprostol, hoping to avoid surgery. I received testing at the maternity ward at the hospital and the shot for my RH factor in my blood. I took the prescription drug Cytotec every 4 hours as prescribed by my OB/Gyn's backup Dr., with painkillers, and was stunned at how painful the contractions were. I had gory blood clots but didn't see anything that was what I expected a fetus to resemble. My OB/Gyn called regularly to monitor my progress at home. After the third day of this I saw my OB at his office, and I was barely able to walk due to contractions and pain. He examined my cervix and said he could see the fetal sac right there, and predicted I'd pass it in his office or on the way home. Making certain I had all the supplies I'd need, I opted to go home, a mere 15 minute drive. I was a little cheerful, hoping for a final resolution and end to this ordeal.

The next day, a Saturday, came and went, without resolution, and I decided to go back into the office on Monday to schedule a D&C and be done with the suffering. I woke up on Sunday morning shaking and shivvering in the recliner as I lay wrapped warmly in my quilt. July turned out cold and cruel, after all. I came to my senses and took my temperature and headed for a hot shower to warm up. It was 102*. That's enough to send a woman in my condition to the ER.

I called the OB who said he'd meet me there. I took my pain medication and ibuprofen for the fever, swallowed a glass of water, and got to work. It took me an hour to get the children awakened, showered, fed breakfast and ready for church and organized to meet Grandma who would keep them for the day. My fever dropped as I went along, as I knew it would.

Then, content that all was well in my little nest of chicks, I went with my husband to the hospital. The OB examined me after I'd received an IV, and said yes, you have a large blood clot at your cervix. I told him it had been there since Friday and we had no tissue pass at all. He asked if I was still feeling strongly about avoiding a D&C. I said not any more. I asked him if I had a UTI. We had tested for that when I arrived. The lab results said no. I was a little anemic though. He held up his hands to show how far I was dialated, and indicated it would be curretage (scraping) only, and would be done under general anesthesia. As I was 15 minutes from needing another pain pill, I told him that as long as it was within 15 minutes I would be fine. I felt calm and noticed that FarmBoy didn't even look like fainting this time. He has that vaso-vagal response which put him on the floor at the sight of blood or trauma, but he held up pretty well, seated safely at my head.

I was wheeled into surgery. The surgery was normal and uneventful, and I had no nausea afterwards. I'm reconciled and have grieved the loss of our child some two weeks as I waited, so I was just clinically noting my responses to each thing and determining that everything was okay with me. I was hungry. I wanted sushi. This amused the nurse and doctor.  I ate sushi on the way home from the hospital.

The surgeon-OB told me that most all of the fetal material was still internal when he did the surgery, so the d&c was a wise choice. A wide open cervix is like a wick to a uterine infection. I had avoided that. He gave me some IV antibiotics, but just one dose, feeling it was sufficient. I recovered well, noting that I felt much better immediately, compared to the previous week of laboring for nearly 5 days.

It was good to see my children at home and my toddler gleefully climbed in my lap and asked if my tummy was all better. I had very gingerly held her over the past week, asking her to avoid my really sore abdomen. She's glad that's past, as she takes flying leaps into my lap with her pink cheeked demand "Hold me, I tired". Grandma, my mother, brought over dinner Sunday night, as I vegetated, while my white faced self recovered from anesthesia.

I rested on Monday, just putting dinner into the crockpot to simmer while I read books and snoozed. The children went to Seabreeze, an amusement park with their Grandfather, and Grandmother kept the toddler with her. Yep, I milked it. Napped, nibbled, novels. A good day to recover. I skipped soccer practice that night, as a nod to my OB, but not because I needed to.

Ladies from church have apparently recieved word that an army has taken up residence, as they brought over trays and trays of food including enough pasta salad and artisanal bread for an encampment, and a turkey dinner for the neighborhood. Bless 'em all.
I had to hurry and put the food away as we had a soccer game for the 7 year old's team that we coach. I ran off and on the field with the kids and assigned positions, blew my whistle incessantly to oblivious 7 year old blue frogs and just generally had a good time. It's nice to feel my muscles again and stretch my back and use my abdominals as we warm up.

When we got home, I still had energy. It's amazing. I've been tired of feeling pathetic, so this is nice! I took half the turkey dinner to a friend undergoing chemotherapy,my excuse being that it just wouldn't fit into our refrigerator with the food of the day before. And she has cancer. I had minor surgery, that I've been expecting for weeks, and I filled my freezer and pantry with easy to prepare foods and crock pot essentials.

It felt good to do something good for someone else for a change. Now that's more like it.
This is in retrospection of my miscarriage in July. It's now the last day of September. One year ago today I gleefully noted that I was pregnant with a new baby after two long years of trying, and had a miscarriage a day or two before Halloween. Then in July, just a month after that baby's due date, I had another later miscarriage. I know that there is a chubby, pink, visibly healthy little boy child waiting to join our family. We eagerly await the news that he's on his way after these two false starts.

If you would like to join us, please pray for a healthy, strong, full term body for a baby to join the Kolz family. Grandma Kolz passed away September 11, and we'd really like to celebrate another one coming, after we noted one passing.  Baby Daniel, Mama longs to hold you in her arms.


dude said...

you and your family are in my prayers.
he'll be there soon enough, I think

Spoodles said...

I'll be praying for you.

KelliSue Kolz said...

Note from KelliSue: One year and 4 days after this blog post was published I held Baby Daniel Kolz in my arms. 8 lbs. 13 oz., healthy, and blonde haired.