Well, it’s been two weeks since my last post. I went to an OBGYN on July 23rd.
Originally, he wasn’t going to do any testing once he read the charts from my ER visits. He said that it “didn’t look good.” I was understandably livid.
“You’re going to bill Medicaid for this consultation but you’re going to perform NO tests?” I thought.
They had me piss in a cup when I first arrived, but they never ran any tests on the urine. What about a pregnancy test? Protein levels? Sugar levels? Infection?
They weren’t going to draw any blood. What about a quantitative HCG pregnancy test? Progesterone levels? Sugar levels?
They weren’t going to perform an ultrasound. Two and a half weeks since the last one, and you’re not even the least bit curious if any changes have occurred?
I told him to run tests. Even though my urine sample remained sitting on the counter not being examined in any way, they did eventually schedule me for a blood test at the hospital’s outpatient clinic and an ultrasound back at the OBGYN group’s office later that afternoon.
When I went in for the ultrasound, I didn’t know the results of the blood test yet. It took forever for them to call me in for the ultrasound, and even longer for them to sit with me and go over the results. Even though there was more in the sac than two and a half weeks earlier, and even though my blood test had shown a 5,000 increase in HCG in that two and a half weeks, and even though the sac was measuring about two weeks larger than it had at the last ultrasound, the doctor still said it “didn’t look good.”
What gives? I would think that rising hormone levels, regardless of the rate of rise, would be a good thing? And what about those medical case studies where levels tend to level off and then lower towards the end of the first trimester? And if I’m enevitably miscarrying, then why is the sac growing? Why is there something that looks like a fetal pole in the sac now, when the previous ultrasound tech claimed not to see such a thing? Why is there a blobby thingy in the sack that could have been the heart if the other thing was a fetal pole? I don’t know where the other two sacs I saw at the first ultrasoun have dissappeared to. Maybe I was imagining their having been there. But I do know that the doctor showed me what my charts had stated before, and what the new tests had shown. Maybe I’m in denial, but I should hold on to any good signs, right?
In 2006, when I had my last miscarriage, the hormone levels were doubling on schedule, the bleeding was ranging from spotty to heavy, and the sac was growing at a steady rate, but I ended up miscarrying at 11.5 weeks. When I was pregnant with Luna, I didn’t see a doctor til I was four months pregnant, so I have no idea what my hormone levels were doing, or how the sac would have measured, but I didn’t bleed, except occasionally after sex. The miscarriage I had in 2003 was an abrupt, all-in-one-day occurance.
Today, based on the start date of my last menstrual period, I am 12wks1day pregnant. Of course, I have no idea when I ovulated. If I ovulated exactly two weeks after that period started, then the actual gestational age would be 10wks1day. If I ovulated a week later than that (which could still have given me the positive test when I got it) then the actual gestational age would be 9wks1day. At the last ultrasound, the sac was measuring a little under 7wks actual gestational age. That would put me behind by two weeks and would be inconsistent with my positive pregnancy test. I have read that sometimes women who have tilted uteruses and/or overtly thickened uterine linings will have sacs that measure a week or two smaller than normal, but later in the pregnancy the sac measures right on schedule once more, as the baby gets larger and is easier to see via ultrasound.
My bleeding is still not heavy enough to require a pad. Sometimes I wipe and it’s their, sometimes I wipe and it’s not there. Sometimes I wipe and it’s old blood, sometimes I wipe and it’s bright red or dark red. No tissue has passed, though some small clotty looking things sometimes appear, which are the consistency of cervical mucous but bloody, kind of like blood mixed with cervical mucous.
I’m not sure when to schedule the next ultrasound. On the one hand, waiting until 20wks would mean that if the baby has survived all of this bleeding it would be plenty large enough to be seen via ultrasound. On the other hand, I kind of want to know NOW whether any changes have occurred, good or bad. One thing I am certain about: I will NOT consent to a D&C or an abortion pill to “help the miscarriage along.” To me, both options would be abortion, even though the doctors are “certain” I’m going to miscarry. I am not faulting women who, for varying reasons, chose to accept medical assitance in terminating a “doomed” pregnancy.
Miscarriages aren’t an easy thing to deal with. Waiting it out, like I am doing, can be emotionally draining, especially if people know you are pregnant and you have to constantly explain your story to each person you run into. But deciding to terminate a pregnancy is also emotionally draining, and if you’re not 100% sure that the pregnancy is doomed, you’ll always be wondering if you’d made the correct decision. If the doctors run tests on the “tissue” they can tell you why you were going to miscarry, and it’s easier to do that if you let them do a D&C, but then there have been occasions where a formerly viable pregnancy was found among the aborted tissue. There have also been babies who have survived abortion procedures (even babies who were supposed to have already been dead or malformed and on their way to miscarrying anyway). Among the survivors, some go on to lead healthy lives while others go on to have disabilities or die.
It is my personal decision to “wait out the diagnosis.” There are potential negative consequences to this decision as well. In some cases, women who wait to miscarry naturally end up with infections or hemhoragging. In other cases, they go on to just miscarry at some point. However, in some glorious cases, they go on to find a healthy viable baby when an ultrasound is performed later on. The “later on” is what I am hoping for.
Aside from the results last Friday, which could be interpreted either way, there are other reasons for me to be hopeful. My breasts are still heavy and tender, still a pregnant woman’s breasts. My abdomen is still expanding; my pants are still tighter and tighter. I have gained plenty of weight in the past three months, but it’s visible only in my breasts and abdomen. I am retaining water moreso than usual. I am having pregnancy cravings. I am urinating even more frequently than usual. I am experiences differences in bowel habits. And though people insist it’s too early for this, I swear I sometimes feel quickening.
To make a long story slightly less long: I am still pregnant and have no plans to terminate this pregnancy, in spite of my doctors’ negative feelings towards the outcome. At some point, either through ultrasound or through obvious physical changes, I will find my healthy baby. That is my positive belief about this pregnancy. I’ll keep all of you imaginary readers updated as I get updated.
Lee Kernaghan–You just keep holding on to hope. Your spirit’s bent and broke, and all that’s left is pride. To work this restless land takes the kind of man who’ll give it one more try, backing your faith and trust in a handful of dust.