Thursday, March 8, 2018

My Scary Pregnancy Stuff - Part 2

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[EDIT: Be warned this post discusses a lot of blood.]

So, at 6 weeks I at least knew that I was cleared of an ectopic pregnancy. Thank goodness.

Then, as things progressed, I had all the awful physical side effects as listed in one of my previous posts. But the good ol' scary question marks have reared their ugly heads twice more now. instance number one is as follows:

When I went in for the anatomy scan at 21 weeks, they found I had a Grade 3 placenta previa. That means the placenta is being a dick and is sitting at the opening of the cervix. While your eyes just glazed over there, I can sum that up to mean that if blood vessels rip there and/or shit doesn't move out of the way on its own, I'm in big trouble. You can hemorrhage out and in extreme cases, Mom can die within 10 minutes from blood loss. Things get pretty grave for baby, too. Your body still keeps pumping blood to the placenta to help the baby, but it's essentially like a garden hose just spraying out of control with the tap turned to full blast.

If they know you have it, but you don't go into early labour, your doc will book a planned C-section so no one dies and bleeds out. If you go into early labour, or you have placental abruption, shit goes bad fast and an emergency C-section is necessary to save mom's life.

I discovered that there were risk factors that increased my chances of having placenta previa. They include: 
  • Being old as fuck while pregnant (that's me, so yep, check)
  • Having had a baby already (here's lookin' at you Baby D, check)
  • Previously having a D&C (had that 12 days after delivering Baby D, check)
  • Previous scarring in the uterus (likely from infection after Baby D, check)
  • Late implantation of the fertilized egg (seems that way based on dates, so check)
  • Cocaine use (wait. No. Goddamnit I never have any fun.)

And while it often CAN self-correct, and you assume that description is a worst case scenario that likely never happens, I can tell you that I sat with my sister's legs elevated on my shoulders as she bled out on her bedroom floor in this exact scenario while pregnant with her second child. It was utterly fucking terrifying. And there was nothing we could do for her but hope the ambulance would arrive soon and somehow fix things. 

I remember chatting with my 2 year old niece at the time, pretending EVERYTHING WAS NORMAL and okey dokey so she wouldn't feel scared, while her Dad was on the phone with 911 running all over the house trying to find my sister's health card. It was surreal as my sister went in and out of consciousness. It felt like everything was moving in slow motion. I felt terrible that I was acting so nonchalant with my sister essentially dying on the floor behind me. I was just so determined not to let my niece see how dire the situation was. 

I eventually took her out to the backyard to play on the swings before the EMT technicians came in, until her Mommy was in the ambulance. We stayed out until it was dark. I vividly remember the ambulance lights flashing in the night sky from the driveway out front. I had to wait until they pulled away to go back into the house. And my God, all the blood. It was everywhere. The bedroom, the hallway and all down the stairs. And they would have taken her out by stretcher... so, WTF.

I don't remember putting my niece to bed, but I did, then I began sopping up the blood in a kind of numb state. We didn't all have cell phones then. I couldn't text or call anywhere for an update. I remember her neighbour came over and asked what was going on, as she proceeded to tell me it was God's will, blah blah blah as I wiped up pool after pool of blood. My sister was only 34 weeks pregnant so it was not a good situation.

They survived. She needed a blood transfusion. Her baby had to go to a specialized hospital. They were both so very close to dying. We later met up with the EMT to attended to her that night and heard even more horrifying details of what happened and just how close we were to losing her.

So as soon as I heard that I had previa, I have been on edge and afraid. In BC, where I live, they don't even consider it an issue until a scan confirms it is still present at 32 weeks - OR - you have bleeding (or a "sentinel" bleed which is like a warning that shit isn't quite right) at some point before that. Relatives (who are doctors) in another province were aghast that I wasn't being followed before that with regular ultrasounds with an obstetrician and that I wasn't put on pelvic rest, either. (No exercise, heavy lifting, sexy time, etc).

Apparently, as the uterus stretches and grows as you get farther along, the placenta can eventually move up and not be in the way. It's clinically insignificant what it's doing before 32 weeks, because the body won't have enough room for it to self-correct before then. So extra ultrasounds may show things improving a bit, or may not, but it doesn't really matter until further down the line. Makes sense, but it definitely not comforting to say the least.

I can tell you that it is a loooooong wait between 21 and 32 weeks. I still have almost three weeks until this scan. Until then, I can't fly, can't be too far from the hospital, can't do road trips, all that, in case I start to bleed. I continued doing spin classes, being careful not to slam my junk down hard on the seat or anything (since my midwives said to keep exercising as normal).

My body totally gave up on exercise just after 24 weeks. The anemia, sciatica and hip/butt pain have made it totally impossible. In the last four days just walking 20 feet I have almost passed out three times. No joke.

That can be attributed to my anemia. My levels are brutal. I am supposed to be getting an IV iron infusion very soon. It also carries risks, and can result in anaphylactic shock or severe allergic reaction. It's scary, I'm scared, but my levels are dropping too fast and my body is not tolerating the oral pills or liquids. Further that, if I DO get a sentinel bleed, or have previa that doesn't resolve, the already low blood and iron levels can mean an even more dangerous situation for me. So, fingers crossed that my body accepts the iron IV with little to no side effects, and I can carry on with this pregnancy hopefully better off and not scared to move, walk or drive.

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Monday, March 5, 2018

My Scary Pregnancy Stuff - Part 1

0 COOOOOOMMENTS! Now you speak up!
I am a blob.

A pregnant, dizzy, pukey blob.

I've been hesitant to write anything here because none of it is particularly enjoyable or positive. But then again, this blog has been a useful outlet for me over the years so to not write is essentially defeating the purpose. Derp.

I wrote my last post around the difficulties I'm having with being pregnant. The plot has thickened further so I might as well keep going with it. Let's take a look back to see where my mind was and where it is at now.

If we go back, way back, way way back to after Baby D was born (4 weeks premature with a stint in the neonatal intensive care unit), I was in a significant amount of pain even 10 days after she was free of my belly. The public health nurse at the time told me that the amount of pain I was having didn't seem normal and that I should get checked out. My family doctor could not have given less fucks, and I ended up back at the hospital emergency department.

I waited for hours, still in pain, and the doctor I saw was very dismissive as well. He asked a few questions, squished my post-baby belly but did no exam. He said to come back the next day for an ultrasound, IF I WANTED TO BOTHER, and that was that.

When I had the ultrasound the next day, the tech's face went serious and she told me not to go home but to proceed back to the emergency department straight away. OH, GOOD, I thought. I'm sure they tell that to everyone that is healthy and normal. The panic started to set in.

I went back to emergency and explained the deal. I assumed the ultrasound report was already there, or at least on its way. After hours and hours of waiting in the waiting area, I finally called the on-call OB (obstetrician, aka baby doctor) number I was given pre-labour and left a message begging for some help. The pain was getting worse, and I was sitting in the waiting area seemingly forgotten.

A resident doctor called back and said she would be down to help me. She examined me and immediately noticed that I was still 4 cm dilated with a clot!! It was visually obvious. It was not good. And my body essentially thought I was trying to push out another baby! Nucking futs if you ask me!

From there, I needed a D&C to get rid of whatever squatters were hanging out in my uterus without a lease agreement. It's the post-delivery surgical equivalent to using a spatula to get all the cake batter out of the bowl when baking. It was awful. I was readmitted to the hospital while my 11-day old newborn and husband were left to fend for themselves. I needed to pump my ginormous milk-filled boobies but by the time I was actually brought to the ward, the lactation consultant wasn't on duty and apparently morphine is readily available, but the breast pumps are on goddamn lock and key. I hadn't eaten. I was alone. I cried myself to sleep that night in pain, scared, missing my family, wondering what was going to happen to me.

Though this type of procedure happens pretty often, I was really worried I would die. Labour was traumatic, Baby D's heart rate skyrocketed and she was whisked away to the NICU. I bled so much. I felt like she was going to die or I was going to die. I had just gotten over that emotional hurdle and then had to go under anesthetic and hope things went ok.

My Mom actually had to meet Baby D at the hospital. She flew in and everyone met up there so I could be a part of it. Not stressful AT ALL. Nope. Good times.

Anyway, fast forward a bit and I had infections post procedure, illness and all kinds of troubles. My OB at the time was a fucking moron and I ended up needing IV antibiotics in-hospital for over a week because she didn't culture anything and the 4 different oral antibiotics she put me on were ineffective. I was the lucky recipient of an infection that caused scarring in my Fallopian tubes. And who says being female isn't awesome?

When I finally saw a competent OB, he explained that I likely had scarring and I would need to be careful and monitor early if I were to get pregnant again because I was at greater risk for an ectopic pregnancy. That's where the fertilized egg gets stuck in one of the two Fallopian tubes and starts to grow, but eventually it runs out of room and bursts. An ectopic pregnancy can never survive, and it often results in serious blood loss and is potentially fatal for the mom. I know someone who nearly died from it a few years ago. You typically end up losing that tube and it can reduce the chances of getting pregnant in the future, too.

So once we found out I was really pregnant, I remembered that advice, and went to my family doctor. While it is almost impossible to see a 4-week embryo on an ultrasound, there is a possibility of seeing a 5 or 6 week embryo. Sometimes the ultrasound technician is able to rule out anything growing in the fallopian tubes, but usually the technician is looking to see is a tiny yolk sac in the uterus. At least then they know that it isn't dangerously growing in a Fallopian tube.

I had researched this and knew it was important. Often times if the tube bursts, mom can get incredibly weak and have a high volume of internal bleeding before she even knows to call for an ambulance. It is scary shit. It is time sensitive and some women don't know there is a problem until someone finds them passed out on their bathroom floor. There is absolutely no warning signs, and nothing that a mom can do to prevent or help an ectopic pregnancy.

So at my doctor's appointment, with my 4 year old in tow, that same family doctor once again gave zero fucks, despite what I told her the experienced, well-respected OB had told me years before. Her response?

"At 4 weeks they can't see anything anyway. Yes, it could burst and you could die, but what can you do?"

SERIOUSLY. I started crying immediately. My poor daughter looked so concerned and asked what was wrong, why I was crying. Ugh. It was just so cold and dismissive.

Luckily for me I had signed up with midwives while the pee was still drying on my positive pregnancy test, and they saved the day, sending me for a scan to be booked between 5-6 weeks. They hadn't even met me yet but they went above and beyond to help me out and relieve my fears of bleeding out and dying in the night.

The technician was able to see the yolk sac in a safe place. So I could breathe a sigh of relief instead of wondering if my tube was going to explode at some point between 4 weeks when I found out I was pregnant and my first dating ultrasound at 9 weeks.

And so it began, the wondering if my body would turn on me, not having any way to check or know for myself, relying solely on how seriously my care providers took the situation, and waiting for the scan to hopefully provide more information. It was a very stressful start to what should feel like an exciting time.

And then, the anatomy scan decided to turn things upside down again...

To Be Continued...


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