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Life, Loss, and the Pursuit of Happiness: Why I'm Blogging

Posted Oct 06 2008 12:00am
A blog...I decided I need a blog. A blog that I can use to blather on about an amazingly sad event that was supposed to end much differently. I’m afraid if I don’t have an outlet, the intense emotion will suffocate me. It has already taken over my mind and body and threatens to invade my soul. I hope that this blog will help me work through the pain and grief.

I called this Blog "Three Little Birds" for a couple of reasons. First, the song by Bob Marley gives me hope that "every little thing is gonna' be all right". Second, for nearly three months I was mom to three little birds - until on September 18, 2008, one flew away.

The littlest bird was inside of me. It had been growing and developing just as it was supposed to. Every ultrasound showed a strong heartbeat, and as the pregnancy went on, we could see movement. Hand and feet kicking and flailing. The first signs that our being was going to be a baby. A baby that would be loved so much and was wanted so much – even though the pregnancy was a complete surprise. In an instant, it all ended at 11 weeks and 2 days. The diagnosis of cornual pregnancy left me with an empty uterus, empty arms, and a very empty heart.

I found out I was pregnant four days before my husband and I were leaving on a vacation to celebrate our 10 year anniversary. The bean – or Bon Bini as we dubbed it on our Aruba vacation – seemed to travel quite well. Aside from nausea and exhaustion, I was okay too. I was actually more than okay – I was smiling and dreaming about the new addition to our family. An ultrasound was scheduled for the day after our return (August 13) to check the size and viability. Strong heartbeat. All looked good.

Four days later we were driving home from a family event. I was napping in the car when all of a sudden I felt strange. There was a twinge - almost a cramp - in my lower belly and I was sweaty and nauseous. I didn’t feel right. When we got home, I was bleeding – not a lot, but enough to concern me. I went in for an ultrasound the next day (August 18). They saw a small subchorionic hematoma – and the Bon Bini still had a heartbeat, a good strong one.

The next week was my first official OB appointment – August 27. They did the ultrasound and a different doctor remarked that the Bon Bini was implanted in the middle of my uterus in "a good spot". I hadn’t had any bleeding, though the hematoma was still there, and had felt well – morning sickness, but no pain or anything.

I bobbled along feeling pregnancy – tired, sick and bloated – and was happy as could be to feel this way. I was so looking forward to buying maternity clothes and making lists of what baby supplies we needed to acquire. No bleeding and no cramping gave me a sense of security about the outcome – which turned out to be false.

I did have twinges in my lower back, but I attributed that to things shifting around. I had also started to feel some pressure, so I called the nurse and she said to come in to rule out a urinary tract infection. I drove to the office on the morning of September 11. I completed the test and was on my way into work when my back started spasming. Then I started feeling cramps. I told myself it was just my mind playing tricks. And then I felt blood, a lot of blood. I drove home, called the OB and called my husband. There was so much blood and the cramps were fierce. “This is it” I thought. I was 10 and a half weeks pregnant and I was convinced the end had occurred.

We drove into the hospital and – through some miracle – they saw that strong heartbeat. My Bon Bini was a fighter! I was shocked. We saw it move for the first time too. So cute.

The ultrasound dr. came in and looked around. He said he was less optimistic about the outcome than he had been during my last couple of scans. He called in the OB and said something to her about a possible cornual pregnancy. Huh? I had no idea what that was. Afterwards, the tech described it to us – an implantation right at the outside of the fallopian tube - and she said that she didn’t think that’s what it was. The OB told us afterwards that she didn’t think that’s what it was either. The pregnancy could grow into the tube, but more likely would go the other way into my uterus and be fine.

I returned to the hospital later that night because the cramps wouldn’t quit. They reconfirmed the heartbeat, signed me up for an ultrasound the following week, and gave me some pain medication to help with the cramps. I had not even taken a Tylenol during the pregnancy, but I gave in an took the prescribed medication (sparingly) because of the pain.

I lumped around the house over the next three days. I researched cornual pregnancy and found out that it was not good. It usually led to uterine rupture or the removal of the pregnancy to prevent the rupture. Some suspected cornuals moved into the uterus and ended up being fine. I didn’t obsess too much because I thought all would be fine.

I continued to have cramps – no bleeding.

Wednesday September 17 was my next ultrasound and OB visit. When I went in, another strong heartbeat was recorded (my little fighter!). The Bon Bini was moving again – I could barely stand to watch. The tech gave us two pictures. The ultrasound doctor then came in. He looked and said “This isn’t going the way I hoped it would. We’re going to get you an MRI to see if we can find out more about what’s going on in there.” He left the room and I immediately broke down. I told my husband to throw out the pictures.

The OB explained that they were concerned the pregnancy was moving into the tube because of where it was implanted. The myometrium was thin the prior week and even thinner now. An MRI may – or may not - provide more clarity on the location and myometrium thickness. An MRI was scheduled for 10:00 a.m. the next morning.

I went home and then to pick up the kids. At about 6:00 p.m. I was making dinner when the most ferocious cramps set in. My husband was home, so I went up to rest. There was no reprieve. Then the bleeding started. I called the doctor and they routed me to Labor and Delivery at the hospital. Upon arrival, they assessed me and were very concerned about rupture. I didn’t have the hallmark symptoms, but they put in an IV and wouldn’t let me eat or drink “just in case”. They booked a "stat" ultrasound (which didn’t occur until 5 hours later!) and gave me some morphine for the pain. All the morphine did was make me nauseous – I’m sure not eating or drinking and just generally being pregnant contributed to this. Another stellar ultrasound. I didn’t watch this one. The tech said “I don’t understand why they would call this ectopic” – obviously she was not versed in obstetrical ultrasound, or any type of social graces in general.

I was being admitted overnight, so when we arrived back in L&D, I told my husband to go home. My MRI was in the morning. I would be fine. When the nurse helped me to the wheelchair, I started bleeding so I went to the bathroom. When I got there, a huge (4”x 4”) blood clot ran down my leg. And then more started coming out. The nurse thought that could be the reason for the cramping. When I arrived at my room, I had a couple of more blood clot episodes. And then things started to settle down. They had given me some motrin through the IV to take the cramping pain away. That helped, but I still couldn’t sleep. I gazed out the windows at the lights and wondered what the next 24 hours would bring.

The morning of September 18, I felt better. The bleeding had slowed. No cramping, though I was very sore (probably from all of the previous days’ events). I was mildly hungry and thirsty – though my IV was going to have to sustain me until the MRI. “This is an improvement”, I thought.

My MRI was pushed back a couple of hours. During that time, the OB came to see me. She told that if the MRI was not conclusive, she would do a laparoscopy to determine if there was a bulge in the tube. If there was, she would convert to a laparotomy and remove it. I was hopeful the MRI would tell us what we needed to know and that I could eat and go home and rest.

The MRI came and went. It was an uneventful test. And then the waiting game began. My husband came to the hospital around 10:30 a.m. or 11:00 a.m. to go to the MRI and wait with me. I guessed the OB would not return until about 4:00 p.m., figuring that she had patients to see at her office.

She returned and delivered the horrible news. I was going in for surgery within hours. My tiny, moving, living Bon Bini had to come out because the pregnancy was not normal. I was in danger. From there, everything was a blur. She explained the MRI results – and I can recall none of that except for some information about how the placenta was not in the uterus. And she also said she reviewed this with the Chief of OB and the ultrasound doctor and the course of action was set. She’d do a laparotomy – best case my uterus would be resected on the right side. Worst case, I’d lose my uterus. Either way, my right tube would be cut. She also said there was no way my uterus could handle a pregnancy in the future after this surgery. So I had her remove my left tube too. I did want to risk going through anything as horrible this ever again. Other risks included me hemorrhaging (the cornual area is very vascular with lots of blood flow).

We cried and cried and cried. We made phone calls to parents to let them know the story. And then we waited for the OR to clear. They came for me at 6:30 p.m. and put me in the staging area. I cried all the way down. How sad that I would never get to meet my little Bon Bini. I loved it so, so much and now it would be taken from me. How could this be? How could everything have gone so wrong, so quickly? I wanted to give birth to this baby, to have it meet its brother and sister, to have it wake me in the middle of the night to eat, to be a sleep deprived and very happy new mom. Now I would have nothing but an empty uterus – if my uterus was even spared.

A very nice OR nurse told me of her own experience with losing a pregnancy at 18 weeks. She told me that time would help, but I would always remember this. How could I not? Bon Bini was a part of me – a very special and cherished part.

They wheeled me into the OR and my sadness was then combined with fear for my own life. All this discussion about hemorrhaging and units from the blood bank was scaring me. I could not calm down. It was all happening too fast. I recall the bright lights, the OB, another attending OB, the nurse and the anesthesiologist hovering around me, preparing to sacrifice my future baby and my fertility all at once. Then they had me take some deep breaths and I feel into a thankfully dreamless sleep.

When I was wheeled up to my room from the PACU, my dear husband was waiting for me. The nurse set me up with a morphine pump and some pressure stockings and left us to rest. This was another sleepless night for me. I didn’t have much physical pain and my head hadn’t had time to process what had happened. I left strangely empty and lonely even though my husband was on a cot next to me and I was in a huge hospital with thousands of other people. The only person who wasn’t there was the one that had mattered – the one that had filled me up to the brim with wonderful emotions for 11 + weeks had a new home.

Friday September 19 the emotional numbness started to wear off. Tears flowed. I couldn’t bring myself to watch TV. I just stared out the window. At my urging, my husband went home to shower and relax. He’s such a great guy, I’m not sure how I would have gotten through any of this without him. My mom came in to visit. I ate for the first time since Wednesday afternoon.

Friday night was another sleepless one. My husband brought back my iPod and headphones, so I listened to songs and watched dusk turn to night and night turn to dawn. I asked for pain pills every four hours – mostly to try and keep my mind empty and body calm more than to alleviate any physical pain. I was going home Saturday, and while I was happy to get out of the hospital, I wondered how I would be able to carry on in the real world after all that I had been through. I had no desire to see or talk to anyone except my husband and kids. I did not want flowers or visitors. I just wanted to be left alone. I was not hungry, I was exhausted, but couldn’t sleep. I just felt guilty and sad.

After I got home, I spent hours online researching cornual pregnancies – much more time than my causal research a week for so earlier. Here are some highlights.

  • They’re rare: occur in 1 in 100,000+ pregnancies (some articles said 1 in 400,000+).
  • Some pregnancies appear to be cornual and then drop into the uterus – since the true ones are so rare, this is typically the scenario that plays out
  • About 11% make it to term – the remainder, if left untreated, rupture
  • Rupture typically occurs between 14 and 18 weeks
  • They have the highest maternal mortality rate of all ectopic pregnancies
  • Diagnosis is extremely difficult (due to the fact that some pregnancies appear to be cornual and then resolve) – it typically can’t be done by ultrasound and/or MRI, but requires a laparoscopy

I started to second guess everything. Had I asked the right questions? Was my life really in danger? Could we have waited – should I have asked to? Was this really a cornual pregnancy – or something just slightly unusual?

How could I ever be sure that what I did was right? Would I ever stop feeling sad, and empty and guilty?

Sleep did not come easily at home either. When I did sleep, my dreams were of losing something or of the whole experience of the diagnosis and surgery. There were medicines to calm me, but I could only take them at night and if I wasn’t driving the kids in the morning because they had a hazy after-effect. I wanted to turn off my brain and my heart. I wanted to be emotionless. A somewhat impossible feat for someone who had been through 1) a traumatic event and 2) still had pregnancy hormones flowing through them. What a wonderful thing that my breasts leaked when I showered….just another reminder of what I had lost.

The Wednesday after the surgery (September 24). the OB called my house to check in. Physically, my recovery was fine. Emotionally, I was a wreck. She made me an appointment with a social worker in the OB practice on Monday September 29. I thought it would help to talk. That just made the rest of the day worse because I was replaying everything in my head.

On September 29, I did a couple of errands to make me feel better. The same the next day too.

The OB called again on October 1. She had the pathology report. It was truly a cornual pregnancy. I was in danger of rupturing. They could not have waited. The bleeding was likely due to where the placenta was growing. That bleeding would result in cramping. I also found out the gender - though my husband did not want to know, so out of respect for him I am not including that detail here.

Even though I’ve been reassured this was medically necessary to preserve my life, I still have doubts about how this played out. In reality, if it had ruptured (and there’s a good probability it would have), Bon Bini would not have made it and I would have been in grave danger as well. Is it selfish that I am here – or would it have been selfish for me to try and hang onto the baby for longer and potentially leave my kids without a mother and my husband without a wife?

I’ll always remember my little brave baby who grew within me for over 11 weeks. Every time the stars come out, I look for Bon Bini in the sky and hope my sweet bird has found peace in a new home. Most of all, I hope Bon Bini knows how much I still love him/her…and I will continue to love him/her every day of my life.

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