9 weeks: finding the reset button.

Today would've been 9 weeks. Last Wednesday I'd resolved to wait, zen-like, for my body to take care of this naturally, gently.

That decision lasted until the evening. I did a little research and found out that with misoprostol, it's frequently over within twelve hours. The old-fashioned way can take, literally, weeks. Weeks of bleeding, weeks of cramps, weeks of pregnancy symptoms.  I did the math (number of weeks multiplied by insanity factor) and by the next morning was super-keen to get the misoprostol.

Except it turns out that the misoprostol I was offered so lightly on Wednesday night was actually a pain in the butt to get. I called Thursday morning, with some idea that I could stop by the office on Thursday afternoon to get the prescription. Hahaha no.

I finally got a call back Thursday night telling me that someone would call me Friday morning. On Friday morning, the PA called and said she'd talk to the doctor and get back to me later in the day. At 5 pm she called me back and said "you'll have to come in for an appointment on Monday."  I'd dreamed that I'd be able get it all over with by the end of the weekend, and was bitterly disappointed to be denied.

Anyway, I dragged through the weekend -- I say "dragged" just because the pregnancy-fatigue was still going strong, along with the need to get up and eat a three-course meal at 2 am every night. Pregnancy symptoms are a lot of fun when you're going to have a baby. They're just an annoying inconvenience when you're not.

Monday morning I went in for my appointment. They'd mixed up the paperwork and had me down for an ultrasound even though I was only supposed to be there for a consultation. "What the heck," thought I. And maybe, just a little, maybe .05% of my brain thought what if it's all a mistake? What if it's a Christmas miracle? What if there's a little heart beating away in there?

There wasn't. There were two little embryos, measuring 6w2d and 7w4d, clearly sharing a placenta (i.e., identical). They looked like little packing peanuts curled up in there, two very quiet packing peanuts. I kind of wish I'd gotten a picture, but for some reason they don't offer you pictures of the dead ones. But in any case, I was still glad to have seen them again. Last week I hadn't gotten a measurement for Little Twin, so it was oddly satisfying to have that verified. 

The doctor's not a big fan of misoprostol. He gave a decent shot at trying to convince me to do a D&C. He assured me that they're "very gentle" and that they "only use suction" and "the chances of getting scars from a correctly-done D&C are almost nil". If I did a D&C it would all be over quickly. If I did a D&C I could have a chromosomal analysis done of the tissue. With misoprostol, 40% of women have to have a D&C anyway.

Unfortunately, I know that most of what he was telling me wasn't true. Don't get me wrong, I think this practice is very good at what they do, which is reproductive endocrinology. They don't know jack shit about Asherman's Syndrome. Yes, you can get adhesions from a properly-done D&C. No, using suction only doesn't prevent scarring.  No, a woman with Asherman's shouldn't get a D&C done unless there is absolutely no alternative. Misoprostol is more than 80% effective if you give it a whole week to do its work (this practice judges after three days).  I'm a walking dictionary of misoprostol trivia at this point. I spewed some figures and he sniffed and shrugged and said he'd go to get the consents.

He left, and then I cried. I wasn't really expecting there to be a living baby in there.  But seeing the pictures was still... hard. Little Twin was pretty indistinct, but Big Twin looked like such a perfect little fetus. Perfect, just dead.

I spent the next three hours getting my blood drawn (they require a hematocrit), waiting for the bloodwork to come back, waiting for this, waiting for that, waiting at the pharmacy. It was, apparently, lovely weather for a sleighride together with me. Also, I should have myself a merry little Christmas, and that's the Jingle Bell Rock. I did not stab anyone.

Four hours later I emerged with 8 200mg tablets of misoprostol, a strip of Zofran (anti-nausea), and a handful of Ativan, I guess in case the process made me edgy? I'd already filled a prescription for some painkillers.

I decided to wait until Wednesday morning. Misoprostol can be unpredictable, and if I were going to be doubled over/vomiting/yelling/cursing/hemorrhaging, I wanted it to happen when Small Boy was at preschool and not when the poor dude was trying to have himself a Merry Little Christmas.

So yeah. This morning I dropped him at preschool, went to the supermarket and picked up a party-sized pack of sanitary napkins. Went home, popped a Zofran and a Perc. Half an hour later I briefly dipped the misoprostol pills in 5% acetic acid, better known as white vinegar, and crammed four of them up the hatch (via my handy PreSeed applicator). I then waited for something to Happen.

An hour later I started cramping. Four hours later I felt like something was going to Happen. I shuffled over to the bathroom and then in a mighty rush, the entire universe fell out of my uterus.  In the space of five minutes I passed the gestational sac, the fetuses, and what Her Indoors was sure was at least some of the placenta (she's a biologist, so I have some faith in her identification).

Friends, that is some good stuff. I know everyone is not as lucky. Some women end up writhing and puking, and some women get no effect at all. But for me, it did exactly what it said on the tin. The cramping has been no worse than bad period cramps (admittedly, without the painkiller it probably would've been a whole lot worse). And holy god has it cleared a lot of underbrush out very quickly.

I've been bleeding briskly since this morning. The cramps have gotten better and worse, but the painkillers keep them bearable.  I won't know until Friday if the job's completely done. If it's not I'll likely have to fight not to have them "clean it up" with a D&C. But fight I will; if anything lingers, you bet I'd rather have another round of misoprostol.

Right now I feel wrung-out and crampy but so relieved, and grateful that the misoprostol seems to have worked for me. Fingers crossed that Friday finds that it truly is over.


¹The literature is a bit mixed on whether or not dipping the pills in acetic acid definitely speeds action/improves absorption. But I figured I'd try it on the grounds that at worst it would have no effect, and at best some studies have found it halving the time to completion (which otherwise averages about 12 hrs from administration). Since my uterus enthusiastically spewed four hours after inserting the tablets, I'm inclined to believe that it helped. It also makes a lot of intuitive sense to me. As soon as I dipped them they started to disintegrate. I was basically inserting a firm paste, not dry pills.  If any internet travelers stumble across this, I personally vote "yes" on dipping in 5% white vinegar.

Stuff that happened yesterday

Kind of funny
One of my coworkers stopped me in the hall to tell me how fabulous I look after having lost all that weight. I was just boggled. I mean yes, I did lose ten pounds in about a week, but only after I gained ten pounds in a similar time frame. Maybe I can make big bucks selling my OHSS-and-pregnancy-loss diet.

Not so funny
Flicking open my Google reader yesterday and seeing a picture of an ultrasound, 6w5d. I would no more than have winced if it had been on one of the many TTC blogs I read, but it wasn't -- it was in a blog belonging to a high school friend, so I was totally unprepared. 6w5d... why does that sound so familiar? Oh, right. Yesterday I was supposed to be 6w5d. And what's that due date at the bottom of the screen? Yup. To the day.

Huh, thought I. So that's what the ultrasound was supposed to look like.

I think anyone who's ever lost a pregnancy is familiar with the "shadow pregnancy"^* problem. In my case it was easy to solve. I just unsubscribed to his feed. High School Friend and I haven't been close in the past 15 years, and I can live just fine without the blow-by-blow here.

I will admit that after I unsubscribed I went back and stared at the picture for a while. Oh. So that's what it was supposed to look like.

In other news, my pee stick was blank this morning. Mostly I'm glad, very glad; the swiftly falling levels mean that chances are excellent that my uterus is clearing out nicely all on its own. And the faster they fall, the sooner we can start again.

Still, I felt a tiny sigh. There is no longer anything pregnant about me.

Never mind. On the whole I'm feeling fine. I never would have believed you if you'd told me last Wednesday that by the following Tuesday I would be feeling pretty darn good (of course, last Tuesday I still thought I was pregnant). The situation sucks , but I knew the rules when I sat down at the table. The fluke was that I was pregnant for a little while, not that I lost the pregnancy.

I'm trying to be grateful for the glimpse I had during that little time. The world really was a different place, and it all seems a little cold and dull and mundane back here on the other side. But it's not, really, it's all just as warm and rich and wonderful as it was before. I just hope that it's not too long until I get to put on those emerald-tinted glasses again.

^*I believe that the term "shadow pregnancy" was coined by the ever-apt Bri at Unwellness.

My weekend

Saturday
All day I kept eagerly rummaging in my nether reasons to see if I'd begun to bleed. Nothing, nothing, nothing.

Saturday night we went to Target. All week I'd been planning a trip to Target after the Friday ultrasound, after we heard a heartbeat. I was going to do a victory lap around the maternity clothes and even walk casually through the baby department.

Well, I love Target. I was not going to miss my Target trip just because I was suddenly unpregnant, dammit.

We went and had a good time. Bought dog biscuits and I'm suddenly unsure what else, but I know there were like five bags, so we must have bought some other stuff as well. Had a good time despite the fact that they clearly made a mistake letting me in the door, because every other woman there was visibly pregnant. One of the men looked a little suspicious, too.

When I stopped at the bathroom on the way out, I had begun to bleed, just a little.


Sunday
Woke at 7:30 cramping like a mofo. Hobbled to the bathroom and realized that I was beginning to bleed in earnest. The next four hours or so weren't pretty. I guess I'm lucky in that with my period I don't usually cramp that much, which is to say that I had no idea that cramps could be this painful. Naproxen and heating pads didn't make a dent. I had to just breathe through them. The nice part was that in between cramps, when they stopped, they were completely gone and I felt totally fine, until the next one hit.

Bled heavily until around 11:30. Being up and walking around made it somewhat better. B made us delicious buttermilk pancakes and bacon and we took it out on the porch.

The next part I am putting in invisible ink for my more sensitive readers, or anyone who simply does not desire to read about the contents of my uterus. Select the text with your mouse if you wish to see it, you gross thing you.

While eating breakfast, I felt something utterly unlike a period cramp -- a sharp lancing pain that made me gasp. I went upstairs to the bathroom and passed three clots each about half the size of my fist. Then I suddenly felt much, much better. Not just physically but emotionally. Can't really explain it.

After that the flow slowed right down. I've had intermittent cramping, but nothing like this morning. That can't be it, there wasn't enough, too easy -- but I feel like something happened, and for whatever reason I have been feeling much better, even a little peaceful. My sweetie's practical explanation is that my ridiculously high hormone levels have finally settled down. She might be right about that. Whatever the reason, I'm grateful.

Edited to add: I'm the luckiest girl in Girlville. Just walked into the bedroom to find that the woman I am blessed to call my own prepared us a spontaneous Beltaine feast, to be served in bed. Now she knows that I love eating in bed like I love ... well, there just isn't anything I love that much.

The food is so lovely I had to take pictures, which will be posted shortly. White wine, beautiful beets, this interesting clam-potato-fresh dill-homemade lemon mayo salad with avocado curls, and the prettiest fruit salad you've ever seen.

I am the luckiest asshole ever.

Gotta go eat.