Showing posts with label dilation and curettage. Show all posts
Showing posts with label dilation and curettage. Show all posts

Saturday, February 05, 2005

About My Retained Tissue Experience

(to a woman dx with retained POC)

I had retained tissue for certain after my d&c, it was due to my uterus being wrapped around my fibroid so the RE had a hard time reaching all of the tissue on the far side of the fibroid. My doc left the clinic a week after my procedure and I had to have a different RE pick up my care. She said that we could do a repeat d&c but the risk was that they might overdo the scraping; methotrexate which would require taking a break for a few months (and it isn't like that's not a pretty hardcore drug on its own -- it affects all the tissues in your body), or wait it out.

Since my beta was dropping she and we decided to wait it out. It took forever and I was having cycle weirdness and finally my body got fed up and did some really crazy things like not letting me sleep for more than 3 hours for over two weeks and then when AF arrived I was hemorrhaging, losing at least 2 pints of blood in 2 days. And then the bleeding continued on and off for another month up until my repeat d&c. I even asked the RE about all the bleeding I was having and she didn't have anything to offer me. I did see my acupunturist during this time and he was a huge help with symptoms like feeling like I was full of cold water, and feeling like I was drinking 3 triple espressos a day.

The only thing that caused any changes though during that time though was that I went to a health spa with a friend at the end of October. The first day of classes I took Feldenkrais, trancendental meditation, qi gong and walked a labrinth. That evening, 3 months after my first d&c, I passed a large chunk of tissue. There had to be something to all that meditational-like movement practices that caused things to shift. Still there was more left, and it was due to the fibroid preventing my uterus from contracting it out properly on it own, so I still had to have the surgery.

Oh, and to just make things feel freakier, I think the retained tissue continues to grow inside of you, though slowly dying off at the same time. Hence you get a larger mass of tissue with slowly lowering beta levels.

Your doc might consider using a hysteroscope while doing the repeat d&c to better see what they are doing though this requires a visit to the OR under general anesthesia for certain. I used cytotec to dialate my cervix for the repeat d&c.

If you do in fact have retained tissue take care of it sooner rather than later to save your body a lot of struggle and your heart a lot of pain. You want to end this physical connection to the miscarriage as soon as possible.

Hope this helps.

Wednesday, July 28, 2004

A message to another woman going through a miscarriage:

I found out on July 1 that we had a blighted ovum, so there wasn't a baby but just a gestational sac. I was deeply sad the first few days about not getting to be a mother. My doctor had us do a follow up u/s the next week which confirmed that no baby was present.

I was offered d&c or to miscarry naturally, I also looked into mifepristone (RU-486) but my doctor said since I have a large fibroid that he didn't think it was a good idea. My doctor was out of town the following week and I opted to have the d&c on July 19th. I figured I was giving my body a good chance to figure it out on its own by waiting.

Well, nothing changed while I waited and it just got kind of frustrating in a way that my body was spending so much energy on a pregnancy that wasn't going anywhere. I would see pg women on the bus or walking downtown and think "I'm pregnant too, but with nothing" and I hated having that in common with them. I also found that I couldn't talk to most people about what had happened, since it wasn't over yet. People heard about our failed pregnancy but didn't quite understand that I was still pregnant.

I had the d&c a week ago on Monday and it wasn't that bad. My doctor is an RE and did an u/s guided procedure to just remove the products of conception and not disturb the endometrium. The full on scrape out type of d&c can lead to scarring. [link=http://worthwhile.blogspot.com/2004/07/im-back-and-i-survived.html]You can read about my d&c here[/link].

The d&c is just helping move along the process of ending the pregnancy. The body has one way to recover from pregnancy and it uses it for miscarriage as well as normal delivery. I'm sure the resulting symptoms are stronger the longer one has been pregnant since the hormone levels only get higher.

[b]I'm someone who likes to know the details about what is going on so I'm sharing my experience with early pregnancy loss with you but skip if you don't want to know[/b]

There isn't a lot of information about what happens post d&c and I don't want to freak you out but in order to prepare you (and others) I will describe what I experienced (and other may have different experiences):

Day 1: (day of procedure) Feeling a little out of it and tired the rest of the day.

Day 2: I went back to work but couldn't really do anything. I felt kind of numb about the experience. Some cramps and very light spotting. A hot water bottle helped.

Day 3: Felt very tired in the afternoon. Still light spotting and occasional cramping. Fairly productive at work. In the afternoon I started feeling really sleepy. I felt sick in the evening which I think was a combination of a 24-hour virus coupled with a big hormonal shift. I got bloated and had a fever overnight (probably unique to my experience).

Day 4: Headache, neck and backache. Stayed home. Still had a fever for part of the day. Slept in the afternoon.

Day 5: Still felt a headache, stayed at home. Cramps all day long. Around 4pm they started getting worse. I tried laying down but they were overwhelming. I had really intense cramping which hurt from just below my ribcage to halfway down my thighs. I took ibuprofen but it didn't really help. Red wine and a hot water bottle offered the best relief. I started bleeding finally around 10pm. The labor like cramps went on until 2:30am at which time I guess they subsided or something because I fell into a deep sleep.

Day 6&7: More cramping, headache, backache and now sadness. Sadness and anger at having to go through this experience.

Day 8: Back to work. Very weepy. Still uncomfortable with cramping.

Day 9: Stayed at home. Saw my chiropractor for a regular appointment (treatment for a back injury) and asked him to do what he could to make sure nothing was contributing to the cramping pain. In the afternoon I had a massage and the massage therapist gave me an abdominal massage, not deep tissue or anything just helping go over the middle. I cried during that part. I ran a little way with my dog in the park and my breasts were killing. I realized when I got home that lactation had kicked in.

Day 10 (today): Stayed at home again. I was feeling very exhausted today. I had an acupuncture appointment this morning to help balance me out. He told me that my liver was out of balance and that it was throwing off my kidney and spleen as well. He said that the bleeding aggravated my anemia and that there was some blood stagnation. He helped get rid of a lot of the pain in my abdomen. I asked him what I could do for my liver since it seems to be the most out of whack and he suggested a small amount of red wine -- which I had already been taking each day and really did seem to be the only thing that helped.

I looked up in my medical endocrinological text today about the lactation thing. Evidently 3-4 days post delivery the levels of progesterone and estrogen drop and prolactin has the stage to itself, those other hormones no longer suppressing its action on the mammary glands. It is supposed to go away on its own, provided you don't add any stimulation, in about a week or so.

The only thing that I would do differently if I could turn back time would be to know about this process ahead of time so I would be more prepared than the fact sheet they gave me that said "you may experience some cramping and bleeding" and I do wish the doctor had given me a prescription for a strong pain killer ahead of time.

The other thing I think we should accept is that society doesn't expect women who have gone through labor to deliver babies to go back to work right away. I think we need to remember that if we who have miscarriages experience labor, that we give ourselves the same TLC that we would want as a new mother.

I'm really sorry for your loss but hopefully knowing more about the physical process will help you through it. It is an emotionally and physically draining experience but allow yourself time to grieve and recover. I think I'm going to wait a fully cycle to try again, but maybe not.

Thursday, July 22, 2004

Why does it seem like there isn't any information about what happens when you miscarry, not the clinical stuff but the physical stuff.

When I left work yesterday I was feeling a bit woozy so I bought a bottle of water before I met a friend visiting from out of town. We then walked to a pub and I felt like laying down but I decided to be a trooper and push through it. I drank about 36 ounces of water over the next few hours and got incredibly bloated. I remembered that the hypothalmus helps control our cycles and also is involved in managing how much water is in our systems -- its what decides when you have to pee. I figure that my brain and endocrine system is starting to make some big adjustments but I was so swollen. My skin felt hot, my breasts had shooting pains, I had a headache and my hearing was weird -- everything sounded hollow.

We took a cab home and I got in bed and took my temp with has been over 100 since last night and was over 101 for several hours. I ache all over, my back and neck and legs in particular -- sort of like when I get the flu. This morning I also had some intense cramps and my heaviest bleeding so far of dark menstrual blood but it isn't really heavy compared to my period.

My partner called the doc this morning and they say this is normal and expected. I can understand why reorganizing my body to shift functions away from the pregnancy is a big deal I just didn't know I would feel like I had been hit by a truck.

Is my experience so far similar to yours? Is each miscarriage its own deal? This is a fairly cruel process overall but I guess that's the way the equipment works. I just makes it even harder that we don't get to have a baby and instead have to go through this.

Monday, July 19, 2004

I'm back and I survived. Overall I have to say it was a relief to finally have this d&c done. I think it was all the prayers that helped make this easier for me. Thank you!

My doctor was great, so careful and conservative. He definitely has a lot of experience working in that area. The nurses were awesome; they were so nice and caring. The procedure was done in the operatory suite where they retrieve eggs for IVF patients. The nurses gave me warmed blankets over my shoulders and stomach and kept my legs and feet warm with towels as well.

Having had a more than typically painful HSG last year, I think that I was better prepared for the sensations which were similar but just more and longer. When I had my HSG the RE tried to help stretch out my uterus for better films, the uterus being wrapped around the fibroid. She did this by pressing the speculum in different directions which pulled on the ligaments I guess. I had cramps for days afterwards. I also have periodic pelvic pain from my fibroid so again, this wasn't shocking to me. If I had never had any such discomfort in my life it probably would have been worse. The nurses and doctor all said that I was a great patient with a good pain tolerance. They asked if I did yoga, I told them that I danced -- I think they were amazed that I could sit in stirrups for so long as it took a while for us to get started.

The worst thing was that it took 3 tries to get the IV started and I left the hospital with bandages on both arms.

My partner was there in with me the entire time which was a great relief, more than I would have supposed. Once the sedatives kicked in I kept babbling on and on about all kinds of things although mostly about how odd this experience was.

Yesterday afternoon I came home and took a nap on the couch for a while. Then my sister and one of my best friends came over and spent time with me for a few hours. my partner and I walked down the street for a late dinner at 9pm. I mostly felt tired.

I feel a little crampy today and I've had just a minor amount of spotting so far. My temp was a little elevated this morning so I'll keep an eye on that. It might just be my thyroid trying to adjust itself at this point.

I actually have less pelvic pain now than I did before the procedure, I think that is because of my fibroid already distending the uterus. My breasts are also starting to soften slightly -- yippee! My doc is still cool with me TTC with the fibroid intact. I did find out that he is leaving the hospital to go out on his own at the end of the month. He'll only be 30 minutes away in Everett, WA but still I'm bummed since that is a hike and it took so long to find someone I like and trust.

I have some tears trapped inside of me still, I know they will come out sooner or later but I'm doing pretty good over all. A little numb maybe but I feel like a survivor.
I'm about to head over to the hospital to get un-pregnant. I wonder how long it will take to get over this. My biggest thing now is finding some sanitary napkins in my purses that I can consolidate. I haven't bought any and I was just out when we found out we were pg in June. I hope I don't feel bad this afternoon. Send me your best thoughts and prayers please.

Sunday, July 18, 2004

These were some of the more useful links that I've found in understanding what was going on with my blighted ovum/early miscarriage. I thought I would share.

GENERAL MISCARRIAGE

Understanding Miscarriage

Early Pregnancy Loss

Miscarriage Explained

Early Miscarriage

Miscarriage and PCOS

Missed Abortion

Post-partum Bleeding (lochia)

Miscarriage Information


BLIGHTED OVUM

Blighted Ovum

Blighted Ovum

Anembryonic gestation


DILATION AND CURETTAGE - D&C

Dilation and curettage

Dilation and curettage 2


MEDICAL MANAGEMENT (DRUGS)

Methotrexate For Noncancerous Conditions (Systemic)

Pharmaceutical Induction - Pitocin and Cytotec (Misoprostol)

Medical Abortions

Completing A Miscarriage


I found this study that was published earlier this year and it was interesting because it was both effective, used a lesser dosage than is commonly used in the US currently for abortion purposes and had fewer side effects.

Medical management of first trimester miscarriage (blighted ovum and missed abortion): is it effective?


NATURAL INDUCTION – NOT RECOMMENDED

I did find this link with information from midwives on ways to medically complete a "missed abortion".

Completing A Miscarriage

Here's someone's reading list from Amazon.com on herbal abortions -- no I don't recommend going that route, I found some other links that talks about how toxic it is for the mother.


RETAINED TISSUE

Detection of retained products of conception following spontaneous abortion in the first trimester

GESTATIONAL TROPHOBLASTIC DISEASE/ MOLAR PREGNANCY

Gestational Trophoblastic Disease


Gestational Trophoblastic Disease (Sloan Kettering)


"Of utmost importance is careful follow-up with serum beta HCG (BHCG) weekly until less than 100 mIU/mL and then every two weeks. The patient should have a careful pelvic examination every other week and a chest x-ray every 4-6 weeks. Once the titer of serum BHCG has fallen to normal levels, these two examinations need no longer be done; however, BHCG titers need to be repeated every 2 weeks for 3 months, then monthly for 3 months, then every 2 months for 6 months, then every 6 months for 3 years. Each patient should be counseled in the use of a reliable birth control method." (from the NIH site)


"Women should be advised to avoid pregnancy until hCG levels have been normal for six months following evacuation of a molar pregnancy and for one year following chemotherapy for gestational trophoblastic tumour. The combined oral contraceptive pill is safe for use by women with GTT (III-C)."
(from: http://sogc.medical.org/sogcnet/sogc_docs/common/guide/pdfs/ps114.pdf)

Embolization of Bleeding Residual Uterine Vascular Malformations in Patients with Treated Gestational Trophoblastic Tumors


Molar Pregnancy



GRIEVING, SUPPORT & RECOVERY

http://www.pregnancyloss.info/

SHARE – Pregnancy and Infant Loss Support

Pregnancy After Miscarriage (PAM)

Hygeia Foundtation & Institute for Perinatal Loss and Bereavement

Coping with the 5 stages of grief and bereavement

October 15th - Pregnancy and Infant Loss Remembrance Day

What is Grief?