My bad bleeding

Starting approximately two weeks ago I started feeling wired like I had too much drip coffee, and kind of anxious feeling as well. I don't drink caffeine regularly and rarely have coffee at all so this was weird. I also didn't have a lot of stress at work or at home so it was even weirder. Then last week I started having insomnia, I was getting up in the middle of the night for hours an ultimately only having 5-6 hours of sleep. It kept getting worse and that anxious feeling kept building. I also had a loss of appetite. It was like something was seriously off in my system.

Then I started feeling vague pregnancy symptoms last week as well, like a vague recap of my first week pregnant including some itchiness, breast fullness, light nausea and my thyroid felt funny again as well. I had two faint positive pregnancy tests on Friday and Saturday but they didn't get darker. On top of everything I was experiencing I felt utterly confused. On Monday I had a beta HCG draw and it was 13, down from 46 a month ago (or perhaps I had a chemical pregnancy?) The nurse called and said that it was probably residual beta from my miscarriage in July.

I continue to feel awful and anxious and tired and then Monday night my period arrives, the second one since my miscarriage. It is very red and very viscous, there is no slimy mucus to it, and not really clotting either. It just is very runny bright red blood. I easily bled 2 cups worth at least, it is hard to estimate since I would have gushes when I went to the toilet. I had a headache, my body felt full of cold water, my thyroid felt strained. I also had odd cramping. I stayed home from work yesterday and took ibuprofen and vitamin C which did seem to help control it somewhat. I also went for an acupuncture treatment and that helped with some of the symptoms, I didn't feel so watery inside any longer. I woke up this morning and had hardly bled at all overnight, practically just spotting. I feel dry and clotting in my abdomen.

I called my RE this morning because I want to get to the bottom of this. It isn't just my fibroid, it isn't just the miscarriage and I'm not taking meds or herbs so something is just out of whack with me.

Since someone posted about von Willebrand's Disease (VWD) in the past year I've thought that I had a predisposition towards it. I brought up my long periods and nosebleed problems as a child, plus my anemia but no doctor has responded to the symptoms (tell me the patient doesn't need to suggest the disorder and I won't believe you). My father is very prone to bruising and I am a bit as well. We'll see. I did see this page on the All About Bleeding/VWD site that talks about how some hormones can influence bleeding problems. As I recover hormonally still it is very possible and also women in my family have noted thyroid problems post pregnancy. I did ask for a check of my thyroid hormones weeks ago as well as on Monday but they didn't write the script for that. I'm going to ask the doctor about getting it checked.

http://www.allaboutbleeding.com/vwd_and_you/view.asp?id=4634

Oh, and you know how I love my links, I found this one that I thought was a good reference about NSAIDs and menstrual bleeding:

Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding (Cochrane Review)
Lethaby A, Augood C, Duckitt K
http://www.update-software.com/abstracts/AB000400.htm

My Ghost Pregnancy

I had a massage appointment yesterday, the first one with this practitioner since my loss in July, though I did have a massage after my m/c just at a spa with a couple friends. I highly recommend getting a massage after you have a miscarriage especially one with some abdominal work, you will probably cry during it but you are crying anyway so why not let it out while you reconnect and take back your body. It really helped to get rid of the pain in my abdomen.

After my appointment my practitioner asked me about my massage. I talked to her about it in great detail, from the physical pain, to the emotional anguish, the heightened physical sensations I experienced and the continued sorrow. I cried and used up quite a few of her tissues. I told her about how most people want miscarriage to be as long as the word is -- over in an instant. But miscarriage as we all have seen is a process and even after your body heals there is a lot of emotional trauma of the experience that needs to be worked through.

I told her about my ghost pregnancy now, the one that has me comparing calendar dates and events to where I would be in my pregnancy, should I have stayed pregnant. I told her how hard it was as I approached the dates around the end of my first trimester, and as August closed and I should have been shopping for maternity clothes.

I also confided that I can stand the thought of seeing my pregnant SIL who is due a week later than I was in February. And how every pregnant belly jumps out at me. Or how I can't really look at babies anymore because it hurts.

I talked about things that people had said or done for me that were helpful, more than half of them were things that women said to me here on the Internet. We talked about how miscarriage is combination of life and demise, birth and death take on new meaning in this process.

She thanked me for sharing with her, and admitted that she had never really known what happened in a miscarriage or that it could take so long. She also asked if there was anything she could do, or that I could do to make sure others in my life knew how I continued to feel. I'm not sure though writing a letter comes to mind. I also feel, though perhaps it isn't fair or nice, that I should share this experience in such a way to make it a tear-jerker, like in the movies where they make you cry. Then I would know that I had gotten through to them and made them hurt too.

Last night I had a dream, I've been having such vivid dreams this whole summer. In this dream I was in a clinic and I was losing a second pregnancy. In the next bed over was a woman who was losing a baby in her second trimester and there was blood everywhere. I remember wrapping my arms around her and crying into her hair and she wailed on my shoulder and I told her how sorry I was. It isn't the kind of dream one can forget about easily. I know that it was triggered in part from talking about my miscarriage in such detail, but it shows me how changed I am in that I had no horror at the blood, only sorrow.

Miscarriage Factoid

I had a miscarriage in July, actually it was more like an abortion since my body didn't miscarry on its own. Having seen the dark side I would like to share some information with you that you probably don't know.

Miscarriages are not like in the movies, over in one scene. They take time, they are painful, and recovery takes weeks if not months. Also, miscarriages are really awful and anguishing. I used to think when I heard about someone's miscarriage "oh that's so sad". To go through one is a 4-dimensional experience of hell and enlightenment. It's more than sad. To the pregnant mother her baby, this idea of baby or embryo or fetus, it died. It doesn't matter that something was wrong with the pregnancy, we have really strong instincts to take care of our young and being pregnant is no different. Even if you couldn't see the baby it was still there and it died along with the idea of being a mother, your new family and all the planning and changes that one would have to make in preparing for the baby's arrival.

If you hear about someone having a miscarriage you need to reach out to that person and at least say you are sorry for their loss, no different than if you heard that someone's parent died. Don't start trying to think of things beyond that such as "it was for the best", "it wasn' t your time" or "it's God's will" -- you don't know and those things aren't helpful. Things you can do are send flowers or drop them off yourself, send cards or letters of condolence. Don't expect the greiving mother to take phone calls, it is really hard to talk on the phone I've found when you can't stop sobbing.

Also, the pregnancy might have ended but that pregnancy has marked time for the mother and father. The due date is supposed to be a difficult time, any other events one had imagined from clothing or furniture shopping to holidays are reminders of the non-pregnant state, that baby that isn't coming. Keep your love and support coming if you can, it is greatly appreciated.

I'll do a separate posting about what to do if you are having a miscarriage or are helping someone through the actual physical process.

Between a fibroid and a hard place

I've been on this long journey over the past 2 1/2 years. I went from not being ready to get pregnant, panicked about the thought of it, to where I am today which is still recovering emotionally from the loss of my first pregnancy.

Along the way it hasn't been easy, I found out I have a large tumor in my uterus which is called a fibroid. It is benign but they don't really go away on their own. It may be compromising my fertility but the only treatment offered to me was to have major abdominal surgery to have it out which could cause pelvic adhesions which could really compromise my fertility. I'm damned if I do and I'm damned if I don't (I'm beginning to notice that theme in my life...hmmmm...)

My fibroid and I are having our second anniversary this week since we first met. Maybe I'll bake a cake. I have not named my fibroid though I know women who have. And I only have the one, I'm monogamous when it comes to uterine fibroids.

At any rate I've done a lot of research into male and female fertility, hormones, supplements, diet, lifestyle, and a ton about fibroids and other gynecological conditions and I'd like to share with you what I have learned. I do think there is more than one way to skin this cat and I hope you find my research worthwhile.

(This was my very first post here.)

Other Causes of Pelvic Pain Besides Fibroid Degeneration

A common complain of women with fibroids is abdominal Pain. This pelvic pain can come from from fibroid degeneration, when the fibroid outgrows its blood supply and dies, but that's fairly rare and there are other possible causes of pelvic pain including (an incomplete list):

Appendicitis

Constipation

Adenomyosis -- endometrial tissue grows into the wall of the uterus and can form pockets that bleed each month

Endometriosis -- endometrial tissue grows on other pelvic structures outside of the interior of the uterus and swell and bleed with the hormones produced as a part of your menstrual cycle

Ovarian Cysts -- mature follicle that does not rupture and can grow pretty large, if they rupture they can be quite painful. Some cysts are normal and most of the time they are just reabsorbed. There are other forms of cyst which require medical intervention such as dermoid cysts, endometrioma, and sometimes chocolate cysts.

Ovulation -- mittelshmerz is pain that is felt around ovulation, perhaps from the release of the egg or perhaps from irritation from fluid released from the follicle

Pelvic Inflammatory Disease -- bacterial vaginosis, gonorrhea, and chlamidia can all cause infections in the pelvic cavity

Pelvic Adhesions from prior abdominal surgery or infection -- a d&c or IUD can sometime result in an infection as well

Fibroid Pressing on blood vessels or other abdominal structure

Cystitis -- bladder infection

Kidney infection

There is also a diagnosis in traditional chinese medicine/acupuncture called blood stagnation which can cause pelvic pain and is generally associated with gynecological conditions such as fibroids. Liver stagnation is usually part of the diagnosis as well, the liver being the major detox organ in the body and one that is also associated with emotion and grief in chinese medicine. I've found acupuncture to be helpful in managing my pelvic pain, as well as breathing exercises that promote movement in the abdomen. Here's a link about blood stagnation that you might find useful.

All About Blood Stagnation
http://www.acupuncture.com/Herbology/bloodstag.htm

If your doctor checks you out and you are still having problems then
you might consider the blood stagnation possibility.

I finally got my period, the first one since my miscarriage in July, this past Saturday (Yeah! Time for a party!). My beta was still up last Friday, I hope to have another draw today to see if it has gone down more.

In the meantime I've noticed that my fibroid has gotten dramatically smaller over the past couple weeks (even more cause for celebration!) I've got a call into the doc to see if I can get another u/s to check on it as I'm starting up on my chinese herbs again and I want to know what we're working with. We'll start trying on the baby-making in October to give some time to treat my fibroid with herbs and acupuncture.

Now if this extra fat around my middle would just go away then I would be back to normal....

It's raining, it's pouring...

After I found out about my fibroid I cried a lot. I cried for 3 days when they told me about my fibroid. I was so upset that my eyelid twitched for 3 months after that! After every doctor's appointment I had I was an emotional wreck afterwards.

A mean RE at the local university fertility clinic told us on a Friday that we needed IVF with ICSI and that we woudn't be able to conceive on our own. The next day we had to go to a wedding and someone from asked me discreetly about my fibroid (we lied and said that was what the Dr's appt was for, we didn't want any one to really know about our fertility problems) and I lost it and had to leave the wedding before the toasts. My partner couldn't get out of there as quickly for social reason so I just sat in the car and cried for 20 minutes by myself on a side street.

I had another time last spring, right after my HSG when I found out my uterus was wrapped around my fibroid and my doctor told me I should probably have the fibroid out. I went to dance class a couple days later -- surely dancing would help me feel like my body was mine again. But there was a guest instructor and when she wanted me to correct my pelvis alignment and I left the class sobbing.

Over Christmas my OB that I had made 2 months beforehand come up so I decided to get another opinion. Aside from crying the entire time in her office when I left I started sobbing in the parking garage and had to wait a long while until I was settled enough to drive.

Another time, at the beginning of the year, after yet another Dr appointment I had to leave dance class again and just cried in the hall while I waited for my partner to finish. It was all so stressful, I was unclear as to what to do, and it seemed like we would never have children without some major medical interventions.

Nutrition and medicine

"The doctors of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease."

--Thomas Edison


In case you didn't know, most medical schools do not offer adequate training in nutrition to medical students -- even today. Ever notice that most doctors won't even ask you if you are getting enough rest or drinking enough water? We could be living on potato chips for all they know.

Naturopathic medicine in contrast focuses on the body's ability to heal itself and nutrition is a key part of this -- hence why some of us have had some improvement of health while under the care of naturopaths. In the ideal world of the future all doctors will look at us holistically and help identify imbalances before they become issues. I'm not saying naturopathy is better than allopathic (western) medicine, but I am saying that you will feel a bit better cared for since they try to get to the bottom of the causes of what ails you -- including psychological, spiritual, emotional, causes, etc. I got my anemia finally in check after other doctors telling me that it was normal for some people -- and I'm feeling much better now.

Since we know that western doctors aren't getting this training it is important that we seek out information about the role of nutrution in our health issues on our own. Doctors might even agree with you when you ask if you should be taking B-12 for instance, it just might not be something they offer you on their own.

Here are a couple links to learn more:

Nutrition Education in U.S. Medical Schools (1985)
Commission on Life Sciences (CLS)

Naturopathic Medicine - Philosophy

Oh, and if you are interested in controlling bad cramping pain then you might consider some of the suggestion for controlling prostaglandin production on these pages:

What causes Menstrual Cramps and Pain (Western and Oriental Medical
Perspective)

25 Ways To Handle PMS

Beta Numbers

Here are the blood test results after my retained POC was diagnosed in mid-August.

543 on 8/12

259 on 8/17

145 on 8/23

78 on 9/1

46 on 9/10

Beta HCG - What it is

Beta HCG is the pregnancy hormone. The fertilized egg and embryo produce it and it cause the corpus luteum to sustain and continue producing progesterone to support the pregnancy. It come from the embryo, not the ovary, uterus or fibroids. I don't know if it contributes to fibroid growth directly, but the progesterone/estrogen produced in pregnancy sure do.

BASELINE ULTRASOUND

A baseline ultrasound just helped to provide a comparison measurement before and after treatment. My RE wanted to see how it was doing since it had been almost a year since the previous scan. Without it I would have no way of knowing if it was larger or smaller than it had been so how would I be able to just if the treatment was really working.

I arranged for a second ultrasound to see if there was any change
from the acupuncture and chinese herbs, but note that I waited 4 months with continuous treatment -- change if any would come slowly
my acupuncturist assured me. I mentioned that I was pregnant for this second ultrasound so it is possible that there was additional
shrinkage but the pregnancy hormones didn't provide a clean comparison.

Your doctor may do yearly ultrasounds to monitor your fibroid, you
may want to go more frequently if you feel a lot of changes, every 6
months perhaps. If you are wanting to try to evaluate the affects of
a particular treatment a baseline comparison before and after will
help you to see the affects.

Fibroid Growth in Pregnancy - SIZE CHANGE

Considering that my fibroid only grew in the 18 months prior to treatment and then shrank back 2 cm I think that is a pretty big change. I knew that when I got pregnant I might experience growth (though I hoped I was the rare girl for which it would shrink) but it was important to me to try to shrink it beforehand.

It did grow, and quite a bit but what can one do. We were ecstatic
that we got pregnant and were taking it all in stride, unfortunately
no embryo developed so I had to have a d&c to terminate since my body was happy cooking along. It also shrank back some right away, I'm hoping we can shrink it some more.

My fibroid I could feel prior to my getting pg and it was 6x7cm. It
grew a lot, at its peak measurement it was up to 9x11x11cm. A couple
weeks ago it was dropped to 8x9cm. When my bladder is full it is
really bad, when I'm lying down you can see it bulging out and it is
more uncomfortable than prior to my pg. Some pairs of pants I have
are also uncomfortable now because they put too much pressure on my
lower abdomen (I know you are probably clucking your tongues at me
telling me not to wear them then).

So, I know I have beta still in my system so it probably isn't
shrinking as much as it might eventually. If you have fibroids and
know by measurement or physical sensation (pelvic pressure, etc.),
how long did it take for them to shrink down for you?

I could live with the pressure prior to my pg but now I feel the
pressure so much that I keep thinking I might want to have it out.
Still, I will first try to shrink it back with acupuncture and herbs
which worked before.

So, can anyone share with me how long until their fibroids shrank
post pregnancy?

Frankincense and Fibroids?

I found this page while surfing that mentions some additional herbal treatments, what got me curious was that this one mentioned frankincense which is one of the ingredients in the chinese herbs my acupuncturist had me taking in the spring -- when my fibroid shrank.

http://www.nspforum.com/faq/bbs.cgi?read=938

I started acupuncture treatment in January and had an ultrasound a couple weeks later to help provide a baseline measurement. My fibroid at the beginning of February was 6x6.5x9cm which was larger, mostly longer than the 5.9x6cm in September 2002 when it was discovered, or 6x7cm in March 2003. I started on herbs in March and took them for about 6-7 weeks only, all the while going for weekly hour-long acupuncture treatments. I stopped taking the herbs because I had an issue with bad bleeding during my period which freaked me out, these are strong herbs and not to be used during pregnancy or during menses. My acupuncturist said the herbs are intended to "break the blood". I scheduled a follow-up ultrasound for the beginning of June and as it would happen I had a positive pregnancy test that same morning. My fibroid was back to 6x7 though the ultrasound was not taken on cycle day 3 since my period never arrived. I'm amazed that there was that much of a change.

Here are the ingredients in my supplement, TumoSolv which is formulated by LongLife (http://drhuang.biz/LongLifeMaster.asp):

Bureed tuber, Zedoary, Fritillary tuber, Prunella, Sargassum, Frankincense, Myrrh, Angelica

I don't know if they sell to the public but I would advise anyone interested in trying it to seek treatment though a licensed practitioner of Oriental Medicine and Acupuncture.

My fibroid is still enlarged from my pregnancy, my body is still producing beta HCG though it is slowly dropping. I'm back in weekly acupuncture treatment and soon I'll start using the herbs once again.

I just thought I would share since I did try very hard to be controlled in my evaluation of my fibroid size before and after treatment and I did have positive results. I hope that this gives you hope and inspiration as well.

In His Grace

Ecstasy.
In His grace.
Something important in store for me.
My closest hour.

The watch wheels spin slowly
the sky turns electric blue, or turquoise
a color really that no words can hold.

The pineapple and the family tree
take sudden shape
from here springs all life.

In the rays of sun, from my front porch
I could touch the stars.
It is completely silent and
the world around me has turned
vivid warm shades.
I catch my breath and pull closer,
the heat penetrates me.
I need to be in the light;
indoors I feel a chill across my skin,
it creeps and is unfriendly.
I go into the light.

I decide that Joan of Arc
had a miscarriage and that was why
they killed her.
And Morrissey, he doesn't actually like
gladiolas
he just tells people that so when
they come at him with flowers
it just reminds him of the fact
that they don't know him at all.
How clever he is.

I tried laying in the bed, on the cloth sheets
settling down, taking a rest
surely I had something to do with it.
I turn, I bend, I contort.
There is no relief.
Please let it stop.

I drink red wine and eat chocolate;
chocolate might be able to keep the pain at bay.
I make tea, hot passionflower tea,
so named in memory of Jesus's crown of thorns.
The tea is soothing some and the pain calms for
a couple of hours.

The doctor said take ibuprofen
was he kidding me?
It is like my uterus is trying to rub itself clean.
Pain radiates from below my ribcage
half way down my thighs.
That is more than half my body mass I think.
More wine, I need more wine
and heat, but I'm not allowed to bathe.
A hot water bottle, a red rubber vessel,
becomes my most prized possesion
filled to the top with hot water.

I breathe deeply,
isn't that what women do?
But breathing is for putting out babies
and there is no baby here
just a cruel test drive
a fire drill
an exception.

Except that God wants me close
closer than ever before; he needs me
to be strong, so strong
I'm not strong enough.
But his rays wrap around me
the growing light and love
I'm not alone, why I'm not sure
and no, it wasn't so clear right then
but I'm sure of it now.

God's children die for our sins
and mine, yes mine too
but not any more than anyone else's
and my baby didn't even come
it wasn't time yet, not our time.
Will it be soon?

So Many Days

I am a waterfall, the weight which pulls down constantly;
a fork, its tines twisted and useless;
a witch wanting to take babies from their mothers
because everyone should know how empty I feel.
I am like Scotland, rubbed raw of her Caledonian forests;
a bird frantically wanting to make nests;
an old teacup with a rotten egg.

I want to be hope on the horizon of a distant ship;
a comfort to those at my breast;
all daisies and dragonflies.
I wait, I count days, so many days

Grieving Loss

I think the hardest part about early loss, especially for us first time mothers, is that we are just starting to get used to the idea of being pregnant and beginning our plans for the next year and then suddenly you aren't expecting anymore. One book I have talks about how it is helpful to recognize that you and your husband are grieving different things -- you each had your own hopes and dreams about your baby. Over the past week my partner and I have had some ups and downs, sometimes he's the only one I can talk to about it and other times I hate how he acts about our loss. Try to use your extended network for support and not just your husband, it can help a little in my experience. But do let yourself grieve.

A new article/research that looks into the role of progesterone and
estrogen as influencers of fibroid growth.

Sex steroidal regulation of uterine leiomyoma growth and apoptosis

[The abstract is available to anyone, the full text requires a
subscription or you can pay for 24 hour access.]


UPDATE ON ME
My beta dropped this week from last week from 543 to 289 (thurs to
tues) which is a good sign and the doctor says we can just wait and
do another blood draw on Monday (the other alternatives were a repeat d&c or methotraxate - yuck!).

The rest of my bloodwork came back normal, which is good since I've
been bleeding/spotting for a month.

My basel temperature also dropped for the first time since the
miscarriage (where it dropped just one day) and is the lowest it has
been since I got pregnant. Keep your fingers crossed that all goes
well and that I get my period in the next week.

I got measurement info about my fibroid, here's for the last 4
ultrasounds (approximately) -- in September 2002 it was 6x6 cm:

Feb 2004 - 6 x 6.5 x 9 cm

June 9 2004 -- 6 x 7 cm (day I found out I was 2.5 weeks pregnant,
with weekly acupuncture treatments and chinese herbs starting in
January)

July 8 2004 -- 9 x 9 x 11 cm (after 3 weeks on 100mg supplemental
progesterone and one week prior off to the ultrasound - 6.5 weeks
pregnant)

August 17 -- 9 x 7 cm (with beta still elevated post miscarriage)

Interesting Facts

Male DNA doesn’t kick in until day 3 of cell division…

“Surprising to many, the male genome (sperm DNA) is silent in the first 3 days of embryo development. The oocyte drives the development and cleavage of the early embryo. On Day 4, a critical switch occurs, and the male genome is turned on. At this time, the maternal and paternal genomes begin to work in concert to orchestrate the activities of the newly developing embryo.

It is at this time - Day 4 - when abnormalities in the paternal genome may begin to have what can be profoundly devastating effects on embryo development. Therefore, using sperm with abnormal DNA for ICSI may lead to normal fertilization and early embryo development yet be followed by embryo death expressed as a failure to implant (no chemical pregnancy) or early pregnancy loss (prior to an ultrasound-confirmed heartbeat.)“

from: ICSI and SCSA Sperm Diagnostics

http://www.inciid.org/newsletter/feb/scsa.html





Maternal RNA helps fertilized egg read DNA instructions

“From the moment of fertilisation, the embryo grows as the cells of the fertilised egg multiply. However, there is a problem. How can the DNA be read if the materials needed to read it have not yet been produced? The answer is that they are provided by the mother in the form of mRNA and proteins. The early stages of development are controlled directly by the mother's genotype for about the first three weeks, in humans, after which the embryo's DNA takes over.”

from: Conception and Development

http://www.gender.org.uk/about/04embryo/44_cncp.htm





Paternal DNA grows placenta and gestational sac, maternal DNA grows healthy embryo

“...These observations suggest that genes expressed by the paternal genome are directed towards the development of extraembryonic tissues essential to support the growth of the embryo, while the maternal genome appears to be geared towards expressing genes that contribute to proper embryo development. The opposing tendencies of the male and female genomes as well as the elucidation from mouse studies that Igf2 and Igf2r are imprinted genes with conflicting functions led to the development of the most widely recognized theory of imprinting, the ‘parental conflict’ hypothesis (Haig and Graham, 1991; Moore and Haig, 1991). This theory proposes that the paternal genome has evolved to express genes that favour the extensive use of maternal resources and lead to optimal fetal development and growth, thus ensuring transmission of the father’s genes to the next generation. On the other hand, genes expressed by the maternal genome serve to counteract the effort made by paternally expressed genes, and limit investments in embryo development and growth in favour of salvaging resources for future pregnancies.”

from: Potential significance of genomic imprinting defects for reproduction and assisted reproductive technology

http://www.humupd.oupjournals.org/cgi/content/full/10/1/3

Too much progesterone -- looks like fibroid grew

I'm still recovering from my miscarriage post d&c and I'm thinking that my uterus is mostly back down to its smallest size, wrapped around my fibroid. I had a feeling that my fibroid grew during the early weeks of pregnancy but since the uterus was enlarged it was hard to be sure. Now though, when I lay on my stomach (doing some exercises on the floor last night) I can feel my uterus/fibroid as I lay there. Big bummer eh? (I had a 6x7cm single intramural fibroid on the right side of my uterus)

My doctor put me on supplemental progesterone since my levels tend to be low, 50 mg of progesterone via vaginal suppositories twice daily. The progesterone actually made me feel like I was on a roller
coaster -- I felt horrible. I only know it was the progesterone since I stopped taking it when we found out our embryo wasn't developing and I felt so much better.

My progesterone level when checked last fall was 9.4 ng/ml, when it
was checked when I got pregnant (about twice the number of days from
ovulation as when I had the previous test) it was 19.8 -- so it had
doubled in twice the amount of time. Studies have shown lower
progesterone levels have been linked to higher miscarriage rates
(http://www.inciid.org/fertinews/progthresh.html), although there is
some disagreement in the medical community as to whether or not
supplementing progesterone will help keep women from miscarrying.

So, I'm not sure if I just have lower progesterone and that's normal for me and it will be fine, or if it might have contributed to our loss (one can only speculate at this time). I imagine that it is possible that my progesterone was low and I needed supplemental but maybe not as much as I was given, or that maybe just the fact that my fibroid is present means that the extra progesterone is going to cause growth regardless and unless it is removed it will always cause the same problem. Hormone levels in early pregnancy aren't that high, so it is possible that this was more progesterone than I could handle and that it wasn't balanced out with the estrogen.

I'll let you know if I learn any more, if my fibroid shrinks any or
if there are new numbers from the ultrasounds I had in the past month about the size change from early June.

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.

I had the worst time yesterday from about 4pm. I was having what I can only describe as someone stabbing me multiple times in the abdomen with a sword and then dying. These were uterine cramps that were probably similar to labor. My uterus decided that it was time to redecorate and worked really hard to rip out the old endometrial lining. It went on for hours, from 4pm until I fell asleep and was still squirming when I got up to pee at 2am.

I tried everything I could think of -- red wine (4 glasses), passion flower tea, lemonbalm tea, chocolate (no really, it is supposed to help), anti-cramping meds I had from France when I had salmonella poisoning, a hot water bottle. Finally I took a muscle relaxant at 12:30 and that seemed to take the edge off a bit, at least it helped me sleep. I felt like a bit time drug abuser, and normally I'm such a straight-edge person, but I had to do something.

I finally had some more productive bleeding so I guess all my uterus's hard work was paying off. It was so bad I considered taking a taxi to the hospital and asking them to give me a sedative.

My partner isn't here, he left for Los Angeles yesterday to spend the weekend with his brother and mother. It's his brother's bday. I'm so glad that I knew not to go, I had a feeling something like this might happen and I couldn't imagine going through it on a plane!

I'm feeling better today and my exciting news is that yesterday my basel temp was 98.2 and this morning 97.8 -- the lowest temps I've had since I was pg. Actually this morning's temp puts me back below the CL and so we have actually reset the cycle on my body! Yeah!