Miscarriage Tips

I just wanted to write down a few things that might be helpful for people dealing with their first losses. Others feel free to add on your advice as well.

-- Unless your pg is dating more than a week behind in the 6-7 week range, you can't be sure about what's going on with your pg until you have waited a week and had a repeat scan unless you are already losing it and bleeding or have blood tests showing that your HCG level is dropping.

-- Don't just get a d&c after one bad u/s, wait a week just to confirm -- barring other situations that might preclude that such as ectopic, molar pg, etc. Sometimes things look badly and then it turns out to be just a bad scan. Not a majority of the time but you don't want to make a decision hastily and then feel guilt-ridden later that you hadn't given it a chance.

-- the medications that they use to knock women out during a d&c can have a side-effect that you might wake up crying. Doctors and anesthesiologists don't often tell women this and when you are dealing with the already emotionally traumatic experience of pg-loss this s/e can really make you feel worse and more out of control. (light sedation won't do this)

-- you usually have the option of doing a d&c under light sedation or under general. Ask your doctor about it. Some gals have had better experiences with light sedation. I've had both but only general during the d&c to remove retained tissue -- one didn't strike me as better than the other but each has it own benefits and drawbacks.

-- You can choose to m/c at home on your own. You need to know what to watch for (hemorrhaging and signs of infection) but lots of women do it. (see my miscarriage prescription)

-- Even if you have a d&c to end a failed pg more quickly you still might go into labor a few days later. (see my miscarriage prescription)

-- you might want to save the POC/baby if you miscarry at home. Some women here have planted it in their garden or even it potted plants. Some women feel guilt later if they have flushed it down the toilet. It's totally up to you what you want to do but don't feel like a freak if you feel the need to honor your loss in that way. And if you don't want to it's okay too.

-- if you have a full-time job it is hard to know how much time to take off and when. Miscarriages can be draw out affairs. Many women take at least a week off, some go back to work right away. I've alternated, going to work when I was up to it and stayed home on the days when I just couldn't cope at all. It's hard, and I think we've all had to deal with it. Know that others have struggled as you have and that it's okay. Just try to be gentle with yourself.

-- its easy to want to stop taking care of yourself after you learn of your baby's demise, wait to miscarry and recover physically afterwards. To go from being so careful about what you eat and taking all your vitamins to eating junk food and drinking wine. Try to do better than that, keep taking your prenatals as your body will need the extra nutrition as it reorganizes your hormones and body back to an unpregnant state. Drink lots of water, go for walks, and eat healthy meals. It's okay if you aren't perfect and can't manage to be super fabulous about it, just make an effort. Not taking care of yourself isn't going to make you feel better ultimately, it might make you feel worse.

-- If you have lost a lot of blood make sure to add in more iron into your diet and take iron supplements for a while. I think taking a separate supplement separately from my prenatals is easier for my body to absorb -- I take a chewable iron that doesn't disagree with my system.

-- bleeding more than two weeks after a d&c should be looked into via u/s or at least a beta draw.

-- you should have a beta draw a week after a d&c to help make sure you have no retained tissue

-- if you continue to have a dragging pregnant feeling after your miscarriage and your doctor hasn't done a f/u beta draw you might have retained tissue.if you have retained tissue that is still growing and engaged the progesterone produced post-O will make you feel more pg

-- your body can ovulate after the hcg level drops below 40-50 ng/ml.

-- you might ovulate a couple weeks later or your body might need more time to recoup and get things reset and restarted after your loss.

What I felt during my brief pregnancy

It was probably more than liver qi stagnation but here were things that I noticed:

SP6 kept throbbing -- it didn't bother me last year

Breast pain that felt like I was having knives stabbed into me for days. This pain surfaced at a new greater level over Memorial Day weekend after which, a couple days later, my symptoms backed off and I had the faintest amount of spotting one day. I think that weekend was when things tipped and my body fought back against the disruption the pregnancy was causing.

Cold feet -- they were as cold in the evenings as they ever were. It didn't feel right to me.

Sweating at night

I had and still have this odd sensation of pressure above my navel.

I emailed Eastern Harmony yesterday and got a referral to someone who has studied with Randine in Seattle. I'm trying to get an appointment to see if we can't do more to rectify my imbalances. I like my acupuncturist but he doesn't specialize in infertility and I've had to suggest that we try herbs or different approaches a bunch of times. He's a little too needle work focused.

----
Here are my general symptoms we've been treating:

Uterine fibroid -- associated with blood stagnation and liver qi stagnation

I was anemic for years (just enough to have it not be a problem for my docs evidently) and this gave me other symptoms such as phlegm issues (coughing a lot, especially after meals), getting sick a lot (so much so that my friends were worried for me)

PMS symptoms starting right after I ovulated including irritibility, depression and breast pain including fibrocystic breasts (this was somewhat improved based on naturopathic and TCM diet changes and tx)

Night sweats during LP

Heavy periods that last 6-7 days

Cold feet at night, cold hands

Constipation

Stress makes me lose my appetite and thirst

Fatigue generally, depressed somewhat

Basel temps tend to lull a bit mid LP (horse pattern as per that article you/I recently posted); jaggy temps during the cycle fairly frequently

Tend to shed hair during LP and also since my surgery also during follicular phase

It's hard to be totally objective since I feel like crap (physically) right now but that's most of it.

And I know it's over still I cling I don't know where else I can go it's over, it's over, it's over I know it's over and it never really began but in my heart it was so real

I Know Its Over, The Smiths
from The Queen is Dead (1986)

I'm feeling like working from home today. Talking to my SIL really stirred up some emotion for me and I feel like I need to be away from people right now. My partner said to me last night that I've been grouchy for days, though I've only noticed that I've been very tired -- though I do get grouchy when I'm tired. I didn't tell him about my conversation with my SIL, just telling my online buddies about it was hard enough -- each time it just opens up the waterworks again and I just need a break from it. I've been almost feeling like I should take a break from charting and even the board too, though I know I couldn't do it easily. I think I need a vacation -- 10 days in Europe sounds nice. Do you know that I'm having a hard time at work right now too, I'm supposed to right all these proposals for new work and I just can't do it. I feel like nothing matters and I don't even understand what people in business want anymore -- it all seems so trivial and petty to me, like "who cares". It's probably just another phase of grief, recovery and acceptance.

My Miscarriage Prescription

Here is my recipe for getting through the pain of a miscarriage, which works for any miscarriage physical pain:

Red Wine -- this helps to take the edge off the pain in a way that nothing else did. My acupuncturist told me afterwards that red wine "moves the blood" in chinese medicine which is why it works. It didn't cause any increase of bleeding just in case it sounds that way.

Marijuana -- the body produces natural painkillers called anandamides akin to THC in marajuana (which is humans are affected by THC at all). There are a large proportion of anandamide receptors in the uterus which is probably why marajuana is helpful for painful menses. Anandamines both dull the pain sensation and dulls the memory -- both useful affects to help women get through childbirth. You can just watch how your body's natural painkillers work or try supplementing with marajuana (which I do not use and didn't try in this situation so I'm not sure quite how it would work).

Dark Chocolate -- it turns out that chocolate helps keep anandamine in the body longer so why not have some chocolate. I can't say it is easy to distinguish whether or not this is working but it sure didn't hurt and it was a great distraction and an excuse to eat chocolate.

Herbal Tea -- lemonbalm and chamomile are nerve tonics and mild sedatives and are pleasant tasting. Passionflower tea is a little stronger but it helps soothe anxiety, it acts as a mild sedative and it reduces tension in the body. I found that passionflower tea helped to calm the pain and cramping for a couple of hours during the most intense part.

Hot Water Bottle -- use this pressed up against your belly or back and just rest against it. Also you might get cold so wrap yourself in a blanket if need be.

Tylenol -- helpful with the intense pain of my second miscarriage, which was all natural and at home.

Massage -- Follow up several days later with an abdominal (as well as full-body) massage by a professional to get rid of any residual pain.

Acupuncture -- With both of my miscarriages I had a lot of pain for days afterwards, acupuncture was able to help release the pain and help my body adjust to the change. I also had several grief treatments Internal/External Dragon (japanese treatment) after my second loss which released a lot of pent up emotion.

In case of bad bleeding, try these tricks for controlling uterine bleeding. This is a harder one as you really have to keep an eye on how much blood you lose. Factor in how far away the nearest hospital and get there ASAP if you think you are in trouble.

Hope this helps, keep it on hand for future reference in case you know anyone who can use it.



Updated 3/18/06.

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.

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....

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

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?

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.

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.