My Second Loss
After successfully managing to make Baby B and escape from the hospital, a year later we were back where we left off.
As before, I’m using the journal entries I made at that time to explain what happened.
Contains some graphic medical detail, not as bad as usual though!
28th September 2007
I debated whether or not to post this, but hell, I could probably do with some sympathy and I guess an explanation as to odd behaviour on my part wouldn’t go amiss.
So, nearly 5 weeks ago, I took a pregnancy test and it came back positive. We were both very pleased! It would be nice for B to have someone to play with close to her own age.
4 weeks: I had some slight spotting, but this is normal. Lots of cramps. Extreme fatigue, which has persisted up until very recently. My bones started aching, and it’s why I have been getting more back and neck problems lately as the pregnancy hormones cause the muscles to relax.
5 weeks: The spotting picked up and the cramps were really, really bad at times.
5 weeks 2 days: The spotting was enough to warrant a trip to A&E. This wasn’t a great deal of fun, but it did mean I got the magic referral to the Early Pregnancy Unit (EPU) and a blood test. If you spot during early pregnancy you should really get it checked out in case it is ectopic. I found out that thanks to the problems I had after having Bethan that my risk of ectopic is ten times what it was before – thank you shit midwife for giving me that injection that was the cause of all that.
5 weeks 4 days: Down the EPU for me. The scan revealed a tiny gestational sac measuring 4 weeks 5 days. Ultrasound accuracy in early pregnancy is generally +/- 5 days – this was not looking good. I had more blood tests taken. The results were curious – 4,000iui of HCG for the A&E blood, and 8,000 for that day’s blood. They were doubling in the 48 hours as they were supposed to. Textbook in fact. But what was curious was that they were so high – well into the range for twins. And at 6000iui you can usually see a 6 week gestation baby with heartbeat, whereas we could only see a tiny sac. Still, sometimes oddities like this occur.
6 weeks: I had shoulder pain, a potential sign of an ectopic (they could not yet be sure there wasn’t another sac outside the womb as an empty sac can be a pseudo sac) so I went in for another scan. Gestational sac had only grown 1 day in 3 days, but at least there was a yolk sac now in the gestational sac which does rule out ectopic except in very rare circumstances.
I was told to come back in a fortnight. I couldn’t wait that long so I booked another scan for a week later with a private clinic. A long week followed, during which time pregnancy symptoms hit me full force. Sodding morning sickness.
7 weeks: Scan at a private clinic. The gestational sac had grown to 6 weeks 3 days, and there was even a 2.6mm embryo, but without a heartbeat yet – it measured 5 weeks 6 days. At 7 weeks, most people have a 1cm embryo with a beating heart. The baby is measuring 8 days behind – 3 days behind what can be considered acceptable. I’ve read of a few miracles happening so I was not prepared to give up hope.
8 weeks – yesterday: My symptoms had faded the day before and the spotting has really picked up again. Time to go back to stinking QE Hospital for another scan. The baby has a heartbeat. That’s the only good news. The baby measures only 1mm more than it did a week previously – that’s one day’s growth in 7 days. It now measures 14 days behind, 9 days outside of the limit at which they should worry. The yolk sac measures 8.8mm – studies show that yolk sacs over 5.6mm usually result in miscarriage. The heartrate of the baby was slow – again, an indicator of failure. Any one of those four factors would damn a pregnancy, well, assuming you were educated enough to know this. Because nobody at that damned hospital is.
Not only did the ultrasound tech tell me that it was all fine because I was obviously out with my dates because I was breastfeeding(!) (I’m not, because I was charting, and also you can’t get a positive pregnancy test 5 days before you have sex last I checked) and refused to listen to me, but the nurse practitioner signed me off as having a “viable” pregnancy. I pointed all those things out to her and she kept saying “we have to give it time” – wtf? Seriously, I am not wrong about any of this – they are.
I don’t want a D&C (an operation under general anaesthetic which ends the pregnancy) with a living embryo, but at the same time I don’t wish to miscarry naturally because it is often quite horrific, and it can happen at any time up to a month or maybe more away, and can lead to serious complications. What that stupid place should have offered me was a repeat scan in a week to see if the baby still lived. Instead I was told to go away and only come back if I “bled more than a period” – at which point I would no doubt be in agony. And then I’d only get a scan the following morning, and they could only schedule me a D&C for the day after that. So possibly not much use, and I’d have up to 48 hours of horrible pain. She did say I could come in and go on a drip for fluids though – hurray!!
Needless to say this isn’t acceptable and I will be spending this morning working out what my options are. I have several routes I can try at least.
On the plus side, I do have some photos of the baby which I guess is something. And B is a great source of comfort to me with her cheeky smile and her toddling across the floor. And Steve is usually being nice (although he has to deal with it all too) and fetched me sausage and chips last night.
So, yep, 3 weeks in limbo, and maybe another month of hell unless I can do something. Frankly I’m already devastated about losing the baby without this crap as well. Even the high blood test numbers indicated chromosomal problems, but they say they’ll refuse to test anything so I’ll never know what went wrong. I’ll just have to rely on my research and my judgement when people ask me.
September is not a good time for pregnancy and me. In 2005 I miscarried (another due in May baby) and last year I delivered B, 3 weeks early. This September I have miscarried again. Clearly I should avoid September if I am pregnant as the pregnancy will end!
So, please excuse my grumpiness past and present. It’s not been exactly easy of late. Whilst I don’t wish miscarriage on anyone, there is a lot to be said for just finding out, and not wondering and wondering over the course of nearly a month. With my first miscarriage we knew right away and although it was a nasty shock, it was good to get it all over with within a week. This is dragging on for eternity.
Later that day:
Some good news from the bad news anyway.
My work BUPA scheme is going to cover me for the cost of a D&C and any follow-up treatment. The clinic where I had the private scan has an obstetrician who works at a local private hospital (ironically he also works at Queen Elizabeth.. heh) This consultant is BUPA-registered and he has taken me on as a patient. BUPA won’t pay for my first initial consultation next Wednesday, but they will pay beyond that. I am not sure if they will cover scans or not – the consultant seemed to think they would, but BUPA said they wouldn’t; I’ll let them argue it. Basically I will be a few hundred pounds out of pocket, but I will be taken care of and that’s what matters. If I start to miscarry before Wednesday, I have his mobile number and he will help me.
I will have a scan to be sure the baby has died, and then I can have the procedure. And then I can move on. At least now we’re waiting on a better timetable; there is no way unless a miracle occurs and the baby is fine (honestly, I think there is zero chance of this) so the baby will die within the next week or so, because a heartbeat at 9 weeks is the best viability sign as first trimester losses tend not to make it that far. I’m 9 weeks on Thursday.
There is the consolation that if I lose another baby I am eligible for tests, which my healthcare also covers, although not any treatment.
I do look kinda pregnant now.
I can relax a bit now and know I will be taken care of no matter what happens. Good 
3rd October 2007
Okay, so I saw the consultant today. Nice chap, he seemed pleased that I was educated and knew what I was talking about – this is a good start. He said to go for a scan between then and Friday, and then see him on Friday and if all is bad, arrange a D&C for Saturday. Fine.
So, I went for a scan today. As far as I was concerned, there were a few possible things I might see. Most likely was a dead embryo measuring a few mm. Or maybe an embryo about a centimetre long but with a slow heartbeat. Or, a miracle might have occurred and there would be a 9 week baby happily in there.
I didn’t expect to see what I did. Heck, as far as I was concerned, it was biologically impossible to see what we did.
Another yolk sac. That makes two, and that means twins. Hurray!! Except, oh wait, there’s still only one embryo, and if anything it’s shrunk since last week and no longer has a heartbeat. The midwife was sure she could see movement, but there was no blood flowing to the baby – which baffled her. She thinks maybe it’s my uterus spasming or something.
So, in the last six days, a sekrit second yolk sac has formed. The first yolk sac has grown to a highly abnormal 10mm, and even the new one is bigger than a yolk sac should be at 6.4mm. The new one is the one on the scan with the dotted line over it. The embryo is the white bit in the smaller yolk sac, which she thinks it’s attached to. Which is also confusing, as surely that embryo would be attached to the bigger yolk sac? Goodness only knows. The midwife officially hasn’t got a clue, except she thinks it’s *probably* not aliens after I asked.
I am not a daft person by any means and I know a heck of a lot about early pregnancy and that which I don’t know, I am very good at researching. I’ve drawn a blank. I can’t find any other cases like mine after a good few hours. All I can say for certain is that I am pregnant with twins (my blood levels at 5 weeks did indicate this weirdly) one presumably has already been reabsorbed or has yet to appear, and that this pregnancy is not viable for probably chromosomal reasons which are probably not related to the fact it’s twins. Statistically I suspect I am one in thousands if not millions with this, depending on what has actually happened. It’s exceedingly rare to have two yolk sacs in one gestational sac for starters.
The crazy thing was that last night I dreamt they found twins at my ultrasound and I woke up and thought what a load of bollocks.
5th October 2007
Appointment just now.
I’m having the procedure tomorrow morning – I have to be there at 7am then I get knocked out and stuff. The consultant confirmed that he thought it was twins too. He’ll do some pathology, to check it’s not molar (potentially cancerous). Because that would suck even worse than this, which is difficult. It’s highly unlikely though and it’s more of a standard precaution.
On the plus side, it was so nice not having to wait 90 minutes to have my blood taken like I often do at QEH – I just walked straight in.
6th October 2007
All over now. Big thanks go to B and the kids playing football next door who alternated between making as much noise as possible all afternoon – next time I will definitely have an operation on a weekday when the kids are at school and B is at nursery. Aside from that, it all went as well as it could be.
I got to the private awspital at the still-dark time of 7am, baby and husband in tow. The bleeding had really picked up since last night and I honestly believe I would not have lasted the weekend so it couldn’t have come at a better time. When we got there, as Steve is wearing a hoodie now and looks about 15, the porter asked if my “friend” wanted to come with me. I said “Well, actually..” and he said “your boyfriend” before I had a chance to correct him. Now maybe he believes me when I say he looks 15.
So I went to my hotel room and admired the curtains, the sanitised en-suite bathroom (with helpful plastic cup for sputum) and was impressed by the desk and chair with MRSA swabs on the top. Even with the few medical things around it didn’t feel like I was going to be there for a Proper Operation – it did just feel like a hotel, and quite a nice one at that. We sat around for about 45 minutes before the inevitable procession of nurses, anaesthetists and eventually the consultant, who also happened to be married to the anaesthetist. It was time to change into the slightly better quality than NHS gowns (we messed this up twice) and wander down to the theatre.
I am always impressed at how quickly general anaesthetics put me to sleep, but this time slightly less so. Due to being so tired most of the time, I don’t think it put me out much quicker than I usually go when I’m at home and go to bed. I do like the sensation of going to sleep though, even if on some intellectual level I’m afraid I might not make it – maybe I’m just weird. Anyhow, in no time at all I was being woken up and the first thing I did was apologise for falling asleep, before remembering about ten seconds later that for the first time in yonks it wasn’t my fault. I’m so used to accidentally or nearly falling asleep all over the place these days. Anyway, I was in practically no pain (last time this happened I was in excruciating agony) and I didn’t even feel particularly groggy. The nurse said I’d actually woken up half an hour earlier when they took the tube out my throat but I’ve no memory of that. The nurse was very friendly and chatty (compare and contrast with being ignored except for the odd non-English-speaking dude who would come past and check down below without asking last time) and went with me as I was wheeled up back to my hotel room.
Sadly as I’d been gone over an hour (doesn’t time fly when you’re forceably unconscious!) Steve and B returned, no doubt expecting me to be ready to go out to the pub. Alas, nurses were still fussing over me with wires and drips so they got sent away briefly. Then they went away and B kicked off so Steve took her away for another half an hour. Sadly I had to be observed so I didn’t get much rest and then the noisebox came back. B likes bashing anything that makes a noise. Steve took her away again after an hour. During that time, my room service order meal order arrived, and as ordered I had a very nice thick creamy mushroom soup, a beef and salad sandwich and lemon sorbet. I was shockingly hungry (being off one’s dinner for 5 weeks tends to do that) and wolfed the lot down in record time. I needed the loo at that point but I’d been told I mustn’t go without a nurse there, so when one showed up I went by lowering magic electric comfy bed and felt surprisingly fine. She seemed surprised too and kept asking me if I was going to faint. Nah.
I didn’t really get much sleep which was a bit of a shame because the drugs seemed to be were mildly hallucinogenic (but only when I’m drifting off) so when I did sleep I had great interesting dreams, whatever they were. It’s nice sleeping in that sort of situation.
Steve and B returned and sat around until the consultant came to visit – by this point it was half 12 or so, so I’d been in there for nearly 6 hours. He said it all went fine, that they got out lots – around what he’d expect for 9 weeks 2 days (last time they said they got barely anything out, and in the week that followed I can believe that) and that he’ll see me on Wednesday for a follow-up to check I’m not dying or anything and to talk about future tests. I then got myself dressed, and the nurse discharged me, expressing surprise I didn’t want to hang around longer in their swanky peaceful room with an LCD telly and loads of Sky channels. I felt well enough to get the train home, so that we did, and I got home just before 2pm, ate chocolate, and slept for as much as my environment allowed me to.
I am eternally grateful for having an employer with private health coverage. It just isn’t comparable to my experience with the NHS. They weren’t too bad with me at first with my last one (aside from having a shared ward) but after the operation it was hell on a stick. I’m so glad I didn’t have to go through that again. Everyone I saw was sorry I’d lost the babies – on the NHS they all (okay, most – some were great there, and I’ve heard anecdotally many times now that QEH does treat people worse than most) treated me as if I’d had a minor operation on my finger or something rather than a loss as well as an operation. Basically they treated me as a human, pretty much. Now I know I have an alternative it will be so hard to use the NHS again. I could have used it last time for both my last D&C and my post partum haemorrhage, but I had no idea I was covered for it. You live and learn. Gawd, after that experience how great would it have been to have had my own quiet room? I’d have got better in half the time.
I’ve got a few cramps and I really don’t feel great (some of that could be down to the cold I got a few days ago) but at the same time, it’s very nice to have my appetite back and I feel more normal in another way. There’s definitely (for some people at least) a “feeling pregnant” feeling which for me mostly consists of a background fatigue. That’s gone, as is to be expected. In the same way it did after my post partum haemorrhage last year after the last big clot went – I felt like I’d woken up finally after 8 months.
Sadly I am forbidden alcohol (or signing legal documents or using the kettle!) for 24 hours so no beer for me yet. I’ve gone without for 6 weeks (and even then it had been a while and only a glass or two of wine) so I guess I can wait another day.
Still, there are better ways to spend one’s weekend than this. I am sorely tempted to take Monday off because I deserve a weekend, but we will see. We’re going away on Friday on holiday anyhow.
The saga was far from over. Find out what happened next..
