Planning for emergencies

Why it keeps happening is unexplained, but it does seem that we can expect it to keep happening.

After week of normality, I experienced another big bleed on Thursday night, in the middle of the night. I had been out for a lovely evening with friends and my husband had been in to London to see a band. He was home, I got up for a glass of water at about 01:30 am. We had a brief chat about what nice evenings we’d both had, and then, whoosh, I was covered in blood again.

We knew what we were supposed to do. I phoned the labour ward and explained the situation. They told us to come in. Since the bleed seemed to have stopped and there had been and was no pain whatsoever, I drove. Whilst my husband wasn’t drunk, he had had a couple of drinks during the evening, so driving would have been unwise. I specifically asked the duty midwife whether it would be OK for me to drive – had the advice been ‘no’, we would have taken a taxi.  I hasten to add that, at 28 weeks, I really don’t think its unreasonable to carry on with some kind of normality. However, under the circumstances of constant uncertainty, we have now reviewed this high risk ‘going out’ policy.

On the way to the hospital we saw an owl, which was pretty cool. But we were rather too preoccupied to really enjoy our Springwatch moment.

Upon arrival we were shown into the maternity triage area and I was treated to the usual procedures of monitoring, blood tests, cannulation, internal exam, showing people the contents of my underwear etc. This time we even got a scan. Was I in pain? No, except for the needles and intimate examinations. This, once again, didn’t seem to be the onset of early labour. Whilst we were being seen, another lady was brought in who was in labour. I think that this was the first time that my husband had ever heard someone in pain like that before (i.e. in real life, not how its portrayed on the telly). I think he found it really rather alarming.

By about 5, it had been agreed that rest and monitoring were the way to go, However, the labour ward was full, so we were put in a delivery suite for the remainder of the night. I had the bed, my husband had a beanbag on the floor. He commented that the beanbag was somewhat lacking in beans. We put this down to NHS cuts. (Bloody Tories!) I was also given an(other) anti-D injection due to my Rhesus -ive status. Apparently you can’t overdose someone on this, so I can expect another jab every time I’m in, as well as the routine one I’m getting next week from my midwife.

We got a couple of hours’ sleep and then were transferred to the Observation ward. This was a private room, which was nice. More monitoring, and baby continues to do well as far as heartbeat and movement are concerned. I was not being fed, which is of some concern, because that means that someone, somewhere thinks that surgery could still be on the table (so to speak). My husband went in search of food (he brought me back a croissant, but I had to wait to get permission to eat it). As we awaited the doctor’s rounds, we realised that we could overhear the phone calls being made at the desk just outside my room. The patient under discussion was me, and there seemed to be some degree of disbelief over the position of my placenta. The doctor doesn’t believe that my placenta praevia could have resolved so much between 20 and 27 weeks. This is consistent with what we were originally told; it might move, but it has a long way to go, so we shouldn’t hold out much hope of that happening. But, according to the scan last week, move it has. She’s not convinced and another scan is required. I am sent, by wheelchair, to radiography. It’s weird being wheeled around. i feel like a bit of a fraud, but I don’t have a choice.

The scan confirmed that the placenta has moved, and that everything is looking good. There was still no obvious bleed site, so, really we’re no further forward, except for confirming something that today’s consultant thought was unlikely, but which was, in fact, true.

After this, I was allowed to eat, and the staff on the observation ward arranged for me to be sent upstairs to the slightly less observationy communal ward. They just needed to check that the bleeding had stopped. I was happy to comply, and sat up, and Gush. The clock started again. I’m not going anywhere for 24 hours. On the plus side, I got to stay in the private room, which is good because I’ve just bled all over it.

Fortunately, the rest of that evening and night passed without further incident, although I did manage to get a couple of hours ‘off cannula’ in the evening. I got a new one before going to sleep, though. No-one wants to have to put in a new one in a midnight emergency. I was told by the evening doctor that no-one knows what keeps causing the bleeding, but that they’re going to treat it as if it is the placenta. Better safe than sorry. It’s a balancing act; as long as the baby is fine, they’ll leave it in as its far better off where it is. However, if the baby starts to become distressed, or growth doesn’t carry on as normal, it could mean that the placenta is failing, and then they’d take the baby out as, at that point, it would be better off in an incubator. Hopefully those things won’t happen, though.

Another morning, another doctor. The same ‘we don’t know so we’re going to be cautious’ message. It was the same doctor that we saw on Tuesday. No, it looks like I can’t keep away, lol. Actually, I do keep running into medical staff when I’m out and about (by which I mean walking between my bed and the toilet), and they greet me like old friends. I’ve been here too long.

So, my current instructions are to take it very seriously, keep as active as I can but don’t go too far from the hospital. I can go back to work (assuming that work will have me) as long as I come straight back to hospital if there is any further pain or blood or anything else that might cause concern. As long as my and the baby’s obs are good on the evening rounds, I will be free.

I spent the rest of the afternoon upstairs on the regular ward. The food, which has been good up until now, was rather hit and miss on Saturday and I got an egg salad sandwich in place of the ordered macaroni cheese, but I was hungry, so I ate it. Dinner took its sweet time, too, and by the time it arrived, I was laying flat so that they could listen to the baby’s heartbeat on the monitor. My husband had to spoon feed it to me in bit size chunks. As if this wasn’t a strange enough experience, at the same time the lady in the next bay, separated from me by a curtain went in to labour very quickly after her baby kicked her hard enough in the cervix to break her waters (she was overdue, so they were probably ready to go). Less than metre away, my husband was leaning over all the machines trying not to get ketchup on everything whilst this poor woman was begging for an epidural. It wasn’t funny really, but it was such an odd situation, that, whilst we and I were trying to be quiet and discrete, we were failing because we kept getting the giggles. You couldn’t make it up, but there is a comedy sketch in there somewhere.

I’m back home now, enjoying the comforts that that entails, hoping we don’t have to return to hospital anytime soon.

I need instructions for normal

We had our consultant appointment yesterday, and we have the all clear to carry on as normal. No bed rest or even house arrest, because apparently all this lying around might lead to blood clots in my legs and the risk of that is now greater than the risk of bringing on any further bleeds or, indeed, labour. On the subject of labour, given the shortened cervix, at 28 weeks we have been advised that the baby is pretty much ‘done’, if small, and, because it’s had the course of steroids, it would have a very good chance if it were to arrive early. It would have to go in an incubator, but it would be considered a better option to let nature take its course rather than try to delay things. The only reason that they would give treatment to delay things is if they needed to move me to a different hospital where there were available incubators.

BUT, all of this is ‘worst case scenario’, because there is every chance that I will carry this baby to term and have a totally normal, emergency free delivery at some point in June. This really is something to get my head around as we had had it in mind for the last 2 months that we would have a planned C-section at the end of May. I have not done any of the mental preparations that the books have been going on about, because I didn’t think it would apply to me. Being something of a control freak, I was quite comforted by the idea that we would go in to hospital at 36 weeks and come out a few days later with a bundle of joy. Job done. Not so straight forward anymore, but normal is good.

The consultant encourages me to take gentle exercise and go swimming, and to take regular stops to stretch my legs in long car journeys. My waking life is now to be treated as if I am on board a long-haul flight; support stockings are on my mind, if not yet on my legs.

My blood pressure was taken (still fine, at the low end), the bump was measured (ahead a little, but I expect that’s down to the growth promoting steroids), and the baby’s heart beat was listened to. We’re keeping the appointments at the end of April ‘just to be extra sure that things are still looking normal’, and we remain on the kind of alert that is normal for women in their third trimester (amazing to think we’ve made it this far!).

Back at home, and in the absence of anything proper to worry about, I decided to read my notes for the day. I was alarmed to see that, under the heading of ‘Hb’ the number 106 had been written. Heart beat of 106? Whose? Not mine! Mine is closer to 80bpm. The baby’s? Should be 140. It was 140 last week! What’s going on?! To add to the confusion, the 106 was written in a different hand writing and a different pen to the rest of the notes from yesterday. Underneath this, in yet more different handwriting, it says ‘x low hb’. This is even more alarming. My husband, upon studying the notes more carefully, notices that the box for ‘fetal heart’ is ticked, indicating that it was heard but not measured today. Looking back, it is this box, not ‘Hb’ where the numbers are usually written. I am reassured that we would still be in hospital if there were any real concerns. After all, they were very cautious with us last week, why suddenly become reckless now? It’s much more likely that I simply don’t understand the notes, he advises. I agree, and bow to my husband’s logic in this matter. Then I secretly google ‘decoding antenatal notes’ and discover that the code ‘Hb’ stands for IRON!!! Not heart beat. What an idiot! (To be fair, heart beat does seem reasonable… maybe I’m not supposed to understand the code?). I have low iron. I mentally note to eat some leafy dark green vegetables tomorrow.

With that panic firmly put to rest, I relax into my new status of ‘normal’ and look forward to remaining ‘normal’ for the next couple of months, at least. Then I awake at 4 am and, realising that I am now 28 weeks and am supposed to no ‘count the kicks’. Unable to get back to sleep, I start counting. I get 10 in 20 mins (apparently you should worry if you don’t feel 10 within 2 hours). More normal, more reassurance. I go back to sleep and have a very vivid dream about blood transfusions…. I think this might be my normal life, now… 🙂

48 hours on the labour ward

I am a walking life support machine. For the moment, this is my only and most important function. It’s a really big responsibility, and, on Tuesday of last week, it looked like I might be breaking down. The diagnosis at 22 weeks of placenta praevia (PP) meant that any spotting whatsoever had to be taken very, very seriously indeed. The issue with PP is that, if you get a bleed, it is usually a precursor to future, more significant and serious bleeds. These are caused by weakening or tears in the placenta, which, if they become worse, can cause it to stop functioning. To manage the risk to both mother and baby in the case of increasingly catastrophic bleed scenarios a decision is usually made, once a bleed gets to about a pints’ worth of loss, to perform an emergency c-section and put the baby in an incubator. The very grave warning to take my diagnosis of PP very seriously indeed was written all over my notes, but no spotting had manifested, and things seemed to be going very ‘normally’.

Until Tuesday of last week, when at 26.6 weeks, with a lack of pain that would almost have convinced me that I had experienced a failure of bladder, I found myself soaked in blood. I was asked for descriptions of how much several times on Tuesday evening, and the best I can do is to say that my underwear was soaked, but it didn’t hit the floor. This equates to about 30ml, apparently. Enough to raise all kinds of alarms.

I was at work, fortunately not teaching (it was the end of lunchtime), and I had gone out of my office to find a student from my tutor group whose birthday it was as I had bought a cupcake for him (a little tradition we have in our class), but had forgotten to give to him in tutor time. Not an especially strenuous activity. Having delivered the cake and birthday greetings, I felt that something was ‘not right’ and went to the toilet next to the school matron’s office. There, I found that I was soaked in blood. I had already given matron the number of the labour ward so that it would be on hand should anything happen such as this, given the PP diagnosis, and I asked her to call it, and an ambulance. I felt surreally calm; I had been warned that this might happen, and now it was happening, and so I had to deal with it. I phoned my husband. There is no way of not sounding alarmist when you tell your husband that, at just under 27 weeks pregnant, you have experienced a significant bleed and are awaiting ambulance transportation to hospital. The same can be said for telling your mother, too.

By the time I had spoken to the midwife at the 999 call centre about the details, the ambulance had arrived and the bleeding had subsided. It was a paramedic and car, rather than a full-blown ambulance, and my blood pressure etc. was taken. Having decided that I could be taken in the car, and after the laying down of an absorbent sheet on the passenger side, I was transferred to Stoke Mandeville labour ward. I was feeling, as usual, some discomfort under my ribs (totally unrelated muscular issue which I have been experiencing for a few weeks), and I kept reassuring the driver that the associated wincing and facial contortions were down to that, and that I was not going into labour in the car.

My husband arrived about 10 minutes after I did, and, from the look of him, was in a much worse state of shock than I was. I was seen and assessed quickly by a midwife who kept calling my husband ‘Dad’ which I could see he found confusing as its not yet a term of address that he has associated with himself. Having been poked and prodded by doctors, we were visited by a team of consultants, the most senior of whom informed me that ‘my maternity leave had just started’ and that I could ‘expect more and heavier bleeds’. I wasn’t going anywhere tonight.

I was installed on the labour ward and my husband dispatched to fetch the overnight bag which we really should have packed when we were given the original PP diagnosis. I was cannulated, given a fish and chip supper, a raspberry pudding and an incredibly painful steroid injection in the backside. My assessment of these developments; if you are in hospital and they cannulate you, you are not going anywhere. If they feed you, they are not anticipating operating on you immanently. If they give you a massive injection, it still has the potential to all get a bit serious. Steroid injections are given when there is a chance that a baby might need to be delivered early. These injections are given, 2, 24 hours apart, to assist with the development of the baby’s lungs in order that respiratory complications after birth are minimised. Better to have them and not need them than need them and not have them. They chuffin’ hurt, though.

Throughout these proceedings the baby was monitored and was active, healthy and apparently completely unbothered by the medical emergency in which is was involved. This was obviously very reassuring.

That night on the ward, I hardly slept and kept imagining that I would find myself covered in blood at any moment. That didn’t happen, though, and I was relieved to be fed again in the morning (so surgery still not immanent). I was told I would be scanned at lunchtime and my husband was going to return in time to accompany me to that. However, a slot became available at about 11am, so I went on my own. The news was good. The PP has resolved, the placenta iss now a good 2cm away from the cervix; a ‘safe’ distance. Even better, it showed no signs of damage or bleeding. In fact, where the bleed had come from was a mystery, with no obvious bleed site anywhere to be seen. The baby, meanwhile, continues to grow well, and seems active and healthy. In the absence of evidence of anything more sinister, the bleed has been attributed to a burst varicose vein. However, the sonographer noted that my cervix has become shortened (thankfully still closed), but this gives us something new to worry about. It seems that we have exchanged the PP diagnosis for the possibility of early labour. It’s less dramatic, but not the ‘normal’ prognosis that I was hoping for.

Back on the ward for a second night, I was fed again (yay!) and the cannula was removed. Red alert had officially been stood down. I still had to endure round two of the pain-tastic butt jabs, but, better done than not done. The consultant has said that the shortened cervix presents ‘no significant clinical concerns at this time’, and I have been released to laze about in my own bed. We have to go in and see another consultant on Tuesday afternoon to find out what the plan will be for the rest of this pregnancy – house rest, bed rest, carry on as normal etc. and I am, of course, on constant vigil for anything else untoward, which would require immediate return to hospital.

The only one who has been seemingly unaffected by all of this has been the baby, which, on Thursday morning gave myself and the duty midwife the proper run around (at 27 weeks, it still has plenty of room to change position) when they were trying to do its obs. It was being very uncooperative; it wouldn’t stay still and kept kicking the doppler probe. I had to literally chase it round my tummy with the machine for an hour and still we couldn’t get a good reading, although it was obvious to all that baby was alive and well in there. I guess that’s the price you pay for giving your baby steroids!

So now its just a case of waiting to see what happens next and hoping that its all normal and non-emergency in nature. Stay in there, baby, not too much longer to go!

A look inside

This week has been a week of scans.The letter that invites us to the routine 20 week anomaly scan is really quite a scary read. It lists a range of unpleasant things that could be missing or damaged with your baby, and the percentage chance of them being detected. (If they are present is what the letter doesn’t say). The wording is alarmingly ambiguous, making you wonder, on first reading, what the chances are that your baby might have all of the unfortunate conditions listed. An addition of the sentence ‘These conditions are rare, however, if present, these are the percentage chances of your sonographer being able to visually detect them’ would make it read slightly better.

My nerves for this scan had been building for some days, but the reassuring kicks helped me to think that things would probably be OK; nothing that wriggles about this much could be poorly. If this optimism sounds like the prelude to the revelation of some terribly sad news, don’t worry. It turns out there’s a little person in there, with two arms and two legs (with reassuringly average length thigh bones). Parts of the developing brain are picked out and measured; all present and correct, head looks normal, as does the face, and it all seems to be proportional, size wise. Abdomen, also fine, with stomach and bladder clearly visible. All four chambers of the heart are busily pumping away and eventually a good enough still image is taken for our records. But, for all it’s wiggling and kicking, this baby doesn’t want to turn around. I am sent to go for a wee in the hope that my moving will encourage baby to move, but it doesn’t. So, whilst we’ve seen the spine, the image wasn’t sufficiently clear to complete the scan report, and the kidneys also need a closer look, so we’re back in 2 weeks for another scan. The placenta also seems to be lying a little low, and although it will probably correct itself, we are also going to need to be re-scanned at 32 weeks just to make sure it’s moved. If it hasn’t we’ll be looking at a sun roof delivery. But that’s ages away.

The extra scan isn’t a problem; I’ll be on half term so no need to ask for more time off work (which isn’t a problem in itself; work are being great), and we were due back in to see the consultant on that day, anyway. The administrative dis-communication with appointments this week and last has been quite special. Last week I was offered an appointment at High Wycombe hospital to see the obstetrics consultant. This would have been the day before the scan, which was going to be at Stoke Mandeville. I was able to make the swap between hospitals to see a different obstetrics consultant, but for 2 weeks time, and now we have been able to organise the repeat scan for the same day as the consultant appointment, too, so it all seems to have worked out.

The other bit of me that’s needed to be scanned this week is my armpit. One of my boobs (which which are going for some sort of world record) has grown into my left armpit, and is a bit lumpy and sore. It’s been like it for years, but it’s got worse since I’ve been pregnant, so I’ve been sent along to the Wycombe breast clinic to get it checked out. The appointment I was allocated? Within 10 minutes of the scan appointment at Stoke Madeville on the same day. They were happy to change it, but I do think that some kind of patient records information system would have been useful here. The breast clinic is excellent, and I was scanned, seen and reassured in one afternoon. They were running late, and I was there for a few hours, but it was OK. Better that than some other kind of bad news.

So, happy mummy, happy (stubborn) baby. And we get two bonus sneak peeks. Meanwhile, I’m still getting kicked, and, since most of the kicks are on the left hand side, I’m guessing baby is still pretty comfortable where he or she is.

Eight weeks of silence begins

I’m writing these posts now (beginning October 19th, 2014), but they won’t be published until much later. I’m doing it this way because, oddly enough, in spite of my grumping to the contrary, I have something that I do want to keep quiet for the moment.

I do, however, want to record the next 8 weeks’ journey, because it’s a scary one that doesn’t always get discussed much and it’s a really scary one for the ladies and their partners who are on it.

Yesterday, I discovered that I am pregnant again for the 4th time. It was a bit of a surprise, to be honest. I had been advised that, since everything was taking so long, I needed a HSG procedure (where they inject liquid into your uterus and tubes and X-ray you to see if there are any blockages etc.). After much chasing of consultant’s poor secretary I had the appointment booked for next cycle. That way we wouldn’t waste an egg and could try again after the procedure. Then, on Friday, I had some spotting. Blasted period was two days early. That changed things. The procedure would now be right on my ovulation date. Another month wasted. Another month I wasn’t going to get any younger. I texted the nurse to see whether I could have an earlier appointment, and she’s going to find out for me on Monday morning. I now need to let her know that I no longer need the procedure at all.

What made me test on Saturday? The pain sleeping on my chest on Friday night, the fact that the spotting had stopped rather than developing into a full period flow. To give you an idea of how confident I was that it would be negative, I can tell you that I left it on the side in the bathroom and didn’t check it for half an hour. Given that the results are only really reliable for 10 minutes, I assumed that the faint line was an evaporation line. But it bothered me enough to buy a ClearBlue digital test later that morning. Which was positive. Decisively.

Alright, then. So far I have emailed every medical care-giver I’m currently connected with (which is a long list) to set the wheels in motion to get the early scans and prescriptions I need if I’m to stick to the Coventry plan of progesterone (straight away) and heparin injections (after the pregnancy is confirmed to be in the right place – heparin and an ectopic pregnancy would be very dangerous indeed) . I’m hoping it won’t be a battle. I’m hoping that this one will stick.

Practical Matters – What Happens at St Mary’s and Coventry RMC Clinics?

This post is intended to help ladies (and their partners) get an idea of what to expect if you have been referred for testing at these hospitals. I’m writing for those who have miscarried for a third (or more) time, as you are now officially sufferers of Recurrent Miscarriage, or Repeated Pregnancy Loss. You are probably in a state of grief and disbelief that you have miscarried again, at the same time as being determined to find some answers. You may have a helpful and supportive GP; you may not. Even if they are supportive, you will probably need to chase things up a bit, because although there are a lot of brilliant things about the NHS, sadly admin isn’t always one of them. See this post for more information: https://justonemoretimeagain.wordpress.com/2014/07/04/full-time-administrative-assistant-required/

These are my experience of these two hospitals. Your experiences might be slightly different, but hopefully this will be helpful to you. If you are able to do so, get your local hospital (wherever you had your last ERPC, if you had one), to send away the tissue samples from that procedure, or any tissues you have been able to recover, for genetic testing. If you take them to the hospital yourself, DO NOT allow them to be stored in formaldehyde, as this will make genetic testing impossible. This advice is from Prof Lesley Regan’s 2001 book, which you may find helpful: http://www.amazon.co.uk/Miscarriage-What-every-Woman-needs/dp/0752837575/ref=sr_1_3?s=books&ie=UTF8&qid=1409471375&sr=1-3&keywords=lesley+regan

A note on genetic testing; you may be asked to sign a parental consent form. This may be upsetting, but it is necessary, so it is good to be prepared to be asked to do so. Results from these tests take about 6 weeks and the consultant will normally phone you to tell you the results and follow it up with a letter. This information is very useful in determining what has happened in your most recent loss, and what might be able to be done to help you carry a baby successfully to term in the future. The NHS offers this kind of testing after three miscarriages, although, if there is a reason to believe that there may be a genetic issue in your or your partner’s family (many people live perfectly normally with a balanced translocation of chromosomes: http://miscarriage.about.com/od/twoormoremiscarriages/p/balancedtranslo.htm), then you might be able to get these tests earlier. Some hospitals will let you pay for these tests after 2 miscarriages, others will fob you off (I was told that they ‘didn’t have the right container’ after my second miscarriage, queue hysterical woman in backless gown – I always regretted not fighting harder for that one). You may be able to get your local services to order karyotyping for you and your partner, which will establish whether either of you have a balanced translocation that you may be passing on. Again, the results take about 6 weeks. All of this information will be very useful in determining your treatment plan for your 4th ‘try’, and your RMC clinic will want to take it in to account.

I was seen at St Mary’s last year (October 2013) and for the first appointment you will be scanned, medical history taken and lots of blood drawn. These are for clotting, thyroid and antiphospholipid antibodies.  You will need to go for a hot chocolate or something afterwards. You may wish to take your old notes and paper work copies with you if you have them, they may take some copies for your file. You may be invited to sign up for the TABLET test which is a study involving thyroid antibodies. Many of us donated a sample but were not used for the trial because we didn’t fit the criteria, but you might be, if you wanted to sign up.

If you need anything doing (hysteroscopy etc.) they’ll book that in. I had a septum removed, which was fine, like an ERPC with two coils and HRT for a month afterwards. It was a day procedure and not very painful. Things to consider for St Mary’s; they don’t allow partners on the ward, so you will be admitted and put in bed for the day and your partner sent away at 07:30 am and asked to come back at about 15:00 (they’ll call him). This is unlike other hospitals where you can wait together until it’s your turn. Take a good book. At St Mary’s, they also try to fit in as many operations as possible, which can mean that there is a long wait if someone’s procedure takes longer than expected. When I was there, someone was sent home and given a new date for surgery. This was obviously very upsetting for them. I think this is rare, however, and was caused by an earlier surgery of the day being more complicated than anticipated. It happens.

You might have a non-surgical procedure, or just the blood tests, so please don’t be worried that you’ll necessarily end up in theatre!

You’ll go back for repeat blood tests 6 weeks or so after the first lot and then have an appointment to give you all your results about a month after that. They’ll tell you what your treatment/plan will be and then you ‘go forth and multiply’ and call them when you’re pregnant again so they can do the TEG blood test again and decide whether you need anything for that, too, in a pregnant state, as it can change that result.

Many ladies have also been up for private NK (natural killer) cell testing with Profs Brosens and Quenby at Coventry. This costs £360 and you need to have had 2 periods before you go. They take a uterine biopsy and then advise what to do when trying again. Some people have told me that the biopsy doesn’t hurt. I found it quite uncomfortable both during and afterwards, but nothing that paracetamol won’t deal with. They usually recommend 200mg progesterone from CD21 to CD28, carrying on if you get pregnant, and then Heparin from ‘in uterine’ scan. If you have high NK cells, you may also be offered steroids, but other ladies will know more about that. I do know of at least two success stories from ladies who have been to this clinic.

The results of the biopsy take about 5 weeks and they will email you with the outline results and a time to call for your consultation. After that, you’ll be emailed a letter detailing your treatment plan. If the protocol doesn’t work within three months (as happened with me), they may suggest not using the progesterone until you get a positive pregnancy test.

You will need to not be pregnant for these procedures and tests, and hopefully the break from trying to conceive will help you to get your head around everything and heal emotionally.

I hope this helps some ladies (and their partners) to understand what tests they can expect at these clinics. Remember, 50% of couples never get a clear answer as to why this has happened to them. As distressing as this is (because we want answers), it’s actually good news, because it means that you have a very good chance of being successful without intervention in the future.

Very Inspiring Blogger Award

20140726-very-inspirational-blogger-awardI’m very honoured to have been nominated for a Very Inspiring Blogger award by twelveweeketernities, thank you. I haven’t been blogging for all that long because a) I didn’t know how (and I’m still learning!), b) I didn’t have the emotional strength to put my experiences in to words until now and c) I was worried that people might think it was somewhat ‘indiscreet’ to air so much of my blood and tear stained gynecological linen in public.

I’m glad that I have started blogging, though, as I have found the process very cathartic and I have also discovered a wonderful community of inspirational and supportive people out there in the Blogosphere. Thank you, one and all.

Below is my list of nominees. I know that many will already have been recognized, but a little more appreciation won’t hurt 🙂 So, in not particular order:

Considerings

justanotherinfertilityblog

myperfectbreakdown

tryagainbaby

findinghopeaftermiscarriage

hopeanchorsthesoul

pregnancypause

mymmcstory

bloomingspiders

migrainefamily

mommy this mommy that

babybumpwishes

beautifullybrokenbyhim

thingspeoplesaidaftermymiscarriage

everupward

 

To accept this award, here are the things you need to do:

1. Thank and link the amazing person(s) who nominated you.

2. List the rules and display the award.

3. Share seven fun facts about yourself.

4. Nominate 15 other amazing blogs and comment on their posts to let them know they have been nominated.

5.  Optional: Proudly display the award logo on your blog and follow the blogger who nominated you.

So, seven fun facts about me…

1. I enjoy wild swimming and swimming outdoors and swimming. Did I mention I like swimming?

2. I baby my cats like a crazy cat lady in the making.

3. I am fascinated by religion and philosophy (even though I am not religious). I teach the subject and also organize a philosophy in the pub group.

4. I like my steak medium rare, but I was a vegetarian for 10 years.

5. I have traveled the full circumference of the earth twice, once taking only two weeks to complete the trip.

6. I have slain zombies in a dis-used shopping mall. It turns out, in a ‘survival’ situation, I’m a ‘lone wolf’ type, not sticking with any particular group of survivors, but forming transient allegiances as I go. Who knew?!

7. I have done a sky-dive with 50 seconds freefall. It was awesome, but once was enough!

Emergency bathroom midwifery ***Birth described***

I have written before about how difficult I have sometimes found it to be around pregnant women and babies. Emotions swing between jealousy, self-hatred (I never used to be such a nasty b*tch) and sadness for what I’ve lost. Self preservation has a lot to do with it, I’m sure. That and the abject humiliation of having to leave a 2 year old’s birthday party because you can’t stop crying (got the t-shirt).

The reality is that you’re going to have to face pregnant women (and all their worries and complaints about their aches and pains) at some point; whether at work or out and about, they’re everywhere (are they breeding?!). You can either get on with it, or let in ruin your day. I’ve opted for a nice balance of both.

I knew that my sister and her husband wanted a second child, and I knew that they were tying (the loaned What to Expect books had made the return journey from my shelf to her’s). When she told me that she was pregnant again, I was pleased, but also envious (and guilty because of feeling the envy). I wouldn’t be able to avoid her for 7 months, and I wouldn’t want to have to try; I love my family, and there’s no way I’d want to make things difficult or awkward. You’d have to ask them if I’ve managed it!

It was very exciting when I fell pregnant again myself a couple of months later, and we discussed the baby things we could share (I believed at that point that I would be facing something of a financial crisis due to being in the middle of moving jobs and there being big question marks over my maternity pay entitlement). I had a few scares with bleeding etc. and I am sure that my sister’s heart was in her mouth every time I went for a reassurance scan, being pregnant and emotional as she undoubtedly was. She was having the most dreadful morning (all the time) sickness and had a demanding toddler already, so was exhausted. Everyone was tired and emotional, all the time.

Then I found out that my baby had died at the 13 week scan.

Awkward!

No need for hand-me-downs anymore. And yet, I could not have predicted then that the sisterly bonding over babies I had imagined would be more powerful and visceral than any amount of hand-me-downs and baby talk could ever have facilitated.

Three months after my third miscarriage and two weeks before my sisters due date, she texted me to say that her waters had broken. Her first had taken several days to put in an appearance, so no-one was rushing to get warm towels just yet. I decided to go over to her place and have a cup of tea while we waited for her husband to come home from work. No problem. My niece was with our parents, we could have a natter in peace.

When I arrived, everything was fine. The things for the overnight bag were laid on the bed, her notes were in a file by the ‘phone. I thought she seemed uncomfortable. I made her some beans on toast to keep her strength up for the task ahead. She couldn’t eat them. She said she was fine. I suggested she ring the midwife. The midwife said that, if we were worried, we should drive down to the hospital and her husband could meet us there. I have a very tiny little sports car, and was slightly concerned about my sister’s ability to get in to or out of it. “No, you can’t have an ambulance, it’s not appropriate,” came the midwife’s reply. Fair enough; if you don’t ask, you don’t get.

I packed the overnight bag and put it in the car. My sister went to use the loo. I heard her shout to me from upstairs that she couldn’t move. I know a contraction when I see it; by the time I got upstairs, she could hardly speak. In an act of desperation and futility, I brought her two paracetamol. She barfed them on to the bathmat. I fetched the overnight bag back into the house and phoned 999.

If you’ve ever had to make a call to the emergency services, you will know that they keep the coolest heads in the country. The operator talked to me calmly, but with extreme authority as I helped (forced) my sister on to the bathroom floor (she waned to stay on the loo – “absolutely not allowed,” said the operator. “Get her on to the floor. Now.”) Could I see the baby’s head? “I’m sorry, I’m going to have to look.” I’ll take that scream of agony as a ‘yes’, then, shall I? “No, I can’t see the head, yet.”

“Help’s on it’s way. Can you hear the sirens? Don’t worry. Help’s on it’s way.” I rubbed her back as she knelt on the floor. Contractions were about two minutes apart.

“Have you got clean towels?” said the operator. “They don’t think they’re going to make it,” I thought, but didn’t say.

No-one tells you this, so I’ll tell you now; if you have had to call an ambulance because you are having to deliver a baby at short notice at home, take a moment to go and open the front door. It’s a small, yet essential detail. I dashed downstairs to answer the banging at the front door. I have never been more relieved to see a paramedic in my life. My sister, by this stage, didn’t care. She’d gone primal. Her labour cries came from the earth itself. I texted my mum; “It’s happening. The ambulance is here. Don’t worry.”

The bathroom was too narrow for me to get to my sister to hold her hand, so I held her knee instead. All attempts to try to transfer her to hospital had now been abandoned. Nature was going to take its course; it was unstoppable.

My nephew was born less than 10 minutes after the ambulance arrived. It was extraordinary. My sister’s husband arrived about 15 minutes later, and did manage to find a space to stand, cradling his new-born son in the shower cubicle. Paramedics tended to my sister, one from in the gap between the toilet and the sink, another crouching in the bathtub. Midwives ran up and down the stairs. I made a few phone calls. Mum, dad and new baby were taken off to hospital in the ambulance. I followed on in the car, with the now overlooked overnight bag. “Don’t let that baby out of your sight,” texted my mum.

It wasn’t exactly the circumstances I would have imagined for my first visit to a maternity ward, but I had one job to do, and that was to look after my nephew. My sister needed surgery, and her husband went with her. I was left, alone, in a side room, literally holding the baby. A nurse made a comment that made it clear that she thought I was my sister’s mother. I’d had a stressful morning, but had it aged me that much?!

I spent the day sitting by my sister’s hospital bedside, getting snacks from the canteen and waiting for her belated epidural to wear off.

Was it better for me, and for her, that I have coped in so many crises before that I could keep a cool head in that one? I will say this; someone’s got a wicked sense of humour.

If you like, or feel you have been helped by what you have read here, please share it. If you want to see more, why not follow me? Thank you for reading!

Extra special thanks to my sister for agreeing to let me write about this.

 

 

Blood bath ***Caution. Contains graphic descriptions***

There is little more alarming that a spot of blood when you go to the loo, if you’re pregnant. Everybody knows that your periods are supposed to stop, and, although we probably all know someone who has had break through bleeding or spotting early on in their pregnancy, it doesn’t make it any less scary if it happens to you.

The start of my first pregnancy was characterised by several episodes of light spotting. This, although never accompanied by pain (which is the scariest sign of all), was worrying enough to result in two separate ambulance rides (once from work, once between hospitals), a day in a bed on Ward 4, several hours in A&E, three trips to the EPU (Early Pregnancy Unit) and more than one out of hours doctor’s appointment. Hysteria will get you a long way.

My second pregnancy was just as short as the first, but much less bleedy, lulling us both into a false sense of security that the outcome might be better. It wasn’t. So much for that theory.

But, for all of these minor episodes of spotting, nothing could have prepared me for what happened at the start of my third pregnancy. We had gone out for the evening and were in a local pub with friends. I was driving, so no need to fib about why I was off the sauce. I was faithfully taking my cyclogest (progesterone), and was (thankfully) wearing a pad, since that can be a rather ikky, messy business. Suddenly I felt what can only be described as a ‘gushing’ sensation. I excused myself and, upon reaching the ladies room, found that I was covered in bright red, fresh blood from the waist down. I cleaned myself up as best I could and asked a passing friend to fetch my husband. I felt strangely calm and detached. Oh well, here we go again. That’s that, then.

We stood staring down a toilet that looked like it had just played a starring role in a slashser movie, wondering whether to flush. We thought that our baby might be in there, somewhere, but there was just too much blood everywhere to tell. I knew that one of the best chances we had of finding out a cause would be to recover it and have it sent away for genetic testing, but, in the end, neither of us could do it. So we flushed.

If you have suffered a serious bleed during pregnancy, and miscarriage seems immanent, you are advised not to drive (in case you faint). My husband had already had a beer or two and I was the designated driver, but now I couldn’t safely drive, either. A friend kindly drove us the 20 minutes to the nearest A&E and dropped us off.

We waited.

And waited.

And waited.

9, 10, 11 o’clock, 12 o’clock rock.

Having arrived at 21:00, we were seen by the triage nurse maybe an hour later, and I was cannulated. My theory is that they do this so that you can’t escape if you get fed up of waiting the further three hours after you’ve been triaged. Targets met; everyone’s a winner! It was almost 2 am before we were seen by a Doctor, 4 by the time we were discharged.

The whole time we were there (sustaining ourselves on chocolate and fizzy drinks from the healthy choices vending machine, having ascertained that I didn’t need to be nil by mouth), at no point were we offered a scan. We were given an appointment at the EPU three days later. Point 2 of the Mumsnet Miscarriage Care Campaign (http://www.mumsnet.com/campaigns/5-things-that-need-to-change-in-miscarriage-care) states that scanning should be available. The reality is that if you present at A&E with bleeding in early pregnancy, there is a good chance you will be waiting several days to find out whether your baby is alive or dead. It is my strong belief that this fact puts appalling mental strain on women and their partners in a, frankly, oppressive ’12 weeks of silence’ (or is that isolation?) culture. More steam to vent on that one another time!

We got home at about 4:30 am, I emailed work to let them know I wouldn’t be in (and set my cover lessons! How’s that for dedication!), and we went to bed. No alarm clocks. We would deal with the morning in the morning.

Tuesday was spent watching day time TV and eating fish and chips. There was a program about cats on. It was nice. Invariably, when we’ve had pregnancy related issues, it’s felt like all that’s on TV is One Born Every Minute, or a character in a favourite show is getting a scan (Bones, Breaking Bad, Homeland, all had story lines featuring scans right after I’d MC’d). The scan was booked for Thursday. We decided to be proactive so we got up and went down to UCLH’s walk in EPU first thing on Wednesday morning and waited.

There, against all odds, we saw a tiny little flicker of a perfect heart beat; 6 weeks, 5 days.

I believe that we experienced the full range of emotions over the course of those three days. It’s not a roller coaster ride I’d care to repeat.

And I know it didn’t, ultimately, end well for baby number 3. But it wasn’t anything to do with what happened that night. In fact, we were told that the combination of progesterone and aspirin can lead to these kinds of sudden, heavy bleeds. As far as this part of the story goes, it may not have been a happy ending, but I’ll take a happy middling. It’s a close as we’ve got, so far.

If you like, or feel you have been helped by what you have read here, please share it. If you want to see more, why not follow me? Thank you for reading!