Experiences with Cytotec

Now that I believe the worst from this miscarriage is over, I wanted to write about my experience. I know I googled a lot the first time I had to take meds for a MMC and not a lot of people had written about what it was like, so it was hard to know what to expect. I've now taken the same meds twice, and I thought I'd write about the physical experience. (Warning: not for the easily grossed-out)

With my second loss, I had an empty sac, I forget exactly how big it was but it wasn't tiny. I was given Mifepristone, and started spotting/light bleeding the following day. The next day (2 days after Mifepristone), I was admitted to the hospital to take the Cytotec (Misoprostol) there. They wanted me there because there was a risk for complications. I don't remember the exact details in terms of timing, but I started the Cytotec in the morning and by lunchtime, the cramps and bleeding were bad. It got worse and worse, and kept escalating to the point I asked for IV painkillers (which I then realized I should've asked for long before!!). Shortly after it got to that point, I passed what I believe was the sac, it was a golf ball-sized bloody clump. After I had passed that, the cramping got MUCH better and the bleeding slowed.

This time, I was given the Mifepristone and then was allowed to do the rest at home. I anticipated spotting/bleeding after the Mifepristone since that was what had happened before, but that didn't happen this time. I had zero blood whatsoever. Yesterday morning, at 7am, I inserted 4 Cytotec vaginally. At 10am, I took 2 orally. At 12 noon, I took another 2 orally. At about 9am, I started cramping, but not too bad. I was able to go about my day with no problems. At around 11am, the cramping got a lot worse. At 11:30, I started bleeding, a moderate amount of bright red blood but no clots. The cramping got worse and worse, until about 3pm when I decided to take a strong painkiller. (Again, I should have done this earlier. I don't know why I didn't learn my lesson). I had some red bleeding but not nearly as much as I had expected. The cramping got better towards the evening but it continued to come in waves. I went to bed concerned that I hadn't bled enough.

This morning, I woke up with pretty bad cramps. By around 9am, they were very bad, about the same as yesterday afternoon. At around 10:30 (so more than 27 hours after my first Cytotec dose), I passed a bunch of clots and started bleeding a lot more. It's 2pm now and the cramping is significantly better but I'm still passing clots and a significant amount of blood. I think most of it is out now, which is a big relief since I leave in less than 72 hours (OMGWTF how is that possible?!).

My advice to anyone going through Cytotec treatment, particularly at home is:
1. DON'T be afraid to take the strong stuff they give you. I don't know why I didn't, it was really stupid. No reason to be in pain. Eat small snacks continuously to help avoid becoming nauesous.
2. The heating pad has been my best friend. Also, chocolate.
3. I got Mr. E to rub my back when the cramps were bad and spreading to my back, that helped a bunch.
4. You'll bleed a lot, and there will be clumps of stuff, but that's normal. And you are almost certainly not losing nearly as much blood as you think you are, most people grossly overestimate blood loss. Odds are you're fine.

Well we have a plan for this loss

My hCG is dropping, but slowly. 182 to 117 in 6 days. Not ideal but at least it's not rising and doing weird things, I guess. I met with my RE yesterday, who did an ultrasound and saw a 3mm bubble-thing that is probably the pregnancy (in the uterus), but she said it was too small to say for sure. Either way, there's no sign of it being ectopic which is good. We talked about the options moving forward (coming back to Sweden to do the FET of the blastocyst, doing PGS in the US, etc). We discussed how to deal with this miscarriage, since I haven't started bleeding. I do NOT want to be miscarrying, or heaving forbid dealing with a complication, while driving a U-Haul with my dad. So we agreed I'd do the Mifepristone and Cytotec that I did with my second loss, but this time I can do it at home. But to do that, I would have to go to the GYN ER. Before I left, I thanked my RE for everything she had done for us, that I really appreciated all their help. I had already been crying but cried more when I said all that. And then she started crying and gave me a hug. I was so incredibly touched that a Swede did that. As you may know from reading this blog, Swedes tend to be a little cold and not express emotions. It meant a lot to see that she cared.

Off I went to the ER, aka the place where I found out about my 2nd loss and where I spent lots of time with losses #1 and #2. OH and did I mention, I had already been there earlier in the morning because I wanted to get my records. So the lady at the counter looked at me like I was nuts to be back here twice in one day. *Sigh.* I get myself checked in.

And then, I see a girl I went to med school with. At work, that shift. UGH! Seriously?! When I first saw her, my instinct was to look away. Mature, I know. But then I saw her again and we said hi. We hung out a lot in the beginning and were in the same group for a bunch of projects, so it would've been even more awkward to avoid it. I explained the situation to the midwife in triage and asked to see someone else. Fortunately, she was accommodating. I explained to my friend that I had requested someone else, and she understood. She was like, "oh, I hope everything's ok!" And I was just like....yeahno. Sweet though. I just kind of nodded.

Hours go by, then I get called in. And for the first time in my 4 years of all this bullshit, I get a really hot doctor! Fortunately he was also nice. Kept explaining exactly what he was going to do for the exam and ultrasound until I was like dude, I'm on my fifth miscarriage and I've done IVF, I'm good, just do it, I know the drill. He saw the same thing on ultrasound that my RE had seen, and agreed to prescribe the meds. I took the Mifepristone at the ER and I got a little envelope with me full of Cytotec and painkillers to take tomorrow.

Unfortunately, tomorrow is going to suck because I already had to go pick up another set of medical records, go to a doctor's appointment, and get my infusion of Remicade for my Crohn's. Now I have to have a miscarriage too. Oh man. But hopefully, since the sac is so tiny, it won't be too painful.

Only 5 days left in Sweden. Between this miscarriage bullshit, and the terrible weather (50's and raining, even hailing yesterday), I must say Sweden is not making much of an effort to get me to stay.

I am the woman who has FIVE miscarriages

Apparently. My hCG is going down. I am obviously completely devastated that I lost this baby. However, I am even more crushed by the increasing chances that we will never ever be able to have children. And I also really really hope this will be over before I leave for the US in 12 days.

Right now, right after the phone call, this feels unsurvivable. But I know, unfortunately, from experience that it always feels that way. And so far, I've survived them all. Hopefully it won't be too bad physically since it's so early. Emotionally, I do not know how I'm going to deal with meeting my niece in a few days, but I guess I will just have to find a way, like I always do. I'm also having 2 parties/get-togethers this weekend. Sheesh.

Angel #5 (Max): BFP 5/10/15. EDD 1/16/16.

Probably loss #5

Last night, had a spot of red blood, followed by some pink and brown spotting. This morning, I took a HPT (well, 2 HPTs) and they are a little bit, but not much, darker than 8 days ago. So this will almost certainly be loss #5. Waiting for a call back from my RE's office now. And dreading having to go meet my baby niece while miscarrying...

Struggling with jealousy

Around the time Mr. E and I started TTC, Mr. E's little brother met a girl. In the past 4-ish years, they started dating, moved in together, got engaged, got married (less than a year ago), and now had a baby last week. In addition, they both graduated from professional school and have landed their dream jobs. I'm happy for them. Everything has worked out perfectly, and they have everything they want. They deserve happiness and I'm glad they were able to have a baby so quickly.

But.

I am having a really hard time with all this. I guess I'm an aunt now, but I feel so disconnected from the baby. Which is my own fault, for distancing myself emotionally because it's so hard. I guess since Mr. E and I are both the oldest, and we've been married for so long, before marriage was even on the radar for any of our siblings, I assumed we would be the first ones to have kids. Obviously, that hasn't happened. I don't want to "just" be an aunt. I want to be a mom and an aunt. I tried talking to my mom about how hard this was, but she just told me how much fun she thought it was to be an aunt, and that it's "so different than being a mother." That did not help. Not.at.all. I feel so jealous of my BIL and SIL and I absolutely HATE that I feel this way. I can't seem to make it go away though. I feel like such an ugly person, which is not who I want to be. I wish I could somehow compartmentalize my own pain from their happiness, but I haven't been able to figure that out.

Next weekend we're going to meet the baby, and I am already dreading it. See what I mean? I'm a horrible person. Dreading meeting their child, how awful is that?! Last night I cried because it was so hard, and then I cried some more because I hated that I was so sad about meeting their perfect little baby. I'm going to have to come up with some kind of strategy between now and next weekend, because this isn't gonna work.

Good news for the first time ever

My beta yesterday (at 18dpo) was 356. From 96 to...356!!!! That's a doubling time of less than 26 hours! I am feeling a lot of relief, and amazement. I've had pretty good betas once before, with my second loss. But this is the first time I've gotten unequivocally good news. We are obviously nowhere close to being out of the woods yet, I mean we're so deep in the woods it's pitch black. But, still, good news is good news.

They said no more betas, and to come in in 2 weeks for an ultrasound. It's gonna be a long 2 weeks. Please grow, baby. Please.

Pleasepleasepleasepleaseplease

Beta yesterday at 16dpo was 96. Seems a little low, based on the bazillion websites I just looked at. But, I know logically that the only thing that matters is if it doubles, and that's what my doctor kept saying. So, back I go tomorrow for another beta. You don't get same-day results here in socialized medicine-land. She said she'd call Friday (Thursday is a holiday). FRIDAY???? No freaking way. I begged to get my results by email or something, I said I would lose my mind waiting that long. She took pity on me and said she could call on Thursday because she was working. THANK YOU.

Please, please, please, please, PLEASE grow little guy. It's our turn goddammit.

Hope?

I tested. It was positive. Not very dark, but positive. Fifth time's a charm?


"Hope" is the thing with feathers
That perches in the soul,
And sings the tune without the words
And never stops at all,

And sweetest in the gale is heard;
And sore must be the storm
That could abash the little bird
That kept so many warm.

I've heard it in the chillest land
And on the strangest sea;
Yet, never, in extremity,
It asked a crumb of me.

- Emily Dickinson

Remembering my angels on Mother's Day

Mother's Day. For women with living children and/or living mothers, it's a day of happiness and celebration. For anyone who's lost their mother, it's a reminder of what was taken away from them. For anyone who's struggling to become a mother, it's a reminder of what they've never had. For anyone who is only a mother of angels, it is a reminder of what could have been.

I am incredibly fortunate to have a wonderful mother who I love very much. I wish I could devote so much energy to celebrating today with her (albeit from afar), but it's too painful. I've explained this to her, and I think she understands. I hope so. I ask my little sister (who I usually boss around) to be in charge of a joint Mother's Day gift from both of us, because it's just too hard.

Today I was cleaning out my bedside table in preparation for our move. I came across the ultrasound picture I have of my second pregnancy. It's just a little black empty sac, but it's the only physical, concrete proof I have of any of my angels. That ultrasound was performed by a very kind OB attending who basically caught me in the middle of a breakdown, asked what was wrong, got an answer which probably made her wish she had never asked, and offered to do an ultrasound right then and there. It was too early to see anything but a sac, and it already didn't look very promising, but at least it calmed me down temporarily. She even printed a picture for me. Obviously, we lost that baby too. I kept the picture though. On purpose. I guess because it's all I have. I don't have pictures of a fetus, or of babies, or of children. All I have is one picture of one empty sac (I don't even have ultrasound pictures from any of the other pregnancies). But I loved that baby, just as much as all the "real" moms love their living children. So it will have to move with us to the US. It's all I have.

Today I remember my four angels, and what could have been.

Angel #1: BFP 1/31/12. EDD 10/11/12. M/C 3/23/12.
Angel #2: BFP 2/27/13. EDD 11/6/13. M/C 3/24/13.
Angel #3: BFP 12/24/13. EDD 8/31/14. M/C 1/17/14.
Angel #4: BFP 3/20/14. EDD 11/28/14. M/C 4/3/14.

Reflections on my Adventures Abroad

Almost 9 (!) years ago, right after I graduated from college, I moved halfway across the world to a country where I knew one person and didn't speak the language. In less than a month, I will be moving back to the U.S. In the past 9 years, I have:

Moved in with a boy.
Gotten married.
Learned a new language.
Taught an English class, adult swim lessons, and histology.
Published 3 scientific articles.
Applied to, gotten into, and graduated from medical school.
Been to the Nobel Prize Ceremony.
Run 2 half marathons.

But I think what I am most grateful for is the opportunity to travel so much. Before meeting my husband, I hadn't even been to Europe. Now, I've been to 30 countries, 15 of which have been during my time abroad. I've done some pretty awesome things on those trips. I've been skiing in the Alps, which was an amazing combination of breathtaking views and great skiing. I've seen a ballet at the Bolshoi, which was like going to the Mothership of Ballet, and was really freaking cool since I did ballet for most of my life. I've marveled in awe at the pyramids in Egypt, and watched the sun rise spectacularly over Mount Sinai. I've seen the ruins in Athens, and tried to imagine what life was like back then.

A lot of Americans never get these opportunities or, if they do, they don't take them for whatever reason. Mr. E and I love to travel, and have prioritized trips over all else, financially and time-wise. And it's been spectacular.

I've also grown immensely as a person. I've faced so many challenges during the last 9 years, everything from learning a new language to dealing with infertility and 4 miscarriages. I am a very different person than I was when I moved here, and I think I am a much stronger one. And I'm excited for the next adventure and next set of challenges!