Sunday evening, the bleeding began to be heavier. I told Curtis that I was bleeding and that I thought it was all going to end in miscarriage. I laid in bed wishing I could change the outcome. I wondered why it seemed that so many times when I've found myself pregnant and had a hard time accepting it initially, miscarriages seemed to follow, especially after I've come to terms with being pregnant and getting excited about it. There is a lot of guilt involved in that, wondering if in some way you've caused the miscarriage and feeling bad that you weren't more excited about the pregnancy to begin with. It has been one of my hardest challenges. I think I've only had one miscarriage where I had planned on the pregnancy and was excited from the get go about it. There was no guilt that time and it was easy to recover from the miscarriage.
Towards midnight, I passed some tissue and it seemed to be attached to me. I thought it was the amniotic sac. I didn't try to detach it, fearing more bleeding, but covered it and got Curtis up, we told Mom and we drove to the Emergency Room in a sober mood. I was checked in and they called the on-call dr. to come examine me. He looked at my chart and history and asked some questions and then did an exam. It was determined that it was only a clot that I had passed (a clot?? on anticoagulants?) and that he could not see any active bleeding from my cervix. It was about 2 a.m. and they decided they would like to keep me for a few hours and then do an ultrasound when the tech got there in the morning. We agreed and they put us in a room to rest. Not much bleeding during that resting time, quite light.
The US tech came and got me sometime between 7-8 in the morning. I was not expecting to see anything and I actually hadn't seen anything but I surely heard the 'whoosh-whoosh' of a little heart beating away. There it was on the screen, a little fetus, with a furiously beating heart. I was so surprised. I was so sure it was gone. I began to feel a glimmer of hope at that point that maybe this was not going to end in miscarriage. After the US they sent me home and told me to keep off my feet, but to come back if the bleeding got worse. I was told to follow up with Dr. Black.
I spend the majority of that day in my favorite chair. It was becoming molded to me, I'd sat in it for so long. The bleeding continued but was very light. As evening came on, I wondered if I should take my Lovenox shot and decided that I should, so I did at 10 pm. About 1/2 hour after taking the shot I again felt some large clumps of tissue being passed from my body and the bleeding seemed to be picking up. By midnight we decided we had better head to the hospital again. So again, we woke my mom to tell her what was going on and then drove to the hospital. Again, I was checked in and the same dr. in the same clothing, came in to examine me, again. Poor guy, he'd been there all that time.
Again, he thought that all the tissue passed was clots, no fetal tissue. He said he still could see no active bleeding in the exam and again he encouraged me to go home and rest. He suggested that I shower and get cleaned up and that would help me feel better. I was rather a mess at that point.
So we drove home and I tried to just climb into bed, but Curtis thought the dr. was right and talked me into showering. It felt really good at first to wash all that day's troubles away, but as I was standing there, eyes closed, and letting the water run over me, I opened my eyes to see red everywhere, running and swirling away down the drain. I stood there in disbelief for a time. It was very surreal to watch my blood wash away. I then tried to figure out how in the world I was going to get out of the shower because the blood was not stopping. Then I started to get panicked because I could not figure out how to get out without covering the bathroom in blood. I finally called for Curtis to come help me, as I did not know what else to do, and it was still a mess. We packed a large chux type pad between my legs and put on some scrubs they had given me and off we went again to the hospital.
By this time, I was feeling very shaky and lightheaded. Probably mostly from fear, but I was very afraid that I might bleed to death. They took one look at me this time and immediately got me in the ER room and started taking care of me.
These are the dr.'s notes from the ER: "Approximately 2 hours later, the patient again returned. She had had mass bleeding. She reported that the floor of her shower and her bathroom, in her words,'looked like somebody had been murdered.' There was an extensive amount of blood. When she came to us, she had filled several chux and several tampons. When she came in, she was pail and diaphoretic. She was lightheaded and complained of being very dizzy. She had a look of panic on her face. Her vitals were P 100, BP 115/66. Her pulse decreased. She was in the 100s-115 on her pulse and 80s-90 systolic.
Immediately on her coming back to us, we put in two large bore IVs and stared running lactated Ringer's wide open. I spoke with Dr. Ludlow, who is a High Risk OB physician at Utah Valley Hospital. We relayed all of this to Dr. Ludlow. He recommended that we give 600 mcg of Cytotec, stating that I should inform the patient that this would like abort the fetus. Dr. Ludlow stated that he wanted the patient flown immediately and that she should have a transfusion begun immediately. I discussed this with the patient and she agreed. I also explained to the patient the effects of the Cytotec, and she also agreed to this.
Dr. Ludlow said that the patient's course of treatment, on her arrival there, would be an emergency D&C regardless, due to the fact that she was bleeding and that there was immediate risk to the mother's life.
We contacted the flight crew and they were on the way. We continued with lactated Ringer's giving the patient blood while we were waiting for the flight crew to come. After the Cytotec was given, the patient did begin to have a little bit better color, higher blood pressures, and less tachycardia. She was doing much better. She was speaking in full sentences. She no longer had the look of panic on her face that she had had before. She was transferred to UVRMC, under the care of Dr. Ludlow, in guarded condition. Dr. Ludlow also expressed to us that we would need to have the ability to do an emergency hysterectomy if we did a D&C of this patient while she was on this much Lovenox."
My memories of my time in that ER room were of some nurses who did everything in their power to help me out. Sheila, particularly, was fantastic and competent in all she did to treat me and also to treat me as a person, not just a medical emergency. I was cold, probably from shock and blood loss and felt often that I was going to hyperventilate. They kept me covered with warm blankets, several of them, as well as monitoring my bleeding and changing bedding and pads when needed so I didn't have to sit in a mess. I think I caused a bit of a stir there that night. There was lots of rushing around and adrenalin seemed to be flowing. I noticed that when one nurse was trying to put in IV's she was a bit shaky. I had to have some large IV's so that blood transfusion could be done as well as in prep for a possible surgery. I remember the blood transfusion and how much better I started to feel after that. I was given 2 units of blood. I am so appreciative of the donors who gave their blood to help me out. I know I should donate more often, since I have the universal donor type, O-. Something to definitely plan on in the future.
I remember wondering again if this was going to be it. When I was lightheaded, the sounds were funny and far away and I wondered if I was heading into that tunnel. Thankfully, once the blood was transfused all those symptoms left me and I actually felt ok.
We did a deja vu of the ambulance transport and airplane ride. This time the plane was the IHC Lifeflight. They were awesome. When we arrived at UVRMC I was rushed into the ER this time.......
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