Tap, tap, tap…

Finally!  I can feel Sam movin’ and groovin’ around in there.  About dang time, kiddo!  Still can’t feel him on the outside of my stomach very much, but I can feel him inside.  I think one of two things may be happening:  either the SCH has changed positions/shape OR after weeks and weeks of bleeding, it’s bleeding itself out.  I haven’t noticed an increase or decrease in bleeding though.  Still pretty much the same amount.

Tuesday, we begin a new year and I am so ready for 2012 to be done.  I think I’m going to go through my photos and do a little 2012 recap to relive the good time and let go of the bad.

Advertisements

So what the heck is a Subchorionic Hematoma anyway?

Basically, it’s a large pocket of blood in the uterus.  It’s unknown why or how they form.  There’s nothing a pregnant woman can do to either cause them or make them go away.  They just happen.  This isn’t exactly comforting news.  There’s no controlling them and there’s nothing the doctor can do, per se, about them.

“What is a subchorionic hematoma or subchorionic clot? The “bag of waters” within the uterus is composed of two layers, called the chorion and the amnion. The inner layer, closer to the baby, is the amnion. The outer layer, which is normally against the uterine wall, is the chorion. The term “subchorionic clot” or “subchorionic hematoma” describes a blood clot between the bag of waters and the uterus.”

I found a very informative article through a support group that explains what they are here.  It’s pretty interesting and it shows examples of what they look like, so please read the whole article if you have a chance.

So what does this mean for my pregnancy?

Wednesday, I was supposed to go see the perinatologist.  That morning, I suddenly realized they had never called to confirm my appointment.  I called their office and was told that not only was the appointment cancelled, but that I was the one who cancelled it!  I told them I’d never spoken to their office and had been told my doctor’s office the appointment had been for 9:00, not 8:00 like they said.  Ian had taken off work especially to take me to this appointment since they’d be doing the anatomy scan and it would be the first time he got a chance to look at the baby.  I even checked my phone records and there were no calls to or from their office.  They told me they didn’t have any openings and because I was still bleeding and hadn’t felt Sam move, I had to go see my regular OB.  I was furious.

Thankfully, my wonderful office was able to get me in that morning and do an ultrasound.  Again, we saw that Sam was growing perfectly.  He was jumping and jiving and kicking and punching.  The ultrasound tech, Allie, explained why I wasn’t able to feel him move.  There was no where for him to kick that wasn’t either the placenta or the blood clot.  When I asked her to measure it, I was shocked when she gave me an estimate of 11cm.  A normal, 18 week old fetus is 13.25cm.  That was almost the length of Sam and I’d hazard a guess that at its widest, it was 5cm.

Again, there’s not a lot of literature on SCHs and even less on second trimester SCHs, but scouring the internet and pregnancy forums, the largest measurement I could find that anyone’s provided is 6cm.  That’s incredibly disheartening.  The more blood, the more irritation, which causes contractions.  Contractions bring on labor.  The SCH has a way to drain, so hopefully, it won’t form a clot and cause placental abruption (which means the placenta detaches from the uterine wall and causes miscarriage).

I asked my midwife to level with me.  I know she was trying not to freak us out, but we were able to read between the lines.  They expect me to go into preterm labor.  She told me once I hit 20 weeks they will make every effort to stave off it off.  However, there’s no guarantee.  I can expect to continue bleeding throughout my pregnancy, possibly another massive bleed like I had at the end of November, as well.

They also don’t know where the bleeding is coming from.  As you can see from the above article, SCHs are part of the placenta, between the layers.  This bleeding is not attached to the placenta.  I may still be bleeding internally, as in the pocket of blood may be filling back up.  I won’t know if there’s blood flow to it or where its coming from until I see the perinatologist (January 4th).  If I’m now looking at a pocket of blood 11cm after all that bleeding (and I’m still currently bleeding), how the hell big was it before it burst?!

Anyway, this is where we are now.  I have a healthy baby and an unhealthy uterus.  I am on bed rest (here’s a pretty interesting article on the benefits of bed rest for SCH patients) and will continue to be monitored throughout my pregnancy and will update this blog as it goes along.  I’ve never been in the situation where I was hanging my hopes on reaching viability at 24 weeks, but that’s where we’re at.  I have 5 1/2 more weeks until I get there.

Fear

This post is quite long and it’s to catch everyone up to speed on what happened at the end of last month.  I’m going to create another post that will go in to the diagnosis and what it means, as well as the plan going forward.

 

“I must say a word about fear.  It is life’s only true opponent.  Only fear can defeat life.  It is a clever, treacherous adversary, how well I know it.  It has no decency, respects no law or convention, shows no mercy.  It goes for your weakest spot, which it finds with unerring ease. (…) The matter is difficult to put into words.  For fear, real fear, such as shakes you to your foundation, such as you feel when you are brought face to face with your mortal end, nestles in your memory like a gangrene:  it seeks to rot everything, even the words with which to speak of it.  So you must fight hard to express it.  You must fight hard to shine a light of words upon it.  Because if you don’t, if your fear becomes a wordless darkness that you avoid, perhaps even manage to forget, you open yourself to further attacks of fear because you never truly forget the opponent who defeated you.”  –Yann Martel, The Life of Pi

I am a planner.  I make lists upon lists and lists of lists.  I like things just-so and if things don’t pan out quite right, I always tell myself, “Well, make a better list next time so you don’t forget!”  So when Ian and I found out we were expecting, I got myself into a little bit of a panic.  This was not on my list!  It took me several weeks and repeating to myself daily that I was pregnant for it to sink in and because it wasn’t on my list, I still wasn’t quite happy about it.

Something felt not-quite-right.  I had an ultrasound to confirm the pregnancy and give me an estimated due date.  The baby’s heart beat was strong and it appeared to be just a wiggly as Gabriel was.  For some reason, I didn’t want to tell people I was pregnant.  I blew it off as maybe I was just still upset about the shock (and truth be told, angry that my insurance plan didn’t cover maternity).  When I found out at 15 weeks I was having another boy, I was a little disappointed.  Ian and I knew we’d only have two kids, so I was sad I wouldn’t get the chance to be a mother to a daughter.  I had stupid worries about always comparing my second son to my first or not knowing how to love them differently, but equally (which is totally ridiculous because they’re two different people, duh, but when you’re pregnant, you can get carried away with your irrational fears even when you know they’re completely irrational).

(To a pregnant woman, this scenario is totally plausible:  Giant Eagles could snatch my baby!!!)

I have a very sweet friend who felt the same way with her first child and after talking with her a bit, I felt a lot better about another boy.  I made a list!  I made a Pinterest board!  I thought of all the different interests this baby could possibly have and how I would make sure he felt special by sharing them with him.  But I still didn’t feel like sharing my pregnancy.  I told my mom and my husband, but when they asked if they could share the news or if I would make an announcement, I skirted the issue and left it up to them.  I had this weird aversion to it.  I thought maybe it was still just my planner-self coming to terms with the unexpected or maybe some left-over gender disappointment… but somehow, it wasn’t that and I couldn’t shake it.

Gabriel came down with a cold on November 24th which turned out to be roseola, so he kept me busy while I kept him out of school.  The rash appeared Wednesday and by Friday it was almost gone, he was no longer contagious, and he was driving me insane.  I felt strange and dizzy the whole day, so I tried repeatedly to get him to take a few naps so he could fully recharge after his illness and I could lie down for a bit.  After a long battle, I finally conceded defeat and headed out to the park to let him blow off some steam.  We live out in the sticks and the nearest park to us (15 minutes up the road) isn’t really designed for toddlers, so I headed to the nicer one 30 minutes away.

We ran around the playground for a while.  I got him to go up the toddler play gym and down the slide himself a few times.  He wanted to climb higher and go down the longer slide (which was all of maybe 5 feet) so I climbed up with him and slid down.  The instant I stood up at the bottom I knew something was wrong.  The slide had a little bump in the middle of it I hadn’t noticed.  I did not feel well at all.  Gabe ran off to the swings so I slowly walked after him, trying to calm my nerves.  After pushing him for about 5 minutes, I knew I needed to leave right that moment.

As I got him into the car, I felt a little gush.  Awesome!  I totally just peed myself at the park!  Nice one.  But then I felt it kept coming and my bladder didn’t feel any emptier.  I strapped Munchkin into the car and drove over to the park restrooms.  I left the car running and ran into the bathroom.  I sat down and used the potty thinking, I’d just empty my bladder and burn my pee-pants when I got home.  But when I wiped, it wasn’t pee.  It was blood.  A lot of blood.  Naturally, I friggin’ panicked and called my midwife sobbing while driving 80mph out of the playground.  She told me to go home, lie down on my left side, and wait to see if the bleeding would stop.  I called my mom on the way home so she could come over and watch Gabe while I rested and I called Ian, bawling, to tell him to come home.  He was working in Atlanta, so I knew the traffic would be awful, so I figured he wouldn’t get there for another 2 hours.

By the time I got to my house and stood up out of the car, I was gushing blood.  I’ve honestly never seen that much blood come out of my body in my life (including the horror that happens after you give birth).  I got Gabe out of the car and let him run free-range in the living room while I ran to the bathroom to wait for my mom.

It was over.  I knew it.  No way could I be losing that much blood and the baby still be alive.  At almost 16 weeks pregnant, there’s nothing anyone can do to prevent a miscarriage.  I resolved myself to let my mom take care of the mess I’d made in the car, the garage, and the house.  I’d wait until Ian got home and she could take me to the emergency room.

When she arrived, I went to lie down in bed and wait for Ian to arrive.  I tried to distract myself by looking at internet forums I frequent and my old friend, Facebook.  As a planner, I couldn’t help but follow the bleeding to its logical end, but I had no idea what happened when you have a miscarriage at that stage of pregnancy.  How would I react when they told me what I already knew?  I had planned to go St. Mary’s.  I know almost all the hospital staff and I knew they’d care for me, but did I really want to go through with something like that in front of them?  I didn’t know.

Ian arrived home and I sat up from bed to greet him.  A new wave of blood soaked me all the way to my socks.  My mom helped me to the bathroom to change again.  I began violently shaking and knew I wouldn’t make it all the way to Athens.  I’d have to go to the nearest hospital and fast.  When we arrived, I asked for a nurse to help me out of the car.  I was so dizzy I was afraid I might fall and my mom wouldn’t be able to catch me, or worse, she would try and injure herself.  The tiny waiting room was packed.  The triage nurse told me they one OB bed and they were discharging that patient, so I would have to wait.  I cried.  I’ve worked in emergency rooms in various positions for almost 10 years now.  I knew I’d have to wait a while the minute I looked at the waiting room, but all I wanted was to know, right then, if Sam was still in there.

Thankfully, I didn’t have to wait long and they brought me back.  The nurse told me the doctor would be in shortly and the on-call ultrasound tech had been paged to come in.  The doctor came in shortly and examined me.  I know it’s a totally human reaction, but I really hate when doctors see something really gorey and go, “Oh my.”  She could’ve even find my cervix because of the amount of blood, but she told me I was more than likely going to lose my baby.  She and the nurses hugged me while my mom and I sobbed.  I’m not a pray-er, but we prayed.

The ultrasound tech arrived and showed me that Sam was indeed still alive.  The placenta was intact.  They didn’t know why I was bleeding.  I called my midwife back and she told me to come to the hospital tomorrow and she would examine and I could come in for an ultrasound later that week.  I left the ER confused and still scared.  Yes, Sam was alive, but the ER doctor said it looked I was dilating.  I still didn’t have high hopes to continue this pregnancy.

The next day I was seen at St. Mary’s and after arguing for about an hour to be seen upstairs instead of the emergency room, the midwife told me my cervix was long and closed, just as it should be and she didn’t have any idea why I was bleeding.  The following week, my mother in law came up and took me to see the doctor’s office.  I am so thankful to have such a wonderful, caring OB practice and a phenomenal ultrasound tech.  It took her all of a minute to find the source of the bleeding.

I had a large subchorionic hematoma.  And that wasn’t just gibberish to me!  I had a very small one early on in my pregnancy with Gabriel.  I had a little bit of spotting and the clot resolved itself within a week or so.  I was so relieved to hear they had a diagnosis for what was going on, I barely registered anything Dr. Allen told me.  Only after I went home did I realize several things:

  • I saw the actual OBGYN.  I usually see the midwives.  At that practice, the midwives see and deliver regular ol’ pregnant patients and the OBs see high risk or gynecological patients unless a patient specifically requests to see the OB.
  • They were referring me out to see a perinatologist.  Like I said, they do see high risk patients at that practice, so for them to refer me out was a bit unusual.
  • She mentioned preterm labor and continued bleeding.  I was still bleeding at that point and I figured I would continue to bleed the rest of the clot out.  I didn’t realize she meant renewed bleeding.

I was put on bed rest and told to go see the perinatologist in 2 weeks.  No picking up my son, no driving, no travel.  Rest, rest, rest.  Sounds like a mini-vacay, right?  Yeah, no.  Immediately when I got home, I wanted to pick up my house, start the laundry, play with my son.  My enthusiasm for finally knowing what exactly was wrong deflated like a popped balloon.  This wasn’t going to be a normal pregnancy anymore.  My feelings of trepidation made sense.  I knew something was wrong from the beginning, but I just didn’t know what.  I had no choice but to take it easy and wait to see the perinatologist.