I’ve been sitting here trying to come up with clever analogies about trains and tracks, routes and detours, positivity and baggage, but sometimes life is, simply, too much for positivity train parallels.
Everything was going along as expected. My HCG level was rising accordingly, I was having the pesky early pregnancy symptoms, I was anxiously awaiting my ultrasound on Friday the 30th, but I felt, for the most part, calm. This time things just felt right.
That was until Sunday morning. I woke up after having a terrible nightmare in which I was in a crowded building trying to tell someone I was miscarrying my baby, but no one could hear me. Needless to say I was freaked out, but I told myself to calm down…it was just a nightmare…the baby is fine. That was until I went into the bathroom and realized I was passing brown clots. I immediately called our fertility center and spoke to the nurse on call. She assured me brown clots were not concerning, but said someone would call me back in a little bit. Half an hour later my usual nurse Marsha called and reassured me again that brown clots and cramping was normal, but implored me to call again if I started passing bright red blood. I spent the majority of the day lounging on the couch, silencing the voice in my head saying something was wrong and forced myself to get dressed and go to dinner with my in-laws.
By Monday I felt mostly better, I was still passing small brown clots, but the cramping was minimal. I went to work and tried to busy myself, but I realized the voice in my head simply could not be silenced. Regardless of what everyone was telling me…something felt wrong. (I should note this week is the same week I miscarried our Warrior last year, so my guard was up). I called our IVF center and spoke to the nurse covering for my nurse, I told her I recognized everything I was feeling was ‘normal’ to them, but it didn’t feel right to me. I used the phrase drilled into a nurse’s head when something doesn’t feel right “I have a concern.” She told me she was going to speak to my physician and call me back. Ten minutes later she called and said my physician was fairly confident everything was fine, but to come in Tuesday morning at 930 for an ultrasound just so we could make sure. I jokingly said to her “Is he doing this because he’s worried something is wrong or because he’s worried I’m losing my mind.” She laughed and replied “Probably a little bit of both.” I went home from work Monday night feeling better, knowing we would see our doctor the next morning was reassuring. Dan and I watched some trash TV and we went to bed around 10pm.
At 10:15 I started having terrible cramps, like the first day of my period. I lay in bed performing deep breathing exercises and practicing mindfulness…’everything is fine’ I kept repeating to myself. I figured if I convinced myself everything was fine, maybe everything really would be fine. By 10:45 the cramping hadn’t stopped and I felt a terrible sensation something was really wrong, I crept into the bathroom and was horrified to find I wasn’t passing small brown clots anymore, this was bright red blood. I opened the door to our bedroom and as the bathroom light caught my husband’s sweet sleeping face I felt an overwhelming feeling of dread…In 30 seconds I was going to wake him up and blow up his entire world.
And that’s exactly what happened.
We rushed to the local ER where I tried to remain as calm as possible as I told the triage nurse I was fairly certain I was having a miscarriage. My hand shook as I reached out my arm to have her place my ID band on, but I refused to cry…I needed to stay in control, now was not the time to breakdown. We waited 2 hours for an ultrasound. The ultrasound tech asked a few questions as she performed the scan and at the end she turned to me and said…
“This is Baby A…and that’s the heartbeat” and then moved the probe and continued “This is Baby B…and that’s the heartbeat” Dan and I looked at each in absolute shock…TWO babies, TWO heartbeats. I asked the ultrasound tech if she ‘off the record’ could tell me why there was so much blood (it had been less than 2 hours and I had already soaked through a pad) and she shrugged “I don’t know, truthfully, there is a lot of blood in your uterus, but there are also two heartbeats.” And so I was wheeled back to my room in the ED and Dan and I waited.
…and waited…and waited.
The nurse and physician assistant who had been caring for me checked in a few times, but stated we were still waiting for the official read from radiology on my ultrasound. Around 3:30am the ER physician came in and explained that my ultrasound had been read…yes, there were two babies and two heartbeats, but Twin A’s heartbeat was very slow. (69bpm, it should be between 90-110bpm, Twin B’s was 109). I also had a large sub chorionic hemorrhage (hematoma) and some blood in my pelvis. He calmly explained that between the blood and Twin A’s heartbeat he was diagnosing me with a ‘threatened miscarriage’ and then said “I think Twin B is a viable pregnancy, I do not think Twin A is.” He agreed to discharge me because I still had my appointment with our fertility doctor that day. (At this point it was almost 4am). Both he and the nurse sent me off with the same sentiment… “Sorry…and congratulations.”
Fast-forward 5 hours and I was again sitting in exam room 7 with our fertility MD. He initially did an internal which revealed my cervix was still closed, he said this was an excellent sign. Then he started the ultrasound: Twin B’s heartbeat was found right away: a strong 110 bpm. Twin A’s…well after searching for what felt like an eternity…my doctor looked at me and for the second time in 14 months stated “I am so sorry, there is no heartbeat.”
I wasn’t stoic this time. Tears streamed down my face as our physician explained the hematoma was massive and was directly next to Twin A. Sub-chorionic hematoma’s occur in about 1% of pregnancies and are the cause of 20% of first trimester bleeding, normally they cause no harm to the baby. Sadly, mine was just really bad luck…it was too big and too close to A. The good news is there was no evidence of active bleeding, the bad news is there is no way to prevent another bleed.
Which is why I sit here in my bed writing this long and detailed blog post, because I have been officially placed on bedrest for an undetermined amount of time. I go back to the doctor tomorrow for a repeat ultrasound to check on Baby B, but my physician explained we need to treat this (for the time being) as a high-risk pregnancy, he said we cannot take any chances with Baby B.
My heart aches today. For the baby that wasn’t and for the baby that is. I won’t physically miscarry this time, if baby B continues to thrive, baby A will simply be ‘absorbed’. I’m not really allowing myself to mourn the loss of A, because I am afraid of how that will affect B. I’m so profoundly grateful this baby’s heart is still beating, I’m trying to live in the happy place I’ve created around that.
So for now, I’ll sit in my bed. I’ll watch trash TV, read books and blog. I’ll try to keep my mind occupied with positive thoughts. I’ll remind myself repeatedly that we still have one growing baby and how much luckier that makes us than so many. My doctor asked me Tuesday how long (financially) he could keep me on bedrest and I joked “for the next 8 months if it means I’ll deliver a healthy baby” and truthfully Dan and I both agree if bedrest is the best thing we’ll make any sacrifice we have to to ensure a live birth.
This train is certainly not taking a smooth ride, but for now, at least, we’re still on the right tracks.