Friday
For anyone not interested in reading about some fairly sensitive medical issues, skip today's blog. Sherry gave it some thought and realized that reading other people's blogs about this sort of thing helped her cope with it, so she'd like to return the favor.
First, a little background information that some of you may or may not know. We found out we were pregnant back in March, and although it was completely unplanned, we were obviously very excited. Sherry was constantly nauseated and experienced a lot of back and pelvic pain, but since no two pregnancies are alike, she chalked it up to that. She also felt like her abdomen was bigger than it should've been for how far along she was, but since you show earlier with your second pregnancy, she was not too concerned.
The concern came when she began spotting at around 7 weeks along. She saw a midwife, since in New Zealand you only see an obstetrician if there is a major problem or high risk pregnancy, and had an ultrasound which showed a 7 week, 1 day fetus with a strong heartbeat. There was no evidence of hemorrhage around the sac. We were thrilled!
First ultrasound was reassuring
The brownish spotting resolved after a couple of days and Sherry stopped worrying. Then, with no warning, she awoke one morning three weeks later to find frank bright red bleeding. A second ultrasound was done emergently, and confirmed fetal demise. She'd had a "missed miscarriage," which simply means that she'd miscarried but the conception products were still in the womb. So, we began the waiting game. The midwife felt it would likely pass in a few days, but warned it may take up to two weeks. At the two week mark with nothing happening, she urged Sherry to "hang in there" and to keep waiting. After a month, Sherry decided to get a second opinion, especially since her pregnancy symptoms were still present for the most part, and her abdomen continued getting larger.
The obstetrician immediately did blood work and repeated an ultrasound, which again confirmed fetal demise and missed miscarriage. The Beta-HCG (i.e. pregnancy hormone) level came back alarmingly high for a woman who'd miscarried a month prior, and we were referred to Tauranga Hospital for a D & C. While discussing the surgical procedure that would remove the miscarriage, we were counseled for the first time on molar pregnancy. If this were indeed a molar event, the thought was that it was a partial molar pregnancy, since we had seen a live fetus previously. A molar pregnancy results in no fetus, only molar tissue. A partial molar event is when there is a live but genetically abnormal fetus, coupled with abnormal placental tissue that grows rapidly, and is essentially a tumor. It continues producing hormones, even after the fetus dies, and your body still thinks it is pregnant. Meanwhile, the placenta forms grape-like vesicles, or tumors and continues to enlarge. There is a risk of the tissue growing back, even after the D & C. If this occurs, they repeat the D & C. If it grows back a third time, they treat the woman with a mild course of chemotherapy, as the tumors are part of the spectrum of choriocarcinoma, and can spread to other parts of the body if not aggressively treated.
See Link:
http://en.wikipedia.org/wiki/Molar_pregnancy
The D & C went off without a hitch on May 13th. The nearly five weeks Sherry spent waiting were emotionally draining. Just looking down at her swollen tummy was a constant painful reminder of what had happened. She was relieved to have the surgery, and get some closure!
All seemed well afterward. The histology reports confirmed partial molar pregnancy, and Sherry has to get her Beta-HCG level drawn weekly for 8 weeks, then monthly for six months. Her first two levels had dropped drastically, and she was feeling good going to her two week checkup knowing this. Yesterday was her two week checkup, but there was a little bump in the road.
About an hour before her appointment, Sherry was killing time in Tauranga running errands in the shopping center near the hospital when she started bleeding heavily. It was absolutely running out of her! When she got to the hospital, she'd soaked through her clothes and was fairly freaking out. The O&G Registrar (a rough equivalent of an OB-GYN resident) who examined her immediately admitted her to the surgical unit for D & C, but wanted an ultrasound scan first.
Sherry giving her thumbs a workout as she waits for her ultrasound
Karla picked up Mark and brought him to the hospital, and agreed to pick up Ro from school and take him back to her house. Meanwhile, once on bedrest for a couple of hours pending the scan, Sherry's bleeding tapered off and she relaxed a little. The scan showed retained products, which meant that either they didn't get it all out last time, or the tumor-like tissue had tried to grow back. Sherry's procedure was going to be delayed for an open operating theatre slot, so she decided to go home and come back this morning rather than stay overnight in the hospital.
The second D & C was quite painful afterward. According to the surgeon, they were more aggressive on the curettage in order to get all of the rogue tissue, and due to the bleeding incurred, they administered two doses of pitocin to make the uterus contract and stop bleeding. Sherry awoke feeling like there were fish hooks in her ovaries and cervix, and every 30 seconds someone was trying to yank them out of her. The first surgery was just not painful at all, so this intense soreness and contractions to boot was a surprise. The pain medicines they were giving her didn't help much; the morphine was just making her goofy. Fortunately, the Buscopan (an anti-spasmodic usually used for bowel problems) they finally gave her made her comfortable enough that she could go home this evening. She didn't want Ro to see her in pain, so she had Mark keep him away from the hospital after school until she was ready to be picked up.
Mark took Ro to Memorial Park to kill some time while Sherry recuperated
Ro and Humpty Dumpty, waiting for Sherry's text-message to give the all-clear
Ro making like a monkey
This was an exhausting week for all of us, with Mark and Ro sick, and we were all glad to get it over with. We are now looking forward to hanging out at home this weekend, doing nothing, and just being together and getting each other well.
Sunset in Mount Maunganui, right outside the liquor store