What happened at the ER and POC testing

They saw me within 20 minutes or so of arriving to the ER.  I was thankful for that.  We spent from 11am until 3:30pm having ultrasounds, waiting on blood work (CBC normal, HCG 14,000ish).  Because my blood type was RH positive, I did not need an RH shot.

The ultrasound showed retained products of conception (I still really, really hate that term) at the base of the uterus.

A nurse practitioner did a vaginal exam, and tried to remove some of the visible POC.  Unfortunately, she didn't have much luck.

We were waiting on an OB consult, but decided to go home and have the nurse phone us with the information.  We were feeling much more relieved just knowing what was going on, so this felt like a good alternative to spending more time in the ER.   We were also hungry, which fuelled our desire to leave sooner.

Not surprisingly, the OB gave us three options.
1.  Wait a while and pass the tissue on your own.   Get follow up ultrasounds and blood work.
2.  Take Misoprostal to *hopefully* get the rest out.
3.  Have a D&C.

The pain of the natural miscarriage is too fresh in my mind.  I can't do #2 any day soon.  I don't see the harm in waiting a while to see what happens on it's own.

Maybe this is what I should have done, rather than go to the ER yesterday? I don't know.  It's easy to second guess things after you have all of the information.  Or, at least that's where my mind usually goes.   Yesterday, I was on the fence about the decision to go to the ER,  but CCRM, a ER nurse, and the nurse receptionist at my OB's all suggested I go in.  And I was freaked out, so I took their comments seriously.   Oh well, I suppose.  At least we know what was going on.

The CCRM nurse gave me a follow up call to see how everything went.  She agreed with the OB's three options.  We also discussed the POC testing.

A few days earlier, the CCRM geneticist told me that they haven't been doing this testing with Natera for very long.  The geneticist told me the test would cost $400 plus shipping.   When I called them to double check the cost of the kit (at D's prompting), they told me that it is $400 with insurance and $800 without.  We don't have insurance.   If there was no sample to test (because we didn't collect it properly), they would still charge us the full price.

We asked Natera questions about the collection of the sample.  We were really unsure about what we collected.  What we have looks nothing really like the pictures they provided, but there really wasn't anything else to select.

We were torn with what to do.  Maybe nothing looks like the diagrams because it is still inside me?  I don't friggin know.

I told our nurse that we were really at a loss for what to do.  I told her that for $800 I could probably buy myself something really great to make myself feel better for everything that's just happened.  Although, sigh, I wouldn't.

She said that it is very confusing to do the collection.  That she has been in the operating room many times where the doctors are trying to identify things appropriately and it is difficult.  She said that she has seen a lot of results come back as normal female (which doesn't mean anything because it could be my own cells).  She reminded me that there was no right or wrong answer here.  That either way, our decision would be ok.

After taking everything in, we decided not to do the testing (again).  I don't feel comfortable with what we have collected.  We don't have an endless supply of money to keep throwing at this problem, and I already feel absolutely sick about how much we have already spent.  The result isn't going to change what we do with our next transfer.  The information may have added something to the conversation if our next transfer is unsuccessful due to BFN or things much worse.

So now, I sit back and wait.  I'm hoping for cramps to help finish up this show, so this part of things at least can all be put to rest.

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(Note - CCRM wants a beta and an HSG or Sono after my next period to confirm everything is ok).

It's over, but not completely

We made a plan that I was going to take the Misoprostal on Monday night and Tuesday morning. This was the latest day that the nurse recommended to do it. We were waiting for the holiday weekend to be over.

My body had its own idea though. On Friday, I started having a small amount of bleeding and slight cramping.  On Saturday night at 6pm, I started having major cramping and knew that it was going to happen. 

For three hours, I passed a lot of blood and clots.  The cramping went from severe period like cramping to horrible abdominal pain. It got really intense. It was the kind of pain where you think about calling an ambulance, but you also can't imagine being touched, let alone leaving your bathroom. 

I took two different kinds of pain meds, but they felt like they did nothing. 

We didn't have any prescription strength meds because we hadn't filled it yet. I didn't expect to need them before I took the Misoprostal, so I was unprepared. Half way through the miscarriage, I was desparate and D asked a friend who lived nearby to fill the prescription for painkillers.   

I passed something the size of the palm of my hand, and that seemed to relieve my pain almost immediately. I don't think that I have ever felt so relieved in my life. 

With my first miscarriage, I assumed that the extreme pain, etc. that had was largely from dramatic effects of the Misoprostal. This time around, I realized that it probably wasn't the meds but the miscarriage itself that was the biggest pain inducer...silly of me to think that, but now I've learned a bit more I guess. 

We tried to save the larger pieces ofthe products of conception. We were hoping to identify the gestational sac, so that we could complete the Natera testing. 

At first that seemed very disgusting but after a while we almost seemed like scientists. It was a somewhat fascinating to see what had been in my uterus. 

We picked out some things that we though were suitable and put them in the specimin container. Honestly, despite having the diagrams to go by, we had absolutely no idea what we were doing. 

We had planned to send that away today after we had D's blood drawn (because it's DE). 

Again, we learned that nature sometimes has its own plans. I checked in the shower today if there was anything left that I could feel in my vagina. I did this because in my first miscarriage, a week after I found a chunk of something lodged. That time, I was able to get it out. This time, I couldn't. 

I didn't have any cramping, otherwise I would have a little hope that it would come out on its own. 

I felt so disappointed and upset. Why couldn't this just be over?  The relief that i felt yesterday was gone. 

So today we decided onve again what we would do. We called the clinic and our OB to see what they thought. Both said to go to the Emergency Department, so that is where we sit now, waiting and wondering what's next.