This is hard...

Miscarriages are hard. I've had two before this one. This one is particularly hard. It's hard because I thought I was "safe". It's hard because I knew he was a boy. It's hard because we named him. It's hard because we felt comfortable enough to buy things and prepare for him. It's hard because I had felt him move. It's hard because I was wearing maternity pants before we left on vacation and I came back to put on my regular pants (and not just like yoga pants or leggings but real dress pants). Except it doesn't feel like any accomplishment to be out of maternity pants when you only want to be wearing them still. It's hard because I spent hours in labor with real and hardcore contractions and I yet I have nothing. It's hard because all I want to do is hold a baby right now. (Seriously I won't steal them I just need to hold somebody's newborn baby and maybe cry a lot as I snuggle them and smell their sweet newborn baby smell). 

I was relieved when the doctor told me I didn't need a D&C. Because I had miscarried naturally twice before and while it was hard and it hurt it was very manageable. And because I was 13 hours away from knowing any kind of support system to help us care for our 2 children. And because I wanted this to impact my family vacation as little as possible. After all my boys were about to learn they lost their brother. And Mack's birthday was coming. It seemed unfair that they also lose their much anticipated vacation. And Mack had been so excited to celebrate his birthday at Magic Kingdom for months! So I was relieved. I didn't know that it would be so different from my last ones when the doctor told me I could miscarry naturally and take Tylenol for the pain. I thought that was good news. I thought this would be good. 

Until the next night when the pain came. It was hurting so bad and it was just the beginning. The Tylenol didn't do anything. So I called my on call OB at home to ask if she could call me in something for the pain.  She seemed disturbed that I was sent to miscarry at home (not even home but to a hotel room with no reliable transportation). And then told me she couldn't call in pain medicine because narcotics can't be called in and I was in another state. This made sense but made me more worried. I got through the night and went to urgent care in the morning in hope of getting pain medication to help. I knew that my doctor was nervous but I still didn't understand the danger quite yet. She kept telling me this would be worse then my other miscarriages but I didn't understand how much worse yet. 

At urgent care they saw me despite saying we don't prescribe narcotics. I think sobbing in the waiting area about having a miscarriage made them feel bad for me.  While I was waiting my OB called me because she had been worried about me. I told her I was at urgent care and she said they could call her if they needed anything. The doctor at urgent care was nervous about prescribing me something afraid that sending me home with pain killers to miscarry on my own would be dangerous (it was). So I called my OB and he talked to her. She clearly had told him to convince me to go to the hospital for a D&C, that this wasn't a good idea. So he convinced me and I listened. I finally started to understand that this wasn't a safe decision. 

So I went back to the first hospital. I called Mike to meet me at the hospital as I figured I would go and have the procedure that day and we could get on with our trip even if the boys missed the day we scheduled to swim at the pool. I saw a nurse practitioner at the ER she seemed to agree this was not a good idea. However the OB on call refused to do the D&C. He (this is an assumption and for ease because I don't know) refused to even come see me. I requested that he at least call and talk to my OB. Again he refused and had the nurse practitioner call my OB for him. No matter how hard my OB tried to advocate for me he refused to listen. I even had my OB call the hospital OB since he would not call her. And so the nurse practitioner (NP) came back and said they had talked and agreed I could get pain killers and miscarry at home. If things got bad (the pain or bleeding) I could come back. She also suggested flying home to get the care elsewhere, trying another hospital (but no guarantee on what they would do) or coming back when there was a new OB on call. At this point I'm scared everyone made it sound like this was dangerous so I asked if I would be okay. The NP made it clear the pain and bleeding would get bad. So I called my OB to see what changed. She apologized told me her hands were tied because she has no privileges at this hospital and the OB and hospitalist were refusing so there was nothing she could do. She clearly felt terrible. And so we asked if we should find an immediate flight home and she tells me no as it would be dangerous to be on a flight when this happens. 

I generally have been lucky with doctors. I've always had great doctors I trust and who I feel are looking out for the best interest of me (or my kids). For the first time I felt scared. Here I was facing what felt like complete negligence on the doctor's part and it was putting my life at risk. And there was nothing I could do about it. I was trapped at the mercy of a doctor who clearly didn't care about me. Not to mention the emotional toll that was being put on me during an already emotionally painful time. It was a really scary feeling to have no control over my health.

So back to the hotel I went with a prescription that I know is probably not going to help and a bunch of stuff I'm hoping I can use to help ease the pain. I went to bed early hoping to get some sleep before things got bad. I woke up in pain and I starting trying to do what I could to manage the pain. As I sat in a hotel bathtub having contractions close together trying my best to manage. Mike tried to get all the sleep he could. We both knew it would be a long night and he would have to care for the kids the next day somehow. Eventually it was too much the pain was bad and I decided it was time to go back to the hospital. But not that hospital, earlier in the evening my sister in law helped me learn of a better hospital to go to in the area. We would go there. So Mike calls the front desk explains what is happening and asks them to call a cab to go to the hospital and says I cannot walk to the lobby. We tell them we don't want an ambulance because we don't want to go back to that hospital. And while I sit in pain Mike wakes up the boys and packs them up with extra clothes for me (smart man). I grab a hotel towel to sit on and the resort manage picks us up and drives us to the lobby to meet a taxi. We take a looooong bumpy cab ride to a new hospital in downtown Orlando. The poor boys in the backseat taking it like troopers that we woke them up sometime around 1am. The poor cab driver driving probably half an hour with a woman in the back seat having terrible contractions and wondering if. I'm going to ruin his cab (it's cool dude I'm sitting on a towel!)

We finally get near the hospital and go towards the sign that says Emergency. I go check in while Mike grabs the boys and tell them through painful contractions I'm having a miscarriage. They try and be positive at first before they eventually get the whole story. I tell them I took Percocet but it didn't help. The triage nurse notes that my contractions are too strong that's not going to do anything. I ask for something more but have to wait to see a doctor. They rush me in though. I see a doctor quickly all the nurses and doctor's are dumbfounded about the situation. They don't understand what the other doctor was thinking. They give me morphine in a shot because it takes too long to get an IV in me (I have terrible veins). The morphine helps. But bad news I went to the wrong hospital. They don't have an OB I need to be across the street but they will work on getting me there. 

The doctors and nurses here are amazing! They do everything they can for me. They are sweet and caring and they put the boys in another room so they can lay in a bed and sleep while a nurse can watch them. It takes hours to move hospitals. That's just how these things work. So I'm in labor for hours but the medicine helps take the edge off. And at least now I have doctor's watching me. The attending doctor makes me learn his name and memorize it so that I can make them call him if they don't do the procedure for me. The ambulance finally comes so we can go to the hospital across the street but the pain is getting bad again so they give me a 4th dose of medicine and off I go. They arrange for Mike and the boys to get driven to the new hospital. The morphine never helps and I'm really hurting the whole ride. Luckily its not far. I get to the new hospital and the pain is horrible so after some talking they give me more morphine. But it's not helping. This is where things start getting bad (they were already bad but...). They tell me stuff is stuck and it's causing the pain that the morphine isn't going to help so I ask for medicine for the anxiety at least (I'm starting to freak out). This is where the bleeding starts to get really concerning. They ask me 8 million questions and I sign a bunch of forms saying I'm ok with a blood transfusion. They are ordering blood from the blood bank now. They let Mike come in (some nurse is watching the boys for him). They are measuring the blood to see how much I am losing. And I'm cursing that damn OB who wouldn't do the procedure in a controlled setting without all this mess. Mike keeps telling the doctors in the room I'm not cursing them I mean the doctor at the first hospital. 

All the meds must have caught up with me because I remember going into the elevator to go to the OR but then everything goes black and I wake up in recovery. The doctor is talking to me but I only remember parts of it. Its all over and I'm ok. They didn't need to do a transfusion once they got everything out the bleeding stopped and I was ok. 

Everyone talks about the state of healthcare in this country but I've always been pretty fortunate I've had good doctors and good care. But this was unnecessary. It's cruel to put a mother through this when she's already suffering. I shouldn't have had to spend hours in active labor. There no reason to not do a D&C on an 18 week pregnant mother when she loses the baby. I was offered a D&C when I miscarried at 9 weeks but at 18 it wasn't even an option. It should have been encouraged. When I look at bills from the whole ordeal the amount of wasted resources and money that occurred because the doctor on call didn't want to come in and perform a relatively safe and easy procedure is insane. If I had been given a D&C the first day when there was no heartbeat (which is what should have happened) my cost of care would have been easily 10% of what the cost ended up being. 90% of thousands of dollars is a lot of wasted resources(note I have amazing health insurance and it will cost me very little out of pocket but this is why health insurance is expensive). And because miscarriages are hard enough and losing a baby so late is so incredibly hard there is no reason I should have ever been put in that situation. 

I'm angry at that hospital. I'm so very angry at that doctor. I'm incredibly grateful for my OB from home. She saved my life. I would not have known the risk without her because the hospital never explained it. I'm grateful for the wonderful staff at the hospitals I ended up in and I will tell everyone to always go to downtown Orlando if you need to go to the hospital at Disney. I feel fortunate for the care I got later and for the support I received from family and friends. And I'm incredibly grateful for my husband and boys who somehow managed that scary situation. But I'm hurting and this is harder then I thought it would be. But writing sometimes helps me so maybe I need to get this story out.  

Also never go to Celebration Hospital at Disney....Just sayin....