When my awesome pregnancy takes a tricky turn

I didn't really get around to writing about the start of this pregnancy. I was too busy globe trotting, visiting family and friends in Hong Kong and England to keep up with it. It is probably worth mentioning that as with nearly all of our pregnancies, I had a scary bleed around week 7. I was in Hong Kong and beside myself when I saw the bleed. I thought it was the beginning of end and despite following up with health providers in Hong Kong who said the baby was still viable I was very surprised to make it back home and do a scan around week 9 that confirmed the pregnancy was progressing well. I still took my time to announce the pregnancy - waiting until week 17 when this little fella seemed well and truly settled in.

This weekend we ticked over into 30-weeks pregnant and dutifully attended our first full day of antenatal classes at the hospital. I've been excited about the classes - it is another marker in the progress in our miracle pregnancy. Hubby thinks 6 hours of sitting at antenatal classes on our Saturday is a drag, but a necessary and useful one.

Day 1 of antenatal classes is a little about familiarising ourselves with warning signs in this later stages of the pregnancy but mostly about understanding the process of labour, how long each stage takes and what is happening at each stage. As demonstrated using a small doll and female pelvis, it is clearly hard work to squeeze a small person out through the female pelvis. Yay!

We did a tour of the birth suites, so we could see where we most likely be bringing our baby into the world. We were shown the parking for dad's bringing in their partners and the pregnancy observation unit, where we will most likely go first up when arriving in labour.

The day was undeniably informative, even it it was a little slow moving and I had to sit in the most uncomfortable chair. I was pretty uncomfortable on the day. I just couldn't settle into my seat. My back and hips were sore. All the other pregnant ladies looked alright, but I kept shifting in my seat.

Pleased with an early mark we headed off to do a little appliance shopping - as I've now decided given it is only 10-weeks to mini matty's arrival that I really should get the damn kitchen renovated. I'm mad! So after some time standing around looking at kitchen appliances, we are pretty happy we have decided on the items we will need to finalise our cabinetry and head home.

I'm tired and sore so I head for a lie down. We have another day of classes tomorrow and I don't want to be a wreck for it. The second day's class is all about caring for our new little chap when he finally arrives.

An hour and a half later I wake up and feel a lot better, I wander out to the lounge room to chat with hubby and suddenly find myself feeling wet. It was weird - I say maybe I've weed myself, but I don't know. Matt is laughing at me as I whisk myself off to the toilet. I do a wee and look at my pants, where I clearly seem to have wet myself. Confused I pat some toilet paper on the wet spots to find the fluid is pink, not wee coloured. When I wipe myself it is clear that blood it definitely a part of the mix and the other fluid could be wee, or given I've just been at antenatal classes I begin to wonder if possibly my waters have broken.

I call Matt in and he isn't giggling about it anymore. He gets changed back into leaving the house clothes and rings the hospital as I try to find something else to wear and a mega pad to catch what ever is going on down there for the nurses and doctors to consider. The pregnancy observation unit want us to come straight in. First win from the antenatal classes - we know where to go and where to park! Oh, and of course we know that bleeding at 30-weeks is a bad sign - but I think we would have been on to that.

It doesn't take us long to get to the hospital and into the pregnancy observation unit. They immediately want to look at the mega pad, so I'm given a fresh one to swap to. The midwife gets me into the bed. She has called my obstetrician, he will be there in about half an hour, meanwhile they want to run a trace on baby to see how he is going. Two different monitor things are connected to me with big elastic straps. One listens to baby's heartbeat, the other monitors what my uterus is doing and the baby's movement. I'm also given a button to push every time I feel baby moving. Despite being pretty busy during the day, I'm not really feeling him much now, so I'm given some water and ice to crunch to try to get him going.

Soon enough our obstetrician arrives. I bumped into him in the morning during the antenatal classes, so he makes a joke about not expecting to see us back so soon. He pushes my tummy a bit to see what my uterus is doing. He tells me it is soft, which is good. He asks about how I've felt, have I had pain, have I had any tightening or contractions? I tell him the whole thing has been painless, just a shock. He wants to do a speculum examination to see what's happening near my cervix. Here things aren't so good. He can see a fair bit of blood and clots. He takes some swabs to be tested for infection.

Now for the verdict. The obstetrician explains he thinks I've had an edge bleed from the placenta, known as an antepartum haemorrhage (APH). He explains that the amount of blood loss I've had and how the cervix looked suggests it was more than just the cervix bleeding. He explains an edge bleed can be a one off and if it settles down with no fresh bleeds over the next 7-days that is considered pretty stable - this is good! However a few not so great things can happen and the window for this to occur is the 48-72 hours following the initial bleed. Firstly - the bleed I've had can cause irritation and trigger contractions and labour - this is bad. Secondly more edge bleeding can occur, leading to irritation of the uterus, contractions and labour - this is bad. Thirdly a complete placenta abruption can occur, leading to contractions and labour - this is bad.

So I have one chance of good, three chances of bad. Hmmmm. The conversation from this point gets a little harder. My ob is going to admit me to hospital for now and with three chances of bad happening the obstetrician wants to start me on a course of steroid injections just in case mini matty is rushed into the world. The steroids will help mature his lungs and give him the best chance if he does arrive early.

At this point my mind starts to catch up we are now seriously preparing for a worst case scenario early delivery. I tell my ob that I'm starting to get a little stressed out and don't mind if I have a little cry. He remains calm and says he'll just continue on. He explains the benefits of the steroids and if it were his baby he'd definitely be taking them. Also even though mini matty is 30+ weeks there would be a benefit in me taking magnesium if I do go into labour. Magnesium is commonly used in pre-term delivery under 30-weeks and has something to do with brain development of the baby. He explains research is currently being undertaken into the benefit of magnesium in delivery of 30-34 week babies, and it seems there is a decreasing benefit, but given I'm so close to 30-weeks there is probably a real benefit in our circumstances.

So he wants me to stay in, do the steroid injections and have twice daily traces run on baby to make sure everything is going okay for him. As if I'm going to say no thanks, I'll go home and take my chances.

My ob leaves and says he'll be back in to see me in the morning. The midwife - who happens to also be 30-weeks pregnant - comes in with the steroid injection and jabs me in the leg. She tells me they are just preparing a room for me upstairs and kindly gets us some shabby hospital sandwiches to chow down, given we've missed dinner and are now staying overnight at least.

Soon enough we are transferred to the antenatal ward and I get settled into my room. The midwives here are very busy and we have a decent wait before I get greeted and checked in properly. We have arrived at hospital with nothing - so I have no pjs, no toiletries, no snacks. Just Matt and I in the room in a kind of shock, both of us willing this to be the one off scenario not any of the other three options.

Once the midwife comes in she tells me about the room. She is very specific about my call button and tells me if I have a problem hit it once, if I have a big problem, ie a big bleed, hit the button three times and they will be there ASAP. This is the first time I've been told about this type of button function and reiterates in my mind they are genuinely concerned about this bleed progressing into something more serious.

We decide Matt should go home and try to get a good night's sleep. I can always call him if anything happens, and he can be back in 15-20 minutes. I've prepared a list of things for him to pack and bring in for me in the morning.

I slip into a hospital issue gown and settle in for the night.

Crashing down

By the time we went into our appointment with the obstetrician I think my hope was outweighed by my doubts. When the ob asked "how are you going?" I was very quick to reply that we weren't so great. I quickly explained the result of the ultrasound from the week before. The ob said it was probably best we get straight to having a look, rather than spend half an hour talking about pregnancy management, just to find out things aren't looking good. He also told us a story about a woman he'd seen whose first scan didn't look good, with the baby having a heartbeat of 78. He said when she came back he felt nervous about what the scan would show, but that everything was great, the baby had a heartbeat over 160 and had really grown.

A glimmer of hope just as we get on the bed for the scan. 

He starts with an external scan. By this time, 8 and a half weeks, the baby should be clearly visible from an external scan. By how hard the ultrasound thing was pushing on me I could tell it was hard for the ob to see the baby, and from what I could see on screen it didn't look good. He switched to an internal scan where he confirmed that things didn't look good. He said he was sorry, but from what he could see the baby didn't have a heartbeat and the size hadn't changed from our last scan. 

Procedure from this point is to have a high resolution/diagnostic scan. The portable scanners the obs have apparently can miss stuff, so they are reluctant to recommend the curette without the diagnostic scan. Our ob rings the women's diagnostic centre and gets us an appointment in a couple of hours. He asks if the result is as expected if we'd like to have the curette that night if they can get a theatre booking.

We head home for a couple of hours. Given we have the chance of having the operation in the evening I've got to eat something now, and then I'm on nil by mouth, just in case we can secure the evening theatre time. An hour before our appointment I drink the obligatory pre ultrasound water, knowing no matter how full my bladder is they will still need to do the internal scan. 

It's funny that it doesn't really matter that we already know that it is pretty much over, when the sonographer sympathetically tells us she can't find a heartbeat I still can't help but cry. She confirms the baby is still the same size it was a week and a half ago. She looks around to make sure the other embryo isn't tucked away somewhere it shouldn't be, but there is nothing else, just the one that is no longer a viable pregnancy. 

With our results in hand we head back over to the obstetrician's office where he quickly sees us between patients. He asks if we'd like to have the curette that night or tomorrow morning. I opt to have it done that night, so that way only one day revolves around the whole ordeal. 

We head home to pack 'a just in case' overnight bag and by 5pm we are back at the hospital being admitted. By 6.30pm I am wheeled down to pre-op and by 8pm I'm back in my room texting home. They keep me in for a few hours and then we are allowed to go home.

Despite having a body full of sleepy drugs I didn't sleep well. I couldn't get into a deep sleep. I don't cry, just toss and turn. 

Hospital days

Hospital days are never fun. They generally start with no food or drink, which for me is never a preferred way to start the day.

On Friday morning I thought a lot about the first time we were going in for a curette. I felt a lot like I did the first time, the suddenness and unexpected nature of the diagnosis were just like the first time. It was August 2009 - I remembered as I was being wheeled into theatre the anaesthetist was with me. Big tears were welling up in my eyes and began sliding down my cheeks. He looked at me and asked something along of the lines of "what's wrong? are you scared?" I told him I was sad. The anaesthetist had nothing to say to that. I also remembered when I woke up the first thing I did was start to cry. At least the nurses in recovery were a little more aware of why I might be crying.

Today I didn't want to cry so much. I'm not sure if that is healthy goal, however I knew that not being able to control my emotions in the setting of QFG day theatre was going to be very uncomfortable for a lot people, including myself. At QFG you wait for the short while before your surgery in a joint waiting room. I've waited in there before egg pick up, before 3 embryo transfers and now 2 curettes. It is a mixed bag of people, some are there for wrist surgery. A crying person would really stress everyone out.

On admission to the day theatre the nurse has to ask me all the questions again about how many times have I been pregnant - how many children - any live births - etc. Attempts to not cry fail at the first step. You see, I've already had to write all this down on the admission forms in the morning. I had to go through it with the new obstetrician yesterday. It's a horrible story and it is our life. I cover my face. Matt starts to give the answers. I pull it together and proceed with the blood pressure and pulse tests. The nurse says I'll benefit from having a good sleep, I deserve a good sleep. It takes me a while to realise she means, assisted by anaesthetic sleep.

Matt and I part ways - I'm going up to the open waiting room, he is going home to wait for the call to come and pick me up. Deep breathes. I must calm down. I am calming down. There is nothing to be done for it, it is over, I must deal with this. I can cope with this. This isn't the end of the world. Life goes on. Matt and I will go on. We will have more chances. I don't know what to do, but uncertainty is just a part of it for us. There will be other opportunities. Deep breathes. Be calm.

Before the surgery I am calm. I meet the anaesthetist, the doctor is there, I'm walking into the operating theatre. As per usual my veins are impossible to find. A jab here, a jab there, another jab and another, and finally I feel the anaesthetic taking hold. I'm breathing in the oxygen. I'm out.

I wake up in recovery. I don't feel too bad. I'm a little sore, but nothing unmanageable. It takes me about an hour from the time I realise I'm awake to being functional. They ring Matt to come in to get me. I get up and get dressed and happily chomp down my hospital sandwiches and ginger ale.

Warning - at this point I hit some fairly gross stuff - so tune out if you don't enjoy the gross bits.

When Matt gets there I've already been through the discharge process so we can head off straight away. I'm pretty slow on my feet as we make our way to the car. On the way home we decide to stop and rent some DVDs. We are in the video store for about 2 minutes when I realise I'm feeling wet around my crotch. I touch my pants and my fingers are covered in blood. I call out for Matt, I show him the fingers. He says holy crap. I've got to get out of here. Matt unlocks the car - I shuffle out and find a grocery bag to sit on in the car. Matt has quickly rented the videos we had in our hands. I tell him I'm not sure what has caused the overflow. I'm wearing a hospital issue surf board size pad. I wonder if it has had an absorbency problem.

In a flash we are home and I am shuffling inside with my grocery bag. I throw the bag in the bin and shuffle to the bathroom. I want to jump into the shower without leaking on the floor. In the end I have no choice but to get with my pants on. When I take them off a massive blood clot hits the shower floor. It is clogging the shower. The hospital issue surf board size pad had no chance of dealing with this! I'm try to pick it up. It is massive. It is the size of my hand and 1cm thick in parts. More, smaller clots are coming out. This is really disgusting and again, I need Matt's help. I ask Matt to bring me a zip lock bag for the clots - they are so big I'm wondering if they are the placenta. I ask Matt to pop them in the fridge until I can speak to the doctor. Poor Matt. This is so gross and he is fully taking it in his stride. When I ask him to put the clots in the fridge his face is a little grossed out. So I suggest they go in a non see-through bag.

It didn't take long and the heavy flow issue passed. I rang the obstetrician and she asked me to lie back down again for a half hour or so and then get up again and see if the issue repeats itself. It seems she expected these types of clots would have passed before I left the hospital, or have come out during the curette.

Matt pops back out to finish the things we were going to do on the way home and I rest up. The doctor rings me back and I tell her the bleeding has settled and there hasn't been any repeat of massive clots. When Matt gets home he takes my clothes and puts them in the wash.

All gross bits finished.

I feel a bit better after the curette. I'm still sad, but it seems manageable. Having a physical issue to deal with takes my mind off the mental side of it all. It is over.

Antibiotics, ultrasounds and patience

IV anitbiotics are the business! After a full night in the women's ward I am only oozing a bit and the smell of the ooze has disappeared. My temperature is also under control. By this time I've had IV antibiotics for more than 24 hours. Of course I am stoked when the consulting specialist says he is happy with how the infection has responded and I can be discharged. Again, given that my specialist has already referred me for the ultrasound, which is now only two days away, the consulting specialist says just to go in for it as planned.

Matt was coming in to visit in the morning and as it turned out he was able to take me back to the beach house. I'm given a prescription for a some serious oral antibiotics that I need to take for the next week.

Back at the beach house Matt and I settle in for a quiet week.

I try not to think about the upcoming scan too much, knowing there is absolutely nothing I can gain from worrying about it.

On Thursday morning we drive to Byron Bay for the scan. Again, only the gestation sack can be seen through the abdomen, so we need to do the internal scan to see how the baby is going. To my great surprise the sonographer starts saying here is the baby and this little flicker you can see here is the heartbeat. It is beating at 91 beats per minute, which is normal for a baby measuring six weeks old, which is the size your baby is measuring at. The baby is 4.3 millimetres long from crown to rump.

I'm stunned. Matt seems pleased.

We ring all our family who we know are waiting. I'm cautious to tell everyone that while the heartbeat is good news, that the baby should be about eight weeks old by now, so I'm concerned it is developing too slowly. We discuss whether this could just be because of all the other things that have been happening and hope it will simply catch up in the weeks to come.

I wait until Friday to ring my fertility specialist's office - they still hadn't received my scan results. I hope even though my specialist is on leave (still!) that they have someone lined up who can give me a clinical opinion on the scan. I have to explain to the receptionist why I'm concerned about the scan result. I'm also concerned about my expected return to work. I'm supposed to be going back Monday week, however I can't help but think, if the baby isn't developing as it should, then next week I'm going to need more tests and at the worst I'll physically miscarry, or need to go in for a curette. All of these things will mean I will need more time off work recovering. I just don't want to go back to work and then again be off on more sick leave. The receptionist tells me she will chase up the scan results and contact some of the specialists from the group to see if she can have someone see me, or look at my scan.

I'm lucky another doctor from the group can fit me in on Tuesday but I start to cry on the phone. I was hoping to get an opinion on the scan today.

That afternoon I'm crying. Matt says "I don't understand why you are upset". I know he doesn't. I know I should be happy, but I'm not. I wanted the scan to give me certainty. Certainty the baby was kicking arse and well or certainty the baby was not viable.

I tell Matt that I've spent the whole day trying to get an opinion on the scan and arranging appointments with other specialists. I was hoping that the scan would put an end to it. I secretly hoped there would be no heartbeat and I would know it was over. This result of a heartbeat, but a small baby just seemed so uncertain. The baby just seemed too small. Now we had to wait until next Tuesday to know for sure.

Sand, sunburn, infection

On the drive down to the coast I tell Matt that I'm feeling pretty tired and that perhaps I've over done it in getting packed up to head to the beach house. Don't get me wrong - I haven't done much. Matt has done all the heavy lifting and I have just packed a few grocery items and my own clothes, Matt has then transferred everything to the car. Just quietly - I wish it was like this all the time. My lazy side loves it! Matt and I agree I should take it really easy on the weekend just resting inside. I'll get to the beach during the week.

Matt's sister and her family are already at the beach house when we arrive. They help Matt unload the car and have got things set up for us, so all I need to do when I get there is heat up the pre-made dinners we bought in advance (knowing that I wouldn't be my usual self in the kitchen this holiday) and settle into the couch.

The following day is a Saturday. The weather is AMAZING! But I stick to the plan. Matt and everyone else head off to the beach and I settle in at the house. My belly button wound is annoying me because it is still oozing. After my other surgeries I didn't have any ooze. This one was oozing while I was at the hospital and hasn't stopped. My sister in law and I decide it would be a good idea to get some sun on it to try and dry it out a bit. So I sit on the deck with my belly slightly exposed to try to get some sun on the belly button.

I'm not here long before Matt comes back to the house and says he thinks I would like it the beach. He will carry a camp chair down for me and walk slowly with me (the full 100 metres) to the beach. I think this sounds completely manageable and quickly apply some sunscreen to all my exposed limbs and face.

The beach is beautiful. It is a really warm day for spring. My nephews are having a great time in the surf, digging in the sand and playing beach soccer. Our dog, Rocky, loves the beach. He is greeting all the other dogs on the beach and then running back to sit under my camp chair in the shade. I'm still trying to get some sun on my belly button and other wounds to try and dry them out a bit.

After an hour we head home and I head to bed. I need about two hours rest before I'm up again. That afternoon Matt's Dad and his partner arrive too. I'm grateful everyone else is taking care of meals. I'm able to take it very easy.

The following day, based on the success of the earlier beach trip, Matt convinces me to join the family in a trip to the nature reserve, where everyone can fish, swim and play in the sand (except Rocky - no dogs allowed). It is only 300 - 400 metres into the reserve. I'm slow moving, but get there. In my attempts to dry out my belly button wound I've managed to get a ridiculous sunburn on a portion of my belly - making me even stiffer when getting in and out of chairs. After a couple of hours sitting in my camp chair enjoying the view, I need to get home. I feel so tired. This time, after we are home I sleep for three hours.

That night I say to Matt "I feel like I'm going backwards". I pull out my discharge information forms and look at the things that might happen and require further medical attention. The only thing I have is a sore abdomen - but I can't figure out if it just recovering normal sore, or extra sore.

Overnight, this changes when I wake up and feel wetness around me in the bed. At first I think I'm bleeding, but then the smell hits me. My belly button has started super oozing and it is super disgusting. In what is now a Paterson~Prior family classic I ask Matt to "smell my fingers" that are covered in ooze. He is suitably grossed out.

Offensive ooze from wounds is definitely on the seek medical attention list. During the day I had looked up the hospitals - just in case we needed them. I ring the Byron Bay emergency number and explain my symptoms and my surgery. They tell me I should come in. I then tell them that I'm still pregnant. With this information they recommend I go to the Tweed Hospital instead as they have ultrasound equipment. I then ring the Tweed Hospital emergency to see if they think Byron would be able to handle it, or if I'll need the ultrasound. The triage nurse tells me I should just see a doctor tomorrow. I decide to ring 13 HEALTH. The nurse strongly recommends I get to the Tweed Hospital and says if the pain is too much in a car, we should call an ambulance.

At 2am ish Matt and I head off on a 40 minute drive to Tweed Heads. As I hobble into emergency the triage nurse is up on her feet and asking if I'm okay. As I get closer her I explain the situation and she says "I remember you from the phone". I'm through to her little office, she is taking my temp - it is high. I'm literally oozing. It really is disgusting. Within minutes I'm in an emergency room bed. I can't believe it, only an hour ago this same nurse told me I could just see a doctor the next day.

From this point it is a bit of blur. There is again needles in and blood out. This time they have these two weird glass bottles. I say to the doctor "I've been in hospital a bit lately and had a lot of blood tests, but those bottles are a bit different, what are they for?" The doctor tells me the that the bottles are for blood cultures. They will literally put those bottle in ovens and see what they grow. Gross.

Physical inspection of the infected area, that is my belly button, is a problem. The best indicators of infection (other than ooze) are hot areas and redness. Of course my sunburn has meant neither of these symptoms are detectible as the whole area is red and hot. It is a bit of laughing point for the medical staff. They are all curious as to how I sunburned just that one area.

The emergency room doctor has arranged for some pain relief (more morphine) and is searching for IV antibiotics that are safe to give during early pregnancy. Because I am worried about all the drugs I'm being administered she explains that some drugs that are okay when the baby is developing in early pregnancy are not ideal in late pregnancy - morphine being an example (apparently you can suck that stuff down in early pregnancy, but at the end the baby gets the same effect, so basically comes out asleep - that can be a problem). Matt is convinced to go back to the beach house as I'm going to be in emergency until the gynaecologist can see me. The doctor thinks I'll be in for a couple of days. At one point the doctor tells me I may even need another surgery to wash out my abdomen depending on the extent of the infection.

My belly button is pouring out this stinky fluid and I keep folding up my hospital gown to absorb it. I'm running out of gown. The nurses change over and I ask my new nurse if I can new gown and perhaps a dressing to absorb the ooze. Once this is taken care of I can rest.

I'm eventually wheeled out to ultrasound. I am disappointed that the sonographer only has instructions to look for the infection collection and not to see if the baby is still okay. He finds a collection, deep under the belly button, but it isn't too big. He thinks now that the ooze has found a way out that I should improve.

Back in emergency it is a few more hours before the gynaecologist comes in to see me. He takes a look at my wound and cleans it up again. He asks me all the questions about the other symptoms. Since I woke up with the infection I've started bleeding more heavily again, including some small clots. The gynaecologist  advises he is going to have me admitted to the women's ward so that I can have more IV antibiotics and see a surgeon consultant.

Matt arrives back at the hospital just in time to come with me up to the women's ward. I meet my new nurse and ask her about changing my dressing. I ask her if there is possibly a way we can dress it with something with a little less stickiness. My damn sunburn is killing me every time the dressing needs to be changed! She immediately understands and provides me with my very own supply of not so sticky tape and sterile bandages that are just big enough that the tape doesn't need to touch the sunburn! Brilliant!

Matt hangs with me for a few hours and then head back to the beach house. I settle in for the night.