Thursday, March 31, 2011

But It Wasn't

I've had quite a few hits from various anti-choice blogs recently. Evidently my raw emotions in the moment of unwillingly seeing my ultrasound (Thanks again for your subersive message and/or negligence, Dr. D.) strike chords with the anti-choice community because I referred to the image I saw in that ultrasound as looking "like a baby."

The passage, specifically, refers to the moment after my gynecologist--informed that I did not plan this pregnancy, wanted to terminate the pregnancy and that I had no desire to see the ultrasound--told me I could go ahead and sit up after she had performed the ultrasound:
I sat up and opened my eyes. To my right, the hovering ultrasound glowed, its screen facing toward me still showing the image of the fetus inside of me. I only saw it for a moment, just long enough to register a little head and nose, arms and a body curled up and facing left.

It looked like a baby.

It looked exactly like the ultrasound that I had imagined for my future.
"Can you please turn that off?" I said weakly, my eyes shut again.

All that I wrote is true. It's exactly what I felt when I was in that moment. It was so upsetting, and it was the image of why terminating pregnancies is so difficult for most women. But for so many women, it wouldn't matter if they saw a fetus at 13 weeks, an embryo at six, or nothing at all. It's upsetting. It's not a happy choice.

The fact that this fetus--this potential life--had begun to take a human form was difficult to see, even for someone like me who has never believed that life begins at conception. Still, seeing the ultrasound had a profound impact on me and on my decision making process.

I researched pro-choice, pro-life and unbiased websites. I spoke to multiple doctors. I read endlessly about the developmental process of the fetus, from conception to birth. I tracked where I was at that point and looked at illustrations of what the fetus looked like and how it had developed. My extensive and exhaustive research even drew my boyfriend and I into an argument.

"You must either want this pregnancy or you are trying to make this as difficult as possible on yourself," he said.

It wasn't either of these things.

Eventually my boyfriend came to understand that I needed to know as much as possible to make my decision. I wanted to make my choice to either bring this pregnancy to term or to terminate it after exploring every facet of our situation. I exposed myself to enlightening, helpful, painful, and even some judgmental information because I wanted to make a fully-informed decision. I did not want to have any regrets.

Perhaps it did make my decision more difficult. Lots of things did: that ultrasound, the sudden bump that appeared, reading terribly derisive websites that called me a baby-killer...

Ultimately, and I have said this before too: "My choice was right for me, my partner and the potential life I carried for 14 weeks. I am grateful to be 26, unmarried and without children, paving a life path that is right for me and that will allow me to flourish as a woman and, one day, a mother."

But the above has also been quoted by both pro-choice and anti-choice websites because, simply, we have different basic beliefs. I don't believe life begins at conception. I also don't believe life begins when a potential life begins to look "like a baby." I believe life begins with sentience, something medical studies (including this JAMA article on fetal pain) find does not begin until the third trimester.

The pro-lifers believe that life starts at conception. I appreciate and respect that belief, though I do not agree with it.

I can understand how a pro-life blog might balk that I saw an ultrasound that looked like a baby and that I could still make the choice to terminate the pregnancy. I appreciate that opinion, though I do not agree with it and I do not respect any individual who believes they are worthy of judging me or my decision.

I will not force my beliefs upon any other individual, and I would ask and expect that other individuals would do the same.

For what it's worth, what I do believe is this:

I believe that I want to provide the very best for my future children.

I believe that I want to give myself the very best in my life to be able to do so.

I believe that I want to be financially sound so I am not scraping by (or helping support my parents) when I have children.

I believe that I want to have a strong, warm and loving home (and not be living out of a bag in my car, bouncing from my apartment where my parents now stay to my boyfriend and his roommates' place) when I have children.

I believe that I want to be in a solid partnership and marriage when I have children.

I believe that I have a right to choose when having children is right for me.

I believe that by living my life the way I want to live it, developing my independence and growing as a person, I will be the best damn mother to my future children.

I believe that this experience has profoundly changed me.

I believe that I am already a more patient, less judgmental and more open person.

I believe that--after years of patience, excuses for anti-choice friends and desperately seeking an understanding middle ground--I am no longer going to tolerate the damaging anti-choice rhetoric that threatens this country, intimidates and judges my fellow women and impinges on tolerance, rights and progress.

I believe now more than ever before that women (not just in this country, but across the world) deserve the very best and so rarely get it.

And I believe that in my life I will help at least some of those women find the support, strength and services they deserve.

Yes, seeing that ultrasound hurt then and it still hurts now, but I made the choice that was right for me. Ultimately, it looked like a baby, but it wasn't.

Tuesday, March 29, 2011

A Chronological Breakdown of My Complication and a Trip to the Emergency Room

*Before you read, you should know that this entry will be relatively graphic--lots of blood, my friends--compared to my other posts.  I should also be clear that this was not a miscarriage, and the tissue left in my body was either blood clots or, at worst, placenta.

I decided to write in detail about my complication because when I went into this process, I never read about any complications on other abortion blogs.

I scoured those blogs for the details of what to expect from the surgery, what other women's experiences were like, what healing and moving on was like... So I think I should be detailed about this part of the process too. Again, hopefully it helps someone.*

6:50 PM
On Friday evening at work, I suddenly became very crampy. I sat for quite a while at my desk, waiting for the cramps to pass before I got up to use the restroom. When I used the restroom, I felt a huge gush of blood and glanced down to discover the toilet bowl, as I described to the doctors later that night in the ER, "looked like a bucket full of red paint, opaque." Literally, I couldn't see the walls of the toilet bowl or the bottom of it. It was just bright red and thick with blood.

That was disconcerting, but I didn't let it phase me too much. I noted that it the bright red color was something I had been told to watch for, however, and decided to keep my eye on my pad for heavy bleeding. Soaking one pad an hour, I remembered my paperwork saying, would mean a phone call to the on-call doctor at the OB/GYNE office.

7:00 PM
I drove home with plans to eat some dinner with my folks before heading out for a game night with friends.

However, I felt crampy upon getting home, noticed more blood and decided to take a Motrin and a hot shower to try to alleviate the cramping. I explained to my mom what was up, she threw some dinner on for me and I jumped in the shower.

Again, I used the toilet to find yet more blood, though not completely opaque this time. I showered.

7:45 PM
I put a new pad (Pad #1 since getting home) on.

8:30 PM
Forty-five minutes later, I had bled pretty heavily in the pad, but I wouldn't say I had "soaked" it. I had noticed, however, that when I sat on the toilet, lots and lots of blood would come out. So there was blood not catching in the pad that would definitely add to its soaking factor.

With that in mind, I called the OB/GYNE's after-hours emergency number, spoke to a male nurse (I mention this because I have never ever dealt with a man before this moment at an OB/GYNE office. This was a first for me.), described the bleeding in detail, and requested that the on-call doctor call me ASAP.

He said the on-call doctor would call me back within twenty minutes. Happily, she called back within five minutes, and we discussed my bleeding. Since I wasn't quite soaking a pad per hour, she asked me to monitor myself for the next hour or two and call back if things were the same or got worse.

Bleeding is generally a sign of something left in the uterus, she said, either placenta or blood clots that haven't passed. If that was the case, I'd need to come into the ER where she would see me. The ER, unfortunately, was the only way I could get to the OB/GYNE team. She apologized for that, which seemed unnecessary but kind.

8:40 PM
I texted my boyfriend to let him know what was up, in case I did need to go to the ER. I felt bad, knowing he was hanging out with his ex-girlfriend (Yup, both he and I are the types who remain close friends with our exes.) and not wanting to make him worry unnecessarily. It didn't seem possible at this point that I would go to the ER, I kept saying to myself. After texting him, I had some ice cream while I sat on the floor watching NCAA basketball with my parents.

During this time, I could feel the bleeding picking up. I could also feel some small clots passing, which is a bizarre sensation since you cannot control or stop the passage of a clot. It's upsetting in the same way as vomiting or, I assume as I happily have not experienced this, uncontrollable diarrhea. Your body is doing something, and you can't do a single thing to stop it. It's a very helpless and foreign feeling.

8:50 PM
My phone rang ten minutes after my text. It was the boyfriend, very concerned and asking me if I wanted him to come pick me up from my apartment to go to the ER right away. I insisted that I didn't, that it probably wasn't anything, and I'd just keep my eyes peeled. But as I talked to him, I had stood up and I felt another clot pass and I sucked my breath in.

"Ughh," I moaned. "Okay, I may need to go, but let's not go yet. I was told to wait an hour and monitor myself anyway."

He agreed, and we hung up.

I changed my pad again. Pad #2.

9:00 PM
I went back to watching basketball and nervously eating ice cream, wondering if eating was a bad idea if I possibly was going to be rushed into an operating room in the next several hours. At this point, I had had three slices of pizza and now ice cream. I stopped eating the ice cream.

I chatted with my mom about the latest sensations, and she insisted that she used to have clotting with her period sometimes. Maybe this was just a bad period?

Uh, no, Mom. I said. I know what period clotting is like. This is definitely more than just a bad period.

9:20 PM
Thirty minutes passed, and the boyfriend called again around 9:20. This time, he was more insistent. What was the difference, he said, between waiting another thirty minutes or going now? He wanted to come pick me up, and as we talked, I checked my pad.

To my horror, as I checked my pad (which was already pretty bloody), two clots the size of quarters, if a quarter was a sphere, dropped down into my underwear.


"What is it? Is it cramping??" my boyfriend asked.

"No," I said. "No, it's just... it's gross. It's just really, really gross." I paused for a second and fished the clots out of my underwear and dropped them into the toilet.

"Is it bleeding?" he asked urgently.

"No, it's clots," I said. "Uh, yeah. Let's go to the ER. Like, now."

9:25 PM
We got off the phone, and I changed my pad again. (Pad #3.)

It took the boyfriend about thirty minutes to get to his place and grab his car (he had been on his motorcycle, which obviously wouldn't work to transport me) and then to my place.

In the meantime, I called the on-call doctor. I first spoke with a new nurse, who said the doctor would return my call "tonight."

I got hot and bothered, asked her if she was aware that the doctor had already spoken with me and that this was an emergency. The nurse then said in a very disinterested voice that it probably wouldn't be that long.

Thankfully, the doctor called me within ten minutes. I spoke with her and confirmed that I should be coming in. The ER would expect me, she said.

I would go through the ER routine and then be taken back for an ultrasound. The ultrasound would reveal whether I had anything left in my uterus. At that point, they would decide whether I should take a drug to help evacuate the uterus, or if I needed surgery, a D&C.

I asked her if my boyfriend could be with me, and she said he could be at my side the whole time, up until the point and only if I needed surgery.

I packed an overnight bag (I have become an expert at the You're Having an Abortion! checklist, apparently... Sigh.) and was suddenly very happy that I had lots of pads and stick-on heating pads leftover from two weeks ago. I had even bought oversized underwear for after my procedure and never used it. Now was the time! I threw a stick-on heating pad on my back and waited, updating this blog in the meantime.

I then sat with my parents, talked with them about what was going on and got very upset when I explained I might need a D&C. They hugged me as I cried.

10:00 PM
When my boyfriend arrived at 10 PM to pick me up, I thought about changing my pad one last time but wanted so badly to get moving that I didn't. The bleeding didn't seem too bad for the last 30 minutes, so I stuffed two or three extra pads into my purse and off we went. I would later regret this decision.

10:20 PM
We arrived at the hospital complex. I insisted to the boyfriend that I wanted to park the car with him in the garage and walk to the ER. I wasn't interested in going in alone.

However, while walking to the ER, I realized that this may have been a bad idea. I felt small clots passing and blood... not quite gushing, and not quite dripping... from my vagina. I picked up the pace to the ER.

The entrance to the ER features a fun little door contraption that requires you to enter through one set of sliding doors, stand in a particular box, wait for the first set of sliding doors to close and then wait for a second set of doors to open. The boyfriend didn't understand and was complaining about the stupid doors while I could feel more blood pouring out of me, and I dragged him into the right box with perhaps not the friendliest of pulls.

10:30 PM
We checked into the ER.

For my first check-in, I checked in at the front desk just to get the basics in the system. There was, of course, very little privacy for this process. I announced that I was bleeding like crazy from my vagina and that I had a D&E procedure ten days prior. The nurse marked some things down and explained I would now check in to get a wristband.

Then, I moved down the counter for the second part of the check-in. I confirmed my name and birthdate and got my wristband. While we were standing there, an RN moved out right next to us and called my name.

"Right here!" I responded.

She glanced around the room and called my name again.

"She's right here!" the nurse checking me in said louder.

The RN stared blankly around the room, looked at her chart and began to call my name again.

"RIGHT HERE!" the nurse and I both very loudly responded to her. The RN blinked at me several times and then gestured that I join her at her station.

For the third, final and most grueling part of my check-in, I was checked by this RN, Tina, we will call her. Tina had me sit down in her patient's cream fabric chair, which I had  the good sense to throw down my dark coat over before sitting. (No, this may be my most intense, but it is certainly not my first rodeo, Uterine Blood.)

Her station was, like the rest of the waiting room and check-in area, not private. The boyfriend stood somewhat in front of me, blocking most of the waiting room, but conversations and the buzz of the TV could be heard in detail.

Tina took my vitals and asked me a few questions.

Tina:  Why are you at the ER this evening?

Me:  I had a D&E procedure ten days ago, and now I am bleeding profusely.

Tina:  Bleeding from where?

Me:   ... Uh, my vagina.

Tina:  You had a what kind of procedure?

Me:  A D&E.

Tina:  What is that?

Me:  ...A dilation and evacuation.

Tina:  A what? What is that?

Me:  ...An abortion... A pregnancy termination.

Tina:  Oh! ... (Tina gets whispery.) OH, oh gosh. Oh, I am so sorry.

Me:  Uhhh, it's okay.

Tina:  What did you say it's called again?

Me:  A dilation and evacuation procedure.

Tina:  Ok. Why did you terminate the pregnancy?

Me:  (Given the way things were going here, I got angry for a half-second, thinking that Tina was getting personal, before I realized that she probably was more interested in whether I had any medical complications that led to the termination.) It was unplanned.

Tina:  Unplanned. (She jots some notes down.) Ok. How many pads are you going through?

Me:  (Feeling what is now a sopping-wet pad underneath me.) Uh, more than one an hour, at this point.

Tina:  Hm. OK. (She fidgets a bit.) I'm going to have to ask my neighbor about this. Sorry. I'm new to this, and I don't know what triage to put you at.

Me:  (New to this. Okay, so this explains something...) Okay.

Tina:  (Leaves, returns, holding a urine cup.) Ok, I need you to wait in the waiting room, and we'll need a urine sample from you. The bathroom is right over there. (She gestures to a hallway off the waiting room.)

Me:  Uh, you need me to do the urine test and then hold onto it?

Tina:  Oh yes. We just need to be sure, you know, that you were pregnant. Just in case, you know, the doctors want to do a CAT scan.

Me:  (Though I am thinking, WTF?! Was I pregnant? CAT scan?? Is this really how crazy hospital administrative BS is??? ...) Uh, I absolutely have to do the urine sample out here?

Tina:  Oh, no! There's a bathroom back there if you can't pee yet.

Me:  I think I'll do that, as long as the doctors know they're probably going to wind up with a mess of blood instead of urine.
At this point, I did go to the waiting room bathroom because I was freaked about how wet my pad was feeling. In true shitty waiting room fashion, there was NO LOCK on this door, and I put my purse in front of it in a very feeble attempt to keep anyone from entering the bathroom.

I discovered that not only was my pad a heaping mess of blood, but my underwear was more or less soaked through too, and I had bled through my stretch pants. Now, anywhere I sit down, I would leave a little red splotch. Fabulous.

In trying to clean myself up, I got blood all over the bathroom floor, toilet seat and sink and then spent time cleaning up after myself too.

I finally returned to my spot in the waiting room, recognized that there was indeed a little red splotch where I had sat briefly, tucked my dark jacket underneath me and sat down. I updated the blog again, taking in the sights and smells of the waiting room. I was happy that we arrived when we did as it was clear already that a later-night, crazier and more upsetting crowd was already arriving.

11 PM:
A friendly nurse called me back to the ER. The nurse rotated my bed for me so that it faced the wall rather than the curtained sheet that separated it from a very busy hallway.

The hallway outside my room was full of other cases--people in wheelchairs, people on gurneys. The gentleman right outside my room was a middle-aged black man on a gurney who was high on cocaine, suicidal and liked orange juice. We would listen to several different medical professionals talk to him throughout the evening, the least effective of whom is Tina who chided him repeatedly.

I went to the bathroom in the ER to attempt that urine sample. The boyfriend and I, after I slipped into my gown, tried to guess what substance my urine sample most looked like. I said tomato juice, but he disagreed and suggested that it looked like some kind of chemical experiment.

A nurse took my vitals again since I was losing so much blood. I kept my underwear and my pad on, though a disposable underpad (lifesaver!) had been tucked underneath me. The nurse also took several blood samples and hooked an IV needle into my arm in case I needed fluids later.

The ER resident arrived to discuss my situation with me. She was intense with hair slicked back into an oily ponytail and a bedside demeanor that involved her sitting wide-legged on her rolling stool while she knotted her face into concerned looks and nodded meaningfully. It was a bit unsettling, and as the boyfriend later said, it felt like she had just returned from her fifth tour of duty in Iraq, but I did like her.

She seemed uneasy about the pelvic exam she was about to perform on me.

"Listen," the ER resident said, "nobody likes pelvic exams. I don't like giving them. You don't like getting them. So we'll just do this as fast as possible."

Uh, okay. Pelvic exams are not that bad, in my book, but ten-four.

I explained that I was bleeding profusely, and at this point, I wanted to throw my underwear away. I requested a pair of disposable underwear for later, which the nurse brought me.

11:15ish PM
It's time for Pelvic Exam Number 1.

I peeled off my bloody underwear, wrapped it up as best I could and, with no help from the resident or my boyfriend, tossed it into a distant trashcan.

"Ha! See, I sort of know how to play basketball," I said to no one in particular. (I would talk somewhat crazily like this throughout the entire ER visit. Not totally sure in retrospect if I was just nervous and trying to calm down or losing lots of blood and not thinking clearly.)

The ER resident directed me into the stirrups and immediately said in surprise, "Oh wow. You weren't kidding. That's a lot of blood."

I looked proudly at my boyfriend. Check me out! Lots of blood, did you hear that? Aww, yeah. How awesome is your girlfriend?

As she put together the ambulatory pelvic exam contraption, she explained, "We get lots of women in the ER who say they are bleeding a lot. 'Meh, I'm bleeding through a pad an hour!' Yeah, right. No, this is a lot of blood."

She began the pelvic exam, and it was immediately clear that she's not an OB/GYNE professional. The speculum scraped my vaginal canal, and I tried to stay relaxed.

"Have you been passing clots like this?" she asked.

Oh, I must be passing a clot. Who knew?

"Uh, am I passing a clot? Uh, yeah. There have been lots of them," I answered.

She removed the speculum and began using her hands for the second part of the exam. This process would be the most excruciating thing I felt at the ER.

With the blood I'd been dropping, my pubic hair had become clotted with blood. It was dry, sticky and clumpy. Part of her hand caught, twisted and pulled my pubic hair. My eyes watered and I laughed in the delirium of the pain.

"Try to relax," she intoned.

Fuck you! I wanted to scream back at her. LET GO OF MY PUBIC HAIR.

I made a note that I shall shave myself as soon as I possibly can.

The ER resident finished and explained that the OB/GYNE team would see me soon. They were also waiting on my blood test results, so I should just relax and let her and the nurses know if I need anything.

I requested another underpad right away. I could feel the wet blood underneath me from the exam, and she pulled one out of a drawer and tucked it underneath me.

11:30 to 12:05ish
We hung out and waited for a long while. I had my vitals taken at some point again. The boyfriend and I talked, joked, held hands. We listened to the man outside our room. We got on Facebook on our phones.

I felt a bit light-headed, but I couldn't tell if it was because I was losing blood or if it was because the lights in my tiny little room were really bright and the whole experience was surreal.

Around 12:00 a supervising resident arrived in my room. I barely got a chance to meet him. He was wearing a white coat unlike anyone else I had met at this point, so I assume he was a supervising resident.

He asked me if I was feeling faint, and I explained that I wasn't sure given the situation. He turned the overhead lights off, which helped immensely and immediately. One up-facing medical light over the far wall remained on, lighting the room but not blinding me.

This doctor only had time to introduce himself, ask how I was doing and turn the lights down before he could explain the OB/GYNE team would arrive soon as they literally knocked and entered.

12:05ish to 12:30ish
The OB/GYNE team, a male/female duo of residents, had obviously just walked off the set of Grey's Anatomy.

The woman was petite with a darling face and cute blond cropped haircut. The man was tall and well-built with dark hair and a handsome face. If it were not for the likelihood, given his mannerims and his lingering eye on my boyfriend, that he was gay, I would say that they had just gotten done making out in a maintenance closet. (That is the way hospitals work, right?)

Anyway, they were awesome. They were nice, gentle and confident. For the first time this evening, I felt like I was in really, really good hands.

I explained for the umpteenth time what was going on with me. This time, I explained in more explicit detail. When I said to them that the toilet bowl at work looked like a bucketful of red paint, both the residents squinched up their faces.

Whoops. That's a bad sign if I am grossing out the doctors.

They explained that they've looked over my chart, and that it looks like everything at the D&E went well. (THIS IS LITERALLY THE FIRST TIME I AM HEARING MY SURGERY WENT FINE.)

They had talked with the on-call doctor, who I had spoken to on the phone, and they would now do a pelvic exam. They apologized because they know I already had one from the ER resident. But such is ER protocol.

The male resident performed the pelvic exam. As I mentioned earlier, talking with a male nurse on the phone earlier that evening was the most contact I'd ever had with male OB/GYNE professionals. Now I was getting my first pelvic exam from a male OB/GYNE resident! And I could not have been in better hands.

He was, by far, the most gentle professional to ever dig around in my vagina. In attempting to feel the uterus and identify where my pain was, he was reassuring and gentle in his touch. When I winced once, he squeezed my thigh with his free hand and said he was sorry and almost done. Such a change from the pubic hair twisting I had received earlier that night!

They then explained they would need to do an internal transvaginal ultrasound to see if they can tell what and how much tissue is left in my uterus. Again, the male resident handled the internal wand while the female resident watched the screen and took images from it.

The ultrasound took much longer than I wanted it to, and it made me uneasy.

As the male resident moved the wand inside me, the female resident would say, "Oh, do you see..."

And he would respond, "Yes."

And then she'd take a picture.

WHAT IS IT?! I wanted to yell. WHAT ARE YOU SEEING?

This went on for several minutes. It seemed their focus had changed at one point when the wand was moving at sharper angles to the left and right. Finally the male resident explained, "Don't worry. Right now we're looking for your ovaries. They can be hard to find sometimes."

"Oh, they're very shy," I said, my voice shaking and laughing at the same time, again with the nervous nonsense talk.

He nodded politely and kept working.

During this part of the exam, dear Tina walked in without knocking and then stood there for a solid 30 seconds not talking. She then announced she'd come back another time. The OB/GYNE team didn't glance at her once. Poor Tina.

He finished up and explained that it was very, very difficult to see anything because of the amount of blood I was producing. There was something there, but they could not tell from the ultrasound if it was tissue or blood clots.

The next step was to decide what treatment I needed: either a drug to evacuate the uterus, or a D&C. The residents would confer with the on-call doctor and return to discuss her decision.

12:30ish to 12:45ish
Again, the boyfriend and I found ourselves waiting. Another new underpad had been placed under me after the OB/GYNE exams, so I was relatively dry.

I was starting to feel really tired. The cramps that had woken me up the night before had robbed me of some sleep, and this whole process was exhausting.

The phone for the ER doctors was outside my room, probably right by the dude on the gurney. This set-up led to the interesting situation of hearing every single word my male OB/GYNE resident said to the on-call doctor about my case.


He said that he estimated there was about six centimeters of tissue in my uterus, but that he could not tell exactly what it was. He said that I was a hearty and strong patient, "not at all squeamish" (I wondered if the fact that I made HIM squirm had helped in this assesment) and "handling everything really well." He said I didn't seem to be reacting to losing blood, and I could probably handle taking the pill.

"I just don't think a surgery is necessary at this point," he said.

The boyfriend and I high-fived.

The OB/GYNE duo returned. I would take a dose of Misoprostol, or Cytotec, that night at the hospital. It would cause cramping and hopefully help evacuate whatever was left in my uterus.

I would be prescribed an additional dose of Cytotec to take the next night.

"If you're still cramping and bleeding tomorrow night, call us, and it's possible you'll need a D&C," the male resident said.

"But aren't I supposed to take the Cytotec at midnight tomorrow night?" I asked, confused.

"Well, just go ahead and take the Cytotec no matter what," the female resident said.

"But should I call you?" I asked, looking back and forth at them.

"Only if you think you need to," the male resident said.

"Wait, how do I know if I need to?"

...It had gotten confusing. Eventually, I discerned the following:

I would take one dose tonight. Most likely, the bleeding and cramping would drop off significantly during the next day. Regardless, I should take the second dose the next day, 24 hours later. If, on Sunday, I was still cramping and bleeding like the dickens, I should call right away. Then, a D&C might be necessary.

The residents added that, despite losing blood, I was handling everything okay. They made sure I was still not feeling chills, light-headed or nauseous.

"You have a ridiculous amount of hemoglobin in your blood," the male resident said. (14.4 actually, which isn't too much, but is on the higher end of healthy for women.)

"Yeah, it's awesome," the female resident enthused, nodding. "You're doing really well."

I was feeling super great at this point. I may be sitting in a big pool of blood, but I am a stellar patient and my blood is awesome! Go me!

Before they left, the male resident told us (actually, he addressed my boyfriend completely) that I would take the four pills buccally. (Pronounced buckle-y, it means in your cheeks.) Shoved down into my gums, the pills would dissolve for a half hour, and then I could swallow.

12:45ish to 1:00ish
We found ourselves waiting yet again. This time, we looked up pictures of Japan on the NYTimes, checked out charts explaining radiation and then tried to understand how radiation works. You know, just your usual "1 o'clock in the morning on a Friday night in the emergency room" business.

The very sweet boyfriend also rearranged my bloody bed/butt situation. He folded up all the used underpads so they wouldn't leak on me and then grabbed two new underpads for me. He also put my bed back a bit to make me more comfortable. Then, he snagged two extra underpads and shoved them in my purse! Heck yeah!

1:05 AM
I realized that I should call my parents to update them on my situation. I knew they will stay up all night until they hear from me, so I wanted to put them at ease so they can go to sleep. I no sooner got my mom on the line than Tina, with what appeared to be an incredible knack for timing, marched into the room carrying pills and a cup of water.

"Uh, I am about to put pills in my mouth for 30 minutes, Mom," I said quickly, "so let me just tell you what's going on."

I explained the situation to her quickly and hung up.

"Oookay, then," Tina asked, "Did I just overhear you saying that you are putting these in your mouth for 30 minutes?"

"Yes," I responded, baffled and realizing that she'd brought the water for me to swallow them.

"Hmm," Tina put the pills and water down on a tray. "Okay, then we better do what the doctors told you to do."

Geez, I guess so? How did this part of the process get confused???

I took a quick last drink of water before shoving the pills down my checks, against my gums. For 30 minutes, I fiddled around and finally swallowed them at 1:37 AM.

The Misoprostol hurt my cheeks. It felt like I had burned the inside of my cheeks and my throat. I drank lots and lots of water to help.

1:45 AM
Tina returned with discharge papers and removed the IV needle from my arm.

"You're all set!" she said and told me to feel better.

At this point, I started to feel chilly, lightheaded and nauseous--all those things that I'd been asked all night if I was feeling. Tina had swept off, and there was no one to take my temperature.

My boyfriend wrapped his arms around me, rubbing my arms. We decided that I was probably feeling these things because I was exhausted, worn out and cold from having sat in my own now cold blood with very little covering me.

Shivering, I put my clothes on and felt much better once I had the weight of my coat on me.

2:10 AM
We started to walk out of the ER and into the waiting room before we realized we hadn't been told if we needed to check out. Just waltzing out of the ER seemed strange.

We walked back into the ER, looking for a sign or a nurse at a desk. There was no one and nothing. Finally, I spotted a small Check-Out sign at an empty desk. We waited for a couple minutes before a nurse asked us if anyone had helped us. She sent someone to the desk.

While we waited, we watched some more typical downtown Friday night ER business go down. A woman screamed profanities from her wheelchair at EMTs. Some serious racial lines were drawn, which I suppose is typical of the city I live in. We had seen and heard racism all night with hatred going in all directions. "OBAMA PRESIDENT NOW!" the black woman yelled at the white male EMT, "Don't you forget that!" The white EMT rolled his eyes and walked away.

We were finally checked out, a quick and painless process, and walked back to the car. I was shaking and very, very cold. We decided what I needed was some food, something with sugar and preferably something hot. COOKIES!!!!!!! My apparent favorite comfort food. Hot chocolate chip cookies!!!

I sipped my water and enjoyed the heated seats and cranked heat in the car.

2:30 AM
We finally arrived back home. I updated my blog, jumped in the shower and the boyfriend ran up the street to the 24-hour drug store to pick me up more pads, underpads, lemonade (yay!), cookie dough (yay!) and other goodies.

I also slammed a leftover Norco, narcotic painkiller, before jumping in the shower. I figured it'd be a good idea, as I could expect more cramps as the night turned into day.

The boyfriend made me peppermint tea (to help my Misoprostol-pained mouth) and fought with a feisty oven to make me my cookies. (He is allergic to dairy and cannot eat the store-bought kind, poor dude.) Finally, he succeeded, but it had gotten really late. We were exhausted, but those cookies were damn good and made me feel SO much better.

4:00 AM
We crawled into bed. I stuck a sticky heating pad onto my abdomen, and a heating pad was cranked to the max under my back.

I should mention that I am not a fan of the guest bed at the boyfriend's mom's place, particularly not when one is crampy. The week following my surgery, as well as the first few nights following my compliction, I slept on top of the comforter for extra cushioning support. I brought my favorite fuzzy blue blanket from home to keep me warm and wrapped around me. (This thing is ratty as all get-out, but I adore it. It got me through mono at age 16, and it still helps me today.)

This night, I also devised a Don't-Bleed-on-the-Bed contraption, consisting of (1) underpad on top of the comforter, (2) an old towel on top of the underpad, and finally (3) the heating pad on top of the towel.

I crawled on top of this Princess and the Pea-like structure and almost immediately began to feel a cramp that was unlike any other. They say it takes about 2 to 4 hours for the true brunt of Misoprostal pain to kick in, and I am here to confirm that.

I went to the bathroom and before I could sit on the toilet, I passed THE BIGGEST CLOT I HAVE EVER SEEN. Like earlier, it dropped into my underwear, and I fished it out to examine it.

It was, most likely, almost 4 inches in length and 1.5 inches at its thickest point. It looked like dark maroon Jell-O and had a consistency similar to Jell-O, but a bit stronger. IT WAS SO GROSS AND AWESOME.

I desperately wanted to show my boyfriend how amazing and disgusting and crazy this clot was, but he was very sleepy and I figured running into the bedroom waving a blood clot around was not a nice way to treat him at 4:15 in the morning.

When I mentioned this passing desire to him the next day, he was very disappointed.

"Why didn't you show me?!" he asked sadly. "I would've wanted to see it! It sounds awesome!"

I promised that if I passed another clot, he would see it. Unfortunately for him, at that point, I seemed to have passed all the clots I would and have not passed any since.... Knock on wood!

P.S. That urine sample/tomato juice/chemical experiment sat on the floor the whole time we were in my ER room until we left. The boyfriend and I put it on the tray, just in case they still wanted it...

Monday, March 28, 2011

My Follow-Up Appointment and (Perhaps No More) Complication Update 5

I had my follow-up appointment today--two weeks after the insertion of laminaria, 13 days after the D&E procedure and 3 days after my apparent complication resulting in an unexpected and bloody trip to the ER this weekend.

I skipped work this morning, slept in a bit and woke up to find a voicemail from the head nurse at the hospital's family planning clinic on my phone. She had heard that I'd had trouble over the weekend and wanted to touch base with me. She seemed to have forgotten or not connected that I also had an appointment that day until I called to confirm that I should still come in for it.

My boyfriend and I went together to this appointment. Initially, I planned to go alone to this follow-up. Everything seemed to have been moving along smoothly, and perhaps in my occasional bull-headed independence, I wanted to go alone and not feel dependent on a boyfriend. That all changed with my trip to the ER, and I also realized that it was important to me that we go together, see this process out as a couple. And happily, he was the one who suggested that he take me to the hospital for my follow-up.

While we waited at the clinic, we sat in the OB/GYNE part of the waiting room for the first time. (For our consultation, we sat in geriatrics, and we sat in the same seats when we went for the laminaria insertion.) Our buzzer quickly buzzed, and we were taken back to a new exam room.

As we walked through the family planning clinic hallway, it felt like a trip through the past three weeks:

First we passed the consultation room where I sat 19 days ago. A young woman about my age sat in the same chair with the door open, waiting for the head nurse to come chat with her.

We then passed the exam room where I had the laminaria insertion two weeks ago today. As we walked by, the door opened, and a nurse walked out. I could see the curtain was drawn and knew that there was someone in there experiencing exactly what I did two weeks ago.

Then we turned a corner where we were led to a new room for my follow-up. My boyfriend and I laughed when we saw the room set-up. For the first time, the visitors' chairs were lined up with a direct view at the table's bottom end. These are VIP seats for vag exams, people.

"Uh, are you sure you want to sit there?" I asked him.

He shrugged and plopped into one of the chairs. "I'll move if they want me to," he said. Of course, aside from the boyfriend seeing my vagina on a regular basis, this is the guy who is disappointed I didn't show him any of the clots I passed. So why on earth would he be freaked out?

The resident who I met at my consultation and who conducted my laminaria insertion knocked and entered the room. She shook my hand and asked me about the ER trip.

I explained that my bleeding and cramping has dropped off, and she explained that she'd do a pelvic exam to check my uterus. (The head nurse explained they'd want to see if it felt "floppy," which would mean that there was more tissue hanging out in there.)

She first used a heated speculum (It was actually super hot, as it turned out, and freaked me out upon entering my vaginal canal. Yipes!) and then did a hand exam. My uterus felt firm, a good sign. No floppy = Great news!

The resident then asked me about the procedure itself, bringing up right away that she was sorry that she and the rest of the scheduled team had been pulled from my case last minute.

"Honestly," I told her, "I think we both felt like there was more disorganization than we expected. I expected to see some of the faces I had seen before, but that didn't happen."

She nodded and explained that the change-up with doctors was frustrating, and she, with the rest of the team, was pulled onto this emergency case that started at 1:30 and lasted until past 6 PM. (Jesus.)

"You know," I said, "I understand that that happened, and it's unexpected. But maybe more upsetting was that I felt like we had to argue with the nurses that I get the shots I needed. We had to remind everyone, and my charts were wrong."

The boyfriend chimed in here, explaining that he had to insist to two different nurses about my depo shot since it seemed they didn't believe me, their patient. He also said that the shift change was a bother, but it honestly didn't bother me as much as the frustration of insisting that you know what care you're supposed to have.

I agreed with him and then added that it was a great thing he was there since, especially post-op, I was hazy, and we were having to act as my case managers.

At this point, I started to feel the emotion of the day rising up in me, and my eyes were getting watery.

Damn it! I thought, I didn't think this would happen! I pulled it together, just barely, to keep myself from crying.

The resident kindly apologized again, and said she felt terrible because if they had been on my team, since they knew my case, it would have been handled better.

She then asked me if I wanted my pathology report.

This stopped me short, though I think I should have expected it. I have even in the last few days been eyeing the number for medical records, considering calling in to request mine. Since I never even heard that everything went okay, I was curious to see what my charts say.

But a pathology report? Suddenly feeling vulnerable from having talked about the day, I immediately said no. I was afraid of what I might learn from it--the sex of the fetus, its viability? I don't actually know. (Does anyone know what exactly I would learn from the pathology report? Would requesting my medical charts reveal this information to me too?)

With that, she said she would chat with the attending physicial (who was supposed to have operated on me, but who I had not yet met) about whether we should do an ultrasound. They'd both be back shortly.

While she was gone, the boyfriend and I chatted more about the day of the procedure. We both felt like we had said what we wanted to say and agreed that the resident was great. There's not anything she can do at this point, obviously, so her words were nice. However, it was the attending doctor who then entered the room who made me really feel better...

The attending physician immediately apologized for the disorganization on the day of the procedure.

In my I-was-raised-to-be-a-way-too-nice-girl way, I said, "It's okay."

She immediately responded, "No. It's not okay." And then delved into how sorry she was that the emergency case had pulled her off of my case and that I hadn't had the familiarity of faces I knew around me for the operation. She said while she was glad I didn't have to face the emergency situation that this other patient did, she didn't think it was fair that I was jostled around because of another case. Basically, I deserved better than I got.

I told her how much I appreciated her saying that, and I didn't repeat that it was okay. She was right, it wasn't okay. So much of what happened was not actually the fault of the OB/GYNE team (in retrospect, it was that fighting to be sure my care was handled by the nurses correctly that was most upsetting), though I did mention that I wished that my operating doctor had made an effort to see me before the sedation kicked in.

We moved on and discussed my complication. Based on my description of what I had passed--dark maroon but not brown in color, gelatinous and smooth, they thought it was most likely blood clots. Tissue would have been darker in color and have had more texture. Chances are less likely that there was anything left in my uterus and more likely that my body simply did not evacuate the way it should have following the procedure.

As I thought I had heard the resident OB/GYNE say on Friday night, the leftover tissue or clots in my uterus were measured at six centimeters on Friday night. While my cervix was completely closed already that night, I passed more and more clots and blood, including that one gigantic clot that must have been most of whatever was in there.

Given that news, the attending physician decided that it was best not to do an ultrasound at this point. 1 or 2 centimeters of tissue in the uterus is normal, she explained. Six centimeters was obviously not normal. But if she did an ultrasound today and saw, say, 3 centimeters of tissue, she'd have to do a D&C procedure, even if my body might still be evacuating clots/tissue. She preferred to avoid subjecting me to another surgery (me too!), and instead monitor my continued recovery.

If my bleeding picks up, then I will need to call right away and most likely have a D&C procedure. Given how things have been going, the doctors are hopeful (and "95%" sure) that I won't need any more procedures. I'm not totally out of the woods, but things are looking good. Some slight bleeding and cramping will be expected--a few days to a week or more, so I'll be diligent in keeping a watch on myself.

Sunday, March 27, 2011

Complication Update 4 - Day 3

That Misoprostol kicked in with a vengeance last night around 3 AM. Literally bolted straight up in bed, clutching my abdomen. The cramps quickly passed, but I didn't bleed very much.

Today, there has been occassional cramping and very little bleeding. I haven't passed any clots since yesterday.

I had my regularly scheduled follow-up tomorrow morning, and I assume that it will now focus on whether my uterus has been completely evacuated. I emailed my supervisor and shared with her my latest update, just in case this complication is... more complicated.... and I need to take additional time off work.

My hope had been to talk more at length with the head nurse tomorrow about the various ways I felt frustrated by the disorganization and miscommunication on my surgery day, but it seems like there'll be more important things to discuss and not a whole ton of time to review what happened. At any rate, I'm hoping that the dropped off cramping and bleeding is a sign that things are good, and my uterus is evacuated. Fingers crossed!

Saturday, March 26, 2011

Complication Update 3 - Day 2

Who knew I'd be back in this good ol' recliner with my heating pad cranked oh-so-very-soon?

I've tried to be as honest and detailed about every single feeling, emotional and physical, I have experienced through this process. My hope is that this writing helps other women who want to know someone else's experience.

However, my friends, I do NOT know how to write about what I felt and saw last night without some seriously disgusting details. I'm not upset, and at this point, I'm not even in that much pain. But I am perversely FASCINATED by my body right now. Who KNEW I could dump so much blood all over the place? The human body is AMAZING.

The good news is that, despite the fact that my uterus is evidently a tank-like lock box unwilling to give up its contents, the Misoprostol (brand name Cytotec) has pushed tons of clots out of my body. I am not too crampy right now, and bleeding seems to be slowing.

I plan to take one more dose of Cytotec tonight. And I also plan to update more about my experience last night just so I continue to be thorough. For now, the boyfriend just got home, and I'm going to spend some quality time with him.

Complication Update 2

I'm still at the ER and currently have 4 small pills shoved in my cheeks. An ultrasound determined I either have placenta left in my uterus or my uterus has not been interested in evacuating all my blood and uterine lining. I'll take another possible dose of this cytotec tomorrow. If all goes well, I'll pass whatever is left. If something remains in my uterus, I will require a D&C. hour after typing that, at 2:40 AM, I am home. Going to take a hot shower for cramps and to very necessarily clean myself. (I had the doctors oohing and aahing over the amount of blood I was discharging.) Boyfriend is picking up some essentials down the street and then we will collapse in bed.

Friday, March 25, 2011

Complication Update 1

Sitting in a huge American city's emergency room. It smells and looks just about how you'd imagine. Waiting to be called. I've bled through my stretch pants, one of those horrifying things you think you're done experiencing at age 13. Waiting for an ultrasound...


This post might be a bit graphic for the squeamish, so stop here if you don't like gross things, particularly blood.

Before leaving work today those pesty cramps came back. I went to the restroom where I urinated and felt some blood pass my body. I glanced down and, horrified, saw what looked like a toilet full of red paint.

I figured this was more of some last passing of blood, but it hasn't stopped. In fact it's only gotten worse. I've talked with an on-call doctor (she sounds great) twice. She actually called while I was typing the above paragraph and we decided I should come in to the emergency room. My parents have offered to drive, but my boyfriend is on his way to pick me up.

Chances are that something was not evacuated, like placenta. She said I will have another ultrasound to try to determine what, if anything, is still in my uterus. I'll take a medication that helps evacuate my uterus, and then possibly have a D&C procedure.

God. Talk about fucking chances. Chances of pregnancy. Chances of complications. I am shaken and scared, but honestly I'm feeling mainly irritated right now.

Alright. I'm going to get my things together to go to the ER. Big sigh.

The Importance of a Good Gynecologist, or The Story of My First Ultrasound

I want to share the story of my first ultrasound and my experience with my old, terrible gynecologists--Dr. D and Dr. S's--office. I haven't really felt up for writing it out yet, but I feel ready now.

It's important to me that I share this story because I know so many young women my age who don't have strong, trustful relationships with their gynecologists. When you're young, healthy and don't have many problems, it's easy to go in for your annual pap smear or your latest birth control prescription and be on your way.

I found my old gynecologists through two search methods. First, their office showed up in a location search on insurance provider's website. Their practice was two blocks away from my work office. Second, I Googled one doctor (Dr. S) and found she had a handful of positive reviews on Yelp. The glowing five star reviews, in retrospect, describe the bare minimum of what a gynecologist should provide her patients: answered questions, made patient feel comfortable, handled the birth of a child.

Good enough for me, I figured at the time. I thought Dr. S, upon meeting her, seemed way more manic than the reviewers had suggested. I felt a bit rushed and like Dr. S might be taking some kind of upper in the breakroom, but she was nice enough, my vag was in good condition and all was well.

But all didn't stay well, as I explained at length in another entry. It took a plethora of vaginal infections to discover that Dr. S and her colleague who I preferred, Dr. D, did not have an approach to women's reproductive health that was holistic or systemic. They were fine for your annual pap, but that was it.

(In fact, around the time that I had these ongoing infections, a Yelp review went up that explained, more or less, "If you have real problems or issues with your reproductive health, then this is not the practice you want to go to.")

This winter I found a new gynecologist, Dr. T, who I saw one time and loved. I couldn't shut up to anyone who might listen about how great she is, how wonderful her approach is, how the entire office is more like a spa and less like a cold clinic.

Naturally, when I got those two pink lines on my at-home pregnancy test, I called Dr. T's office. Here is how my call with her office went:
Dr. T's Receptionist:  Hi, this is (Your New Gynecologist's Office at This Awesome Women's Health Institute). How can I help you?

Me:  Hi, I'm a patient of Dr. T's, and I just took a pregnancy test. And it's positive.

Dr. T's Receptionist:  Okay, when did you want to see Dr. T?

Me:  As soon as possible. This isn't a planned pregnancy, and I'm really concerned about how far along I might be.

Dr. T's Receptionist: Okay, let me look... Dr. T is out of the office until next Monday. She can see you that morning.

Me:  Oh. (It's Thursday afternoon at this point.) Uh, I guess that's going to have to work.
Dr. T's Receptionist:  I'm really sorry about that. I've got you marked down here, and she'll be able to go over everything with you.

I was very, very disappointed. When I broke the news to my boyfriend and we discussed our concerns that I might be far along (as I was), he urged me to call my shitty former gynecologists' office to try to squeeze in an appointment the next morning. We talked about how I had come not to trust these doctors but agreed that we wanted to know as soon as possible how far along we were and what our options would be. Time was of the essence, and since it was already after 6 PM on Thursday evening, I would have to call first thing in the morning and take care of it. After all, how bad could going to their office possibly be?

I rose early Friday morning. Before I called, I took the second at-home pregnancy test in the box. Positive. Shaking, I called Dr. D and Dr. S's office. Here is how the call to their office went:
Dr. D and S's Receptionist:  Hi, this is (That Really Terrible Gynecologists' Office You Used To Go To).

Me:  Hi, I'm a patient of both Dr. D and Dr. S's. I would like to schedule an appointment with them as soon as possible. I took a pregnancy test, and it's positive.

Dr. D and S's Receptionist:  Ooooh!!! Congratulations! You must be so excited!

Me:  (Silent, breathing.) Um, this isn't a planned pregnancy, and it isn't wanted. I need to find out how far along I am quickly. Dr. S prescribed me a three month birth control cycle, and I'm concerned that I am really far along now.

Dr. D and S's Receptionist:  Oh. (Silence.) Well, our first available appointment is next Wednesday.

MeNext Wednesday?? (I have never had to wait this long for an appointment with this office.) Nevermind. (I pause for a second, feeling extremely upset with this receptionist, who I've dealt with multiple times in the past and has always seemed pretty clueless.) You know, both Dr. D and Dr. S have told me that if I ever had any issue that was pressing, I could be fit in. This needs to be taken care of quickly. I need to know as soon as possible how far along I am, but if your office can't do that for me, then fine.

Dr. D and S's Receptionist:  Uhhh... Let me check with the doctors real fast. (I'm put on hold for a minute.) Ok, they can see you today at 11 AM.

Later that morning, sitting in the tiny waiting room at Dr. D and Dr. S's office, I felt a panicky fight or flight reaction. My trust in this place was gone.

The same receptionist called me to the front desk.

"We need you to pee in this cup to confirm the pregnancy," she said loudly, shoving a cup at me.

I stood stock-still for a moment, horrified that the quiet but full waiting room was aware of why I was there. Then, I realized that this receptionist had rolled away from the window on her chair without telling me where the restroom was! When I called her back and asked her, she gestured through the door that leads to the private clinic area. Why couldn't she have brought me through that door, away from the waiting room, handed me the cup in privacy and gestured to the restroom that would have been right next to me? Why did she announce my situation to this roomful of strangers?

When I returned to the waiting room, she did the exact same thing to another woman, also about my age and (seemingly) unmarried. She, too, looked horrified. I returned to staring out the window for forty minutes until I was called back around 11:45 AM.

A nurse walked back with me to an exam room I'd never been in before. She took my weight, height, and I explained to her why I was there: I've never been pregnant before, and my home test is positive. I am pretty sure I want to terminate the pregnancy, if termination is still an option.

The nurse seemed awkward and stumbled through her usual questions.

"Smoke? Drink? Drugs? Ever been pregnant bef--?" She halted mid-sentence and then looked at the floor. "Uh," she said, marking her chart.

"Nope, first time," I reminded her, almost laughing to keep from crying in front of her.

She asked me when my last pap smear was, and I explained that I was now seeing a new gynecologist who had recently done a pap smear with normal results.

She told me that Dr. D would be with me shortly. The pee-cup test was positive too, she added before leaving the room. I would need an ultrasound.

An ultrasound.

I hadn't even considered that part of the process until now. What do I know? I've never been pregnant before. Can they not tell how far along the pregnancy is from the urine? Of course I'd need an ultrasound. Why hadn't I thought of that? As I sat on the table in the cold exam room, I wished I had brought my boyfriend with me.

Up until this moment, ultrasounds lived as happy moments in my imagination. Enough movies and television shows had helped me develop a fantasty of what my first ultrasound might be like.

I would be at my wonderful OB/GYNE's office with my husband. We'd have been married for a few or several years at this point. We'd have been trying to get pregnant, and it wouldn't have taken us long to do so. We'd happily look at the image on the screen, huddled together and closer than ever before, admiring the little healthy life that we'd wanted to bring into the world.

Instead, I was now sitting in the ultrasound room, alone, freezing and staring at my blue wool socks that I'd kept on my feet. I avoided looking at the massive ultrasound machine that hovered close to me like an unwelcome and imposing visitor.

Dr. D breezed into the room and talked with me about the situation.

"This is unexpected?" she asked. "Unwanted?" She asked me how I was doing, and I cried just a little.

She explained to me that she'd do the ultrasound to estimate how far along I was.

She pointed out a phallic-looking ultrasound wand. "Most likely, we'll need to do an internal ultrasound because you'd have to be further along for the abdomen ultrasound. It will feel like a pelvic exam," she said. "But why don't you lay back, and I'll first try to see if I can use the abdomenal wand instead."

I knew she wouldn't need to do the internal ultrasound. I was suddenly very certain that I knew how far along I was, and it would show with the regular ultrasound. I was almost angry with Dr. D for suggesting reassuringly that the regular ultrasound would be unnecessary. Why say that? Why conjecture? Why plant any hope or expectation in your patient's mind?

"Would you like to see it?" she asked before she started the abdomenal ultrasound.

"No," I said very quickly. "I don't want to see it."

Dr. D squeezed jelly onto the wand and pressed it against my abdomen. She slid it against my skin, paused, slid again, paused. I stared up at the flourescent lights, my eyes burning, and then squeezed my eyes shut.

I felt faint, nauseous, and my heart was slamming around in my chest like it was trying to break free from this room, from this situation.

"Okay, there is a pregnancy that I can see," she said. "We won't need to do the internal."

I exhaled and sucked air back in, realizing that I hadn't been breathing.

"It's healthy," she added.

Dr. D explained she'd take a few snapshots to measure the fetus. I kept my eyes shut and waited until she was done.

"Okay," she said. "It looks like the pregnancy is about twelve weeks along." The room spun, even with my eyes closed.  "You can go ahead and sit up."

I sat up and opened my eyes. To my right, the hovering ultrasound glowed, its screen facing toward me still showing the image of the fetus inside of me. I only saw it for a moment, just long enough to register a little head and nose, arms and a body curled up and facing left.

It looked like a baby.

It looked exactly like the ultrasound that I had imagined for my future.

"Can you please turn that off?" I said weakly, my eyes shut again.

"What?" Dr. D asked. She had rolled away on her chair to toss gloves into a trash bin. "Oh!" she said, sounding startled.

I heard the machine clicking.

"You can open your eyes," she said. I glanced at the screen, now empty of any image. "I'm so sorry," she said, placing a hand on my knee.

I was angry with her, I wanted to scream and cry. I wanted to ask her how she could be so negligent, how her staff could be so unprofessional and insensitive, how it could be okay to run a practice like this. But instead, I said nothing. I looked up at her, and she repeated that she was sorry. I nodded, and she left me to change back into my clothes before we discussed my options.

I've thought a lot about this moment since then. I'm still shocked, though I no longer become viscerally upset when I think about it.

Every single person I have told--my boyfriend, my best friend, my therapist, my parents--has immediately said they each think that Dr. D left the image on the screen intentionally as a subtle "forgetful moment" to make an impression on me.

That's possible. The pro-baby feel of that office was pretty obvious the whole time I was there and was hammered home with that unwarranted 'Congratulations!' when I made my appointment.

But I think that all these people jump to the conclusion that it was intentional because it is so hard to imagine a female gynecologist, dealing with a patient who is so clearly shaken by her situation, making that mistake. Mistakes happen, but this mistake shouldn't have.

I will never know why I saw that image, if it was a human error or an intentional move. But I have to accept that it happened and move on.

Dr. D returned to the room and explained what options were open to me. She asked if I was sure termination was right for me, and then said I'd probably have a dilation and cutterage procedure. She would be wrong about that guess too.

She apologetically explained she could not do the procedure for me. "My hospital network does not allow me to do second trimester abortions, except in cases of danger to the mother's health," she said. Again, I don't know if it was her intention, but I suddenly felt a wave of guilt for my decision: For this procedure, I wouldn't get an OB/GYNE I'd seen for years because I was making a choice that is unsupported by her employer.

But I also felt like saying, 'Hey lady, it's okay. You have done enough already. Trust me.'

When I left Dr. D's office that day, the receptionist, seemingly in an effort to fully botch the entire experience at this appointment, forgot to give me some of the information I was promised on who to contact for abortion services. Again, what was probably a mistake felt somewhat like an intentional move to influence my decision by keeping me from full access to the information I needed.

As I left, the receptionist also told me that I might receive a survey in the mail from the hospital network they are associated with, and yeah, I am looking forward to receiving that survey.

If I don't get the survey in the mail, I plan to write a letter about my many experiences with that office to the hospital network and to Dr. D and Dr. S.: An unprofessional and seemingly incompetant staff who mixed up prescriptions and appointments for years; Contradictory statements from the doctors and shallow, non-systemic approaches to reproductive health; Intentionally or unintentionally showing an upset patient who wants to terminate her pregnancy her first trimester ultrasound; Neglecting to provide a patient with full pregnancy termination information material.

It's absymal, and I wish I could get on Yelp and share my experience there with every woman who might look at that site for guidance.

The great thing is that I never have to go back to that office again.

I kept that Monday appointment with my new gynecologist, Dr. T, and told her what happened with the ultrasound. She shook her head but, like the professional she is, kept her mouth shut and her opinion to herself. Her staff, from the receptionist who first scheduled my appointment to the nurse who took my vitals, reserved their felicitations or regrets on my pregnancy, like the professionals they are too.

I told Dr. T that former OB/GYNE Dr. D had told me I would have a D&C. Dr. T quickly said that she would not make any guesses about the procedure. "It could be a  D&C, but it could also be a D&E," she said. "I don't know, and only the physicians who will do your procedure at the hospital can tell you that. They'll make the choice that's best for you."

I should also add that Dr. T asked me if I would be interested in an IUD after the procedure and why I hadn't had one implanted before. I explained that, when I had asked her a year prior, former OB/GYNE Dr. S told me that a woman who had not been pregnant could not have an IUD. Dr. T responded that that used to be the case, but for the last five years or more, more and more doctors have moved toward IUD implantation for all women. I sighed and said that I wished I had gone to her a long time ago.

At that appointment with Dr. T, I felt safe and calm for the first time since finding out I was pregnant. I felt confident in my choice and in my doctor.

Shouldn't it always be that way for every woman?

That's why I am writing this post--to share my experience and urge any woman who might have stumbled upon my blog to be sure their doctor is one they trust. I had my doubts about that first office. I brushed them aside and stuck with them for months, years. In pushing down that doubt, I trusted these doctors to handle my health, my body and me with a respect and professionalism that they and their staff obviously lack.

I learned the hard way that my instincts were right. I deserved better, and thankfully, I now have it. I hope that anyone reading this entry has the best health care providers she deserves too.

Recovery Day 10 - The Cramps Return???

Man. What a bummer.

Perhaps in some effort to show me what's-what and don't-you-dare-sayonara-us-sister, my cramps came back in full force last night around 3 AM.

The boyfriend and I stayed up for three late hours after getting in bed, cuddling and talking about our relationship and generally being affectionate. Once I finally started to get sleepy (yeah, sleep schedule is way off), my abdomen and back blew up in pain.

While I rolled around trying to find the right way to position my body, my boyfriend rubbed my belly and back. It helped, and eventually I fell asleep.

There was a great deal more blood this morning, but I'm not concerned.

Feeling better today. Cramps are gone, feet are on the ground and moving happily forward.

Thursday, March 24, 2011

A question for abortion providers...

..or clinic volunteers, or women who have had abortions, or any other pro-choicers out there who feel they have insight into this topic:

After an abortion procedure, is it common practice for hospitals, clinics, etc., to provide the patient with support materials?

I'm thinking more of emotional support information (the number for, for example, or locally-recommended social workers or therapists, or basic information about the wide-ranging emotions different women experience after the procedure, etc. etc.) rather than a list of physical symptoms to expect.

Thanks, everyone!

Wednesday, March 23, 2011

The Onion - New Law Requires Women to Name Baby, Paint Nursey Before Getting Abortion

Old news to many, I am sure, but I had not seen this before. Give it a watch--it's brilliant. Thanks, Onion!

Recovery - 8 days later

I will take it that the cramping is behind me. However, I did bleed a whole lot more last night than I have recently. I'm guessing the increase has something to do with my having been way more active last night: out with friends, climbing on roofs, dancing, catching a tiny brown mouse in a friend's apartment and then setting it loose outside (I feel awesome!)...

I also drank for the first time in a long while. While I was unknowingly pregnant, I pretty much stopped drinking. Beer was absolutely disgusting to me. Even my favorite brews (dark, often aged in whiskey barrels) tasted vile. I had the occasional glass of red wine with dinner, or a tiny pour of bourbon while curled up watching Deadwood. But otherwise, blecchhh.

So needless to say, going to a wine bar and drinking more afterward with friends hit me pretty hard after months of only one or two drinks at a time. Lesson learned, body. Thanks for the reminder.

Tuesday, March 22, 2011

Recovery: One Week Later Update

A week ago at this time, I was sipping ginger ale and water in my recovery room, trying to feel like I could sit up on my own.

I am now cramp-free (day two of no cramps!), very little bleeding and returning to my normal physical self. My breasts are less swollen. Last night I washed my skinny jeans (I hadn't washed them since before I found out I was pregnant because I swelled up that fast and I wanted them stretched out) and they fit again like normal. There was a point about ten days ago where I thought, 'I don't even remember what my profile looked like before this bump appeared.' This morning I looked in the mirror, and I remembered.

I am also seeing friends tonight who I haven't seen for a long while. My great friend/ex-boyfriend (who I mentioned before was one of the few people I told), his new lady friend, and several of our college friends will be going out for wine to toast him on a long voyage across South America. It'll be so, so great to see friends.

Dream Babble and Judgment

I haven't really remembered my dreams much in the last couple weeks. I had a few nightmares (other friends were pregnant; I was about to give birth; I already had one kid and was pregnant again), but I think that my subconscious mind mostly graciously granted me heavy sleep this month so I could truly rest. Unfortunately, that wasn't in the cards last night.

After a long, late night of heavy emotional conversation, I fell asleep around 4:30 AM. I slept restlessly, dreaming nightmares of my abortion happening at a protestor-heavy clinic. I woke several times before I fell into what seemed like a regular old dream:
In this dream, I am at my favorite coffee shop in the city.

(FYI: I adore this place. However, I haven't spent much time there since January because my usual absolute NEED for ONE LARGE AMERICANO PER DAY dissipated when I was pregnant. Coffee, let alone espresso, was revolting. I showed up there a few times this past month for a bagel or cookie, and the staff was baffled as they'd call out a 'Hey!' and a 'Where have you been?' and then start brewing me an Americano before I could stop them. At one point, one of the baristas said in frustration, 'Why don't you order large Americanos anymore? It used to be so easy!')

In this dream, I am at the coffee shop and I am telling the manager that I had a dream with him in it. Then, I "awake" from my dream, find myself at the coffee shop again and say, 'Weird! I just had a dream where I was telling you that you were in my dream,' and then I woke up for real, feeling very confused.
I didn't feel like that dream had much to do with anything, but it did leave me thinking that I might give a morning Americano a try today. I swung by my coffee shop on my way to work and ordered a small one.

As I stood waiting and thinking about the dream that had led me here, I overheard two of the baristas discussing a woman who comes in regularly.

"She just stares at you blankly," one guy said.

"Maybe she's in love with you," the second male barista suggested.

"I mean, she's beautiful, but what's going on with her?"

At this point, I smiled to myself, wondering who this young woman is and how she manages to so affect these two guys.

"Yeah," the second barista said, "but now we know: She's PREGNANT," he pointed at his left hand, "AND unmarried." He rolled his eyes.

Whoa. What?!

With that, my Americano was ready and the second barista offered me a flirty, twinkly-eyed smile and wished me a great day. I felt like he had just punched me in the chest. This guy has been handing me Americanos for years now, but I looked at him differently this time.

When I was still making my choice, I often wondered if I had chosen to bring my pregnancy to term: What judgment would there be if I showed up in my usual places, showing my pregnancy and unmarried?

There's an amazing thought: As an unexpectedly pregnant single woman, you are subject to judgment no matter what.

If you choose to terminate the pregnancy, the anti-choice trolls will clang their bells and beat their chests and scream about the unborn children.

If you choose to carry the pregnancy to term, the small lowlifes will point at your bulging stomach and your unringed hand and whisper their assesment of your low character.

If you choose to carry the pregnancy to term and get married, there will be those people who look at your wedding pictures, trying to discern the bump in the white folds of your dress, and pityingly remark how it's just too bad, isn't it?

Damned if you do. Damned if you don't. Damned if you don't and you get married.

Not that everyone in this world is a judgmental dick. I'm not that cynical. But man, I felt like I saw a shining example of the reverse judgment I might be receiving right now. That moment was a small glimpse into an alternate reality.

I believe in synchronicity, and I don't think it's a coincidence that I had this dream that led me to a morning coffee for the first time in weeks, only to experience what I did there.

I went to bed last night weighted by judgment from some self-righteous anti-choice urchins who had linked to my blog last night, weighted by my own self-judgment and fear. I woke up and went for a coffee and saw what kind of judgment is reserved for unmarried women like me who do choose to bring their pregnancy to term.

Judgment is everywhere. I made a mistake last night in internalizing some of it. Thanks, beautiful Universe, for slapping me out of it and reminding me that ill-informed conjecture and graceless judgment are the products of narrow minds and small people.

Monday, March 21, 2011


I knew this process wouldn't be easy, but I didn't know what form or shape the difficulties I'd face would take. You can't schedule when unexpected and sudden grief might overtake you--like when I was walking back to work after lunch today and found myself with tears rolling down my cheeks. There's no post-abortion calendar for that kind of thing.

I don't have a timer for my next cry, but I am lucky to have an amazing network of support to help me through when those times come.

My best girl friend has been perhaps my biggest support throughout this process. From the moments where I've tried to make light of the situation (I told her I was pregnant by first prefacing, "Okay, get ready for a Lifetime Movie moment," right before disintegrating into tears.) to the difficult topics, to the bucking up and cheering up, she's been a grace. She's kept me honest with myself, listened to everything I've had to say and been there for me in a way I never could have imagined. I'm lucky to have a friendship with such openness and honesty. I know she's reading this blog, and I hope she knows that I love her.

I couldn't have had a better support through the procedure than my boyfriend. I am still in shock over how things were handled, from my first ultrasound at my terrible former OB/GYNE's office to the shuffling, disorder and confusion on the procedure day. My boyfriend was there to keep me calm, keep me collected and wipe away my tears and run his fingers through my hair. I'm still not sure how I could have handled all of it without his comfort. He has been a balm to the hurt, from quiet hand-holding to his sweet jokes that bring a smile back to my usually cheerful face.

After weeks of thinking that I knew no one personally who had ever been through an abortion, I discovered that I did. When I finally confided in them, my parents shared that they had been through it before. My parents had had an abortion. I was in third grade, and they couldn't have another child for many reasons at that point. They terminated their pregnancy, and I never knew until two days before my own procedure. To know that my own mother had been through it, to talk with her about it, it gave me unspeakable strength.

And finally, the brave women who have kept abortion and pro-choice blogs before me have been a beautiful network of community, solidarity and strength. Reading through the experiences of other women--abortion providers, pro-choice activists and women who have faced the same choice as me--it gave me support when I had none. When I've been scared, when I've been confused, when I've been alone and when I've needed to hear someone else's voice about this difficult choice, I've had support in all of these women. What an amazing support it has been.

I am incredibly honored that Angie, the strong and honest woman behind the blog My Journey Through Abortion, mentioned my blog today. It is women like her whose chronicles through this experience inspired me to share my own.

I hope that my blog offers someone support the same way that her blog bolstered me. I hope that this network of support only continues to grow and flourish. I hope that in doing so, we continue to strengthen the fabric of a safe community that swathes and supports women who make this choice.

Thanks, Angie. You rock.

Recovery Day 6 - Feeling good

Physically, I am feeling pretty darn good today. I woke up with no cramps, and the bleeding seems to have dropped off a bit. Fingers crossed, it will stay that way.

I'm back at work today, and things definitely feel a bit weird. I feel isolated from my social world and a bit like I'm emerging from some kind of cocoon. I plan to reach out a lot to friends in the next week or two, try to see a lot of people and feel like I'm back to myself.

In the meantime, I thought I would post the chocolate chip cookie recipe that was my comfort food savior over the last week. You can find it online, as it's from famous Brooklyn chocolatier Jacques Torres and the recipe is posted on The New York Times.

Believe the recipe: The cookies taste best if the dough rests for at least a day. I made the dough on Sunday, and we made our first batch of cookies as soon as we returned from my procedure on Tuesday evening. We would scoop spoonfuls from the dough each time we wanted cookies and bake them fresh, so they were hot and gooey each time. So delicious, and definitely a wonderful comfort.

Posted on The New York Times online:

Time: 45 minutes (for 1 6-cookie batch), plus at least 24 hours’ chilling

2 cups minus 2 tablespoons
(8 1/2 ounces) cake flour
1 2/3 cups (8 1/2 ounces) bread flour
1 1/4 teaspoons baking soda
1 1/2 teaspoons baking powder
1 1/2 teaspoons coarse salt
2 1/2 sticks (1 1/4 cups) unsalted butter
1 1/4 cups (10 ounces) light brown sugar
1 cup plus 2 tablespoons (8 ounces) granulated sugar
2 large eggs
2 teaspoons natural vanilla extract
1 1/4 pounds bittersweet chocolate disks or fèves, at least 60 percent cacao content (see note) (**I used chocolate discs from Trader Joe's. They were a bit big, so I chopped them into quarters.**)
Sea salt.

1. Sift flours, baking soda, baking powder and salt into a bowl. Set aside.

2. Using a mixer fitted with paddle attachment, cream butter and sugars together until very light, about 5 minutes. Add eggs, one at a time, mixing well after each addition. Stir in the vanilla. Reduce speed to low, add dry ingredients and mix until just combined, 5 to 10 seconds. Drop chocolate pieces in and incorporate them without breaking them. Press plastic wrap against dough and refrigerate for 24 to 36 hours. Dough may be used in batches, and can be refrigerated for up to 72 hours.

3. When ready to bake, preheat oven to 350 degrees. Line a baking sheet with parchment paper or a nonstick baking mat. Set aside.

4. Scoop 6 3 1/2-ounce mounds of dough (the size of generous golf balls) onto baking sheet, making sure to turn horizontally any chocolate pieces that are poking up; it will make for a more attractive cookie. Sprinkle lightly with sea salt and bake until golden brown but still soft, 18 to 20 minutes. Transfer sheet to a wire rack for 10 minutes, then slip cookies onto another rack to cool a bit more. Repeat with remaining dough, or reserve dough, refrigerated, for baking remaining batches the next day. Eat warm, with a big napkin.

Yield: 1 1/2 dozen 5-inch cookies.

Note: Disks are sold at Jacques Torres Chocolate; Valrhona fèves, oval-shaped chocolate pieces, are at Whole Foods.

Sunday, March 20, 2011

Honesty, or Strapping on My Skis

This past January, when I was about five weeks unknowingly pregnant, I went skiing for the first time ever.

My boyfriend's mother, her good friend, my boyfriend and I all traveled up north to some relatively tame slopes where I had three days to learn the skills and then embrace the slopes. I loved it.

I loved that I could learn something new and challenge myself. I loved feeling out of control and IN CONTROL at the same time. I loved that I could go from feeling like the slopes were scary to feeling like I could manage them, even have a blast on them.

When I returned from my trip, I had an appointment with my awesome therapist where we talked about how much I had loved skiing, feeling active and how in touch with my feelings I had been recently.

Here's my problem: I have a hard time being honest with myself about what I feel, and thus, I can't really be honest with the people in my life about my feelings or what I need from my relationships with them. I desperately want everything to be "okay," so I instead push down the feelings I would rather not have. This, of course, leads to problems: blow-ups with my boyfriend, resentment toward my parents, frustration with my friends... Honesty with myself about my feelings is something I have been working very hard on for the last several months.

Toward the end of our session, my therapist drew an analogy for me that I found inspirational, and that I've tried to adhere to since.

I should approach life like the difficult runs I experienced on some slopes. It's fun, it's fast, and there will be obstacles (patches of ice, unruly snowboarders, unplanned pregnancies...) along the way. If I keep my skis beneath me and stay aware of how I feel on them, I can gracefully handle each obstacle I encounter. A small adjustment here, a small movement there, and I can move effortlessly between these obstacles. But if I try to avoid or ignore the obstacle, I'll lose control. I might not fall right that very moment, but chances are pretty good that I will be flat out on my ass within seconds.

So instead of trying to ignore the things that upset me that I wish didn't, I am trying to be present and honest with my feelings. It's difficult. Especially now.

Right now I wish so badly that I just felt free and excited not to be pregnant. But I'm not just free or excited. I'm also sad and frustrated and scared. It occurred to me today, while reading what I wrote last night, that I was trying to ignore those less pleasant feelings. (Funny how keeping a blog can keep you accountable!)

In my update yesterday when I referred to my breasts' leaking as "annoying," I didn't really mean annoying. I mean that it's upsetting.

It's upsetting because I see and feel that change in my body, and I think about what it would be like to have a baby attached to my breast, to have that leaking milk feed and nurture the potential life that might have been realized. But when I think about that, I cry.

Ignoring that feeling, skipping the crying, was easier yesterday. I know that ignoring that sadness, denying its presence, would only create problems for me down the road. I also don't plan to relish in pain or sadness and torture myself either.

Instead, I will acknowledge the upset, stay present with it, and then let it go. I can glide past it--with perhaps a little bump or cry along the way--all while standing and secure on those skis, headed to the next exciting part of my journey.

Saturday, March 19, 2011

Recovery and returning to the swing of things

Today was busy. My boyfriend has come down with a bad sore throat, so I took up the reins of comfort today by making him a throat coat and pancakes this morning. We both subsequently fell asleep for a couple hour nap. (I seem to be able to nap a lot these days...)

I had an appointment with my therapist and spent my remaining afternoon and evening running errands and making chicken wild rice soup. I found myself carrying some heavy bags, and I think I now understand why I'm not supposed to: some bad cramping, more bleeding than I've had.

I took the advice of some support sites online and rested the rest of the evening with my heating pad on and my feet up. I noticed more breast milk leakage tonight, which is annoying. But despite all my running around this afternoon and evening, I took only one 600 mg Motrin today and felt a-okay!

I'm looking forward to returning to my normal schedule. Today felt good to take care of someone else, but now I'm zapped. Pulling myself into bed as I type...

Friday, March 18, 2011

Unpleasant Questions and Personal Truths

"What do they do with it, you know, afterward?"

My friend asked the question after I'd talked at length about the procedure. She'd asked me lots of questions throughout my story, throughout the last two weeks. She even rubbed my swollen belly. "Careful. It's contagious," I warned her.

But this was the first question she asked me that threw me, unsettled me, and my answer got caught in my throat for a second.

"Oh, uh," I struggled, my energy suddenly drained from me. "They incinerate it."


"Yeah," I was quiet for a second. "I had actually forgotten all about that, but the nurse told my boyfriend and I just before the laminaria insertion. It was surprising."

"Wow." She sounded stunned, but in a very removed and clinical way. "I've always wondered, you know. I mean, the hospital must go through so much human bio-waste. What do they do with all of it?"

And off she went, chattering without thinking about all the things a hospital must get rid of in a day: kidneys, appendixes, aborted fetuses... I felt sick to my stomach.

I didn't tell her straight up that it was a painful question or that I didn't want to talk about it. I just tried to segue us back into the story of the procedure.

"Well, I do remember thinking when I came to in the operating room--I could hear all these things being thrown away and gloves being taken off and stuff like that. And I thought, I wonder if any of those sounds are the... you know," I said. "But I was back under really quickly, and when I woke again, I was in my recovery room, and then..."

I continued rattling on just to get past the moment. But it stuck with me.

After she left, it kept coming to mind. Laying in bed last night, I brought it up to my boyfriend. He got upset. "Why would she ask such a stupid thing like that? What was she thinking?"

Honestly, I don't know. This is one of my best girl friends--the only girl friend who I told about my pregnancy and abortion.

I know she didn't mean to hurt me. She's had all sorts of clinical questions about the entire process, as she's never had an abortion, and I'm a very candid person. She wanted to know if I felt different knowing I was pregnant. She wanted to know if it felt "like something had gone on down there" after the laminaria insertion. She wanted to know if I "felt hollow" after the evacuation.

I've answered all these questions relatively unemotionally and openly. I think it appears that I'm handling everything really, really well. I think that she didn't even think about how her question might affect me because I appear, on the surface, very unaffected in general.

And while I haven't and don't have any regrets, I was feeling relatively unaffected until last night when my friend asked that question. Today, I am really sad. I feel loss and grief in a more acute way that I haven't felt since I was ambivalent about my decision.

When I started this blog, the subhead didn't mention abortion. It simply said: "A pro-choice blog chronicling an unplanned pregnancy." I was confused, upset and unsure I could choose to terminate a second trimester pregnancy. I actually don't remember at what point I added "and its abortion," but I did add it. After talking with many support people and weighing endless considerations for myself and my future children, I decided that terminating this pregnancy was the right choice.

I do feel loss, but I am not and will not be unhappy. My choice was right for me, my partner and the potential life I carried for 14 weeks. I am grateful to be 26, unmarried and without children, paving a life path that is right for me and that will allow me to flourish as a woman and, one day, a mother.