the d&c

I has my D&C done this morning, and I am home and resting(ish). I was really nervous and a little scared because I haven’t been put under anesthesia is over 20 years, but also because I didn’t really know what to expect, so I wanted to write about my experience here in case it helps anyone else if they ever need this procedure.

Last week I had to repeat some bloodwork to check my hcg levels and also get a CBC for pre-op. The CBC has to be within the last 30 days, and the beta was to see if my numbers were falling (I found out today they were, down in the one-thousands from the twos a week prior.) I was scheduled for 7:45am so I had to arrive at 6:45am, and I couldn’t have anything to eat or drink after midnight. I did cheat and had some water in the middle of the night and also when I woke up, but I didn’t tell them that. Also the night before I would look at the clock and think “In 12 hours this will be over” every couple of hours and that helped me not be too upset and nervous all night.

My friend picked me up at 6am to drive me, and thankfully she just talked to me about random stuff on the way so I didn’t have time to think too much or get in my head and be nervous. My tummy was nervous so I found a bathroom when we got there right away before checking in.

When I arrived I checked in and after a few minutes met with registration to verify all my info and sign the billing forms. After that my friend and I sat and talked for a few minutes but my nervous tummy made me find  the bathroom again. When I got back the pre-op nurse was collecting my friend’s information, and she took me to the back to have me change. I had to take off everything but because I was spotting I could leave my undies on for now. They made me put on compression stockings and footies. When I first was left alone to change I started to get a little freaked out and panicked and started to cry, but I made myself get undressed and just do this.

When I came out the nurse wanted to check my blood pressure, temperature, start an IV, and lots of questions on the computer. I told her I was very nervous, and she was so kind asking me questions about what happened and showing genuine care and concern and telling me how sorry she was. She mentioned I was posted for general anesthesia where you have to be intubated, and I kind of freaked out and she said “You don’t want that” and I told her No, that’s not what I thought I was going to get, I thought I was getting Twilight (IV sedation) and she assured me I could talk to the anesthesiologist shortly and not to worry. I also asked about the level of pain afterward and was assured it should be minimal, like period cramps, since I was already in the process of miscarriage, meaning my cervix was already open and I had passed a lot of tissue myself already. She couldn’t get an IV to work in my left hand so she got another nurse to try while she finished questioning me and straightening out my meds listened in the computer. Somehow the pain meds and other stuff I was given after my last C-section during my hospital stay was listed as drugs I currently take, so it looked like I had a pain-meds habit HAH so we had to adjust all of that.

The OB resident came in to explain the procedure and risks, and I was asked if I was OK with receiving blood products if they were needed (unlikely, but still) I signed all the consents. I also spoke to the nurse and my doctor that while I didn’t have a written advanced directive, my husband and I had a verbal one so that if something happened they needed to call him because he knows what I would want for my care. This is scary but necessary, and I plan to have it in writing soon. All I will say is do not wait to have one, because if something sudden happens to you, your spouse or next of kin will be asked to make decisions on your care, and that is way too emotional of a time for anyone to be trying to think clearly, and it is a burden on them to decide for you. This prompted a quick recap with my doc about why my husband was at home (GI bug still cycling through the house, 2 others home sick today) and that my friend he was talking to was outside. He also told me all the tissue would be sent to pathology for testing which is routine here, but not necessarily a routine thing everywhere.

My doc came in while Anesthesia was just walking in, and together they clarified (and I overheard) that I would NOT need general anesthesia so I was relieved. The Anesthesiologist took time to listen to my concerns (mainly anxiety and panicked attacks when I get on the OR table) and gave me lots of time for questions and told me I could have whatever drugs I needed to be calm and comfortable. Versed is an anti-anxiety med I have been given before getting a Spinal during my C-section and it is wonderfully calming, and I told him that was my friend for making his job easier and he said he would give that to me.

One thing I want to say here is that anytime you are in a hospital receiving care, it can feel like things just happen to you without you really understanding what is happening or having a choice in it. You almost always have a choice (as long as there is no immediate emergent issue) so ALL of your care providers should talk to you about everything that is/will happen and give you time to ask questions, and they should listen to you if you know there are things you need that work best, ect. If things feel rushed, it is you right to slow things down and ask for a minute to think.

After that they brought my friend in to give me a hug and kiss and take my phone from me and my locker key. I stopped in the bathroom one more time and then we walked to the OR with my doctor, who explained the procedure in medical terms for me (and when he said blade and I grimaced he teased me and said oh gosh, it’s a tiny thing, and I joked that it wasn’t going in his uterus, and I was calm for a second. It was super tiny, not at all like the actual hospital rooms, and my anesthesia doc asked why I had that terrible look in my face, and I kind of bounced on my heals for a few while they got the bed ready and moved my one gown, and got me a bag for my undies I had taken off in the bathroom. As soon as they got me positioned on the table, they gave me an oxygen mask and the Versed and I immediately felt relaxed and shortly after that I was asleep.

I woke up not too much later super groggy for the first few minutes, but I looked over at the anesthesiologist and thanked him for waking me up. They were asking me to move over to the stretcher but I couldn’t figure out which way to go and went the wrong direction, like my brain couldn’t tell my body what to do, I couldn’t figure out what to do. I said “hold on, I feel drunk” and my doctor laughed at me and said “well, you are drunk. When is the last time you drank?” And I told him about the Margaritas my friend and I had Wednesday at our Mexican place, and we talked for a minute about how it was one of the only places open again in this town that flooded recently. It so funny because I had to have sounded like a fruit loop, I don’t know how I formed words because I didn’t feel like I was there at all, I think my eyes were half shut. My nose felt weird and the anesthesia doctor pulled a tube out of my nostril, because I was snoring bad. I told him that I have a deviated septum and I also think I was starting to come down with a cold. I also realized I had a massive headache along the front of my head and the back of my neck. He told me the drugs he gave me (Propofol, Fentanyl, and Toradol) because Propfol wasn’t quite enough to keep me from moving. I have never had Fentanly and it’s strong so I think my headache was from that.

I got in recovery and the nurse gave me a million blankets that I don’t think I needed but I still felt a bit groggy. My mouth was like cotton and I had to pee. She said I could get up soon if I could hold it, and asked if I wanted juice or soda and some crackers. I just wanted water but they like to see you eat something to make sure you don’t vomit. It was seriously the best water I ever had. She brought me Tylenol and oxycodone so I decided to try the crackers but my mouth was so dry it was turning to a super thick, dry goo so I gave up on that. My doctor came in and told me there was still a very tiny sac, but no baby. So either the sac was so small we couldn’t see it on ultrasound, or there were possibly 2 sacs and we missed one on the early scans. He said had I waited it out it would have taken a long time to bleed that all out and a lot of it had just been sitting there. He said my uterus looked good otherwise with no scar tissue and my C-sections scars were in good shape.

A few minutes later they brought my friend back and the nurse got my locker key and I got up and was allowed to get dressed. They made me get in a wheelchair to get there, and told me to keep the compression stockings on for 24 hours, no driving for 24 hours, no lifting anything over 5lbs for 48 hours. They also gave me a preyfor 600mgs Ibuprofen.

Things that are normal are light spotting or bleeding for a few days to 2 weeks and period cramps. Not normal is heavy bleeding, severe pain, not being able to go to the bathroom, nausea and vomiting, foul smelling smelling discharge, or fever.

So afterwards my friend and I got in the car (the nurse wheeled me out and helped me get in and buckled, which felt a bit much) and we stopped at Walmart to get something for my dinner and a few other supplies. She was hungry and convinced me to eat subway with her, then we stopped for Starbucks, and then she wanted to see the Goodwill near my house since I was up for it. I didn’t feel bad, just a little high from the pain meds but other than that I was ok.

It’s been about 8 hours now and I still feel ok, I have a headache and I got a little crampy, but Inteied to lay down and can’t really relax. I already called the office and made my 2 week follow-up appointment and the girl in the office was surprised I was doing so well already. I don’t think I really understood the full-ranging effects of this prolonged miscarriage until now. I feel...relieved. And I feel so cared for, from the nursing staff to my doctor, to my friend. I know they were just doing their jobs, but I work in healthcare and not everyone has great bedside matter or makes you feel safe and loved and listened to.

While I was laying down, my 14 year old daughter came home from school. She had been worried all day, and I didn’t really talk about this with them, because I was so scared myself and didn’t know what it would be like so I felt like I didn’t have anything I could share with them. So she laid with me and I told her everything and what they do and even things she didn’t understand about women exams that it’s all through the vaginau. And I felt really bad that my fear and silence did a disservice to her. I made a mental note to try and better keep my kids informed of things, as much as I may want to shield them from it or not feel the feelings myself.

I still have a headache and feel a bit foggy, so I plan to get to bed early tonight. But overall I feel such relief and healing. Thank you to everyone who has read my words or left comments or emails of support and abiding over these past few weeks. It feel really good to have so much support here when I feel like people on the outside don’t really understand these feelings. While I don’t wish this on anyone, it is comforting to know I am not alone, and haven’t been alone in my feelings or experience, unfortunately.

I have a Day in The Life post all documented I just need to write it up, but I plan to get that posted this week.