Yesterday happened as expected. Dear Leggy, thank you for clinging onto hope, but really there was none. I did have flashes over the last week of thinking we'd go in and there would be our embryo, heart beating away, but they were just flashes and I was fundamentally unsurprised when the sonographer's wanding showed a gestational sac that had started to collapse. It was long and thin like one of the balloons that you use to make balloon animals with. Only not orange or purple or anything. There was no sign of anything in it, the yolk sac from last week had already reabsorbed. The pregnancy had definitely failed. I got her to tell us our hcg result from last week. It was 9,100. Not really what you're looking for at 7w1d. So really, I think we could all have declared this over last week. No matter, this is the life (or not) we got and I'm not going to get angry at anyone after the fact.
We went up to the private ward to get checked in etc for our ERPC. It stands for the Evacuation of the Retained Products of Conception (that link is patient info from another hospital in the UK - best explanation I found through googling). It's supposed to be more gentle than a D&C. Then of course we waited and waited. Turned out Dr Candour was in a consultant's meeting that morning so he didn't show up until 9ish to do our pre-op discussion. That was after the nurse had checked us in. During which she asked me if I was pregnant. Which I thought was a bit of a dumb question. And which, for a change, I actually said to her. Well, what I said was: "That's kind of the point, isn't it?" She had the grace to blush, and said, "Sorry, we have to ask everyone."
We also had a little drama in that it had not occurred to me to contact my health insurance company. After the nurse had found this out, the insurance lady bustled up to my room and told me: "You know you must call them to get pre-authorisation before you come in, this really isn't the right way to do things." Luckily I remembered that in February when the insurance co had authorised the wrong date for my lap we had called them that day and they'd been good at sorting it out, so I pointed this out to her, told her she'd have a letter in the files from them from February with all the contact info on, and that my company has a dedicated line to them so presumably I could call them and we'd get it all sorted. She went off to get the letter and I burst into tears. She didn't come back at any point during the day so I assume she got it sorted. Insurance ladies aren't famous for letting you leave the hospital - or even have the procedure - until you've paid.
When Dr Candour turned up he was his usual calm, kind and reasonable self. Which of course made me cry. He hadn't seen the notes from the clinic so I told him that everything looked bad. He was, of course, not surprised, went through the procedure, the risks etc. The anaesthetist was also very kind. It was the same woman who'd done both of my laps, and she remembered (from the notes presumably) that I had problems with dehydration so she told me to keep drinking water until we had to go for the procedure. Which wasn't until around 11:30. So we waited. At around 11:10 a junior doctor came to tell me she was going to insert a drug which would start to soften the cervix. She was, to put it mildly, cack-handed. That made me cry a bit. After that I started to get mild cramping and at 11:30 they wheeled me down to theatre. In the prep room I started to cry again. Not sobbing, just tears running from my eyes. It just all felt so sad. Although I'd started to give up on this pregnancy two weeks ago, I guess it's not really over til it's over. Dr Candour came out to see me again, and after all the prep I was put under at about 11:40. At 12:15 I was waking up in recovery, and by 12:40 I was back upstairs in the room, and H was there waiting for me.
As always after a general my mouth felt horrible, and no matter how much water I drank it wasn't helping much. The nurses were very sweet to me, and H kept asking if he could get me anything. He was trying to work but gave up and watched the tennis instead after a while. I felt ok, just crampy. They kept giving me painkillers, but told me I had to eat before I could have the good stuff. That was encouragement enough so I ate a sandwich at about 13:30 and got some di-hydro-codeine shortly afterwards. That made me feel a bit better. At this point I wasn't really teary any more. I'm not sure why. Perhaps it was a relief that things were over.
Around 14:45 Dr Candour came to see us. He said that everything had gone well. The uterus wall looked good and smooth afterwards so he was confident I would not need a second ERPC (happens in about 8% of cases). He also said that everything looked very sterile and intact, so he did not think I had suffered from an infection that caused the embryo demise. He had sent samples off for histology and genetic testing. I asked if they really had enough for genetic testing given we couldn't see any embryonic tissue on the scan, and he said he didn't know but it was worth trying (This is where I get a little cross about the delay. Presumably we'd have had more chance of finding something if everything hadn't already deteriorated. Oh well). The histology scan will see if there was a problem with blood clotting etc. He asked us to make an appointment to see him in about 3 weeks, when he'll have all the results back and we can make a forward plan.
I had been freaking out over the last few days about whether I am kidding myself even trying this again. At 39, having been pregnant only once in my life, and then with an embryo that had no chance of developing, I wonder about whether my eggs are just never going to make it. I saw that the chance of genetic abnormalities of the embryo at my age is 1 in 70. That's pretty high. So I asked Dr Candour whether he thought that was our chance, that we've had our pregnancy, it's not worth us trying again. He answered that the fact we got pregnant was definitely a good thing. That what they worry about most is lots of cycles of negatives with no sign of implantation. That it's implantation that is the biggest barrier to successful pregnancy, and one that they can do the least about - and the one they understand the least. So the fact we got implantation this time gets us over a hurdle, and, as far as he is concerned, makes it worth trying again. I can't tell you how much of a relief that was. I know that it is entirely possible that we won't get pregnant again next time, or that if we do, that we may have another miscarriage. I know that. But I want to try again so it matters that the doctor I trust to help us make that decision thinks it's worth it.
We were released at around 1600 with a packet of augmentin - prophylactic antibiotics. Unlike last time, the nurse in charge sent a junior down to the pharmacy to wait for our prescription, and wrote URGENT all over it so we didn't have to wait two hours. That was a relief. H and I got home fast and decided on gazpacho for dinner as it was another horribly hot day, and I thought it might work ok with how horrible my mouth felt. H went off to get the ingredients, and we then chopped and blended together. He did a bit of work and I watched a soppy movie. We had dinner (delicious. First time I've made gazpacho but totally worth it) and watched an episode of ER (not sure that was our best choice, but our next Lost episode is the one where you get the back story of the Mr Eko group and it looked pretty terrifying so I thought probably not my best option).
All evening I was mostly doing ok. Each family member texted me which was nice. I wasn't teary. I felt sad but not bereft. I was bleeding a bit but not too much. Dr Candour told me that a little light bleeding might continue all the way to my next period. Around 10 I went to bed and read some more of my fantastic chick-saga type novel that I'd carefully selected last week. No pregnancies, just lots of family feuding and delicious jewels. Then I slept. With a fan blowing because it was so bloody hot, but I slept and I don't really remember the dreams. I slept a lot better than the previous night when I kept waking up with Imelda Staunton singing into my subconscious "maybe they're really magic, who knows" in my ear (yes, I've been overdosing on Into the Woods).
This morning I woke up sad again, but I do feel ok. I'm not going to work til Thursday, but yet I don't feel ill - not like recovering from a lap when I really needed the time off because I was in pain. I have a few cramps, but Dr Candour told me that was the uterus shrinking itself back and was a good thing. And they're really not bad - not even bad enough to take painkillers any more. I'm bleeding a bit, but nothing major. I'm sad, but it's a dull kind of ache, not the sharp, immediate panicky pain of seeing that ultrasound last week. The kind of ache I'll carry around for some time, I imagine. Dr Candour told me I'd really feel the hcg and progesterone coming down, but other than the sadness and feeling of fragility I'm not noticing anything. Luckily the heat has broken a little, so it won't be too miserable being at home today with no air conditioning. I've got gazpacho for lunch and plenty of work admin to keep me busy if I so desire. Or else that chick-saga to finish.
I'll be ok. I want to get on with further treatment so we can see if we can finally get that baby we're dreaming of. I know I'm going to be sad, and I feel a bit lonely, but I know that that's normal. I don't know how I'm going to manage to cope with work again, but I guess I'll manage that, as well. My first appointment on Thursday morning is to get my annual review feedback. Not sure that was my best option, but it's the only time my evaluator can see me. How much do you bet that at least some of the meeting involves me crying? My evaluator is a sweet, but conservative, Polish man so I'm not sure how well he's going to cope. Poor guy doesn't know what he's got coming.