Next on Lifetime....

January 2nd, 2011

Tonight is my first night back to work---almost exactly 96 hours from the time I arrived in the ED of West Allis Memorial Hospital presenting with complaints of sudden onset right lower quadrant pain for the past hour that was described as sharp, constant, stabbing, and rated as a 4 out of 10 on the pain scale. Nothing made it better or worse; it was just there.

Three hours prior I had been told by Susan, RN at the fertility clinic I went to, that my HCG level had gone up slightly and my progesterone level had dropped significantly. She had talked with doctor on call about this; they suspected an ectopic pregnancy. Did I have any pain? How was my bleeding?

I was kinda crampy, but nothing major and the bleeding had picked up, but not saturating a pad or anything...I knew I was miscarrying, but an ectopic?

I was instructed to come in for an ultrasound the following morning at 8:15 a.m. unless I experienced any pain that night. Then I was to go to the emergency department.

Dr. W would come in for me, right? I wouldn't have to deal with whoever was the ER ob/gyn on call for the night?

No, Dr. W would come in.

Ok. Holy shit.

I had accepted that I was pregnant again with a pregnancy that I was going to lose. 

I had continued to spot and now the spotting was heavier and those stories about women who spot/bleed their entire pregnancies--no way was I one of those. I knew I was going to lose this pregnancy-but a friggin' ectopic! 

Are you kidding me? Seriously? How can someone go through FIVE pregnancy losses and the last one is a potentially life threatening ectopic? This cannot be happening.

It can't be happening.

It's too much.

It's too much for one person to endure.

It's unbelievable.

unbelievable.

Like Lifetime movie unbelievable. 

Alright. Well, I'm bleeding...so, it's probably already started to pass, right? I'll just need an injection of methotrexate and it will finish passing and it will be okay. It will just be a complicated miscarriage. 

I'm going to the grocery store. I'm going to get something for dinner. Watch a movie. Lay low and worry about my ultrasound tomorrow morning. I'll call and text my girlfriends and be okay.

Driving to the grocery store: I feel some right sided cramping, like ovarian cramping--I get it all the time. No big deal, it's the luteal cyst---nothing to worry about. Right? nothing to worry about. You are being paranoid, MaryAnne. Paranoid. Don't be that way...it's fine.

I call my friend, Shelby, who just so happens to be a midwife and a brainiac--she'll triage me and make me feel better. I tell her what's going on. 

"Oh my God, MaryAnne. Are you having pain?"

"No, just kinda cramping. I think I'm overanalyzing everything. I'm being paranoid."

"MaryAnne, you so much as feel cramping and you go in. Stop being the provider and start being the patient."

"Really?"

"Yes. Really. Go in."

"Okay. I'm going in."

"Good. Let me know what happens."

So, I put on my creme-to-powder foundation and some mascara and I drive myself to the ED.

One litany of questions and a pelvic exam later, I am being wheeled down to the Radiology Department for an ultrasound.

The ultrasound tech is sweet and chatty especially after she finds out what I'm a midwife.  She "just knew" it was something in healthcare. "You can always tell when people know things."

And that began the pleasant conversation about birth and midwifery. Until she got to the internal exam of my right fallopian tube and ovary.

"Now, how did they know it was the right side?"

"They didn't. I knew. I have pain on that side."

"Okay. You're doing great."

And that ended the pleasant conversation about birth and midwifery.

It was a LONG ultrasound exam.

Back to the ER.

ED RN checks in.

ED doctor checks in.

"It will be about 30 minutes until the ultrasound is read."

....

5 minutes later.

It's back. It's ectopic. It's in the right fallopian tube. It hasn't ruptured. It has a heartbeat.

"Well, that's what I expected. I knew it was an ectopic....Wait. It has a heartbeat?"

"We're going to start an IV. This will be surgical. I'm sorry."

"Fuck."

"I'm sorry.--Fuck."

"I'm going to call my husband."

"That's a good idea."

And I do. And I call Julie. And they come. And I cry. And my ED nurse hugs me. And she's awesome. And my ED doctor says she is so sorry. She is awesome. And then my surgeon comes in. And he's so nice.

"You'll try to save my tube."

"Yes."

Approximately 3 hours later I am in post-op.

"Did he take my tube?"

"Let me check. Not the whole thing. Just the distal portion."

SERIOUSLY? Who answers like that? What the hell am I going to do with a PORTION of a fallopian tube. 

"Ok."

"How's your pain?"

"An 8."

I need more drugs....