Friday, November 19, 2010

post m/c follow-up appointment

so i had my follow up this morning. it will be two weeks since i passed the tissue tomorrow and my hpts are still positive so my midwife wanted me to come in so we could make sure everything is ok.

i was kind of afraid i was going to leave the office a total crying disaster. when i walked into the office and checked in with the receptionist, she pulled out my file, opened it and said "second trimester already! wow! any major changes since your last visit?" i was able to mutter "um yeah, i had a miscarriage..." before i had to hide my face so she wouldn't see my eyes fill up.

then, added to that, i was sort of nervous about seeing my midwife. she and i had only met in person once and then when i started losing the baby we talked constantly, she was calling me twice a day just to check in and i did a lot of weeping and sobbing and venting over the phone to her. so i was kind of nervous to see her after all that. but, seriously, i shouldn't have been. she is just amazing. she gave me the first appt slot of the day (7AM) so i wouldn't have to see any preggos on the way in. then when she came into the room she immediately gave me this huge huge and said she was so happy to see me and she was so proud of me. it was nice to be called "brave" when i've been feeling so crumbled. she kept saying "i can't believe you've gone through all this with your first pregnancy, you're so brave. i'm so proud of you." it was so comforting to hear. and we both started crying when i talked about everything that happened. i've never had a doctor cry with me before.

she asked me how my husband was and how our marriage is and if i wanted to talk about trying again (i did). i think this is the main difference between a doctor and a midwife, no doctor would ever talk like this. it was almost like a therapy session. i could tell that she really cared about me.

i had a manual pelvic exam to make sure my cervix had closed back up and she felt for my uterus and ovaries to make sure everything was back in place and in good order. i also was asked to take a urine pregnancy test, which came up negative even though i peed on a FRER yesterday morning and it was positive. so it looks like my hcg has gone down a lot, which i'm happy about.

we talked about my pre-miscarriage pregnancy screening results. my TSH (thyroid) was great at only 2 (anything under 3 is optimal) my gestational diabetes number was 64 (i think 130 is the maximum) all my screens and cultures came back great. everything was great and going smoothly. she recommended i wait for 2 normal periods before trying again. she said she never wanted to see this happen to me again and i needed to give my uterus time to recuperate (when you're pregs your uterus swells and then it shrinks back down when you lose it and shed all the lining, so one cycle is asking a lot to make your uterus swell, shrink, shed, build back up, and then swell again- and in 30 days, to boot!) it made sense. i didn't tell her that we've been trying since about a week after the loss. we decided after this appointment to put TTC on the back burner til i get better.

the best part was when she totally validated what i assumed all along- that exercising hastened the loss. ok, wait, let me back up. i told her that we'd been TTC for 2 years. 2 years in which i went to the gym religiously 4-5 days a week and did stairmaster, elliptical, and weights. then in august we missed going for about a month (we had a TON going on and were traveling) and that is the month i ended up conceiving. then i was so nervous in the beginning of my pregnancy that i still didn't work out. at 6w2d i had an ultrasound and a blood draw, the baby looked great, had a heartbeat, and my hcg was 10,000. i felt more comfortable and went back to the gym. the night after i worked out (and i wrote a journal about this, so you can look back and verify) i had horrible cramping down the middle of my pelvis. the radiology report says the embryo never developed past 7 weeks. so i asked her, is it possible that i over extended myself?

"ok" she said, "i'm going to level with you since you don't look suicidal and i think you're doing well emotionally and not blaming yourself. in a good pregnancy, nothing you do is going to harm the baby. BUT in a delicate pregnancy, that may be already doomed to fail, YES, exercise can hasten the demise of the embryo."

exactly what i thought. i get it, believe me, i'm not blaming myself, but i *know* something happened that night, i know that's when the pregnancy ended. it was nice to feel validated in that respect. i know a failing pregnancy is going to fail no matter what, and a healthy pregnancy is going to continue no matter what. but it made me feel less crazy.

we had a long talk about nutrition, and taking care of myself emotionally, and how long i should wait before going back to the RE for more assisted reproductive technology. it was a great appointment. i'm so glad i got that out of the way. i almost can't wait to get pregnant again so i can see my amazing midwife more. now, how do i get around the other 7 midwives in the practice and just keep going to this one...

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