I’ve been bleeding for four days now

It was starting to taper off after the second day and then I may have indulged in some activities that equivalate to what landed me in this unplanned position in the first place. So the next day it was a bit heavier and brighter, but after some more health-professional driven research I noted that that can be pretty normal too. I re-booked my ultrasound to occur earlier because who wouldn’t be a bit worried now and I just needed some confirmation and reassurance. But it’s still two days away. By the fourth day of bleeding it’s heavier – which it shouldn’t be if it was only coitus-related and there were clots.

Red flags for miscarriage include (from emedicine.medscape.com):

• Lower back or abdominal pain – worse than normal period cramps
• Bleeding more severe then a normal period
• Clots or tissue

I’ve been thinking about it all morning during the ward round (the round of the patients who were admitted to the hospital the previous day, plus some old ones still under our care, in the company of the boss, the senior doctor, and myself – the junior). I went to the toilet following the round and there was still blood

I start panicking at work. I have no idea what to do. Is it appropriate for me to just go to the ED? Is that an ED issue? Is it more appropriate to see my GP who is 40 minutes away? I can’t concentrate on what I’m supposed to be doing. I’m trying to write discharge summaries so patients have the correct instructions to go home with and I’ve still got to call a specialty doctor for advice about a particular patients’ management plan. I go to the toilet again and there’s clots now.

Crap, crap, crap

I can’t talk to anyone. Who am I supposed to talk to? I don’t interact with anyone outside of work and I enjoy the company of all the doctors I work with but they are busy doing things for their patients and this is super personal. I can’t burden another like this. But I also can’t just break down and not do anything – I can’t even leave this toilet without being seen by someone. I txt my registrar (the senior doctor) asking her if she’s free and she calls me in the middle of her lunch time meeting because she probably thinks it’s about a patient. Crap. I try to tell her; I just need her help with something when she’s free but like a silly sausage I break down on the phone and can’t talk properly. She just asks where I am and tells me she’s coming. She still doesn’t know what’s wrong so she’s probably a bit freaked that it’s something really serious. This is kind of serious?

I explain what’s happening. She talks to the gynae registrar (vagina doctor) who sees the admissions from ED and they organise a single room bed for me in ED for a work-up.

Crap.

I’m calmer now because there’s action. There’s a plan in place, things are being done. In a few minutes or hours (depending on how busy the staff are) I’ll know what’s happening. I’ll know if I really am just being a silly sausage and then I can feel (blessedly) embarrassed or I’ll know if it’s something more and my reaction has been understandable. I don’t want to think about the possibilities right now because otherwise I’ll crack so I ignore it, but in the back of my head, I know the likelihood is high.

The ED doctor tells me my beta-HCG (hormone that’s secreted in pregnancy and is what the standard pregnancy test is based off) is lower than expected for the number of weeks I should be. The probability is 99% (I avoid thinking the word miscarriage because I can’t think that right now).

I’ve told my partner not to come from work yet. He’s not quite finished and it’d be a 40 min – 1 hour drive through traffic regardless of the time he leaves at this stage. There’s no point in him coming all the way out here if it is nothing (I’m based at North Shore Hospital in Auckland), but if it is something at least he can bring me clothes once he finishes. I tell the ED doctor I don’t need to wait for him before she does the bedside ultrasound. The results of this will decide the next step.

The foetus is smaller than expected she says. She doesn’t specifically say there’s no heart beat but that’s what I’m looking for and I can’t see it. She says they’ll still need a formal ultrasound to be certain but given my low beta-HCG and her preliminary ultrasound findings I have most likely have miscarried.

Ah. . . not a silly sausage then. That’s good to know. Unfortunately, it’s not the blessedly embarrassed scenario. I’m looking at the ceiling without seeing it and although I have tears streaming down the sides of my face and my hands are tightly clasped to turn them white on my belly my voice is strong when I answer her gentle statement about the plan and thank her for her help. It’s not till she leaves that I crack.

I’d txted my mum earlier to give her a heads up that I was in hospital and to lay the foundation for bad news if it happened. She had replied with positive affirmations at the time, and it was awful to have to break the news to her that she wasn’t going to be a grandmother. I’d txt her again first saying “bad news” and to let me know when to call. I think a quick txt saying “bad news!” is a nicer segway into a bad conversation because it allows people to prepare for the possibility – slightly diminishing their hope before crushing them rather than just outright crushing them without warning – it’s like the light house warning boats about rocks, you crashed but the light house did warn you so you can’t be as upset about it. . . not really the same scenario I guess. I call my mum and she’s in the bathroom. I can tell from the echo, and I know that the fierce, stoic woman who pretty much never cries (and used to beat up boys that picked on her younger sister), is crying. For my other family, I say the actual words in a txt (but also get them to let me know when they are free for a call) because this way they know exactly what’s happening before the call and they’ve had the opportunity to break down in private and piece themselves together. This then allows them to feel like they’ve been able to offer some measure of comfort at having supported me because they haven’t been completely wild on the phone. It also mean I don’t have to relive my own heartbreak through them over and over again

My partner arrives just in time for my ultrasound. I know the hospital so I can easily direct him over the phone where to go. He left straight after work near central Auckland, shot home out West to grab clothes, chargers etc. (because we don’t know how long we’ll be here) and then headed north in peak traffic.

Confirmed miscarriage at 12+6 weeks.