Feb 11, 2011

Clear(ish) Skies at the End(ish) of the Road.

Don't you just love it when the title and the first photo of a post match perfectly?

This post is an update and I hope the conclusion to what I talked about here.  It contains references to medical treatments, pregnancy loss and my personal thoughts as a patient.  If any of these may be upsetting to you then you may wish to ignore this post.

As it turned out, more than a cup of tea was needed for my trying time.  The miscarriage ended up being an ectopic pregnancy and I had to make a decision for myself as to how it should be treated.  That's right.  No being told what the 'best option' was and 'what we suggest is this' but 'it's your decision to make'.  The blood tests and my rudely good health meant that I was suitable for either medical treatment with methotrexate or a laporoscopy and salpingectomy.

Despite 2 weeks of knowing that I wasn't pregnant in a healthy way, being told what I knew and the options that I had researched thoroughly on my own, it was still a mind numbing shock to be told as much by the specialist sitting across the desk from me.  I froze, I cried and my mind flew from one option to the other, desperate to make a decision and get on with it.  Whatever it may be.  Thankfully, common sense prevailed.  Everyone (but me) in the room could see that I was in no state to make a decision.  I was sent home to ponder my options with the advice to call back when I had decided.  It was the best thing to happen on Wednesday February 3 2011.

The Early Pregnancy Clinic is staffed by friendly and caring staff who are tactful, make no judgements and chirpy when it counts. They get on with their jobs to ensure that their patients in their varying levels of happiness, anxiety and fear obtain the treatment and attention they deserve in as timely a manner that a busy hospital with its tendency to unpredictability and unforeseen circumstances can manage.

Being in the Early Pregnancy Clinic when you're looking at management options for a desperately wanted but nonviable pregnancy is challenging.  You enter the general waiting room filled with proud bumps and waddling women with your flat stomach (relatively) and sprightly gait.  It's hard to know where to look and how to assemble your face.  Then, after being processed and getting your blood tests done, it's off to the designated waiting area for the Early Pregnants.

The atmosphere is different here.  We avoid eye contact with each other.  But there are small, encouraging smiles if we do catch each others' eyes.  This is not the time for small talk more probing than one of the male partners standing to offer their seat to a new patient that enters the room or to offer to go off and buy coffee for their other half.

There are some for whom a viable pregnancy has come at a terrible time and that termination is the best option for both mother and child.  The loss will not be forgotten but at the same time the mother and her partner had a 'real' choice to make.  Then there are those who know that they are there for only one reason.  To safely end a pregnancy that had no chance to begin with.  In the emotionally charged walls of this waiting room, how easy it is for one to judge and envy the other.

Time seems to have stood still in life outside of The Ectopic Pregnancy.  Making an extrapolation from my efforts at making my own medical decisions, I decided to take a few days off work.  It seems like I've been in pregnancy limbo for weeks and weeks.  The once in a century Sydney heat wave may have contributed to this feeling.

My decision was made after a few calming hours on my sofa at home.  I would have methotrexate.  I felt stronger, clearer and more positive the moment I decided.  I had so much written information from a good range of sources, I felt fully prepared for what to expect and how long it would take to 'get back to normal'.

Because methotrexate is a cytotoxic agent, it must be administered in Australia under the guidance of an oncologist in a chemotherapy unit.  I discover another specialist unit of what is now 'my hospital'.

My appointment is on a Friday afternoon.  It's the height of summer and I'm sporting a tan from all the incidental sun exposure the average person gets when they live in Sydney.  It is hard not to feel a fraud and also slightly anxious as I walk down the corridor to the cancer unit.  The waiting room isn't full.  It's brightly lit and airy.  The people sitting around me are bright eyed and relaxed.  I'm here for a dose of relatively safe medication for a condition from which I will make a full physical recovery without the fear of recurrence or metastasis.  Yet I am the most pensive person in the room.

I need to get weighed and have my height checked so that my dosage can be calculated.  I'm not too rattled to consider whether I should ask that my weight be knocked down a kilo or two to take into account my jeans and belt.  The scales in hospitals always lie, I swear they're too sensitive and pick up movement as an extra kilo or two.  But I forgo the hospital twin packs of Arnott's biscuits at the patient tea and coffee station all the same.

It's time to meet my oncologist.  The door shuts and I become the patient who just happens to have read all the evidence based medical guidelines and latest literature reviews but still has to ask questions like 'will it work for me?', 'when can we start trying again?', 'what foods can I eat?' and 'can I still keep on doing my normal daily activities?'.

Then it's time for my injection.  It's a short walk to the chemo suite where I'm greeted by a room full of comfy easy chairs and brightly chattering and smiling nurses.  Patients and their support people sit quietly leafing through the paper or chatting to each other.

My treatment doesn't take enough time to require my settling down into an easy chair.  So Mr SSG nabs one of the empty ones on my behalf while I get my injection in the treatment bay.

We're now in real time.  Time seems to have slowed or else I've been going to hospital to get blood tests at the crack of dawn before work for my entire life....   It's difficult to know which is the truer observation.

It's been a week since the methotrexate.  Some good shopping has gone down. I've been to work every day this week.  I've been a bit tired, my eyes are dry (I knew I'd get my money's worth out of those new specs) but on paper, all my vital organs survived unscathed.  In the commotion of daily life and being watchful for potential drug side effects, I haven't really had space in my thoughts to revisit the emotions I had in that first week.  There have been many blessings in disguises over the last few weeks. 

I've titled this post indecisively because I really have been in limbo even until today.  Wouldn't you know it?  My results today fell in the grey area of needing a further dose of methotrexate or being left alone.  We decided to go for it.  Physically and emotionally, I really need this loss to declare itself sooner rather than later (more indecision there).  There's a 99% chance this will be it.  No more trips to the chemotherapy suite. 

So, I'm being the optimist.  Today is the start of my 3 months or so of being kind to myself and really appreciating what I have before me.  Life really is to short and uncertain to live otherwise.

I've assembled my 3 piece emotional toolkit (the fewer items the better, I'm trying to keep things simple) to get me through the weeks and months that lie ahead:
- I'm going to feel every emotion I need to and not push it away because it seems selfish or wrong.  It's there and it's got to run its course eventually
- knowing that taking a little time out every now and then accompanied by a few deep breaths of air is much more beneficial than getting teary, anxious and exasperated 'with everything'
- I'm taking stock of what I have each day and making a commitment to not lose sight of these people and things no matter what the future holds.

And that, for the moment, will be all there is to it.


  1. Dear SSG

    Huge massive hugs, I am sorry you have had to go through such a heartbreaking experience. Feel better and stay positive.
    Thinking of you

  2. what a moving post. i have had two miscarriages, both followed by d&c. i only had to cope with the loss, with none of the decisions you have had to make. look after yourself xx

  3. The Distressed Mother: I've come to the conclusion that there is so much to cope with in any pregnancy that ends in loss. There doesn't seem to be an 'only' because there are so many emotions to contend with and each situation is different. I'm so sorry you've also had to deal with this. Take care, xxx.

    Nic: Thank you, hun. Hope all coming together for you and L.

    AFW: Thank you as always.

    SSG xxx

  4. Oh darling, all my love to you! I have patients that are on Methotrexate for other reasons and they respond to it very well. Thinking of you. ♥

  5. Sending you lots of love SSG and positive thoughts.... you are very brave. This is a courageous post and informative too - I had no idea there were these decisions to be made and how hard it must have been to know what to do for the best. I am sure that there will be lots of sunlight at the end of the tunnel though.....XXX

  6. It's not easy is it. No matter which way you choose to go with treatment the numbness is the same. My situation was the same as yours and I opted for Laparoscopic surgery. And I can share your feelings of being in the ob's waiting room full of large bellies and feeling gutted. However the weird thing is that at the time I didn't realise just how common it was. And I bet if I surveyed the pregnant women in the room, many would have been through the same thing before going on to have a successful pregnancy. I know this time sucks for you and it is easy for those of us who have been through it to say "You wait and see. You'll get through this and go on to have a healthy baby". Right now it just sounds hollow and I remember being told the same thing and never believing it. Even now typing this I have tears in my eyes. You never forget the loss and grieving is part of the process. Hold onto each other and try to stay strong. Cry and feel angry if you need to. And reach out to others like this as much as you want. xx

  7. SSG, I'm thinking of you. A long time ago, I also had an ectopic pregnancy. It was a horrible time but I was very quiet about it. I now have three adult children,and recently in the course of a discussion, I told my children the story about the ectopic pregnancy. My husband commented that he had totally forgotten the whole event as I had acted so calmly at the time. My two daughters started to cry as they knew instinctively that I had hidden all my feelings and pain.So my suggestion is to share all your feelings with Mr. SSG and never feel that you have to be brave or stoic or quiet. xxx

  8. Oh I've just read the comment of The Real Housewife of Sydney. Well said.

  9. I'm so sorry for your loss! Losing a premature child myself many years ago (and thus being unable to have children since) I can somehow relate to this post, and my heart bleeds for you. Take care and be brave, and don't forget all the other good things in life. xxx

  10. Kate, I agree re Real Housewife.
    Mine were nearly 18-20 years ago, but each year at the time that would have been their birth, I think of what might have been. When I celebrate an occasion, I wonder who might have been with us to celebrate. As time goes on, it is not as devastating, but it never truly disappears.
    I now have two beautiful children that I am eternally grateful for. One has a disability that makes life, at times, seemingly impossible. But I would never have it any other way.

  11. SSG I hope that 3 months of kindness to yourself will be filled to the brim with lovely gestures and wonderfully nurturing tonics...take care.
    Hugs from the Hostess

  12. Wow. thanks so much for sharing. That's a lot to got through. Your emotional toolbox is a good one. Hang in there SSG. Thinking of you lots.

  13. Thank you all for your support and willingness to share your own highly private thoughts and experiences with me.

    SSG xxx

  14. SSG, I totally feel for you. I have had two ectopic pregnancies and was not given the methotrexate option either time, so lost both tubes. One was a planned pregnancy; the other was a compete surprise, but we were over the moon at the prospect of another baby. Wishing you a very healing time.

  15. Dear SSG,
    Thank you so much for sharing your deeply personal and poignant story with us all. The loss of a baby no matter when is a deeply sad thing and it is so important that you allow yourself to grieve.
    Thankfully we are now in a time that we can support woman and allow them to be open with their loss no matter how early on in the pregnancy. I am reminded of my own mother's life long grief for her stillborn twins that she was never able to acknowledge, and how shocked I was to find out of this tragedy as an adult.
    Take care of yourself in all ways. It sounds like Mr SSG is being wonderfully supportive and together you can heal from this hurt.
    Kate Bx

  16. Dear SSG. I am so sorry. My sister had this experience, in her case after several rounds of IVF. I remember crying on the phone as we talked, and going to visit her after the procedure. It's not trivial, not routine. ((((hugs))))

  17. I am really sorry SSG for what you are going through. I wish I knew at least a little bit what its like, but I've never tried to get pregnant or wanted a child....I have though experienced loss and know what horrible pain that brings.

    I was worried about you when you mentioned going to the cancer ward to get this drug methtrexate administered. I googled it so I'd understand. I'm hoping the side effects haven't been too bad. I admire you going to work in the midst of all this....you're one tough cookie.

    I'm glad you are allowing yourself to feel everything and not avoiding the emotions...its the quickest way to heal.

    Hang in there.

    Christine ;)

  18. Hi girl...
    Yet another wonderful post, and the loved the start:)

    Have a great weekend...

  19. How I missed this post is beyond me, but I am so glad you used it for the rewind. Touching. Heartbreaking. Honest. And clear.

    I loved it. Or more accurately, it touched me. And I love it for that. It moved me.

    Hugs xox

  20. I'm so sorry. :( I've been through 3 very different miscarriages - and they are all horrible in their own way. I hope that the grief lessens (or is starting to, I know this post was a little while ago) and is not so raw. A part of this loss will always remain, of course.

    Best wishes..this was an incredibly touching post.

  21. Hello SSG, I dont' think I've ever visited you and for that, I'm really sorry. How poignant to visit via the Fibro today and discover we have the M word in common. I've had 11 now. They are not trivial things by any stretch. I love your resolve to allow your emotions to come up and be there... Yes, they do run their course eventually. I love that you have such great care at 'your hospital' (though I wish you didn't frequent it that often). I hope you're also feeling somewhat more healed, a couple of months on from your trying ordeal. I'm so sorry you had to make this choice xxoo

  22. What a terrible time you've had. I learned a lot from this post. I've had my own experience of miscarriage - so many women have - and I think your resolve to take care of yourself is a good one. I hope that you are still doing so.

    Thanks for Rewinding at the Fibro.

  23. I'm so sorry you're going through this. I have nothing to add, but my support. I'll be thinking of you.

  24. That was so well written, I felt I was there with you in that waiting room and the chemo unit. It would have been a very emotionally draining time for you. I hope that things have improved for you since then..


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