Having a HSG (hydro-salpingo-gram)

This year we’ve lost three pregnancies – two naturally conceived guys lost between four and five weeks and an embryo from IVF at around five weeks. We’re not 100% sure what defeated our third guy. I’m adamant that it was parvovirus, which I caught the day after (the DAY AFTER, WTF!) we had our successful pregnancy test. I am still really devastated about that. It put me in bed for days with aches and a spectacular rash. But, given our other two losses, moving forward we want to be 100% sure I don’t have an implantation issue.

My gynaecologist had encouraged me to read a medical study earlier in the year. It reported that women with unexplained infertility, particularly endometriosis, experienced impressive implantation results after having an oil based solution”flushed” through their uterus and fallopian tubes. Because at that stage I’d been pregnant six times, and had carried three babies past nine weeks, we didn’t think that implantation was “our issue”. But, I had also had four surgeries, and following my most recent D&E my  lining was completely destroyed. It took months and months to repair. Maybe I had some sort of scarring that was preventing implantation?

I’d tried an HSG once before. It was the single most painful experience of my life. I don’t think I’m exaggerating when I say that (I had a c-section so I’m not sure if giving birth would be as painful!). It had transpired that there was a blockage right in my cervix, so the HSG had failed completely. I’d had surgery for Ashermans since then and hopefully, fingers crossed, there was no further issue. Needless to say though, I was really, really anxious about the pain factor.

I changed into my hospital gown and climbed up onto the doctors table. They have to insert a catheter right through your cervix. It’s entirely undignified (as is basically everything infertility related). Then they blow up a little balloon inside the cervix to hold the catheter and inject the solution. The first three or four times they tried to insert the catheter, it failed. It was beginning to feel a lot like groundhog day.

Then, the doctor suggested a different style of catheter, perhaps I had a curved cervix, she suggested. After a couple of tries, and feeling as though things were looking a bit futile, it suddenly worked. My uterus cramped something unbelievable. Aaaaahhhhhhh!!! The pain was awful. The doctor adjusted it slightly, and suddenly it was still working, but not painful. This might just work!

I didn’t get my hopes up too much, but focussed on each instruction. Suddenly, I was looking at the screen and the fluid was showing in my fallopian tubes and in my uterus. I wondered if that meant everything was alright.

After being told to shower and get dressed, I went and talked to the doctor. She said there was nothing she could see that meant I couldn’t conceive. I was so relieved. I shed a couple of tears. All of a sudden she opened up. She had second infertility as well. Her second child had been conceived through IVF. “People just don’t understand with secondary infertility, do they?” she said. We talked about the pain of secondary infertility, of colleagues asking you why you haven’t had a second child, of desperately wanting a sibling for your one child. She was so kind, and sincere when she said she hoped our turn was coming. It was a really special conversation.

 

 

 

 

 

 

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You think you’re ok. Then…

It has been nearly six months since we ended our last pregnancy. I can’t quite believe it. Yesterday, I messaged a friend to say that I think I have come to accept our situation and have adjusted my expectations. Today, I broke down like a deranged mess in front of a whole toddler gym class when someone asked me how I was.

You see, today is our (latest) baby’s due date.

Today is also the day that I think I have got my period again, after trying so hard to get pregnant last month. This was the first month we have been able to try and get pregnant since we ended our pregnancy. I’ll explain why.

For a few months I had little to no periods, with horrendous abdominal pain. I’d never really experienced period pain before, so I visited a gynaecologist. He wanted to run a few tests to make sure I didn’t have Asherman’s.

We started with a HSG. It’s when a radiologist puts a catheter in your cervix and into your uterus and squirts dye in there that should flow around and show up on a screen. It was at the same hospital that we went to when we ended our pregnancy. That alone was enough to set me off. Then I had to take a pregnancy test. It felt cruel. Then I was back in a hospital gown again. Lying on a table in a brightly lit room again. This time there was no anaesthetic. The pain was excruciating. I honestly can’t remember ever being in so much pain. It was painful because the dye wasn’t going where it was supposed to. It was stuck in the neck of the uterus. I cried so much that day that the radiologist put a note on my report that she thought I needed psychological help. I had Asherman’s.

It was in December last year that I feared I had Asherman’s. I never thought I would be in the same situation again nearly a year later. This time I arrived at a private hospital. I was dressed in a gown again. I was given misoprostol again. I was led into the brightly lit theatre room again. The anaesthetist was there, she held my hand. The operation was a “success” if you put aside the fact I had bad scarring in the neck of my uterus. The gynaecologist said he had divided the scar tissue and we could start trying again immediately. We were so optimistic. It was a rare win for us in the crap of the last two years that we have plodded through.

Now though, as I sit on our couch writing this, I feel like I’ve come down to earth with a thud. We are still on a long road. We’re not even pregnant. If we get pregnant we and our little baby then have 39 weeks to survive, well, 35 if you minus out the first four weeks that you don’t know you’re pregnant. It’s hard to stay positive sometimes.

 

 

 

 

The days after we ended our pregnancy

It has been over three months since I ended my pregnancy. I can say now with hindsight that I have more or less made it through.

The first week was bloody hard. We chose to escape the city and headed to a remote beach a few hours away. During the day we skimmed stones, dawdled on the beach, visited walking tracks and touristy places. In the evenings my husband and I sat with a glass of wine in our hands, often quiet, often upset, talking about how shit life can be across the dinner table. It was a surreal time, it was as though everything slowed down so we could marinate in our sadness.

Being back at work was hard. I went back a week and a day after surgery. The first person I saw from work was in the lift, she asked, “is everything OK with you?” I’d been out of the office for nearly three weeks without much explanation. I thought I would cry then and there. I looked away and said, “yes, fine thanks.” For the first couple of weeks, I was OK maybe one day in three. By OK I mean that I was able to do some work. The other days I stared at the screen, thinking constantly of what had happened. Trying not to cry.

Then I had a meltdown. I was sitting at my desk one Monday and for some reason I was fixated on our loss. I couldn’t think of anything else. I couldn’t look anyone in the eye. I achieved nothing at work. My anxiety grew. I couldn’t continue like this, I had billable hours to meet. My boss would lose his patience and eventually I’d get fired. Surely. I panicked. I decided I needed time out. I didn’t know how much time.

I talked to my husband and my close friends, they told me to be brave and to talk to my boss. So I did. And he was fine with my taking some time out. But then I faltered. It was as though the fact of telling my boss lifted an immense weight off my shoulders and all of a sudden I felt like I was able to keep working. What a mess I was.

And so here I am. I didn’t take any time off after all. I have terrible days filled with anxiety and sadness, and then great days where I feel a bit like the old me. It’s a process  I suppose.

The day of the surgery

We were asked to be at the hospital by 8.30am. We dropped our son at daycare and drove there with the music turned up loud and ragey, each putting on a brave face for the other. We sat in the waiting room and waited for an eternity, well, one and half long hours. It was not the best start to what you anticipate to be one of the worst days of your life. The explanation given to us for the wait was that I was right at the end of the surgery list of 14 women. It seemed to escape the staff that perhaps they could schedule patients to arrive at different times depending on their position in the list. My mind still boggles at how the hospital was prepared to leave  someone about to undergo a significantly traumatic procedure to sit in a waiting room for one and a half hours.

I met the charge nurse. She was short, probably in her 50s, with red coloured hair and matching lipstick. She apologised for the delay. She asked if I had been advised to bring in an urn or box. I cracked at this, “why does no-one ever tell you anything around here!!” I exploded and cried. “No, no-one told me that.” “Didn’t the social worker talk to you about taking the remains?” “No, but I’ve done it twice before. Can we take the remains?” I explained that the first miscarriage we had left me calling a blood test laboratory trying to find my miscarried remains after being given the wrong number by the hospital. “yes, you can take the remains home with you.”

The nurse then said something quite shocking. “Believe me, this is as hard for you as it is for me.” ARE YOU FUCKING KIDDING ME! I was incredulous. My husband was incredulous. I told her that I doubted that very much and set about disliking her for the rest of our stay. I was flabbergasted that she was the front-facing nurse of the ward. She then gave me misoprostol. I told her I knew what it was and swallowed it. It was a thousand times easier this time compared to my second D&C.

I then had to get changed into the standard issue backless blue hospital gown with underwear that they can cut off. So undignified. It made me cry. I felt like a nobody in that gown. The nurse came in to check that I was OK. She asked if she could give me a hug. That was nice of her. She said, “I don’t have any children either.” I told her, “actually I have a son, he’s at daycare today, he’s two.” Not knowing when to just shut up the nurse advised, “well you should be grateful that you have him.” I don’t know how I was so relaxed about that. Rather than punching her in the face, I let it roll off me. I had enough to deal with today. I was barely holding it together. I could chose not to let her get to me.

We were then ushered into a private room to wait for the misoprostol to take effect. All that really happened is that I began to shake uncontrollably from the cold, or from the drugs, I’m not sure. I ended up smothered in a hot air blanket. I listened to the clock tick away. My poor husband didn’t really know what to do with himself.

Finally it was time. I was wheeled up to theatre. I asked the theatre nurse to please hold my hand. She did. The anaesthetist was there. There was a man holding the blood pressure monitor. I thought to myself, “how can anyone perform this procedure? Doesn’t it break their hearts as much as mine is breaking? Don’t they feel as sick and guilty?” At that moment I completely lost it. I started sobbing uncontrollably and vaguely remember trying to sit up and protest something, although I don’t know what exactly. I felt the theatre staff quickly grab my arms and shoulders and I was almost immediately unconscious. I’m glad the anaesthetist put me out of my miserable state.

As I came to I wanted someone to hold my hand. I was eventually allowed to leave my bed to use the bathroom. And we waited to be discharged  in a small cubicle with another two couples. It didn’t seem the right place to be following such a traumatic event. That said, the anti-anxiety drugs were keeping me relatively calm. The anaesthetist must have really dialled up the dose, as I don’t remember feeling so at ease after my previous two surgeries. The nurse advised I was not to drive, to sign any legal documents, or drink alcohol in the next 24 hours. I had no intention of complying with the alcohol ban.