I'm only Interesting when I'm Reproducing

I'm not sure what happened. We bought a house and Cargo started being a person and next thing I know I have all sorts of no time for blogging.

But here we are again, spring has sprung, and I have a dusty old blog and zero readers. But the reason I'm here this time is not to entertain, but rather to document and inform.

You see, Mot is pregnant. Yes, again. It's funny how the reaction of people to the news is so different when it's your third child and pushing forty. Well, I'll be 39 in July which is practically 40 so yeah. I do have to admit that many women who I tell are super thrilled, especially childless women in their early thirties who see this as a ray of hope that they too can comfortably (yeah RIGHT!) squeeze in three offspring before they hit 40.

So, anywho. I am now, sorry we are now 15 weeks 2 days pregnant with our third child. We know the sex but I'm not going to just blab it here on my pseudo anonymous blog.

Everything in the pregnancy has been normal. We got pregnant on the first try (hey, at 38 you have to be proud of the little things). Heartbeat showed up on time. All measurements and tests are good so far. The first trimester was a bit more queasy and I took a few more naps than usual, but at 13 weeks I emerged into the second trimester feeling healthy and energetic, ready to enjoy a summer of long walks and generally enjoying my last pregnancy.

So when I needed to plan a trip out west for my annual business trip to see my boss, I saw it as an opportunity to spend a week in a hotel, long stretches of uninterrupted sleep, dinners with old friends with no battles to make a toddler eat something other than french fries.

I flew out on a Monday, a horrific 9+ hours of travel due to the unfortunate lack of direct flights from Portland Me to SFO. But I got a great nights sleep and spent the first three nights enjoying some much needed down time while my husband and the au pair juggled the kids back home.

I told my boss I was preggers on Tuesday. He seemed un-phased. All was well.

Thursday I attended a company meeting which required a long stretch of sitting and awkwardly feigning rapt interest for about 1.5 hours. A meeting followed with more sitting. By lunch I was ready for a long walk around Union Square.

PREGNANT LADY TMI ALERT TMI ALERT>>>

I go to the ladies room before leaving for lunch to discover upon wiping that I was bleeding bright red blood. Fuck. I scurry back to my hotel room so I can cry in private and call Chris and generally panic. I get his voicemail and then call my OBs office.

The nurse on call settles my nerves and sayd if it is just spotting I am probably fine until my regular appointment on Tuesday, and they will add an ultrasound to check things out. I am ok to fly, if things get worse, go to the ER.

Things seemed to settle down, I see no more blood and I go back to the office for the rest of the day. I go out for a mocktail with some current and ex-coworkers. I leave to meet another dear old girlfriend for a thai dinner.

I'm standing on the streetcorner in front of the restaurant directing my friend via cell phone when all of a sudden I'm peeing my pants. Only I'm not peeing and I know its not good. I run past the hostess at the restaurant and into the ladies room.

Blood everywhere. I'm thinking "this is it, this is it, I'm loosing the baby." I know in my head I'm 14 odd weeks and that it is too late for your average miscarriage and that I would likely have to go through a very long and painful process to complete a miscarriage, if I would not in fact need a D&C.

I make do with wads of TP and run back to the street to find my friend. I tell her I'm bleeding and she asks if she should call an ambulence.

At that point I'm thinking, no, no, I'm losing the baby, what will they do in the ER? I just need some mega feminine products and to go back to the hotel so I can freak out in private. I am in shock and basically thinking this is the end and I don't know if I can even handle another pregnancy and generally thinking dark dark thoughts.

I call Chris and he asks immediately why I'm not on my way to the hospital. I explain my "all is lost" theory and he gets mad and starts googling directions to UCSF.

About seventy billion hours and a waiting room full of Swine Flu later, I'm at the ER, being checked in and fast tracked up to Labor and Delivery so they can check me out.

En route to the hospital I called my OB again. It was 10 pm EST so I got a call back from the on-call OB. She seemed convinced everything would be fine, and that this was probably just a small hemorrhage. If it was 1 cm I could probably fly, but if its "large" I should probably hang tight in CA until I stablize.

When someone finally remembers I'm in one of the examination rooms, they come in with the glorious Doppler and check for the heartbeat. Before my girlfriend and I can muster up sufficient suspense and worry she smacks it on my belly and THERE IT IS! A solid heartbeat. Holy shit, the OB was right. The baby is fine. 170 or something, and solid. Ok. Deep breath. Maybe it will be ok.

I've been to the restroom several times now and the bleeding seems to have tapered off. I'm getting that sense of optimism that Everything Will be Alright.

But I also know that even when faced with terminal cancer of a loved one, somehow we as humans are able to grasp that hope. Somehow it won't happen that way for my loved one. Yeah, I was gushing blood and that's totally not normal in the second trimester, but pshaw!, I'm sure everything will be just fine.

They then check my cervix. Fine. Closed, healthy. But I can't tell you how totally and utterly wrong it feels to have a pelvic exam while 14 weeks pregnant. My maternal instinct told me to rip the residents head off and drink her blood for getting near my womb, but I decided I could tolerate it for a few minutes if it meant determining that my cervix was still cooperating with this whole 40 weeks gestation thing.

Finally they wheel in a circa 1986 ultrasound machine and fire that thing up. they look, there it is, a healthy wriggling baby!

And they also see.....nothing. no reason for all the blood. In my half day of attending Google MD and my brief convo with the on-call OB, I think, "oh this must mean there is such a small hemorrhage that I am in the clear." They say there's no reason I can't fly the next day.

I also think back to the fact that I never really soaked pads. They're always using that as the benchmark for uterus related problems, "how many pads are you soaking in an hour?" Well, um, I think maybe one. And one over night.

Through all of this I am certain I have what is called a subchorionic hematoma or hemorrhage. I think hematoma is when it is old/bruised/clotted, and hemorrhage is used to describe that it is bleeding.

So fast forward to my office visit and ultrasound here in Maine. Of course not forgetting the intervening 20 billion hours of air travel (snarky) thanks to US AIR for cancelling the last connecting flight to Portland, and genuine thanks to my husband for re-routing me to Manchester NH while I was in the air oblivious to my lack of a way home from Philadelphia.

Ultrasound in maine shows immediately a healthy and active baby. Strong heartbeat. But ohhhh yeah... there it is, as clear as day to this technician - what looks like a "large" clot of old blood just adjacent to the placenta. It appears as though the placenta is mostly unaffected, the clot is more like an extension off one end. The clot measures 7+ cm by one measurement. But it runs along the elbow at the end of my uterus down by the cervix, so perhaps that is why it stretches along so much surface. At any rate it is deemed "large." FVUCK. I was expecting "Small" or better yet, "nothing."

Upstairs to OB's office where he tells me not to worry. "Most of these resolve themselves." BUT. BIG BIG BUT. He does want me on pseudo bedrest. Which means "no lifting, no bending, no sex (and no orgasms in case you were wondering), no cooking or cleaning." I think he may have ordered full bedrest if I worked outside the home, but he knows I can work in bed, so yeah.

He also added that I have "a mango sized ball of old blood in my uterus and it will have to come out." It may reabsorb, but don't be surprised if it comes out the other way.

So that was four days ago. I've been respecting the orders. We patched together child care help and in less than a week my kids have shunned me for my lack of picking them up. I hope they get over it. I am happy to see the chocolate sauce in my drawers as the OB suggested I might, because in my view of things that means its coming out. And the sooner the mango comes out, the sooner the whole thing can heal and then the sooner things will be just fine.

Right?

And now for the internets PSA part of my entry. I found so many different opinions on this whole thing, I've read conflicting studies, read personal accounts of people who are so woefully misinformed I wonder if their OBs are not just high school drop outs duping small town mothers across america.

So here's what I have found and personally believe to be true about subchorionic hematomas:

1. Seems like they are more common in first trimester. Some are attributed to implantation and something going wrong at that moment. First trimester SCHs "usually resolve by the second trimester."

2. They do happen in second trimester and no one knows what causes them. Personally, I blame 12 hours of air travel. I tried to walk around on the flight, but I can't see how something that might cause a pulminary embolism might not also cause a clot to form in your uterus, no?

3. The most solid evidence is that the size of the SCH in relation to the size of the fetus/gestational age is the most important factor in determining outcome. So you cannot just say, if its 7 cm it is BAD. or if its 2 cm its GOOD. Because a 7 cm SCH in relation to a 4 week old fetus is far different from a 7 cm SCH in relation to a 15 week old fetus.

4. Location matters. I believe, from my reading, that where the SCH is will have an impact on outcome. If it is directly behind the placenta, that is not good. If it is off to the side, that is better, and if it is no where near the placenta that is even better. It all boils down to the placenta and it's ability to adhere to the uterine wall and thereby support your growing baby. If the SCH interferes with that, therein lies the problem. Also, the greatest risk of a SCH seems to be that it will grow and ultimately dislodge the placenta from the uterine wall, which if it happens after 20 weeks is called Placental Abruption. I don't know what you would call it before 20 weeks.

My SCH is next to the placenta and does not seem to interfere with the relationship between the placenta and the uterine wall. I hope this is a good thing. It also looks like mostly old blood right now, which I assume means it is done bleeding and is on the mend.

I go back on Tuesday for a 1 week check up to see if it grew, got smaller, or stayed the same. I am hoping for one of the later two. I am hopeful. Everything will be just fine. Right?