Thursday, January 15, 2015

what to expect when you're expecting a d&e.

Yesterday, I talked to a nurse at my clinic to ask about the D&E procedure. It was Nurse Special, who's like 80,000 years old. I told her that I didn't think it was humane to perform it when a woman was awake and 100% conscious. She seemed to think I was nuts. She said, "We do it all of the time. It only takes about three minutes." Oh, only three? This procedure is getting shorter every day.

I told her I didn't want to be awake. I didn't want to hear anything, I didn't want to feel anything. She confirmed that I would feel pain. I said, "There's PAIN?" And she said, "Well, I've never had one, but yes, you're going to feel a lot of cramping. You should call the doctor. He's at the other office today."

So I call the other office. The message I give the front desk woman is this: "Please tell him there's NO WAY IN HELL that I am going to be awake for this thing." She takes my number and tells me he'll call me back.

I get the call while I'm at work. In a meeting with one of my staff. I tell her I have to take it and send her off, closing the door behind her. My doctor is not amused by my message. He tells me that when he does the procedure in the office, there's no sedation. If I'm not comfortable with that, I'll have to call my OB. I tell him I don't have one. He says, "I can refer you to someone else."

This I don't understand. I get Versed for my egg retrievals. Why can't I get it for this?

Because, he explains, that part of the clinic is for the IVF side. Not the physician side.

The clinic is attached to a hospital. When I had my hysteroscopy, it was done there. Can he do the procedure at the hospital?

No, he says. I do it in the office or I don't do it at all.

Now I'm in a pickle. The last time I let someone do surgery on my lady business, I came back with one ovary. This after everyone told me that there was no way I'd lose my ovary. That doctor was a complete son of a bitch and the reason I don't have an OB anymore (and why my primary has done my paps/breast exams two years in a row). 

I trust Dr. Smiles. Not because he's a famous doctor who's been on TV several times, but because I know his top priority is preserving my fertility. He's not going to cut anything or scar anything or do anything to compromise my ability to make or carry a baby.

Look, he says, it's really a quick procedure. It only takes a few seconds.

Two things:
  1. Oh, so now we're down to SECONDS? Is this meant to comfort me? I'm stuck on the math: Four years. Nine weeks of pregnancy. Undone in mere seconds. Yeah, that doesn't make me feel better.
  2. I can't help but think of Hemingway's "Hills Like White Elephants": "'It’s really an awfully simple operation, Jig... It’s really not anything. It’s just to let the air in.'"
Fine, I tell Dr. Smiles. Let's keep it on the books and I'll call you if I change my mind.

I email Mr. Hope. I email the BFF. I talk about this with two of my closest coworkers. Everyone is horrified that I will be awake for this procedure. 

Dr. Smiles had said I could take two Vicodin an hour before. This, he feels, will make me really loopy. 

That's great and all, but here's MY plan: 

I'm going to wear a sleep mask. I do this whenever I have to get an MRI and it helps. If I can't see it, it doesn't exist!

I'm going to load some speed metal on my iPhone and listen to it through noise-canceling headphones. I don't want to hear anything but obnoxiously bad music. I know if I hear the suction as I feel it, it will give me nightmares for the rest of my life.

I might bring a stuffie. Something to squeeze. That something will not be my husband's hand. This is how he lost a close relative, remember? He will be in the waiting room with the BFF, who's coming with us. Yep, I'm bringing her for him, not for me. Me, I'll have a stuffie. Preferably one I don't care about donating to Goodwill immediately after.

So this is my plan. I'm still terrified. I'm not good with pain, physical or emotional. I have such a freakishly good sensory memory that unless the Vicodin really wipes me out, I will remember every single second. I will relive every single second over and over and over again.

But the fear of having someone botch the job is way worse than the fear of pain. I need my ladyparts to work. I need there to be no scarring. I need to know that when we cycle again, there will be nothing standing between us and our rainbow baby.

So, awake it is. 

Let's hope I don't regret it.


  1. I have been thinking about you evee since your post yesterday. I, too, am horrified that they do this procedure while you are awake. Do they not know that a miscarriage is traumatic enough all on it's own??? I don't blame you one bit, I would feel the exact same way. Maybe have a shot or two with the vicodin for good measure!
    Praying for you. This sucks.

    1. The funny thing is, the worst the Vicodin did was make me sleepy. And that was when I took it at night! I took one about an hour before the procedure was supposed to take place and it didn't do crap.

  2. I don't think either option is good but I think you're making a smart decision. I was never even told about possibility of permanent adhesions and only discovered that could happen after my second d&c. Trauma is never preferable but scarring would be devastating. Hugs!!!!

    1. Yes, you're right. And in hindsight it was not physically that devastating. Just emotionally so.

      I'm ready for the next part. The part where I am no longer bleeding and my hCG has returned to zero and I can move on.

  3. Try a trial run with the Vicodin a few days before to see if it will do the trick. Hopefully all will go smoothly and your lady parts won't suffer. Good idea to have the BFF there for Mr Hope too. This must be so hard for him too.

    1. It was, and later he told me he wanted to be with me for the ultrasound. But I didn't know if they were going to do the procedure so I didn't have him go back with me. I was trying to protect him but I don't know that he wanted me to. It's too late now anyway.

  4. I am so sorry for your loss.... In these kind of situations others usually wish to take your pain away with their words. But guess there is not such a thing!
    Here is one poem what I found and back then it helped me to cope:
    How do I say goodbye ... when I didn't get to say hello?
    I want so bad to keep you ... how do I let you go?
    I have so many dreams, so much love I want to share
    There's nothing I can do ...why is life unfair?
    You're my perfect angel...I dreamed you long ago
    I never got to hold you but it breaks my heart to let you go
    The pain and confusion I feel inside
    I can not explain...I can not describe
    God will rock you in your cradle and watch you as you sleep
    I will love you in my heart ... it's all I get to keep
    you are blessed my child ... you're in heaven up above
    You'll never be have Mommy & Daddy's love
    Hush my little need not ever cry
    You were always wanted! I wish you didn't die
    You'll be my sunshine in the daylight and the brightest star at night
    Reach for God's hand and go to the light
    I would rather endure the pain of losing you right now
    Then the thought of you suffering thru life...we'll get thru somehow
    I was blessed to have you briefly...even though I have to let you go