Tag Archive | hospital

Anti-D, Anti-Everything

Last week Shirley, one of the nurses at the clinic, phoned me and told me that I had to come in at 7am the next morning for a blood test and an anti-D injection.

For those who aren’t aware, Rhesus Immune Globulin (anti-d) is an injection that is used to prevent the immunological condition Rhesus disease. I need to get these injections because I am Rhesus negative but around 85% of the population is Rhesus positive, including my husband. When I am pregnant there’s a high chance my baby is also Rhesus positive like Doug, because most people are Rhesus positive and my babies already have a Rhesus positive parent. You all with me so far?

When the baby is on it’s way out of my body (either during miscarriage or labour – if I ever make it that far in a pregnancy!) there is a risk that a small number of the baby’s red blood cells can leak into my blood stream, allowing my body to develop antibodies against anything Rhesus positive entering my body in the future. If left untreated, during subsequent pregnancies if my baby is once again Rhesus positive my body may use those antibodies to attack and ‘remove’ it (yay!). Otherwise it can still cause lots of long-term problems for the baby including anaemia and jaundice. And nobody wants that. So basically I need to get an injection of anti-D to prevent this happening every time I miscarry and also at 28 weeks and 34 weeks pregnant (again, if I ever get that far in a pregnancy…).

The anti-d injection is produced from the blood of Australian Red Cross donors. I always find it fascinating when I’m injected with other people’s blood. Does that make me a weirdo? I know blood products from donors are also used to assist fertilization of eggs during IVF cycles and I’m also fascinated by that. I wonder if those donors have any idea they’re helping to create life rather than save life. When I imagine donating blood I see it going towards saving a car crash victim who is rushed into the hospital with an amputated leg and is bleeding out and close to death. I can see doctors running around the room and intubating the patient and shouting orders to each other. And I can hear the theme song to the television show ER. And I can see Doctor Green and Doctor Weaver, and definitely Doctor Ross. Oh hello, Doctor Ross. I have a fever would you like to do a full body examination? Oh…sorry…I think I just steered you all into one of my fantasies…

Back to the anti-d.

When I lost my first pregnancy in April I was with a large and impersonal clinic with unimpressive levels of patient care. I was never offered the anti-d injection, even though it should have been mandatory. Luckily when I was tested at my new clinic they found that Nemo’s blood cells had very kindly avoided my blood stream as he vacated the premises and I hadn’t developed anti-bodies. But I’d completely forgotten this time around that I would need an injection and was unpleasantly surprised to receive the phone call from the nurse.

Not only did I have to come in at 7am, I had to get another huge intra-muscular needle in my thigh. Why is it always in the damn thigh lately? And why always in the muscle? Give a girl a break.

After terminating the ectopic pregnancy I was looking forward to resting in the weeks coming up to Christmas. I was looking forward to not having to be up at the hospital most mornings before work for tests or scans or appointments or injections. I was trying to see the positive side to losing my little Peanut and/or Butters. But no! The inconveniences continued!

Five minutes after receiving the bad news, my phone rang again.

“Hi Sadie, it’s just Shirley again.” said the voice on the other end of the line. “We’ve changed our minds. Can you come in tomorrow at 7am for the blood test and then 7am the following day for the anti-d shot.”

Ugh. Seriously? Two days in a row? Just my luck.

“If the blood test comes back negative do I still need to get the shot?” I asked hopefully.

“Yes.” Shirley replied sternly. “And don’t forget the day after that you need to come in here for your first follow-up blood test following the methotrexate.”

Well…..damn. Apparently you can’t sleep in when you’re going through IVF, you can’t sleep in when you’re pregnant and you can’t sleep in when you’ve lost a pregnancy. You just can’t sleep in. At least not if you’re me. And I am me.

To be fair, the anti-d shot itself wasn’t too bad. It certainly wasn’t anywhere near as painful as the methotrexate. It sort of just felt like a regular FSH injection, except with a much bigger needle. I’m glad I had it done. Now I don’t have to worry about anything else going wrong next time we go through a cycle. Because let’s face it, not too much else can really go wrong for me at this point.

Now I’m just waiting for my next follow-up appointment with Doctor Vacation. Sorry, wait. I meant to say with Doctor B when she comes back from yet another holiday abroad. That will happen in the first week of December.

Now that everything is out of the way for this cycle, I can simply be “anti-everything” and just take a break from all the infertility stuff. At least for another couple of weeks. It feels so nice to just be away from it all. I can focus on other things now! I might even be able to catch up with a couple of friends for coffee and not bore them with fertility treatment talk. And I might even drink actual caffeinated coffee. I’m wild!

I can’t believe how positive I am being at the moment. I actually feel a little bit like a real human being!

You guys, I give it a week tops until I am back on here complaining about some other crisis or drama in my life.

A week.

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And you let her go

I’m currently up at the hospital sitting in a comfy reclining chair in the oncology unit.

I came here to receive an intramuscular methotrexate injection to end my pregnancy of unknown location. They can’t pick it up on any scans because it is too small, but it’s clearly there somewhere. Most likely in my right tube, but we’ll never know for certain.

In the ward each patient gets their own little nook with a big green recliner, visitors chair, tv and little table, but we can all see each other which is a little confronting.

Everyone else here has cancer. Everyone else here is receiving chemotherapy. Everyone else here is potentially dying. I am here just to end an unviable yet persistent pregnancy. I feel like a massive fraud. I feel unworthy to sit amongst these people. They are the true faces of strength and bravery.

The nurses are so lovely. They keep asking everyone questions like “can I get you a warm blanket?” “can I get you a tea or coffee?” “can I get you a sandwich or some biscuits?”

I would love a cup of tea but I keep politely declining. I don’t feel entitled to consume this food or drink. This level of care is not for people like me, it’s for people going through life threatening illnesses.

Other than that I feel calm and unemotional. I know this is the right thing to do. I wish my husband was with me, but I am coping fine on my own. I don’t want to weep or scream, and I am able to joke with the nurses. I am doing okay.

A nurse approaches me and picks up my chart. She’s probably 40 years old with cropped blonde hair and a friendly smile.

“Oh golly intramuscular methotrexate! Yuk!” she says sympathetically.

“It’s fine, I’m doing IVF so I’m used to being injected and poked and prodded.” I reply, replicating her friendly smile.

“I have a close friend who did IVF!” she gushes. “She got 6 eggs and ended up with 2 children.”

“That’s nice.” I say, understanding that she’s trying to be positive and helpful.

“How many cycles have you done?” she asks.

“Four.” I tell her.

“Wow!” she gasps. “So how old are they?”

“Sorry? How old are what?” I ask, confused.

“Your kids.” she says. “Your IVF babies.”

My chest tightens and my stomach drops. I’m sitting in a recliner in a cancer ward waiting to get an injection of a chemotherapy drug to end a much wanted pregnancy, and a nurse is asking me how old my children are? Seriously?

“I have no children.” I say soberly. “All of my cycles have been failures.”

For a moment she is silent, then she brings her hand to her mouth in shock.

“I’ve just put my foot in my mouth haven’t I?? I’m so sorry! I shouldn’t have asked you that!” she says frantically.

At this particular moment in my life I really don’t need to be having this conversation, so I quickly try to shut it down.

“It’s fine.” I reply hastily. “What you said was pretty low on the insensitivity scale.”

But in my mind I’m not so calm. I’m actually boggled by the fact this registered nurse standing in front of me clearly believes each cycle of IVF is guaranteed to give you a child. What the actual fuck.

After apologizing a few more times the blonde nurse scurries away and is quickly replaced by a brunette.

“Ok I’ll be taking your vitals.” she says. “Can you hop on these scales for me?”

I nervously do as she asks and step onto the scales. I watch the digital reader dance between 75.50 and 76.20 before finally landing on exactly 76.00kg. After 10 days of daily exercise and extremely healthy eating I have lost a grand total of 0.00 grams. Yay me.

The nurse then takes my temperature, and checks my heart rate and blood pressure. She is extremely surprised to see my blood pressure is ‘text book perfect’ for my age and weight, particularly as the hospital environment tends to have a significant detrimental effect. I told you – I am cool as a cucumber.

After a boring discussion about drug side effects and after care, the nurse disappears. I am left alone for some time to watch tv, while the pharmacy downstairs prepares my dose. Morning television blows. I flick channels until I find Antiques Roadshow. I stare at the screen but I’m not absorbing what I am watching.

After 20 minutes a new nurse comes to see me, pushing a silver cart. She opens a draw at the bottom of the cart and pulls out scrubs, goggles and a mask.

“We have to fully suit up when we’re administering chemotherapy drugs.” she explains. “Even though you’re not getting actual chemo.”

I want to tell her I don’t really give a damn what she wears, but I remain silent and smiling. I know soon this will all be over.

The nurse draws the curtain so the patients around me can no longer see me, adjusts my recliner so I’m lying almost flat and lifts my dress to my hips. Then she cleans my thigh with an alcohol swab and turns back to her tray to prepare my needle. It’s a much bigger needle than I’m used to, but I am not afraid.

“Do you want me to warn you when I’m about to inject you?” she asks, the needle hovering inches above my skin.

“No.” I say decisively, closing my eyes. “Just jab me.”

Once I feel the initial sting as the needle touches my leg, I open my eyes to watch with interest as she pushes it down into my thigh muscle. She then draws up on the syringe before slowly injecting a yellow liquid into my body. She holds the needle in place for a few moments to make sure the contents has been fully administered. I am used to this process because it’s a regular step in self-administering FSH injections.

Almost immediately a searing pain starts moving across my thigh muscle and down into my lower leg.

“Wow that hurts!” I gasp.

“I’m so sorry,” the nurse says. “There’s nothing I can give you to help the pain.”

“It’s okay.” I assure her. “I’ve had far worse pain on a multitude of occasions.”

I am left to sit for a while to make sure I have no adverse reactions. The nurse goes off to let my doctor know the dose has been successfully given and I am told that soon I will be discharged.

At the moment I’m feeling incredibly nauseous but otherwise fine. I don’t feel overwhelming sadness or grief or anything at all really. Apart from the aching in my leg I feel like maybe I’ve just been at the doctor for a check-up, rather than to terminate a pregnancy. I am numb to it all.

After they let me leave I’m going in to work. The nurses were shocked when I told them, but honestly I don’t have much of a choice.

On Wednesday night I started bleeding out of the blue so I went up to the hospital to get tests, and also sent my inconsiderate boss a text message to let her know I wouldn’t be in on Thursday. She responded at midday the next day, informing me that since I was at the hospital she would expect me to provide a medical certificate to prove I was telling the truth about my whereabouts. Upon reading the message I simply burst into tears. What an awful thing to send someone when they’re going through a crisis. I’ve kept her really up-to-date with my IVF progress, even though I am not legally obliged to. How appalling that she chooses to treat me with such disdain.

I don’t know how the rules work in other countries, but in Australia all government departments, statutory authorities, bodies and entities strictly enforce a policy that only requires staff to produce a medical certificate when they have been on sick leave for three consecutive days. I was asking for one day of leave in dire circumstances and she just had no right to make me feel so awful.

All of last night I was much more anxious about calling in sick again today than I was about the methotrexate shot, even though my doctor gave me the medical certificate my boss had requested. In the end I decided it was just less stress to drive in to work after I’m discharged, so that’s what I’ll be doing.

Yesterday I was informed I will be getting weekly blood draws until my hcg level drops below 5, and then the doctor said we can start planning our next FET cycle, which is promising news.

Doctor B told me she is extremely reluctant to consider removing my Fallopian tubes at this stage because I am so young, and removal of the tubes leads to decreased blood flow to the ovaries and also the risk of lower quality eggs. But she did stress that if I keep having problems the option is not off the table. I’m satisfied with that for now, but still feel uneasy about my risks in the future.

I guess I’m just going to focus on taking it easy this weekend and trying to move forward with my life. There’s nothing else I can do.

Flicking television channels just now I landed on a music channel that was playing the Passenger song ‘Let her go’. This is the song I listened to over and over when I had my first loss in April. I can’t believe it’s playing now as I haven’t heard it for months, but it really is quite fitting.

Only know you’ve been high when you’re feeling low.
Only hate the road when you’re missing home.
Only know you love her when you let her go…
And you let her go.

Hospital day

I’m updating from the hospital. I’m sitting in the waiting room, well…..waiting.

I’m so relieved and excited and nervous at once. Finally we’re doing something! Our baby journey is starting in earnest today, a year since we started trying to conceive.

I’m having the surgery at a small private hospital and everyone has been really nice and efficient. Ironically, my mother is here with me instead of my husband because he actually does have a big meeting at work today. I’ve told my boss that I’m having surgery, but not explained why. I’ve also told my mother the truth about why I’m having the surgery, but everyone else in both our families is still in the dark. I need it to be that way otherwise I won’t cope with their constant well wishes and questions.

My mother has been great and super supportive. I’m really glad that I have her to rely on now as well as my husband, because it takes the pressure off him a little.

My surgery is at 2.30pm so I have a few hours to wait. I’m fasting so I’m really hungry. I’m not even allowed to have water and the nurses are concerned I’m going to get too dehydrated in the air conditioning.

Last time I had this surgery I can remember sobbing while they were prepping me because I was so nervous. I feel a lot calmer today and I don’t think there will be any tears. I am determined to get through this with a positive attitude.

I suppose there’s nothing else to do now except keep waiting…..