Saturday, March 10, 2012

My Experience With Cytotec: Miscarriage at Home Part 1

I want to share my story, long and convoluted as it is, about my medically managed miscarriage experience for one reason - I searched high and low for other women’s stories when facing this, and found very little help.  One site that was a great comfort to me was this blog - , and even with the many many comments and stories I still found very little similar to my own experience.  I want to answer questions I had such as how long does Cytotec take to kick in?  What’s the best dose of Cytotec?  What does a miscarriage feel like?  Can I miscarry at home alone?  How long does a miscarriage last?  Etc.  So, here goes.  First a little about my story, then a very important list of things you’ll need to prepare your home and body for a miscarriage.  Later I’ll update with more details about the miscarriage process, however it is a long and winding road and I am in the middle of the process now, though hopefully past the worst of it!

Why did I have to do this in the first place?
My baby stopped growing at about 6 and a half weeks.  The heartbeat was difficult to detect, and I was nearly 10 weeks along at that point.  The pregnancy was difficult from the getgo and we had some forewarning though no bleeding or cramping.  I began to spot on a Friday.  My doctor confirmed that this was the beginning of a miscarriage, I should expect to bleed, prescribed Percocet, cancelled my second round of 48 hour bloodwork as it was moot, along with the advice that I could schedule a D&C at any time.  I did not want to have a D&C for many personal reasons, and certainly not when I had just seen my baby’s heart beating.

The spotting stopped, so I went for my second set of bloodwork to get some answers, and was relieved and comforted to see that my HCG levels were dropping quickly.  I’d had quite a bit of time to expect this, and along with the spotting it was such a blessing to finally have confirmation one way or the other - we’d come to terms with losing our baby, so this was good news.  I was so frustrated though when the bleeding did not start.  I was experiencing a “missed miscarriage”.

Choosing Misoprostol (Cytotec)
So, spotting on Friday, blood work confirmation Sunday, back to the doctor Tuesday.  I could not face a month of waiting for the bleeding to begin, and was feeling pressure on all sides to just get the D&C and get it over with.  I was so happy when I asked my doctor if there was a medicinal option, and he said yes.  The relief was immediate, a way to do this as close to naturally as possible, at home in private with my husband.

Supply List
SO many things on here but I would try to gather ALL of these items if you can.  If anyone has any other suggestions please leave them in the comments!  I felt very prepared and empowered by the control I had over my own comfort during this awful process, and I hope I can help you feel that small consolation during these rough nights.  The most important supply of all is someone to be with you - even if the process takes a week, someone who can come stay for 8 hours when you call the first night it gets bad is the minimum here.  There’s a LOT of blood loss, disorientation, dizziness, physical weakness, emotion and unfamiliar medication going on here - its nothing to mess around with, and if you can’t find someone patient and helpful to stay with you I honestly would not recommend doing this at home in the first place, just my personal opinion as I was too weak to function alone and have heard horror stories of passing out, etc.  Anyway, the list:

  • Prescription pain medicine - if it isn’t offered, ask, because this is no joke.  Some of the times the pain was really bad and I had only taken 1 Percocet to try and make it on just one, I was scrambling in desperation for the second half of the dose...I can’t even fathom doing this with just Advil.
  • Place to write down your medication - when and how much you took, pattern of when things kicked in, etc.  It gets really confusing and there’s a lot to keep track of, plus sleep loss and vivid dreams, please write it down so you don’t accidentally over or under dose.
  • Large pack of half-decent toilet paper - you’ll fly through it, but public restroom grade stuff will not fly, and the extra thick cushiony stuff might not be the best idea considering the staggering volume you’ll be flushing (you will begin to worry your toilet will rise up and rebel against you).  Angel Soft is a good choice.
  • Bath mats you don’t mind staining
  • Towels you don’t mind staining - some in the bathroom, some by your bed and one laying down where you get out of bed/off the couch for gushing incidents.  BIG NOTE - My lower back was dying sitting on the toilet so much.  I rolled two large bath towels together like a thick firm pillow, and kept it on my lap on the toilet, so I could lean my elbows on it and relax my back or bear down to push, without being hunched all the way over in pain.  It makes more sense in practice, I couldn’t bear it without this.  Others have said towels in the bathroom for your lap to stay warm were helpful as they had the chills.
  • Wash cloths if its hot out, you may be overheated and soaking one with some water for your forehead is a great relief; plus, good for accidents.
  • Large exercise ball blown up ahead of time - $10 at Target, in my case I made zero progress (meaning nothing came out of me & cramps became unproductive) if I was laying down.  But my back and butt were killing me from sitting on the toilet/couch.  Sitting on the ball was heaven.  Best of all was putting the ball braced against my side of the bed with a pillow behind me, my feet braced against an overturned laundry basket which was against the wall.  It was like being in a bouncy hammock.  Sounds crazy and it looked it too, but this was what got me through.  Resting your head and chest against the ball with your knees on the floor is another productive position, as is putting the ball on top of your bed, standing next to the bed and resting head and chest on the ball.  Encouraging cramps and getting this over with asap while staying comfortable!
  • Extra blankets - for chills which many women get but mostly for when you’re sitting on your exercise ball or laying on the floor or in the hallway for whatever reason.
  • Variety of maxi pads and tons of them - NO YOU MAY NOT WEAR TAMPONS for the majority of this time.  You won’t want to anyway trust me.  Need more convincing, picture a giant clot or tissue trapped halfway through your cervix and it can’t pass out of you because a tampon is in the way - pain, infection, halting of progress, omg not good.  For the lighter bleed days talk to your doctor, I don’t know.  Anyway, pads will be soaked quickly, and wear ones with wings as they’ll save you from tons of underwear changes
  • Extra underwear, looser and ok with being stained - loose for comfort, fitting large pads, and because the front of your underwear waistband is a great place to tuck your heating pad
  • Loose pajama pants or shorts - could wear a nightgown but I liked the extra barrier between pad and furniture, plus shorts helped hold my heating pad in.
  • Heating pads - MOST IMPORTANT ITEM next to toilet paper!  I liked the Thermacare wraparound one for my lower back, which will experience cramps and also be very sore from sitting on the toilet and other efforts!  But for the front, Thermacare can’t touch this kind of pain, you need a thick heavy heating pad.  Plus those are one time use and this is a marathon.  An electric would work if you can also add weight, but you’re not going to be in one place and may find you want the heating pad while on the toilet, walking to encourage contractions, switching from ball to bed and back again, and a cord isn’t helpful here.  I suggest rice heating pads, with the bonus of the pleasant smells and giving your husband something helpful to do by microwaving them from time to time, and they hold heat very well.  If you don’t have one, I made one at 3 am in the middle of raging contractions while screaming and crying in under 5 minutes - scrap fabric in a rectangle sewed all along the edges except a 3 inch opening, fill with rice, stitch up opening, done.  You can add herbs or cinnamon etc but it was 3 am.  I prefer these to a hot water bottle as they can be different shapes and are cozier & easier to reheat.
  • Stool softener - pooping with menstrual cramps isn’t fun so I was keen to avoid it during this more painful process.  Some women experience diarrhea on Misoprostol though so see how you do.
  • Advil - some days I just couldn’t stand the idea of being a zombie on Percocet and the cramps were lighter, so I was glad for an alternative.  NOT for the big nights though.
  • Space heater - a tiny fan heater in my bathroom was a huge comfort in the middle of the night
  • Night light - for bathroom definitely as you’ll get tired of going from light to dark and its just calmer and more comfortable this way.  
  • Entertainment - rent movies, you can play some on your phone in the bathroom (Crackle is an app with free movies), gather some books and a booklight for nights up laboring, start a really addictive book series right before this starts, it was a very welcome distraction and anchor for me.  Lots of pausing of course but its so important to have something to do and think about aside from bleeding and grieving, and preferably something you can do in the dark for 3 minute intervals.
  • Hair ties, bobby pins, lots of clean socks and jammies - comfort is the name of the game
  • SO many carbs - crackers on your night stand please please please, you will need them for medical nausea, but in general keep your cabinets well stocked with carbs and mild soups
  • Zofran for nausea if you can get it - some nights were worse than others.
  • Eye mask if you have trouble sleeping during the day, as you will need to sleep whenever you get a chance.
  • Thermometer - a very high fever is a sign of trouble, have a way to check.
  • Vitamins - keep your strength up.  Take with food (nausea).
  • Bottles of water everywhere - everywhere!!  Don’t drink too much when swallowing your medicines as it will aggravate nausea, little sips are best.  Other times, stay hydrated girl.

That’s already so so so much, and I’m still in the process of my miscarriage, so I’ll leave it at that for now.  I hope this post can help even one woman struggling with this or her partner looking for the best way to comfort her.  I’ll update as my own journey becomes clearer!