Spring break was approaching and we had planned a trip to St. Louis to stay at a hotel, swim and relax for a few days with the kids.  My busy husband, who is the only lung doctor at his hospital, had managed to secure a few days off and my mother had traveled 2 1/2 hours to spend some time with us as well. These two things would turn out to be very important to me.  The kids were really excited about the trip; there was something about staying in a hotel that thrilled them.  A few days before we were due to leave, I noticed the dreaded pink on the toilet paper.  How could this be, I cried out to the L-rd.  I thought there were more children coming, maybe even twin girls, but here I am, looking at 3 miscarriages in a row.  L-rd, I’m a doctor, an Ob/Gyn, a hormone doctor.  Yes, I know I’m older, chromosomes and all that, but I’ve prayed about that.  I’ve prayed over my and my husband’s chromosomes for years.  Why is this happening to me? Is it time to stop?

Even though I was further along this time, the spotting was very light and intermittent, and I felt we should go ahead and go on our trip.  I didn’t want to disappoint the kids and I figured with Dennis and my mom both there, I could rest most of the time.  I started to get a little concerned when I had to change my pad and my clothes at the first bathroom stop about 30 minutes north of Springfield on I-44.  I told my husband I thought I would be OK because I wasn’t cramping.  Unfortunately by the time we made it to Rolla, I was bleeding very heavily and asked my husband to pull off at Wal-mart.  He came back with Granny-panties, super-deluxe heavy duty pads and Depends.  We had two vehicles so the kids were largely unaware of what was going on.  I was still feeling fine and even felt hungry, so we pulled in the drive-through and got some chicken.  I suppose I felt a false sense of security as an OB/GYN traveling with an ICU doc.  I had just eaten a little bit of chicken and was starting to feel tired so I reclined my seat back to take a nap.

The next thing I knew, my husband was on my side of the car, lifting my head up, screaming to the other vehicle to call 911.  I had thrown up and passed out, so here we are on the shoulder of I-44, with me in and out of consciousness and my panicked mom & nanny in the other car with the kids, who had no clue what had happened.  The paramedics showed up quickly and I remember observing rather dispassionately a blood clot sliding down my leg onto the ground.  My blood pressure was not too stable but I didn’t feel pain as the friendly EMT quickly inserted the IV.  Dennis sent our nanny and the sad children home, the trip cancelled because mommy was “sick.”

The ambulance took us back the way we had come to Phelps County Regional Medical Center in Rolla, MO.  The ER doctor insisted on doing a pelvic exam and then ordered a pelvic ultrasound.  I remember vaguely wondering why all this was necessary when it was clear what was going on.  The US tech insisted I needed a full bladder for the US and proceeded to fill my bladder with “cold” saline via the Foley that had been inserted earlier in the triage room.  I started feeling sick to my stomach.  I turned to my husband and said, “I feel bad, babe, really nauseated.”  I must have had a vasovagal reaction to the cold fluids and dropped my pressure. I could hear my husband shouting at the paralyzed tech, “get somebody in here now!” I don’t think they are used to rapid response situations in the US room.

Back in the ER, I was moved to the trauma bay. The nurses were very nice and advised me that the on-call OB/GYN was tied up but would be there shortly and that anesthesia would be coming to see me about a D&C.  I’m not sure how many bags of fluid I had gotten by then or what my lab work showed.  After I was stabilized, the nurses stepped out and a young man introduced himself as an anesthesia student along with his overseeing nurse anesthetist.  They asked me the usual questions about allergies and prior surgeries (two C-sections and a D&C for my first miscarriage).  As I answered the last question, I started to get that sick feeling again, and looked at my husband, “Babe, I don’t feel good.”  Dennis later related to me that when my blood pressure was dropping before, I had always maintained my pulse. Since I was in trauma bay hooked up to telemetry, I observed rather calmly that my blood pressure was 70/40 and my pulse was 50. In spite of this, the anesthesia team, having gathered their information, walked right out of the room while I became unconscious.  Remember the nurses had already exited so I was in the room with just my husband and my mother, and this time, not only was I hypotensive, but my pulse was falling.  I didn’t see a white light or feel any fear, but I could clearly hear my mother praying loudly in the Spirit and yelling, “Poppy, come back, come back to us.” I heard Dennis screaming for the second time for medical personnel to come into the room.  Thank G-d he was one, because he came over and performed a sternal rub (a procedure to try to cause an unresponsive person to react to pain).

IMG_2666Finally a frazzled nurse come running in, having seen my crashing vitals on the monitor at the nurses station, followed shortly by the ER doc.  I’m sure the last thing they felt they needed was a physician coding in a room with no medical person except that physician’s pissed off Critical Care physician husband. *High PR Red Alert* Dennis insisted I be started on Dopamine (a vasopressor to sustain blood pressure) since I had already had bags of fluid and my blood pressure was still dropping.  The nurse quickly said “the Ob/gyn is in the building and they will be taking you back to surgery ASAP.” Finally, the grouchy old (late 60s by my guess) OB/GYN came in, introduced himself, and questioned me about my history, especially the C-Sections and the uterine rupture.

Once I finally got to the OR, everything was OK. My hemoglobin dropped from 12 to 8 but I thankfully avoided a blood transfusion. Grouchy doc came in to see me in the wee hours the next morning while Dennis was sleeping in the recliner next to me. “You know, you shouldn’t ever get pregnant again. You’re playing Russian roulette with your age and your history.” I knew he was just doing what he felt like was his job. I wasn’t mad at him. But I immediately rejected his pronouncement over me. I said to myself, “It’s up to G-d, not you.” I thanked him for his help and he went on his way, and I’m sure he was rolling his eyes as he went out the door.

Stay tuned for Part 3. Click here to read Part 1.