Maybe I would have reacted differently if we hadn't watched Michael Moore's Sicko on Friday night.
On Saturday, I woke up bleeding. It was a very small amount. I looked it up in my Mayo Clinic guide, and it advised calling a doctor if the bleeding continued past 24 hours. Jeff and I decided not to worry about it unless it got worse. This past Thursday's ultrasound showed the little thing looking perfectly fine. And when I had some spotting two weeks ago, we rushed in for an ultrasound only to find out that all was ok.
On Sunday morning, I was bleeding again. I called my doctor's hotline and spoke to a triage nurse who asked me to call back if I started passing clots the size of a plum. I tried to rest, but when I used the restroom again, I appeared to be bleeding more. And this time, the blood looked fresh, as if I had some open wound somewhere, instead of the brownish color I had been seeing earlier. My first miscarriage started with a small streak of fresh blood in mid-afternoon. By 3am the following morning, I was dropping blood in buckets. I couldn't bear the thought of going through that process again -- sitting on the toilet, crying as my body purged itself, and feeling so out of control. I assumed that if I were already miscarrying, there was nothing the doctor could do. But she could at least help me cut the process short.
So I called the hotline again and spoke to another triage nurse. I explained that I was bleeding more, and I wanted to go in for an ultrasound. She asked me how much I was bleeding. I said that it wasn't very much but it now looked fresh, and I was concerned given my past two miscarriages at about the same stage in my pregnancy. She advised me against going into the emergency room since I was not bleeding enough. I asked her what harm it would do to just go in for a quick checkup to make sure the baby was ok.
She responded, "We have our protocol, and we don't advise you to go in unless you are filling more than one pad an hour or passing clots the size of plums." She advised me to lie in bed for the rest of the day.
I then asked her, "Do you know what is causing the bleeding? Can you tell me if this is normal?"
She responded, "No, Ma'am, we don't know the cause and we certainly wouldn't say it's normal."
I said, "Well, if you don't know what's causing the bleeding, then how do you know that bed rest would help?"
She simply repeated that that was the protocol.
I then explained that my first miscarriage started with a small amount of blood, and by that evening, I was miscarrying. Waiting until I was bleeding more to see a doctor didn't seem to make sense.
But she kept insisting that I rest in bed and not go to the emergency room.
I responded that I was going to go in and that I wasn't taking her advice. Then, she kept repeating, "Ma'am, that is not my advice. You would be going in against my advice."
I asked her what difference that made. Would going against her advice mean that insurance would refuse to cover my emergency visit? Would doctors refuse to see me?
She said, "No, maam, that's not what I'm saying. It's just our protocol, and I'm supposed to call ahead if we are sending someone."
I finally got fed up and said, "Well, I'm going in. Thank you for your help." Then I hung up.
When Jeff and I arrived at the CPMC emergeny room, there were two patients waiting. We waited for less than 20 minutes, and a nurse set us up in a room. She explained that the ultrasound in the emergency room wasn't very clear, but the doctor would be in shortly. When the doctor appeared in less than 15 minutes, he quickly performed an ultrasound. On the screen, the baby appeared alive and well, and we saw the little heart pumping away.
I asked the doctor if I needed to stay in bed for the rest of the day. He shook his head and said, "Don't lift anything heavy. Don't climb Mount Tam today. Otherwise, you're fine."
I could have spent the whole day lying in bed, fearful that I was miscarrying, reading everything on the web on bleeding during pregnancy, and counting the minutes until I could call my regular doctor on Monday morning. Instead, I spent the rest of the afternoon at my friend's baby shower, celebrating her new arrival. Sometimes, it helps not to listen to a professional.