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Early pregnancy loss

LV - welcome back. glad it all went well. take all the time you need to rest. I was going to go back to work a day after resting, but in the end I''m glad I took 2. I think it is standard procedure for them to send the tissue to a pathologist for analysis. the gynae told me that usually no cause for the m/c is found. if it is chromosomal, then they can''t find anything. I guess they do it to check for molar pregnancies and those type of things. and exactly what HouMedGal said, "meltdowns are perfectly acceptable". and we don''t have to blame things on dropping hormone levels. having a miscarriage is already frustrating and really sad on its own, without all the physical complications it brings.

HMG - I''m really sorry about your friend. DH has always said that it''s better that this happened to us now rather than later on in the pregnancy. I know everyone grieves differently, but I personally think it would be worse to know things aren''t going well later on the pregnancy, like what you said after seeing the heartbeat, the sex, the movement.
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by 23 weeks I would really consider it as my baby, and it must be torture knowing that your child is fighting for its life, and you don''t know if it''s experiencing pain and you can''t really hold it or whisper encouraging words into its ear... all you can do is lie there and try and think positive thoughts. my heart really goes out to your friend, and I''m glad it''s looking good right now.
 
Noel, thank you. I agree with you, it must be soooo hard to have something happen later on in the pregnancy...I just can''t imagine.
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Hi, I just wanted to pop in here and let you all know I am thinking of you.

Noel, I hope you stop spotting soon and AF comes soon. Thumbs up on the HPT, that''s a great sign.

Geri, I am sorry about your levels. Hang in there, your body is just taking its time getting back to normal. I was definitely depressed for a while after my m/c and D&C, and it''s just a normal part of moving on. So sorry that you have to go through it.
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LV, I am glad the procedure went well. (((HUGS))) Take it easy, my friend.

HOU, sorry your AF is being such a PITA! I think your''re right, it''s just a wonky period and she''s throwing you a bunch of curve balls. Your friend will be in my thoughts, that must be an incredibly difficult thing to go through and I hope it all works out for her and the babe.
 
just wanted to share that the cramping finished a few days ago and I''ve been on the treadmill yesterday and this morning, and over all I feel good and back to normal. and I think that''s a big accomplishment just on it''s own.
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Yay Noelwr, Gald to hear that!!!
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big hugs, and a little jealousy for your upcoming cruise
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Laila - Thank you for your support and your kind words. You know, I consider you a PS sister in this, since we've followed similar paths at about the same time. I do hope you get your BFP soon!! I know it is just a matter of time!

Bella - Thank you so much for your kind words. I'm so glad that you've joined us. Since you've started posting here, you've been nothing but positive energy for all of us. I appreciate it very much.
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Lucy - Thank you for your kind words. I've read your recent updates in the JBP thread. I am so happy that things are going so well for you and that you were able to see your little one on the US screen.

HMG - Thank you! I hope that your friend is doing well. It sounds like she is receiving excellent care and that they will do everything they can to help her son arrive safely.

Noel - Hey there! Thanks for your thoughts. Glad to hear things are looking up for you and that you are back on the treadmill. I'm going to get on mine tonight! I wish I was as consistent with it as you are.

Kit - Thank you my friend. I read your recent post in the JBP thread, and I hope you are not worrying too much and that your DR can put your mind at ease today.

***************

As it turns out, I did not need much rest. I couldn't even fall asleep during the day on Friday. I thought for sure I would be so tired because of the anesthesia and because I woke up at 5 am. On Saturday, I felt quite normal, went out shopping, errands, dinner out. I had some bleeding, not a lot, and it has progessively gotten less and less to just occasional spotting now.

Regarding the testing, I think there are different types of testing that can be performed. My impression was that they would investigate down to the chromosomal level, so that if the issue was an extra chromosome, for example, they would be able to determine which chromosome that was. I did not clarify this specifically, but because my RE wants to see the results before committing to a plan for next cycle, I suspect there may be certain issues that could be resolved during IVF? Maybe?
 
LV - that''s so good that you felt fine shortly after. I felt really
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for a week. once the pain was gone, I was in a much better mood. I''m glad you didn''t have to wait.

I hope that they do tissue testing for you at that level. at least they told me not to expect it for mine. maybe they don''t because my insurance won''t cover it. I imagine DNA testing is expensive.

talking about insurance, I haven''t seen any bills regarding any of this. I hope my insurance covers it all. then again, if it would have cost me money out of my own pocket, I would have paid it just to be able to move on. who knows... I might still have to pay something.
 
Hi Noel,

Yeah, I'm pretty happy about the recovery time. The doctor had prescribed methergine to "tone" the uterus. I imagine this is why the spotting stopped so quickly. It officially stopped yesterday afternoon.

What type of insurance do you have in Holland? Is it private insurance provided by your employer?

I'm having some insurance issues too. I have no idea if the genetic testing would be covered, and I am sure my doctor's office doesn't know for sure either, though I suspect it will be. My plan changed on January 1, and I have my id card, but my specific plan of benefits is not loaded into the insurance co's system yet. I called yesterday to see if they could tell me what my benefits are, and they again said it hasn't been loaded into the system, but they are contacting the account manager for the plan. She will apply pressure on the person who codes benefits to move things along. Many years ago, I used to be the person who coded benefits into the system (for a different insurance company), and those benefits were coded before any id cards went out. Because I know how things should work, I'm a bit frustrated with this insurance co, especially when I came home to a denied claim for my RE. The least they could do is hold claims for a member whose benefits are not in the system!!! Of course the claim was denied -- acc'g to their system, I have no benefits! Annoying, though I am sure this will all be resolved eventually. I could see how these denied claims would put some women into panic-mode (thinking they have no fertility coverage under the new plan!) I actually did go into panic-mode, last Thursday, when I received a notice from the insurance company that implied the infertility is a pre-existing condition, but we researched it and because I had no break in coverage from my prior plan, they cannot deny coverage based on a pre-existing condition.

Whew, sorry for the long post about insurance. I guess it's been on my mind.
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LV - yes, I''ve got private insurance (all insurance in Holland is now private since a few years) which is partially subsidized by my employer. I have a follow-up appointment on Thurs so I will ask the hospital if I need anything from them for the insurance. I think it''s a valid concern because at the time we were just thinking about our bodies and now we''re of course thinking about our wallets. I mean no one said to me, "It will cost this much, are you sure your insurance will cover it?"
 
Re: insurance, yeah it sucks to have to think about $ at a time like this. We got some bills from the hospital after the D&C, I don''t recall exact numbers but recall thinking it cost somewhere around $10,000 and our out of pocket was like $700. My insurance covered a lot, but not all. It was kind of a kick in the pants to have to fork out that much cash for an unwanted procedure, KWIM? Oh well, I just wanted to share in case it helps anyone to prepare financially.
 
Losing a baby no matter how far along you are is heartbreaking. The emotional toll that it takes is devastating. My ex-husband and I wanted to have a baby right away after we got married. I went for my yearly with my ob/gyn and she told me it usually takes 6 months to get pregnant. So we started trying at the end of April since our wedding was early June. We figured we would not get preggo right away but sure enough we did. Needless to say I showed right away and barely fit into my dress at 6.5 weeks preggo. We got married in TN and our whole family came with us. We got married early morning and that same day in the evening I got a funny backache. By the next morning I was bleeding very heavy and we left to drive home early to get to my ob. Needless to say, we had a miscarriage. I was a wreck and got depressed and gained a ton of weight. It took 6 months to get preggo again and going through not getting pregnant each month took it''s toll on me.
 
Kit - $10,000 !!! for a standard procedure?!? that''s crazy. I mean luckily you only had to pay a small part of it, but like you said, $700 out of your pocket is a lot for something that no one wants.

lknvrb4 - I''m really sorry for your loss. that must have been so difficult - especially on your wedding night! and if you showed right away, that means when you look at your wedding photos you will be reminded of it?
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I''m so sorry. thanks for confirming again that the 2nd time TTC isn''t always as easy as the first. I''m not being saracastic, I truly appreciate. sometimes I let myself believe it will happen very quickly again like the first time, but then I have to remind myself that if it takes the average couple 9 months to conceive, why do I think it will be any quicker for me? ... especially now that my body will have to get back into a rhythm, which might take a few months.
 
Kit, yup, my total hospital bills for the D&C came back at $10,000 and some change (maybe $10,200 or so? I can''t remember) and we will end up paying somewhere close to $500 out of pocket for the whole thing. Definitely a kick in the pants.
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lknvrb4, I am so sorry for your loss. It must have been so painful, what with the very unfortunate timing. *hugs* How long has it been? Sounds like you ended up having a successful pregnancy afterward, though?? That''s awesome. :)
 
lknvrb4, I am so sorry to hear your story. DH took a photo of me the night we learned we were pregnant and I looked SO HAPPY. Sometimes I look at that photo now and I think about how different things are today. I can't imagine losing your baby on your wedding night. I am so sorry... I am really glad to hear, however, that you were blessed again 6 months later. Oh, you are such a brave and wonderful person. Glad you are a mommy again.

On another note... I don't think we paid anything for my procedure... I don't think we had a deductible because I've never paid for any of my ultrasounds or OB care either. DH handles all the bills but I don't remember ever paying for any medical care throughout our ordeal. Wow, I didn't realize that D&C operations were so expensive but it makes sense in that it's surgery. I am so sorry, ladies. How awful to have to pay for something that you really didn't want.
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I''ve just come back from my follow-up appointment with the gynae, and it went well.


was a woman this time and most of the information I got out of her was because I asked questions. she wasn''t really informative, but luckily I have you ladies to educate me. she first asked if I was still bleeding, and I asked what she considered bleeding, and she said any flesh red blood, which I haven''t had since the first week. I told her I took the sensitive pregnancy test which turned out negative, and she said that was good (she was probably wondering if I thought I was still pregnant... they don''t seem to discuss hormone levels ever). I then asked if I bleed again how will I know if it''s my period or if it''s left over tissue, so she did an u/s. the uterus walls are now back together which she said is perfect, so next time I bleed it will be my period. she didn''t mention anything about this thing of not bleeding for 21 days. then I asked her if my body would assume its regular rhythm right away, and her answer was yes. I don''t think she should have said that because everyone''s body is different, and I''ve read that it can take months for a body to get back into repetitive same-amount-of-days cycles. if I don''t get my period within 6 weeks, she said it is need for concern, but she expects it will return in about 2 weeks (this without even asking how long my cycles were before).

oh, she also said she got the analysis back from the pathologist, and it was indeed a miscarriage. what the... ? DUH! I really didn''t understand this comment, but might be the Dutch language and terminology. and they were able to remove everything so they don''t think anything remained inside, which we saw later in the u/s was correct.

but she told me the main thing I wanted to hear which was that once I get my period we can start TTC again and next time I get pregnant, I can have an u/s done at 7 weeks instead of waiting til 10 like last time.


hope everyone else is ok.


Date: 2/3/2010 8:50:47 PM
Author: Bliss

DH took a photo of me the night we learned we were pregnant and I looked SO HAPPY.
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that breaks my heart.
 
HOUmedgirl-I had three normal pregnancies afterwards and I know I am blessed.

Bliss-I should have taken my miscarriage on my wedding night as a sign that I did not marry the love of my life. I have two beautiful children from that marriage though. Everything happens for reasons.

Noelwr-I was paranoid with each of my following pregnancies and I had an ultrasound at 6-7 weeks with each of them for my own sanity. I wish you the best of luck.
 
Kit
Wow, that seems a like a lot of money for a D&C. If you don''t mind me asking, did you spend the night at the hospital?

My procedure total was $3,600 and the majority of the charge was for post procedural care (basically the room after the D&C). Our co-pay was $100.00 for the hospital.

As far as our insurance is concerned, we have great insurance with regards to prenatal care. They cover all ultrasounds cost with no maximun which is plus. After my m/cI asked the Dr. is he would monitor more for "peace of mind" for my next pregnancy and he said absolutely. His protocol for post m/c women are appointments and ultrasounds every two weeks until week 20 or I get tired of going that often.
 
Oh, goody noel. Sounds like a reasonable outcome to your visit, even if the doctor''s info wasn''t entirely perfectly nuanced.

Its really hard sometimes. I am pretty well researched and science-based person, so I want to discuss numbers and risk and evidence and the medical people aren''t always prepared for that. Or they have their opinion and give it and don''t expect any questions back or someone that wants a nuanced answer not a absolute one.

Sounds like... they are a little more go-with-the-flow over there on certain stuff, like not monitoring your levels and just assuming you will perfectly go back on your cycles right away. I guess pick your poison, sometimes the medical people here can emphasize the possible bad outcomes beyond their likelihood and that is no good either.

But good luck with the recovery and TTC again soon!
 
Update on my friend:

She went into labor yesterday...they decided not to stop it since her membranes have been ruptured for so long, and the onset of labor can be an early sign of infection, so they let her go ahead, and baby Conell Phoenix was born at around 4pm today, at 25 weeks 0 days, 1 lb 8 oz. Both mom and baby are doing well right now...the proud Papa took some pictures for us, and he looks really good, like a real fighter!! Please send prayers and/or hopes for peace, comfort, and wellness their way!!!
 
OMG, 25 weeks! Wow, what a long road they have ahead of them. Hopefully a long road with a happy ending. Best wishes for them...
 
Thank you, Cara.
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Houmedgal - I have all my fingers and toes crossed for your friend, Conell and all their family.
 
HMG - thinking of your friend and her new family. I hope it all goes well as it sure sounds like they could use a break.
 
lknvrb4 - I am sorry for your loss and for the terrible timing. It is wonderful to hear that you had three successful pregnancies following your loss. Thank you for coming here to tell us your story. So many women go through this terrible loss, and yet, it is often not discussed.

HMG - I will be thinking of your friends and will send many positive thoughts for wellness to their family. Are they close-by? Will you be able to visit? Please keep us updated. Much hope for positive progress.

Noel - Your follow-up visit sounded interesting. I'm glad that you will be able to get an earlier ultrasound for your future pregancy.

****

My HCG is way down. It is now 17. The office will call me when they have the results of the lab testing. I have a follow-up scheduled with the doctor mid-February, and we will talk about future plans then. The nurse told me that it will likely be 4 weeks before AF arrives.

I asked the nurse today about IVF, and learned that they can detect whether an embryo has a chromosomal issue and would not transfer such an embryo. I had no idea. I really have not researched IVF at all. At this point, I am hoping the future plan will be to try another IUI first, unless of course, there is some reason why we should advance to IVF. Only time will tell.

I made an appointment with a new accupuncturist for tomorrow morning. I am really looking forward to it.

 
Date: 2/3/2010 10:48:37 AM
Author: noelwr
Kit - $10,000 !!! for a standard procedure?!? that's crazy. I mean luckily you only had to pay a small part of it, but like you said, $700 out of your pocket is a lot for something that no one wants.
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Noel, your post made me go out and add it up to see, because yes that does sound crazy!! Well, correction: $11,008.
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Now I am seeing HOU's post too so I guess I am not alone.

Anyone who thinks our health care system is not in need of reform needs to rethink their stance.

LL, no I did not have an overnight stay. It was all done within a few hours. I got bills from the hospital, the anaesthesiologist, and I think the pathology exam of the pregnancy. The hospital charges were $8500 approximatley.
 
lknvrb4, glad you are on this thread and I am so sorry for your loss, that is a sad story. I am glad you went on to have children that you cherish.

Noel, I am glad your follow up appointment went well. I hope your period comes for you ASAP and you can begin TTC again. I never had any monitoring of my hCG levels, I never even bothered to POAS--didn''t think of it! Only had one follow up appointment with my OB 2 weeks after the D&C, no U/S. She just did a pelvic and manually felt my uterus and said it had gone back down to size. Anyhow, my point is my Dr. is also kind of hands off in many ways and while that kind of freaked me out it did work out okay--sometimes more information is good and sometimes it''s just stressful.

Hou, your friend and her family are in my thoughts. Go Conell, go!!!

LV, glad your levels are dropping. Sounds like you are slowly moving forward, which is good. Hope you enjoy your appointment!
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Kit, LV, Noel, Geri, and Cara....thanks so much for the thoughts and prayers for my friend and baby Conell! I''m happy to report that Conell had a good day today, and is hanging in there doing well! I saw the first picture of my friend and him together a few minutes ago on Facebook...made me cry. She''s standing at his incubator with one hand on his head and one at his feet, and the look on her face....broke my heart. I could just see all the feelings she must be having right now...so much love, yet so scared. They are only a 3 hr drive away, so I plan on going to visit as soon as I can. Unfortunately it won''t be in the next couple of weeks because of my lovely work schedule.

LV, YAAAAY for that low HCG!!! Rock on!!!
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Kit, I don''t think I ever replied to your post about your SCH, but what I meant to say is that I have heard of several women who have them and have absolutely no issues, so I will pray for the same for you!!!
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The posts about how much a D&C has cost some of you caught my eye. What I earn from the public insurance system doing the anesthesia for a D&C in Ontario is $116.32. The surgeon earns $112.40. I''m not sure how much the hospital would charge, but since there should be no overnight stay required, just the preop bloodwork and assessment, maybe an ultrasound, and an hour in recovery room after, plus probably an hour in day surgery before discharge, I can''t imagine the fees coming to more than $1000, even with what the pathologist would bill. We''d all earn a little more if it were billed privately, but I doubt I''d get much more than $220 or so for the anesthesia. $8000-10000 seems absolutely insane!

LV - Yes, they can look for genetic abnormalities with IVF (PGD = preimplantation genetic diagnosis), but it''s complicated and not cheap. Probably adds thousands to the cost of the cycle. I think generally they''d fertilize all the eggs, see which get to day 3, send a cell from each for testing, and freeze them. Then you''d transfer a couple of normals on a future cycle. I''d imagine they''d start off by checking yours and DH''s chromosomes first if anything came back as abnormal. If you don''t have some sort of balanced translocation or other issue that''s likely to keep coming up in future pregnancies, it might not be worth doing the PGD.
 
HMG - I'm glad to hear that Conell had a good day. Sending good wishes his way.

DRK - I'm really surprised at how low the reimbursement rates are for both the surgeon and anesthesiologist! Out of curiosity, I asked my RE's office what the charge was for my D&C and was told it was $1800. I assumed this was the RE's charge only and that the anesthesiology group would also bill 1000+?!? Maybe they do because they are a separate practice, or perhaps they are integrated? I'm sure this does not include the lab testing. My procedure was performed in a surgical center, not a hospital, so I assumed that's part of the reason why the fee is lower, but there does seem to be a broad range of charges.

If I receive the statement from my insurance co with reimbursement rates, I'll let you know what the anesthesiology group receives. I believe he was a nurse anesthetist, though, so presumably the reimbursement rate would be lower than for a doctor.

Thank you for answering my question and for letting me know about the PGD. I've been avoiding educating myself about IVF, sort of approaching things on a need-to-know basis only. Fortunately, if needed, I will have 2 IVF cycles covered by insurance thanks to CT state law. It looks like only 2 embryos will be implanted per cycle - maybe that's typical. The PGD would not be covered. I will have to wait and see what my doctor has to say about future treatment. I expect he will want to do another IUI, and I just hope that I respond as well this time.
 
Hey DrK, I thought you''d be interested to know that the anesthesia team (1 dr. 1 nurse) each charged a little over $900 for my procedure, so $1821 total. I do recall meeting the nurse anesthesist, she was the one who was able to set up my IV, she had a very nice bed side manner...not sure if it was worth $900 though. Never even saw the dr.

I think this is a great example of how the US health care system does not even try to keep costs down.

Okay this will be my last post on the matter, as I am sure you all are sick of hearing about it, but thought DrK might like to know.
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