Wednesday, April 1, 2015

TMI About Cytotec

WARNING:  Though pro-Cytotec (misoprostol), this post is going to be gross, TMI, and probably triggering.  It's gross, graphic, and sad.  In fact, there's no reason for you to read this at all this unless Cytotec is an option in your life because you are facing a "missed abortion."  So I hope you found this when you Googled something like "cytotec and pain" or "cytotec experience" or "how long misoprostol take" or "cytotec pros and cons."  If not, nothing to see here.  THIS IS SAD AND TMI AND GROSS.

I wrote this because I found so little information about Cytotec (misoprostol) when I was considering my options.  I was grateful for the personal accounts I found on message boards, but really was surprised how rarely anyone writes about this, and everyone seems to regret it.  There were very few positive experiences with Cytotec.  I mean, this has been around since the 80s!  I'm nothing special, but maybe this story about Cytotec can help someone.

I decided to take Cytotec because I did not want a natural miscarriage that takes weeks -- with no painkillers!  And go in twice a week to the clinic anyway.  Nope.  I also wanted to avoid a D&C/anesthesia/possible uterine damage if at all possible.  And I didn't want to pay my 20% of the surgery in my insurance.  After years of fertility treatments, privacy was important to me.  I just wanted to be left alone.  Cytotec seemed like a good solution for me.  I had a couple days to spare (no work) and I was willing to take on some short-lived intense pain to avoid weeks of bleeding out or surgery.  Though I was 9.5 weeks pregnant, the embryo was only measuring 6 weeks, so this seemed reasonable.

You can read my preparations here.   My painkillers and the Cytotec would have been about $30 without insurance, and it took two scans to "confirm fetal demise" and to check up the next day - about $150 total with no insurance.  Apparently, some doctors check up later than that or less than that.

The doctor put the Cytotec WAY up on my cervix at 10AM. Uh, hello there.  I had four pills, which was the max dose on the consent form.  She said they use four because one or two might fall out, which is no big deal.  I could feel something was happening.  Not pain, just kind of gurgling, if you will.  I could feel the gurgling 15 minutes later when I went shopping for my provisions.  I took my Hydrocodone and waited.  Luckily I ate before all this started, no way I would have eaten anything after this started.

I spent a lot of time on the toilet because it felt like things were happening, but nothing was happening.  I wasn't in pain, I just parked on the toilet because I felt like I had to #2 the whole time, but nothing happened.  About noon, nausea hit me like a truck and I threw up half my breakfast.  From sitting on the toilet, I barely made it in the toilet.  Then the nausea was gone and that was over.  About 12:30, the diarrhea kicked in, curing my last pregnancy symptom, constipation, then that was over.  I felt pretty great after that.  With that, I lost a pill in the mix, maybe two, and that was over quick.  I had thought I could put them back, but, uh, no.  Then nothing happened.  I just hung out on the toilet, no big deal.

About 2PM, I took more hydrocodone because nothing was happening, and I was thinking I either lost too much of the medicine or things were about to get real.  Then it gets hazy.  I think the real contractions kicked in around 2:30-3PM.  This must be what labor feels like.  The painkillers helped, and somehow I worked really hard to drift in and out of sleep.  This was far beyond period cramps, but it was nothing compared to my other gynecological adventures: emergency laproscopic surgery and egg retrieval recovery without painkillers.  Someone on a message board said this was a 10 on the pain scale.  Well, I've experienced a diverse rainbow of gynecological pain.  I'd give this a 7.5, maybe an 8.  And it was SHORT, only a few hours, not like IVF recovery, which took days.

Don't get me wrong, this definitely required painkillers, and you need to get out in FRONT of this pain because if this hits, it's too late.  Hydrocodone was good, I'm sure oxy would have been even better.  Sometimes I felt like the only tolerable position was a fetal position.  Sometimes I stretched my whole body out as long as I could go.  Sometimes I laid out on the cool tile.  Sometimes I was on the toilet, but nothing was happening.  My dog thought I was crazy.  She sat at a safe distance staring at me the whole time.  It made her nervous and she was barking at every little city noise, ha.

I was actually able to sleep through a lot of it, just like the doctor said.  It was some kind of cool body defense mechanism, or maybe just how the drugs work, but I'll take it.  I slept through most of it, so the three hours was mostly not actively involved.  It started to hurt too much, so I would will myself to sleep.  People texted me, and I remember thinking I couldn't answer because I was in too much pain to reach for my phone.  I had an idea of something I wanted to Google and realized I had no way to do it because I couldn't even see my phone and there was no way I could possibly move.  The TV was on something annoying and I couldn't move to change it, so I just went back to sleep so I wouldn't have to hear it.  The lights were too bright, but there was no way to turn them off, so I went to sleep.  I can see how this could be different with another person there.  For me, it would have been harder to sleep.

I think I was in serious cramps for three hours.  Then the cramps were just gone, like nothing had happened, and I felt perfectly normal, no pain at all.  I didn't feel pregnant, I didn't feel like my period was coming.  I felt nothing.  I called my mom and chatted on the phone for a half hour.  I told my mom I thought it had failed and she would have to take me for a D&C anyway, LOL.  I took some more hydrocodone, but that turned out to be unnecessary because there would be no more cramping.

At 6PM, I started bleeding like a normal, light period.  No pain.  This was the first blood.  At 6:30PM, the sac passed.  I could feel instantly that this was not the usual things that my vagina encounters.  Based on some gross Google searches, I was able to confirm this was the sac and placenta, intact, passed at once.  It was like a thin dumpling skin with an intact sac full of fluid, bigger than I expected.  Almost the size of my palm.  The placenta looked like ground beef. And inside was a fetus.  Amazing, really.  I put it in the specimen cup, then in the paper bag, and then in the fridge next to some hummus and some yogurt.  It was very emotional to see it.  I can see how this could be a dealbreaker for some, but for me it was cathartic.  I was glad to be able to handle it myself, with privacy, and to know for sure and see it with my own eyes.

Then no cramping, no pain at all.  I bled the rest of the night, just like a regular period with some clotting.  No pain, no more urges to sit on the toilet.  At about 8PM, I ate something and rehydrated.

The next day, I had a scan to make sure I didn't need another dose.  Everything was clear except some of the lining, just like I expected.  I bled for another seven days, like a period on the heavy side. I would have been able to go back to work the next day for sure.  I was well-rested and felt great.  Mostly the next seven days was like a regular period, but there were a couple times when the bleeding kicked in, and couple other times when the pain really kicked in, maybe four days later.  The pain was always at night.  I took a little hydrodone twice.  Of course, gardening for four hours three days after cyctotec and helping someone move five days after Cytotec were probably not the best choices.  I got my period back 6 weeks and 1 day after the day I took the Cytotec.  That's about normal for a D&C or a natural miscarriage as well.

I was alone because my sperm donor was traveling.  I think this worked out well for me because I was able to sleep during the rough parts and put all my emotional energy into just dealing with it.  It would have smart for me to have someone to check in on me, but oh well.  I think being alone was the best thing for me.  The whole thing was very emotional to me, and I was grateful to be able to do it in my home with some privacy.  I just wanted to be left alone in the dark with some ice cream and some Real Housewives.  I didn't want another clinic visit, like I had every other day when IVF failed.  It felt healing and empowering in a way.

Overall, I consider Cytotec an inconvenient day on the toilet, three hours of INTENSE pain (tempered by painkillers and sleep) and then a 8 day heavy period.  To me, this was a good tradeoff considering the other choices.

A few tips:
Eat before this starts
Take your painkillers BEFORE the pain
Buy mega maxi pads and rehydrating drinks
You need a couch or bed very close to a toilet.  Maybe improvise something on the ground.  You won't be able to make it far, and you won't care that it's an air mattress.

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