Ectopic Pregnancy: Dancing With Death

Ectopic Pregnancy: Dancing With Death
I thought I was going to die. And for once, I didn’t want to. ...
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I thought I was going to die.  And for once, I didn’t want to.

You see, I have placed myself in plenty of death-provoking circumstances before, not really caring whether I lived or died.  Those many times when I coyly seduced death, taunting and teasing it in a rather catty way – giving it my most smoldering “come hither” look as I peered down my outstretched arm, palm up, slowly curling my finger toward me.  “Come on … that’s it … just a little further …”   As if I were a dancer in some sort of twisted burlesque show.  “Touch me, Death …   I dare you!  Betcha’ can’t …” as I raised an inviting eyebrow.  Then I would suddenly plop to the floor like a rag doll.  “And I don’t really care if you do,” I’d sneer, rationalizing the self-centered delusion that I deserved it anyway – death, that is. 

But not this time.  This time I cared.   

The pain began one Saturday night in January.  My husband and I had planned on going to a local theater to see the latest indie film. 

I was taking a shower in preparation of our evening out when the cramping began in my lower abdomen -- a slow, constant, gripping, slightly-piercing pain.  It wasn’t excruciating, but it definitely got my attention.  “Shall we dance?” asked Death.

I quickly looked down.  “Whew!  No blood,” I sighed.  That had to be good, right?  Every time that I’d had those kind of cramps before, there had been blood.  Blood was bad.  So, no blood must be okay – right?  Yet a twinge of panic hovered that I couldn’t dismiss.  And there was the pain.  It wouldn’t stop.

My husband chose to stay home with me and rented a movie.  But pain and a slight nausea kept me in bed.  I could hear the movie playing in the living room, where the TV was located.  A feeling of tightness began to accompany the pain and nausea in my belly.

I convinced myself that I had some kind of food poisoning.  It couldn’t be another miscarriage.  No, no, NO!  There was no blood!  Sure, lots of unrelenting, painful cramping – but no blood.  Yes, I thought, that was it!  Something that I had eaten gave me an acute case of gastrointestinal distress.

As I moved certain ways, a flash of scalding electricity ripped up my back, to the shoulder opposite of the limb I was moving.  Referred shoulder pain?  No!  It couldn’t be.  It was just really bad gas.  Really, really bad gas.  Probably food poisoning. 

Death was leading me, unwillingly, to the dance floor while as I tried to delude myself that I wasn’t that sick.  God knows how made it to the kitchen and living room.  I knew that I needed stay hydrated, yet I had little thirst and no appetite.  I managed to scrounge up a few crackers and some water in the kitchen, force them down, and inched my way toward the living room couch. 

While lying on the couch that morning, watching TV and trying to force down a few more crackers, I dropped the TV remote on my stomach.  Death then tried to shove His hand in mine to dance. 

The pain was beyond excruciating.  My vision went pitch black except for some bolts of bright white, blue, green, and blue light which flashed before my eyes.  A four-letter word suddenly made its way to the back of my throat, but never materialized because I just as rapidly inhaled it back in at that moment.  All went black. 

That damn little gritty voice wasn’t so little now.  “This is serious, Sue!  You do not faint!”  And that blasted little voice was right.  I had never fainted before.  In the past, I’ve had my fair share of moments of “passing out” in some rather unflattering ways while under the influence, but I’d never truly fainted.  Over the years, I had seen some pretty gory things in the operating room, but I’d never fainted.  But ironically, I felt a fleeting sense of relief at that moment – the relief that came when I laid down my heavily-armored ego.  I finally acknowledged that I was in some serious trouble. 

Shortly thereafter, I heard my husband bounce in from church, still high on the fellowship there.  His face fell as he walked into the bedroom.  

I confessed what had happened.  I told him that I had fainted twice from abdominal pain while he was gone.  In so doing, I relinquished my façade about the severity of the pain.  I quietly but urgently said, “I need to go to the hospital now.”

My husband quickly picked up the bedside telephone and called the Ob/Gyn department at Kaiser hospital.  I heard him talk, but didn’t hear what he said.  “What’d they say?”

He looked at me briefly and hurriedly said, “They told me to call the Emergency Department.” 

More dialing and more talking.  I couldn’t make out either side of the conversation.  Again, I pleaded, “What!?!”

He hung up the phone and said, “They want me to bring you to the ER at Kaiser.”

There was his voice again.  “Susan!!  Can you hear me?”  He had been holding the trash can in front of my face as I lay on the floor. 

I whispered a reply as I did not have enough air to talk, “Call 911.” 

Next I heard my husband’s voice – he was talking on the phone again.  His voice held a tension that I had never heard before.  “Call 911!” I cried out silently as I drifted in and out of consciousness.  At that moment, I felt a strange yet comforting sense of release.  The pain was unbearable – it felt like my innards were being ripped out of me while I was still conscious.  I felt Death’s determination to have its last dance with me.

But there was that peculiar sense of release in it all.  That release in giving up the fight.  Letting go of my obstinate, perverse desire for control.  I closed my eyes.

The paramedics arrived faster than I thought – within 5 minutes, I wagered.  I heard the siren wail as it came up our street, then abruptly stop in front of my house.  Normally, I would’ve been embarrassed if they had stopped in front of my house.  But not today.  Today, I had a new gratitude for that ambulance’s normally obnoxious blare.

Suddenly, my tiny bedroom was very busy.  I heard several voices – a male and a female – perhaps 2 males and a female.  I wasn’t sure because I never saw any distinct faces – I only heard terse exchanges of words.  At their request, my husband recited the basic information: age, weight, height, etc.  Pause.  “Is she pregnant?” an unfamiliar voice asked.

“Yes”, my husband replied.  “About 7 or 8 weeks … something like that.” 

I wanted to yell, “Seven weeks, you idiot!  How could you not know?” but no words materialized.  He sincerely didn’t know.  He didn’t want a baby like I did.  He hadn’t been the one obsessing about their temperature every day and blow money on ovulation predictor kits.  And he wasn’t the one who had an early miscarriage a few months prior …

What felt like a plastic bear-nosed clear mask was hastily placed over my nose and mouth and soon the familiar “fssssss!” sound of oxygen filled my ears.  Now knew what my patients felt when I strapped that blasted thing on them and why they immediately reached up to take it off.  It seems instinctual to want to remove something covering one’s nose and mouth – even if that “thing” is providing critical oxygen. 

I heard an EMT ask, “Does she have any health insurance?”

“Yes,” my husband replied.  “We have Kaiser.”

There was a distinct, brief pause.  The EMT continued, “That’s good but … she’s going to UCSD.”  The implication being, of course, that I was too medically unstable to transport across town to the main Kaiser hospital.  UCSD was a block and a half away.

Searing pain from the movement of the stretcher wrenched me back into reality.  I was being taken out of the ambulance and wheeled up a ramp through the doors to the Emergency Department.

I was thrust into a room of bright lights and commotion.  Every movement of the stretcher brought excruciating pain – yet I had no breath to cry out.  I felt all of the paramedic’s monitoring equipment being exchanged for those in the ED and I heard a brief report being given by the EMT.

Amidst the poking and prodding, I felt the sharp coldness of ultrasound gel being applied to my abdomen.  Then intense pressure as the probe was moved around my belly.  Black, white, blue, and orange flashes of light again raced before my eyes against a dark background.  The piercing pain overcame my inability to vocalize and I let out an audible moan.  The pressure let up a few seconds later, and I settled into my familiar Vaseline-smeared fog.

Then I heard what confirmed what that pesky little voice had been trying to tell me all along and which I had been deliriously trying to deny:  “Free fluid in the abdomen,” a male voice pronounced above all the clatter.  A small tear trickled down the side of my face.  More needle poking ensued as the ED staff attempted to start another I.V.

In a strange sort of paradox, the more I felt Death’s slowly-tightening squeeze, just that much more I let go.  The onion-like layers of denial and pride and stubborn independence peeled away much easier now …   I was surrendering the fight.

A man’s face suddenly invaded my vision.  I don’t recall what he looked like as I was still unable to focus.  He delivered the final blow that shattered any remaining shards of denial I held.  “Susan, we think you have a ruptured ectopic pregnancy.  We need to get some fluids in you quickly, so I’m going to put a big I.V. line in right …  here,” the man said as I felt the pressure of a gloved finger just below my right collarbone.  I closed my eyes in passive consent. 

Another blurry male face was forced into my view.  “Susan, you have a lot of fluid in your abdomen.  We need to take you to surgery now to find out the cause of it, okay?”  My gurney began to rattle and move.  “Do you agree to the surgery?”

My head began to swim with worries about who was going to be on the surgical team, and most importantly, my anesthesia provider.  You see, my worst nightmare was to be a patient in the hospital where I had worked.  I feared that my dark, dirty chemical dependency history would surface.  I also worried that they would deduce how stupidly arrogant I was to abstain from getting much-needed help earlier.

I had been a nurse anesthetist in that hospital up until 10 months before this incident.  I had worked with many of the nurses, surgical technicians, residents, and attending doctors for 3 years.  My biggest fear, interestingly, was not who were going to be my surgeons, but who was going to do my anesthesia!  The skills of the anesthesia provider were crucial in a case like mine. 

As I was positioned on the table, I felt the familiar placement of my arms on the padded armboards, with the raspy, fabric-ripping Velcro sound as the wrist restraints were applied.  The oxygen mask was removed and replaced with the bulkier plastic, padded mask that the anesthesia provider uses.  It was being firmly held to my face by a rubber-gloved hand. 

The ““fssssss!” noise of the oxygen became louder than before.  I was being “pre-oxygenated” prior to induction of anesthesia.  Part of the problem of being a patient in the environment in which you work is that you know everything that is going on … and panic if a step is missed or not done to your liking. Another hypercritical moment:  analyzing and critiquing the movements of those around me – especially my anesthetist – while I was slowly hemorrhaging to death internally.  Unbelievable.  My tenacious ego was alive and kicking, even though the rest of me was half-dead!  

I awoke in the recovery room a few hours later, knowing that I had (reluctantly) taken the first dance step with Death that day.  I had held its colder-than-ice hand and looked into the eyes of the great abyss.  I felt a surge of overwhelming gratitude that I had not finished the waltz.  Reality then jolted me through the remaining wisps of anesthesia fog.

I suddenly knew a new kind of pain.  It wasn’t from just having had my abdomen sliced open and inner organs manipulated.  It wasn’t from the loss of my right Fallopian tube, or even the loss of the potential baby that the tube had so preciously tried to hold. 

No, this was a new kind of pain entirely.  It was coming from an intangible, yet vital, part of my life.  It was the loss of hope.  It was then that I scoured the horizon for Death, but He had cunningly slipped away.  He had silently left me amidst the ether, holding His dance card.

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