Pregnancy After Salpingectomy

I am just going to continue with my pregnancy story and get it all out this week :)

I found out I was pregnant exactly 7 weeks after my surgery, and I had some pretty mixed reactions. I was, of course, extremely happy, but that was tempered with lots of anxiety. There was no way to know if this pregnancy was ectopic too (once you have an ectopic pregnancy, the likelihood of it happening again is much higher) or if there were complications from being so soon after surgery. My incisions were still sore! I made an appointment the next day with my OB, and due to my history they scheduled me for an immediate ultrasound. I cannot begin to describe the relief I felt when they found the embryo was in the right place! I was only about 4 weeks along, so we weren't able to see a heartbeat, but our baby was definitely there!

The doctor told me that now that we knew the embryo was in the right place, we were out of the woods. There was no reason that this pregnancy should not proceed like normal. This was wonderful to hear, but did nothing for the anxiety I was feeling. I could find very little on the internet about pregnancies after salpingectomies, and my imagination was running wild. I was so concerned that something would happen with the baby, since I felt like my insides were still scrambled eggs.

I was also very fragile emotionally, as I was still dealing with the loss of our second pregnancy and the feelings surrounding a "near death" experience. Add an influx of hormones to that, and the emotional upheaval of finding out you're pregnant, and just imagine the crazy that comes out.

I spent the first trimester in a haze. I was moody, nauseous, and depressed. It feels terrible to share this, but I was so angry about being pregnant again. I didn't have time to mourn my second baby, and already I was supposed to bond with a new one? This pregnancy felt like an impostor, sneaking in during the absence of what was supposed to be my "real" baby. This was a very difficult time for me, as most people can't possibly understand why you aren't happy about a pregnancy so soon after the loss of one. I'm sure I seemed ungrateful for this gift, but that was never the case. I clearly remember thinking that I wished we had a little time in between, so I could move on and be properly grateful for this blessing. But God's timing is perfect, as I have come to find out :)

15 weeks pregnant

We didn't share the news outside of immediate family members until I began my second trimester, and I am so happy we waited. By the second trimester, I was coming out of the fog a little bit and beginning to look forward with happy anticipation. I had a few weeks of feeling great, but then, I slowly began to feel depleted. I was just SO tired, I could barely make myself get out of bed, or go up stairs. There were days that lifting my arms felt like an impossible task.  Around this time, I had my first round of routine blood work at the OB/GYN, and it was discovered that I was extremely anemic. Getting pregnant so soon after such extreme blood loss had completely depleted my iron stores. My doctor prescribed iron supplements, which I immediately began taking. Within hours of taking the first dose, I started vomiting. This continued throughout the day, and happened every time I tried taking the oral supplement, so the doctor told me to discontinue it.

When my iron levels were checked again, they were even lower. The decision was made at this point to begin IV iron infusions. I went to the cancer center once a week for 20 minute infusions. Let me tell you something, friends. It is impossible to be depressed or ungrateful for your situation when you go and sit next to chemo patients once a week. This did so much to change my outlook during this time. These people were some of the bravest, and sickest, I have ever seen. They were amazing to me and made me feel so grateful and blessed for the life I'd been given, the good and the bad.

The iron infusions worked wonderfully, and I started to feel like a real person again. My energy returned, and I was able to truly enjoy my pregnancy for the third trimester. The last few weeks were, of course, interminable and uncomfortable, but that just goes with the territory.

I struggled so much with bonding with my unborn baby for most of the pregnancy. Towards the end, I was happy I was pregnant and looking forward to meeting the baby, but didn't feel that bond that I remember having with D's pregnancy. That's why I was so pleasantly surprised at my wonderful labor experience. I felt so energized after delivery, I was able to stay up all night staring at my beautiful baby. My husband went to sleep, and I just lay in the hospital bed, in the quiet stillness, with her in my arms, memorizing her face. Everything I had been through in the past year had led me to her. Of course, I remember thinking. Of course it's you. I know you. I knew you all along.

the hard stuff

I shared Hannah's birth story yesterday and alluded to the difficulties I experienced during that pregnancy. I plan to share more about the pregnancy itself, but today I want to share something very personal. The difficulties I experienced during pregnancy were directly related to what happened here.

I've been writing this post in my mind for months now, and just never feel like I can do it justice. But, I've realized that getting it out there is more important than doing it eloquently, and I feel like it's really important to have a conversation about this, if only to give other women who have dealt with / are dealing with this same issue a place to come during that inevitable Google search that leads to nothing satisfying or informative. So, here we go (it's a long one- sorry in advance!)

In February of last year, I was diagnosed with an ectopic pregnancy that had ruptured, causing severe internal bleeding. I was rushed into surgery to remove the pregnancy and it was determined once the surgeon saw the extent of the damage that the entire Fallopian tube had to be completely removed, as well. It was one of the most traumatic, terrifying, and heart-breaking days of my life.

Let me back up to the beginning. I had not been feeling great for a few weeks, and my cycle had been a little wacky. I went to see my doctor, and they performed a pregnancy test and a few other lab tests, and other than being a little anemic, everything seemed fine. I distinctly remember telling the doctor, "I don't know what it is, I just feel like something is wrong". She assured me I was fine, and sent me on my way.

Two weeks passed, and I just wasn't feeling better. I had a nagging pain in my side and a period that just wouldn't go away. A few nights, the pain in my side woke me up out of my sleep. My husband was very concerned and kept urging me to go to the doctor, but I refused. It honestly felt like a more painful version of ovulation, and I thought I was just having an extreme period (after several months of not having one).

Then, on a Sunday morning, I was shocked awake from a dead sleep at about 4am with extreme pain in my side. I didn't wake up my husband, took some Tylenol and tried to go back to sleep. A few hours passed and it didn't seem to be getting better, so I started Googling (it's what I do)! The main concern was, of course, a ruptured appendix. I woke my husband up to tell him about the pain, and he insisted I go to the ER right away. I was resistant, but finally agreed to go if I could go by myself, with him staying home with D. There was no reason to wake D up at 6am and drag him to the hospital if it was just gas, I reasoned! He reluctantly agreed, and I drove myself to the hospital. I knew something was really wrong when I involuntarily started crying while driving, and clutching my side. I still wouldn't have said the pain was extreme, more like incredibly wrong. I limped my way into the ER and was immediately whisked back through triage.

The doctor on call ordered all the standard tests, and after much waiting, came in to examine me. He was positive it was my appendix, and wanted to do an MRI first, and then an ultrasound to rule out anything else. I remember asking him to do the ultrasound first, because I hadn't met my deductible and it was the cheaper test (the ridiculous things we worry about, even in a situation like that!). He agreed, but a few minutes later, he came in and told me that my routine pregnancy test came back positive. He delivered the news happily, and told me they could easily operate on my appendix without harming the baby, and congratulated me. I texted my husband that he needed to get to the hospital, and he started scrambling around for a babysitter for D.

With the positive pregnancy test, the ER doctor did decide to do the ultrasound first. I was terrified, but still reeling from the shock of the pregnancy. My ultrasound tech was a kind of endearing, gruff old guy and he chatted with me as he began. I knew something wasn't right when the conversation died, and he was making way too many "hmms..." He finally told me that he wasn't seeing anything in the uterus, and he moved over to the Fallopian tubes. As soon as he moved the wand, it was obvious there was a problem. There were huge black masses that he said was internal bleeding.  He told me that he wasn't technically supposed to say, but that the pregnancy was not viable and they were going to have to do surgery as soon as possible due to how much I was bleeding.

I was wheeled back to the ER right as my husband arrived. At this point, he knew nothing about what was going on. As soon as I saw him, I dissolved into tears and tried to explain. The nurse came in and gave me morphine for the pain, which helped in calming me down tremendously. Everything happened very quickly after that. The surgeon came in and explained what was going to happen, and told me that we would plan to go into surgery in a few hours. I sent my husband home to relieve the babysitter who had to go to work, and gather up D and his things to come back and say goodbye to me before surgery. Not 20 minutes after he left, the surgeon came back in and said he'd taken a closer look at my ultrasound and I needed to go to surgery right then. I told him no, I needed to wait for my husband to come back. I will never forget what he said; "If we wait any longer, you will die."

Well, shit.

The next few minutes were a flurry of activity. The nurses prepped me and ran me down the hall to the OR. I was bawling hysterically about not seeing my husband or baby before they put me under, and the sweetest nurse told me everything was going to be fine, and kissed my forehead. The anesthesiologist came in and talked to me for a few minutes (about what? Who the heck knows!). I signed some forms and was unconscious before I knew it. I remember thinking back afterwards that I didn't even get to count backwards!  I remember bits and pieces after the surgery. I asked the nurse if they put everything back where they found it (always a joke to lighten the mood) and she hesitated. She tried to explain that the damage was too extensive and the entire Fallopian tube had to be removed, but I was too loopy for any of it to register. They discharged me from the hospital while I was still pretty sedated, and Mike took me home.

My parents were luckily visiting DC from Montana, and Mike had texted them to come down as soon as we knew there would be surgery. They arrived a few hours after I got home, and were SUCH a huge help. The doctor told me I should be able to go back to work in a few days, but I was home for a full week before I was up to it. I had lost so much blood, and felt pretty traumatized, that the one day I did go to work for about an hour, I dissolved into tears at my desk and had to go home.

I looked all over the internet for information about ectopic pregnancies, laproscopic salpingectomies (the Fallopian tube removal) and dealing with the loss, but I was so frustrated to find there was barely any information. I have never felt so entirely alone and confused as I did in those first few weeks.

I didn't feel like I deserved to be sad. I had only known I was pregnant for less than an hour. The pregnancy would never have been viable, even if it hadn't ruptured so violently, it could never have resulted in a baby. Not to mention all the feelings that I had about being literally near death. What if Mike hadn't convinced me to go to the ER? Would I have just laid in bed, thinking I was just overreacting, until I just passed out from blood loss? The fear, anxiety, and depression that I experienced in the weeks and months that followed were rough.

I didn't share the experience with a lot of people, but those that knew did their best to comfort me. Nothing was really helping though, I was just so sad. While I had a great surgeon, his bedside manner was not the best and at my post-op appointments, I was given the distinct "get over it" impression. He did tell us, however, that we could start trying again after the first normal cycle, but not to get our hopes up. With all the trauma my body had been through and the missing tube, it could take 6 months to a year before we got pregnant again. The chance of conceiving again with only one Fallopian tube was less than 30%.  He urged us to go ahead and start now, if we wanted to have another baby. It wasn't the worst news in the world, but being told it may take months or years to achieve what you literally just had within your grasp was challenging, to say the least. We decided that rather than aggressively trying and being disappointed, we would just not prevent things and hope God surprised us with a miracle.

And surprise us, He did! 7 weeks after my surgery, I started feeling woozy and moody, and decided to take a pregnancy test, just for the heck of it. Imagine my shock (and pure terror) when the test was positive! I cannot even begin to describe the emotions that I experienced at that point, and I will detail all that in a subsequent post.

My goal in putting this extremely personal story out into the internet is that someone experiencing this does not feel alone. I couldn't stand the thought of another woman suffering in silence, having no where to go and no one to tell her that her feelings are completely justified and normal. You are not alone!

If you have any questions, or want to share your own story, please leave them in the comments or email me at abookwormandababy@gmail.com.

Birth Story: Introducing Hannah!

Considering my sweet baby girl is almost 3 months old, I thought it was time to write down her birth story! One of my favorite things about this blog is being able to go back and see what we were doing years ago, and watching how our family has changed. I had a pretty rough pregnancy this time around (I'll save that for another post!) and I was beyond ready for my December 25th due date. I was hoping she'd come a little earlier than that, as I didn't love the idea of spending Christmas in the hospital! On December 21st, I woke up around 2 am with minor contractions, not painful really, just uncomfortable. I tossed and turned for the rest of the night and didn't get much sleep.

My last "bump selfie"! 39 weeks, 3 days before delivery!

I took D to daycare that morning and just felt really restless. I decided to occupy myself, so I cleaned the whole house. Still feeling antsy, I went for a long walk and then decided to bake some cookies. I had taken my maternity leave a week before, and was going a little stir crazy. I had contractions pretty steadily all day, 10-12 minutes apart. That wasn't odd for me though, as I had been having contractions for weeks. My husband got home around 5 o'clock and the contractions started getting more intense. Around 6:30, I called my parents and asked them to come over to stay with D, because we wanted to go to the hospital "just to be sure". At my appointment a few days prior, I had been 5 centimeters dilated, so I knew when it happened, it would be fast. I didn't want to get my hopes up though, so I told them we'd probably be back.

My husband hadn't eaten dinner and I was still feeling a little uncertain about going to the hospital, so we went through Taco Bell for him to grab a bite. As we were sitting in the parking lot, the contractions started coming hard and fast. The hospital was right across the street, so we booked it over. As I got out of the car in the parking lot in front of the emergency room, my water broke. Great timing, right? I was so excited now that I knew it was officially go time! We got up to Labor and Delivery and got settled. The monitor showed my contractions were fast and regular, and the nurse said she could feel the baby's head. We'd have a baby sooner than we thought!

I was laughing and joking in between contractions, and playing "Don't Stop Believing" on my phone. About halfway through the song, an intense change came over me and I did NOT want any more noise. It became less fun and I got serious about the contractions. I was laboring on the birthing ball, which was a life-saver! My husband was applying counter-pressure to my back, and I was breathing through the intense contractions. I was determined to have a completely natural birth, especially after my experience with my first labor. I spent about 2 hours on the ball, and then completely lost my composure. I started asking for pain meds, telling my husband I wanted them NOW. I didn't realize it at the time because I was on the ball and hadn't been checked since we were admitted, but I was crowning! He knew I didn't want a medicated birth, so he tried to stall a little bit, but ending up calling the nurse and asking her to bring the meds. Literally about 30 seconds after he did that, I needed to push. The nurse walked in and helped me climb up on the bed. As soon as she saw me, she paged the midwife. I vaguely remember her saying, "Tell her to HURRY!" The nurses didn't even get set up, and my midwife was still pulling on her gown when the baby came out. I honestly don't even think I pushed, she just came out on her own! The midwife caught her from the side of the bed; she didn't even have time to get down near the bottom. At 10:36 pm, 2.5 hours after we checked into the hospital, Hannah Kate was born! Weighing 6 pounds, 14 ounces (exactly a pound heavier than big brother!) she was waiting for no one!

I held her skin to skin for a long time, and when she started rooting around, I was able to get her latched on right away, and she ate like a champ! I was so pleased, because after D's birth, I had some bleeding issues and was so disoriented from the medication that I remember very little of that precious time. I am so thankful I was able to have the non-medicated birth that I wanted. I felt so wonderful after birth! I was energized and felt the most incredible adrenaline rush. I even walked from Labor and Delivery down to the recovery room! I was so excited, I stayed up most of the night, holding that beautiful girl and memorizing her face. I am so thankful that after a difficult pregnancy, I was able to have exactly the labor that I wanted. Welcome to the world, Hannah Kate!