Friday, 7 February 2014

The Second Ectopic Pregnancy

The bracelet I bought after my first miscarriage
Having had to wait 9 months to try again with my first pregnancy, I was happy that the doctor who did my surgery said that I could start trying again as soon as my period returned. It took 6 weeks for my body to get back to its regular cycle. In that time, I had a tubal patency test done on my right ovary to make sure that it was clear. It was a huge relief to find out that everything looked okay on that side.

We started trying again as soon as my cycle returned. I had my doubts about how long it would take as the average person in their early 30's has less than a 20% chance of getting pregnant every month. And since I am one tube down (if I ever start a band, that's going to be our name!), my chances are reduced to about 12%. That's not very high but somehow I managed to get pregnant after a couple of months of trying. The human body is a pretty amazing thing. A scan would reveal that I had ovulated from my left ovary (the side with no fallopian tube), and yet somehow, my right tube managed to pick up the egg.

For those who have suffered repeated losses, you'll know what I mean when I say that I felt so robbed when I found out I was pregnant again. Don't get me wrong - I was really happy, but that feeling of happiness was completely overshadowed by fear. When I got a positive on my pregnancy test, instead of screaming and shouting with excitement, my husband and I looked at each other with wry smiles as if to say, "here we go again." It shouldn't be that way. At this point we know better now than to get excited about a pregnancy. It's more of a "wait and see" situation.

I called up a specialist who dealt with difficult fertility cases and over the next couple of weeks I went through regular blood tests to check on my hCG levels. Unlike my last pregnancy, the levels looked really good and were more than doubling each time. My doctor even joked that he thought it might be twins!

Over the course of two weeks I began to have the familiar sharp gas pains that I had had with my previous ectopic pregnancy. I tried to tell myself that it was probably constipation which pregnancy tends to give me, but I was extremely worried. What I couldn't figure out was that the pains were on the left side again, just like the last time. I tried to reassure myself that it couldn't be another ectopic because I had no tube on that side.

On the day of my first scan, I suddenly began to have terrible abdominal pains, worse than I had ever had, and found myself on the bed, doubled over in pain. Standing up, I nearly passed out and decided that I needed to call my doctor. He managed to get me in for an earlier appointment and gave me an ultrasound. Once again, there was blood in my uterus and he wasn't able to see a gestational sac. He admitted me to hospital for more tests but I already knew the answer. One of the signs of an ectopic pregnancy is shoulder tip pain, and while I hadn't felt any with my first ectopic, I had now begun to feel it alternating in each shoulder. Another scan confirmed my worst fears - the embryo had implanted again on my left side, but this time in the STUMP of what was left of my fallopian tube. The chances of this happening are almost impossible. Almost.

One of the things that will stay in my mind forever is lying on the operating table right before they put me under. In my previous pregnancies, I had already lost the babies by the time I realised that I had miscarried, but this one was still very much alive. I closed my eyes and took a moment to say goodbye to my child who was about to be terminated. To the child whose birthday should have been the day after my husbands' and who I had so desperately hoped would be our rainbow baby.

The rest of the story is pretty much how the second ectopic went: laparoscopic surgery, an overnight stay in the hospital, and then sent home to grieve and recover. The chances of having a molar pregnancy followed by not one, but two ectopics, is literally a million to one. With those odds I feel like I should be playing the lottery.

Saturday, 11 January 2014

The First Ectopic Pregnancy

It took me only a few months of trying before I got pregnant a second time. Knowing that I was able to move forward with my life after being stuck in medical limbo for so long was such a wonderful feeling. I was finally seeing light at the end of the proverbial tunnel.

I had been taking pregnancy tests in the days leading up to what would have been my period, but each test was painfully negative. There was no line to be seen. On the day that my period was due, I took one last test in the hopes that I would see something but still nada. I put the test aside and got on with things, disappointed, but knowing that we would just have to try again.

A few hours later, I picked up the test to have another look, and low and behold, there was the faintest of faint lines to be seen. Shocked, I headed out and picked up a First Response pregnancy test to confirm my suspicions. This also gave me a faint positive!

I called my doctor straight away as he had told me that he wanted to closely monitor me the next time I got pregnant, and he sent me in for an hCG test. That came back at a level of 14 and my heart sank. I could tell that things didn't look great from the nurse's voice when she gave me the number over the phone. The level was too low for 4 weeks into a pregnancy. And from that point on, I told myself I wasn't going to get attached. I knew in my heart that this pregnancy probably wasn't going to make it and so I didn't even let myself calculate my due date. I couldn't bear the thought of counting down to another birthday that should have been.

My heart leaped however, when a second and third blood test over the following days showed appropriate doubling of  hCG levels, although they were still really low. I tried desperately not to get my hopes up, but when you're carrying something so precious, it is almost impossible not to get emotionally attached. 

Over the next 10 days or so, I would experience sharp pains in my abdomen. I was a little concerned, but a quick internet search showed that gas pains were very common in pregnant women, and so I didn't think too much about it.

At about 5 weeks, I had a small amount of spotting which then progressed into painful cramps on the left side of my abdomen, similar to the ones that I had when I had taken cytotec. I waited through the night and then went to the hospital to find out if I had miscarried. It was too early to do an ultrasound and so more blood was taken to see where my hCG levels were at. Surprisingly, they looked ok. The nurse told me not to worry and that bleeding in early pregnancy was common.

The bleeding tapered off, but over the next four or five days, the pain in my left side remained. It wasn't a terrible pain - hell, we moved house during those few days so it definitely wasn't crippling, but I just knew in the back of my mind that something wasn't right with this pregnancy. With the hCG numbers being so low and the fact that the pain was only on one side of my body, I was starting to get concerned. 

I finally decided to go to the ER. It was a public holiday and everything else was closed. After being there for 5 hours and having an ultrasound done, they determined that they couldn’t see a gestational sac in my uterus but that I had a lot of blood in my pelvic area. They were unable to see my left ovary on the ultrasound because of the amount of blood and it was decided that I had an ectopic pregnancy that had ruptured my left fallopian tube which had resulted in internal bleeding. Within an hour of that diagnosis, I was on the operating table.

I have never felt more incapacitated than I did after the surgery. My D&C was a cakewalk compared to that. Not surprising considering they cut three holes in my abdomen. Unfortunately, they were unable to save my fallopian tube and so it was removed.

I was released from hospital the next day. As I was wheeled out, I passed a very pregnant woman in her 20’s puffing away on a cigarette. I was totally shocked but it made me so angry as well. I wanted to go up to her and shake her and ask her if she knew how lucky she was? That she was able to get pregnant and have a successful pregnancy. And how many women would kill to be in her shoes?  Instead, I went home to grieve the loss of another baby.