Ectopic Pregnancy

This is one once again one of those posts that is more for my benefit than anyone else. I feel like most people who read this blog are either a) family or b) good friends who I don't stay in regular contact with. If you fall into category a, you already know a lot of this. If you fall into category b, I would probably willingly tell you all about it. If you don't fall into either, there must be a category c, the blog stalkers that I didn't know existed. Whoever you are my readers, here is a long, long story.

It all began at the end of July. The weekend of Anders' birthday had been a rough one for me. I hadn't been feeling very good-just slightly ill. Tired, slightly nauseous at times, and just an overall feeling of malaise. That Sunday had been particularly bad-Ellen was terrible in Sacrament Meeting, the family we normally sit with was gone, and I had someone make some comments to me that (in my four years of parenting) were about the most rude and judgmental I have ever received. I then had to come home and put on a happy face for the family birthday dinner that Anders almost didn't make it to because of church responsibilities. Really, it was a pretty awful day.

The next day I was still feeling pretty crummy (both physically and emotionally) and as I went to climb in the shower, I noticed my breasts were leaking. Now, I don't know about you,  but that's not a normal thing unless I am nursing a baby. Between that and the nausea and malaise I had been feeling for a few days, I decided to take a a pregnancy test and it came back positive almost immediately. It was a big surprise since a week and a half before that I had what I thought was a period. I had been having lots of spotting prior to that and still some after that, which can be very normal for several months after going off of birth control, so I wasn't worried about it. However, with this very strong positive pregnancy test and some basic calculations, I realized that it couldn't have been a period I had a week and half before and that something was not right.

I called the doctor the next day (since they were closed for Pioneer Day) and got an appointment for late that morning. The doctor did an ultrasound and couldn't see anything at all. He told me it was either too early to see (since I didn't really know when my last period was) or there was something else going on that he couldn't see that a ultrasound tech could find. He sent me for blood tests to see what my hormone levels were. After about  2 1/2 hours at the hospital (my doctors office is in the hospital), I headed home to wait. I called the doctors office that evening and the nurse who I talked to just said "Your test was negative. You don't need to come back." I tried asking her a few questions, but she just kept saying, it's negative, you're not pregnant, there's nothing wrong. She was obviously tired at the end of the day and didn't want to deal with me. After I hung up I couldn't really figure out what was going on, so I took two more pregnancy tests, both which came back very positive.

I called the doctors office first thing the next morning and the nurse I talked to informed me that my tests had in fact come back positive and the hormone levels were high enough that the doctor should have seen something. She scheduled me for an ultrasound with a tech for 12:30 that day. I was very grateful to have the ultrasound tech that I did. She was actually just filling in at the hospital that day. She was quite chatty and answered any questions I had as we went along. After about 10 minutes of checking things, her talking stopped and I noticed her focusing in on one area (which I knew was my Fallopian tube) and start taking a lot of measurements and pictures. I knew then that I had an ectopic pregnancy. An ultrasound tech is technically not supposed to diagnose anything or tell us what I have, but I am so grateful for this tech who did tell me once we were done. She knew I was going to have to wait a while for a doctor to come and she basically knew that I knew, so she just confirmed it for me. She let me cry for a while and then started to talk to me about other things- mostly my kids and her granddaughter. We showed each other pictures and she was just what I needed while I waited for the doctor to come. The doctor who finally came was a random doctor (possibly from the ER?) who basically said, "you've have an ectopic pregnancy and it looks like you'll probably be a good candidate for medicinal treatment. We're contacting your normal doctor to figure out further treatment" and then he left.

After that, no one knew where to send me, so I ended up in a tiny waiting room in the middle of the hospital with no cell service. I waited there for a while until they realized my doctors office was just upstairs, so I was eventually sent there to wait while the on-call doctor made it. The same doctor who diagnosed me with the infection when Ellen was born was the doctor that day. He gave me a better run-down of what my treatment was going to be. I was a perfect candidate for a dose of a chemotherapy drug called Methotrexate. My hormone levels were in the needed range and I had caught the pregnancy early enough (just over 5 weeks) that all I needed was a shot of the drug. However, apparently only a few nurses are authorized to give it and the only ones still at the hospital (it was almost 4 pm by this point) were in the ER.

I had to head down to the ER and soon after I was checked in, two different ambulances came. I waited in the waiting room for only for about 45 minutes when the hospital's head nurse came and found me (she had originally escorted me to the ER) and got me back to a room. She started to put my IV in and had to try three different spots. The nurse the day before had really poked me good on both of my arms and she couldn't get a good spot the first time. On the second time, she was in the middle of trying to put it in when the ER doctor came to talk to me. I started to cry and blew out the vein, so she had to find a third spot to do. I finally got the IV in and they ordered the meds.

I ended up waiting for a few more hours and Anders was able to eventually find someone to take the girls and come. All afternoon I kept thinking I was almost done and ready to come home, so I didn't think I needed Anders to come. I am grateful that he finally just did it (without asking me). He waited with me a while longer and eventually the medication made it's way down. I was given the shot and within 20 minutes I was in some pretty extreme pain. I had major cramping, which is one of the side effects of the drug. I was given some Percocet and once that started to control the pain, we were sent home (at about 8:30 pm).

For the next three days I was dizzy, nauseous, had diarrhea, was bloated, was cramping, and was unbelievably tired. Anders was supposed to go to Scout Camp those couple of days and I am so grateful this all happened right before he left instead of after he was gone. I am also glad he had the time off so he could take care of me and the girls. I slept about 20 hours each day for the first three days and didn't each much for about 5 days. Finally, at about day 7 I was starting to function and could more or less help out at home. I was told that there would be minor side effects from the drugs. Apparently minor side effects wipe me out for a week. We had several people bring us meals and take our girls each day. A special thanks to Isaac & Dylan, Nisha, and Melissa who all took their fair share of babysitting time.

I had to continue to go in for regular blood tests at certain times (day 4, day 7, and then weekly) to check my hormone levels. Everything was dropping exactly as it should have been. I was a picture perfect case and they thought that by the end of August or beginning of September, the hormone levels would be at 0 (which is what they wanted).

Two and half weeks after (August 13) I was given the methotrexate was the day of Nisha's graduation. Yay Nisha! We were hosting a party at her house after the ceremony, so the last few days had been the busiest days since I had the medication. I still wasn't back up to normal and my energy levels were low, but was feeling pretty good overall. At Nisha's graduation I had some cramping and a little bleeding (which I hadn't had for a week or more). It didn't last long, so I figured it was just because of how much I had done the last few days. We had the party that afternoon, got everything cleaned up, everyone was sent home, and Anders and I basically collapsed on the living room floor. I was so tired and didn't move for about an hour. I then got my second wind, so Anders and I went and watched a TV show and I worked on a project while we watched.

A little after 10:30 we went up to bed and as I was brushing my teeth, I started to get some more cramps. I went and sat on the bed and within 3 minutes I was in extreme pain. Anders called Nisha (the family nurse) and she basically said, take her to the ER. She was about 7 minutes away and said she could come watch the girls.  Anders, who we found out stays calm in an emergency, gave me a quick blessing and had the foresight to gather several things we would need. By the time Nisha arrived, I was in an amazing amount of pain. Anders had to carry me down the first flight of steps and I had to have a lot of help to make it to the car. By the time we got to the hospital (which was 2 minutes away) 20 minutes after the pain started, I was a mess. I couldn't feel my limbs and they were cramping up (probably due to my lack of breathing because of pain) and was close to being unconscious. Anders grabbed a wheel chair, got me in it, and wheeled me into the ER. We had been there long enough to give the receptionist my name and birthday when one of the nurses saw me through the window in the door and came out. He just said "She needs to be back here. Follow me." Bless that nurse for not making me wait in the waiting room. Anders gave him a rundown of what was going on as they wheeled me into a room, and then I started throwing up because of the pain. They got me in a bed and suddenly there were 3 male nurses there. With Anders help, they got me in a hospital gown, and then two of the nurses each grabbed an arm and put in an IV (so I had two). They then got a doctor in and he ordered some pain meds and some zofran for the nausea. Eventually, they were able to get my pain levels down enough that they could do some basic examination and I could at least be settled. Turns out that bursting organs and internal bleeding is no picnic.

They had to call in an Ultrasound Tech to do an ultrasound and once she got there, she started to take care of somethings. The ultrasound was quite painful and about halfway through, I was supposed to empty my bladder. I was sent to the bathroom with, help from Anders, and as we were leaving the bathroom, I totally passed out. He had to pull the little red string and he and a nurse got me into a wheel chair (after passing out at least once more) and back to my bed. They finished the ultrasound and sent the results off to the ER doctor.

He came in later to tell me that he thought it was not a burst tube from the ectopic pregnancy and was just an ovarian cyst that had burst, which sometimes can cause pain. He did say that they would send them to my on-call doctor and see what he thought.

As we waited, I had to go to the restroom again and once again, I totally passed out. It took a few nurses and Anders to get me back to the room. They finally put in a catheter and we did quite a bit of waiting. After one of my pass-out instances I remember looking at my blood pressure numbers and noticing that my bottom number was in the low 30's. It was funny because I remember thinking "Wow, that's really low. That's not good" and then not caring about it at all.

Eventually, my OBGYN made it to the hospital at about 3 AM. He was the one I had originally seen, had ordered the first ultrasound, and was following my blood work, so he was familiar with what was going on. He came and talked to us for a few minutes, confirmed that it was, in fact, a ruptured tube, and that they were calling in an operating room team. After that, we had nurses come in to do some paperwork and prep me for surgery.  Within an hour I was in the OR having surgery.

I woke up around 7:30 or 8 pretty groggy and feeling pretty miserable. Because it was a Sunday, I had been checked into the mother/baby floor since they commonly deal with women's reproductive systems. They kept me until about 6:30 that night. I had to have my pain managed and the biggest thing was I had to be able to get up and use the bathroom. We once again had a trip to the bathroom (which was 5 feet away), in which I passed out on Anders. He pulled the red string again and we had a whole bunch of nurses swarm to my room. I think there were about 6 of them there. I passed out 4 different times trying to get from the toilet back to my bed. I got real familiar with the bathroom floors at the hospital in my less than 24 hour stay. Eventually I was able to get up and use the bathroom with lots of assistance and without passing out.

Once we got home, Anders got me settled, Isaac & Dylan went and got my pain medication, and I gave the girls kisses right before they were put to bed. I spent the next week and a half not very functional. I had a good two days of having to be escorted everywhere since I was so dizzy (due to blood loss and pain killers), I had several days of not being able to eat much, and then just the pure exhaustion that comes from surgery. Anders once again had time off since we were supposed to be on vacation that week and we had someone take the girls everyday for a little while for that first week. It took me a good two weeks before I really felt like I was going to make it through.

I am grateful for all the family and ward members who brought us meals and took care of children. My mom called me everyday for at least two weeks to check on me. We also had fresh flowers for a month in our house (ones that had been sent with the first go-round were still alive) and we received more. Flowers from my parents, from my in-laws, from Melissa, from Mike & Tamara (her mom dropped them off since they live in Texas), from Anders' work, from someone in our ward (Susie Eager), and two different bouquets from Matt & Rosemary. Karma Lambert brought be a lovely little cactus as a reminder that even hard and prickly things can grow in a desert and become beautiful. It currently sits in my kitchen window where I see it on a regular basis. I also had a beautiful book brought to me by our Relief Society President. We had a lot of help, and we needed it.

I still am not feeling quite up to 100%. I lost about a liter of blood and my iron levels will take a while to get back to normal (my hematocrite was at 38 before surgery and dropped to 28 afterwards). I also have had some major hormone changes (more so than I think I've ever really experienced) that haven't been my favorite. Hopefully those will regulate soon and I'll be feeling more myself.

The doctor ended up having to remove my entire right fallopian tube. He said that he always tries to save it, but often it is too damaged to save. I was told prior to this that any future pregnancies I have will have a 33% chance of also being ectopic. I had hoped that the removal of the tube would lower those numbers (since there would be no scar tissue for an embryo to attach to), but apparently I was wrong. I still am considered at high risk for another one and will have to go immediately to the doctor once I find out I am pregnant in the future. The doctor also told me that I actually have a higher than 50% fertility rate. Both of my ovaries are working just fine and apparently an egg from my right side can find its way over to the left tube (pretty amazing, huh?). It does mean my ability to get pregnant is not as high or as easy as it was, but it is higher than I expected it to be.

Through all of this, there are a few major things that stick out. How grateful I am for family and friends who showed up when we needed them is one of the major things. Another is how grateful I am to still be able to have children-and for my two beautiful girls. I am grateful for the doctors and nurses who were woken up at 3 am on a Sunday to come help with surgery and those who were working to help in my recovery (and for a hospital that is 2 minutes away). I am grateful for modern medicine, knowing that I would be dead without it. I am especially grateful for a couple of friends who reminded me that life is unfair, stupid, and painful at times and it is okay to feel that-it is one of the reasons we were sent to this earth. Finally, I am grateful for Anders-for all that he had to do to keep our family together and to take care of me. I married a good one. :)

Well, that's the end of this story. If you made it this far, I'm impressed.