Sunday, 29 August 2010


A few things about the physical recovery after being operated on for ectopic pregnancy...

Like with any pregnancy, your body has prepared itself to be pregnant.  This includes the lining of the womb thickening and blood capacity starting to increase.  When you're suddenly not pregnant anymore, your body must re-adjust to being normal.  This includes shedding the extra lining.  As a result, after an ectopic pregnancy you will bleed for awhile (about a week and a half in my case, although it was not at all steady).  Like after childbirth, you can't use tampons because of the risk of infection.  You also can't have sex again until you've completely finished bleeding (to give your body a chance to recover and because of the risk of infection).

If you have surgery, you won't be allowed to shower for the first day or two.  After that, you can take shower, but you can't submerge your wounds in water until they're completely healed over.  So no baths, swimming, etc.

Even if you do everything you're told to, you can still get an infection.  One of my incision sites got infected and so I had to go through two rounds of antibiotics.  If your wound starts to look really red and inflamed, stink, or have a yellow colored discharge (yes, I do realize it's gross), see your doctor immediately and make them swab it and prescribe antibiotics.

Tuesday, 24 August 2010

After the sun goes down...

During the day it is easier to get distracted.  Whether or not we always want it to, life goes on.  We still have to take care of the kids we have, take care of the house, pay the bills, etc.  The grief is still there, but you can move it to the background for awhile, let it simmer on the back burner while you go through the motions.

At night it demands your attention.  For the first week after it happened, I went to bed at night and the tears just came.  My husband just put his arms around me and held me while I sobbed for hours at a time.  He usually ended up crying with me.

Weeping should be listed as one of the side effects of an ectopic pregnancy.

Sunday, 22 August 2010

Other People

We hadn't told anyone that I was pregnant yet.  When I was first went into the ER, my husband called both of our sets of parents.  Our siblings got filled in as well.  That's it.  Those are the only people we told.  I understand that some people in my situation would probably want to tell all of their friends and would need to talk and get support. 

For us, we just found it too painful to have to keep explaining it to everyone.  There was nothing that they could do to help, and I really didn't want any platitudes.  It was hard enough to process to ourselves that it had been an ectopic pregnancy and that our baby was gone.  Explaining it to lots of other people (and--even worse--having word get around so that acquaintances brought it up to us) was just too much.  I needed to recover from the surgery anyway, so we just kind of dropped out of society for a few weeks.  (It was easier because we had planned to be out of town about now, so people just thought that we were on summer vacation like everybody else.)  That's all of the people we told, although I know that my mom did tell some people (at least a few relatives, but I suspect many more of her friends as well).

A few people who know have been fantastic, and I will be forever grateful for their unconditional and absolute sympathy and love.  Some people, though, just don't know how to react.  Perhaps worst of all, my parents seem determined to just avoid the subject completely.  They will discuss my physical recovery (as briefly as possible) if I bring it up, but there's been absolutely no mention that this was their grandbaby.  That's hard too.

So here's my advice.  If you know someone who suffers through an ectopic pregnancy (or miscarriage, for that matter), don't avoid them or keep bringing the subject up.  Just be ready to sit down with them, let them talk, cry with them, and then give them a hug if you're the hugging type.  Maybe bring by some food for them.

Thursday, 19 August 2010

Things I want to remember about this pregnancy:

  • We were so happy and excited.  I can remember all of the anticipation before hand, and how absolutely thrilled we were when I took the test and it came back positive.
  • Like with all of my pregnancies, I was really tired during the first couple of weeks.  It was a satisfying kind of tired, the kind that makes you sleepy but also a bit smug because you know the reason why.   My husband was fantastic about getting up with our girls in the morning and letting me rest (sometimes for naps in the afternoon too).  The girls were also very patient about watching children's TV more often than normal so that I could rest.
  • This little baby was (and is) greatly loved.  I remember my husband saying "I love you", then putting his hand over my tummy and saying "and you."
  • I may only have been in the first trimester, but being pregnant definitely affected my eating.  I ate stuffed vine leaves like crazy.  My husband kept buying them for me, and I just couldn't get enough of them.  I remember one perfect day when I felt pregnant and fantastic.  We went to the market and the olive guy gave me a huge free pot of stuffed vine leaves.  A kind lady on Freecycle gave me a huge bag of fantastic maternity clothes.  It was a beautiful sunny day and we played outside with our girls.  It was just a bunch of little things, but it was such a happy day.
  • I also really liked shakes.  It was really hot, and we don't have air conditioning.  Pretty much every day I made myself a shake for breakfast with ice, a banana, some milk, some nesquik, a spoonful of peanut butter, and some flaxseed.

Monday, 16 August 2010


Only a few weeks ago, I told my husband that the only thing that I was really afraid of was something happening to him or any of our kids (including the one not born yet).  I can't say that I really faced that fear, but because of my pregnancy being ectopic pregnancy I have been forced to live through it.

Unless you have had this experience, you can not imagine how heart-wrenching the loss is.  You walk into the surgery pregnant, and you walk out empty with a huge gaping aching spot instead.  It's not a hole, because a hole is passive.  It's more of a black hole that threatens to suck everything into its grief.

If we hadn't already have had two kids, I don't know how I would have made it through.  My daughters were my reason for trying to hold it together.  This baby, this tiny baby who will never be born now, was already a part of our family.  My husband packed away the baby things that had already started accumulating so that I wouldn't have to see them.  I packed away the maternity clothes calmly, then burst into tears.

I need to go now, but I'll write more about this later.

Tuesday, 10 August 2010

The Hospital: Part Four

I was able to walk back to the preparation room adjacent to the operating room.  I was accompanied by one of the nurses (she pushed along my IV stand).

They immediately had me lay down on the operating table.  I remember most vividly that it was extremely cold (it probably seemed more extreme to me as I was just wearing a hospital gown and by this point had multiple bags of cold liquid pumping into my IV).  The only real preparation left was that I had to take out my contact lenses. 

The surgeons, anesthesiologists, etc. made small talk during the short time between my entering the OR and going under.  Most of it was fine, but some one asked if I had known that I was pregnant.  I nodded and struggled to keep it together and not just break out into tears.  I kept trying not to think about it, but I knew that at that point my baby was still alive and fine.  Logically I knew that although my baby was still alive for the moment, there's no way that they could have survived for much longer--whether or not I went in for the surgery.  Emotionally, I felt horrifically guilty knowing that the surgery that was going to save my life was going to kill my baby...even if everyone at the hospital was very careful not to word it that way.

As had been explained to me previously, the anesthetic was administered through my IV.  I was out within seconds.

Obviously I don't remember what happened next.  According to my husband, I was in surgery for about three hours.  I don't want to speak for him, but I think it's safe to say that they were three of the more miserable and nerve wracking hours of his life.

I woke up in recovery.  It was extra disorienting because I couldn't see (they gave me my glasses after they realized I had come to).  After only a couple of minutes I was wheeled on the bed back to the ward where my husband was waiting for me.  Considering all of the horror stories that I had heard about general anesthetic, physically I felt much better than I had expected.

The surgeon came and spoke with us and explained that the surgery was successful.  They "removed the pregnancy", stopped the internal bleeding, and removed most of my right fallopian tube.  Amazingly they did not have to remove my right ovary, which they had anticipated they would probably have to do.  The surgery was performed laproscopically.  I had a small incision in my belly button for the camera, a slightly larger incision on the left side of my tummy for tools (suction, etc.), and the largest incision about four inches below my belly button (right next to my C-section scar).  That was the incision they worked through.

We realized what a hurry they had been in to get me into surgery when I noticed, with surprise, that although I had been under general anesthetic, they hadn't taken the time to put in a catheter.

The rest of my time in the hospital was just recovering enough to go home.  I was still on an IV until shortly before I was discharged.  I was also still being observed fairly regularly, although not as strictly as before going into surgery.  Although I kind of shuffled, I was able to walk myself to the toilet (with my husband's support and help with the IV) within an hour or so of the surgery.  By the end of the day I could walk slowly unassisted.

When they discharged me, they gave me a leaflet on miscarriage.  I looked through it, and it really upsets me that they didn't have any better information to give out about ectopic pregnancies.  None of the miscarriage application was really applicable to my situation, and it just seemed worse than being given nothing at all.  It made me realize how little information and support is available for people who lose a baby through ectopic pregnancy.  I was also given a leaflet on recovering from laproscopic surgery and two types of prescription painkillers (cocodamol and ibuprofen).  I was also given instructions about recovery and future care (I'll discuss that later).

Although an ectopic pregnancy is an absolutely horrid reason to be in hospital, I did appreciate the staff there.  They were kind, which I really needed.

Sunday, 8 August 2010

The Hospital: Part 3

I was transferred to the breast and gynecological ward to be prepared for surgery. 

I was put under observation.  At regular intervals (it seemed like constantly), nurses came and checked my blood pressure, heart rate, blood oxygen level, and temperature.

The main thing that they needed to do before surgery was to take more blood for further testing, and to get some good lines in.  The nurse couldn't find a vein.  The phlebotomist put such a tight tourniquet on me that my hand was going all pins and needly, but she couldn't find a vein either.  The doctor came back and explained that my veins were basically shutting down.  So much of my blood supply was pumping into my tummy that there just wasn't enough left for the rest of my body.  I felt very cold (due to low circulation) and at times very light-headed.  Normally I can donate blood without a problem, and no one's ever had a problem taking my blood before.  However, my veins were just collapsing, and so a whole host of medical professionals couldn't find a good vein.

Eventually, in hopes of increasing their chances, the doctor had my arm wrapped up.  Warming it can help, so my arm was wrapped in layers of padding before they tried again.  After a lot of tapping and prodding at my veins (and several false attempts), the department's chief anesthesiologist finally managed to get a cannula into my hand.  Although she finally managed to feed the tube into my vein, they couldn't get any blood to come out of it.  There was just nothing there to draw.  So they gave up on drawing blood then and just started pumping me full of fluids instead.  I wasn't allowed to drink or eat as I was about to go in for surgery, but they started me on an IV.  Normally when you see IV's, they are at a slow drip.  This was more like a waterfall.  It was a steady pour into my veins trying to rehydrate me as much as possible.  (They also went ahead and ordered several units of blood in my type to be sent to the operating room as they expected me to need a transfusion.)

After having my other arm wrapped up and then tourniqueted again, and being on the IV, they managed to draw some blood.  I also had to do your standard hospital pee in a cup for testing.  (This was particularly great as I already had an IV in, so I had to go use the toilet with an IV stand and tubes hooked up to my hand.)

It seems that there was a steady stream of people to see us.  The anesthesiologist (two of them, actually) came and explained what would happen.  For surgery for an ectopic pregnancy, they use a general anesthetic.  They explained what I should expect and checked on my cannula (the tube into my hand that could be used for IV's).  For surgery, they usually require patients to have two working IV lines.  That way, just in case they have a problem with one, they already have a back-up.  In my case, they gave up on getting a second line in, and said they were just thankful that they managed the one.

I also had the doctor come back several times to check on me and to discuss things to my husband and myself.  I had to sign consent forms for the surgery, and they explained all of the possible risks to me.  Honestly, though, I didn't really have a choice.  I could either have the surgery, or I could refuse medical help and die.  It was an absolutely heart-wrenching thing to sign the consent forms, but there just wasn't another option.

There were also nurses and student nurses constantly checking me, checking my blood pressure, etc.  The surgeon also came out to speak with me.  They also dry shaved me to prepare for the surgery.  (If you go in for abdominal surgery, don't be surprised if they shave off the top couple of inches of your hair first.  If you know in advance that you're going in, it's definitely preferable to do it yourself.)

Then we just had to wait for the operating room to be ready.  They pushed all of the other surgeries back so that they could fit me in next.  We literally just waited long enough for them to clean the operating room, and then it was my turn.

Saturday, 7 August 2010

The Hospital: Part 2

After finishing with the scan, it wasn't long before we spoke with one of the doctors.  She was really good and we had actually seen her before when Princess was born.  She explained to us that it was definitely an ectopic pregnancy, and that our only real choice was for me to go in for emergency surgery. 

If you're not familiar with what an ectopic pregnancy is, I'll give just a brief explanation.  An ectopic pregnancy is basically when the pregnancy is in the wrong place.  Normally, the ovary releases the egg.  It then travels along the Fallopian Tube.  Somewhere along the way, the egg gets fertilized by sperm.  In a healthy pregnancy, the fertilized egg then keeps going down the tube and implants itself in the lining of the uterus.  In an ectopic pregnancy, the egg implants itself somewhere else (normally, including in my case, inside the Fallopian Tube).  Sometimes there is a reason for this to happen (infections, having a contraceptive coil, damage to or malformations of the tubes, etc.).  About half of the time there is no apparent reason for it to happen.  (The surgeon eventually told me that it was "bad luck" as there was no apparent reason for me to have had an ectopic pregnancy.)

Ectopic pregnancies are never viable.  That sounds really clinical.  What it really means is that your baby has absolutely no chance of survival.  Ectopic pregnancies never make it to term (in fact they almost never survive past about 7 weeks, and most end much sooner), and there is no way to save the baby. 

Ectopic pregnancies can also be dangerous for the mothers.  According to WebMD, ectopic pregnancies are: "the leading cause of pregnancy-related death during the first trimester in the United States."  Many ectopic pregnancies will naturally miscarry before they become dangerous for the mother (often before she even knows that she was pregnant).  In other cases, they are caught early enough to avoid serious health risks.  A lot of the time, though, ectopic pregnancies aren't diagnosed until they rupture the area where they have implanted.  In my case, the first sign that my pregnancy was ectopic was when I experienced severe abdominal pain, etc. because the pregnancy had grown large enough that it was literally causing my fallopian tube to burst (leading to internal bleeding, etc.).  In many parts of the world, this still leads to a lot of maternal fatalities.  Where people don't have access to prompt and quality medical care, they can die from the internal bleeding and infections.

My ectopic pregnancy had reached the point where the only option was to have emergency surgery to remove it.  There was no chance of saving my baby.  At this point, the doctors were concerned about saving my life.  The doctor that we were meeting with sent me over to the ward to be prepared for emergency surgery.  Then she rushed off to book me for the next available operating room in the hospital, and to enlist the help of the best surgery team that she could.

Wednesday, 4 August 2010

The Hospital: Part 1

I mentioned in my last post that I ended up in the ER with severe abdominal pain (especially on the right side) and a few other symptoms.  After spending a very emotional day at home, we went in for our appointment at the hospital's early pregnancy unit.  Although it was in the same building as the maternity ward, I was really grateful that it was on the other side of the building so that we weren't surrounded by happy couples sporting huge bumps or new babies.  I just couldn't have handled it then.

First they looked at my blood work.  For 6 weeks pregnant, my hormone level (Hcg) was about 4x what they are looking for.  Otherwise, although no single thing was glaringly dangerous, everything was slightly off.  Although it didn't give an obvious answer as to what, my blood test results showed that something was definitely wrong.

Then I had a vaginal scan.  I'd never had a vaginal ultrasound before, but it was the best way to see exactly what was happening at this stage of pregnancy.  I had to lie back in a chair with stirrups.  My husband sat next to me holding my hand.  The sonographer spoke the whole time, explaining what she was doing and what she could see.  When she started, she could immediately see a thick endometrius.  This means that the lining of the womb was very thick, as would be expected during pregnancy.  However, it was also empty.  She couldn't see any signs of pregnancy: either there or recently miscarried.

As she moved the wand, she saw more things that worried her.  By this point the screen was turned so that I couldn't see what was happening during the scan, and she had the clearest view.  She found the pregnancy, but in the right fallopian tube.  My baby was still alive, but in the wrong place.  She also found another worrying area on my right tube.  She could also see signs of fluid. 

At this point, she wanted a second opinion (or verifications of the seriousness of what she was seeing).  She left for a minute and then came back with another experienced sonographer.  Together they confirmed that I had an ectopic pregnancy in my right fallopian tube that had grown to the point of rupturing my tube.  This was causing significant internal bleeding.  My abdomen was basically filling up with blood.  They said it was common to see some signs of fluid around the tube itself during an ectopic pregnancy, but that they could see it pretty much everywhere they looked with me.  They took pictures and measurements on the ultrasound machine the whole time.

At this point I was able to get up, wipe off all of the jelly they use for scans, and get re-dressed.  Then my husband and I were ushered into a private office to wait to speak with a specialist.