Tag: ectopic pregnancy

Nothing….

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There was nothing there on the ultrasound screen, just my beautiful uterus – empty.  There was the teeniest tiniest black spot that may have been the beginning of a sac, but it was so small my Doctor was not certain.  She didn’t need to say anything for me to quickly realise that I was not one of the lucky 1%.  My doctor checked my ovaries: my right one is still hyperstimulated from the IVF and I had some VERY big follicles/cysts (but this is normal for after IVF and of no concern, but may explain any pain I may have here), my left ovary too was swollen, but not as bad as my right one.

What does this mean?  It was difficult for my doctor to say without knowing what my beta test results are.  If my hCG levels are continuing to rise, it is likely that I have a tubal pregnancy (ectopic pregnancy – a pregnancy that grows outside of the uterus).  If my hCG levels are falling, then it will be safe to assume that I have a chemical pregnancy* and the little black spot on the screen was indeed huckleberry.

My symptoms have been spotting dark brown blood since Friday, general abdominal pains all day Monday, my spotting surprisingly stopped today (Tuesday).  I have had some pains specifically on my left side, although not overly sharp pains, and I pointed out to the doctor (doctors – there were 2 others in the room with her) where this was….yeh, about where my ovary/fallopian tubes are.

If this is a chemical pregnancy then the doctor will prescribe me some medication (a vaginal pessary, I cannot remember the name of it) to help my body along with expelling the uterine pregnancy.  If this medication doesn’t work, or my hCG levels come back higher with a likelihood of a tubal pregnancy, then I will be prescribed Methotrexate (an intramuscular injection – YEY another injection, of course!!!).  I want to avoid taking this drug because it will mean we are not allowed to conceive for at least another 3 months because the chemical can stay in the body and harm a developing embryo.  But at the same time, we don’t want to wait and see for too long because there is a chance my tube could rupture and I would lose a fallopian tube.  I have read that even after being given the shot their tube still ruptured because it was left too late.

So I was asking you to hope with me that I didn’t bleed, but now I want to bleed….please, please body, just bleed!!!  I think this will be one of those times when I cry tears of happiness when I start to bleed full flow!  I know it will also be sad at the same time….choo choo, all aboard the emotional train wreck!!!

I mentioned that there were two other doctors in the room, one was ‘shadowing’, the other was a fellow (no not a chappie you silly Brits!!!).  The fellow interjected and answered some of our questions, he was clearly very knowledgeable, but there was a lot of bouncing around between them.  Chris was getting frustrated with the information we were receiving, they were talking to us as if we were medical professionals.  It took 5 minutes of Chris’s continued questioning to get the doctors to say that despite the miscarriage being bad (and sad), what we were seeing was ‘normal’ or ‘common’.  What they really needed to start out with was – don’t worry, there is nothing seriously wrong with you, chemical pregnancies happen frequently with IVF (because they are transferring 2 embryos).  I think I had a bit more knowledge than Chris and didn’t feel quite as frustrated because I had googled a lot on miscarriage, chemical pregnancy, blighted ovum and have read forums/blogs etc.  So my lesson here is to share more of my ‘google expert medical opinion’ knowledge with Chris before these types of appointments.

We also discussed my hCG levels (49, 110 and 345) and my doctor did admit that my first hCG result of 49 was borderline low- to non viable.  So why, oh why, did the other doctor (who did my IUIs) seem so happy and chirpy on the phone, proceed to tell me my progesterone and estrogen levels were excellent but fail to tell me my hCG level.  All it required was this:  “Congratulations Ms Dani, you are pregnant, but your levels were a little lower than average, we would like to see you again in 5 days just to make sure you levels are doubling nicely.  Your estrogen & progesterone levels are excellent, so this is a good thing.”  Expectation management is not a bad thing.

So – we have one big question answered, I feel a relief, albeit a sad relief – there is no viable pregnancy.  The next big question we wait for an answer is – is this a chemical pregnancy or a tubal pregnancy?

*A chemical pregnancy is a clinical term for a very early miscarriage. It happens before an ultrasound could even detect a heartbeat (before the 5th week of gestation). This occurs when an egg is fertilized but it does not implant on the uterine wall. Chemical pregnancies are actually quite common, occurring in 50 – 60% of first pregnancies.  There are many possible causes of chemical pregnancy – inadequate uterine lining, low hormone levels, luteal phase defect, infection, or other unknown reasons. The most common assumption is that they are due to chromosomal problems in the developing foetus. This can result from poor sperm or egg quality, genetic abnormalities from either mother or father, or abnormal cell division of the foetus.

Trying not to cry at work is HARD

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On Tuesday, after my second beta test, I went home from work early so that I could receive the good or bad news in private.  But my results had not ‘come back in time’, so not knowing when I would receive my results, I went into work on Wednesday.  I was busy running around the office preparing for a one day workshop I was leading the next day when I received the phone call.  You may know already that the news was ‘not good’.  Receiving news like this whilst at work is difficult. My eyes were welling up when I dashed to the toilet quickly, passing one of my senior bosses and trying not to look him in the eye.   I called Chris and had a good old cry – lucky there are not many women at my work to gate crash my pity parade.  Chris said he would come to my work for a hug and he would be there in about 30 minutes.  So I collected myself, and headed back to my desk.  A colleague of mine who had promised to provide me some input to my project report for about 3 weeks decided to tell me he was not able to do it and he was going on leave the next day.  Let’s just say, this was the wrong time to be telling me this.  My attitude initially to him going on leave was….”and…..?????”.  I had waited some time for his input and my report was already late.  I said “No worries…..” in a very sarcastic and mean tone.  Then my friend walked past us happy and bubbly….realised she had just interrupted something and asked if she should go, to which I nodded.  Anyway, I was clearly in a grump.

After 40 minutes of being really pissy one minute, and on the verge of tears the next, Chris arrived at my work.  We had a big hug and cry together in my work car park (parking lot).  Chris stayed for a coffee, and we decided we would work from home for the rest of the day.  I went back to my desk to finish off my preparations for the next day when my colleague (who I had been grumpy to) asked if everything was OK?  So I told him about my phone call. I held back the tears as I said it, but said it was OK, I was going home for the afternoon, which he agreed I should do.  I felt a little bit bad for my pissyness, but I know he understood that it wasn’t personal against him.

Thursday….I kept myself super busy at my workshop all day, I hardly stopped to think about anything else other than work.  It was great!

Today, Friday, I had my third beta blood test.  It didn’t start out great as my appointment was already eating into some ‘compulsory training’ time at work…and of course, the clinic had a waiting room FULL of patients.  I was greeted by a nice enough nurse who I had never met before. I thought I had met them all!!!!  In fact, it was very bizarre, I noticed that the receptionist was someone I had never met before, and all the other nurses I saw wondering around were all new. I wondered briefly if they had done ‘swap staff with another clinic’ day.  V. weird.  Anyway, the nurse who took my blood was pretty distracted by another nurse who was ‘in training’ (who at my last beta test, I blamed for my late result 🙂 ).  They were gossiping, I did not appreciate a lack of attention when I was already upset with having to be there. Grrrr.

After I made into work this morning 40 minutes late, I sat in on about 1.5hrs of pointless training (I am actually already trained, and didn’t know they were going to be covering this same material).  You can tell it was going to be a good day for me….not.  The office was very quiet today, everyone was out on travel or on leave, which was probably a good thing, but I felt lonely.  So I took myself off to a quiet empty meeting room and typed up notes from Thursday’s workshop to keep me busy…but it was slow going, my mind kept wondering to my results.

At 2pm my phone rang, I was surprised because the results weren’t due back til 3pm.  It was the doctor who had done my egg retrieval and  transfer calling with the bad news.  He said my hCG levels were 395 (actually it turns out he was wrong, they were actually 345).  My first response was wow it went up again, OK – I wasn’t expecting that!  But he brought me back down to earth and said he did not believe this would be a normal pregnancy, he would expect an absolute minimum level of 800 by now, and I should stop taking my medications to prevent prolonging the pain (Emotional pain he meant), he did say that I could choose to stay on the meds if I wanted to be 110% sure, but he recommended to stop them. He also told me to arrange a follow up appointment with my doctor as soon as possible.  And that was it.  I actually did not cry, I was just confused.  Sad, but confused.  I stayed in my meeting room and focused on my task at hand, surprisingly I got a lot done in the next two hours.

It is so hard to not cry in front of work colleagues, but at the same time, being there has been a good thing when I needed to divert my mind’s wondering to sad things.

As I left work I received a phone call from my doctor, she started talking to me as if I did not know my results.  However, she was far more informative about my results and what she wanted to do next.  She told me that she agreed with the other doctor I should stop taking the medication, there is a very very small chance (about 1%) that this might be a viable pregnancy, but coming off the meds will not harm the developing foetus if in fact it is developing.  By stopping the medication my body will be allowed to do what it probably would ordinarily have done and let me bleed.  She wants to see me on Tuesday afternoon for an ultrasound and another beta test to be sure I do not have an ectopic pregnancy, although very unlikely, she wants to check.  It is normal if I don’t start bleeding for another 4-5 days, but in the mean time if I get any sharp sudden pains or difficulty breathing to call her immediately.  She also started talking about what we have in the freezer – we have just one blastocyst that was frozen on Day 5 stored away.  They won’t do a transfer with just one frozen, so we would have to do another round of IVF.  Can’t even think about that right now.

As soon as I got home I took off the estrogen patches from my stomach.  It feels good to not have anything stuck there, and we don’t need to think about doing an injection either.  I’m trying to think of the positives here!

On Being Pregnant in a War Zone Pt 2

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Spring 2007 continued

Finally, two days after discovering I was pregnant, I received my ‘Call Forward’ to fly to a US Military Hospital in Kuwait.  By this point, I had made my excuses to colleagues (An Ovarian Cyst that probably needed surgery), eaten just two crackers, hid under my bed from another five rocket attacks, slept a lot, caught up on several episodes of 24 and thoroughly read up on pregnancy and ectopic pregnancies.  I was exhausted and feeling weak.  I could barely pick up my daypack, body armour and rifle; the bag was packed for only 2 nights – that officially made me pathetically weak.

I waited for my ride to Kuwait in the helicopter departures lounge.  I was the only one there waiting.  A crew member called my name and asked me to follow him, he took my bag from me (he probably thought I was actually a real medevac patient).  My pre-deployment training was running through my head.  How to get on and off a helicopter, depending on the type of helicopter, depends on where you can and can’t load/unload.  This helicopter, a lynx, had its engine off anyway, so it didn’t matter.  There was no chance of getting my head chopped off or sucked into the intakes.  The crew member showed me to my seat, he was overly jolly considering it was 0130 AM.    It looked like I was getting the helicopter all to myself.  The crew member turned out to be the door gunner.  The two pilots arrived shortly after and introduced themselves.  They were HILARIOUS, typical Army Air Corps pilots.  I was given a headset so I could listen in to all their intercom chatter.

As the engines started, I began to feel nervous.  Last time I flew into Iraq, we got shot at and rocketed.  A nice welcome from the Insurgents.  But suddenly my nerves were overtaken by pain.  Pain in my shoulder.  I read about this in ectopic pregnancies.  Just as I started to worry and think the worst, the gunner handed me some night vision goggles.  He pointed out the window.  I looked through the goggles and I could see the shimmering lights of Basrah City, and the oil fields.  It was magical.  It was bitter-sweet.

As soon as we crossed the border into Kuwait, the gunner closed the door and removed his body armour, indicating to me I should do the same.  The comedy pilots debated where they should land in the US base.  Is this not something you would know before taking off??!  We flew over at least 25 parked up black hawks.  Do we even have this many helicopters in the British Forces??  After a few laps of the base we found somewhere to land.  No one was there to greet us. Well it was 0230AM, I wasn’t too surprised at this!  Whilst I received a comedy show, one of the pilots managed to call through to the hospital.  We were at the wrong helipad.  No shit Sherlock!  Of course, this base was big enough to have two helipads.  We were told to wait there and a nurse would come pick me up.  I could have been sleepwalking at this point, the next hour was a blur.

Somehow, I woke up lying down on a hospital bed, trying to answer the doctor’s questions.  I was immediately put on an IV drip as I was severely dehydrated.  Wow, I felt almost instantly better, but it was temporary.  Next was the vaginal ultrasound.  The whole reason I was in Kuwait.  I had no clue what to expect, no one really explained what was going to happen and that the nurse would be male.  The nurse told me I was about 6 weeks pregnant, and he printed out a picture of the ‘blob’.  Because that is all it was, I wasn’t really experienced in ultrasound photos at this stage of pregnancy.  He reassured me that everything looked just fine.  No ectopic pregnancy.  Phew!!!  So what now?

Well I had a few more hours with the IV drip, and I was ‘quizzed’ by one of the nurses – what was I going to call my baby?  Had I thought of names?  Would I name the baby after him?  Would I email him to let me know how the baby was? He was genuinely excited for me.  Bless him, because he seemed to be the only one.  I was given a prescription for the nausea (no idea what the drug was called), some folic acid and vitamin D and told I HAD to eat, for the sake of my baby.

I was taken to a temporary bunk where there was one other British female who was recovering from surgery from Appendicitis.  She was an Officer so I kept myself to myself.  The next day, I was driven to the ‘weekend spa resort’.  This is where battle weary soldiers were sent to from Iraq at least once in their 6 month tour to get a break.  It had a makeshift Jacuzzi (more like a paddling pool), sunbed loungers, massages, decent internet, volleyball, and computer games.  Lots of computer games.  Everyone was in civvies (civilian attire), I had not packed any civilian clothes, so I walked around in my pyjama shorts and a T-shirt.  I felt free!  No, body armour, rifle or rocket attacks.  I still felt nauseous so I didn’t even get to enjoy one of the ‘two cans of beer’ we were allowed.  I tried to eat, I really wanted to, so I took one of the tablets I was prescribed.  That seemed to do the job, and I managed to get half a plate of food down me.  The nurse would be proud of me.  Despite the ‘spa’ environment, it was lonely and I tried to get on the earliest flight back to Iraq, I missed my squadron, I missed my friends and I knew I was letting them down right now.  After one more night in Kuwait and I was back in Iraq, feeling a little better, but the pains were still coming.  This sucked.

Back in Basrah, I had an appointment at the medical center to discuss what next.  I had a completely different doctor, so had to start my story from the very beginning.  I think this doctor was the first to show any compassion.  He also told me that I was lucky to get the prescription for the nausea because it was not allowed in the UK, it was up to me if I wanted to keep taking it.  To date I still have no idea what this drug was because I threw it in the bin after the British Doctor told me this.  Of course the next step was to ‘medevac’ me back to the UK because I was not allowed to be in the theatre of operations anymore, it was too dangerous for my unborn baby.

A total of seven days had passed since I discovered I was pregnant.  The only person who knew I was pregnant was my boyfriend (and of course the doctors and nurses I had met).  As I sat in the hospital’s morale, welfare and recreational area waiting for my pre-flight checkup, I read many letters from random people wishing our soldiers well.  It’s amazing so many people care to take time out of their day to write to ‘unknown soldiers’.  Although the letters were clearly not aimed at pregnant female soldiers, their words were comforting.  But this comfort slowly turned back to guilt.  And the biggest guilt was yet to come.  As I boarded the C-17 aircraft to fly home with the other 20 ‘Medevacs’, I sat down amongst people who had broken arms, missing legs, wounds and scars to their face.  Then there were the two bed patients, one of whom was in a controlled coma so that he could fly back and be with his family.  He was probably not going to live for much longer.

I hadn’t told anyone I was flying back to the UK, I couldn’t; I was shamed, confused and exhausted.  I just needed some time on my own to figure out what was going on.  My life was never going to be the same again.

On Being Pregnant in a War Zone Pt 1

On being pregnant in a war zone Pt 1

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Spring 2007

I winced as the doctor examined my stomach.  The pain was excruciating.  As he prodded, he said “feel here…see?”  I felt my own stomach where he indicated – it was hard, not squishy like normal.  I continued to wince as he poked around my tummy.  “This is your poo.  You are constipated.  We will get you some laxatives and you should be better in a few……”.  The piercing alarm sounded.  We both looked at each other and quickly dived on to the floor.  My body armour and helmet were in the waiting room, no chance of me grabbing hold of it in time.  I leopard crawled under the table, it probably wouldn’t offer me much protection. The doctor grabbed his own body armour and helmet just as there was a loud thud and the ground shaked.  As he put his body armour on and quickly threw on his helmet, he mumbled “Here we go again!”  I wasn’t sure if he was trying to make conversation or if he had genuine grievance by the incoming rockets.  The way I was feeling about these rockets I felt it was probably the latter.  After a few minutes of what was probably the last rocket (usually 2-3 at a time), the doctor quickly stood up and said, “I’ve got to go, I’m on call for the crash emergency team.  Wait here until the all clear, someone will be with you soon.”  And he ran out of his office.

As I lay there on the dusty floor waiting for the all clear siren to sound, I felt stupid.  I felt stupid and embarrassed that all I had was constipation. I wondered how it had happened.  For the last 8 days I had hardly eaten a thing, I felt nauseous and I had horrific stomach pains.  These pains were sharp and short, sort of like my IBS pains, but twice as painful as usual. But this didn’t seem like IBS.  I promised myself I would go to the doctor after 7 days of feeling like this.

The all clear siren sounded. I got up and left the office to speak to the corporal at the reception desk. I explained what had happened, she told me to take a seat in the waiting room and another Doctor would see me shortly. I waited for half an hour. All I could think about was that someone must have been injured by the rocket attack, otherwise my doctor would be back by now. This made me very sad.

I was called into the very same office I had been in just 30 minutes ago, but this doctor was different. I explained that the previous doctor was just about to prescribe me something for constipation. He asked me to tell him from the beginning what the problem was and the symptoms I was suffering. He wasn’t going to sign anything until he made his own diagnosis.

He asked me all sorts of questions about my IBS, what I had been eating, how often etc…it all made sense to me. New environment, crappy food, stress from rockets. Usually my IBS presents with horrific diarrhea, but now my IBS was giving me constipation. Not uncommon, right? But this doctor asked me (like the other doctor) “Is there a chance you could be pregnant?” I laughed and said “No, very unlikely!”, he said, “Well let’s be sure, I want you to take a pregnancy test before I prescribe you anything”. “Sure….” I said, but muttered to myself “…if you want to waste our time”. The doctor called in the nurse and explained I was to take a pregnancy test. I dutifully peed in the cup and together we sat down and waited for the results. The nurse tried to make small talk about the recent rocket attack. She proceeded to tell me that a lot of girls try to get pregnant on purpose to avoid deploying or wanting to be sent home. But then her words slowly slurred to a halt, she paused and exclaimed with a look of unexpected shock “errrr you are………pregnant! Ummm, congratulations?!?”.

I could feel the blood drain from my face in disbelief. I haven’t had a period in years after my depo provera issues, how was this possible? What is going to happen now? I’m not ready for this. I’m not one of these girls who purposefully gets pregnant just to be sent home. I volunteered to deploy to Iraq! I volunteered to be with the rest of my unit. Despite the shit getting real with the rockets, I wanted to be there, to do my job, to serve my country.

I could hear in the distant background, the nurse asking me all sorts of questions about if this is what I wanted? Was I excited? Did I need anything? But I was in too much shock to answer her questions other than mumble a no.

The doctor who made me take the test called me back into his office and said “Well, now we can explain the constipation and nausea. But this doesn’t explain your pain. We need to make sure you are not having an ectopic pregnancy. Let’s get you to the Emergency Hospital for a checkup by the specialist. I was hurried out of the doctor’s office, into the back of an ambulance to drive the half mile to the emergency hospital. This was the most embarrassing thing of it all. Being driven into the ER entrance. Pregnant. Not shot, wounded or even sick. Just pregnant.

I had no idea what an ectopic pregnancy really meant. I was prodded and poked all over again by several nurses and doctors. They even checked my constipation and try to help it along, but there was nothing in there. There was no poo. After all, I had barely eaten for the last 7 days. I hadn’t pooed in 4 days.

Finally, my boyfriend arrived at the hospital (yes we were deployed together, we got it together during pre-deployment training). He had no idea why I was in the hospital, he had left me at the doctors only 2 hours ago! He looked panicked. I looked at him and tried to get the words out, but I just started crying. It was the first time I cried since finding out my news. Eventually he got it out of me, and we both cried. We cried conspicuously together as we were not really sure how else to do it, this crying thing.

The hospital facilities on our camp did not have a vaginal ultrasound machine. The closest one was in another country – Kuwait at a US Airforce base. They wanted to check if the pregnancy was ectopic as the symptoms matched. I was put on the medevac waiting list and told to go back to my room and rest until I was called to fly.

I went back to my room, cried a lot, read up on ectopic pregnancy, and asked myself a lot of questions. How will I explain this to my unit, to my boss? Will my boss know already? What are the rules on medical confidentiality? Will they send me home? Will I be discharged from the Army? What if I have an ectopic pregnancy? Should I tell my family? When will I be able to eat again? When will this pain go away? So many questions as I lay in my room, sometimes in bed, sometimes on the floor under my bed as the rockets kept coming throughout the day and night. Get some rest? Ha. No rest for me….

TBC.