The heartache of ectopic pregnancy

Sunset of July 4th, the evening before my emergency surgery.

I wrote this as a reflection on my second ectopic pregnancy. In posting the account, maybe it can be of some help to others in a similiar situation. 

I had that feeling of, "I am pregnant." But when I took a test, it came back negative. Even though they say not to read a test after ten minutes, I still checked the test hours later. To me, it looked like a very faint line was there. Since it was Friday and I didn't have another test, I decided to wait till Monday when I could call the clinic to see about getting a blood draw to confirm if I was indeed pregnant.

Patience is hard, and I am particularly not good with this virtue. I somehow managed to wait till Monday, 6-10-19, and was able to get in for a blood draw. By Tuesday it was confirmed that I was pregnant with an hcg of 39 and a progesterone level of 14. My doctor ordered that I have serial blood draws to check the rise of my hcg. So every other day if could, I would go for a draw. On Wednesday my hcg was 76, so it had almost doubled in 48 hours. Normally you want to see the hcg levels double every 48-72 hours. My next blood draw was taken five days later on 6-17-19. When the results came in the next day, they were not looking good. My hcg was only at 158, meaning over five days it had barely doubled.

So, I went again two days later another draw, and my hcg was now 228. Still rising slowly. I had been reading and searching for anything to try to give myself hope. I reasoned that maybe I was in the 15% of women who do not follow the typical rise in hcg. I had some twinges of pain on my right side, but they never lasted and went away. My first ectopic was nine years ago, and it was in my right tube. The tube was basically blocked and scarred. Every pregnancy since I have some pain on the right side because of the scarring. I did have a lower back ache, but again, I reasoned that it was sciatic nerve pain. The emotional toll of going in and having blood drawn and then having to wait a day was becoming overwhelming. After having my blood drawn on 6-21-19 I told the doctor I wanted to stop. The results were that my hcg were still rising slowly being at 395.

The next week was a reprieve: no blood draws. I still felt pregnant, but not in the same way. The doctor prescribed me progesterone. In hindsight I did not feel my uterus growing like I normally would. But, I still had signs of pregnancy. So I still hoped and worried about what-ifs. So on 7-1-19 I called Scenic Bluffs to ask if my doctor could get me in for an ultrasound because I was far enough along to try to see what was going on. It was a bit of a hassle with communication to get my ultrasound. But, I finally was able to go for one at Vernon Memorial in Viroqua on 7-2-19. My sister-in-law graciously offered and watched the boys with my Mom so that Franz could go with me. 

We went in, still hoping for the best. Franz was more optimistic than I. In part I think it was because in my subconscious I knew not all was well. First an abdomen ultrasound was tried, but nothing showed up. So, the technician said we would have to do a vaginal. When the ultrasound technician was doing the imaging I watched her and Franz's faces. There was seriousness in the technician and confusion in Franz's face. The sinking feeling of the last strains of hope for our baby were unraveling. I didn't say anything because I already knew. I never saw the screen and didn't ask to. It was too painful. The technician had us go back to the waiting room saying that a doctor would meet with us to discuss the results.

When the doctor met with us in a room it did not take me by surprise when he said we had an ectopic pregnancy. I asked if there was a heartbeat and he said there was an empty sac and no fetal pole discernable. I asked if I had to do anything. I was not in phyiscal pain at the moment and wanted to try to let my body take care of the process itself. The doctor said that if I was not experiencing symptoms of complication that he did not see why I couldn't wait to see if things would resolve by themself.

As we left the hospital in quiet sadness, Franz and I kept our conversation light but serious. We went to get something to eat and pick up somethings from the store. While Franz was in the store I made the phone call to my doctor at Scenic Bluffs. He said that he had sent my records over to Gunderson in LaCrosse and talked with an OB doctor more familiar with ectopic. They wanted me to get my blood drawn in the ER because that way I would get the results right away. He also talked to me about starting to take the methotrexate shot. I said I did not want to do that. He asked me why. When I explained to him my first experience with having an ectopic, where the doctor would not let me leave without taking the shot or doing surgery. At the time we were informed and thought that was our only option, as we had no idea when we went in that I had an ectopic. The fact was that I was bleeding and my body had already rejected the pregnancy. The baby had already died, and there was no heartbeat. I took the shot that time, as the doctor said it gave us the greatest chance at future fertility. He never informed me, despite having seen me nursing Cyprian, that I would have to stop. So I ended up having to abruptly quit nursing Cyprian, who was just a year old and still fulltime nursing. Then both Cyprian and I ended up very sick. The overall experience was awful. The only peace I have about it was that our baby had already died, and I did not end the baby's life with the shot and end up with the grief and confusion that would come from not knowing.

So this time, I went in a lot more informed than nine years ago. I made it clear I understood that I was taking a risk in not going in right away. But, I was tired of the stress of tests and being pushed to do something I was not okay with. My doctor said I should have a plan of action ready, as things can quickly change in my situation. I am thankful that he did not push me. I needed to make this choice myself. So, we did not even go in for blood tests. I kept on with my daily schedule. My anxiety was sometimes high, but I still felt some peace too.

July 4th 2019: what a day. We worked hard all day in preparation for the festivities in the evening. Our goat Jaling gave birth to twin doelings all by herself, and Franz found her at chore time being a superb mom. The twins are affectionately named Independence (Indy) and Liberty (Libby). Originally we were going to have everyone over at our house for a cookout and fireworks. But under the circumstances we decided to switch the festivities over to my parents. The kids still played at our house, but we did not have to worry about the mealtime. We had our own supper at our house, as the craziness that comes when you have several families together had me wanting to keep my stress level down. So the rest of the families ate at my parents. We joined everyone after supper at my parents for the awesome firework display curtesy of my sister-in-law and sister. Seriously, we have never had so many and such fun fireworks to watch.

I also was able to talk with my sister-in-law who has also gone through the loss of ectopic pregnancies. It was a God-send because talking to her is what gave me the confidence to go when I did. My sister-in-law gently cautioned me to be careful, as she herself had gone through a ruptured tubal pregnancy that could have killed her.

Early in the 4 a.m. hour of the 5th of July I started experiencing pain. I have had pain before, so I just tried to rest quietly. My anxiety was high, as I knew the risks of waiting. At 5 a.m. I finally woke Franz. He was groggy and when I said I thought he should start chores he said, "Are you sure?" "Yes!" I said, "I am in pain and it is not getting better." He quickly got dressed, made sure I had my phone by me and headed out. At 5:18 a.m I called my Mom. She immediately came over when I said I was in pain and it was only getting worse. I called Franz and told him he needed to get me to the hospital. So, he dropped chores and we called my sister Rebecca to come and take over animal chores.

The pain was so bad that I was shaking. I think my anxiety was making it even more so. I was helped to the car, where I then called the Gunderson Emergency to inform them we were headed in. They already had my records and charts on hand from my doctor. Luckily they did have my records as I forgot my wallet with my id and insurance. I was admitted and taken back pretty quick after we arrived. They put in an IV and shortly drew several vials of blood for testing. Franz kept a phone dialog with my sister helping her through the process of our animals chores. I was taken for an ultrasound. This time the ultrasound hurt. I also asked the technician to see the screen. I wanted to be clear on what was going on in my body. There was a sac but still no visible fetus. Three days earlier when I had the first ultrasound I barely felt it. This time is was very uncomfortable even with having been given pain medicine. Then we waited for the doctor to come see us. While waiting for the doctor we discussed our thoughts and concerns openly, as both Franz and I did not want to be taken off guard or put on the spot.

When the doctor came in she was very gentle but straightforward. We made clear off the bat that we did not want to do methotrexate for moral reasons, as it is an attack on living cells. The doctor said at this point the shot wasn't even recommended as the sac was still growing. My hcg levels were at 2,200, meaning they were still climbing. Franz posed the question of the rare instances of when the embryo, though temporarily stuck in the tube, had later been able to move and to implant in the uterus. The sac in my right tube was firmly implanted and embedded, though, as indicated by the hcg level rise. There still was no fetal pole or heartbeat, but my hcg was still climbing. I was having some internal bleeding, but the tube had not burst yet. It was very enlarged and ready to burst.

When asked if I was wanting to have more children, I said definitely "yes." It came down to two options, both being surgery. They could scoop the sac out, or remove the entire tube. Scooping out the sac would leave a higher risk of another ectopic, and is also to my understanding not morally permissable. Removing the tube would take away the scarring and leave the sac undisturbed. So, with hesitation we voted for the full removal of my tube. I was still having qualms. Though there was not a fetus present, there were still living cells, an embryo. Though sometimes things, very rarely, things can work out, this was not going to be a viable pregnancy, and, in the doctor's eyes, this was an immediate, emergency situation. At my request, Franz started calling priests so that we could talk this over. We spoke with our parish priest and with one of Franz's fellow seminarian priest-friends, whose degree is in medical bioethics. As we discussed and walked our thoughts through what was happening, both priests did not hesitate to say that what we were persuing treatment-wise was permissable. Here is a link to what the Catholic church teaches about ectopic pregnancy. https://www.catholiceducation.org/en/science/ethical-issues/when-pregnancy-goes-awry-ectopic-pregnancies.html

Franz tried diligently to get a priest to give me annointing of the sick before surgery. Playing phone and time tag, he finally was able to get a priest over to the hospital post surgery for the annointing.

Do not judge a person. I have to remember this as I struggle with the decisions we make everyday. It may seem weird, wrong, or okay to some people what we did. I will grieve, I will at times have peace, I will at times wonder, I will at times just pray. We are not always given easy choices. I hope and pray that I do the will of God. Because no matter what, it is the only way I will ever be at rest and peace.

I am home resting and being helped by family and friends. Franz told me to look at the resting as a retreat. I have been able to pray, read, and reflect. What is hard is the inactivity. It is trying on my patience and a humbling experience. This is a busy time on the farm, and I cannot lift anything heavy and often have to rest. Yesterday out of need and desperation I sat under the currant bushes and picked the currants for Franz to make wine. Reining in my desire to get things done is in itself taxing. I have much to be thankful for and many blessings to count. We are taking it one day at a time. 

To all the mothers who deal with infertility, misscarriage, complications, and any trial of motherhood: You are ardently in my prayers that you can find peace and yes even joy. God does not abandon us even in our darkest hours. Take courage and keep your faith, so that one day you can see the glory of God in your life.

I have seven little intercessors, Cosmas James, Anastasia May, Andrew Joseph, Agatha June, Caspar Marion, Cyril Hugh, and now Gianna Marie.