Tag: methotrexate

Today’s guest and I just fell into our conversation, so I’ll introduce her: Her name is Kristi and she’s from Oregon and here’s her story.

 

Kristi: so my first daughter, we were not planning for. And we were actually honestly not planning on having kids period. That was one of the things that kind of joined me and my husband, it was like we are both on the same page, We’re gonna get married and we’re just going to live our own life and not have children. And then I got pregnant. But it was like this …I’m the one who actually freaked out my husband did not. He was like, Alright, let’s go. And I sort of had to take a moment to realize that this was a new plan for us, and have the smoothest pregnancy, no morning sickness, the only side effect of my pregnancy was heartburn. It was awesome. I loved being pregnant, giving birth was a different story, and honestly even that first birth, even though it didn’t go as planned, like it wasn’t crazy she got stuck and 

 

P: let’s go slower, your water broke

 

K: my water never broke i Okay, so I guess she is a little bit of a story but I was actually four and a half hours out of town. My husband’s grandpa died, and we made the joint decision that we were going to go to the funeral, even though it was the weekend of my due date, I researched the hospital that it was close to, and I was fine with it like if it happened it was okay, we were just going to tackle it as it came and it was fine, managed to go the entire time in that town, and we were on our way out of town in at a gas station, getting gas to head home, and I had my first contraction. So, was in labor for four and a half hours in the car. And 

 

P: did you know what it was?

 

K:  I had had Braxton Hicks, but these were definitely different and I don’t know if I really registered it, but they became pretty constant. And I think they got to within like four or five minutes apart when we were approaching Portland. And we had to make the decision of either turning off and going to the hospital I was delivering at, or going home, we had moved so I lived a little bit far from our hospital. So we opted to go to the hospital, I already had my bag so it was like, yeah, why not, we’ll just, they’ll tell us what we need to do, I think we ended up checking into the hospital a lot about noon on Friday. And it’s weird how this birth is a little bit foggy, I forget little details but when I got in there they let me hang out for a little while the contractions were definitely regulars so they actually ended up breaking my water. And then, obviously, the clock starts ticking, I got an epidural, but it never worked. Fully, so I was having 

 

P: you didn’t feel numb?

 

K: No. 

 

P: Oh

 

K:  it’s funny because now I hear people tell the story about like yeah like I took a nap, and I’m like, what you took a nap. Are you kidding me, so I had to keep having the anesthesiologist had to keep coming in and give me me boosters. So they finally decided to pull it and redo it. So they tried it again, and it’s still never really took effect. So I was in pretty hard labor, until Sunday, so I went with no sleep because I never not felt a contraction so they were coming. And about six o’clock on Sunday we decided we’re far enough along i i dilated I dilated all the way to 10. To start pushing at least try to see if we can make something happen because she just wasn’t really very low but I mean I was dilated so we’re going to try and I pushed for three hours. And my doctor finally it was just like, This is ridiculous. You’re exhausted. Her heart rate never did anything super weird but it kind of did so we just called it and ended up doing a C section, as it turns out. Her head was tipped sideways. So she was pushing with the side of her head she came out with a huge bump on her head where that part of her head was being sucked into the birth canal, but not the rest of her was perfectly big, she weighed eight pounds six ounces, big puffy pink never looked like the old man she’d looked like a baby like fine just took a long time to come out. 

 

P: Yeah

 

K: I recovered from my C section really well, and it was fine. It wasn’t, obviously, my story is always a person ever go the way you plan them, but

 

P: had you imagine like a natural birth or you just didn’t want a C section,

 

K: I just hadn’t planned on a C section, I was C section and my brother was C section, it’s always, it was always there, it just wasn’t the plan. Yeah. When the doctor finally made the call and we were going to have a C section. All of my contractions completely stopped it just stopped and my body was like yeah, thank you. Let’s just get her out. Like, I didn’t have another contraction. So I went into the O R, and never had a single contraction, after they called it. So I was probably ready for that

 

P: Yeah, yeah

 

K:  and recovered just fine and she was totally healthy like that bump went away within like two days and

 

P:  yeah, good 

 

K:she was healthy and, perfect. So that’s my first daughter. I mean a little bit stressful but to me it was nothing serious. I had to have a C section, but whatever, they are super common… So my daughter was about 2 we actually decided we wanted to have another and We tried for probably about six months, I think, and I got, I got pregnant. And at six weeks had a miscarriage. And it was a slow miscarriage, so I found out from the doctor that I was going to miscarry before I actually had a miscarriage my numbers were just dropping.

 

Paulette: So when Christie talks about numbers, I think she’s talking about HCG human chorionic gonadotropin, which is a hormone produced by the embryonic cells that will become the placenta during pregnancy. This hormone generally makes the uterus a happy place for a growing embryo it Ward’s off the mother’s immune cells, it signals to the years that implantation is coming, and it tells the body to make the hormone progesterone, to protect the endometrial lining and avoid a period. Early on the level of HCG roughly doubles every two to three days, and tells you that you’re pregnant, but if the level of HCG doesn’t increase in this way it can signal that something’s wrong. Doctors can take blood tests a few days apart to verify a falling hCG.

 

K: I wasn’t feeling good, I don’t think, and so I literally just waited at home for it to happen because I knew it was coming. And then we just kept trying and we went, I think we went about a year of trying.

 

P: wait, let me back you up here for one second, upset about the miscarriage?

 

K: Yeah, I was, I definitely was but it’s crazy all these people started coming out of the woodwork who had had miscarriages, they’re very common. 

 

P: Yeah, yeah, yah

 

K:  And, but I hadn’t realized it so just having all those people around you, being like, Yeah, I had a miscarriage too but I have three great kids so

 

P: yeah March of Dimes says it’s 50%

 

K:  I wouldn’t be surprised if it’s way more than that, 

 

P: because so many people don’t report or don’t even know. Yeah, 50% is already a coin toss, right, so. 

 

K:  I called in sick as soon as I found out this was happening and I didn’t go to work until it was done so I missed like a week of work, of just basically sitting at home. 

 

P: Yeah, 

 

K: waiting to lose baby which is obviously devastating, and I think because the rest of my story is so dramatic that feels like nothing. 

 

P: Okay, 

 

K: So, after trying for about a year, my doctor referred us to the local fertility clinic, I guess, like first thing she had us do was had my husband go get checked. And so he got checked and his numbers came out good but not good had plenty, but their movement was off a little bit so that raised kind of a red flag, so she wrote, she recommended us to one of two places. I happen to be extremely lucky at the time and my employer covered fertility.

 

P:  Oh wow. 

 

K: Yeah, so they covered 80% I think, 

 

P: wow

 

K:  all fertility, they’re extremely like gay marriage and family, very. Yeah, yeah. So they covered that. So, the goal is to stay employed with them for sure until we figured everything out. So we started with them, and you go through lots of testing, did that if I had completely unexplained. There was no reason that we could tell why I couldn’t get pregnant. So we started with IU I.

 

P: So an IUIi is an intro uterine insemination. Basically the doctor takes sperm and shoots them directly into the uterus with a little thin tube. When you’re ovulating, it can increase your chances of getting pregnant, but in fertility, nothing’s guaranteed.

 

K: And did four rounds of that. So you like do that and then wait a month, you do it again, wait a month so we went through four of that, 

 

P: and you find that  okay?  I did that also…

 

K: I mean it makes sense why they think that would work to me, especially if there’s question on the guide side, we’re just going to help these little guys out and get them right in there to the right place so it makes sense to me why it would work. I don’t know anyone who that has been successful for I’m sure there are people, but the I did not work for me. So, we went through four rounds of it, and then it was decided that we were going to try IVF. So, I, I learned the hard way that I don’t like giving myself shots. I know other people who went through it, but the idea of everything that happens, and I’d say now I should have written all of it down but I didn’t…it didn’t feel necessary  for some reason. So, our first round of IVF was successful. 

 

P: Oh wow, 

 

K: I got pregnant. You go through the whole process of them gathering the eggs right so a horrible part of blowing up and filling yourself with as many eggs as you can get.

 

P: I talked to one woman who said she could feel her ovaries, they got so big that she felt like said like well walking around, you can kind of feel them.

 

K: It is crazy it is a weird feeling. I don’t know if I could feel them but I definitely just felt like bloated and uncomfortable and like this is not normal. 

 

P: Yeah, 

 

K: after they take them out and they, you know, get rid of the ones that are definite no’s. Yeah, we ended with nine. We opted to do the genetic testing. I didn’t feel like after all of this, why would you put in one that’s not 100% 

 

P: Yeah, 

 

K: so, and I had the health coverage so I get, like, not doing it because it’s expensive, but we had the health coverage so that left us with four. 

 

P: what do they test for? 

 

K: So, they test for any genetic anomalies, so if there’s anything that sort of looks like it’s, it could possibly be rejected by your body. Because of a genetic mutation.

 

P: Yeah, 

 

K: it’s pulled. 

 

P: Okay, so it’s broad is pretty broad,

 

K: it is broad… I think, Because like we ended up with four super healthy, these are the best of the best of your, of what you got. And so we had four and we knew those, those are your four chances, we knew we had three boys and one girl, because part of the genetic testing is knowing exactly what sex you have, so we go the first round, and they’re doing lots of tests up to the point before they put that egg in. And I had fluid in my uterus, and I took a specific type of medicine and to try and get rid of that fluid, and like the day before we were going to put the egg in the fluid disappeared so that medicine we’re assuming works, so put the, again, I get pregnant. Everything seems fine. I get to, I’m pretty sure it was week six, because that’s, that seemed to be my magic number, and I call it was at work, and I call my doctor because I’m having like weird pains in my left side and it’s kind of going down my lane, which also feels weird.

 

P: Today I’m bringing questions about Christy’s experience to Dr. Tanya Glen. She’s a published author who’s written and researched about ectopic pregnancies, and is currently a fellow at Yale’s reproductive endocrinology and fertility clinic. Hi Dr Glenn thanks so much for coming on the show. 

 

Dr. Glenn: My pleasure 

 

P: in Christy’s case, she gets pain of her leg. Why does an ectopic cause that kind of pain.

 

Dr. Glenn: It’s not necessarily that every ectopic would cause that specific type of pain. And so, could very well be that if it was a ruptured ectopic already, the blood in the abdomen could cause irritation down the leg, but the majority of time when people have a ruptured ectopic they’ll have abdominal pain. That’s not a symptom that I get often from my patients usually it’s abdominal pain.

 

K: So I call them, just because I didn’t actually know if there was anything wrong but I called them and they tell me to come in. So I go in, and he breaks the news to me that he’s pretty sure I’m having an ectopic pregnancy. The embryo has went up into the fallopian tube and I’m gonna lose the pregnancy. He calls my doctor and my doctor wants me to come and see her, so she’s taking space in her schedule and she has me drive to her office from the downtown office to come see her, so it’s confirmed Yes, this is an ectopic pregnancy

 

P: Did they do an ultrasound?

 

K: Yes, They did an outside and a vaginal ultrasound. So you’re going to lose this pregnancy, we can help you along with this so they schedule me an appointment at the cancer center, but I can’t get in until for this is like new. So like for, you’re going to drive to the cancer clinic, and you’re going to go in and you’re going to get this medicine that is basically like a chemo medicine it’s going to make your body reject the pregnancy and your system will just flush it out. So that’s the plan like.

 

P: So Christy’s ectopic is going to be resolved with medication. What do you think the doctors gave her and how does it work, 

 

Dr. Glenn: people that may be having a ectopic that was treated like she was with medication first which is called methotrexate and attacks rapidly dividing cells, it’s actually used also for chemotherapy but we use it for tech topics we use it as a much lower dose, But attacks rapidly dividing cells and we’re gonna think about that, that also can cause pain itself. So most of my patients who get methotrexate will feel uncomfortable, you know, they’ll have some cramping, they might have back pain and it is just all kind of response to maybe having some bleeding, and that ectopic pregnancy or that pregnancy that’s not inside the uterus is resolving and those cells are dying, and that causes pain,

 

K: I have nowhere to go because I live so far from work so I go back to work, and hang out until I’m supposed to go, and my husband’s at work and I’m reassuring him that like I can do this just meet me at home. There’s nothing you can do, take care of, you know, our oldest daughter, and just be there when I get home. So, I go to Portland, get two shots, one in each butt cheek. By this time, I’m in quite a significant amount of pain, I remember not being able to get comfortable in. On the bed that this clinic is having me sit on and like I’m finding weird positions to sit so it doesn’t hurt, and it takes a long time by the time I’m driving home it’s dark, so I’ve had to wait so long at that clinic, it’s all the way on the other side of Portland so I’m having to go through Portland and to the other side to get home. They’ve prescribed me Vicodin, and something else for nausea. So Vicodin for the pain and something else for the nausea, because I’m, I’m just not feeling good, it’s super super painful to medicines I’ve never taken before also. So, I don’t know if you’re familiar with Portland but to get from one side of Portland to the other you drive through a tunnel. I just remember that when I went through the tunnel. I was in so much pain that I was basically driving with one foot pushing on the dash and one foot on the gas pedal because I, the pain was so excruciating, but

 

P: Did they  tell you that would happened, 

 

K: yeah that’s that’s why they gave me the Vicodin, it would be really painful. Not that I have no frame of reference,

 

P: yeah. 

 

K: What is too much pain, what is normal. Yeah, they said it would be painful, so this must be right. 

 

P: Yeah. 

K: So I still have to get to Safeway actually to turn in my prescription so that I can get this prescription so I can go home, so I have a standing job that I probably looked like a drug addict, by the time I got to Safeway, but I go to Safeway, I’m in my work clothes but I am sweating. I constantly have this rolling sense of feeling like I’m gonna throw up, which I’m thinking is because it’s so painful. So I go into Safeway, I literally like lean on the counter and hand them this prescription for Vicodin

 

P: Yeah, 

 

K: I’m sure. They’re like, yeah, lady. You’re a complete drug addict. 

 

P: Yeah, we’ll definitely fill this. 

 

K: Yeah, we’ll get right on that. Yeah, they told me it’s gonna be a half hour. So, I just go out to my car, I sit in my car, I get out of my car twice, and go into the Safeway bathroom convinced I’m going to throw up. I don’t go back, sit in my car, I’m sweating. I’m in pain, finally go in, I get the prescription. I go home. I take one nausea medicine, two vicodin, and I tell my husband and going to bed. I’ve never taken Vicodin before. I don’t know I don’t know what’s gonna happen, I go to bed and I go to sleep. I kind of remember him coming in and going to bed. I mean he’s clearly worried, but we also have a two year old in the house. 

 

P: Yeah, 

 

K: so he’s, you know door, trying to keep it together and trying to keep her, you know, Kara, wake up at like 11 o’clock. And I think I’m gonna throw up. And I remember getting up grabbing the closet or cuz I feel like I’m gonna fall over. And that’s it. The next memory I have is laying on my bedroom floor and there’s a fireman above me, sitting, sitting on me. Apparently what has happened is…

P: Goose bumps! Yikes…

 

K: Yeah, literally, so my husband heard me, thank God, fall into the bathroom. It was a really, really small bathroom so I’m laying in the door and he kind of wakes up and he’s like Christie What are you doing, don’t answer. And he turns on his light, and gets up and I’m laying in the bathroom door, and I’m unconscious and not breathing. Thankfully, my husband used to be a paramedic, so he grabs my shoulder he yanks me up, he’s pretty sure he pops my shoulder out of socket, but he doesn’t get to me over and into our bedroom. And that movement. I did throw up, but I aspirated it… so gets me breathing is yelling to our two year old to wake up to go get him his phone. She never wakes up. 

 

P: Yeah, 

 

K: so he leaves me for a second, goes and get this phone comes back and he’s calling 911 calls 911 hangs up with them, they’re on their way, he calls her friend to come over because he needs somebody to stay with her. My friend comes in, goes directly into my daughter’s bedroom shuts the door and sits on the floor and just doesn’t leave her. So I, when I wake up, my blood pressure is like 30 over 60 

 

P: Oh my god, 

 

K: I’m in really, really bad shape. So because my husband was a paramedic, they give us the choice of them either him driving me or them driving me to the hospital, we don’t know what’s wrong with me but my husband decides, we decide, I don’t, I wake up at one, I don’t care. I remember being like, yeah. Hey, how’s it going, it’s firemen and looking at my hand and realizing there’s like throw up in my hair and just been like yeah that’s okay that’s been going back wanting to go back to sleep on my floor. I don’t care what’s happening, I don’t care I just want to go to sleep, so they carry me down in a, in a sheet, my husband and two firemen carry me down our stairs and put me in my husband’s car. And he drives me to the ER, I kind of remember the drive but i All I remember is laying on my side and putting my feet on the dash and pushing on it because, again, my stomach is hurting so bad. We get to the ER, and I remember, a doctor coming in, and I’m doing an ultrasound on my stomach. Leaving really quick. And another doctor coming in, and then doing another ultrasound. And then I don’t remember anything until I woke up, so all I know it was really bad, and my whole abdomen was for full of  blood basically fluid. So my fallopian tube had ruptured, probably on the drive. That’s why my pain, suddenly got so bad, and I bled it, I was bleeding internally that entire time.

 

P: Here’s what Dr. Glenn had to say about how a ruptured fallopian tube behaves….

 

Dr. Glenn: What I’m really concerned about is, let say it ruptures, and you start bleeding because a tube has a lot of blood supply to it..it’s delicate, and it bleeds if you look at it wrong, and so if people are bleeding from that, they are going to continue bleeding

 

K: So when I woke up. My husband had apparently had a breakdown at some point in time and was calling on my family and crying and they had given me, 2  liters of blood 

 

P: for context here. According to medical news today the average size woman has 4.3 liters of blood in her system 

 

K: and removed that fallopian tube….I survived and woke up with my doctor,

 

P: wait, let’s let’s pause for one second here. I can’t believe you have another child. 

 

K: I do, yeah. 

 

P: So I’m just gonna say it’s amazingly brave to go back into the breach, 

 

K: yeah.

 

P: to say like yeah let’s try it again. 

 

K; Yeah, 

 

P: that’s so scary, Oh my god.

 

K: Yeah. Yeah, that’s probably the scariest. 

 

P: Also, the cancer drugs methotrexate isn’t what it is I,

 

K:  you know what I couldn’t even tell you. But I, I know you were like,

 

P: did it not work?  do they know what went wrong, 

 

K: it was too late. So they gave me this medicine, But it was too I was, it was too late. I was too far along, and too far past that point, that’s the answer I’ve been given is that if I had caught it like a little bit earlier, even hours earlier, it might have worked but I was too far along, for it to actually be able to reject.

 

P: So you’ve identified a tubal ectopic, is there any way to know how close the tube is to bursting.

 

Dr. Glenn: No, that’s the hardest part I think about we call them pregnancy but unknown location. So in Christie’s case I’m not sure if they actually saw like a mass in the tube. A lot of times we don’t we have to kind of go empirically like our ultrasounds are only so good, now they’re so much better they keep getting better and keep being the detect things that are smaller and smaller. But sometimes if their hormone pregnancy hormone levels too low, like it’s rising up normally that’s too low, we’re not gonna see anything that to 

 

P: roughly how big is the embryo at this point 

 

Dr. Glenn: three to five millimeters. 

 

P: Okay. that’s tiny

 

Dr. Glenn: It’s very tiny. Yeah. Now, let’s say her pregnancy hormone level was very high. That was kind of a relative contraindication to getting methotrexate, we say if it’s over 5000 or we see a heartbeat, in the, like, called adnexa which is in the tube or outside the uterus, those are relative contraindications to getting methotrexate, but they’re not absolute because some people really want to avoid surgery. There’s risks and benefits to both, but there’s no way to know that tube could be rupturing, as I’m seeing her, and she might feel fine that point, we do know that ectopic pregnancies can resolve on their own, and one that happened in the tube, when their pregnancy hormone level is very low like less than 200, about 80% of those will actually resolve without any medication intervention, It kind of extrudes out the tube and gets absorbed by the abdomen.

 

P: so then you had the burst fallopian tube on top of chemotherapy Vicodin and nausea medicine. Yeah,

 

K: to say the least, I, I pretty much I’m petrified to take it again, and just don’t want it in my body

 

P: that seems fair. 

 

K: I’m sure it has nothing to do with any of it but all the medicine that was involved with that little window of time I never want in my body ever again. 

 

P: Yeah, I feel like that’s fair. 

 

K: Yeah, so there’s lots of checkups that happened after, obviously I now have chemo medicine in me so even the thought of trying to have a baby again isn’t going to happen three months I think took three months for that to be completely out of my body,

 

P:  I know there are risk factors for ectopic Did you meet any of those risk factors?

 

K:  no 

 

P: In the published literature I saw about risk factors, there are a wide variety of things linked to ectopics…so I took this question to Dr. Glenn: What are the risk factors for ectopic pregnancy?

 

K: Actually, infertility, just in general is a risk factor. You have tubal factor. What that means is, if we know your tubes are abnormal, you know, if you’ve had pelvic inflammatory disease that can actually affect the tubes cause the tubes to become dilated and fluid filled, and they have cilia and your tubes to help sweep along the eggs kind of  like brooms. And we know that if there’s fluid in there, those can disrupt the. Yeah. And so, tubal factor being that we know that the tubes are not normal, increased risk for a topic, even if we do IVF, and we’re actually avoiding the tubes in general, still an increased risk. Other things were kind of unsure about why infertility itself is causing it. Even people with unexplained infertility, maybe they have some underlying factor in their uterus that doesn’t make it a good environment for an embryo implant or there is something in the tubes that we just don’t know yet. One reason I love and it’s frustrating about my field is, it’s so much unknown still. And so, you know, other things people realize that our risk factors is smoking, endometriosis….And then we also know you know that there has been an association between doing IVF cycles your hormones get incredibly high. We know that actually increases risk for ectopic that has been shown to I should say, but we don’t really know why, but about at least a good 50% of people that topics have no risk factors.

 

K: The thing that we come up with is that this mystery fluid in my body was coming from my C section scar, from my first daughter, I never healed completely on the inside so weird fluid from this scar from years ago was seeping into my uterus and the embryo didn’t like that fluid, so it was running away from it.

 

P:  Okay. 

 

K: And the only way to go was up. So, ran out and into my fallopian tube. Nobody knew that. And on every, you know, scan that I had and everything we could hear a heartbeat and, but we didn’t know, I mean there was no way of knowing where it was sitting. 

 

P: Yeah,

 

P: So the theory about why this happens to Christy is that her previous cesarean scar led to fluid in her uterus and the embryo was making implantation decisions based on the fluid in the uterus, I mean, that brings up all kinds of questions like how we’re as the embryo figure out where to implant, 

 

Dr. Glenn: yeah 

 

P: I did a brief literature search for that and couldn’t find anything in humans, but in animals, there’s all these suggestions that the placement of embryo implantation is pretty consistent across animals suggesting that something is guiding the embryo to figure out where to implant.

 

Dr. Glenn: Yeah, and is it like a chemo some kind of chemo attractant, is it the receptors that are have on their endometrial receptivity, is a huge area in our field because we know that in IVF it’s like if we have a let’s say a tested embryo, which is, you know when the eggs and the sperm come together and fertilize that egg. It will grow and become an embryo and usually about five days after that so Lightstation is called a blastocyst and that’s when we will put it back into our patient usually the day three or day five, we can test those embryos to see if they’re completely normal. And we can have normal embryos not implant. So we know there’s a lot of underlying factors about the receptivity between an endometrium or the uterus which enemies from being the lining of the uterus and the embryo that we just don’t understand yet, is why even with IVF, you know, even in let’s say a young patient 30s or, you know, Overall, the success rate per cycle of placing that embryo back in. It’s only 50 to 60%. There’s so much we don’t know yet. The embryo that doesn’t know how to attract the uterus, or the uterus, that’s not having all the right factors or adhesion molecules to actually be receptive to the embryo.

 

K: So, there’s a surgery, you can have done where they go into your uterus and they burn each side of your scar to seal it up. So, after all of this happens, I have that surgery. So I go see a specialist for the basically cauterize around your the scar to make the skin fused together so now that it’s just like in a little pocket, and not releasing any fluid into the uterus

 

P: does that hurt, or No, 

 

K: that wasn’t too bad actually. There were the recovery was super minimal, they go, I’m trying to think, I think they go in through your cervix. 

 

P: Okay, so they don’t have to make an incision or anything. 

 

K: No, so recovery super easy. I don’t remember that being bad at all. 

 

P: Okay. 

 

K: We tried the idea of another idea first and instantly rejected wasn’t a, I didn’t get pregnant, or anything it just didn’t take. And then I had the surgery to take care of that, because that fluid kept showing up. So, this is the determining factor since I had nothing else. 

 

P: Yeah, 

 

K: so I do the surgery where we seal off my scar. And we have, I have two more embryos, I have a boy and a girl. So because we’ve tried boy boy, we’re obviously going for boy. So when we decide that since nothings working. We’re going to put the girl in. And it’s sort of like our, like if it’s not going to work. Let’s try it with the girl. Yeah, which is horrible thing to say because now I have a daughter, but it works. And so we’ve sealed off the, this, the scar, and I get pregnant. And I remember standing in my bedroom when they call you right to tell you your numbers, that’s how you find out if you’re pregnant or not, and my numbers being crazy high, and it was like, YOU’RE NOT PREGNANT like you are 100% pregnant. Even with the like first pregnancy my numbers weren’t this high so it was like, this was the best possible thing like you are, you’re definitely pregnant. Yeah. Like, I’m not pregnant until I passed six weeks, just so you know, but I do, and I totally have another perfect pregnancy, again no morning sickness, no, I make it all the way, I graduated from my fertility clinic you graduate after the first semester you get to leave your fertility clinic and go to the regular doctor and I remember that day happening and everyone in the clinic cried my doctor cried. The person who was taking my blood every freaking day was crying like the receptionist cried, everyone knew what I had been through the whole office knew that that was like my last appointment. And it was the most amazing craziest feeling I was like, you see ladies with real bad shit. And you’re crying because I’m leaving, so this is a big deal. So, I remembered like starting with my regular doctor and it was great, the birth was completely different but still ended in a C section, but I had a doula, this time for my second daughter, the entire birth situation was completely different and 100% Amazing, with my second daughter, It still ended in a C section because I got a fever and she, her heart rate started getting weird. But I went to the hospital at 4am and she was born at 8pm. 

 

P: Oh, that’s not so bad. 

 

K: Right. That was like my water broke naturally, I got to walk around and I was had her over the toilet because I my water broke and I went from like four centimeters to 10 centimeters and the time it took me to go to the bathroom and come back. 

 

P: Wow. 

 

K: Yeah, but it was like all fine. It was amazing. Completely different this, she still did ended up having to be a C section but she was, it was still fine, and

 

P: wait, how we feel about the C section after the fears about the scar.

 

K: Well, we were pretty sure we were not having any more children at this point. 

 

P: Okay, 

 

K: and my and my doctor was well aware of whole situation. We made sure she knew I apparently don’t heal very well, we need to be like extra clean and clear on what’s happening on the inside of my body, so I felt like I had a lot of confidence in my doctor, so I mean it’s obviously not ideal, but I can’t get pregnant naturally so that’s what how me and my husband were thinking is like, its gonna be fine because we’re pretty sure we’re at the time, we were pretty sure we didn’t want to go down this road again.

 

P:  Yeah, 

 

K: this is it, and this is going to be amazing and our family is complete, still have one more embryo, but we weren’t even completely sure that we wanted to use it, and we had talked about what we were going to do with it. So to me it was okay. Again not ideal, it wasn’t what I was going for. I was pretty damn determined to have her naturally, actually, all the way to the point of seeing her head, and my husband could see her head. The biggest difference was, by when we decided we were going to call it and do a C section. I kept having contractions this time. So, laying outside the ER, completely flat because I’m getting ready to go in and still having contractions and being on the bed with the sheet up and still having contractions like that part was weird this time. And because she was had really gotten all the way down there, they said they like had to go in and get her, and pull her out of the birth canal this time we’re just he was just like, right there ready to hold out I recovered from C sections pretty fine. I’d never, like, say that you can really tell, I don’t have this car like it’s fine. We Bring her home, but we have to make the decision, we paid for the storage for the second embryo for quite a while, and made the decision to donate it to science so we did that, and then, so my second daughter was born in April of 2018. So February of 2019. I start having really crazy stomach pains, and they last for like a week, but they’re weird and I tried, I tried every medicine you can name for every stomach ailment you could think of, we finally decided I’m going to go to zoom care, and just going to get checked out that we can a car but I figure that’s just for like checking for different things and the doctor comes in is like, I have good news and bad news. The good news is you’re pregnant. The bad news is, because you have a history of ectopic pregnancies, I think you need to go to the ER. So I leave there immediately and call my husband and start driving to the hospital, 

 

P: wait, let’s pause here for one second, I feel traumatized by this news, are you traumatized.

 

K; Oh yeah. Oh, and this is impossible because I can’t get pregnant. So, this never crossed my mind that this was what was wrong with me. 

 

P: Yeah. 

 

K: So I tell my husband in the exact same way. Great news. I’m pregnant. Bad news I’m on my way to the ER, because they’re pretty sure I’m having another ectopic, but the pain doesn’t feel the same, so I’m like, I’m confident that, like we’re catching it in time, like this is gonna be okay. So my husband meets me at the ER, and we are sitting in the ER at a table and I have a glass of water, and my husband watches me change color, and almost fall out of my chair which is the exact moment that my fallopian tube ruptured again. So he goes and gets the doctors, 

 

P: I hope you went and bought a lottery ticket after this. 

 

K: It’s my, my second daughter is the definition of a miracle pregnant. Yeah, because, literally every pregnancy before her, didn’t work, and the pregnancy after her. Didn’t work. 

 

P: Yeah, 

 

K: and they two on either side of her literally almost killed me. 

 

P: Yeah, 

 

K: yeah.

 

P: So you, you fold the ground I assume that helps you to skip the line of the ER,

 

K: you skip the line magically Yes, you instantly get a bed, which is pretty amazing. And they did a lot of scans, I feel like I was in the ER, a lot longer this time because it hasn’t had a timeframe so like it just ruptured. 

 

P: Yeah, 

 

K: so the process of bleeding internally and stuff is happening in hospital. I still get two more liters of blood. I still have all of that stuff happen. I know I have no fallopian tubes, so I really can’t get pregnant now, unless I were to do IVF again, which obviously I’m not doing the fact that it happened twice, I guess that never happens. Yeah. Never. And even the doctors at the hospital were like this doesn’t happen. You can’t have this happen two times. So I now have two beautiful daughters. And that’s it. 

 

P: Wow. 

 

K: Yeah.

 

P: So you this one the certain they did surgery immediately you recover more easily.

 

K: Yeah, I mean it’s the recovery is pretty the same surgery is done with it orthoscopic Lee Yeah. So, I already have the scars pre made for them they just have to go into the same place, and they take. Yeah, they take that one out. Also, though.

 

P: So, so no one can explain why this happens again,

 

K: I mean the only thought is that, you know I had a C section with my second daughter, so is it just that same thing, and I just really don’t feel very well. So, I mean that’s all we can think of.

 

P: Clearly Christie had a pretty unusual experience, and I’ll talk to Dr. Glenn a little bit about that in a second. But one of the other things that’s clear from this experience is that there are a lot of unknowns in this area of medicine, and we may never be sure about why these two ectopics happened. Having said that, it sounds like Dr Glenn may have a slightly different theory. One of the risk factors for ectopic is previous ectopic which suggests that people are having more than one. 

 

Dr. Glenn: Absolutely. 

 

P: So, is this unusual for you or what’s your experience

 

Dr. Glenn:  overall, you don’t see people with multiple ectopic pregnancies in a row, but since this is kind of my patient population is infertile. Then I see it at probably a higher rate than majority of providers, but yes definitely just like so many different things in medicine, the one of the biggest risk factors is prior history. And so prior history of an ectopic definitely increases your risk so if you have a history of ectopic, you have a 10% chance of being a second topic, so you have to make topics, you have a 25% chance. And that’s because an ectopic pregnancy is already telling you you have something abnormal with your tube, 

 

P: it’s crazy. That is totally crazy, and I would never have known that those are the only surgeries I’ve ever had and 

 

P: my experience with the infertility stuff is that they know a certain amount, but beyond that, they don’t really know what which is why would you say to me like I can’t get pregnant without IVF, I think, of course you can right they just, they didn’t find your problem so they don’t entirely know what it is and, 

 

K: yeah, 

 

P: my guess is that is most people right if you pass all those things right like I passed to and then it turns out I have an autoimmune problem, which we found in the pregnancy when I tried to kill my daughter right like but I was totally cleared, they said like, oh you’re sitting, you know, we check the five things we’re gonna check for everything’s in working order. Goodbye. Good luck, 

 

K; Right, it is no, even the conversation I remember sitting in the like seminar that they do for the fertility clinic where they talk about, you know, it’s like the little class you go to before you actually are a patient, it’s like to introduce you to this clinic and they go over how a baby, actually, is made craziness of how actual impossible. It is, 

 

P: yeah,

 

K: you don’t know that until you sit down and somebody tells you exactly what is happening in your body, to make this happen. Here there’s so many people.

 

P: Yeah, I totally agree. I’ve just seen response like how is any baby born, how does it work, 

 

K: how does anybody actually have a baby. Yeah, yeah, 

 

P: there are a million complicated steps so it is easy to imagine that like, you know, you will be able to pinpoint all of them unless you have some obvious problem. Yeah, you know you won’t know what’s going on, both of your daughters seem kind of miraculous. Yeah,

 

K: I mean, and I funny thing because we’re my daughter’s, you know she’s eight and we’re getting to the point where she’s asking some questions and I had this realization, laying in bed the other night that when she finally does want to hear the story and want to learn how babies are made. I have two amazing stories. Yes, they, she gets to hear how the story of her and she gets to hear the story of her sister. She doesn’t necessarily yet have to understand all the things that happened in the middle but they’re both two amazing stories, yeah, yeah,

 

P: that is amazing what was the eight year old into.

 

K; She wants to be a vet, 

 

P: that’s fun. 

 

K: Yeah, she’s super into animals, and she takes horse riding lessons and play softball, 

 

P: that sounds busy. 

 

K; Yeah. 

 

P: What about the two year old What are her latest tricks. 

 

K: so my two year old is our firecracker. She is 100%. And they’re, They’re very different personalities. So, my oldest name is Josie and my youngest is Cody, one is soft spoken and sweet and nurturing and loving and one is a terror of my house. Yeah. she earned it I guess,

 

P: yeah, she totally did 

 

K: oh my god she totally did. Yeah, 

 

P: that’s awesome. That’s a great, that’s a great and triumphant story.

 

K: Yeah, it’s pretty crazy. I feel like I should like be doing more things. I almost died twice, I should being doing something. 

 

P: Well you I mean you have had two amazing children that’s right yeah, but I think you should play the lottery. I think you really have like access to numbers that the rest of us don’t right 

 

K: something, there’s something, right, yeah. Oh, yes, 

 

P: your story is a huge story of triumph, right, it’s amazing that you guys are. Everyone, like your kids do not bear any of the marks of your experience, 

 

K: no, 

 

P: which is amazing, right.

 

K: Yeah, I have two very perfectly healthy children. 

 

P: Yeah, that’s awesome. 

 

K: Yeah, they I have scars and things and, you know, I have no fallopian tubes, but they are perfect. 

 

P: That’s awesome. Totally awesome. 

 

K: Yeah, it’s pretty crazy.

 

P: So let me ask you one other question if you could give advice to your younger self, what would you, what would you tell her

 

K; Don’t ignore stomach pain.. It’s funny because I so my, my thing now is always, I didn’t want kids. Oh, look at what I went through to make sure I had to. Yeah. Like, I clearly did want kids, and they’re definitely my proudest, most amazing thing I would never ever change. Yeah, super. Like it never goes as planned. Yeah, 

 

P: there’s no plan, there’s no, no,

 

K:  I had a birth plan with with my children, I wrote it all out.

 

P: Yeah, yeah. 

 

K: Nope. It would be having no plan, 

 

P: right, your body’s going through so much transformation there is the sense of a loss of control or all these things are happening inside you that you literally there’s nothing you can do. Yeah, so the birth plan sort of makes psychological sense at the very least to say, you know at the end of this long process. This is how it’s going to go.

K:  Yeah,

 

P:  at least in your mind, as long as you’re able to give it up in the last minute when it doesn’t happen.

 

K: Yeah, I think my biggest recommendation, this would probably because I know I know lots of people have different things but I was so sure that I understood the birthing process with my first daughter, that in the, in the room with me and my sister in law, and my husband, obviously. And after having her. I decided with my second daughter to have a doula. And the reason for having her was that, I then learned that I’m in the middle of a situation where I cannot be my own voice. 

 

P: Yeah, 

 

K: and I need somebody to be there to be my voice, who’s not my husband, who’s not my family member, but understands what’s happening, and can be a voice of reason and that’s 100% what she was,

 

P:  it makes sense to have an advocate, I think you don’t realize the first time that you will need one. Yeah, because you think I’ll be totally in control, which I know people do. Yeah, and it’s useful to have someone who’s seen 100, who can say like this is, this makes sense or this doesn’t make sense yeah that’s good advice.

 

K: Yeah, she was amazing, and I recommend her to everybody now, so having that person who will this person literally dropped on all fours in the waiting room so that I could lean on her to have a contraction. Like, that’s the person you want in your ballpark,

P: yeah, yeah, that sounds like good advice. Yeah. Awesome, well thank you for telling me your story. I’m so glad to see you looking very vital. And that’s all kind of behind you now. So I didn’t catch Kristi’s sign off on tape, but 

P: I’d like to thank her again for sharing her story and to Dr. Glenn for her medical insights, Christy describes her children as the miracle. And on some level that’s true to grow a child from seed is nothing short of miraculous, especially given some of her specific circumstances. But hearing this story I really think it’s Christy’s response to all these overwhelmingly challenging obstacles. That’s miraculous and I found it totally inspiring.  Thanks for listening. If you like this episode, feel free to like and subscribe to the podcast, you can find detailed show notes at war stories from the womb, calm, and if you’re interested in sharing your story there’s a place in the website to contact us. We’ll be back soon with another inspiring story.