My ectopic pregnancy - part 3/3

In the days which followed my surgery my family and friends rallied around me. Thoughtful gifts, fresh blooms, meal drop offs, gourmet doughnut deliveries and kind messages filled my days. I felt so very lucky to have been inundated with such wonderful support, both in person and on social media 😊 My wonderful mum, sister, in-laws and closest girlfriends all helped with the kids and housework, because for the first week I couldn’t drive or lift anything heavy, and as for my endearing husband, well he did absolutely everything in between. Pain wise, it was the gas pain from my abdomen being inflated to move my organs easily out of the way, which troubled me the most post-operatively. Thankfully I was sent home with pain relief which helped with the shoulder tip pain (from the trapped gas) and the constant ache where my right fallopian tube once was.

My distended gas-filled abdomen and three incision sites the day after surgery. 

A couple of days after surgery, I sat having breaky at our dining table in my charcoal-grey terry towelling robe, Nespresso coffee in hand, when the bereavement of my experience finally hit. The catalyst; a flashback of the photo the doctor had shown me of my sweet babe. Tears welled in my eyes as the despair set in. I uncontrollably wailed for our innocent baby and the fact it was completely unaware he/she was in the wrong place. That photo was its last moments in the world and I felt grief stricken knowing our precious baby had no idea what was coming... As I type these words, I am again filled with overwhelming anguish over this notion and quite sure, I always will. When I miscarried my first baby I was devastated, but in time I did slowly accept it was nature’s way. This however feels very different. We had to say goodbye to a baby who was deeply loved, a baby I would have done anything to keep and this brings me more heartache than I’ll ever be able to accurately explain…

I have had my pregnancy hormone tracked for two weeks now. I am so happy to say it went from 1262, to 28 in a week. Last Monday 14th it was thankfully down to less than 2, which means I no longer need to continue the blood tests nor do I need any further intervention. YAY, YAY, YAY. Of everything that transpired, its this part of my story I am monumentally relieved about. 

At the end of the day, I was extremely lucky. My Fallopian tube didn’t rupture, because of where my baby was. This was why my obs remained stable that day and I was not rushed in for surgery the minute I arrived in ED. The internal bleeding I experienced was likely because my body was trying to miscarry and “flush” the pregnancy, knowing the baby was in the wrong place. How clever is that? Sadly, because most of my tube was blocked, this didn’t work and created the pooling of the blood in my abdomen. The risk of an ectopic pregnancy in the general population is 1-2%, having now had one, my risk in a future pregnancy is 10%. I have avoided getting overwhelmed thinking of the “what’s if’s” had this experience taken a scary turn, but it has certainly created fear in my mind around the idea of another pregnancy...

Possible causes of ectopic pregnancies are smoking, pelvic inflammatory disease, endometriosis, uterine infection or scar tissue from previous surgery. In my case I ticked the last box on previous surgery, having had a Caesarean with my first baby. Scar tissue from that Caesarean is the likely culprit and yet another reason Caesareans are rubbish... Scar tissue is a jerk. It affects subsequent pregnancies, placenta placement, placenta detachment post birth and for women later in life, can create adhesions to the bladder, bowel, etc causing a whole gamut of issues. Scar tissue is no joke and avoiding scenarios which create this are absolutely for the best. This is why I avoided a dilation and curette (D & C) with both my miscarriages and why I didn’t want my Caesarean scar reopened during this recent surgery. As for my Caesarean in 2013, well I would have moved heaven and earth to avoid that. In the end, my breech boy got stuck, but it didn’t make it any easier to stomach on the day, because nothing about major abdominal surgery is easy.

On this 21st day of August it has been three weeks since my surgery. Physically I am healing well and have been given the approval to start gentle exercise again. As for emotionally, that really depends what day you ask me... I am lucky to be in the midst of building this breastfeeding empire of mine, which in truth has been a most welcome distraction from the sadness. As always there are silver linings with times of sorrow. The best thing to come from this is the love I feel both from and for my husband, and a wonderful next-level sense of gratitude when I look at my two gorgeous children.

My ectopic pregnancy - part 2/3

The early morning photo I sent hubby to reassure him I was doing okay.

An hour later, I awoke in recovery feeling woozy and absolutely bombed from the anaesthetic drugs.  Forcing my eyes opened with all my might, I remember a voice telling me the positives; I’d had keyhole surgery and still had my left Fallopian tube. This information brought me much relief, so with that in my dazed state, I chose to surrender to the sleep my body and mind was so desperately craving. Up on the ward, I dozed through regular upper arm squeezes from the BP cuff, pad changes, inspections of my abdominal dressings and constant alarms from my occluded IV pump, while the distinct smell of oxygen was delivered through my nostrils. Thankfully the analgesia I had on board covered me well and the sleep I did have felt amazing, yet I craved so much more. Come breaky time I was rested enough to sit up and eat some stone-cold, raspberry jam covered, burnt toast but unfortunately the toast (and every other meal I ate that day) came straight back up a short while later.

My darling hubby came in around 9am and not long after the OB/GYN team came to review me and explain the ins and outs of my surgery. First came the good news. My internal bleeding was easily managed and the surgery was all performed laparoscopically. My left Ovary and Fallopian tube were healthy, the tube itself patent and therefore was left well alone. I was told this while I followed along through the photo series the Consultant promised and watched in awe at seeing my phenomenal anatomy from the inside. The next image however ignited a very different feeling in me, which didn’t fully register until several days later. It was my baby. Our baby. There it was… Shaped like a neat jelly bean, inside the bubble of the amniotic sac, with its wiggly cord connecting it to me. Time stood still as I learnt our beloved babe, of eight weeks gestation, was not inside my Fallopian tube per say, but was on the end. By Google definition, an ectopic pregnancy is when a fertilised egg implants itself outside of the womb, and most commonly this is in one of the Fallopian tubes, but like in my case it can be in many other places. Using the next photo, the doctor explained that half of my right Fallopian tube was blocked (the inner half, closest to my uterus) so the baby had no choice to attach itself at the opposing end and did so on the Fimbria (finger like projections) near my right Ovary (see image). This is where the not-so-good news came. I learnt the doctor was only able to remove half my right Fallopian tube (the outer half), because the inner half had adhered to my uterus and attempts to remove this section would have caused too much trauma. Consequently, the doctor could not unequivocally say they were able to remove all of the pregnancy. I was advised I would need my pregnancy hormone tracked via blood tests for several weeks, until it reached less than 2, but if this did not occur, I would need treatment using the drug Methotrexate. Processing all of this information at once was a lot and there felt no space for sorrow. Instead I remained impassive so I could also work my way through the extensive list of questions I had complied in my phone. Once all of this was finished and my three tummy incisions checked, I was given the all clear to be discharged that afternoon, when I was stable on my feet and after I did a wee, post catheter removal.

Black arrow is pointing to the location where my baby had attached itself to the Fimbria on the end of my right Fallopian tube.

Source: Google.

By 6pm that evening I was thankfully home. My heart was full of gratitude that I was okay and with my beloved family; especially my two dearest children. I wanted so much for this ordeal to be over and yet not knowing what my blood test results were going to reveal over the coming weeks, was a worry I couldn’t escape. I knew little about Methotrexate but what I did know brought me no comfort, nor did the information the doctor had mentioned, being a full week hospitalisation and administration of the drug using a strict regime. I enjoy maintaining a healthy lifestyle and truly think of my body as my temple. Conscious living, clean eating and endorphin-packed exercise are all part of my day to day, so the notion of a chemotherapy drug in my body was especially troubling. The other thing I found troubling was 48 hours after my surgery I still hadn’t cried. Not one tear. I realised I had been unintentionally suppressing all emotion in order to just get through the experience, but I knew the grief would surface soon and gosh would it hit hard... 

My ectopic pregnancy - part 1/3

Nine days ago, I awoke at sunrise to severe right sided abdominal pain. Thankfully Prince Charming was working from home that day and already had the kids making their way to the breakfast table, so I hoped straight in the shower thinking the heat would help. With every minute, the pain seemed to get worst and when I brought my right knee up to my chest to loather my lower leg with soap, it was like an excruciating electric shock zapped me from the inside. When I repeated this with my other knee and felt no pain, I immediately knew this localised pain I was experiencing was very worrisome. I cut my shower short and started drying myself, thinking I just needed to lie down so I could regroup. I immediately started to experience shortness of breath and was doubled over trying my best to guard my abdomen. Suddenly standing was no longer an option, so I crawled out of the bathroom, through our walk-in-robe and made it to the base of our bed. I called out to my love and he found me on all fours with a towel partially draped across my back. I breathlessly said “Something is wrong. We need to go straight to hospital”. Tears rushed down my cheeks from the agony, while I breathlessly explained to my man my panicked suspicions. “I think it’s an ectopic pregnancy.” “Oh my gosh!” I said, as I winced in pain. “These can be fatal”. Peak hour traffic made for an anxiety filled car ride where I prayed I would get to the hospital in time. My Prince did so well to keep a calm facade, while I grappled with both the mind-blowing pain and the worst-case scenarios in my head. All I could think of was my two darling cherubs riding in the back seat, hysterically telling my love over and over again “I have to be ok. I just have to”.

We arrived at the hospital where my mother in law met us and took Lawson and Avery back to her place. I was taken straight into a resus bay in Emergency. A blood test reflected my pregnancy hormone, which was 462 only five days prior, had gone up to 1232, indicating I had not miscarried last week like I thought. A pelvic ultrasound found a collection along my right fallopian tube, supporting my fearful theory; I had an ectopic pregnancy. My abdomen was filled with free fluid, which the Consultant Obstetrician explained was likely as I was haemorrhaging internally. My situation was explained to me, being that although my obs were currently stable (BP and heart rate), my fallopian tube could potentially rupture at any minute. The non-surgical option (treatment using a chemotherapy drug called Methotrexate) did not apply to me because my ectopic pregnancy was too advanced, so surgery to remove my fallopian tube was strongly recommended. I asked the Consultant did I have any other options, to which he gently but urgently explained, “Amber, surgery is your only option”. The Consultant hoped to perform the surgery laparoscopically (keyhole surgery) but because of the blood in my abdomen, there was the potential he would need to open up my Caesarean scar, from my son’s birth. I loathed the idea of my Caesar scar being reopened, most worried of the creation of more scar tissue. If my left fallopian tube was damaged, the Consultant would remove this as well (in order to avoid the chance of another ectopic pregnancy in my future) which would also eliminate my chances of conceiving naturally again. I asked if they could keep my Fallopian tube for me to see post surgery, but was sadly told this was not an option, but they would take photos for me to view after. I was prepped for surgery but lost track how many times I was bumped for an emergency Caesarean over the day. Thankfully I remained stable (which was why this happened) but it made for a most scary day because I felt like a ticking time bomb, grief stricken on that hospital trolley, that at any point my tube was going to burst.

Minutes after I learnt my sweet baby was in my right fallopian tube.

Finally, after fasting for 27 hours (which left me feeling utterly lousy!) my time came at 10pm that night. I was wheeled into the brightly lit theatre with my hubby’s hand in mine as tears rolled down my cheeks. I cried for many reasons in that moment but mostly for not knowing what exactly was going to happened to my cherished reproductive organs while I was under. Would I lose one or both fallopian tubes? Would it be done laparoscopically? Would my Caesarean scar be used? And then finally would I be ok? The anaesthetist gave me something to make me “relax” through my IV and this is the last I remember…  

Miscarriage numero dos

July 9th: The exciting day we had found out I was pregnant with a sibling for Lawson and Avery. 

Two weeks ago today, I awoke to Avery tucked snuggly up against me under the warm covers, chatting. It was 7am on Saturday and as I stretched I noticed Lawson too had ended up in our bed at some point overnight, him now waking as well to Avery’s cute early morning chit chat. When I finished getting both kids dressed I felt some vaginal fluid come away. I’ve not bled before in pregnancy, so I thought it was likely just normal vaginal loss but took myself off to the loo for a wee and to double check. I was relieved there was no blood in my underwear but when I looked down and saw the moderate amount of bright red bleeding on wiping, my heart immediately sank. I went to find my Prince Charming who was asleep in Lawson’s bed, after taking his 6’2 self there in the early hours of the morning when longing for bed space. I climbed into the single bed with my love, and tearily whispered, “I’m having a miscarriage”. The tears cascaded down my cheeks as my Prince swiftly scooped me up in his arms. “Oh no” he tenderly replied. With an urgency in his voice he then compassionately asked “What do you need?”. “Nothing” I sobbed “just hug me”.

For the day my womb cramped strongly and regularly, some of the waves taking my breath away while I attended to mundane household tasks. The bleeding was a light flow which concerned me, because I knew if this was to be a complete miscarriage at 7 weeks gestation, I needed to pass at least a full monthly bleeds worth. My instincts told me to retreat so I spent this time at home where I felt warm and safe. I drank tea and cried lots with my man while snuggled on our Plush chase, as the kids played around us. The cramping peaked in intensity that night and I tossed and turned in bed while having wacky colourful dreams.

The following morning, I had a new client who was requesting a Breastfeeding Appointment. My bleeding had started to pick up but the cramps were mild come sunrise. I knew my bleeding could last several days (of which I didn’t expect I would be staying home the whole time for) and this mama really needed my help, so I decided to attend the appointment. Although, when I left my house that morning I instantly felt fragile. The world felt cold and fast paced and I felt like I didn’t belong in it. My goal: to support this mama completely for the 90 minutes I was with her, then retreat home as soon as possible. The appointment went well but while driving home I felt my body pass a large clot. When in the safety of my own ensuite, I was able to see the 50-cent piece size clot; likely housing my little babe inside. Nothing about that made me squeamish, instead I marveled at my clever body for knowingly bringing this baby (the size of a blueberry) out in its entirety. For the rest of the day I had heavy bleeding and passed a few more smaller clots. My hubby and I went out for a late lunch together while mum babysat Lawson and Avery. We had such a lovely long chat about our baby and the sadness we both felt over this whole experience. I shed so many tears over tapas and treasured the love I felt between my darling man and I, as we walked this heavy-hearted road again together.

Three days later my bleeding had moved from heavy, to medium, to light flow. Just like with my first miscarriage, I hoped to avoid any kind of surgical intervention and up until that point, I was very comfortable monitoring my body myself from home. I had felt no need to see a doctor but promised myself (and my mum!) that if things deviated from normal, I would definitely follow it up with a medico.

Waiting for my ultrasound

On the last day of my bleeding, I noticed a change in the smell to my loss. While it was not an offensive smell, it was a strong smell and I felt it wise to have it checked. I went and had an ultrasound which found my uterus was empty, indicating I’d had a complete miscarriage; an especially sad reality, but this also brought relief. A blood test showed no signs of infection and the swabs I had taken came back normal. Two days later the doctor from the Early Pregnancy Assessment Service (EPAS) phoned to check how I was. My pregnancy symptoms had all resolved and although my pregnancy hormone was still high at that point, the doctor theorised it was either because; I was further along than I thought (which I knew was not possible) or she explained; it was highly likely I’d had a multiple pregnancy. The doctor offered a repeat blood test but was happy if I decided to decline this. She gave me some parting instructions, being if anything changed, such as sudden onset pain or bleeding, I seek medical assistance asap, but otherwise she wished me well. In the days which followed I felt relieved my miscarriage was drawing to a close and my toughest days were behind me. How wrong I was…

To be continued...

Breastfeeding my breech boy

Lawson's first breastfeed (one hour old). 

The first few days of Lawson's life were spent nestled under the bed covers in just a nappy, blissfully content, against my bare toasty chest. One positive of being cooped up in hospital after a surgical birth is that you have no other place to be than resting and bonding with your baby.  I knew all too well that mothers of babies born via Caesarean statistically have a harder time bonding with their little ones and have lower success rates with breastfeeding. So with that in mind, I did what I knew would help prevent me from adding to that very statistic; I kept my son close, against my skin, so he knew where ‘home’ was; where his senses were met with all things of his mama; and I nursed him at my breast frequently (and I mean frequently!). Because of this, my breastfeeding was off to a great start in those first few days. I had loads of colostrum, my milk came in easily on the night of day two and my little man was attaching and feeding very well. I had no damage to my nipples in those early days despite expecting to (because of my anatomy and skin type) and went home from hospital feeling hopeful it would stay that way.

Breastfeeding on day two in hospital.

When Lawson was four days old I went to my girlfriends wedding. Many of my family and friends thought I was crackers attending a wedding the day after being discharged from hospital, but this was a very dear friend of mines nuptials and I simply wasn’t going to miss it. The wedding itself was just beautiful and a very unforgettable occasion; a country wedding on a stunning property,  celebrated under two adjoined tipis, for a gorgeous couple who were very much in love.  This all made the enormity of getting my 96 hours post Caesar self there all the more worthwhile. On the night, my Prince did all the hard yards in wrangling the pram and our two tonne nappy bag (since my tummy incision meant I couldn’t lift a great deal), so all I had to do was cuddle and feed our newborn son throughout the evening. When we got home at 11pm that night my boobs ached…badly, so I took my dress and bra off to reveal my best ever Pammy Anderson impersonation!! Considering I’ve wanted knockers my WHOLE life, you would think this would have been grounds for celebration, but my mammaries were ragingly hot and throbbing and I knew action was needed; and relishing my air bags wasn’t it (although I do recall a quick smirk to my reflection in the mirror). I tried a feed but the skin on my norks was tort and shiny, so when Lawson eagerly tried to attach to my nipple (his head bobbing around for dear life), his little mouth just slide off my breast like he was trying desperately to suck on a drum. We made it through a feed but what I didn’t realise at the time, was that very night was when my dreadful nipple damage first began.

Two weeks into our breastfeeding journey and my nipple damage was worsening.

Several days later and my cans had still remained very full and engorged. I persisted with tricks of the trade to help with attachment including warm compresses, hand expressing, and massage, all to make the nipple area softer and more pliable so my little pumpkin could feed, but attachment became problematic. I had so, so, so, so much milk, that Lawson was inundated with my supply each time he fed. He would slurp and slosh his way through that first let down, gulping milk as fast as he could, while it flooded out the corners of his mouth. I frequently squirted that liquid gold in his face, into his eyes, up his nose, well absolutely everywhere! Two small cracks formed on my right side when Little Duke was 14 days old, and breastfeeding went from what started out as a pleasurable, easy experience to a toe curling, teeth clenching, Lamaze breathing event. I applied Lansinoh cream (pure Lanolin) liberally post feed and paraded around our pad topless, but no healing to the area occurred and instead those damn cracks deepened. I contacted our brilliant Lactation Consultant, TheBoobWhisperer and developed a feeding plan over the phone to try for a few days. I didn’t want to introduce a bottle in those important first six weeks, (when I knew it could negatively interfere with Lawson learning the correct technique at the breast) but I was at a point where I dreaded each feed with a passion. I continued to worked tirelessly on my technique and made Prince Charming be physically and emotionally present for each feed so I could lock eyes with him and huff and puff my way through it – may sound odd, but it really helped. In supporting the healing process, I ordered some aloe vera impregnated breast pads from my local pharmacy and had Holly track down some Calendula nipple cream from her supplier. I kept hoping to see light at the end of the tunnel, but to my devastation the cracks worsened, becoming deep fissures. My nipples were red raw and the painful fissures seeped haemoserous fluid constantly, and suddenly nothing of my tatas resembled Pammy’s…

By week three of breastfeeding I contacted TheBoobWhisperer again since my attachment woes had moved out of my knowledge base, and I needed an expert. She came over and did a two hour home consultation. I don’t exactly remember the ins and outs of the consult (since I was too sleep deprived!) but what it felt like was TheBoobWhisperer was my Breastfeeding Fairy Godmother who sprinkled her magic fairy dust and made everything better. Since my attachment clearly was not right, TheBoobWhisperer’s magic fairy dust included teaching me a technique called Baby-Led Attachment (BLA), something I had heard of but didn’t know much about. BLA is the term used to describe the process of a baby seeking out his mother’s breast in the most natural and instinctive way. It includes skin-to-skin contact, and watching your baby’s cues as they show readiness to feed, search for the breast and self-attach.  When learning, it is best done in a semi reclined position with your baby facing you, sitting upright straddling your thigh, like a little bear. Interestingly, I had only developed damage to my right side, giving weight to TheBoobWhisperer’s theory that Lawson may have had soreness in his neck when he turned to feed that side (likely from his position inutero). She thought the upright position of BLA would solve this problem (plus a trip to our brilliant Paediatric Osteo played a big part here).

A photo from the newborn shoot.

Two days later and while I had some successful feeds doing BLA, the ongoing pain from my fissures wasn’t improving. I was so stuck what to do, since I still wasn’t willing to give Lawson expressed milk via a bottle, but each and every feed was pure agony and it was wearing me down.  We had some baby photos taken of Lawson during this time and he needed a feed during the shoot. While I breastfed, our photographer Leanne casually snapped away trying to capture a beautiful moment between mother and son. On the outside I did my best to look serene and besotted with my bundle of joy, but on the inside I housed my torture filled reaction to what felt like having a Piranha locked onto my nipple. When the shoot was over I called TheBoobWhisperer in a blubbering mess, feeling quite sure I had reached my limit. She talked me down and went over our options here on. TheBoobWhisperer was concerned I may have had a bacterial staph infection in the deep crevices of my fissures, preventing them from healing, and an antibiotic ointment was her suggested line of treatment. I loathed the idea of Lawson indirectly getting antibiotics, knowing it would do his natural gut flora nothing but harm. I pleaded there must be another way. Through our phone consult TheBoobWhisperer determined I wasn’t doing the BLA quite right, incorrectly letting Little Duke do too much of the attachment himself. TheBoobWhisperer gave me a few more pointers to work on (since she thought the pain did sound more like an attachment issue after all, and not a bacterial one), and our chat gave me the confidence to keep trying, because success may have been just around the corner.

When Baby-Led Attachment solved our feeding challenges.

On April 26th, something happened. Not sure what, but Lawson all the sudden started to open his mouth wider and together we finally coordinated BLA. A few days passed and although the fissures where not healed, there was a marked improvement in the pain during feeding and, well, I guess we finally found our breastfeeding mojo!! A mix of elation and relief followed, when I remember spending a few days ecstatic to have made it to this point. A week passed and I was fairly confident with my feeding by then, even proudly showing off my new found skill at places like the hairdresser and Bunnings. Breastfeeding returned to being the precious bonding experience it had started out as, and I was immensely happy.

By week six my confidence in my ability to successfully breastfeed had returned. “I’ll be absolutely fine now” I thought to myself. Wrong. One night that week, when Lawson was cluster feeding during witching hour, I felt some pain on my left side, on the outer aspect of my breast. As the tingling sensation of my let-down took place, a stabbing feeling in that localised area took over and I immediately knew this equalled bad; it was a blocked duct. I suspected the culprit was a cheap and poorly designed feeding top I had become frustrated by earlier that day, where the window to access my breast was very small and off centre, so I had slung the whole neckline under my boob for a feed. The top must have dug in on that left axillary side, blocking the flow of my milk and clogging the duct, and jeepers it was sore. I spent the night using heat and massage to try unblocking the duct, but by morning the lump had doubled in size; the surrounding wedge of breast tissue was hot and red in appearance; and by then it was fiercely painful. For the next few days I did lots of massage, applied heat and feed in all sorts of wacky positions (including hanging upside down)to try and drain the duct fully. The feeds at this time were mind-blowingly painful as the milk hit the blocked duct from behind, sending shooting pain all through my left bazooka.  After a week of this, coupled with a Physio appointment for some ultrasound/vibration treatment, thankfully the duct finally began flowing freely again. Fortunately this blocked duct was the last hurdle I had to overcome in establishing breastfeeding and from there on, things have been smooth sailing for my darling Lawson and I.

The experts will tell you, it takes four to six weeks to establish breastfeeding. When you are recovering from giving birth, adjusting to motherhood while caring for a newborn, and are sleep deprived like there’s no tomorrow, committing to this time frame (especially if it’s filled with hurdles), is a colossal undertaking. However, this is the all-important time when it comes to mastering breastfeeding.  If you make it to the golden 6 week mark post birth, chances are, you and your baby have got the hang of it and from here on it’s going to be super easy! For some women, conquering breastfeeding is stress-free and effortless, for others it is filled with challenges. In the end, I personally found it such a huge sense of achievement, to have gone through some really rough days and made it through the other side. I felt victorious, triumphant, even like some sort of champion, to have gone through the torrential thunderstorm, and made it to the glorious rainbow on the other side. I stuck at it for an abundance of reasons, but above all, I did it for my little pot of honey – my gorgeous baby boy. 

Special thanks to the website 138 slang words for breasts, who made this blog possible!

http://www.listaholic.com/138-slang-words-for-breasts.html