The Complete Egg

The before, during and after of a molar pregnancy, with a side of chemo and a 12 month wait before ttc. And most recently: experience of a healthy pregnancy.

Friday, September 08, 2006

Molar what? Molar who? Molar why?? I think I asked these and a million other questions to my very British, somewhat arrogant ("I have slaves to do that") gynecologist oncologist. Who would have ever thought that my egg could have no genetic material in it? Empty egg. Or maybe somehow the material got kicked out of it. I don't think they really have any hard evidence how it happens (or maybe I'm wrong...let me know). They do know that a complete molar pregnancy has all paternal genetic material and no maternal. And it's rare...only 1 in 1000, or 1 in 1500 or 1 in 2000 pregnancies in North America depending on who you talk to. That's not that rare though, is it?

I should start at the beginning. I was pregnant again in May 2006 after my first pregnancy ended in a natural miscarriage at 14 weeks in March. This second pregnancy felt not right from the beginning. I peed on a stick 2 days before expected period and it read negative. Then I missed period and I tested again...nothing. Tested again the next day...nothing. Spending lots of money on pregnancy tests. A week after expected period I tested again and got a very faint line. My husband and I were happy but very guarded.

I went to my family doctor early on at about 5 weeks gestation. I decided to go to my family doctor instead of my midwife until the pregnancy was deemed "viable". Then I would switch back to my midwife. This indicates my whole wacked-up thinking from the beginning. I was still greiving from my previous loss. Not aware of it at that point though.

My doctor scheduled an early ultrasound for 7 weeks. I remember that ultrasound because I drank way too much water and they were late getting me in. Since then, I have never drank the full amount of water. He could only see the gestational sac and no fetal pole. He said that it may be too early but I knew it wasn't a good sign. I thought that it was a blighted ovum. Still, he said to come back in a week or two. We went away on holidays and I was a miserable person the whole time. I kept trying to make all these requests to the Big Mama (you know, God). "Please help this to be a healthy baby".

When we returned, I went back to the doctor and she set up another ultrasound and a hcg quantitative blood test. The ultrasound was at a different and better ultrasound office, with more sophisticated machines. I felt almost sick to my stomach before going in. I had a really nice technician who asked for more information about my situation. The doctor had scribbled something about viability. I told her about my previous miscarriage and how there had been bleeding with this one.

While doing the exam she was able to tell me that there was no evidence of a fetal pole or heartbeat. I was glad that she was honest with me. I didn't want to have to wait until I saw my doctor to hear about that. After the u/s, my husband was invited down and we both saw the Radiologist doctor who explained that there looked to be a "mass" in my uterus. That freaked me out. She did not use the term "molar pregnancy" and I don't understand why not because it was in her report that she sent to the doctor.

My husband and I went in to see my family doctor on Monday. I was supremely annoyed when a resident came in and asked if I would see her instead of Dr.Z. I declined. Dr. Z came in to deliver the news that it was a suspected molar pregnancy. I had had the whole weekend to read so that was one of the things on my question list, however I did not think so because I had no other extreme symptoms. Dr. Z was pretty sympathetic. She said that she had only seen two cases of this. One case was her good friend who she said now has two healthy children.

Dr.Z referred me to a gynecologist (Dr.G) who would handle my case. I would not be able to have a natural miscarriage (which I wanted) because it was harmful to continue to let the hcg levels rise and the placental cells would grow even more. I had to have a d&c. This really scared me. I didn't want anyone fussing with my reproductive organs. But I had no choice really.

We went over right away to Dr.G's office. Dr.G was very straightforward and honest. No condolences on the whole matter. She was strictly business and facts. I did like her though. Her partner in her practice was going to do the d&c and then Dr.G would follow my hcg levels. I would have to have weekly blood tests. B, her office assistant, would call me with the blood test results. Unfortunately, B was short for B-i-t-c-h.

I remember when my husband and I went to the hospital to be admitted for the d&c . We were asked to wait in an area where all these people were waiting to see their family member's new baby. They were so happy! My god, talk about torture. I think there may have been another young women who was having a d&c and the rest were waiting to see a baby. The pain was intense. I felt like I was going to dissolve into a puddle.

Then we went in and I was "prepped" for surgery. Most of the nurses were great but one just treated me like a number to be processed. I'm glad they knocked me out right away as soon as I lay down on the operating table. Those surgery rooms freak me out. They're so big and then there is all of this foriegn equipment.

I woke up crying in unison with a newborn in the next cubicle in the recovery room. Why had they put a women who had just had a c-section next to me? I was so glad that my husband came in soon afterwards. I was shivering and he got me a warm blanket when the nurses didn't. He was so sweet and nice. He had such a hard time seeing me cry in such a sad circumstance. It was very comforting to have him there.

It took me about 2 weeks after my d&c (which was on July 27, 2006) to find out about the pathology report. The pathology report summarizes what they found after analyzing the "products of conception". I kind of had a feeling that it was a complete molar pregnancy because my hormones levels were extremely high (above 200,000 at 10 weeks gestation) and in my two previous ultrasounds they had not found a fetal pole. I had no other symptoms that indicated it was a molar pregnancy except bleeding.

I had to go out of my way to get the information from my pathology report. I called to make an appointment with the gyny, Dr. G, and the receptionist, B, told me that she would see me in 6 weeks. No, no, no, I wanted to see her sooner please. It took a lot of questions to figure out why Dr.G couldn't see me sooner and the answer? "She won't get paid if she sees you before 6 weeks." Huh? B told me if I wanted the results to my pathology report then I could go and see my family doctor who would get a copy. So after my next blood test, I went and made an appointment with my family doctor.

So far, my beta hcg levels were coming down nicely (200,000+ pre-d&c to 29,545 one week post-d&c to 3279 two weeks post). I would get totally freaked out after having the tests done but B was very hostile if I called her before she called me. I wish the stupid testing place would send me a copy of the results as well. Send one to my gyny and one to my family doctor but not one to the patient. How's that empowering the patient?

When I found out I had a complete molar pregnancy I felt that I was getting the worst of the worst. The tears started and Dr.Z did her best to console me. I knew the stats. There's I think a 15-20% (vs. 2% risk for partial molar) chance that a complete molar pregnancy will have further complications of Gestational Trophoblastic Neoplasia (GTN), aka invasive mole. Basically, the cells that make the placenta bury deep into the uterine muscle wall and if your immune system cannot kill off these cells then they "persist" and can spread to other parts of your body. All I could do was wait until the next blood test and search the internet freaking myself out. And woah did I freak myself out. But I also learned that a lot of women have gone through this and I met a few of them online at This is one of the few sites devoted to molar pregnancies. I was really glad to find it because the other miscarriage sites did not have a section specifically for molar pregnancies.

It felt like my anxiety went up because I could not get an appointment with Dr. G. I wanted reassurance. Some doctors underestimate how much their reassurance can go a long way to helping ease their patient's mind. I see now how much power I was giving away to her. But she had seen other patients through this process. She had more knowledge than me. It was so frustrating not to get an appointment when I wanted one.

The next blood draw showed levels had "plateaued" at 3034 (less than a 10% drop is considered a plateau) and the next showed that they had climbed back up to 3434. Told all of this by my friendly receptionist, B. Then, she also got to give me the good news to go and see the oncologist at the CANCER AGENCY (I was pretty scared to hear this). She rattled off a list of things...she needed a chest x-ray, go here, do this.

"And when was that meeting with the oncologist?" I ask politely.

(do your best impersonation of the office manager slug on Monsters Inc.) "As I already told you, I need to wait until Dr.G is back so that she can make the referral."

Fuck you lady. You just gave me bad news and I hardly heard anything you said after the 3434. It felt good to be mad so that I didn't have to feel so scared. This whole experience was made so much more unpleasant because I didn't feel like any of these people really gave a shit about me. In fact, I didn't feel like B was on my side at all. I think she was relieved when I was referred to the cancer agency. I know I was glad to be rid of her.

I was so scared. As I sat in traffic on my way over to have a chest x-ray, my heart was very heavy. The fear made me feel like I couldn't breathe. I felt guilty too. I felt that all of my worrying and anxiety and pessimism had caused this to happen. I knew that was not true but there it was, that's what I felt. I felt like the universe was taking a crap on my head. Why me?

Chemo. I was going to have to have chemo. I was going to have to go to a cancer clinic. I was going to have to wait for a year before being able to try again to have a baby.


Anonymous Anonymous said...

Oh! Chantelle...

I am so sorry. I was thinking that I was the only one with he bad luck until I fount and read stories like yours.

Hang in there and you will see that everything will come out good.

I know when people tell that to me I get mad 'cause they do not know what I am going thru.

I don't know exactly what you are going thru, my molar pregnancy has not been confirmed yet; but I do know that better things are ahead of us.

Be strong!


2:31 PM  

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