The scary medical wait begins

“The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” -Martin Luther King Jr.

Today would have been my “follow up” visit for the first D&C if everything had gone as planned. Unfortunately, instead it was one of what will likely be many more visits to the doctor in the weeks to come. Just two days after my third surgery we were asked to return to visit with the same doctor who performed two of my surgeries. With it being such short notice they booked me a last minute appointment, squeezing us into the doctor’s already full schedule. So arriving at the doctor’s office today we did quite a bit of waiting.

We waited close to an hour before talking to the doctor, and thankfully Jason and I found ways to be humored during our wait. Jason didn’t hesitate to take my 365 photo laying back resting waiting for the doctor while admiring the poster on the ceiling. I’ve always been intrigued by seeing the visual stimulation they leave on the ceiling at the doctor’s office, so sarcastically I was definitely twittering pictures as I was humored. Of course I can always rely on Jason’s humor to keep my spirits as lifted as they possibly could be during these challenging times. Though Jason is definitely serious when the situation calls for it, I have to admit he has always humored me when he accompanies me to the doctor. He’s full of medical jokes and well, today was no different when he was left bored waiting joking about the contraception poster on the wall in the doctor’s office. Yes, even in these trying times he continues to give me reasons to smile.


Most of our appointment today was spent talking with the doctor about the concerns ahead, many of which she expressed to Jason the night of my last surgery. The major concern right now is that my body must somehow eliminate the remainder of the pregnancy tissue, even after a D&C the body still naturally must eliminate the residual amounts remaining. Surprisingly after three surgeries my body still has pregnancy tissue that needs to find a way out of my body. The biopsy from surgery Monday confirmed that the tissue taken was still pregnancy tissue, the doctor referred to it as “degenerate” meaning it was showing signs that the tissue is deteriorating. The doctor’s main concern is that this pregnancy completely end as soon as possible, otherwise it could turn into what is considered as a molar pregnancy. If the pregnancy becomes molar it means my body continues to try to support the tissue, even though the pregnancy is no longer viable. The biggest fear of molar pregnancies is that they often lead to form a type of cancer which obviously is very scary to consider that thought. So the doctors are going to be monitoring me very closely to ensure that they do everything in their power to ensure the pregnancy is fully terminated so that in time I can gradually resume my life again.

So for now I must wait to see what happens. I will be going to the doctor weekly to have blood drawn for lab tests to test my HCG levels, the hormone that supports pregnancy. If my levels do not go down enough in the coming weeks or if I begin to bleed excessively again then I will be given a medicine called methotrexate. If the tissue doesn’t go away soon the doctor does not want to put me through another surgery. They all fear that doing so would compromise the stability of my uterus and would likely lead to a hysterectomy. So we are hopeful that my body is able to terminate this pregnancy fully on it’s own, but if it doesn’t I would have to go to the hospital to be given methotrexate, which is also used as a form of chemotherapy. Though the dosage I’d receive would be less than chemo dosage, it would have side effects very similar to chemotherapy. As  you might imagine, even the thoughts of having to take this medication scare me, but I understand that if I have to go through taking the medication would increase the chances that this pregnancy would finally fully come to an end. Ultimately my current and long term health are a priority as all these decisions will likely be made in the coming week or two. Needless to say it all truly frightens me.

Right now our biggest concern is ensuring this pregnancy is fully terminated. We’re so concerned about my health right now, but we have also come to realize that with the latest news comes a lot of long term struggles for us that will likely affect us for months and years to come. During the ultrasound Monday they discovered that my uterus was not shaped like the usual pear shape. Though I’ve been through many ultrasounds over the years, for the first time the doctor and ultrasound tech noticed that my uterus appeared to be shaped like a heart and that due to this shape the tissue was tougher to fully extract. The doctor referred to it as a possible type of “double uterus”, meaning that before I was born my uterus never fully formed correctly, resulting in the uterus being somewhat separated in the middle by tissue. This is said to be a very rare condition that most women never know they have until they encounter fertility problems or recurrent miscarriages. The doctor’s believe that the shape of my uterus is likely an influencing factor in my previous miscarriages. They informed us that if in a heart shaped uterus a pregnancy implants on the side walls of the uterus it would likely go full term, but if it implants at the top or middle section of the uterus it would always result in a miscarriage merely because of the way the uterus is formed.

This is obviously a big concern for us moving forward. Once we get past terminating this pregnancy fully our next concern would be to fully diagnose this condition. During my last D&C, despite the doctor being able to explore and see inside my uterus with a camera, she was unable to see clearly because of the amount of bleeding. However, she seemed very certain that I did have a heart shaped uterus from what she was able to see. Once we are past this pregnancy I will likely undergo a hysterosalpingography where I would undergo an X-ray using a dye to confirm that this condition does exist. If it is confirmed I would likely be advised to undergo a surgical procedure to correct the problem. It is discouraged that we even consider conceiving again without confirming this condition and without ensuring it is corrected if it does in fact exist. Though women who have this condition are able to carry a baby through a full term pregnancy, as I have twice, the condition poses a major risk to me and any potential future children – that is if we even decide to put ourselves through conceiving another child. Right now the thoughts of having another child are very frightening for us after going through three surgeries and now learning of this potential condition I may have. Having this uterine condition poses complications with fertility, a threat of more recurrent miscarriages, potential premature birth and improper positioning of babies in the uterus. All of which are frightening thoughts for us to worry about moving forward.

I must extend an apology to the many of you who we haven’t called since any of the previous surgeries. Jason has spoken to many of you over the last 2 1/2 weeks at some point, but we hope you all understand just how draining it has been to continually have to repeat telling you all this news over, and over, and over again. I admire Jason’s ability to stand up and having to break this news to many of you the last few weeks, though we both admit that going through telling you all by phone and even email over and over again really has put a toll on us. Every time we have to tell any of you the news  or let you know how we’re doing it just has us reliving these challenging moments that the last few weeks have brought. I send my apologies to those of you we haven’t called or emailed as we have continued to endure more challenging moments this past week.

I know some of you have heard me at times these last few weeks complaining about our phones ringing non-stop some days. I apologize if I have offended any of you. I do realize just how many of you who care, however, if it isn’t evident it’s very overwhelming to continually answer “how are you doing?” or “what’s going on?” type questions. Please understand it is not that we don’t accept the care and concern, its just truly challenging at times to go through the repeat conversations and emails to update you all. I have had many of you scrutinize my decision to disclose such personal information through my blog, but to be honest, writing about these recent events have helped me in the healing process. I really do realize just how many of you care and how many of you are concerned and I do not want to leave any of you wondering how we are doing. At times I have considered keeping all of the news from the last two weeks completely private, but to me, after being through this several times in the past I do not feel as though my family will benefit any by cornering ourselves into our home and not allowing any of you to know just how troubling these moments have been for our family. I have no secrets to keep – I’ve come to accept that there isn’t much that’s too personal for me to share publicly with family, friends, co-workers, teachers and students. So in the absence of calls or emails please know you may revisit my blog, facebook, or twitter to see how we are doing. And it’s really not that we are asking for you all not to call ever again, but right now we really truly value the bit of space we need as we continue to cope through this recent loss and now also the traumatic news we’ve learned this week. We thank all of you who have offered to help or have reminded us that you’re “there” for us. Trust me, if we need anything we won’t hesitate to contact you.

The week ahead we will continue to play the waiting game and pray that my body terminates this pregnancy fully on its own. I have major fears after the traumatizing experience Monday where I bled excessively on campus, so due to the recent concerns the doctor advised that I remain home from work this next week. I truly fear being on campus again and going through a similar experience as I went through Monday. I will likely only leave my home in the next week for my visit to the doctor or in the company of Jason or close friends and family who I trust will be there if I experience another event like Monday. Overall I’m steadily beginning to recover from the last surgery. I do feel a lot more discomfort this time around, which is likely due to how much more the doctor poked around during the exploratory surgery. Right now my biggest fear is to go through another experience like happened Monday which I still fear may happen again in the coming days.

If you’re a student in any of my classes I will be emailing you all soon with information on whom will be helping me with my classes this next week and with any potential changes so you are fully informed. I will definitely be online often this next week as I hope to get as caught up as possible with grading and getting in touch with all of you online in my classes. I also hope to spend some time this next week getting caught up with homework with my online classes at SCAD. I have 2 1/2 weeks worth of homework but I have faith that I will be able to complete the quarter successfully. I can’t thank my instructors, classmates, and students for being equally as understanding and supportive during these challenging moments.

Once again, thank you all for the care and support you continue to give. Now we wait…and pray.

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October 21, 2009 - 9:02 pm

Erica Reynoso Montalvo - Amanda & Jason – Team Montalvo sends our love and prayers for a complete, healthy recovery. Please feel welcome to tap us as we’ve officially signed up to be part of your support group. Whatever you need, we’re here. HUGS, Love and Rock n Roll,
Erica, Mike, Isa & Lili
:o) =o) :) :)

October 22, 2009 - 12:33 am

joleen - well im glad you update us with everything and anyone who feels my sister is sharing too much can jump off acliff! i love you guys still praying for ya too!

October 22, 2009 - 9:53 am

kristy pennino - ditto to that, joleen. transparency is very helpful at times like these for those of us that care and worry. it takes a great deal of courage to share and be so open with issues so traumatic and personal. dr. volker gallichio says hang in there and make sure you get some rest amanda! :-)

October 22, 2009 - 10:42 am

Amanda Kern - thanks guys. It’s definitely been tough to rest this mind of mine until more time passes. That said on just 2 1/2 hours of sleep between being in discomfort still from the effects of surgery and just having my mind unsettled about all the recent news. :o( They say pain is weakness leaving the body…so give me a bit more time and I’ll seriously be tough as nails guys. I don’t see how I can have much more weakness inside me after all I’ve been through these last few weeks.

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