Have you eaten today?

Nikki Mackin 3

During what was meant to be a quick check up on the way to lunch in Newtown, mother-to-be Nikki was instead told that her pregnancy was ectopic, and that she would be escorted directly to the emergency room. This is Nikki’s Story.

I didn’t watch Geordie Shore. Charlotte. Gaz. Holly. Greg. The cast names, story lines and off camera antics were all reality television episodes, magazine articles and social media posts I hadn’t followed.

Unlike (what felt like) everybody else, I knew nothing about Charlotte’s ectopic pregnancy tragedy, while Gaz was off filming Ex on the Beach in Thailand.

That she was in so much pain she couldn’t walk. That she had emergency surgery to remove her ruptured fallopian tube.

Or that if she hadn’t visited the hospital when she did, there was the very real possibility she could have died.

So, when I was given a referral to the Early Pregnancy Assessment Service (EPAS) for a pregnancy of an unknown location, possible ectopic, I didn’t know what that meant. I didn’t know Charlotte’s story.

“Have you eaten today ‘cause we need to operate and remove your fallopian tube?”

After an ultrasound confirmed an ectopic on my right, this was the first question asked by the clinical consultant.

Did this mean I wasn’t having a quick check up before inhaling a poke bowl by lunchtime from somewhere in nearby Newtown as planned? Rice was all I could think about since falling pregnant.

But an ectopic pregnancy, a pregnancy that occurs outside the uterus, usually the fallopian tube, which can lead to life threatening problems if mismanaged, meant this was serious.

I don’t recall what went through my mind as I was escorted from EPAS to the emergency room.

All I remember was bypassing triage and being shown straight to a bed, given a gown and having a cannula shoved into my left arm, while I fought back my tears.

I’m terrified of needles so that’s when sh#t got real for me. But nothing could have prepared me for what was to come.

After spending several days being monitored in the ward, I opted for the treatment of methotrexate.

An injection that stops the growth of a fertilised egg, rather than surgery to remove my tube. A decision the scalpel loving surgeon I had been liaising with seemed pissed off about when I confirmed that’s what I wanted.

But hey, whose prerogative is it to lose a fallopian tube?

But an injection of methotrexate. The immediate effects made my butt cheek feel numb at the point of insertion. Then came the feeling of the drug taking over my body.

This was not the satisfying euphoria type Mark Renton in Trainspotting would have you believe. Rather the roll around on your parents’ loungeroom floor crying in pain while they watched on type.

I can only then describe this experience as the longest ride to the town of Depression, stopping at all stations including Appetite Changes, Sleepless Nights and Thinning Hair.

I lost so much hair I had to get a short blunt cut. As if I wasn’t already feeling sh#t enough.

This, for me, made me feel even less feminine.

Weekly blood tests (yes, needles!) followed by a visit to EPAS was the required follow up treatment for the injection.

This was to monitor my pregnancy hormone level (Bhcg) and ensure it was dropping by a certain percentage each week, an indicator of the injection’s success.

I felt like these weekly visits had given me a platinum membership at the hospital, one where both my laptop and iPhone automatically connected to the WIFI when I walked in.

Where on the short walk between the entrance and pathology I was recognised and greeted like a celebrity by the ward staff in which I stayed - but hospital was not the nicest place to visit every week.

Sitting for hours in a nook within a clinic corridor with drab white walls, not a television or magazine in sight.

The air conditioning set to the same level as the frozen food section at your local Woolworths, surrounded by other women riding the same f#cked up emotional roller coaster I was.

But no one looks at each other. No one makes conversation.

Even a simple pleasantry exchange could rarely be heard.

My name would finally get called. Yaaaay. I go in and after all that waiting have the same very brief conversation with the clinical consultant I have every week.

She updates me on my new Bhcg level, reminds me about the importance of not falling pregnant again while going through the treatment and drills into me the symptoms experienced when a tube ruptures.

See the thing is, I’m not out of the danger zone yet. Until my pregnancy level drops to below five, the possibility of having to be rushed to hospital for emergency surgery to remove my tube is still very real.

My pregnancy hormone level dropped slower than watching the numbers on the microwave finish heating your midnight snack after a big night out.

The most head f#cked thing about this was that my body and my brain were fighting two different fights.

While my brain had succumbed to the fact my would-be baby was not going to enter the world, my body still had the pregnancy hormone and kept preparing to nourish it.

I continued to have all the symptoms of a pregnant woman. I felt sick. I had cravings. My hips widened. My abdomen became less toned.

I had become a stranger in my own body.

Then three weeks post my methotrexate injection, I developed a linea nigra. A dark line that forms on a pregnant stomach, running vertically along the middle of the abdomen.

The emotional trauma of seeing this aside, had it not been for one-piece swimmers coming back into fashion, my days at the beach that summer would have been numbered. Another shattering blow.

The beach is one of my favourite places to spend down time and one of the few activities I continued to enjoy throughout this experience.

Without realising it at the time, my train had left the platform and I was well on my way to the town of Depression.

I grew more and more frustrated at this slow process as the weeks continued. But where to direct these frustrations? Who to talk to?

Planned or not, failed pregnancies aren’t something we talk about. I don’t know whether that’s because it’s too painful or whether it’s taboo.

So it’s an experience we only tell very few people about and even fewer about how it’s affecting us. Even those you don’t confide in, know something is up.

When you’re spending as much time working from home (pre COVID-19) as you do from the office or suddenly cut right back on social activities with family, friends and colleagues, people notice.

Ask those who know me best. They’ll say I’m the most honest person they know. But every time I responded to their general question of “how are you?” with the equally general “good thanks”, I was lying.

The journey to the town of Depression was hard.

I used social media platforms to do my best at portraying a normal life. Not to boost my self-esteem, but to maintain appearances.

I continued to present a socially desirable, positive self-view to the extent I now cringe when I look back at my online behaviour during those months.

I distinctly remember one friend saying to me “Nikki, I haven’t seen you in ages, but you look like you’re having such a great time.” Others would say “How was your weekend? It looked fun.”

But behind those sunglasses (in the photos I actually took at the time), I was crying. Real tears.

And for the other posts, those were uploaded while I sat in the confines of my four-bedroom walls alone, eagerly waiting for my pregnancy level to drop using photos I had in the bank.

But “yes friend, my weekend was a rager. Thanks for asking”.

By this point, my train had reached its destination. I was now living in the town of Depression.

I understand how and why women get so attached to their little someone before they even meet.

Just the thought of something growing inside of you is truly amazing and with an ectopic, you can literally feel it.

My body had become so sensitive I could tell you the exact place my mass of cells (that’s what I’m comfortable calling it) was sitting at any given time.

Some days it was a quick sharp pain. Some days it was a jagging or pulling sensation. And on other days, it was an ache that didn’t go away.

Feelings always felt just to the right of my belly button.

On the nights I was utterly exhausted by the process I was going through, I would cry and plead with my body to stop fighting the injection. To please break down those cells and dissolve in my body.

Then one morning I woke up and I couldn’t feel it anymore. It literally happened overnight.

All those weeks I had been so aware that something alive had sparked in me and now that little spark had gone out.

There was this horrible stillness in my stomach, like the silence after a bell has stopped ringing.

I felt terrible for all the times I had wished for it to leave me. Now all I wanted was to feel it again.

I continued my weekly visits to EPAS for another few weeks until finally my pregnancy hormone level dropped to four and I was discharged from the hospital.

I felt the physical effects of the ectopic for another few months. But it was now time to really deal with all that other stuff.

The stuff I wanted to ignore. The stuff I thought if I pushed down far enough that it might just go away. The emotional stuff. Eeeek.

Overcoming the emotional effects of this experience is something I still work on today and I’m warned, probably will for some time.

Like most things, it was hard to get started. Or perhaps more honestly, knowing where to start.

When (relatively) healthy eating, exercising, taking baths and socialising are already part of your regular routine, what do you do to pick yourself up?

“You’re a different girl now” were the words of a close friend that hit me hard during one of our catchups.

I didn’t want to be different. I didn’t want to change from the person I was before I was pregnant. So, I did nothing about it.

The weeks passed and I was miserable. I put on a happy facade but unsurprisingly would lapse regularly.

There were days and situations I knew were going to be triggers, so I was relatively prepared for those lows. But the hardest ones were those that crept up on you, totally unexpectedly.

Grief hides in plain sight. It’ll get you when you’re doing the most mundane tasks.

One minute, you’re putting away the night’s dishes then the next, you’re crying so hard all you want to do is scream.

But you don’t. You don’t want to wake your housemates (and likely the whole apartment block).

I continued like this for some time, until I realised the pain of change was probably less than the pain of staying the same.

I decided to embrace this “new girl”, learn to refocus, reengage with life and look for fresh and different ways to pick myself back up.

On this journey, I found new interests and hobbies. I have a new fondness for creative endeavours, be it woodwork or painting (not that I’m any good at either).

I now enjoy reading non-fiction novels in my down time, something I rarely did before and my view on fitness evolved. Fitness to me now is more about well-being and less about maintaining a certain body type.

I won’t just hit the gym but will instead take a walk along a coastal or bush trail or go for a swim in the ocean.

These quiet activities also allow an opportunity for reflection and positive self-talk. Habits I have come to realise the importance of.

I don’t always hurt, but I always remember. And I decided that was okay.

Growth starts with not forgetting but accepting.

So, with this strong will to get better, a desire for new activities and the stabilising of my hormones due to the return of my menstrual cycle (who would have thought that would be exciting?!), my train turned around and headed back to a station that resembled some kind of normal.

I continued to silently win battles and transform myself. Progress no one else recognised, because I never let anyone see my darkest moments.

The journey of healing from such an experience is one I never imagined taking and I’m not ashamed to admit I haven’t done this on my own.

Along with the encouragement from close friends, I was also helped by seeking professional counselling to talk through and understand what was going on in my mind.

I visited a kinesiologist to rebalance my body from the inside and interestingly, had a couple of hypnotherapy sessions. Placebo or not, something worked for me.

I physically and emotionally made, and still make, improvements. I have devised new goals for myself and move towards them. I break them down, so I achieve little victories along the way.

As I continue through the healing process, I can’t help but remember how busy EPAS was every week.

Often, there was standing room only, in that little nook outside those two consultation rooms, when I came down to wait my turn.

While uncommon, ectopic pregnancies are the leading cause of death in early pregnancy for the would-be mother.

Furthermore, data reveals miscarriage is the result of 1 in 4 recognised pregnancies. 1 in 4. That’s a significantly high number of women and families affected by this diagnosis.

A friend shared with me that he and his wife suffered several miscarriages before the birth of their first son.

Two years later, following the birth of their second son, the emotional trauma of those miscarriages caught up with his wife.

Another friend shared a story of a barbeque they attended and the topic of miscarriage came up. All who were there were surprised to learn that every couple had suffered at least one miscarriage, while growing their families.

Yet no one shared at the time.

If we know complications in early pregnancy, be it ectopic, miscarriage or other, are an experience that many women go through and a memory that lives with us forever, why do we insist on suffering in silence?

Why have we been so conditioned to hide our hurt, when working hard to keep our pain a secret, ends up being part of the overall problem?

How many of those women sitting in EPAS, or at that barbeque, reached out to a health service provider or even knew about the services available to them I wonder?

Were they equipped to handle the emotional rollercoaster they were on, or about to join, themselves?

Those that have gone through this know it doesn’t only affect the would-be mother.

It affects their partners, family and friends who watch them go through this experience and who are trying to find the right thing to say - are they okay?

Let’s stop failed pregnancies being a taboo subject.

Women and their families need to know how to access information and support for themselves and those around them.

Friends and workplaces need to know how to have, and how to react to, these conversations. They need access to information and support as well.

Knowledge will lead to courage, the guts to take on an unknown future with practical actions, big and small.

Whether it is your partner, daughter, sister, cousin, friend or colleague suffering a complication, it affects us all. And we can do this together.

After all, there are few battles that can be fought entirely on our own. Until such a conversation exists, I can only share my learnings with you.

My (unqualified) advice to anyone reading this and going through something similar is to accept that sometimes life happens to you.

Still, you rise.

Ask for help, there are no prizes for toughing it out. Cry if it makes you feel better. Take that extra nap. Get some fresh air.

Join a support group who understand the little wins and can celebrate them with you.

Do it all at your own pace. Progress is progress, no matter how long it takes.

Then when you feel well enough to implement change, don’t resist it.

Acknowledge that change is a good thing. It means you can move onto the next chapter of your life.

And you will, just keep at it. It’s hard to fathom initially, but it does get better.

And to my own little someone who was too beautiful for Earth. I carried you for a little while, but you will be in my heart forever.

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Last reviewed: 13/10/20