hello welcome back to another episode of
obgyn reacts to tlc's famously
entertaining i didn't know i was
pregnant and runs it with educational
commentary
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we talk about
with two kids from previous marriages 40
year old michelle and her fiance cliff
believe their baby rearing years are
behind them so i'll be back at 11.
i didn't think they were gonna have any
more children have fun guys
i have a thick blood condition
do me a favor and let's get ready to
make a salad
michelle has polycythemia vera
polycythemia vera is pretty rare
it's a red blood cell disorder or a milo
proliferative disorder where the bone
marrow makes
too much red blood cells the most common
sign that people present with is
really bad itching when they get out of
especially a hot shower
they also can have hypercoagulability
meaning they have an increased risk of
blood clots
it's pretty rare and people who are
young enough to
be pregnant which i'm assuming we're
going to be pregnant given the name of
the show
so that's a little bit unusual people
who have this they can have an increased
risk in pregnancy of things like
hypertension or high blood pressure
preeclampsia pregnancy loss
abruption which is where the placenta
separates from the side of the uterus
uh babies that don't grow big enough
called iugr or growth restriction so
that's a an interesting thing that we
don't see very often but can have
complications related to pregnancy we
weren't looking for an addition to the
brady bunch
we were using condoms my menstrual
cycles
my entire life have been very strange
very random we were working out and
running jogging i made it down
from a 12 to a size 8.
so she's exercising a lot which
sometimes weight loss can prompt
ovulation and someone who maybe wasn't
previously ovulating regularly she said
our periods were not
previously regular so that could be
what's about to happen here
and then they also were using condoms as
their primary form of birth control
condoms are about 99 effective when
they're used every single time
and correctly but they are more likely
to be forgotten
broken oh it's just this once we'll just
skip it things like that so the
effectiveness rate in what's called
typical use which is how
most people use condoms when they're
utilizing them as their birth control
is a lot lower a little bit less than 90
so you're
always running a little bit more risk
unless you're using them exactly as
you're supposed to
which is not the norm and that's okay i
mean that doesn't mean you can't use
condoms and use them perfectly every
time
it just means that a lot of people don't
true or false
breastfeeding while you are pregnant
could cause you to have contractions
the answer when we return
it's me while we wait on them to answer
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to i didn't know i was pregnant
breastfeeding while you are pregnant
could cause you to have contractions
the answer true breastfeeding triggers
the release of the hormone oxytocin
which could cause contractions
[Music]
i think i've actually seen this question
before
in one of these episodes but i'm going
to go over it again breastfeeding while
pregnant
might cause contractions however
breastfeeding during pregnancy is
not associated with an increased risk of
preterm labor or pregnancy complications
so in an otherwise normal pregnancy
there is no reason for someone to have
to wean and this is a really really
common thing
that is told to people that is not
scientifically based that summer
michelle's father is diagnosed with a
serious illness
losing weight went to the wayside my
priorities went
into taking care of him so went back to
a size 12.
michelle also has to contend with her
own health issues
my legs are very tired and my feet are
very heavy
due to my blood clotting disorder her
feet would swell
her legs would swell so this is common
in pregnancy but it's also common with
people who have polycythemia vera so
you know she has a regular periods as it
is is using condoms to prevent pregnancy
and has swelling which she has had
previously because of the polycythemia
vera so she may not recognize this as a
pregnancy symptom if that's what it
actually is
november 12th of 2006
i started to feel intense pain in my
lower back
which progressed around to the front i
thought i was having a kidney stone
attack
there was blood in my urine exactly what
you have when you have a kidney stone
she just keeps getting all the things
stacked on top of each other so she has
polycythemia vera where she's had these
symptoms in the past she's had a regular
period so it's not unusual for her to
miss a period
and now she has symptoms which are
likely labor given the
context of this video but what she says
feels
just like a kidney stone which is really
common when people have
had nephrolithiasis or kidney stones in
the past they will often compare that
pain to labor
because it can be very similar so i'm
still not shocked at this point that she
hasn't realized what's going on
sometimes these
episodes i'm like how do they not know
yet but this one i
i don't know i'm i can see it michelle
goes immediately to the emergency room
where she gives the nurse a urine sample
they came back with some pain medication
for me
and it really alleviated the pain i was
very relaxed
lying there waiting for news about my
kidney stone the door opened
and five people walked into the room
so i thought why do all these people
need to talk to me about a kidney stone
okay but i want to know why do all these
people need to talk to her about a
pregnancy
i mean all they've done so far is take
her urine right so they don't even know
how far along she is or anything but
i don't understand why it's an emergency
all of a sudden i mean i guess maybe
they could be worried about ectopic
pregnancy or rupturing up topic with how
much pain she had coming in or something
like that but it's still
jarring to have that many people run in
for what you think is a kidney stone
doctor said michelle we have some news
for you
and you don't have a kidney stone so i
thought okay
now there's really something serious
wrong with me i just got an eerie
feeling like are they going to tell me
i'm dying
and he said you're pregnant and you're
in labor
what i'm like people i'm 40 years old
i'm not pregnant
i kept saying i can't be pregnant i'm
not pregnant so she's in denial
i am in confusion how did they only take
a urine sample
and then tell her she's in labor they
haven't even done any imaging or
anything yet
a common misconception is that based on
a urine sample you can tell how far
along someone is and that is
not at all accurate there are some very
wide ranges of normal for hcg which is
what is measured in the urine
and they tell us almost nothing about
how far along someone is
so i'm sure something is just edited out
of this story they had to do more
between taking her urine
and telling her she's in labor but
that's an interesting thing and
something i see clinically a lot even
sometimes we have physicians who will
say
oh the patient's eight weeks and we'll
say how do you know and they'll say well
the hcg level was xyz and that's just
not at all accurate i'm talking about i
came in here for a kidney stone i didn't
come in here for a baby
a little kidney stone hello i don't look
pregnant she is about to deliver without
even being aware that she'd been
pregnant for nine months
i just went hysterical i started crying
the blood in michelle's urine was not
kidney stones after all
but in fact her water breaking
so what she thought was blood in her
urine was her water breaking and some
bloody show
or cervical mucus with blood in it
that's something to easily mistake the
vagina and the urethra are very close to
each other
but just of note the way that they
phrased that it wouldn't actually be in
the urine if it was your water breaking
because
your bladder connects to your urethra
which connects to the outside
and the uterus connects to the cervix
connects to the vagina which connects
the outside so they're separate places
so the blood in her urine was actually
blood that was coming out vaginally from
her water breaking
we're sitting in the waiting room and
they finally let cliff go back so he
came back out
told me and megan that michelle is
pregnant and labor
there was no prenatal care for either
one of us i am
40 years old i'm on a large dosage of
blood thinners
it does lead to quite a bit of bleeding
the doctors did
tell everybody that she might bleed to
death we always worry about people on
blood thinners and it kind of depends
which one she's on and what her dose is
but it's usually something we can
control if someone happens to go into
labor when they're on blood thinners it
happens people are on
blood thinners in pregnancy i wouldn't
ever go so far as to sell someone your
mom might bleed to death that's really
poor bedside manner so the appropriate
way to counsel is
you know being on blood thinners
increases your risk of bleeding and
because you're having a baby we expect
some amount of bleeding to begin with
we have ways of stopping the bleeding if
it happens but you should know that
there's a risk that you will have more
bleeding than is anticipated
very very rarely that can be bleeding
that threatens your life
and in that case blah blah blah and go
into discussion about blood transfusions
surgeries things like that that's
informed consent informed consent is not
your mom might bleed to death that is
terrifying nobody wants to be counseled
like that
i could hear screaming from outside i
had to hold my ears because i couldn't
really take it when i was completely 10
centimeters dilated they said
okay we're going to start pushing you're
almost there
my worst fears was that she might die
i was really scared i didn't want my mom
to see it
i would walk outside this breaks my
heart i
i can kind of imagine being in that
position because i had a good friend who
had a baby when i was
a very early medical student i had no
idea like anything about
physiology and birth and all of that
yeah it was very early in my medical
school
career and so i remember that feeling of
just being terrified that something
horrible was going to happen and just
not knowing and
i want to say that i think that the
reason people feel like this
is one because of course birth can be
scary but it is also very natural and we
don't get hardly any
really good education about anatomy
about physiology
about sex education and therefore about
birth so
anything related to this is just kind of
confidentially kept within the community
of people who have babies
and that can cause for a lot of panic
both in people who are pregnant and have
never delivered a baby before
and in their family members and their
teenage children in this case so
i think this is a really good cry for we
need better sex and physiology and
anatomy
and reproductive education in general in
this country
and in the world probably too but
especially here it's just poorly taught
across the board but i really feel for
them i mean can you imagine how
absolutely terrifying that would be to
just not know
that your mom was even pregnant and then
to just hear her
screaming and not know what's going on
and be told by the
team she could bleed to death and all of
these things i mean of course that's
terrifying you can tell by the way
they're talking about it that they're
really traumatized
it didn't take very long oh my god it's
my little sister michelle
michelle gives birth to a baby girl they
named charity
i don't know is she gonna be okay i
started to think back on all the things
that i
had done for nine months is there
anything that i have done
that could affect her this is very
common in these episodes and i say it
every single time but
we do the best we can with the
information that we have of course
it would be ideal if you knew you were
pregnant and you got prenatal care
and that's why i always say if something
is odd something is off take a pregnancy
test
but this is not a perfect world and we
don't always know and you have to try to
move forward without guilt because
you didn't have any idea i also like how
this baby is like
two months old and just looking around
when it comes out
adorable neither charity nor i had any
complications the doctors were just
amazed
the happiest moment is when they laid
charity in my arms
and i knew that she was here for a
reason
i cried it was a very very
very touching moment i can't imagine
going from
i didn't know anything was wrong to i
have a kidney stone to oh my gosh i am
pregnant
to i'm not only pregnant i'm in labor
and delivering a baby
and then having a new baby in the family
that's a lot to process all at once and
it's okay if you ever find yourself in
the position of having a baby expectedly
or not expectedly
and you don't immediately feel that oh
my gosh i'm in love connection
for some people it takes time i loved my
babies i would have thrown myself under
a bus for them
but i didn't like know them and i didn't
have this starry-eyed moment the minute
they came out
i needed to get to know them of course i
would protect them with everything i am
and i loved them
to no end but it still took time this is
a new person
i want to get to know them so it's okay
if you don't always have that immediate
starry eye connection if you do
wonderful but if you don't it doesn't
mean you're going to be a bad parent or
something is wrong with you
i had no movement i had no cravings
there was a red flag that would say
michelle you're pregnant
there was nothing michelle most likely
conceived in march of 2006
apparently we weren't using condom that
day heat of passion got the best of us
okay that's what i was saying it's not
uncommon for people to use them
as what is called typical use that's why
it's typical
because most people will occasionally
not get a condom because they're
out or they forgot to buy them or they
had a glass of wine and who cares it's
just this once
that is what typical use is quoted as so
don't get mad at me when i say this
every time in the comments someone is
like oh why are we gauging it by typical
use because it's
typical because normal people
occasionally do this
and it's okay and it's normal and you
should know that the failure rates
increase
a lot if this is the case though
michelle
continues to deal with her blood
disorder two years later
healthy and happy charity lives up to
her name
the birth of charity was a very big
blessing
everything that happened was my little
sister being born
i really think it was a miracle she was
just a blessing that i didn't know that
we needed
adorable little charity i'm so glad that
everybody made it out perfectly fine and
safe
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