On a Tuesday afternoon in 2011, Chicago-based author Nadine Kenney Johnstone went into an in vitro fertilization egg retrieval procedure at a fertility clinic in Massachusetts. Although IVF is considered generally safe, less than 12 hours later, Nadine was back in the ER for near-fatal internal bleeding.
After six months of recovery, Nadine and her husband Jamie were ready to try again. And after a series of additional setbacks - including another unsuccessful attempt at IVF - she and Jamie conceived naturally and had their son Geo in May 2013.
Nadine decided to write a memoir about her harrowing experience and it was an email she received during one of the lowest points along the way that would ultimately inspire the book's title. “My husband’s cousin, Amy, wrote me and said, 'You will have your baby - of this much I’m sure,’” says Nadine.
It was that kind of encouragement that Nadine learned she and Jamie needed most during their experience with IVF - a realization that led her to write Of This Much I’m Sure. “My hope is that readers will understand that they are not alone,” she says.
Here, Nadine opens up about her traumatizing IVF experience and the healing process that followed it all.
I got married just before my 28th birthday; Jamie is 10 years older. We started trying for kids right away. We were living a great life in Massachusetts and envisioned having this child of ours. We had and still have so much love for each other, and we wanted to create a family.
Jamie had cancer when he was in his mid-20s and the chemo can affect fertility. He had a semen analysis done that showed below-average motility and morphology. I'd been off of birth control for about eight months but I was having issues with ovulation, even with the right medications. While most couples are told to wait a year before seeing a fertility specialist, we gave it eight months because we knew that our fertility chances were most likely compromised.
When we saw the specialist, she said that our best chance would be with IVF and that we were great candidates for it. She explained how everything went: how the woman would prep herself with these different injections and then her ovaries fill with egg follicles. The goal is to extract these eggs with a needle and suction, put them into a petri dish, inseminate them, and wait three to five days. It’s like survival of the fittest - they see which ones are developing best and that’s how they decide which ones to implant in the uterus. The embryos then have to attach to your uterus, which isn’t a sure thing either.
And that’s the thing with IVF: When you’re signing up for this, there are so many variables, so you’re literally crossing your fingers, closing your eyes, and leaping. Nothing is guaranteed.
I asked the doctor if there was anything to worry about during any of the procedures. The big one she brought up was hyperstimulation. Because of the surging hormones, your abdomen ends up retaining a lot of fluid, and you end up needing to return to the hospital to have that fluid drained. [Editor's note: hyperstimulation is rare; about 10% of women who undergo IVF experience it.].
We were given a stack of 20-plus pages of fine print that the doctor summarized for us, and while she never verbally indicated that I could nearly bleed to death from the procedure, I'm sure they cover their behinds in the fine print.
When I went in for the egg retrieval procedure, I was put under while they extracted the eggs from my ovaries, which are then supposed to clot on their own. It’s a quick procedure, so we were in and out of the clinic in less than two hours.
As we were leaving, I asked the nurses about the recovery process. They told me, “Just take it easy. Don’t climb any mountains or anything, but you should feel fine.” They gave me a sheet outlining symptoms like vomiting, diarrhea, and others to look out for that could point to hyperstimulation.
I started vomiting and saw red. To this day, I’m not sure if it was the red Gatorade or blood.
Jamie and I were on our way home, and I was feeling totally normal. We drove through Concord, and Louisa May Alcott’s home is there, and you can take tours. It was a Tuesday at noon, and we had nothing to do, so we stopped and did one. As we were walking through the different rooms of the house, I started feeling really weird - dizzy, hot, and like I couldn’t stand up on my own. I thought, OK, maybe I just need to lie down. We got into the car, and as we were driving home, I was feeling worse and worse. My abdomen started feeling uncomfortable. We figured that maybe I needed some fluids, so Jamie stopped and got me a red Gatorade. I took a few sips and felt worse.
We got home, but as soon as I lay down, the pressure on my abdomen was unbearable. It felt like I was wearing a corset of spikes and it felt like knives were being lodged into my shoulders. I felt like maybe I was overreacting, though, since I still wasn’t experiencing the symptoms they’d warned me about. Soon enough, though, I did start vomiting - and saw red. To this day, I’m not sure if it was the red Gatorade or if it was blood. I was sitting there, shaking and crying out in pain, so Jamie called the nurse. As soon as he described the shoulder pain, she said I needed to come to the ER immediately; I was having internal bleeding.
Jamie had to carry me to the car. When I sat down, it hurt, but when I reclined, it felt like I couldn’t breathe. I didn’t understand it at the time, but I later learned this was because the blood was saturating my lungs, and I was basically drowning. It was the scariest feeling I’ve ever experienced.
I started to realize it was serious when we arrived at the ER and they rushed me past every single person. They did an ultrasound of my abdomen and the pressure of the wand was unlike anything. I was screaming like I never have my entire life. It felt like I was at once being stabbed and drowning. All they could see was blood and they had no idea where it was coming from. The surgeon told us that he’d need to take me into emergency surgery and that he’d have to do whatever he needed to do to save my life.
I had PTSD symptoms and a ton of anxiety — every time I went to bed, I was afraid I wouldn’t wake up.
I woke up and was totally disoriented. Jamie came in and told me the doctors said that my left ovary never clotted after the egg retrieval - that it looked like “Swiss cheese” and had been bleeding profusely as a result. But they had sutured it and were able to save it, and they said that I would be OK. I went to move and it felt like I had been sawed in half. I looked down and saw a massive bandage from my bellybutton down.
The aftermath of that was a lot of recovery. I couldn’t sit up on my own and for a couple of days, I couldn’t get out of bed. My core muscles were completely gone. I had a lot of PTSD symptoms and a ton of anxiety - every time I went to bed, I was afraid I wouldn’t wake up. In order to get back to normal life, I started doing a lot of yoga and seeing a therapist. It was crazy to go into a procedure as a 28-year-old optimistic young woman who’s very athletic, independent, and ready to start a family, and the very next day, to wake up feeling like a 90-year-old woman who’s dependent on everyone. It literally stopped my life.
Although I was terrified, we waited six months and tried IVF again, and those attempts failed too. Jamie and I got a cabin in New Hampshire for a while to chill out, and we tried to live normally.
Then in September, I found out I was pregnant naturally and it had happened during our time away. I was in total disbelief! I went through three home pregnancy tests and when "pregnant" appeared on the little screen, I jumped and laughed and cried and hugged our dog, because she was the only one home. Then I drove to Jamie's work and pulled him out of a meeting to tell him. He stared at my stomach and shook his head. He kept hugging me, repeating, "I can’t believe it."
I was excited but I was also always worried. Because life had shown time and time again that nothing was guaranteed, I was afraid of miscarriage or complications with the pregnancy. The emergency surgery after the egg retrieval forever changed me from an optimistic person to a constantly worried person.
But Geo was born on May 20, 2013, and he is amazingly healthy and wonderful. I look at him now and think about the sibling that I'd love to give him, but then I think of everything we went through, and I shudder. I can't do IVF again - and not because I don't support it. I do. Many of my friends have gotten pregnant through IVF. But it was so traumatic for me that it would cause too much emotional strain.
I wrote the first draft of my book during the first year of Geo's life. I was just writing to make sense of what had happened. It helped me to gain distance. When I read it through, I experienced it all over again - my heart would race. But with each draft, I got less emotional, and I knew I was processing it more and more.
I hope that when people read it, they feel empowered to speak their truth. Though we all suffer differently from different causes, we are much more alike in how we deal with our pain than we realize.
Update 4/13: Additional information about the frequency of hyperstimulation was added.
Purchase a copy of Kenney Johnstone’s book or catch one of her readings here.
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