After multiple miscarriages, Kelli and Mitch Fonner feared that they would have to give up their dream of expanding their family. Doctors from larger hospitals had told them that a healthy pregnancy may never happen, but SBL Obstetrician-Gynecologist Scott Meyer, MD, FACOG, and SBL Hematologist/Oncologist Kuppuswamy Jagarlamudi, MD, made their dream a reality.
After three failed rounds of in vitro fertilization, Kelli was diagnosed in January 2017 with a genetic clotting disorder called Factor V Leiden. Since the disorder affects only a small number of people, little is known about its impact on fertility and pregnancy. “I was so excited to finally have a diagnosis, but it was frustrating that there was no clear plan,” Kelli said.
A subsequent surgery led to dangerous pulmonary embolisms— a consequence of the clotting disorder. A specialist told Kelli that no doctor would be able to successfully monitor her throughout a pregnancy. However, the Fonners were not ready to give up.
Kelli’s primary obstetrician, Dr. Meyer, referred her to Dr. Jagarlamudi, who specializes in treating diseases of the blood and cancers.
Kelli said from the moment she first phoned the Regional Cancer Center, the staff was incredibly helpful and compassionate. “They were invested in us from the beginning,” Kelli said. “My records and prescriptions were in St. Louis, but the Regional Cancer Center staff helped take care of everything.”
While the Fonners feared another heartbreaking miscarriage, they had one remaining embryo at the IVF clinic and felt strongly that they should try once more to make their dream come true. “We told Dr. Jagarlamudi that we knew the risks of another pregnancy, and we realized that the odds were not in our favor, but he squeezed my hand and told me that he would do everything he could do to avoid another blood clot and keep me safe and protect the pregnancy,” Kelli said.
Dr. Jagarlamudi discovered that the hormones used to help Kelli get pregnant were also exacerbating the development of blood clots in her lungs. The bleeding can also cause subchorionic hematomas that can cause detachment of the placenta during pregnancy. Despite the risks, the Fonners moved forward with their last embryo and learned that the attempt was successful in the summer of 2017. While Mitch was thrilled about the pregnancy, he was also filled with anxiety. “It was difficult to watch everything going on and not be able to do anything,” he said. “As a husband and a paramedic, I felt helpless.”
In October of 2017, Kelli and Mitch’s fears were realized when she was diagnosed with another blood clot. In the emergency room, they were told that Kelli had not yet miscarried but there was nothing that could be done to protect the eight-week pregnancy. As they sat in their car after the visit, they decided, out of desperation, to call Dr. Jagarlamudi. He told them to come immediately to his office where he ordered labs and made a change to Kelli’s medicine. “He started tracking my labs daily for the first several months of the pregnancy, then he moved to weekly so he could change my dose as needed,” Kelli said. “If lab results came in after-hours, he called me personally to update me. Sometimes it was 7 a.m., sometimes 8 p.m., but he was always there for us. He never made us feel like we were taking his time. We felt like we were his only patients.”
Kelli and Mitch were touched by the communication and compassion expressed by the entire care team. Dr. Meyer did weekly scans to ensure that the baby was healthy, and he routinely communicated with Dr. Jagarlamudi so he could provide the best possible care to Kelli and the baby. “All of my Sarah Bush Lincoln doctors worked together to track my pregnancy daily for 22 weeks straight,” Kelli said. “Everything was in one place, from radiology and lab, to Prairie Medical [specialty pharmacy] and my doctors. It was life-changing.”
The Fonners said they hoped for the best but prepared for the worst for the first 28 weeks, but each time they had a successful visit, their hope increased. Finally, on May 15, 2018, Adam Joseph Fonner was born. He weighed 8 pounds 7 ounces and measured 21 inches long. Despite the chaos surrounding Kelli’s pregnancy, Adam is “happy, relaxed, and not fazed by much,” Kelli said.
She credits her care team for helping her to bring Adam into the world by providing her with compassionate care, from beginning to end. “We got to know our ultrasound technologist; she cried with us when we learned we were pregnant. The receptionists greeted me by name, and the nurses shared in our excitement and joy,” she said. “The kindness and compassion that everyone showed us will stick with us always.”
Kelli also appreciated the policies in the Women and Children’s Center that allowed her to have a family viewing drape, cut the umbilical cord and have skin-to-skin contact during her cesarean section. “We got to experience so many things we didn’t think we’d get to experience,” Kelli said.
The Fonners learned many things through their journey that they share with other patients. “You have to learn to speak up for yourself,” Kelli said. “Advocate for yourself, educate yourself, and insist on a treatment plan that you believe in. Find someone who will listen to you and treat you as more than a statistic.”