Monday, February 11, 2008

Dr. Monteith is Joining Dr. Berger as a Tubal Reversal Surgeon

Dr. Monteith is joining Dr. Berger as a tubal reversal surgeon at Chapel Hill Tubal Reversal Center. Dr. Charles Monteith graduated Summa Cum Laude from Xavier University and received his Medical Degree from the University of California at San Francisco. Following a Howard Hughes Research Fellowship in molecular biology, he completed his residency in obstetrics and gynecology at the University of North Carolina at Chapel Hill in 2001. Since then he has been a Clinical Assistant Professor of Obstetrics and Gynecology at the University of North Carolina Medical School. Dr. Monteith is board certified in obstetrics and gynecology and has extensive experience in laparoscopic surgery and high risk obstetrics.

Explaining his decision to join Dr. Berger in practice, Dr. Monteith says, “My interest in tubal ligation reversal comes from my love of outpatient surgery and the desire to learn skills which are becoming a dying art. My hope is to be able to continue to practice tubal reversal surgery and to keep it as an option for patients who have had prior tubal ligation and desire to become pregnant.”

Like all of Dr. Berger's staff Dr. Monteith can be contacted via the tubal reversal message board. Here you can read Dr. Monteith's most recent posts

As this thread from the Tubal Reversal Message Board shows Dr. Monteith as well as being an excellent surgeon also has quite a sense of humor:

Posted by Dr. Monteith (Member # 11996) on February 04, 2008 09:00 AM:

I answered your questions under the threads of scheduling and posting with Dr. Montieth

Posted by sweeet_mommie (Member # 11471) on February 04, 2008 06:50 PM:

Dr.Monteith thank you so much for responding to my questions and your responces were very helpful. We are very happy to know that there is hope for us. We never thought that we would want another child considering we have 5, 4boys 11,10,8 and 6 and 1girl 6. We were very scared when they told us twins and that is why we had my tubes tied, well that was a mistakeand at the time my Doctor didnt think it was a good idea but went along with it considering I was only 23 years old in 2001. Tell me something how likely (is it if there are twins on both sides of the family), are we likely to have twins again? Thank you for you help and another thing the most thing I am afaid of is getting surgery, in 2006 when I lost my right tube I was so scared of be put to sleep. any suggestions?
thanks again
luquesua

I am considering getting my TR maybe late spring.

Posted by Dr. Monteith (Member # 11996) on February 04, 2008 09:08 PM:

Twins do run higher in some races of people. Certain tribes from Africa have very high twin rates- can be as high as 1 in 50 pregnancies. In general, the chances of having a twin pregnancy is about 1 out of 200 pregnancies.

If you and your husband are Nigerian then I would be worried you would have a higher chance of a twin pregnancy- for the most part I have not been impressed that twin rates have been higher when patients come to me in the USA and say twins run in both families. I would say your risk of twin pregnancy would be about 1 out fo 200. If you have to take clomid about 10 out of 200 and if you have IVF about 1 out of 3!

General anesthesia is very safe when it is done in a low risk patient in a controlled situation. The only problems I have seen is in emergency surgery when everyone is rushing and the patient is high risk- say 300lbs, poor airway, heart disease, trauma, etc.


Posted by sweeet_mommie (Member # 11471) on February 05, 2008 05:46 PM:

Dr.Monteith another question I have is the TR is it done vaginal? How long after surgery can we try to conceive?


Posted by Dr. Monteith (Member # 11996) on February 05, 2008 11:04 PM:

The reversal is done through a small incision- about 4 inches- just above your pubic hair line. We ask that you wait until you leave the office before you try to conceive! (the real answer is when you feel up to it- about 2-4 weeks).

Posted by mommyof4wantingmore (Member # 11914) on February 06, 2008 04:06 AM:

What a great sense of humor Dr. Monteith! I read almost all of the posts on here, but that has to be the best reply of the day!! LOL Sorry if I butted in on the thread but that was GREAT!!
-Donielle

DH-34
Me-32
DS-14
DD-6
DS-5 (soon)
DS-2
TL-7/05
TR-Goal is Summer 2008!

Posted by sweeet_mommie (Member # 11471) on February 06, 2008 07:10 AM:

thanks Dr. that information was very helpful, we will be scheduling my appointment for April wil you be there assisting Dr. Berger?

Posted by in-Gods-hands (Member # 11795) on February 06, 2008 08:17 AM:

I am with Donielle that was the best one yet. I liked that. Miranda


More Information on Dr. Monteith

Thursday, February 7, 2008

The Importance of Early Pregnancy Monitoring

The importance of early pregnancy monitoring cannot be stressed enough. All women have a chance of ectopic pregnancy, but after tubal reversal surgery, the chance is slightly higher. For this reason, Dr. Berger recommends all patients at Chapel Hill Tubal Reversal Center work closely with their home physicians to follow the course of pregnancy as soon as conception is detected. Once a tubal reversal patients gets a positive pregnancy test, she should get her first HCG blood level drawn. After this, her doctor should be drawing the blood for HCG at least twice week. When the HCG level reaches 1500, the pregnancy can be detected by ultrasound. A vaginal ultrasound should be performed to determine the location of the implantation. This greatly reduces the chance of tubal rupture should the pregnancy prove to be ectopic. Dr. Berger should be notified as soon as you are pregnant so that he can ensure you are receiving timely early pregnancy care.

The following is from the Tubal Reversal Message Board:

Posted by Kristy Isett (Member # 8861) on February 05, 2008 05:58 PM:

Hi Dr B, I just found out on 1/24/08 that I was PG again after taking 200 mg clomid. My LMP was on 12/30/05 Since then, I've had 5 hcg betas drawn. My concern is the last two I had.
My first 3 betas were
1/24/08= 19.45 Progesterone= 27.1
1/26/08= 48.64
1/28/08= 104.22
Thursday 01/31/08
hCG was 371 progesterone was 45.2 (on suppositories)
Monday 02/04/2008
hCG was 576Why the small rise?? I mean I figured it should have been closer to the 1400-1500 level.
My blood tests were done at two different labs, but I honestly don't think that there would be that much of a difference between them. I go again tomorrow for another beta.
I had an internal exam yesterday 2/4/08 and dr said there was no sign of bleeding, cervix was closed and long. He felt my uterus and said it felt normal. I then went for a vaginal u/s and the tech was unable to see anything at that point. Dr called me and told me that there was a bit of free fluid??? in my uterus but not enough to have him concerned at this point. I don't know what to think at this point. Thanks in advance!
Kris
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Posted by lori4 (Member # 11661) on February 05, 2008 06:48 PM:

Kristy, Can't answer any of your questions, but I'm praying for you girl
Lori
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Posted by Gary S Berger MD (Member # 3) on February 05, 2008 06:58 PM:

Hi Kris -Using our HCG doubling time calculator, I entered your first HCG level of 19 and the last one of 576 taken 11 days apart. The calculator shows a doubling time of 53.6 hours, or doubling every 1.36 days. This is normal. At this rate, your HCG level should reach 1500 by Friday or Saturday, and when it does, a vaginal US exam should be performed to look for the gestational sac.
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Posted by Kristy Isett (Member # 8861) on February 05, 2008 07:24 PM:

Thanks Dr. Berger, but shouldn't I be concerned with the fact that it didn't double from Thursday 1/31/08 to Monday 02/04/08??? The doubling rate from those two beta's is like every 6.30 days or every 111 hours I think.Thanks again!
Kris
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Posted by Noelle DiBernardo (Member # 8906) on February 05, 2008 10:47 PM:

Kris,
Did you have another draw today, (Tuesday)If you see this...I emailed you the information you asked for...sorry it took so long!noelle
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Posted by Gary S Berger MD (Member # 3) on February 06, 2008 04:56 AM:

Kristy - Let's wait and see what your next HCG level is.
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Posted by Kristy Isett (Member # 8861) on February 06, 2008 08:23 AM:

Dr. Berger, thanks. I go this morning for my next draw. I know it'll tell me more. I'll let you know.
Noelle~ Yeah I got your email, thanks so much my computer died yesterday, I couldn't get on for anything all day until after DH got home from work to fix it!Love,
~Kris~
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Posted by jami (Member # 9521) on February 06, 2008 08:33 AM:

kris, i love you and your little bean(s)!!! i'm waiting to see what today's labs say....
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Posted by Kristy Isett (Member # 8861) on February 06, 2008 12:05 PM:

Dr B. Ok, today my levels are 746.... what do you think is going on??I'm so confused, I thought these hCG levels were to double every 2-3 days....mine are totally not doing that.I'm so worried that this is another ectopic and I'm going to lose my only tube I have left.I'll check back later to see what you think.
Thanks again,
Kris
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Posted by mamasoup8 (Member # 11212) on February 06, 2008 12:19 PM:

Krys- I don't have any answers for you, just wanted you to know you and your lil bean are in my prayers!-Traci
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Posted by Meridith4321 (Member # 11469) on February 06, 2008 12:29 PM:

Kristy - I would call and try to get an ultrasound - I know 700 is too small to see a sac but sometimes they can see a bulge in the tube or fluid in the uterus. There are other symptoms!!! maybe I would go to the ER. One tube is just too precious to lose, not to even mention that you life is at risk here. Does your Dr. know the protocol? I have heard to tubes bursting at 700 - just to be on the safe side I would try to get an ultrasound - fake pain if you have to!!!! Talk to Berta - I know she is on some of the lists and recently posted about losses on the main page - she can tell you what her number was when her tube burst.Good luck - we are all pulling for you!!!
Meridith
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Posted by Noelle DiBernardo (Member # 8906) on February 06, 2008 01:01 PM:

I am thinking of you Kris.
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Posted by berta8133 (Member # 11188) on February 06, 2008 01:12 PM:

Kristy....Personally if it were me...I would go to the ER. It could be several things. Some need for concern, others - everything could be just fine.Numbers sometimes become stagnet (for lack of a better word)...even though raising a bit...)I think for piece of mind....get to ER for an u/s, tell them you are high risk for e/p due to TR and tell them your last number, and also that you are having pain..tell them- it's kinda tender (pick a side) and that the pain feels like it comes from the back and moves to the front.They should be able to see 'something'...whether a shadow, fluid or swollen tube...etc etc... if they can't see anything yet...then all could be fine and nothing to worry over.There was a sister on our july thread....she no longer posts, but her number never got higher than like 300, and become stagnet, dr did nothing, and she ended up rupturing and losing the tube.My numbers were higher at time of rupture.....a week before rupture they were about 6700 or so... HOWEVER there are those that rupture with a small number due to the tube becoming swollen etc etc....Get it checked. Better safe than sorry down the road. I'd rather worry about something and it turn out to be nothing, than not to worry at all and it become something that can't be fixed.Thoughts are with you and I surely do hope all is okay. Just get it checked--ok??Berta
TR 7/23/07
E/P 0/25/07
M/C 12/8/07TTC our little Z
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Posted by pumpkin_powers (Member # 9198) on February 06, 2008 01:36 PM:

Krys,
Please go to the ER. You're right that those numbers aren't doubling right and it may be just a slow starter or possibly an ectopic. It's better to be safe than to lose your only tube. I went through two ectopics last year, and with the second my numbers were right around doubling for the first couple draws then they started slowing down like yours are doing. With that pregnancy the baby ended up implanted near my bladder and if I hadn't had early monitoring it would definitely have been life threatening. Please take care, and I'll be saying prayers for you and your little bean.Lots of Love
Staci
TR 3-7-06
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Posted by Gary S Berger MD (Member # 3) on February 06, 2008 04:12 PM:

Kristy - I agree that based on today's result your HCG rise is no longer rising normally. When HCG ceases to double within 3 days on more than one occasion, I recommend ending the pregnancy with Methotrexate and continuing to follow the serum HCG until it is back to non-pregnant levels (less than 10). At your current HCG level, it is still too early for an ultrasound examination to be diagnostic about whether it is in the uterus or outside of the uterus. But when a pregnancy is no longer progressing normally, it should not be continued.
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Posted by berta8133 (Member # 11188) on February 06, 2008 04:54 PM:

Kristy, please let us know how you are doing.Berta
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Posted by Melissa In NC (Member # 8796) on February 06, 2008 11:06 PM:

Kris- just wanted to let you know that i am thinking about you & praying
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Posted by brlracer (Member # 11897) on February 07, 2008 12:56 PM:

Any news on Kris? I will keep you in my prayers!
Trish
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Posted by Kristy Isett (Member # 8861) on February 07, 2008 02:58 PM:

Dr. Berger~ I just wanted to update you on what happened, I did in fact have an ectopic. There was a 4.7 CM buldge in my tube, the Dr told me that she would do everything possible to save my tube, but after surgery she told me that there was no way to save it even though it wasn't ruptured, she felt that the tube itself was too "stretched out" she said it looked unhealthy. So, that ends my journey in TTC for now, hopefully we'll find a way to do IVF sometime in the future. Heck, I'm not getting any younger! LOL! Thanks for all of the advice and thanks for everything!Kris
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Posted by brlracer (Member # 11897) on February 07, 2008 03:10 PM:

Kris, I am so sorry for this, I just don't know what to say
Trish K.
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Posted by Amy1234 (Member # 5192) on February 07, 2008 03:17 PM:

I am very, very sorry Kris!
Amy
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Posted by lori4 (Member # 11661) on February 07, 2008 04:45 PM:

Kris, that sucks! I was really pulling for you girl. I'll keep you in my prayers. I hope one day God blesses you with a baby if it is in his plan for you.
Lori
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Posted by JulesnKev (Member # 7375) on February 07, 2008 05:54 PM:

Kris, I am so sorry you are having to go through this heart rending experience. You mentioned IVF, so when you are ready to talk about it you can e-mail me at trulyjulee1967@msn dot com. I have some information you may find interesting. Take time to heal and take care of yourself.
Hugs,
Julia
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Posted by pumpkin_powers (Member # 9198) on February 07, 2008 05:55 PM:

Kris, I'm so sorry that this has happened. Please take care of yourself. This part of the journey is so hard. I hope that you are able to persue IVF in the future. I ended my ttc journey this dec after my second ectopic within a 6month period. I just couldn't take it anymore emotionally or physically. I hope that things get back to normal for you quickly. Please take care.
Lots of Love
Staci
TR3-7-06
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Posted by berta8133 (Member # 11188) on February 07, 2008 06:03 PM:

Oh Krys....I'm soooo very sorry this has happened. Thoughts are with you definitely! I pray you will be successful in your IVF journey.Good luck always,
Berta

Monday, February 4, 2008

Pregnancy Testimonials January 2008

About Babies and Pregnancy After Tubal Reversal Procedures from Dr. Berger’s Patients


“Dr. Berger has made another miracle happen for my family. Our tubal reversal baby, Anlyn Grace, was born on January 29, 2008″ Mark and Tammy S.

“I had a beautiful baby girl one year after my tubal reversal. Thank you for making this dream come true.” Steve and Polly B.
“I had the tubal reversal surgery at Chapel Hill Tubal Reversal Center in September of 2005. We truly believe in Dr. Berger and thank him for making our dreams of being parents come true!” Bea and Mike Q.
“I now have 2 reversal babies. I could never have had this much joy in my life without the help of Dr Berger and his staff so thank all of you for such a wonderful gift….the gift of LIFE!” Julie C.
“I am so happy to announce we had out tubal reversal baby. Thank you, Dr. Berger. I feel so blessed to be have this child thanks to all of you.” Tina D.
“Every time we look at our TR miracle baby boy we think of Dr. Berger and everyone at Chapel Hill Tubal Reversal Center who helped make him possible.” Monique and Emil B.
“We made the decision to have my tubal ligation reversed after 6 years of trying to adopt. God bless Dr. Berger for providing me a way to conceive naturally after my tubal ligation.” Susan H.
“We have 3 tr babies. We came to Chapel Hill in 2000 for our tubal reversal and that became the most profound turning point in all our lives. Our tr journey has actually just begun.” Mark and Heather N.
“We had the reverse tubal done by Dr. Berger in October 2006. We found out we were pregnant in April 2007, only 6 months after the procedure. Our first child, Collin Adam, was born on January 7th, 2008. Dr. Berger is a miracle worker in our eyes.” Randi and Mark S.