Tubal Reversal Blog ‘dr berger’

My Tubal Ligation – Then The Loss of My Son

My journey to Dr. Berger began on May 29, 2007, the day my youngest son, Jayden, was born. I knew in my heart I did not want my tubes tied, but because of 2 very life threatening pregnancies, we (me, my other half and doctor) decided it would be best to have a TL. But then life became all too real to me on July 30, 2007 when I lost my youngest son, only 2 months and 1 day after he was born. This picture of Jayden shows what a happy baby he was.

In the earliest part of my tubal reversal journey, I did not think I would want another baby, but as time passed, I did a lot of soul searching. When you lose a child, at any time in their life, a lot of guilt comes with your “new” life. Added to my guilt was that yearning, the desire of wanting another baby. It became painfully and almost obsessively clearer with time that having the TR would be such an important part of my healing journey.

I can never have my sweet Jayden back. He can never be replaced. He will always be my second born son, and will remain with me forever. But it would be such a blessing to have a chance of having another baby, and a piece of him… a gift from him… and a gift to him. He watches over his big brother, and if I ever were given the chance to have another baby, he will be able to have a younger sibling as well, another sibling to watch over and be proud of. I am extremely proud of both of my sons, and it is my every hope that Jayden will be excited about the idea of being an older sibling.

The Added Problem of PTLS

I would also like to say that, along with much emotional stress, my body physically went through a terrible amount of stress from the day I had the TL. I was constantly in pain, I suffered from what I believed to be PTLS, and though many people do not believe in it, I DO! I had more problems from the very day of the surgery that I never had, not one single day in my life, and I was searching for that relief as well.

How I Found Dr. Berger

It was amazing how I found Dr. Berger, and I was instantly drawn to him. I did what many people to and search around, mainly because my family made me… but I can not lie… when I saw Dr. Berger and his website, it was my own personal immediate decision: This is where I am going to go! Not a single doubt in my mind, I instantly knew it. The next part of my journey began, which was the financial issue, but a kiss in the wind was blown my way, and in February of 2009 I was able to schedule my surgery on May 21, 2009. Only 8 days before Jayden would have been 2. My oldest son had turned 3 only days before I scheduled my tubal reversal.

Submitted by Lisa R.
angeljdclilcake@aol.com

Next Part of My Journey – Going to Chapel Hill will be published next as Part 2 of this blog topic.

More About Tubal Reversal Journey

“An Angel, in the book of life, wrote down our baby’s birth. Then whispered as she closed the book, too beautiful for Earth.”
-Unknown Author (currently searching)

“Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired, and success achieved.”
-Helen Keller

“It was written in the book before ever being born
Both heaven and earth would have to mourn.”
-ME

Chapel Hill Tubal Reversal Center specializes in reversing tubal ligation and repairing damaged or blocked fallopian tubes. We perform over 800 tubal repair surgeries per year and have patients who travel to us from around the world and across the United States to have tubal surgery at our center.

Read the rest of this article and comment on it. »

Tubal blockage or tubal occlusion (the medical term) is the reason that tubal ligation prevents pregnancy. The blockage of the fallopian tube prevents joining of the sperm and egg and prevents eggs from being able to reach the uterine cavity. In the case of tubal sterilization, tubal blockage is intentional. Tubal blockage may also occur due to disease conditions and result in involuntary infertility. Tubal blockage, whether intentional or from disease,  can be corrected with reconstructive tubal surgery.

Facts about Tubal Blockage

Tubal blockage affects millions of women in the US and hundreds of millions worldwide. More than 10 million women in the US, and more than 100 million worldwide, have had a tubal sterilization. There are approximately 6 million infertile couples in the US. It is estimated that 10-20% (600,000 to 1.2 million) cases of infertility may be due to tubal disease. In the majority of cases, tubal occlusion due to disease is caused by pelvic inflammatory disease (PID), an infection of the fallopian tubes (salpingitis) and sometimes the ovaries and pelvic cavity. PID is  “silent”, unrecognized, or misdiagnosed in many and perhaps in the majority of cases.

Read the rest of this article and comment on it. »

Tubal Reanastomosis for International Patients

The widespread acceptance of tubal sterilization means that there are women throughout the world who decide to have their tubes reversed for a variety of reasons. Finding a doctor who is an expert in tubal reanastomosis, however, is much more difficult than the simple procedure of having the tubal ligation to begin with. With the availability of the internet, international patients increasingly are traveling to Chapel Hill Tubal Reversal Center from many different countries to have their tubes untied. This map in the recovery room shows just how far couples will travel to have the best doctors when it comes to reversing tied tubes.

Why Travel Thousands of Miles for Tubal Reanastomosis?

Someone unfamiliar with Chapel Hill Tubal Reversal Center might wonder what makes people travel from such long distances to have a tubal ligation reversal. The answer is simple – Dr. Berger and Dr. Monteith have the best doctor reputations as tubal ligation reversal specialists. That is what they do exclusively, and the Tubal Reversal Center is dedicated to just one thing – providing the best medical care for patients having their tubes untied. Dr. Berger has specialized in tubal reversal operations for 30 years and has the most experience reversing tied tubes of any doctor in the world. Dr. Monteith, who was trained by Dr. Berger, is the first doctor certified as a tubal reversal specialist. Their reputations as tubal reversal doctors are unsurpassed.

With the low cost of tubal reanastomosis at Chapel Hill Tubal Reversal Center, women who want their tubes untied are better financially coming to Chapel Hill than having their operation performed closer to home – and they get better results! Examine the pregnancy statistics from Chapel Hill Tubal Reversal Center. You will find no other tubal reversal doctors or medical center anywhere in the world with better proven results. In addition, Chapel Hill Tubal Reversal Center has the best patient safety record and highest patient satisfaction scores. It is rare to have a patient give less than a perfect score on their 2 week follow-up evaluation report.

Medical Translation Services

Many international patients and their spouse or other responsible adult speak English, but we also have provided international patient care where neither person spoke or understand English. In the case of individuals who are not fluent in English, Chapel Hill Tubal Reversal Center provides free medical translation services using certified medical translators. This ensures accurate communication among patients, their responsible adults, and Chapel Hill Tubal Reversal Center staff. Even though several members of our staff are fluent in Spanish, we feel that certified medical translators provide the best assurance of complete and accurate translation for international patient care.

Returning Home After the Reversal Procedure

International travel requires prolonged traveling time, often with multiple airline connections and waiting times between flights. We recommend, therefore, that couples traveling from other continents stay for at least 2 nights following the tubal reversal operation before returning home. We also recommend that international patients notify their airline carriers of the passenger’s recent surgery and request special services for transportation, early boarding, and complimentary upgrades if available. These help make the trip home as comfortable as possible.

More Information on Tubal Reanastomosis

We are interrupting our 14 part Post Tubal Ligation Syndrome (PTLS) blog series to announce the first reported Monteith tubal reversal pregnancies and the arrival of the Monteith Miracle Tubal Reversal baby shirts!

Dr. Monteith’s Success at Reversing Tied Tubes

Dr. Charles Monteith started working full time as a tubal reversal specialist on July 21st 2008 at Chapel Hill Tubal Reversal Center. We have received four pregnancy reports from patients during his first two weeks of reversing tied tubes.  His tubal reversal pregnancies have started to roll in!

The First Pregnancies

These four patients are representative of the patient population Chapel Hill Tubal Reversal Center and they come from all across the United States. They have had different types of tubal ligations and tubal lengths measuring from 3 to 8.5 cms.

Alaska (Falope ring tubal ligation)
New York (Bipolar cautery)
North Carolina (Bipolar cautery)
Idaho (Filshie clip tubal ligation)

And The Winner Is…

There has been an unofficial competition among patients of our Tubal Reversal Message Board for who would be the first patient to report a Monteith tubal reversal pregnancy. A patient from Alaska was the first to report a positive pregnancy test. She has confirmed that a first trimester ultrasound showed the pregnancy is in the uterus and is doing well. We have asked her to share her story and experience with us in a future blog article and she has said she will do this once her life calms down and her morning sickness disappears.

Why Have Pregnancies Been Reported So Soon?

These pregnancies have all occurred within the first two weeks of his reversing tied tubes. We typically ask our patients to wait a month until they try to conceive. So these patients likely started to attempt to conceive mid to end of August. They obviously had success and conceived at their first ovulation after ligation reversal!

To the patients of Dr. Monteith who have not yet conceived: keep up the faith and it should happen in due time. Most people do not realize how long it may take to become pregnant until they actually try. It can sometimes take up to 10-12 months before a successful conception can occur.

Monteith Miracle Tubal Reversal Baby Shirts

The Monteith Miracle Shirts have just arrived and are hot off the presses. They are ready to be sent out when the babies are delivered. All you have to do to receive one is:

Be a patient of Chapel Hill Tubal Reversal Center.
Be a tubal reversal patient of Dr. Montieth.
Become pregnant after tubal reversal.
Report the pregnancy to us.
Report the birth to us.

The first shirt goes out April of 2009 and the rest shortly thereafter. We wish these women good luck and all of the women who have had tubal ligation reversals by the tubal reversal doctors at Chapel Hill Tubal Reversal Center.

Our first patient of the day came to us from New Jersey. Her last child was born 10 years ago and she had a tubal ligation five years after the birth of her last child.

She eventually met a new partner who did not have any children. Together they wanted to have a child. Our patient began researching tubal ligation reversal. She eventually found Chapel Hill Tubal Reversal Center on the Internet and decided to proceed with plans for a tubal ligation reversal.

Her partner was unable to attend the surgery because he had to stay behind and work, but our patient was able to travel with a close friend in attendance. Dr. Berger and I met both of them the morning of the surgery and we were able to explain the surgical procedure of tubal ligation reversal, the risks involved and the post procedure recovery. We answered all their questions and the patient went down for her surgery while her friend waited in the waiting room.

Her surgery went well. During the surgery we found both tubes had good lengths and were easily repairable. She had a successful bilateral tubal ligation and reversal. The incision was about three inches long and the blood loss was minimal. The surgery was without problems and we were quickly in the recovery room.

We discharged the patient with her friend to stay in town overnight. She was doing well the next day and went back to New Jersey to pursue her dream of giving her partner a child. We wish her well and we want her to keep in touch.

I started week number two at Chapel Hill Tubal Reversal Center with a beautiful ligation reversal.

Our patient was from North Carolina. She had a tubal ligation, which was done with bipolar cautery (burning) several years ago.

She went to her doctor to have her tubes tied, and after the surgery, her doctor told her, “The procedures I do are irreversible. You will never get pregnant again.” She told me she was fine with this at the time, but deep down she had feelings about why the doctor did such an aggressive procedure. She told me she thought to herself, what if she ever wanted to get pregnant again?

Well none of us can predict the future. As things so often go, she met a very special man who did not have any children. They married and together they desired a child. They came to us seeking to have her tubes untied.

I reviewed her operative note and things did not look good! Her operative note described cautery of the tube starting at the ampullary segment (the very end of the tube), and then cauterizing along the entire tube towards the side of the uterus. From the appearance of the operative note, it appeared most of the tube had been destroyed.

I recommended a screening laparoscopy to give us a quick evaluation before undergoing any surgical incisions. This would allow us to stop early if the tubes were not repairable. Unfortunately because of her Body Mass Index (BMI) issues, we were not able to proceed with a laparoscopy. Although we will perform tubal reversals for patients with BMIs up to 35, we do not perform laparoscopy for patients with a BMI over 30 due the possible increased risk of surgical complications.

This patient wanted a reversal and it was her personal decision to undergo a surgical incision so she could have an evaluation of her tubes.

As we started her surgery, we were uncertain if she would have repairable tubes. This was a wonderful patient who emanated a sense of enthusiasm and faith. She was someone you would characterize as having a beautiful personality. The entire surgical team was praying we would be able to help her.

As we started the incision, I was inwardly a little pessimistic that we would not be able to find any repairable tubes. I was afraid her doctor’s declaration about the nature of his tubal occlusions would be correct. I worried we would have to open her up, observe both her tubes having been obliterated and have to close her without doing her any good.

I was especially fearful of having to make the long surgeon’s walk. The long surgeon’s walk is the short, but measurable walk to the recovery/waiting room to give bad news to a patient’s family.

The worst thing for any tubal reversal surgeon is to have to tell a patient we could not repair their tubes. This is very comparable to a general surgeon having to tell a family their loved one did not make it through a risky surgery. To be honest, the two bad results are vastly different, but for a woman desiring tubal ligation reversal, it can feel very similar.

Things seem to happen for reasons. We found her to have good end segments and, as the operative note described, the tubes were cauterized to the very extreme side of the uterus. We were able to recover about 3cm of distal tube and found the remaining tubal lumens where they were hidden deep in the walls of the uterus. Isthmic-ampullary tubotubal anastamosis (tubal ligation reversal) was done on both sides and the average length of both tubes was about 3cm.

They ended up being short tubes. But short tubes are theoretically better than no tubes or closed tubes. We do have patients report pregnancies with tubal lengths much shorter than these.  We cannot create tubes. We can only work with what we find. Pregnancy for this patient is now very, very possible and prior to her reversal surgery, a natural pregnancy was impossible.

After the surgery, the entire team was thrilled. We never want to disappoint any patient, and we were able to give this woman both of her tubes back.

Dr. Berger and I were both very happy for this patient. We will be even happier when she reports a sticky bean to us (that’s a pregnancy for those who are not savvy to our Message Board lingo)!

To the patients of the Chapel Hill Tubal Reversal Center message board, sorry. It has been a long time since I last posted a blog. I have worked six to seven days a week for the last eight years and sometimes 36-hour shifts in the hospital. Needless to say, many sleepless nights and long hours. Recently, I completed a six-month training period with Dr. Gary Berger while at the same time, working in the hospital and delivering babies. Before starting my new career at Chapel Hill Tubal Reversal Center, I took some time off to be with my family and now I am back!

It has been a long process to become a tubal ligation reversal specialist, but well worth it.

My path to become a specialist in tubal ligation reversal actually started 18 months ago when I first made contact with Dr. Berger. Six months of meetings, followed by six months of tubal ligation reversal training has gone by quite fast. This week has gone by even faster. Monday, July 21 was my first ‘official’ day with Chapel Hill Tubal Reversal Center. As I write this blog, this is my fourth day of surgery and we have completed 16 tubal ligation reversals thus far. So far, we have had nothing but success. All patients this week have had at least one tube opened or successfully reversed. I hope they will all become pregnant.

My first day untying tubes was wonderful, and all of the surgeries went well. Each day has been both a challenge and a joy. Dr. Berger and I are doing four reversal surgeries a day. I help him with his two patients and he helps me with my two patients. We have been working very well together and the staff at the center have been great and very accommodating.

The best thing about my new career has been the patients. The patients have been wonderful people to work with. I have the opportunity to meet patients from all over the United States and from all walks of life. They each have a unique story to tell. They have been wonderful individuals and couples who desire either more children or improvement in their menstrual symptoms. In the first three days of my new job I received more ‘Thank you Doctor….’ than I did in eight years as a general Ob/Gyn.

I think this will be the beginning of a long and lovely career…..

By Lisa D. Hourmouzis, RN
Tubal Reversal Nurse

It’s 7:30 am at Chapel Hill Surgical Center. In a moment of solitude, Dr. Gary Berger meticulously scrubs for the first surgery of the day. As he stands there quietly, I can’t help to wonder about the story behind the man in the surgical mask.

How did he become the surgeon he is today? What drives him to succeed?

These questions led to the following sit down with America’s leading tubal reversal surgeon, Dr. Gary Berger:

When did you decide to go into obstetrics and gynecology?
GB – When I was beginning my fourth year of medical school, during the time when we had to decide what direction we were going to go in, I felt like I wasn’t really secure enough in my basic medical foundation to want to jump into a specialty. So, I made the decision I would take a year of internship in internal medicine. But I had already made the decision that year to start my OB/GYN residency after the internship in medicine.

What led you to Duke?
GB – I was always a very hard worker. I guess I believed in the adage, “No pain, no gain.” So, I picked the hardest program in the US which was the medical internship at Duke University Medical Center. They had that reputation at the time. You were on-call five nights out of seven, and it was a very grueling program. But I thought I needed that to feel like I had a basic medical education before I proceeded.

Did anyone influence your decision to enter OB/GYN?
GB – I had been thinking about going into obstetrics and gynecology, and it just so happened that during that time we had a visit from Dr. Carl Tyler from the Centers for Disease Control. He was looking to recruit physicians into the EIS program, the Epidemic Intelligence Service. He came to the University of Rochester where I attended medical school and made contact with one of the pediatric professors there. I remember being on my pediatric rotation at that time.

Unbeknown to me, my pediatrics  professor had been an EIS officer; he also taught the courses in epidemiology and statistics, which I loved. Most of the other medical students weren’t so interested in them. Because I had done so well in those courses, he recommended that Dr. Tyler interview me. That was definitely a turning point in my life.

I was offered the opportunity to be in the U.S. Public Health Service at the CDC, but Dr. Tyler needed me to complete one year of my OB/GYN residency before I could join the program. That made my decision. I immediately started looking for residencies in OB/GYN.  And as it turned out, that two-year period was probably one of the most influential periods in my life. It was an absolute amazing experience.

What did you like most about obstetrics and gynecology?
GB – The thing I liked about obstetrics and gynecology was the obstetrics. I really did not think I would ever have an interest in performing surgery. In medical school, my surgical rotation was one of my least favorites.

What changed your view about surgery?
GB – During my third and fourth year of my OB/GYN residency, I had the good fortune of working closely with Dr. Jerry Hulka, the inventor of the Hulka clip. He made a big impression on me. His interests, aside from developing this technique in sterilization, were laparoscopic surgery and tubal surgery. So, it was during that time I became interested in tubal surgery; and what really solidified it was when I had the chance to see microsurgery performed. I knew at that point, that’s what I wanted to do.

Why did you decide to focus on tubal reversal surgery?
GB – My ideal was always to be able to do this surgery. I’ve done infertility treatment, IVF. I’ve done almost every type of GYN operation there is, with the exception of cancer surgery, but tubal microsurgery was always my special love. Fortunately, that’s where I am at this point.

What drives you?
GB – I think it’s a desire to be successful at whatever I do. If I’m doing tubal surgery, I want to be the best at doing tubal surgery. I want to know the most about it, have done the most and not just have the most experience, but intellectually, collected the most information. To me, that’s enjoyable because then I feel like it’s something that I’ve mastered. And of course, I like being able to help the couples that come here. I really feel that we can help most people. I know that  people are better off coming here than taking any other alternative that they have, in terms of having tubal reversal surgery.

What do you enjoy most about tubal reversal surgery?
GB – I like the challenge, the meticulousness about it. And I like being able to operate on patients and see them be comfortable and safe, and not dealing with complications.

I have a very idealistic view of things. If there’s a better way to do something, let’s find it and do it that way. I just think that’s a good way to practice medicine. But it’s not just about me personally; it has to do with everyone on our staff  who is involved in it.

Where do you hope to see tubal reversal surgery in the future?
GB – I don’t know if the pendulum will ever swing back to tubal reversal, it was there when I started 30 years ago. It was the new, exciting thing. And then IVF became the new and exciting thing.

Tubal surgery is quite different. I don’t think tubal surgery will ever suddenly become widely used or widely taught, but I think there is clearly a place for it. I like the fact that I’m training another doctor. And maybe in the future, one thing we might consider is becoming a training center where we could take physicians who are already at an advanced level like Dr. Monteith, and help them be able to do this type of surgery with expertise.

Tubal reversal helps a lot of patients, and there definitely should be the option for doctors to have additional education in it so that doctors don’t automatically send their patients into IVF programs when a simple tubal operation could be the solution.

Do you have a philosophy in your professional life?
GB – There’s an expression that I heard when I was in medical school, the quote was, “the secret in caring for the patient, is in caring for the patient.” And part of my philosophy is that I want to provide the exact type of medical care that I would want for myself, no less.

If I have to have a doctor, I want somebody who knows what they’re doing, is educated and a decent and kind person. Technically an expert, as knowledgeable about it as anyone, or more so than anybody else in the world. That’s the kind of doctor I would want for myself. Someone who will really take care of me if I have a problem and won’t brush it off or be too busy because it’s inconvenient for them. That’s the same thing that I want for my patients.

To learn more about Dr. Berger and Chapel Hill Tubal Reversal Center, call 919.968.4656 or contact one of our tubal reversal professionals today.

Sally Muncy, R.N.
Chapel Hill Tubal Reversal Center

Introducing Myself

Dr. Berger has asked me to give a short description of what I do as an Operating Room Nurse so that you will feel that you know me when you come here for your tubal reversal surgery. I am a nurse who accompanies you to the operating room once the preoperative nurses have admitted you and taken care of all your physical as well as emotional needs. I am there for you to make sure that you are comfortable and have no last minute questions or misgivings.

One more time I will check your name on your name band and ask you about allergies and if you have eaten. I will ask you to use the rest room to empty your bladder as Dr. Berger does not use any bladder catheter in your bladder during surgery. I’m not asking these same questions that the other nurses have ask you because I don’t know the answers, but ask them only as one more opportunity to avoid a mistake about something you may have forgotten to mention.

In The Operating Room

In operating room, you will be made comfortable and warm and everything that is being done will be explained to you. I realize this is a little frightening since everyone in the operating room wears a mask, gloves and gown for your protection. This brings up another point about who will be in the operating room with you. As I said I will be at your side the whole time. There will also be an anesthesiologist or anesthetist, a surgical assistant, and a surgical scrub technician (the person who is responsible for all the sterility of the surgical equipment and for seeing that Dr. Berger has the instruments as he needs them when he is concentrating on surgery). The only other person present is Dr. Berger.

For those of you (and there are many) who have a concern for modesty in the operating room, you really have nothing to worry about. After the surgical area is cleansed you are covered from head to toe. There is only about an 8 inch by 3 inch window of skin exposed on your abdomen. Many ladies also come for surgery while having their menstrual period. This also is handled very discreetly. You will keep your underwear and pad on until the last minute and then you can remove them in the bathroom and we will have a pad on the bed for you. I really want to impress upon you that from the time you walk in the front door to when you leave after surgery you will be treated with the utmost respect and dignity.

Once you are settled in the operating room you go off to sleep fairly quickly after being attached to heart monitors and a final safety check being done. One more time every staff person in the room checks your name, allergies, and other important data regarding your health. At this point everyone takes their designated position in the room and like a finely choreographed dance surgery begins. Because of keeping sterility in the room, no one can touch another person so each one has to know exactly what they are doing and where the other four people are.
I am the one who keeps computer records of anything pertinent to your surgery while Dr. Berger dictates in detail. I am also responsible to see that everyone has the sterile equipment, medications, irrigating fluids, or anything else that needs to be brought in to the operating room. And finally I perform, with the scrub technician, a counting of all the instruments and dressings that are used during surgery. This count is also done before you enter the room and two more times. The final count must match exactly. This avoids any concern of a lost instrument or dressing. This is to insure absolute safety.

On To The Recovery Room

When Dr. Berger finishes surgery I will put a small dressing on your abdomen. Surgical time will be recorded and you will soon wake up and move back to your original bed. It is then my pleasure to return you to the recovery room where your nurse will greet you and I will bring your family member in to sit with you.

I just want to assure you once again that you will be in good, safe hands throughout your tubal reversal surgery. Every staff member at Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center is there to meet your needs and we are honored that you have put your trust, first in Dr. Berger, and then in everyone else who has any part in your care.