“Lisa’s Birth Story: A complicated journey” – with Dr. Lisa Kalik

Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Dr. Lisa Kalik, thank you for coming in. Welcome to the podcast. I’m so happy you’re here. It’s so nice to see you.

Dr. Kalik: Thank you for having me.

Dr. Fox: So I’ve been thinking about you for a long time. We were talking just offline before. You know, a lot of people come to our office. You’re a doctor, I’m a doctor. You see a lot of patients over the course of your career. Many remember. Some you don’t, just because, you know, you don’t see them that often. And some really stick out. So for better or worse, you’re one of the people who stick out, and we’ll go through it, obviously because your story is so dramatic, but also thank God because it ended sort of well. And also the fact that you’re going through this as a physician added definitely a layer of more about complexity, but certainly interest to the whole story that this was happening to a physician. You sort of knew what was happening to you at the time. So thank you for coming in. I think everyone’s going to really appreciate your story. How are you doing right now?

Dr. Kalik: I’m doing great. Everything’s good. I have no surprise stories for you. No disasters this time.

Dr. Fox: Terrific. So I guess we should probably start. Just give our listeners a sense of, you know, who you are, where you’re from, and sort of where you were in life coming in to your pregnancies, you know, I guess in the 2010s.

Dr. Kalik: Yes. So I got married at 35 and I started to try to get pregnant right away, which, by New York City standards, is pretty young, but, you know… And I, you know, just was trying to get pregnant. I went off birth control after 18 years plus or whatever. And I was, you know, peeing on a stick trying to get…you know, I was actually ovulating regularly, but I peed on a stick for, like, 60 days in a row and I got pregnant, you know, naturally. And that this is great. Easy-peasy. I then actually had a very early miscarriage with that pregnancy, just sort of typical, started spotting at eight, nine weeks. And, you know, there was an empty gestational sac and no baby. I had had a confirmed heartbeat prior to that. So that was sort of a typical miscarriage. And I actually remember the OB that I was seeing at the time. She said, “Don’t worry, you’ll have another baby. No problem.”

Dr. Fox: No problem. Yeah.

Dr. Kalik: It sticks in my mind because, you know, especially as a physician, you have to be so careful with your words, because I remembered her saying that, like, you know, as time went on, and I was like, “She was so wrong.” Not that it was her fault. And that miscarriage, the only tough part of it, I mean, I was, of course, disappointed and sad, and I chose, on her advice, to not do a D&C after I had the miscarriage. I took misoprostol, medication that helps you remove the remaining pregnancy. And that was really actually a horrible experience. I don’t know what most people experience, but I just felt terrible on the medication. I was, like, having chills, stomach pain. Then you start bleeding. I mean, it was just not a fun experience. I wouldn’t recommend it to anyone. Maybe it’s not like that for everyone, but I found the drug really hard to tolerate. So that happened. And then I continued to…you know, there was no reason to think there was anything unusual about that.

Dr. Fox: Right. So, at the time, obviously, you were disappointed, but you weren’t, like, discouraged about the prospects.

Dr. Kalik: No, I was really sad. But I thought, “Okay,” like, “I understand. This is probably chromosomal, a normal miscarriage.” And, you know, this happens. And there’s no reason to think that there’s not…

Dr. Fox: Right. And do you think that being a physician…because, you know, most people who would take care of her are not doctors, but a certain percentage are. As you know from taking care of doctors, it can go in two ways. Some of the doctors take care of her like, “Yeah, this is fine. I’m good. I get it.” Like, all is good, and they’re, like, the easiest patients. And others, the exact opposite, because they can do the deep dive into, like, “Oh, no, I did a deep research on to this and there’s something horribly wrong with me,” and, you know, “Everything is terrible,” and “Why isn’t this, this, this, this?” So you sound to be more like the former.

Dr. Kalik: Yeah. I mean, I was very sad. I mean, yeah, compared to what happened after the fact, it’s like small potato. But no, so, I mean, I don’t want to downplay it. I was really sad and disappointed, but I wasn’t worried that I wasn’t going to have a baby, you know, in the long run. So over the next several months, I didn’t get pregnant. And then I think, I don’t know, six or seven months went by, and then I was 36 and I was like, “Wait, let me just, you know, make sure,” because I wasn’t ovulating regularly so I was getting nervous that I should get it checked out. So I went to a reproductive endocrinologist, got a workup, you know, sort of unexplained infertility. And he just recommended doing Clomid and, you know, timed intercourse, see what happens. And I actually got pregnant, you know, the first month doing that. And I had a confirmed heartbeat. And then that ended in a miscarriage very early as well, like, six or seven, I think six weeks even. And I opted to do a D&C, which was so much better than the medication, even though it’s anesthesia and the whole thing. It was actually my first time having anesthesia. So that part, that was the scariest part. But the procedure itself was very smooth and, you know, I was disappointed again, but the pathology on that embryo was a trisomy 18. So, again, that is not uncommon at 36, 37 to have a chromosomal abnormality. So there is still no real reason to think I couldn’t have a child. So the REI at that point said, “Let’s do some IUIs,” which I did. They were unsuccessful. I actually can’t remember how many I tried. I think three or four over a few-month period. You know, they don’t always work. So he said, “Let’s go down to IVF. I can control the situation. It’ll probably work out fine.” So I did a retrieval and I actually got six healthy, normal embryos. So it was very exciting. We did a transfer and I got pregnant. So then I was like, everything was perfect. I was so happy. And I knew that I had a normal embryo growing. And I came here, actually. I came to the office.

Dr. Fox: Yeah. What was it that brought you to our practice?

Dr. Kalik: So Dr. Silverstein was my clerkship director in my OB-GYN rotation.

Dr. Fox: You know what, I had forgotten that, but now I remember that. That’s right. From NYU back in the day. I assume he was the best clerkship director ever.

Dr. Kalik: He was. He was great.

Dr. Fox: He was awesome. Yeah.

Dr. Kalik: I did deliver a baby with him, actually. Like, you know, one of the couple babies I delivered during med school. He, you know, helped me catch the baby. So I was like, “Well, if he taught me, he’s got to be pretty good.” So, yeah, actually, at my first appointment, he looked at my grades. That’s like his shtick to do with his former students.

Dr. Fox: He keeps everything. He has data from his whole life. Ever since computers were invented, he started keeping data.

Dr. Kalik: Yeah, he literally read it back to me. The good news was I had done well.

Dr. Fox: And just for the listeners, what kind of physician are you?

Dr. Kalik: I’m an internal medicine physician. Yeah. So I treat adult patients in primary care. So, you know, everything in the beginning of my pregnancy went smoothly. We did the, you know, regular genetic, like, the NIPT, had the blood test to make sure the chromosomes were correct and everything looked good. My nuchal scan looked good and I felt good. I actually love being pregnant. This is not to dismiss people. I know a lot of people don’t feel good during pregnancy. I felt fine. You know, I thought it was so cool that I was pregnant. I was really happy and feeling well. And then at 19 weeks, one night, I think it was exactly 19 weeks, I was getting ready for bed and I looked at my legs and they were so swollen. And I was like, “This is not normal.” And I think being a physician helped me because I think a lot of women hear about swollen legs during pregnancy and they’re like, “Oh, my legs are swollen.” Like, this just happens. But it doesn’t usually happen that early, not typically. And this was really significant, the swelling. And it was like at nine o’clock at night when I saw this. I’m like, “Well, I feel okay. Let me just go to bed and see how it is in the morning.” And I woke up and my legs were still really swollen.

So my first thought being, you know, at this point, knowledge is good and bad. I’m not even close to having OB knowledge, but I have some. So I was like, “I need to get my blood pressure checked” because I was just worried that this was a sign of high blood pressure. So I went to my office, which at that time was in midtown, and I had one of my colleagues check my blood pressure. At this point, I’m also in a panic about it. And my blood pressure was, like, 180 over 90 or something. Horrible. So she rechecked it. I think it came down a little bit, but I was like, “This is not okay.” So I, of course, called you guys. You know, I was 19 weeks. So the first thought was like, “Well, this is not preeclampsia. This is, you know, probably just high blood pressure. Let’s see a cardiologist,” which I happened to be in an office that had a cardiologist. So that day, I saw the cardiologist. They checked me out. They did EKG, you know, the whole workup. They spoke to…Dr. Bender that day was available. And they did send all the preeclampsia labs, which were normal. He saw me that day and scanned the baby. Baby looks fine. And so I was put on blood pressure medication. The assumption, since I was, you know, pre 20 weeks, was that this was gestational hypertension, which is a little bit uncommon to be that severe, I think, but happens.

Dr. Fox: Right. So just for our listeners, preeclampsia is a condition of pregnancy. but traditionally, it would not happen under 20 weeks. It’s usually 20 weeks. Now, that’s obviously just, you know, not a random number, but it’s sort of a line in the sand that doesn’t make sense. So in 19 weeks, it’s really borderline. Is this a pregnancy-related phenomenon like preeclampsia? Or is this just unmasking something that existed before pregnancy, like chronic hypertension, which you would probably know if you had, which is why it was so confusing. It’s like, well, we would know she had chronic hypertension. Like, you know, she’s a doctor. She sees doctors. But on the other hand, it’s so odd to get preeclampsia this early. And it’s like a really…you know, if you were 24 weeks, everyone would say it’s preeclampsia. And if you’re eight weeks, everyone would say it’s chronic hypertension. But at 19, it’s sort of like, you know, tough call in that sense.

Dr. Kalik: Yes. Yeah. So, at that point, we were just monitoring me. And I did go on blood pressure medicine. I went on Labetalol. And I think the leg swelling did get better. I don’t really remember that. I think I’ve blocked that part out. I don’t know. And we were just watching me. And I came in for my anatomy scan. I think it was just a scheduling thing. I was 21 or 20 weeks and five days or something. I came in for my anatomy scan, which looked good. I forget who… I think he’s retired now, but he came in and said, “Everything looks good. Baby’s on the smaller side, but looks fine.” And actually, I came up to see you that day for my appointment, and you checked my blood pressure and it was okay. It was 130 over 80, which, you know, is fine in pregnancy. And I mentioned to you that I had called the triage nurse a few days prior because I’d had some right rib pain. You probably don’t remember this. And she said, you know, “It’s probably just,” you know, I don’t know, “the baby moving around or something.” But looking back, it was pretty bad pain. I really was having, you know, right upper abdomen pain that woke me up from sleep, that kind of thing. And it had gone away. But I remember when I said that to you, you had that doctor look, because I’ve had that look too, like that flash, like, “That doesn’t sound good, but I’m not going to panic her.” And you said, “Well, we should do blood work.” I said, “Okay.” He’s like, “Let’s just make sure it wasn’t anything serious,” because, I don’t know, you know, for preeclampsia, you can, like, affect the liver and cause right upper abdominal pain.

So it was the end of the day and the lab had already closed, so I didn’t do blood work that day. But being a doctor, I could do blood work in my office the next day, which is what I did at the end of the following day. So this is then the next morning. So this is two days after I saw you that one of the nurse practitioners in my office texted me, or called me, actually, and she said, “Are you feeling okay?” Because she’s like, “Your blood work came back and your platelets are, like, 77,” which is very abnormal, for people who don’t know that. And I said, “Okay.” I’m like, “Don’t worry.” I’m like, “I’m going to call my doctor.” Because the blood work didn’t go to you. I had ordered it myself essentially with your order. So I called you guys and the nurse got on the line, and I said, “I need to speak to someone right away.” I said, “I think I have preeclampsia.” And I said, “My labs are really abnormal.” She said, “Well, you’re pregnant. Labs are sometimes different.” And I did pull the doctor card. I was like, “No.” I’m like…

Dr. Fox: “Listen here.”

Dr. Kalik: “I am a doctor.” And I had gotten the whole set of labs. My liver tests were abnormal. I knew I was really sick. So I said, “I’ll send them to you right now.” I was like, “I need to speak to someone as soon as possible.” So, you know, I’m at work, you know, about to start seeing patients. So I’m trying to figure all that out because I knew that I was in trouble. And I’m also at this point really upset because I know, the one thing you know from your OB training or from med school is the only way to treat preeclampsia is to deliver the baby. And at this point, I’m 21 weeks. So I’m, you know, devastated because I know what’s coming. And so I’m, like, you know, trying to figure out what to do with my patients. Luckily, I had a nurse practitioner who’s there who could take over. And like, you know, I’m waiting for you guys to call me. You know, tears are streaming down my face. I actually think I finished a pre-op. Like, I was trying to, like, manage my regular life and deal with this. And you and Michael Silverstein got on the phone with me, and you said, “You have to come in right now.” Like, “Don’t eat anything. You’re really sick.” I mean, you said that. You said, “You’re very sick.” And I really actually appreciate that because I think doctors need to be straight when something is serious. And that’s kind of how I practice also, because, you know, you have to tell the truth. If it’s serious, it’s serious. And you can say it kindly, but you have to be, you know, [crosstalk 00:14:18.181].

Dr. Fox: And I’m peppy positive. So if I’m telling you you’re really sick, you’re really sick.

Dr. Kalik: And I was like, “Okay.” Like, “This is happening.” And this is kind of a silly, crazy part of the story. It was rush hour in New York City at that time. And so with my preeclampsia and finishing my pre-op and all that, I’m like, “I think I should take the subway. It’s going to take too long in a cab.” So I’m, like, you know, preeclamptic and who knows what’s happening in my body, and I get on the subway.

Dr. Fox: It’s a motley crew on those subway cars. You got everything going on.

Dr. Kalik: To go uptown. I’m like, “Why not?” And also…

Dr. Fox: By the way, it’s probably the fastest.

Dr. Kalik: Yeah, it was. I’m like, “This is the fastest way.” But who knows? I mean, I could have had a seizure on the train. Who knows? And I’m, you know, calling my mom as I’m going to the subway. My husband, who was working the restaurant business at the time, was sleeping with his phone off because he had worked late the night before. So I left him, you know, 42,000 messages and text messages that he didn’t hear as I’m trying to get up to the hospital. And yeah, and I arrived there. So I’m by myself in the L&D triage and seeing all these, like, happy, healthy pregnant women, and I’m like, you know, about to probably end this pregnancy. And I finally did get in touch with my husband. I think I called his friend. He was on his way. And I called one of my best friends from med school who’s an OB, and I told her what’s happening. And she just said, “I’m so sorry.” And then I really…like, that was that. Like, that confirmed it. Because I just knew, like, there was nothing to be done to save the pregnancy and now it was just about saving me.

So Dr. Silverstein met me there because they were waiting for a room and the whole thing. And he just came out there and, like, in his very kind way, he just took my hand and he was like…and he said, “I’m sorry.” But, you know, I knew that I was in good hands. And I have to say, all my care was, even though terrible things were happening, I felt so, you know, supported and cared for by at the hospital and this group and everything. So it was a long couple of days because I opted at the time to do a D&E procedure, a dilatation and evacuation to take the baby out. And so that was a process because I had to have my cervix dilated. And I was also pretty sick at that point with preeclampsia. And actually, technically, I had HELLP syndrome because I had…

Dr. Fox: Everything.

Dr. Kalik: …low platelets, liver enzyme elevation. And I was put on a magnesium drip, which is a really hard drug to be on. Very important to protect you from having seizures. And in the case where the baby is viable, it helps protect the baby as well. But that drug makes you feel like you are on fire. The only way I can describe it is your whole body feels like it’s on fire. So, you know, that took, you know, 24 hours, I guess, to dilate the cervix and all of that to prepare for the procedure. And I just felt physically horrible at that. I don’t know if it was the drug or the preeclampsia or the combination by the next day, but I was relieved. At that moment, I was relieved to be ending the pregnancy because I just felt so physically bad and I was so scared.

Dr. Fox: And, you know, had you not ended the pregnancy, I mean, it only gets worse. This is life-threatening type of stuff.

Dr. Kalik: Exactly.

Dr. Fox: You know, which is… And again, it happens, but it’s extremely rare. It’s extremely rare, you know, but it’s pretty awful.

Dr. Kalik: Yeah. So I remember being wheeled up to the OR and it was Dr. Malka [SP] and I think maybe Dr. [inaudible 00:17:56]. I can’t remember. And I looked at Dr. Malka and I was like, “Please fix this,” because I just felt so sick. I remember saying that to her. And I was relieved to go under anesthesia because I just didn’t want to be awake for this anymore. And I remember waking up and, at that moment, I felt that I just could tell that the pregnancy was not in me anymore. It was almost like, I don’t know, I can’t describe it. But it was like I knew whatever was, you know, trying to kill me was not there anymore. And then, of course, in the days, weeks now, I was devastated. I was just so, so sad. Because it’s a weird kind of loss because there was never a live baby in my hands, but it was the hope of that baby. And, you know, everybody knew I was pregnant. It’s different than an early miscarriage when people don’t know. But everybody knew, including patient. “Oh, how’s your baby?” I was just, like… So I came up, you know, with the quick [inaudible 00:18:53] until I kind of, you know, changed the subject with patients and people I didn’t want to talk about it with. But it was really hard. I was really sad. I still have sadness about that pregnancy and others. In the beginning, it was about that baby. And I think over time and going through what’s happened since then, but it was more also just the loss of being able to, like, carry that pregnancy. That in itself creates a lot of sadness and grief for me. But I was alive and I was healthy. And, you know, my blood pressure came back to normal.

Dr. Fox: Did you tell people what happened? Like, let’s say, you know, your circle, like your friends.

Dr. Kalik: Yeah.

Dr. Fox: That you were sick and, you know, the whole thing.

Dr. Kalik: Yes. Yeah. I mean, depending on the person, how much detail I went into it. You know, I mean, like, I had an abortion. I mean, that’s what I had, which I also think about in that…you know, not to get too political, but, like, if I had lived in another state and it had been 2024, it might have been even more difficult, you know, logistically to have done what I had done. So I told people. And at work, I was, you know, more vague about what had happened other than, you know, I lost the pregnancy. Yeah. So I did. People knew. But, you know, the thing is when something like this happens, it’s also like when people have any death in the family. In the beginning, people are very, you know, talking about it and, you know, supportive. And of course, my close family was supportive for a lot longer, and my husband still is. But over time, people kind of forget that it happened. But it’s still, like, very, you know, prominent in your mind months, years later. So that part of it’s hard.

And, you know, one of the reasons that I wanted to do the podcast with you is because I think that this type of experience, as much support as you have from a partner and family and friends, it still is something that happened to your body, and that can feel really, really, really lonely and isolating. And so I want other women who have gone through this to know that I think a lot of people feel that way. And actually, we’re not alone because there’s other people that have gone through this. So I think that’s important to know.

Dr. Fox: Absolutely.

Dr. Kalik: So anyway, I had a workup through you guys. There was no identifiable reason why this happened at such an early stage. And I saw a cardiologist and, you know, we did all this stuff and everything. You know, no reason to think I could try again.

Dr. Fox: Right. Perfectly healthy, you know, yeah, when you’re not pregnant.

Dr. Kalik: So I did. The first, I had a failed transfer. I had a subsequent pregnancy that didn’t go to preeclampsia, but there was a problem with that fetus. And, you know, long story short, it was not a viable pregnancy. But it went on for… I mean, the pregnancy didn’t end until, like, 17 weeks, that pregnancy. So that was also…

Dr. Fox: And a totally, totally separate thing.

Dr. Kalik: I think.

Dr. Fox: Yeah, no, totally separate. Crazy.

Dr. Kalik: Another crazy thing. And it was a normal embryo. But, you know, the testing of embryos isn’t perfect. Who knows? So at this point, a lot of time, and, you know, this is, like, you know, a year and a half. So anyway, then everyone said, “Don’t worry. You can try again.” I said, “Okay.” I came back for more. So then I had a successful transfer and everything was going along fine. I did an amnio with that just to make sure it… I think I did the amnio at 17-ish weeks or 18. And I’d been checking my blood pressure regularly throughout that pregnancy, but at 18 and a half weeks, I got, like, a little cold or something. And I didn’t check my blood pressure for a few days because, I don’t know, I just didn’t. And then the weekend came. I was 19 weeks and two days, I remember. I was like, “I should probably check my blood pressure.” And I did. And it was, like, 160 over 90 or something. So I called. You were on call, actually. Spoke to you, and I told you what was happening. And I said, “Should I start blood pressure medication?” And you were like, “No, you need to come to the hospital.” And I was like, “Oh. Okay.” He’s like, “This could be preeclampsia again.” And, I mean, I kind of knew, but I was still, you know, sort of surprised.

Dr. Fox: That I remember. I remember the second time because I was…

Dr. Kalik: You were very involved.

Dr. Fox: I was like, “I cannot believe this is happening again to this poor woman.” I was like, it’s, you know…I mean, it’s not that I can’t believe it because it’s happening, but it’s just… Yeah, I remember that, sadly.

Dr. Kalik: So I went in and I was in the hospital for a few days because I think you and the team were like, “Let’s see how this progresses. Maybe it is just hypertension because of the history and everything.” And my blood work looked okay for the first couple of days. But it became clearer after, I don’t know, 72 hours or so in the hospital that my liver…and I think my liver enzymes started to [crosstalk 00:23:34.787].

Dr. Fox: On day one. I mean, you’re not going to throw in the towel just because your blood pressure goes up because who knows? Maybe, like, you know… Obviously, everyone knows in the back of their mind this could be the exact same story happening again. But you definitely want to see that before you do anything drastic.

Dr. Kalik: Right. Right. And I remember talking to you about it. And I remember saying that I’m not going to have a D&E. I said, “If I need to end the pregnancy, I’m going to deliver this baby.” And you were like, “Okay, no problem.” Like, “I can give you an epidural. We can keep it in for a week.” And again, I really appreciate it. Like, you’re very open to what I wanted. I mean, all of you were very honest and straight about what was happening. And I think that’s so important in this kind of situation, because, I mean, I think as a doctor, I knew a lot and I knew what was happening, but I think for someone who’s not, it’s hard to, like, wrap your head around that you have to end a pregnancy, and how are you going to end a pregnancy, and what’s the best way, you know, for you to do that? But I couldn’t bear the thought of, you know, having an abortion type procedure again for a pregnancy that I wanted so much. So anyway, I was monitored for a few days. It was progressing. It was clear that this was progressing into preeclampsia. And at that point, I was, you know, 19 and a half weeks or something. No chance of viability. So we decided to…we did an epidural and I was essentially induced, the way anyone is induced for labor, I mean, with pitocin and the whole thing. I think it was less than 24 hours, the whole thing.

Dr. Fox: Yeah. I mean, all these options are obviously horrible. But if you’re at that point, you know, you’re 20 weeks-ish and you have to end the pregnancy, you can either do a procedure in the operating room where you can induce. The operating room procedure itself is 20 minutes. But to get to the operating room, like you said, you need at least a day, sometimes two. If you induce the labor, the process is usually 12 hours. It could be shorter, it could be longer, but sort of from the moment you decide until it being done is actually faster with an induction, even though it takes much longer than the operation. It’s sort of like a backwards thinking about it.

Dr. Kalik: Yeah. And I really wanted to see this baby.

Dr. Fox: Sure.

Dr. Kalik: You know, not to be graphic, but you know, the D&E procedures, the babies do not come out whole. And I wanted to at least see one of my babies. And so we did that. And it was actually, you know…that aspect of it was not really hard. I mean, it was kind of, in a weird way, I was like, “Oh, I’m going through labor.” Like, you know, it was sort of… I mean, I kept having to remind myself, like, “You are not going to have a baby at the end of this,” but at the same time, it was like going through a procedure that would be to have a baby. But it wasn’t difficult physically. So when I ultimately delivered the baby, and I actually called my same friend from med school, I was like, “What should I expect?” Because I wanted to know what to expect when this baby came out of me. I was like, “What is the baby going to look like?” I had never seen a 20-week, you know, birth. And she said, “Well…” She said, you know, “It may or may not make any sound, may not be alive. By the time the baby is born, it’ll be really small, big head, red skin,” you know. So I was, like, mentally prepared visually what I would see. So I delivered the baby. The baby was not…you know, it was not alive by the time of delivery, which I think was probably easier for me, to be honest. Then I remember you were in the room and then the placenta came out, and you were like, “I think that’s the placenta,” because I don’t think my placenta looked so good, which makes sense.

I did hold that baby. Her name was Cassie. We named her. It was like I was just… I mean, I was just hysterical holding this baby because it was like I saw this little, tiny, I mean, hardly a baby, but a baby. And everything looked perfect. I remember seeing her… I just remember, like, touching her chest and, like, seeing her…because, you know, there wasn’t a lot of fat at that point. And so I could feel, like, her little, you know, her ribs. And I was like, this is a perfect baby that I felt like my body had just, you know, destroyed. And so that was really painful for me. But I was still glad that I had that experience to, like, see the baby and hold the baby.

Dr. Fox: Did you take pictures?

Dr. Kalik: The hospital did. And I have them. I haven’t looked at them in a long time. I almost looked at them today before I came here, but I was like, “I don’t think I can do that.”

Dr. Fox: Yeah. The hospital, the tape, and they hold on to them because people sometimes years and years and years later say, “I wannna see them.”

Dr. Kalik: They asked me. They said, “Do you want them?” And I said yes. They put everything in, like, a little thing…

Dr. Fox: With a box.

Dr. Kalik: …with the footprints and the whole… And I have it at my bedside night table, actually. And my husband was there. I remember he didn’t want to hold the baby. I think it was scary for him. I mean, look, a 20-week… It’s not like a cute, cuddly baby. It’s scary. But he was there with me. I mean, he’s amazing. And he’s not medical, you know, so he was like, “What is happening?” And I really knew what was happening, which was, I think, helpful in some ways. And I knew that pregnancy for me was over. And that was also really painful because I knew that no one in their right mind would put an embryo in me. And I wouldn’t want to do it either because I want to be alive. And pregnancy just kept trying to, you know…

Dr. Fox: Did you know that right away?

Dr. Kalik: Yeah. Oh, yeah.

Dr. Fox: Like, probably, like, from the moment the decision was made to…

Dr. Kalik: Yeah, I knew I was done. And I remember you…I think it was you that came to the room, like, the next day. I’m like, “I want an IUD. I want one now.” I’m like, “I can’t get pregnant again, even by accident.” And I’ve thought about that since. I mean, I still theoretically could get pregnant. And I would not continue pregnancy. It’s just not safe for me. For whatever reason, my placentas… I mean, I know not everything is understood about preeclampsia, but I think the general understanding is that it’s a bad, unhealthy placenta. And for whatever reason, that’s what my body makes. So, yeah, so I knew that I would no longer be pregnant, or could no longer get pregnant. And so I had to decide. We had to decide what we wanted to do at that point.

Dr. Fox: Yeah. How hard was that decision at that time about what to do? ?

Dr. Kalik: What to do next? You know, I get this from my mom. I’m like a fixer. I’m like, “Okay,” you know, “I can’t carry a pregnancy, but I want a baby.”

Dr. Fox: Classic doctor. Problem solver.

Dr. Kalik: I’m like, “How can I…” And, you know, Jeff and I, my husband is Jeff, had talked. I mean, I don’t even know if adoption had come up at that point, but I immediately thought of… I don’t know if we talked about it. I’m like, “I’ll get a surrogate, a gestational carrier.” And literally, I think the next day, I was, like, on the phone trying to figure this out. I think it was part of my grief process. I was like, “I need to take action because I want to be a mom.” And, you know, I’m just going to… I mean, we got…

Dr. Fox: That’s not uncommon, by the way. I mean, obviously, I know people have had babies through carriers, and I’ve interviewed people that had babies your carriers. And that’s a very common thing that if it’s due to something dramatic, like someone had a hysterectomy at one of their births. You know, again, frequently they’re, like, the next day, “I am, like, deep into this already,” you know, “I’m gonna deep dive into carriers. And where are they? What do I do? Who do I talk to?” And it’s therapeutic in a sense because there’s, like, this hole in you and it’s the only way you could start filling it, in a sense.

Dr. Kalik: And also, it gives you a sense of control, because with these types of scenarios, you have no control. It’s nothing that you did wrong. There’s nothing you could have done to prevent it. And so you have to gain back some of your control by making phone calls, what the next step is.

Dr. Fox: “Look, I can’t meet now because I’m on magnesium in the hospital, you know, but next week.”

Dr. Kalik: Exactly. And I had embryos left still. I ended up having to make more embryos later on. But yeah, Jeff and I really wanted to have a biological baby. I mean, we just did. And we had embryos.

Dr. Fox: Right. So there wasn’t like a mental shift you had to go through. It was pretty quick. Because, again, obviously, people grappled because, you know, it’s unusual, obviously. But, you know, so some people have just sort of that hurdle to get over.

Dr. Kalik: I mean, I had a lot of feelings about it throughout and during and still, but none of those things were strong enough to prevent me from moving forward.

Dr. Fox: Sure. Sure.

Dr. Kalik: And also, I knew, you know, time was ticking. We’re getting older. Jeff’s a few years older than me. And, you know, I’d already been so many years, like, to get to this point.

Dr. Fox: Right. I mean, from the point you first started getting pregnant until now, how much time has elapsed?

Dr. Kalik: Let’s see.

Dr. Fox: Years.

Dr. Kalik: Yeah. Three or four years.

Dr. Fox: Three, four years. And you were saying before, you know, your body’s been pregnant how many weeks?

Dr. Kalik: I had 60 weeks of pregnancy, of all these pregnancies. And no baby.

Dr. Fox: Yeah. It’s a lot.

Dr. Kalik: Yeah. It’s a lot. Yeah. So we started that process and we found an agency quickly that was recommended by my REI. At that time in New York, gestational carriers weren’t legal.

Dr. Fox: Right. You had to go out of state.

Dr. Kalik: You had to go out of state. Now they are. I don’t know how that’s changed. I don’t know if you’re seeing any patients.

Dr. Fox: Some. Yeah, we are.

Dr. Kalik: So we had an agency out in New Jersey and you have to…there’s a whole process for matching with a gestational carrier, which takes time. Our first carrier, it was actually pretty. At first, we thought it was great because she was an experienced carrier, meaning she has had her own pregnancies as well as been a gestational carrier a couple of times. So, like, “This is great. What can go wrong?” Well, three transfers in, she still wasn’t pregnant. We’re running out of embryos. So we actually had to, you know, sort of end our contract with her.

Dr. Fox: Yeah. That must suck for the carrier, too, because they want to they want to do this, you know.

Dr. Kalik: It was really…it was hard. She was not medical. And even though she’d been through this, she was like, “Oh, let’s do another transfer.” And all the doctors involved were like, “We don’t know why. Your embryos are healthy. Everything looks good on paper and blood work, but she’s not getting pregnant.” And, you know…

Dr. Fox: Switch.

Dr. Kalik: “You have to make a change.” So that’s another, like, you know…another year has gone by that followed that. So we were back on the list on the waiting period with the agency. And, you know, my best childhood friend, you know, even when we started this, had sort of, I thought, jokingly said, “I’ll do this for you.” She and her wife had had two children. She carried one of them and gone pregnant through IVF with a sperm donor. I never really thought she was serious. And that seemed like a lot of emotional, you know, complication to have a really good friend do it. I’d always thought, “Let’s keep this more separate.” But, you know, Jeff and I talked about it, and I was like, “Maybe she really meant it. And let me really talk to her about this.” And so I called her and I was like, “You know how you said you wouldn’t mind carrying my baby? Did you really mean that?” And she was like, “Yeah.” She’s like, “I really…” So then we actually, like, had a real conversation with me and my husband and her and her wife. And we talked about it.

Dr. Fox: That’s a pretty good friend.

Dr. Kalik: Yeah. Oh, I mean, yeah, like, there’s nothing I can do to thank her. So we had a conversation and we talked about it. And she was like, “I really…I can do this for you.” And, I mean, like, it’s just such a gift. And so we did bring her into the agency, so to speak, because I wanted to make sure.

Dr. Fox: Make it official.

Dr. Kalik: Yeah, we made it official. There was a contract. I mean, it’s a big deal to carry someone else’s baby. It’s not like, you know, picking up, you know, something at the store for them. So that took some time, but it was a lot faster than waiting for someone, a regular person through the agency. And so we did all that. First transfer with her didn’t work. And now we were down to two embryos. I had done two more retrievals, like, for this process. So in the whole thing, I made a total of 10 embryos. And now we’re down to two. Second transfer worked with her, though. And she had, you know, picture perfect pregnancy.

Dr. Fox: For the pregnancy, did you go to all the visits? Like, how did you do that? Because everyone does it differently.

Dr. Kalik: So she lives outside of Boston and we went to the anatomy scan. I mean, we talked about it. Like, you know, this is someone I talk to regularly. And so that was the only visit we went to just because, you know, like, it was complicated scheduling-wise. But she was great. And she, you know, knows how neurotic I am. And I’m a doctor. So that made it very easy because, like, she would tell me what happened right after the appointments. The OB was willing to speak with me if I had questions. And luckily, it was a very… You know, I kept waiting for the disasters. But, like, she’s good at being pregnant.

Dr. Fox: What did her, you know, her kids…like, how did that dynamic work?

Dr. Kalik: You know, they she didn’t tell her kids until she was about 20 weeks pregnant because she waited a long time. And because they have sort of a non-traditional, you know, they used a sperm donor and all this, her kids at the time, I think they were eight and six or five and something like that. Or no, eight and seven. Her kids are 16 months apart. So they already understood the concept of, like, sperm and an embryo. So they had that language. So she just told them that, you know, “Lisa needed a uterus.”

Dr. Fox: It’s amazing.

Dr. Kalik: “And that’s what I’m doing.” So, yeah, so they were they thought it was really special. And the good, I think, was really… And it was a little bit different with, you know, subsequent [inaudible 00:37:11]. But with my friend, because she knew me and because she was doing this for me very specifically, like, she, you know, could stay very separate emotionally from the…meaning there was no…I think it was a little bit harder for my other carrier with my daughter. You know, it was like she knew that this was my, you know… So there’s no…like, it was really easy for her in that sense. Like, I remember when she delivered the baby the next day, she’s like, “Okay, I’m going home. See you. See you in a week.” But it was, I mean, she had a very healthy pregnancy. And we did decide to induce her just so that Jeff and I could, you know, plan it and be there and everything. The induction went fine. And we were all there when my son came out.

Dr. Fox: Wow. What was that like?

Dr. Kalik: It’s really crazy. I mean, first of all, to have a live baby that, you know, is, like, your baby. For me, I’ve had all these non-live babies. That part of it was amazing. But yeah, the baby came out. He looks more like me now, but in that moment, he looked really like my husband. And we, you know, put the baby on her belly. And, like, everyone put their hands on it. So he got lots of, you know, immediate touch from everyone. I actually didn’t do lactation, which is a whole other, like, part of the story. But I was wearing a hoodie with, you know, like, just skin underneath. And I just, like, took him in. And, like, you know, tear in my husband. It was just so emotional to see this baby that was ours after the whole… You know, at that point, he was born in 2019, so…

Dr. Fox: Over five years.

Dr. Kalik: Yeah. Over five years. No. We got married in 2012, so it had been, like, six or seven years with just so much loss and disappointment, and then here was this, like, baby in our arms. And I was relieved that my friend was okay, because it’s also…I mean, especially because it was a friend. Like, I didn’t want anything bad to happen to this generous person who’s… Because to me, pregnancy is so dangerous. I don’t know how anyone has a baby without dying. So that was always on my mind. So I was glad when, you know, she was safe and healthy. And here was this baby that we got to bring home with us.

Dr. Fox: That’s crazy. I also remember vividly when we all found out that you had a baby.

Dr. Kalik: Yeah, I texted all of you guys.

Dr. Fox: And it was just like, “Oh, thank God.” Because, you know, it’s like these things weigh on you, you know. Like, this poor woman, you know, what she’s been through, and, like, we couldn’t help her. There’s nothing we can do for her. And it’s like she’s out there in the world, like, in misery. And it’s very hard to know that. And then it was like, thank God you made us feel all better. We’re like, “Oh, my God. Finally. Thank God for this family.” Like, you know, they have some happiness. And it was just awesome. It was so cool.

Dr. Kalik: And I think anyone who knew us and knew this story, everyone was so happy because it seemed like such a magical miracle. We had this healthy baby. And yeah, I mean, in the meantime, while this was going on, we were still working with the agency and we had actually matched with another carrier for a second journey. So when my son was…I think he was 9 or 10 days old, we transferred another embryo to this very kind woman who was living in Washington, D.C. And it was our last embryo. I had a 10-day-old baby. I couldn’t even go to the transfer because I just had a 10-day-old baby. And she got pregnant.

Dr. Fox: Wow.

Dr. Kalik: Yeah. My son was born in May of 2019. And my daughter was born in January of 2020.

Dr. Fox: Right. So you, by surrogate, were pregnant for 17 consecutive months, basically.

Dr. Kalik: Yes. Essentially. Yeah.

Dr. Fox: Wow.

Dr. Kalik: And my daughter was born in January of ’20. And six weeks later, you know, COVID happened. So we had these, like, two babies under my…

Dr. Fox: How far apart are your kids?

Dr. Kalik: They’re eight months and three weeks.

Dr. Fox: That’s unbelievable.

Dr. Kalik: So, you know, that time, because they’re so close together, confuses a lot of people. Because, you know, it’s hard to get into this whole story with, you know, random people that you’re meeting. So it’s, like, you know, a lot.

Dr. Fox: They’re a year apart.

Dr. Kalik: Yeah. I just say they’re a year apart. For the people that know me well, I get into it. But, like, they’re a year apart.

Dr. Fox: I was just talking to [inaudible 00:41:28] before because I said you were coming in and she’s like, “Didn’t we have someone?” I was like, “Yes, we had someone who had a carrier who was pregnant. And then she got pregnant.” They’re doing for, like, infertility. And so, like, she has kids who are, like, three months apart. People are like, “What?” Like, yeah, it happens.

Dr. Kalik: Yeah. I’ve heard stories like that. Yeah.

Dr. Fox: Yeah. And they’re siblings, right? Because, you know, they’re genetically siblings and they’re just born three months apart. Okay. You know, whatever.

Dr. Kalik: Yeah. But it’s actually nice because they really…especially now, they’re aged four and five, and they’re friends. I mean, they also, you know, fight with each other.

Dr. Fox: Sure.

Dr. Kalik: But they love each other. And I’m so glad that my son has a sibling. You know, the pregnancy with that carrier went basically…there were some, like, questions that came up on an anatomy scan. But it all was stressful because she had to get an MRI. But it all, you know, worked out.

Dr. Fox: Overall, though, since you had just been through the process, I imagine there was probably a little bit of, like, relief, you know, the second time around.

Dr. Kalik: There was.

Dr. Fox: And you’re also busy with a newborn. You don’t have time to think about these things as much.

Dr. Kalik: Yeah. And I was much more separate from that pregnancy because it wasn’t a friend. I mean, it was more…I don’t want to say business, but it was more of a…

Dr. Fox: You didn’t have a relationship with this person prior, you know.

Dr. Kalik: And we do keep in touch. Well, I keep in touch with her, you know, not all the time, but we send pictures.

Dr. Fox: I think that’s pretty common.

Dr. Kalik: When I left the hospital with my daughter, it was a lot harder for her than for my friend, because I think with my friend…

Dr. Fox: Was that her first time being a carrier?

Dr. Kalik: It was her first time being a carrier.

Dr. Fox: Yeah, that makes sense.

Dr. Kalik: And, you know, she was postpartum. I said, “Do you want to hold the baby?” and she said, “No.” And I said, “Okay.” And, you know, I asked the social worker to check on her. I’m like, “Just make sure she’s okay. She’s really emotional.” And, you know, but I think for her, she knew that, you know, we would keep in touch, but we don’t have a relationship. So, like, her connection to this baby that you’ve been carrying was ending. And I think that was hard for her a little bit in that moment.

Dr. Fox: Do your kids know?

Dr. Kalik: So good question. We recently told them. It was never a secret.

Dr. Fox: Yeah, but when you tell them, like, what’s the difference, you know?

Dr. Kalik: But I was starting to feel like maybe they were going to hear something from someone else and I wanted to explain it to them. And I didn’t want them to think it was a big deal or that it’s, like, abnormal, even though it’s unusual. I wanted it to just be woven into the fabric of their lives. So just, like, a month or six weeks ago, we sat there and we’ve gotten…there’s a book about a kangaroo.

Dr. Fox: Yeah, a kangaroo pouch or something. Yeah.

Dr. Kalik: So we read them that book. And then I have two little books about their stories. I actually brought them to show you. My friend who carried my son, she made a little board book about his story, and then I made one for my daughter. So we read the kangaroo book. I read them their books and I basically said, I was like, “Mama had a boo-boo,” because I didn’t know how to explain preeclampsia. So preeclampsia is my boo-boo. “And so I needed, you know, my friend and this other woman to help bring you into the world.” And I’m, like, so emotional, crying, you know, silent tears.

Dr. Fox: And they’re like, “Cool.”

Dr. Kalik: They’re like, “Okay, mama, let’s go play.” And I’m like, “Oh.”

Dr. Fox: They’re like, “Wow, cool. All right. I’ll tell my friends. Thanks.”

Dr. Kalik: Yeah. Which is really how it should be. Like, I don’t want it to be a big deal.

Dr. Fox: These kids are better equipped to handle the world than we are, you know?

Dr. Kalik: Yeah. And my son, my five year old, I don’t know. I think my daughter has retained it, but she hasn’t really talked about it. But she’s sometimes…like, I feel like six months from now, she’s going to say something about it. But my son has brought it up a couple of times and he understands. He was like, “You had a boo boo. You needed my friend to put her in my belly.” And it’s like, that’s okay. And actually, I told them I was coming here to tell the story about how they were born. And my son said, “Oh, you should bring the books that you have to show the doctor.” So, yeah, so I think they’re just like, “Okay, that’s how it happened.” And actually, my son today said, “Well, don’t a lot of people do this?” Like, to him, which I was so happy about. I’m like, “Good. He doesn’t feel like this is a stigma.” I was like, “Well, you know, a lot of people do it, but not everyone has babies this way. So I want to tell the stories in case it might help other mommies and daddies who, you know, want to have their babies this way.” So, yeah, so they know. And I’m relieved. It was starting to feel stressful to me that they didn’t know, because, you know, things that are secretive seem shameful and bad. And, you know, this is…

Dr. Fox: Yeah, it’s just hard. At what age are they processing this? And so, you know, and probably to be revisited as they get older and understand more and start to say, “Wait, huh?” and then start to think about it and biology and all that stuff. But that’s just day to day. You know, when you’re running around, you’re working, you got two kids. Does this come up at all? Like, you know, do you think about it or, like, do you have to talk about it at any time, or is it just only if there’s, like, a deliberate conversation like this?

Dr. Kalik: I think it doesn’t come up, but I do think about it. I think my husband doesn’t think about it at all.

Dr. Fox: Men.

Dr. Kalik: No, but also, like, it didn’t happen to him physically, the whole experience. So I think that my grief process with not being able to carry a baby is what I deal with the most still. Like, I’m not over it, for lack of a better way of saying it. You know, I think it was so traumatic for me. And, you know, I’ve talked about it. I mean, I have therapy. I mean, I’ve done all the things. But I think I still feel very sad that I wasn’t able to carry a pregnancy successfully. And so I see pregnant women. I see patients who have just had babies. So it’s in my mind. It doesn’t come up out loud a lot. And, you know, when I’m with my kids, I mean, they’re my kids. Like, there’s no bonding issue or, like, worry that I’m not their mom or anything like that. And I think now that they know about it, that feels better, too, because I don’t want them to, like, I don’t know…I don’t want them to question, like, who their parents were. But I think that that grief is still there.

And that’s the other, you know…again, like, that… And that grief feels very lonely now because… I have two. And I’m so grateful and I’m so happy, and my kids are wonderful, and, you know, I wouldn’t want it any other way, but I still feel sad about what happened. I mean, I think it’s like any loss or grief. Like, it never goes away completely. And, you know, certain things trigger it. And, you know, I, of course, have gone to baby showers and had pregnant friends and all this over the years. And, you know, when I still hear those things, I still have, like, little twinges. Like, I couldn’t do that. You know, why couldn’t I do that? And I think some of it is also, you know, my own perfectionist… Because in a way, it doesn’t matter. Like, I have my kids. The process, you know, shouldn’t matter. But it still matters to me. That’s just being honest about it. And I think that’s important for people out there to know who have struggled with infertility and loss. But I think it’s a pain to continue to have feelings about it because it’s such a hard thing.

Dr. Fox: Yeah. I mean, that’s a theme that’s come up a lot on this podcast where, you know, you can simultaneously feel very blessed and grateful and have tremendous loss over bad things that happened. And they’re not exclusive. You know, they’re not mutually exclusive because it’s true. It’s no different. If someone lost a parent, you’re grateful you have your other parent, but doesn’t mean you’re not sad. You lost your parent. Like, of course, like, people grasp that and so many other aspects of life. But for some reason, with, you know, fertility and having children, there’s this thought that, okay, you ultimately have your baby or your babies or your family, so all’s good. But like, no, like, all’s not good. You know, horrible things happened to you, and beautiful things happened to you. And you have to walk through life with both of those. And you will. Are there, like, certain dates that trigger? Like the date you delivered or the date you were due. Like, those are frequently… Or Mother’s Day. Things come up sort of on the calendar.

Dr. Kalik: It’s the delivery dates. The two major pregnancies. I mean, obviously, I’ve had five pregnancies, but the two preeclampsia pregnancies.

Dr. Fox: So, like, those birthdays, I guess.

Dr. Kalik: Those birthdays. And nobody… I mean, only my husband, who barely… I mean, he tries to remember because he knows it affects me. And he’s honest about it. You know, for him, I think he was, of course, so sad, and he’s sad that I still feel lost, you know, and feels sad about what happened. But I think for the partner in these scenarios, once you’ve gotten to the happy ending, I think it’s easier for them, or they don’t think about as much about what happened. But yeah those days are so hard for me. They’re not as hard for me as they were, you know, initially. And, you know, the other thing that’s…you know, we all have memories in our life, but there are some of those moments from those pregnancy losses that I can see. It’s like a movie reel in my brain. I remember, like, walking to the subway that day, like, coming up to the hospital. It’s like it just happened. You know, there’s certain moments that are just so, you know, so strong in my mind, the visual images of it. And those, you know, they pop into my head. I think about it. And I think it’s just part of…I think it’s like processing trauma, honestly.

Dr. Fox: It is. It’s exactly processing trauma.

Dr. Kalik: It is. But overall, you know, I am so grateful. And I think I’m a slightly older parent, although by New York City standards, not necessarily.

Dr. Fox: Slightly.

Dr. Kalik: Slightly older. I mean, 47. I think in some ways, that makes it easier to be a parent because you’re a little more relaxed about things. But I am grateful. I mean, I have two healthy kids. I mean, the fact that I got one healthy kid was a miracle after all the things I went through. And, you know, we pushed ahead and went for a second. And so I’m grateful. I mean, they’re healthy, adorable. They’re funny.

Dr. Fox: It’s great. You sort of sprinkled it in throughout the podcast, but has this experience sort of changed your interactions either with friends and family or you as a doctor with your patients? Because there’s both. There’s sort of, like, the social aspect of this, but obviously there’s a medical aspect to it as well.

Dr. Kalik: I mean, I take care of adults, obviously, but I have a lot of female patients of reproductive age. And, you know, I have a lot of patients who deal with infertility. I mean, I’ve always been empathetic, but I think I have extra empathy. But I have to remember…I mean, there have been times where I’ve wanted to share. Some of my patients do know what happened that were around at the time, my longtime patients. You know, other patients, sometimes I do have this urge, like, “I know how you feel.” But I have to, you know, be professional and, like, you know… So it’s a fine line. And I get very nervous, I will admit, when I see, you know, pregnant patients in their second and third trimester, and I go in to read their blood pressure and I’m like, “Please let their blood pressure be normal.” But actually, this past year, I saw someone who happened to be coming in for a checkup. She was, like, 23 weeks pregnant. And her blood pressure was through the roof. I mean, she ended up having a healthy baby, but it was scary for me. You know, like, I’m human.

Dr. Fox: Yeah, it’s triggering.

Dr. Kalik: I was just, like, calling her OB and I’m like, “Got to [inaudible 00:52:42].” Like, “I can’t handle this.” But yeah. So I think in that sense, it does bring up a lot of feelings for me when I’m dealing with pregnancy or pregnancy-related issues. But I think I also have a lot of empathy for it, or more empathy than I would have. And I also have more knowledge. I think as an internist, I have more knowledge than average about infertility and pregnancy loss and complications because of what I went through.

Dr. Fox: And probably preeclampsia.

Dr. Kalik: I wish there was more expert stuff on preeclampsia. It’s such a crazy disease.

Dr. Fox: It is. It is absolutely crazy.

Dr. Kalik: And I don’t know if your listeners know this, but back in the day, it was called toxemia, right?

Dr. Fox: Back in the day.

Dr. Kalik: Yeah, I actually think in some ways, it’s a better term, because, like, physically, that’s what it feels like. You feel like you’re being poisoned. I think that’s where the name originates.

Dr. Fox: Yeah, no, it originated because it’s basically your body saying, “This pregnancy is killing me,” you know? And if it stays inside, it’s going to… It is. It’s like it’s a toxic pregnancy. I think they took it out because, for most people, they will deliver a healthy baby and they didn’t want to say, like, this is… I have no idea, actually, why they renamed it. But yes, it was not incorrectly named. It was just maybe they wanted to soften it, you know.

Dr. Kalik: But yeah, but I do feel like we beat preeclampsia. I do feel like we won. And, you know, just for your listeners, and as an internist, I worry about patients who have had preeclampsia, including myself, because there are increased rates of high blood pressure down the line and heart disease. So that is something that I monitor in myself. And my blood pressure has been good, but, you know, I worry that I’m going to have cardiac complications from this down the road. Although I think in some ways, because my preeclampsia was so early at both times, I didn’t have it, like, swimming around in me for too long.

Dr. Fox: Yeah, there’s also two theories, and they’re probably both true, whether the preeclampsia actually changes your, like, physiology, your blood vessels. And there is some data to support that. But it’s also probably there’s something that people who get preeclampsia may have some susceptibility, whatever that is. It’s genetic. I don’t know. So that we haven’t exactly worked out. But yeah. So people have preeclampsia in pregnancy for one of those two reasons or both have a risk of hypertension. I’ve seen things like diabetes in pregnancy. That’s more the latter. We don’t think the diabetes actually changes someone’s metabolism. It’s probably just a risk factor. Yeah, something about it. So we think. But, you know, who the hell knows?

Dr. Kalik: Well, I found, and I don’t know if there’s any data to support this. Don’t quote me on this. But I have found that a lot of my…

Dr. Fox: I won’t quote you, but you’re recorded, so, yeah, everyone else might.

Dr. Kalik: This is not evidence-based. This is anecdotal. I found that a lot of patients who have white coat hypertension with me very commonly get preeclampsia.

Dr. Fox: Yes. No, absolutely. I think there’s something… I agree.

Dr. Kalik: So then there you go.

Dr. Fox: White coat hypertension is one of the funniest names of things. It’s where your blood pressure is high, like in a doctor’s office, but it’s normal at home. And the thought is you come to a doctor’s office and we freak you out a little bit, and everyone’s a little nervous to go to the doctor, and your blood pressure is a little bit high. And it’s called white coats because many of us… I actually don’t wear a white. Yeah, I don’t wear a white coat. For me, it should be called, you know, gray scrub hypertension. But yes, I think that there’s probably something to it that their blood vessels are more reactive or something. Because most people, if they’re anxious, you check their blood pressure, it’s not high, right? So who knows? It is interesting. Look at that. We’re sort of shifting into medicine here.

Dr. Kalik: Yeah.

Dr. Fox: Wow. Amazing. Thank you so much for coming in and telling your story. I do think it’s really important for people to hear it and to know, like you said, this does happen to people. For those who are listening to whom it happened, you are not alone. Others, unfortunately, have gone through this. Also, for the majority of people listening who have never gone through this and will never go through this, to understand that it does happen to people. And if you hear stories about your friends and they lost a pregnancy, like, sometimes it’s more than you think. And just to really, again, that extra empathy. And it’s still going to be there years and years and years later. It doesn’t go away. And sometimes for people telling it, it’s nice. It’s memorialized. Your kids can hear this. You know, as long as this podcast lives on in Apple, they’ll be able to hear it, or wherever they’ll be dropping, Spotify. Yeah, cool. But thank you. I really do appreciate it.

Dr. Kalik: Thank you for having me. And thank you for taking care of me.

Dr. Fox: It was a pleasure. Thank you for listening to the “Healthful Woman” podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day. The information discussed in “Healthful Woman” is intended for educational uses only. It does not replace medical care from your physician. “Healthful Woman” is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.