Possible Pregnancy After Tubal Ligation: Symptoms & Advice

Question
My age is 40.  I have 2 children 15 & 13. The first day of last last cycle was 10/3/05.  Then I had a very light one maybe a day or so the end of December.  I have not had one since.  I had my tubal 13 years ago after a c-section.  I am hoping it is all in my head but I am tired, I fell some movement in my stomach.  I have been on the Atkins diet for about 3 weeks now and have lost some weight.  Please give me any advise because I think that I am too old for this.  My life is no longer as stressful because my husband came back from Iraq the end of September.

Answer
Any time that you miss one or two periods, you have to rule out pregnancy (even if you had a tubal ligation in the past). I would suggest that you get a pregnancy test as well as a pelvic sonogram. If your last period started on October 3, and you did, indeed, become pregnant, yuou wold now be  around 18 weeks pregnant and would see a fetus in the uterus. It is still too early for you to feel fetal movement, but you may feel nauseated, fatigue, and breast tenderness. Thirteen years ago, when we performed the Pomeroy tubal ligation (at the time of a cesarean), we merely made a loop in the tube and tied it off at the base of the loop, and cut off the ends. However, sometimes, "recanalization" could occur at the base of the loop and result in patent tubes again. Check it out.