Ectopic Loss

g'morning, all...

i have an appointment with my OB this morning at 9 am to pick up paperwork for the MTX shot, which i will get later in the day at the hospital. i'm a little nervous, don't know what to expect. when i get the paperwork, the doc will talk to me about that stuff, but in the meantime, i'm just a little worried.

my story, as short as possible:

i was scheduled for a minor surgery on my wrist a couple weeks ago, but i had been spotting/light bleeding for a couple weeks after having had what i thought was a light period. i read a little about implantation bleeding so took a HPT and was shocked to see it was positive!

blood test the next day confirmed but with low hCG levels -- 131. US didn't show anything, not even a sac. it was probably still very early, so my GP ordered repeat hCG tests and US, and eventually i had to establish with an OB.

so, on 9/4, hCG was 131, nothing visible on US
9/10 hCG 151, nothing visible on US, but moderate free fluid in abdominal cul-de-sac
9/14 hCG 310
9/15 hCG 329, progesterone 16, cyst visible on US, but no "ring of fire". nothing visible intrauterine
9/17 hCG 379, US showed cyst collapsing
9/21 hCG 333.

throughout all this, i have continued to spot, sometimes light bleeding. lower backache has been intense, due to fluid in abdominal cul-de-sac. breasts have gotten really tender, and i've put on a few pounds. this weekend, i started having some cramping -- about the intensity of a moderate period, nothing severe enough to warrant an ER trip.

when the levels started going up more last week, and the progesterone was within normal range (even though it was low), my OB was hopeful that things could be okay. i have known from the 1st repeat hCG that the combination of my low, slow-rising levels and continual bleeding, that a miscarriage or ectopic was likely, and my husband and i have been prepared for that, while remaining cautiously hopeful. we have been together over 9 years, married over 5, and for the first 6 or 7 years of our relationship, neither of us wanted children, EVER. a couple years ago our outlook changed and while we haven't been charting fertility, we stopped using barrier BC last year about this time (i had been off the pill a couple years before that). we have taken the attitude that we no longer DIDN'T want kids, but we would let nature take its course; if it's meant to be, it'll happen. if not, we can always adopt should we feel compelled to have a child.

so, this pregnancy was slightly unexpected but not a complete surprise. it certainly wasn't unwelcome, just sort of snuck up on us! there had also been some concerns over my fertility due to polycystic ovaries and a very unusual cycle... so we are at least taking this situation as indication that i CAN get pregnant; that's a good thing!

i also found out during one of the sonos that i have a heart-shaped uterus. not severe, but i still may be considered high-risk when i get pregnant again.

anyway, when we got the call last night that the levels are going down and that i would need the shot, i was more disappointed thatn i thought i would be, but we still both know it is for the best. we know we can try again. had this just been a miscarriage, my husband and i both feel that is nature's way of taking care of a pregnancy that would have had something wrong... and with it being ectopic, we just want to make sure I am ok, get me healthy, and then we can always try again (besides, that's the fun part!)

but i am nervous about what the MTX will bring... worried about side effects, anxious about pain... unfortunately, my husband may not be able to go with me to get the shot, but he will be home with me after. and he treats me like a delicate flower when i'm healthy, so he'll really be taking care of me after the shot, for sure! my best friend is going with me, though, so i will not be without support.

luckily, i was already scheduled off work for 3 weeks due to the original hand surgery i was supposed to have (i'm a hairstylist)... and my manager is pregnant having her second baby, and she has had 2 miscarriages herself -- one of which was after having heard the heartbeat -- so she is super understanding and supportive of me during this.

on the positive side, once my hCG levels return to 0, i will be able to have the surgery on my hand, so when i do return to work, i'll be back at full throttle!

i don't know if i'm really asking for any advice, information, or support, i guess i just needed to get all this out. so thanks for reading!

I'm sorry we have to meet under these circumstances, but I'm glad you found our board.  I hope we can be helpful as you are undergoing this stressful time.  I'm glad they figured it all out and you're getting treatment without delay.  I didn't have mtx...mine was a ruptured ep with lap surgery...so I can't tell you about the effects from the mtx.  I can tell you, however, that in my experience, no two women respond the same to it.  Some will bleed heavy, others lighter.  Some will have quite a bit of pain, others very little.  Some will require only one shot, while others may need two to resolve the ep.  You do need to make sure that your doc monitors your hcg levels all the way back to zero.  Oh, and you'll probably see your levels rise until after the 4th day after the shot...that is perfectly normal, don't freak out about it!  Some docs will rush the 2nd shot in because the levels are still rising, instead of letting it work.  Hopefully yours won't do that to you.

I'm glad you have your hubby's support...that can mean everything during a time like this.  You sound like you have a positive attitude thru all of this.  You might want to consider having an HSG test at some point once your cycles resume, to make sure your tubes are open.

Feel free to post, ask questions, vent, or whatever you need.  We've all btdt and we're here to help.

well, the MTX shot was done yesterday, without any complications. i spent the better part of the day waiting in the Women's Hospital triage after they drew what seemed like endless tubes of blood, for all the necessary tests. that sucked, but my best friend was with me to keep me company :)

i found out that my hCG levels had already dropped to 222, from 333 on Monday. so i'm pretty confident that the one dose of MTX will work without needing a second dose.

i got one shot in each side of my bum, and i'm not gonna lie, the shots themselves were pretty painful! after the first one, i felt a little lightheaded, but that is not uncommon for me when i undergo a medical procedure that i'm anxious about, i don't think it had anything to do with the MTX itself.

after 30 minutes of monitoring, i was able to go home and the injection sites weren't even sore.

i was a little tired from all the waiting, and i'm sure from having had all the blood drawn, so i came home and rested. my OB had given me a script for Darvocet to have on hand in case i need it if/when the cramping starts, so i got that filled.

today and most of yesterday have been otherwise pretty uneventful. oddly enough, the spotting had almost completely stopped yesterday even before i got the MTX, and today there is no sign of it at all. my breasts were very tender before yesterday, but now not so much (i'm sure that is also due to the already-dropping hCG levels). also, the cramping i was having sunday night and most of yesterday has almost stopped.

the worst part of this so far is figuring out what to eat, since i have to avoid folic acid... and i'm basically vegetarian so pretty much everything i eat and love is forbidden right now!

i'm prepared that tomorrow may bring back the cramping and possibly spotting. i know there is also the chance i may be very lucky and not have any pain or bleeding, but i'd rather expect it than not. that way if i don't have it, it'll be a pleasant surprise.

my husband is being very militant about not letting me do ANYTHING. i'm bored out of my mind, but i know i have to take it easy. my discharge paperwork even said no housework for 2 weeks! LOL!

i have an appointment on Friday at my OBs office for a blood test to check the hCG levels, and i was told they may rise at first. i'll go back Monday for the re-check, and that will determine whether i need a second dose of MTX. i also asked the OB whether i'll get that test to check if my tubes are open, and she said that'll be later.

so anyway, that's it for now, i guess. just resting and waiting!

I'm glad you're doing ok so far.  I hope you'll continue with little to no effects and that this will be over for your easily.

Yea, the folic acid thing would kill me too...I'm vegetarian as well.  I didn't know about that back when I had my ep...no internet in '95.  I don't even know what my hcg levels got to before I ruptured...stupid RE wasn't watching me closely and just let it go on and on.  Grrrrr.

I'm glad your hubby is making you do nothing...that's a good thing to do and I'm glad he's taking good care of you :-)

Keep us posted on how you're doing.