Ectopic, round 2

[CamLe]

I had been writing on the ‘next pregnancy’ board, but my story turns out to be more relevant for the main board. It's a bit long, so feel free to skip ahead..

Last February, I was diagnosed with my first ectopic pregnancy at 7.5 weeks, after being woken up in the middle of the night by violent cramps on my left side. It was my first pregnancy, and I had gotten pregnant on he first month TTC. I ended up needing 2 doses of MTX, which completely wiped my energy for a good 1.5 months.

We started TTC again when we could, though initially not trying too hard because I still felt so nervous about getting pregnant. Sept was the first month I felt we really did try. When I started getting cramps, I was sure it was my pre-menstrual cramps (they’ve been intense since the ectopic). Then I started bleeding on Oct 13 and thought that was my period until after a few days it became clear I was only spotting. I felt dull pain on the side of my former ectopic for about 24 hrs, so by Oct 16 I took a pregnancy test and found out I was pregnant. Called the clinic right away and got booked for the early US on Oct 18. Then we were back in the same room as the last time. They saw something small in my uterus they couldn’t identify, and then found a mass on my left side again that they labelled ectopic right away. I’m in Canada and the clinic doesn’t do the surgery, which they strongly recommended given it was my second EP on the same side. They sent me to the general hospital, said they would expect me when I arrived, and that I’d likely get surgery the same day.

We got to the hospital, and all of the sudden they revised the diagnosis to ‘probable’ ectopic and told me they couldn’t see the gestational sac on the US, nor confirm what they things in my uterus were. So, they decided we should wait 48 hrs for the HCG trend and get another US. A stressful 1.5 days ensued, after which we went back to hospital on Oct 20 for blood draw + US 2. After the US they sent us to wait in the ER for a few hours. Physically, I felt fine. When they came to find us in the ER, they told me they though I had a ruptured EP and needed surgery asap. All of a sudden, I was in a bed with tons of medical professionals around, and wheeled up to prep for surgery. As I was talking with the anesthesiologist, the OB-GYN came back and told me they had just received my HCG results and that based on that info + another review of my US, they actually only thought there was a 30% chance it was ectopic, and 60% chance it was intra-uterine. So they stopped preparing me for surgery, but decided to keep me under observation because they had suspected a ruptured EP and didn’t want to take chances. I was set to have yet another US and blood draw the next day.

Finally, on Oct 21 they came to my hospital room and told me it actually really did look like an EP on my third US. The structure they had initially identified as the EP turned out to be the corpus luteum, but now they could see another mass next to it that they suspected was the EP, and the things in my uterus had not grown in size and seemed too small for how high my HCG was. They recommended surgery again, but this time because it was considered less urgent (not ruptured), I waited all day before getting it.

And that’s it. Now I’m one tube and another pregnancy lighter. At least this time with the surgery they recommended and I am taking proper time off work. My emotions are a mess and I feel like I’m randomly feeling all the things I should have felt while this mess was unfolding just now – fear, anxiety, sadness… I’m relieved that I don’t have to be scared about rupture or pain this time like I was last time with MTX because the pregnancy is gone. Also sad and angry because they had told me it was random bad luck last time, but as soon as they found what they thought was an EP this time they jumped straight to ‘you’re more at risk with your history’. And just so unsure what the lesson is in all of this. So far in my adult life my only serious health issues have been my two catastrophic pregnancies.

I am grateful for this organization + forum. Last time, I had found it while trying to figure out what they [heck] they had meant saying I should watch out for ‘shoulder tip pain’. At least this time I felt better equipped and inform going into it – thank you, deeply.

[Ellie89]

Hey,
I'm so sorry you went through this twice. I'm currently going through similar and similar dates to yours too.. I started bleeding beginning of October and thought it was my period.. I took a pregnancy test as it seemed a little off for my normal period and was a vvfl. 2 weeks later I started bleeding again so I called the EPU and was scheduled for a scan on October 18th. I went in where I was told it was an ectopic pregnancy iny right tube but that my HCG level was low enough to manage conservatively (also known as expectant management) my HCG levels have slowly crept up and I was offered methotrexate booked on the 24th, however I ended up on A&E with what can only be described as period cramp. I was monitored overnight then scammed in the morning, again iw as told all was okay no change in the ectopic but there was a small hemorrhage around it which was the cause of the cramps and spotting due to my body attempting to resolve the pregnancy itself and that in their opinion it's not a good idea to have the injection until I've had bloods 4 days later.. that takes us to yesterday when I had bloods and this morning I got the call to say my bloods are still suboptimally rising and that I will need the injection after all but I now have to wait til Monday as the chemo suite isn't open over the weekend xx

[CamLe]

Hey Ellie,

I'm so sorry you're going through that, and soeeu for your loss . The wait can be so stressful. My first ectopic was treated with mtx and even after receiving it I was si nervous about rupture and all. Now having had the surgery I don't need to worry about that but still I started bleeding last night (which I guess would be my uterus lining coming out) and it sent me into full blown panic feeling blood gushing out all of a sudden. EP is a scary expérience to say the least..

To answer your question on your other post, my levels when I received mtx were just slightly lower than yours. I ended up needing 2 doses because after 7 days I obly had devreased 13% and they want to see 15% drop. I don't think the level you're at is necessarily the biggest influence on how well it works, and I've certainly read on this forum women who started higher than you and got good results from mtx, so I'll have my fibgers crossed for you.

How are you feeling now, as you wait for Monday? Sending hugs, xo Cam