As I write this I am 4 weeks into my healing and still facing challenges relating to my ectopic (tubal) pregnancy and a last minute surprise I got this week. I live in the United States so some of my experiences may be a bit different from what is typical in the UK. I am sorry if this is long, but this is the type of detail I like reading so, I figured I’d put the effort into writing it.
My husband and I were not trying to conceive when we were blessed with our first pregnancy. It came as a shock as we were using birth control (NuvaRing) at the time. It came time to start a new month of birth control and I had not yet had my period so I decided to take a home pregnancy test just to be sure. It was not unusual for me to miss cycles altogether, but I felt a bit nauseous so I decided to check. Four home pregnancy tests later I was 99.9% sure we were pregnant.
I figured that I was about 8 weeks at that point as when I thought back the cycle before had really been just spotting. So I made an appointment with my Ob/Gyn for two weeks from then. I started reading baby books and getting excited. It was only supposed to be a couple months until we were going to start trying so it was not that big a shock.
The next two weeks I experienced all the normal pregnancy symptoms. I threw up a lot, I had mild cramping, I was EXHAUSTED all the time. I also experienced not so normal symptoms, like pain during bowel movements, and almost constant colicy abdominal pain, but those I ignored and did not mention to my doctor when I went in. My sister said she got constipated and had gas pains during her pregnancy, and maybe I was just farther along then I thought.
At my doctor’s office the first thing they always do is a vaginal ultrasound to help date the pregnancy because us women are notoriously bad at doing so, especially when we were not trying! So I go in at what I figured was about 8 weeks and we went through all the date stuff. I had had a TINY bit of spotting, not enough to need a panty liner, just a couple spots on one swipe of toilet paper. That had happened twice. I guess I thought maybe something was wrong, because I ALWAYS checked my toilet paper.
Then she did the ultrasound and her decision was either 1. I had miscalculated dates or 2. I was having a miscarriage. She decided this based on the fact that she could see a sac (which was hard for her to find) but no poles or heartbeat. She decided to send me in for a 48 hour beta hCG. I drove right from her office to the hospital to get my blood taken crying the whole way. (I had to go to the hospital to get the test because it was a Friday so my second test would be Sunday and she did not want to wait until Monday for the first test that she could do in the office.)
She had told me that she had wanted to see a 66% rise at least in my levels over that time. Mine went from 17,000 to 20,500 only 20%. I did not get my results until Tuesday and they told me to come in the next day to the office and get another level done. That one was 96 hours after my last and was only 25,000. I got the results on Thursday, and was pretty sure I was miscarrying at that point.
When they called to give me the results the nurse said they wanted to see me as soon as I could come in, either Friday or Monday. Thankfully I was upset enough that I decided to cancel a work meeting and go in Friday morning.
On Friday morning they did another ultrasound and this time she had a really hard time finding anything. She had me empty my bladder, and she tried again, and this time saw the sac. But it did not look right. “Well, I think you may have an ectopic.” She said “I want you to drive straight to the hospital.” She told me to go to OB triage and another Doctor from the practice would meet me there and do another ultrasound. If she thought it was tubal she would do a laproscopy. “Don’t worry,” she said “you’re going to be fine.” I did not feel fine.
Dumbfounded, was more like it. I had told my office that I might not be back, thinking I might be scheduled for a D&C but this was no where in my mind. I had even told my husband after my first appointment “Well, at least she saw a sac, that means it’s not tubal!” And then went on with him about dangerous those were and how women still died from those. He talked to some friends who had ectopic horror stories so when I called him on the way to the hospital to tell him I’m sure he was more scared then he needed to be. He was also about an hour and a half away doing sales calls for his job, so I am very glad that he was able to make it to me safely.
Then the fun started. We had moved to the area about a year before, but I usually went north towards Cleveland and not south towards Akron. But the Akron hospitals is where my doctors practice. They told me to go to Akron General and gave me a map. They would call and the hospital would be ready for me. Now, I was very upset, although not crying and doing a good job of holding it together, but that day my mom was moving to my city from another state and a lot was going on, so my mind was not working and I ended up at Akron City Hospital, which is identified everywhere by big signs as “SUMMA” and nowhere as Akron City, and the two hospitals are only a couple miles apart off the same highway! All the signage is similar, as are the colors and shapes of their logos. I think they count on some patients being confused. So I went to the wrong hospital.
I got to OB triage and they did not know why I was there. I said I am supposed to see Doctor X and my office said she was here, but they never said she wasn’t. They did say my doctor’s office had not called, which upset me as they said they would call ahead for me. They had a nurse walk me down to the ER, because unless your doctor calls they only see women more then 20 weeks pregnancy on that floor. Well my doctor was supposed to call! And she did, but the hospital I was supposed to be in.
So I end up in the ER and they tried to get me out of the ER by telling me I’d get my ultrasound quicker if I was seen in Radiology and not the ER. “But…” and I started crying “my doctor said to go upstairs and they said come here and…” They see me pretty quick and bring me back and again I mention Doctor X’s name and no one tells me she is not there! In fact I started to cry again and they put me a room and called my doctor’s office. After that things moved fast.
I still thought I was at the right hospital. But my husband is not there yet. So I called his cell and he says “Where are you?” I said “General where are you?” He asked where in General, I said the ER. He responded that I was not because he was and I was not there! Just then a nurse came in and I asked like an idiot “What hospital am I at?” I handed her the phone and she talked to my husband.
So my hubby drove over and met me as I was coming out of ultrasound, which they got me to very quick once they talked to my Doctor. I told my hubby that if they said I needed surgery I wanted to go to the hospital I was supposed to go to so I could see my doctor, but I guess by the time I was back in the ER my doctor was driving over from the other hospital.
You know you are going to get bad news when the attending doctor in an ER comes in with the resident you’d been seeing until then. The ER doctors came in and explained that the results were “suspicious for an ectopic.” They saw no heartbeat but otherwise it looked ectopic and was defiantly in my tube and since my hormone level was up to 40,000 they decided I need surgery, and they were prepping a room. A few minutes later the OB residents came down and talked to me in more detail and had me sign consent forms. I felt to stunned to really think, let alone feel upset that would come a little later. They said that the surgery should be fairly quick and even though it was already 3:00 that I could probably go home that night, unless they had to give me a blood transfusion. They said there was a small chance that they would have to do an open surgery. They discussed the option of medical management, but said with hCG levels above 1,000 they do not recommend it. They said there was a 95%+ chance that it was ectopic and if it wasn’t it still should be evaluated laproscopically, because obviously there was something wrong.
It felt like an eternity I was sitting in the ER room with my hubby, looking at a poster on the wall on how to test men and women for STDs (insert brush 1-2 cm and…!) But in reality it was only half an hour. I starting hearing them come over the loudspeaker and say “Room ready for 21” and my hubby said that was me. They came in and started my IV and all that fun stuff, and up I went.
I have had a ton of surgeries in my life (12), some pretty major, mainly on my ears but once on my gallbladder laproscopically, so I thought I knew what I was in for. When I got up to the OR I met my doctor for the first time, she had come over from the other hospital and even though I had never met here, just knowing she was in practice with my doctors made me feel good. She had me sign another consent form saying they were going to do a D&C first, just to be sure. As I signed that form, laying on my back, the reality kind of hit me. When I signed a form for the baby in my tube it was life and death for me, and if I had not consented my husband would have knocked me out so he could have signed it for me! But now they were saying that maybe it was in my uterus, and if it was, I felt like I was signing a death warrant.
As I laid there, the female OB resident came over and held my hand, which was so kind. And as I laid there on the table I actually started to cry, which I never did before, even as a child. I was trying not to, but tears were rolling down my cheeks as they said “Try to count backwards from 100…”
I woke up in the recovery room a couple hours later and I knew something was wrong, because I hurt! The nurse was right there and asked if I wanted any pain meds, which I did! And I was out again. I was in and out for a little while. It turns out I was in there about 3 hours, and my hubby in the waiting room was really starting to worry. He had spoken to the surgeon, but she had said I would probably only be 90 minutes or so in there.
I woke up again and the nurse asked if I wanted anymore pain meds. I said no and asked why I hurt so bad. She told me that they had been unable to do the laprosocpy and had to do an incision, and I would be staying in the hospital overnight. I saw a blurry clock over in the corner (no glasses) and I thought it said 8:30, I asked and sure enough it was 8:30! She asked again if I wanted pain meds, and I had a blurry recollection of her saying to another patient that if she took them she would not be able to go to her room for another half hour. I asked if that was the case, which it was. I said “No, I want to see my husband.” She said they could bring him back, by that time I was the last patient in the recovery room. But I didn’t want to see him, I wanted to be with him, and I had tons of questions running through my mind, so I said no I wanted to go to my room.
It ended up that it took them about half an hour before anyone came and got me for my room, and by that time I was in a lot of pain, and it was SO hard to switch to my bed from the gurney, even with help, but I did it. My hubby came up and gave me a kiss and sat with me about an hour and then he had to go home to put the chickens in. (We have a small farm, and if the chicken coop door is not closed at night a raccoon can get in and kill them all.)
Now I don’t mean to bore anyone to death, but it feels kind of good to write this, so I am going to keep giving some details, and feelings and stuff, and if you are done reading this amazing long story, that is fine with me. Thanks for reading this far!
About 11 that night the nurse came in and told me I had to get out of bed and sit in the chair for half an hour, if I thought I could. She said it was important to get up as soon as possible. I still had the catheter in, and was a little nauseous from the morphine they were giving me, and don’t get me wrong it hurt! But it was not as bad as I feared and she and an aide helped a lot, and they showed me how to roll so it did not put pressure on my abdominal, and I really think it is important to get up as soon as you can. The next day as soon as they took my catheter out I was getting up myself to go to the bathroom without help.
The next morning I got the initial scoop from the Doctor, not that I remember this to be honest, but my husband says she came in and talked to us and repeated what she had told my husband the night before… I was still on morphine. She said that it was as large an ectopic as she had ever seen, the size of a large plum. It had not yet ruptured, but could have at anytime. (Hence, my comment at the beginning that I was lucky I went in Friday and did not wait until Monday!) It had so distorted my tube that she could not see if there was any diseases present before the ectopic, but there would have been no way the tube would have functioned normally so they took it. The risk of rupture was so high that she did not feel safe doing the surgery laproscopically so they did a laporotomy instead (that is an incision like a c-section one on your bikini line, mine is about 6 inches long (sorry UK = 14cm.) She looked at my other tube and it looked fine, and they saw no evidence of anything else going on, and my fertility should be unaffected.
I stayed in the hospital 2 nights total. All in all it was OK and I don’t remember much. They switched me to Percocet from Morphine the first day, it was as needed every 4 hours, so every four hours I was waiting for the clock and would press my nurse button. I think I was annoying the nurses, but I was more work then they were used to on a high risk early maternity ward, where women stayed for weeks sometimes to stop labor. But at least I was in a private room.
That was especially nice the first time I got out of bed to go to the bathroom after they removed my catheter. They had said “You can ask for help the first time you go to the bathroom if you need it.” I took that to mean “Don’t bother us unless you have to.”
(This may be a TMI paragraph!) So I carefully rolled off my bed, and got on my feet OK. Then I started to feel moistness. I hobbled around the bed, and by the time I got to the other side I had a stream of something rolling down each leg! I looked down and had trailed little drops of blood all around the bed. It was not a huge amount but enough to totally freak me out. So I pressed the nurse call button, started to cry, and stood there until someone came in.
She said “Oh, yeah, we should have told you that could happen!” (Note to others: So beware the D&C, that can happen, ask for and put on a pad and panties before you get out of bed!) That was actually the end of any bleeding I had from my D&C or surgery, it was just really freaky.
My third day at the hospital I was woken to a nurse coming in and saying “Oh, you’re still here?” Which was a pleasant way to start the day. I had just had major abdominal surgery, and did very well to go home that day! Try to ignore your nurses or aids if they are rude!
The next week was spent laying on the couch and doing nothing much but sleeping and watching bad daytime television. Friday a week after my surgery I stopped in the office for a laptop so I could do a few things from home the next week (the US does not have the same sick time laws as the UK, so I did not want to loose to much pay) I also had my follow up which went OK. My hCG levels went down to around 17,000.
The second week, was pretty much like the first. I walked to our garden a couple times, REALLY slowly, I did about 12 hours of work during the week, which was OK and helped relieve my boredom. On Thursday I sat at a table and started some seeds for lettuce which made me feel less like an invalid. My follow up went well, and they said I could try work part time on Monday if I wanted, as long as I was not on pain killers for 6 hours before driving. hCG levels down to 700!
That weekend I started peering down my painkillers, and I went out to the store with my husband, which felt GREAT! But durning the weekend my incision site, which had been looking fantastic, started getting a little red in the middle and a bit swelled.
Monday I went to the office for 6 hours and that felt pretty overwhelming, I called about the redness and they said to wait for my Wednesday follow up. That night I started feeling a bit sick.
(Another TMI Paragraph!) Tuesday I went to work again, but my incision had started to feel weird, the healing ridge you get under the skin had parted in the middle, I wondered if I had pulled it apart somehow. So when the office opened at 9 I called again and they said to wait until the next day since I was already scheduled. So I was standing there talking to my boss a few minutes later and felt a moistness on my skin. I went in the bathroom and looked and there was a TON of pus and blood all over my stomach, totally had soaked my panties! It was very gross! But after I wiped up I found only a tiny hole in the incision.
I obviously, called back (this was only 20 minutes later) and the nurse had the audacity to tell me that EITHER I could come in that morning or I could go to my appointment the next day! Hello! What part of blood and puss don’t you understand! I went in that morning.
They took a culture, put a gauze pad over it, gave me a shot of antibiotics, a prescription for Augmenton, and sent me home with a follow-up appointment scheduled on Friday. Later that afternoon my incision started opening up. It was pretty small at first but was getting bigger. By the time I talked to my sister in law (who is a nurse) that afternoon it was open maybe 2 cm, and you could see maybe 1 cm deep. When I told her it was opening up she told me to call the office again. They told me to cover it tightly, double my antibiotics, and come in the next afternoon at 2:00.
So I went to work at 6:30 the next morning to finish a report. I really did not feel that bad. I was running a slight fever, and my stomach hurt, but nothing major, I thought. I finally got done with the report about 1:15 by working through lunch. And then off I went to the doctors.
The doctor took one look at it and said “We’re going to admit you.” I guess it can be VERY serious when incisions open up, because sometimes it involves deeper layers as well, and you can open up all the way to your organs! Obviously that is not good.
But they gave me permission to stop home on my way to the hospital (as it is right on the way.) And by 4:00 I was in admitting signing into the hospital again! OMG! Was I worried about medical bills, by now I started to get the bills for the first admission, thankfully I have pretty good insurance, but this whole thing will still probably be close to $1,000 before it is done, which will top my deducible.
Now, I felt pretty stupid. I mean I went to work that morning and now I’m sick enough to be hospitalized? When I called my husband on the way in he said that his sister had said that they would probably admit me. But I had not been expecting it at all. I told the transport person that I wanted to walk and not take a wheel chair. He asked if I was sure and I said I walked from the parking garage, just go slow. He didn’t, but I still walked.
The good news was that this time I found my way to the correct hospital! And I was very glad I did because it is newer and I got a private room and the nurses were much much nicer. As the nurses on the floor were doing my IV and asking all the admission questions, I felt so stupid, because I did not feel sick! But my docs wanted to do a couple days of IV antibiotics, and it turns out it is good they did. I remember more about this hospital stay, because I was only on Percoct. But mainly it was just puzzle books, meals, IVs, and daytime TV. Pretty boring. The nurses were as I said nicer, and they always came to my room when I was due for more medicine and asked if I wanted it, and they never made me feel like I was bothering them. Once a Chaplin came in and it was nice to talk to her, especially since this whole thing is just the cherry on the top of year which included my mom being diagnosed with advanced lung cancer, my wedding, a new farm, my father dieing, and my mom moving closer to me for her last time with us.
I stayed for 3 days, and they taught my husband how to change my dressings and pack my wound. (TMI) Which involves pulling out old gauze bloody and stuffing it with new damp gauze, which actually doesn’t hurt much, go figure! I mean you feel it, but it’s not that bad. It ended up opening up to a size of about 4cm wide and about 2.5 cm deep. They let me go on Saturday.
I went to work again on the Monday and did 6 hours, same with Tuesday. On Wednesday was a follow up Doctor’s appointment and I got two pieces of bad news. The first was that the infection is Staph, so hopefully the antibiotics will treat it, but there is no guarantee. To date, I feel OK and am heeling really well, but that is no guarantee of things to come. They can seem healed and flair worse then first time. So it is possible I may need to be hospitalized yet again, this time longer for more IV antibiotics. It seems like everything is going wrong with this whole pregnancy and aftermath so I kind of expect it to continue.
The worse news was a total shock. My pregnancy in addition to being ectopic(1/100) was molar(1/1000). I am still grappling with the implications of that, but here is the brief version. I cannot try to get pregnant for 6 months to a year. And a year is preferable. There is a 20% that something will start to grow again, if it does I get a Meth shot, but then I am also at risk for cancer. I am 33 this week and really wanted to have baby one before I was 35. But now I cannot even try until I am 34. That is scary, because if all this can happen to pregnancy one what will happen with number two. I had two potentially life threatening complications with this one, what is next? Am I even capable of carrying a normal healthy baby to term?
So that is where I am one month out. If you are still reading this I am amazed! Thanks and why don’t you email me and tell me you got to the end! Next week will be week 5 and I will try to do a full work week, if my infection stays under control. As they say what does not kill us only makes us stronger, and it is stupid, but maybe in some ways true. I hope that this long narrative will be of help to someone. Thanks for reading it.