Please help

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1

Hello

I’m Sally and have been going through a traumatic experience.

I had a positive pregnancy test on the 01 st of June. My LMP was 24/04/16.

Went to the OB/GYN and she ordered a routine scan. No sac was seen. A BHCG was then recommended.

Me levels started at 1036. 48 hours later they were at 2024.

This was on the 3rd of June.

On the 8th of June I started expevidencing a light cramp and brown diacharge. My husband and me rushed to the hospital and they then did a TVS and still found no sac. An ectopic pregnancy was what they thought it to be.

The HCG levels at that point were 2200.

On the 12th of June and ectopic pregnancy was detected as right adnexal mass at 2.0cms. My BHCG at that point was 2849.

Methotrecate was then administerEd on the 12th. The second one on the 15th and the 3rd on the 18th. My levels on the 15th were at 2680.

After the last shot of methotrexate now I started bleeding like a period accompanied with period like cramps. Doctor advised another ultrasound to be safe. The tubal mass has increased to 2.5cms which aparently is normal. My next BHCG is on the 25th of June.

My question to all those who may have gone through a similar situation. Does it look like I’m on the road to recovery? I dread surgery. Really do :frowning:

Any input would help ease my troubled mind at this point.

Thank you so much.

Sally.

2

Dear Sally-2478,

I am so sorry to hear of your ectopic pregnancy and loss, it is an overwhelming experience and I will do my best to help.

Following methotrexate the hCG level often rises on the day four blood test because the action of Methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. If there has not been a 15% drop, this is when the doctors will consider a second dose of Methotrexate or surgery, but you can discuss this with them.

I am afraid it is difficult to predict how long it will take for your hormone levels reach non-pregnant levels. As we are all individual, our bodies respond differently to the drug and it depends on factors like how high levels reached and our unique physiology. What I can say is that it can take a number of weeks and, while it can take some time, it is not as invasive a procedure as surgery. It is also encouraging that your levels are falling steadily although I appreciate that it can be a drawn out process. Also, in terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).

As a gentle reminder following methotrexate injection, please do not undertake any strenuous exercise or lifting or housework while your hCG levels are dropping. While I do not want to alarm you, there remains the risk of rupture even with low or declining hCG levels. You should not resume exercise until your hCG levels are falling consistently and are in the low 100s.

Please continue to lean on us for as long as you need,

Sending much love,

Karen x

If we have been able to help you, are you able to help us with a small donation or by volunteering?

Further information is available at www.ectopic.org.uk

Email us at ept@ectopic.org.uk.

Our helpline is 020 7733 2653 (available Monday to Friday 10am - 4pm).

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team.

3

Dear Karen

Thank you so much for your kind words of comfort and encouragement.

My day 14 BHCG results were at a 989 (just yesterday) and am thankful to see the drop now.

Sometimes patience is the most difficult virtue to exercise in times of distress and I thank you for holding my hand through this.

Will keep you constantly posted and much love Karen.

Bless you and thank you again.

Sally.

4

Dear Karen,

I hope you are doing well. I thought I should update the forum and you about my progress and my personal journey related to my Ectopic Pregnancy. I have to also advise that this was my personal experience and it should in no way bear any sort of medical affirmation that this is what should/should not happen to another.

My journey is documented as;

JOURNEY (JUNE/JUL/AUG 2018)

FIRST EP: 21/09/05, ruptured left, salpingectomy.

LMP: 24/04/18

SECOND EP: 08/06/18, medically managed- Methotrexate

DATE READING

03-06-18 1036

05-06-18 2024

08-06-18 2122(experienced sharp pains and bleeding)

10-06-18 2500(

12-06-18 2850( Diagnosis of the Ectopic and was administered my 1st methotrexate)

15-06-18 2849(2nd methotrexate)

18-06-18 2690(3rd methotrexate)

25-06-18 987.1

02-07-18 408.7

09-07-18 212.8

16-07-18 58.0

23-07-18 16.0

30-07-18 test not done (advised as not required)

06-08-18 <2.0(for my affirmation and done on my own accord)

Symptoms such as bleeding & cramping were the worst from the 21st to the 24th of June. Intermittent thereafter, but bearable and controlled with Paracetemol(SOS). Heightened anxiety ,muscular aches including backaches, labored breathing and pricking pain all over towards the end of June/first week of July for the entire month of July as well. I developed General & Health Anxiety which was the worst about a week back(which simply means I had every symptom of Hypochondria as well).

So went to see my GP of 14 years a couple of days back and showed him my case history to which he consequently started Folic Acid only and said I needed it badly. I admittedly feel so much better. My gynecologist strangely did not prescribe me anything other than a multivitamin.

I want to let everyone know that whatever it is you’ll may be facing post-methotrexate must be conveyed to your doctor to help you feel better. I kept on stalling till 2 days back and feel so much better now.

I do have an intermittent “pricky” pain at the site of my Ectopic pregnancy(right side)and again was a bit concerned about it. I am scheduled for a follow-up ultrasound on the 9th of August. I am worried there still may be some adnexal mass present causing the pain, but then again, that’s my health anxiety acting up so much and I thought of posting this for reaffirmation and comfort for the sake of others and myself.

Sally.

5

Sally-2478 I also am going through an ep and it certainly does make you heightened to every ache and pain and i see myself as a ‘ticking timebomb’ at the mo and its a horrible feeling!

I was diagnosed on Thursday 26th July following blood tests (my hcg was 1234 and 5-6 weeks pregnant) and an internal scan and I THINK, as they told me very little, there was a mass of 12mm but I have no idea where it is located.

I was offered surgery or methatrexate and was just told there were pros and cons to both, not very helpful! After waiting 10 hrs in hospital i was given the methatrexate and sent home with very little info on what to expect pain wise etc.

By Saturday 28th July i was doubled over in pain and very scared so ended up going to A & E following a phone call to the hospital. After more blood tests and a horrible internal scan where i began to bleed i was admitted over night for monitoring. After morphene, tramadol and codeine and a sleepless night the pain had subsided enough for me to go home. My hcg had gone to 1089.

After an anxious 48 hrs i was tested again on day 4 30th July and my hcg had fallen to around 689 which was a relief as i had read that it was normal for them to continue to increase by day 4. I am now waiting for Thursday 9th as this will be day 14 and im praying they have continued to decrease and although i feel ok, any slight twinge im getting anxious.

I also have the fact that im due to fly to Portugal on Mon 13th hanging over me. I have resigned myself to the fact that i wont be going but still holding on to some kind of miracle that my levels will be safe for me to fly … i know, never going to happen. I want to request a scan on Thurs to confirm where the actual pregnancy is growing as if it isnt in one of my tubes and just attached to my uterus or similar and its decreasing surely there is no chance of it rupturing? Can they refuse if i ask for a scan?

I just want this nightmare to be over and the irony of not being able to go on holiday when ive never needed one so much in my life is driving me crazy