Methotrexate second dose

[BD90]

On the 16th Dec I had just booked in with the midwife who had me at 6 weeks, about two hours later I had started bleeding. I had been having mild cramps but I thought it was normal growing pains, I then spent the next four mornings in hospital, which was difficult as they weren't actually doing anything other than making me wait about and have a blood test and have another blood test, no one was telling me why or what they suspected it was.

When they finally scanned me they saw something in my left tube and made me come back the next day to the EPU.

I had the first does of methotrexate on the 21st, but my levels rose from approx 600 on the first day I went to hosp to 1800 by the 29th. Two days after the first dose I had a funny turn where I was sick, all hot and dizzy, intense stomach pain. I took paracetamol and 30 minutes later it began to pass, about an hour later I was just left with mild stomach cramps. They had said if it was managed by pain meds it was nothing to worry about but it was worrying!

On the 31st they called me for more blood tests which showed a steady rise but didn't tell me by how much, and gave me a second dose of methotrexate. Im now starting to feel ill again and dreading it getting as intense as the first time.

I have been bleeding the whole time, and constant mild cramps. I have lower back pain all the time, and my hips feel like they are being slowly pulled form my body.

I just don't know whats normal. What pain I should be concerned about. I'm worried that my levels are still rising and that they are just waiting to see what happens, I'm not due back till the 4th for another blood test. Why are my levels rising and why didn't the first dose work?!

I've been off work since the 16th, only my direct supervision know what's going on and have been really good. I have a very intense and physical job but I'm to worried that even if I felt like going back (which my head hasn't been in the game) that I would cause a rupture. I will be due back on the 8th unless I get a sick note or something, which I've never done and don't know how to go about that so the stress of thats just making me think ill go back and crack on.

I dont really know what Im asking here, I'm just so tired.

[LauraG]

I'm so sorry you're going through this. I have had 2 ectopic pregnancy's. The first was treated successfully with methotrexate. Then at the end of Nov I was told I was having another ectopic. My levels were 51 so I was given methotrexate but my levels doubled by day 7. I then had a second dose and levels fell by 10 but on my second day 7 they'd risen again. I ended up in surgery on the 6th Dec. They said its very unusual for a second dose not to work. With the methotrexate I felt quite sick and had a couple of days of bad period type pains. It's so worrying as you're constantly on edge wondering if your tube could be rupturing. If you're in any doubt call your EPU or Gyne ward. I really hope your levels are going down. Sending lots of love. Xx

[lolly2481]

I cannot advise on methotrexate, I'm afraid, as I am being managed expectantly but you can get a sick note from the hospital. If you ask when you next go to the hospital for bloods taking then they will provide you with one, especially if you explain what your job entails. Sending love x

[LauraG]

Sorry I should have added - the hospital will give you a sick note. Methotrexate suppresses your immune system so be extra careful with COVID restrictions. My husband did all our shopping etc and u stayed at home and only left to go to hospital appointments. Xx

[EPT Host 20]

Dear BD90,
I am so sorry to hear of your ectopic pregnancy and loss and of lack of information you seem to be getting.
Whilst I do not wish to alarm you, there is sadly a risk of rupture with low or declining levels. I would like to think your EPU have given you a contact number to call to discuss any worsening pain. If so, I would advise calling them to speak through your symptoms. If they haven't, call your local hospital and ask to be put through to the EPU. If you still have no joy, call NHS111 to speak to a health professional and if your pain worsens or you feel dizzy and unwell, I would advise attending your local A&E.
Do feel free to ask your team questions about what is happening to you if the information isn't forthcoming. You have a right to know what is happening and what to expect.

Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
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