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6 weeks post-op physical pain and difficulty processing

This is a welcoming place for you to ask your questions and share your knowledge and experiences of ectopic pregnancy.
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Kirstie
Posts: 4
Joined: Fri Jan 22, 2021 2:22 pm

6 weeks post-op physical pain and difficulty processing

Post by Kirstie »

Hello everyone,

Thank you for this safe space.

I thought I had passed a miscarriage naturally in December, but when the pain returned 10 days later and was excruciating, we went to E.R. I was kept for observation overnight, and after many ultrasounds and blood tests, they were still undecided if I should stay or not. By 3pm when the pain relief was wearing off again I called for the nurse. She took one look at me and rushed me for more tests and eventually they prepped me for surgery.

My right fallopian tube had ruptured. They removed it with keyhole surgery. I spent the next four nights recovering in hospital before I could finally go home to my husband.

I am Australian but living in Italy. I don't speak Italian yet, and with Covid rules, my (Italian) husband wasn't able to enter the hospital to support me, or translate. The entire experience was very traumatic. The cultural differences are huge (no privacy, bring your own toilet paper etc!), plus I had no idea what was happening as none of the staff speak English and my limited Italian wasn't enough.

I am having trouble processing what happened. I want answers. I don't understand why they waited so long. I want to know if they saw anything in surgery that would indicate why I can't stay pregnant?
Whenever my husband called and spoke to the doctors or nurses he was told "she doesn't have to understand, she just has to get better". Don't they know to get better mentally, I do need to understand.

This was my third, possibly fourth pregnancy. The first was an "elective" termination at 10 weeks, 2 day. Although not much about it felt elective. Now I blame myself for not being able to stay pregnant. Did that surgery cause damage? Am I being punished for making that incredibly hard decision?
The second, may or may not have been a chemical pregnancy. I never had a positive test.
The third was a confirmed miscarriage at 5 weeks.
And this ectopic bleeding begun at 6.5 weeks but surgery at 7+ weeks.

Physical recovery was not too bad for me. 2 weeks post op I was back to teaching (with modifications) Pilates. 4 weeks post op I went for a slow run/walk. I had my period 5 weeks post op and it lasted for 11 days. But today, 6.5weeks post op I have physical pain on the right side. Exactly where the pain was before surgery, but no where near the same level.

So I guess I am hear to share my story, and also, because I have multiple questions and I'm not sure where else to ask them?

Thank you for having this space open.

EPT Host 20
Posts: 2078
Joined: Thu May 31, 2012 9:58 pm

Re: 6 weeks post-op physical pain and difficulty processing

Post by EPT Host 20 »

Dear Kirstie,
I am so sorry to hear of your ectopic pregnancy and losses. I cannot imagine what it must have been like for you, having to experience this without the support of your partner and with a language barrier. My heart truly goes out to you and I wanted to say that you are among friends here.
Unfortunately I am not medically trained but will try my best to help.

Ectopic pregnancies can be notoriously difficult to diagnose. If small, they can sometimes be difficult to see on scans and hCG bloods are by themselves not enough to diagnose ectopic pregnancy.
Doctors usually use a combination of transvaginal ultrasound scanning and blood tests to check HCG levels to diagnose ectopic pregnancy. If scans are inconclusive, doctors usually test hCG levels and a hCG level that is rising by less than 66% over 48 hours can mean it is likely, but not a certainty, that the pregnancy is ectopic. However, in isolation, hCG tests only provide a part of the picture - declining levels indicate that a pregnancy has ended and will be miscarried. It can also possibly indicate an ectopic pregnancy that is "self-resolving". Also hCG levels rising by less than 66% over 48 hours means it is likely (but not certain) that it is ectopic. If levels rise normally, they suggest the pregnancy is implanted in the uterus. You may see from this that hCG levels only indicate certain possibilities and are not in themselves a definitive guide. Your pain levels worsened whilst you were in hospital and your nurse rightly highlighted that you looked unwell, which could indicate a ruptured tube, so it seems that appropriate action was taken by taking you to theatre, although this was obviously not communicated well.

I know that when I had my ectopic pregnancy I also looked for a reason and almost automatically we tend to blame ourselves. From the bottom of my heart, there is nothing you could have done to prevent the ectopic pregnancy from happening. A previous elective termination does not increase risk of ectopic pregnancy. I cannot emphasise enough - you are not to blame. Please be kind to yourself and I send you gentle hugs.I
You have many questions about what the surgeon saw. As we are a UK based charity, we cannot comment on the heath care systems abroad but could you make an appointment with the surgeon that your husband could attend with you to help with translation?
I have lived abroad too and they seemed to work on a very medical based model of "fixing" the personal whilst ignoring the emotional impact of what had happened. (Actually that happened to me in the UK after my ectopic pregnancy too, but this was 10 years ago and I like to think we have moved on a bit). These boards are a safe space to share, ask questions, or to vent. They are filled with people who have been through similar experiences and journeys, and we are here for you for as long as you need.

Experiencing some pain after an ectopic pregnancy is normal as your body has been through a great deal. The pain may be due to adhesions (scar tissue that binds two parts of the body together) which form and take some time to settle. Your body may be preparing to ovulate and many women experience ovulation pain when they did not before their ectopic pregnancy - including myself. You also may have a heightened perception because of the sad loss that you have had to go through. Also returning to work and exercise so soon after surgery may not have given your body the time It needed to recover. We generally advise resting for 6 weeks then building things up slowly. It is unlikely that you have done any harm, but it maybe worth slowing down on the exercise to see if this settles the pain. If it continues to worsen, please seek medical advice.

You haven't mentioned about trying again, but I am not sure what information you were given so here is some advise and we have more on our website here
https://ectopic.org.uk/patients/trying-to-conceive/
It is normal to feel anxious about the future. We generally feel a mix of emotions from wanting to try again to being petrified of what may lie ahead. We never forget, but we learn to accept what happened. It is a slow process that might be weeks or months ahead.
In time, we can get to a place where we feel comfortable trying again. When this is, is individual for each person. There is no timeframe for recovery, take each day as it comes.
Importantly early scans avail. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self refer route is the best route in our view. Hopefully you will have some comfort to know you are under the radar of medical professionals right away.

Many women experience feelings of isolation after an ectopic pregnancy - I did, too. It is a frightening experience. Like you, I reached out to the Trust for support and we will be here for you to lean on for as long as you need.

Sending much love and warm hugs,
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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