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Serious mental health issues after methotrexate

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Idge
Posts: 2
Joined: Thu Nov 11, 2021 10:22 am

Serious mental health issues after methotrexate

Post by Idge »

I'm currently undergoing treatment for an ectopic pregnancy and just hoping that getting my story out will help me, because I'm really struggling.

My partner and I have been trying to conceive since January this year, and then on the 15th of October, a Friday, I got my first positive result. That would have made me 4+2. We were so happy. That lasted all of 48 hours.

I was getting a lot of brown discharge that I mistook for implantation bleeding, but I saw the first fresh blood on the Sunday. I thought I'd miscarried. I looked everywhere for help, but my local EPAC told me that until I'm at 6 weeks they can't help, and that some bleeding early pregnancy can be completely normal. I took a pregnancy test every day, in the evening - they seemed to be stronger than in the morning. The positive lines were getting darker. I started experiencing symptoms like breast tenderness and that metallic taste. I was definitely pregnant. Maybe it was just a haematoma like that midwife I spoke to said.

I bled for 14 days. On and off. Two days were particularly awful. I grieved a miscarriage. I got my first ultrasound at 6+6. My blood hCG was at 3011, so I was definitely still pregnant. The doctor said at levels above 1,500 something should show on an internal ultrasound. Butt they couldn't find anything in my uterus.

Two days later, when my hCG should have roughly doubled, my blood test results showed a hormone level of 3883 - just 29%. I was admitted to hospital the next day, and again there was no sign of anything on an internal ultrasound. I was told I have an ectopic pregnancy, and was told I'd be given methotrexate.

I don't think I've ever cried so hard in my life. I'd already grieved after a miscarriage. Then when I realised I was still pregnant, we'd made our dreams. We've just bought a house and had started plans for the nursery. We'd started discussing names and when and how we'd tell our parents. And that was just gone. And now, after grieving a miscarriage, I was having to grieve a termination. Not any termination, but one that means I'm not allowed to conceive for 3 months. I'm already 32. I've been feeling my clock ticking for years. I always knew an older pregnancy carried more risks.

I didn't want to do it. I kept asking - myself, my boyfriend, the doctors and nurses - what if there's still a a chance? The numbers are high and I'm not in any pain, what if they just can't see it? What if they've made a mistake? But I was told that if I didn't take the injection, I could experience a rupture that might kill me. I almost didn't care.

My day 4 post-injection bloods - and 4 days after my 3,883 hCG result - my hormones were at 5,252. I was told that there may be an increase but this seemed extreme. It had nearly doubled since my last hormone level check, so this had to be a mistake. I know it's not - by this point a normal pregnancy should have been around 15,000 since my second blood test. Or 24,000 since my first. But it really knocked me. Luckily my boyfriend was there to bring me back down from my hysterics that I'd just killed my baby, my healthy baby.

I'm on day 7 after the injection now. I've just had my bloods taken, I'm waiting on the results. If they don't see that 15% decrease, I'll need to go in for a second dose, and I don't know if I can. That extends my conception parole by 6 months. I'll be 33 before I'm even allowed to try again, and we had enough difficulty getting the first pregnancy. I almost don't want to try again. Almost.

I'm really struggling. I'm angry, and I'm sad. I keep blaming myself, that I did something wrong, and no matter how much everyone tells me I didn't do anything wrong, that it's not my fault, I can't accept it. I've been taking folic acid supplements for months, I have one glass of wine a month when I start my period. Is it because I had that ibuprofen before I realised I was pregnant? Am I being punished for something?

Then I blame my boyfriend. He wants kids even more than I do, somehow. But did he not want it after all? Was his face when I told him, of sheer joy, a front? After all, when we were in the hospital and I kept saying I didn't want to get the injection, he talked me into it. So this is his fault.

Except it's not, and I know it's not, it's just one of those things. But what I know and what I feel haven't been lining up terribly well lately.

In the same breath, I worry he blames me. That it's my body that killed his child. That I'm at fault. That I'm broken. He says he doesn't, not at all, but what if what he knows and what he feels aren't lining up either?

I hate this. I've been fighting depression for a long time, but it's winning at the moment. I really want to kill myself. But it's fine because I'm not brave enough to. I hate this. I need to talk to someone. I don't know what to do.

Idge
Posts: 2
Joined: Thu Nov 11, 2021 10:22 am

Re: Serious mental health issues after methotrexate

Post by Idge »

Results were 4,096, a 29% increase. So I guess that's good. Means my baby is officially going. Brilliant.

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: Serious mental health issues after methotrexate

Post by EPT Host 20 »

Dear Idge,
I am so sorry to hear of your ectopic pregnancy and loss, I've never wanted to reach out and give someone a hug so much.
From your own words, I can imagine what a frightening ordeal this has been and I am so sorry you have had to go through this.
When we experience ectopic pregnancy we are suddenly faced with a life threatening emergency and it's treatment, reduction in fertility, concerns about the future and the loss of our babies. Experiencing any one of these is an ordeal, putting them together is immense and your feelings are completely normal.

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. I cannot emphasise enough - you are not to blame. Please be kind to yourself.

some doctors mistakenly think that you have to wait longer before trying to conceive following 2 injections of methotrexate. However, if you have had either one or two injections of methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urinary tests) and then take a folic acid supplement for 12 weeks before you try to conceive. I hope this helps with your worries about timings.

Please take all the time you need, be kind to yourself and allow time to grieve, to heal both physically and emotionally.
Your are among friends here who understand what you are going through. Please lean on us for as long as you need,
Sending much love and warm hugs,
Karen x

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Hmc163
Posts: 2
Joined: Sat Oct 23, 2021 5:53 pm

Re: Serious mental health issues after methotrexate

Post by Hmc163 »

Hi Idge,

I’m so sorry for loss and how you are feeling. It’s incredibly tough and I wish we could take away this pain for all of us, it all seems so unfair. Especially when you make the decision, and your numbers don’t do what you expect.

I too am experiencing a loss but hope I’m coming to the end of my ordeal. I had a pregnancy of unknown location at 7weeks. After several weeks of blood tests and scans they suspected it was a miscarriage, and completed an MVA (medical procedure to remove an remaining tissue) unfortunately that didn’t work, as my numbers kept rising and they were at 2,400 when they decided to give me methotrexate.

My numbers did come down very quickly though and I thought this advice might help you, I read lots on this forum and I have been avoiding all food with folic acids for the last 3 weeks. It’s quite challenging as a lot of foods contain it but my numbers have dropped a 1,000 a week initially. A lot of food contain folic acids so I’ve mostly been eating white bread, porridge, cheese, meat, seafood, pasta, potatoes, then limited fruit and veg. Only mushrooms, peppers, blueberries courgettes without skin, occasional tomatoes and basically avoiding anything else - in particular any thing green, citrus, nuts, grains, cereal as fortified etc. Ohh and some people recommend to drink green tea too which I’ve done a little bit.

For me this seems to have worked, my numbers went from 2400 on day of injection, day 7 - 1400, day 14 - 250 day 20- 43 I’m now waiting for my week 4 numbers on Friday and hoping they will be below 5. I just wish the hospitals gave this advice about diet, in the US they do as my friend gave me something her friend had received from the drs there.

I know right now it feels like the pain will never go away and you won’t have your chance again. But it can happen. Unfortunately I went through a baby loss at 24 weeks pregnant some years ago and thought my time would never come again. I panicked about my age and still do - I’m 35 now and feel like I can hear my biological clock ticking at me everyday. Sadly this time didn’t go right either with having an ectopic but I’m really hopeful now for when we eventually get to try again in 12 weeks, although it’s absolutely terrifying. I’ve found being really open and honest with my partner about my feelings helped, and I can’t fault him as he’s been really supportive. My friends and family have been great too. (When I had my baby loss before I was in a different relationship and wasn’t able to do that - which made it very challenging and hard to process my feelings, I too had very dark days and thoughts of not going on)

I don’t know if anything that I’ve said helps, but I wanted you to know you are not alone, and you are absolutely not to blame, this is sadly out of our control. The pain and feelings you are having are completely valid and normal. I never normally post on these forums I tend to read through them only but I saw your post and wanted to reply. I also had counselling / therapy after my baby loss, however some years later (I never thought I needed it) and that really helped me too, so it may be something you want to discuss with your Dr. Going through loss like we are is extremely traumatic, be really kind to yourself and take time to grieve. x x

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