my experience with ectopic pregnancy

[MNT08]

From the beginning. On October 24th my period was supposed to start and it didn’t come. The 25th, 26th, 27th, 28th and 30th I had positive pregnancy tests. I was so excited I was finally going to have a baby, we had been trying and i actually tracked my cycle this month and used ovulation pee sticks. After the first 4 tests I called to set up my first appt with the obgyn. They stated you have to be 10 weeks before you could be seen. My first appointment was then scheduled for December 6th for my first ultrasound. We were already talking about how we were going to break the news on our little one and decided we were going to tell everyone a little before that first ultrasound on thanksgiving when everyone was in one place. Before anything happened I actually changed my mind and said lets wait for the ultrasound because anything can happen early on. On the 30th I had slight lower abdominal cramping and brown blood when wiping. I started stressing and thinking the worst, I was googling my symptoms and reading countless articles about what this meant. I confined in a close friend about what I was experiencing, who recently had a baby. She said she had the same brown discharge and that it is pretty normal but if got worse or red to definitely let my OB know. As the week went on the color of the discharge changed from brown to bright red and got slightly heavier. Sunday November 5th rolled around. I woke up and went to the bathroom like every other morning and I had a big red blood clot that came out. I knew right then something wasn’t right. I called the obgyn first thing Monday morning to ask if this was normal or if I should be concerned. They told me to come in for blood work when I can and that I could come in that day if I was able to (Nov 6th) so did. They called me Tuesday November 7th with the worst news I could imagine, “were sorry to do this over the phone but it seems you’ve had a miscarriage” they went on to tell me my HCG was 79, my progesterone was 0.6 and my blood type was AB+. They said that those levels were extremely low for someone pregnant. They told me to come back in a week and that my HCG should be in half and gradually go back to zero. I went back November 14th for the blood work. The following day I get a call from the obgyn with the result, she says, “I am stumped, your value actually increased to 219.” I immediately got excited thinking maybe she diagnosed me wrong, she went on to even say “maybe we tested to early” continuing to lead me to think this was good news. Then again told me to come back the following week for another blood test. November 20th rolls around, I go get blood work, same thing the next day I get a call from the NP while I am getting my hair done. She tells me, “your hcg has increased again to 364, but this isn’t a significant increase in hcg, we are concerned for something called an ectopic pregnancy” I then began to panic because I was googling what increased hcg levels meant after being low prior to this phone call and thats what I read, “a slow rise in HCG is concern for ectopic pregnancy, though rare”. I asked the NP what I need to do now. She said, “we need to get you in for a stat ultrasound to confirm placement and see what is going on”. I had so many questions, does this mean I need surgery? What happens after the ultrasound? ect. She said surgery Is last option and that they have a medication called methotrexate that they try first. I then went on to ask if they see something on the ultrasound if they are going to just give me the shot she said “yes”. I said, “ok, I can come in now or today any time” she said she would talk to the front office and get back to me. Shortly after she called back and said they could get me in on Wednesday the 22nd at 4pm for the ultrasound but they can’t get me the shot the same day so after my ultrasound depending on the finding they would send me to the er to get the medication.My anxiety was out of control I kept calling back asking questions because from what I read on line this could be life threatening and they said I needed to be seen STAT but then the following end of the day was ok. As I sat and finished getting my hair done I was so anxious and scared I decided to go check myself into the hospital and get it taken care of right that second, I didn’t see the point of waiting and extra day to go to the OB and then be sent to the ER after, id rather skip an unnecessary step. when I got to the er I didn’t have any cramping or any symptoms. They did blood work, an ultrasound and trans-vaginal ultrasound and confirmed I had a right side ectopic pregnancy. My hCG was up to 407 from 364 over night. They then gave me the methotrexate shot in my right hip. They monitored me in the er for 30 minutes and then sent me home. I was doing great I calmed down and relaxed a little bit but I did tell my husband and my dad my fear of it not working and what if it doesn’t. Everyone I spoke with at the hospital told me to stop worrying I caught it In time and that im lucky I was still a candidate for it and caught it when I did. All day Wednesday I was doing fine, Thanksgiving I went with family and had a great day. Friday morning rolls around me and my husband wake up, get ready and then go to brunch with his dad, uncle and brother. Everything was fine I felt great. We got to the restaurant and were waiting for a table. The second I received a text, “your table for 5 is ready” I started getting some aches in my stomach, honestly it felt like gas pain like I had to poop. I got up and went to the bathroom and only peed, I was pacing in the bathroom for a second then decided to go back to the table. I actually unbuttoned my pants and pulled my sweatshirt down over it because my belly felt bloated and my pants got tight all of a sudden. I slid back in the booth between my husband and father in law and out of no where I got lightheaded and started seeing white. I felt nauseous and like I was going to pass out. I felt like I was In and out of concsciencousness my husband and his uncle were talking to me and I felt cold and I couldn’t talk they kept going on and on and I just remember putting my elbows on the table and my head in my hands and saying I’m going to be sick. My husband looked at me and saw beads of sweat rolling off my head and neck and he asked his dad who is a dr “what’s wrong with her?” He had thought my blood sugar was low, so he got up to get me orange juice. I was shaking picking up the cup but took a sip of the orange juice and then immediately threw up. I told my husband, “take me to the hospital please” he got me in the car and was driving 120 on the freeway to get me there. We got to the er I explained all my symptoms and told them I was in the er at a different hospital 3 days prior with a confirmed ectopic pregnancy and that they gave me the methotrexate. They sat me in the waiting room for over a half hour, my pants still unbuttoned, uncomfortable and the belly pain getting worse. Finally my husband got up angrily and told them, “I am worried about internal bleeding she needs to be seen” they told us they were working on a room. Few more minutes go by and they finally called me back. They took me to a room, put in an iv, checked my vitals, ran some blood work yet again, and the doctor came in and did a bedside ultrasound to see if he saw bleeding. The doctor said he didn’t see any fluid higher up on my right side so “thats a good thing” he said thats the first place blood typically travels. They then took me to ultrasound for a more detailed ultrasound of my abdomen as well as another trans-vaginal ultrasound. This time, when doing the trans-vaginal ultrasound there was discomfort and pain when pushing and looking at right side. I knew something was wrong seeing the first one didn’t hurt and and zero discomfort but the ultrasound tech said she couldn’t tell me what she saw even tho I watched her facial expressions and her eyebrows raise while looking inside me. When I got back to my er room the doctor came in and told me and my husband, “so good news it didn’t rupture but we are at a pre rupture your hcg also went down to 392”. He lead us to believe that the methotrexate was working just not fast enough and then denied my fear of needing surgery. They gave me some morphine for pain while he consulted an obgyn on call. When the on call physician showed up first thing out of her mouth was, “so it looks like it ruptured your right fallopian tube and we are going to have to take you back to the OR for surgery”. before I could even process what was happening my husband was like, “wait… so it did rupture he just said it was still pre rupture” and she said yes it did and we won’t be able to save your tube. They then prepped me for surgery, had me sign consent, take off all jewlery, placed a 3 lead ekg on me, and took me back and did it. It was around 30-45 minutes laparoscopic surgery and when I woke up I got to go home. I was lucky I went straight to the hospital when I got sick because they found 500cc of blood in my abdomen which explains my pants needing to be unbuttoned and the feeling of having to go to the bathroom, it could have ended up a lot worse if I waited. It was an emotional roller coaster with everything that happened. Lots of false hope and lots of time wasted from the OB trying to figure out my HCG levels. I feel like I could have got the shot alot sooner and maybe it wouldn’t have lead to emergency surgery. What I learned from this experience is to just trust your body and gut when it is telling you something is wrong.

[EPT Host 20]

Dear MNT,
I am so sorry to hear of your ectopic pregnancy loss. From your own words I can only imagine what a frightening experience this must have been and I am so sorry you have had to go through this.
We are a UK based charity so can only comment on usual procedure in the UK and I'm guessing from the terminology in your post that you are not based here.
What I can say is that from a UK perspective, you were not managed well. You should have been reviewed quicker for a scan with the low rising hCG blood tests and followed up more closely after the methotrexate, including telling you signs and symptoms of a possible rupture and what to do it they happen.
We sadly cannot change this experience for you but we can be here to help you through the next steps of recovery.

Experiencing an ectopic pregnancy is a huge ordeal and you are in the early stages of recovery. Your body needs time to heal from your surgery which is in itself a gruelling task. You have also had to process the loss of your baby and been through an immense rollercoaster of emotions - all of this will take time to come to terms with.

You should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body's signals and pain and feeling tired are your body's signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.

Above all be kind to yourself and allow time to grieve and heal both physically and emotionally.
These boards are a safe place to ask questions, share experiences and vent if you need too. You have friends here who understand.

Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
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[MNT08]

Karen,

Thank you so much for your kind words. I am in the US and I agree. I also felt like I wasn't managed very well. I am glad I found this group. Reading other people’s stories and seeing how kind and compassionate everyone is. I find comfort in knowing there is still kind people in the world and people I can share my story with, with no judgement.

Take care