Wow, it has been quite a while since I've posted here and boy have there been many a topic I wish I had covered. What sticks out most in my mind for what qualifies most for a 'Mommy Blog' is my recent experience in trying to expand my family.
My Miscarriage and Ectopic Pregnancy Story
March of last year my husband and I were not trying to expand our family. In fact, having another baby was the furthest thing on our minds. We had just purchased a new house and were over our heads with remodeling projects, unpacking boxes and my new job as a real estate agent. We were exhausted and caring for a rambunctious 2 year old at this time was enough for us to decide putting off having another for some time.
And then I woke up one morning and had the feeling I needed to take a test, so take a test I did. Positive. Big. Fat. Positive.
I was a nervous wreck. Mostly nervous to tell my husband. So nervous, in fact, that I did not tell him I was pregnant until I woke up Easter Morning and discovered I was having a miscarriage. There was a very awkward and very short discussion had, and it was never spoken about again.
Seeing as I am a typical hormonal woman, the unexpected slight excitement of expecting another baby that I felt for the week and a half that I was pregnant was enough to jump start my deep longing to actively start trying to have another baby. My husband, however, was not having it. He wanted to wait another year. Sigh.
Then, one random night in July we discussed trying. My husband decided he wanted to 'just see what happens'. To him that meant sometimes using protection and others throwing all caution to the wind. To me it meant baby time! My husband went back and forth on this 'see what happens' attitude and yanked my hopes around like a yo-yo until October.
October 22nd I found out I was pregnant again. I was nervous to tell my husband again, but as we both knew it was bound to happen even if you only occasionally 'see what happens'. He was actually pretty excited and even went to far as to asking to be a part of telling my family and we made plans to surprise everyone over Thanksgiving.
Christmas morning I woke up and took a test. Positive!
At 14 Days Past Ovulation my HCG levels were at 102.
At 16 Days Past Ovulation my HCG levels were at 139.
It should have doubled..
At 20 Days Past Ovulation my HCG levels were at 349.
It should have tripled.
The next day I went in for an ultrasound.
The nurse did not find a baby. I had bleeding in my left ovary, a sac of fluid that did not have the characteristics of a gestational sac and what looked to her like a polyp. But, no baby. The nurse said that because she could not see anything, but because I have pregnancy hormones in me that it could be an ectopic pregnancy and that if I felt any big pains to go to the hospital.
She told me to come back in a week for a follow up ultrasound, and after force feeding me more of those horrible cliches: 'your eggs are still young, keep trying', she let me go home.
On my way home she received the results of my blood work and my HCG levels went from 349 to 438 in 48 hours and then said I can take methotrexate or get a d&c. Like that’s it. Like it’s a simple A or B, get it done, move on with my life. She then asked what outcome I was looking for. Dumbfounded I said, "Well I was hoping for a viable pregnancy." She responded, "Well, yeah, but this is not a live pregnancy." So I told her I’d like to keep my ultrasound appointment for a week from then and then decide. She said if I change my mind before then and ‘want to do something about it’ to just call.
I ached. I physically ached.
At my follow up ultrasound appointment one week later I had the strangest, out of body experience I've ever experienced.
The nurse performed the ultrasound and finds my left ovary is still full of blood. Kept repeating that my uterus does not look normal. There was still a giant fibroid in the middle, and some other strange growth looking things. There was still a fluid filled sac which I noticed right away. THEN she points to the tippy-top of the sac and says ‘well, look there, that circle is a yolk sac’.
Cue wide eyes from me.
That wasn't there during the last ultrasound.
The nurse 'rush' scheduled me for a formal ultrasound at a bigger facility for the next day and lets me head home more confused than ever and with a small grain of hope that had been lost at my appointment prior. After all, my pregnancy was now seen in utero!
The night after the formal ultrasound I received a phone call from another nurse. She was cold and calloused. She told me I had to immediately go to the hospital for a shot of Methotrexate as she was leaving for the night and couldn't be bothered to stay. And that was it. So I decided not to go and waited for the nurse I had been working with to call me a couple days later. She laughed when I told her I didn't get the injection, as she knew I'd have tons of questions before deciding it was right for me.
My numbers on the 14th went from 438 on the 6th to 675. So didn’t even double over 8 days.
The blood in the left ovary is just what she thought it was: a hemorrhagic cysts, which she said was not a big deal.
I asked if they saw polyps and she said they couldn't really say until the uterus is empty and they can run some tests involving filling the uterus .
Now according to the radiologist from the formal ultrasound:
There is no pregnancy located in the uterus, tubes or ovaries.
There is a sac of irregular fluid.
There is no gestational sac, or yolk sac , and could be representative of a residual spontaneous abortion.
My nurse commented under her breath that she knows she saw a yolk sac, so that confused her.
In the long run I was given the option to go through a D and C or get the Methotrexate injection. I was told they could treat me with the Methotrexate and I'll never conclusively know if the pregnancy was an ectopic pregnancy, or I could get the D and C and then potentially need the methotrexate anyway. I decided to take my chances, since i had been told at one point there was a gestational sac and yolk sac in utero. After a whole lot of research I decided methotrexate was not for me and I wanted to avoid it at all costs. During my feverish research I found numerous women would bleed for excessively long periods of time after the methotrexate and that there is a recommended waiting period of 3-6 months after the injection to start trying to conceive again.
Methotrexate is an anti-cancer chemotherapy drug that in smaller doses is used to treat ectopic pregnancies by depleting the body of folic acid. Folic acid is important for cell division, like a forming embryo. There are side effects associated with the injections that were off putting enough for me to make me want to use this as a last resort. D & C scheduled for 2pm Wednesday, January 20th.
I went in that morning and was home late that evening. It was painless and the most traumatic part was being couped up in recovery watching newborns being wheeled in and out of their mothers rooms. It was painless and over faster than I could have imagined.
Unfortunately, the pathologist did not find any pregnancy tissue from the D and C (confirming the ectopic pregnancy) and the next day I was in my doctors office with my pants around my ankles receiving an injection of methotrexate in each hip.
I was right about the side effects. The pain I felt in my hips grew increasingly more unbearable my the hour and the fatigue and nausea was so bad I told my husband if the injections didn't work I would rather have my tube removed than get any more injections.
I wrote this in my journal two days after receiving the methotrexate:
For my future reference, I was right about methotrexate being a bad option for me. I have been in excruciating pain in my hips, lower back, thighs, that whole area since leaving the doctors office. It’s so bad I’ve spent the last few nights in the fetal position in bed moaning and rocking back and forth. Aside from that horrible pain I’ve also had the worst acid reflux of my life. The first night I had stomach acid just chilling in the back of my throat all night, and have had awful nausea on and off since. As it turns out the antibiotics I have to take for the D and C specifically cause the side effects of methotrexate to be exaggerated. The antibiotic also says all over it that I cannot take pepcid complete, which is my go-to drug. Aside from the hip pain and the reflux and the nausea I’ve had this weird headache that isn’t so much painful as it is nauseating. I’m also not sure if my exhaustion is worse now or not as between the hormones and the stress I’ve been under for the last 4 weeks or so has been exhausting as it is.
After numerous more blood draws the close out of the horrid event came when my doctor sent me a three line email informing me not to conceive for three months and that I was now 'cured'.
I am now on my second cycle since the D and C and Methotrexate injections and we are back to throwing all caution to the wind. (Yes, against Doctors orders.)
I have less concern over conceiving before the three months are up than I do just conceiving in general. To clarify: I have taken folic acid vitamins in excess for over 6 years now, my diet is VERY high in folic acid, and there is plenty of research to suggest Methotrexate when used for ectopic pregnancy in single does use it is out of your system in as quickly as 7-14 days. What does concern me about conceiving in general is that now that I have had numerous consecutive miscarriages the likelihood I will have another is 60%. Also, because I've had an ectopic pregnancy there is a 20% chance it will happen again. These numbers leave little room for things to actually go RIGHT.
Sigh. I hope for the best, but have no idea what the future holds.
The nurse has urged me to undergo a hysterosalpingogram, where they inject the uterus with dye to see if it can flow freely through the fallopian tubes. As much as I'd love the peace of mind, my bank account is still reeling from the months of blood work, ultrasounds, injections and surgeries. My arms are finally healed and no longer look like I'm covered in track marks and I finally feel like a healthy woman again.
I love being a mom and would love to have another child and to give my son a sibling, but beyond 'seeing what happens' and 'throwing caution to the wind' at this point in time, I'm not desperately to actively try to conceive. I can usually swallow my baby-fever urges by reminding myself of the torment of the last few months and realizing the impact it had on my ability to fully care and commit to my son.
For those of you that have been through this, my condolences, and hope you have found the strength to try again. For those that are currently going through it, I know it hurts, physically and emotionally in every way possible, but you will feel joy again somehow, someway.
