feeling sad, scared and confused

[marmitemad]

Hello,

I wonder if anyone out there can offer any advice as to what is currently going on in my body?

I had light spotting start 3 weeks ago at nearly 6 weeks. Internal scan on 29/7 (6+2) showed an empty uterus and something on my right ovary, blood test showed a Hcg level of 679. I then had 2 more 48hr blood tests which showed rising but not doubling levels (see below).

Last Tuesday (4/8) I had another internal scan which was the same as previous (empty uterus, something unclear on right ovary), registrar said it was a suspected ectopic so I had 4 MTX injections (ouch).

Follow up blood test this week showed a very slight increase in Hcg of 66. Scan department refused to re-scan me as they were full and didn?t feel it was necessary so I agreed to a second round of MTX injections which were given yesterday.

I am now feeling uneasy as to whether the 2nd lot of injections were necessary after such a small increase (over 1 week not 48hrs) and also the registrar (haven?t seen a consultant yet) was quite determined that if next weeks level goes up again they will do a laparoscopy to completely remove my right tube although it is still a suspected ectopic and there is no firm evidence that it is in my right tube/right ovary.

It is quite horrible waiting on tenterhooks for the blood tests and I am really worried things are going to move quickly out of my control next week. Does anyone have any advice as to what I should be asking about / pushing for? Of course it may be that I am jumping ahead and the Hcg has finally started to go down next week.

Thanks in advance

29/7 (6+2) = 679
31/7 (6+4) = 805
2/8 (6+6) = 1112
4/8 (7+1) = 1628
11/8 (8+2) = 1694

[Shellseeker]

Hi Marmite
I really don't have any advice but just wanted to wish you all the best - I know from previous experiences that the waiting for news on things like this is so draining. The only thing I would say is don't be bamboozled and do kick up a fuss if you're not happy with what is happening - it's your body & you do have the right to be fully aware of what is going on. Stamp your feet if you have to.
Good luck and hope it all turns out OK.

[MrsHappy]

Hi Marmitemad

I'm sorry you've been going through this. It is so very hard.

When I had an ectopic which was treated with MTX, they tested my bloods on day 4 after the shot - the HCG level had increased a fair bit - and then they looked for a decrease on day 7 from the day 4 values. So in other words it was ok for the HCG to go up initially, as long as it then showed a decrease (I think of at least 15% between day 4 and day 7). So if you had had a test on day 4 it might have shown that sort of pattern and I guess (am not medically trained) you might not have needed the second shot.

However, I have also read that in 10 or 15% of cases the first dose of methotrexate does not work and a second needs to be given. Perhaps your docs are just erring on the side of caution.

The drugs worked for me (and hopefully they will for you too) but I would have thought that if your HCG levels are still high the next stage might be a diagnostic laparoscopy to see what is going on. Apparently lots of ectopics are never identified on scan, so laparoscopy is sometimes the only way to be certain of what is going on. It sounds like that registrar is being a bit gung-ho talking about removing the tube when they are not even certain that there is an ectopic, but if they do a diagnostic lap and there is one they would I imagine operate to remove the pregnancy while they are in there.

One thing I would suggest is that if you feel things aren't being explained to you properly you ask to see your consultant. They are the experts in all of this and should make themselves available to discuss the options if you want.

Other than that I don't know what you could push the doctors for. TBH I think it is just a waiting game and you have to just hang on in there (I know it's not easy) and see what the outcome of your next blood test is. In the meantime, can I recommend you check out the Ectopic Pregnancy Trust? They have some really useful information on their website and have saved my sanity on more than one occasion...