No help from NHS services

[Akemi]

I had my period last week starting on Tuesday with 1.5 days of medium to heavy bleeding after 2 days of heavy spottting on Sunday and Monday. Bleeding stopped on Wednesday night and I've been light spotting brown since then.

I though last cycle was unsuccessful so on Saturday I took an LH test to start tracking ovulation again and it came back super positive which was weird for my "CD 5" so I took an hcg and came back positive. Not as dark as I thought it would be at "20 dpo" but clearly positive.

I knew straight away that this will not end well because I'm very sure of my dates given I'm tracking with LH and BBT but nobody will do anything! I called 111 and my GP and they both said that because I'm not in pain they can't refer me anywhere but to go to A&E if I develop pain ir heavy bleeding. But I know that by that point is usually too late in case of an ectopic.

The reason I'm so worried with an ectopic is because I know that bleeding before a positive hpt + erratic hcg is a classic pattern, and my tests have been varying in intensity since the first positive on Saturday but all of them are too light for "20-25 dpo"

I really don't know what to do anymore and I'm at the verge of a breakdown. Why is the system so horrible with pregnant women? I just want to know if this is a "safe" miscarriage or get the help I need if an ectopic.

but what can they do?

you’re very early, chances are nothing will be visible, ectopic or uterine. Ectopics won’t usually show until about 6 weeks, so no point scanning before then.

you could book a private scan to make sure.

but they’re right. All you can do is wait until you’re far enough along that intervention is possible.

I spoke with the midwife and gp of my private insurance through work - unfortunately it doesn't cover much more than advice - and they both said that the protocol is checking Betas until ultrasound is plausible. They both said GP has to refer me to EPU. I'm 5W 3D now, by the time I get an ultrasound I will probably be closer to 6 when is possible to see something. All it takes is some action from them.

Sorry, its a bit hard to follow. Am I correct you've had no bleeding nor pain since your positive pregnancy test? Have you had an ectopic before or have scar tissue/PID or something to make you higher risk of having one?

I'm sure you know what pregnancy tests can be darker/lighter depending on urine concentration and several other factors. When I was pregnant, some tests were very pale, yet the next day could be darker.

It doesn’t sound like they would refer you though unless you’ve got previous history? You’re so early, and possibly a chemical pregnancy which they can’t do anything about.

Sorry, I wrote this while feeling very frustrated.

I haven't had pain but I'm still spotting brown.

I know lines can be different intensities depending on urine concentration and so on, but I've been testing at the same time every day with similar levels of hydration and one day I would get the faintest line only for the next to be pretty strong but not nearly as dark as the control line. I'm 5w 2d now so I understand hcg levels should be higher and duplicating every 48-72 hours.

This is my first known pregnancy and no suspicion of other risk factors. I really wish is a chemical at this point but I tested negative up until 12dpo when I stopped to wait for my period, and only started testing positive 5 days into my new cycle.

My understanding of chemicals and miscarriages in general is that hcg goes down not up and down.

I really wish is a chemical at this point

Sorry, still confused. Do you mean you don't want to be pregnant? A chemical is a very early miscarriage.

As frustrating as it is though, sometimes the best thing to do is nothing.

there is nothing you can do to change the outcome. Noting will help you keep the pregnancy, nothing you can do to stop you losing it.

only time will help.

there’s no point in doing bloods either as again that won’t change your treatment or the outcome. Whatever your HCG is doing, there’s nothing you can do about it but wait.

there’s only thing you can do is wait until you’re far enough along that a scan will assist in managing a possible loss. Which is about 6-8 weeks. In fact the longer you do nothing the easier it will be to manage- too early and you’ll just be sent away to come back when something shows itself.

if it is ectopic again nothing you can do until a scan or you get pain etc. think about it- this early it’s not as if they can remove both tubes just in case it’s an ectopic, you have to wait until it’s seen.

Sorry, I'm still learning how to use this platform. That comment was in response to Overthebow.

I do want to be pregnant. But now that I'm experiencing whatever it is I'm going through now, I wish is a chemical over an ectopic.

I'm not sure where you are getting the idea that your HCG is going up and down and is erratic? Have you had blood tests that determine this?

If you put the Sunday and Tuesday pregnancy tests next to eachother, there is a clear difference (showing that HCG increased in that 24hr period).

I think this is the whole point of my rant. I haven't had blood tests as 111 and my GP said they can't refer me for any of these services.

I feel they are erratic because on Saturday I had a very clear line which was barely visible on Sunday. Then on Monday I had an even stronger line than the one of Saturday but it has gone to light today. Is the erratic pattern that raises concerns of ectopic.

Do you have other tests that aren't in the pictures shown? The ones you've uploaded aren't erratic... they clearly show progression from Saturday through Tuesday.

If it would help you to settle, perhaps you could book a private scan from window to the womb or something similar after the 6/7 week mark?

From what yigve uploaded, there's no reason to get bloods (I only asked about this because you keep referring to erratic HCG, but I don't see anything to confirm this).

ETA: I think you are picking up on the Monday 11.30am line being slightly darker.... but the a different test brands than all the others so isn't comparable.

Home tests aren’t quantitative though.

they differ from brand to brand and even test to test. Whether you’re hydrated or not.

you can’t say what your HCG level is based on a home test. You could more easily conclude your hydration is erratic or your kidney function is.

you’re testing at different times of day as well so that will have a significant effect.

blood tests aren’t quantitative though pointless. Even if your HCG is not doing what is expected the answer will be to wait until a scan before any action. So why waste your time and money, and the NHS’s, for no difference in outcome.

waiting is the best course of action.

You've said all it takes it action from them but they will have a specific criteria for referral to EPU, in my area they wont refer anyone until at least 6 weeks, regardless of how long it would then take to be scanned.
I understand your frustration, it feels like there is no-one to help in that 4-6 week window, I felt the same when I was spotting, but there would be nothing they could see on a scan anyway. I know how scary it can be, when I mentioned brown spotting for 4 days to my midwife she didn't seem in the slightest bit concerned as it wasnt red/getting heavier, to me it had felt terrifying but to her she said it was totally normal

Thank you for your suggestion. I will look into the early scan for sure.

I think I was getting frustrated because my GP didn't even offer to book an appointment to discuss my concerns when I called, and they completely dismissed me saying they can't help and to go to A&E.

I only have a picture of these unfortunately. I took a digital on Saturday which put me at 1-2 weeks but I know based on when we last had sex that I should be further along if this was a normal pregnancy.

I get that there is a protocol but when I called my GP they didn't even offer to see me, they just dismissed me on the phone. I think that is what made me feel so hopeless and scared.

That and also the countless of posts I've read here and in other platforms about people that had a very similar chain of events and tests that turned out to be an ectopic only diagnosed when it ruptured.

I get that there is a protocol but when I called my GP they didn't even offer to see me, they just dismissed me on the phone. I think that is what made me feel so hopeless and scared.

That and also the countless of posts I've read here and in other platforms about people that had a very similar chain of events and tests that turned out to be an ectopic only diagnosed when it ruptured.

I think you need to take a breather here for a second. A GP literally cannot do anything. It'd be a complete waste of time.. and then you'd probably be getting yourself in a spin that they didn't help you (despite the fact that they literally can't do anything).

I would recommend you step away from the tests for awhile as I think you are working yourself up into a bit of a tizz to be honest which won't help anything.

If this is a chemical / early loss then unfortunately there's nothing to do but wait. But hopefully it'll be just an unexpected pregnancy. It actually sounds like you may have had implantation bleeding last week on the Tuesday. Brown blood is usually old blood just getting dislodged and wouldn't be a cause for concern to the medical community.

Nothing suggests an ectopic pregnancy though.

Hi OP as someone whose had two confirmed ectopics that both followed this exact pattern I understand your concerns.

Bleeding followed by a string of positive faint tests (later than expected) is absolutely an ectopic red flag.

What should be happening here is beta HCG tests. If the HCG is stagnating, or falling then rising again, or rising slowly, that is another key indicator of ectopic.

Whilst a previous poster is correct that they will be unable to see anything on scan at early stages (or until HCG reaches roughly 1500), a pregnancy with abnormally rising or stagnating HCG that cannot be seen on US is treated as pregnancy of unknown location.

This needs to then be monitored, as if HCG rises, and it is indeed ectopic, it will rupture.

In your shoes OP (and I've been in your shoes where I've been unsure if it's ectopic pregnancy or miscarriage - and I've had both happen) I would be going to EPU and asking for HCG blood tests.

If it's diagnosed as PUL, then whilst you wait to see the outcome, you'll be able to be monitored to keep you safe.

I understand you hoping it's a chemical pregnancy. Obviously you hope for a happy ongoing pregnancy, but if it isn't, then the best you can hope for is chemical.

Good luck x

Also, to commenters stating there is no point doing bloods, that is incorrect. If the HCG is rising, even if nothing can be seen on a scan, they can and will use methotrexate after identifying the pattern for long enough. Similarly, they can and will do investigative lap if needed, again if nothing is seen on a scan and yet the HCG is monitored to be rising over a period of time.

Without taking the bloods you can present at 6 weeks pregnant, see nothing on a scan, and be told you are probably less pregnant than expected, nothing to worry about. With bloods taken you can be certain that isn't the case.

Thank you so much for your comments. I cried a little reading it and it feels that someone is at least validating my concerns.

Your explanation regarding betas is exactly the protocol my private insurance gp mentioned. But she also said that unfortunately only my NHS GP can issue the referral... hence my breakdown after being told by the NHS GP over the phone that they can't help.

Honestly, thank you.

Also, I'm really sorry to hear you went through this twice 😔 I hope in the end you had the outcome you desired.

Stop testing yourself. Relax.
If you get any pain go to a and e.
Otherwise wait til further along.
You need to stop all this self testing and obsessing. It is not helping you at all.

You will get real things to stress about.
This is not it.
Take it week by week.
Any real symptoms like pain or bleeding go to a and e

This

I'm sorry that you have or had things that are worrying and stressing in your life, but that doesn't make mine any less "real". I hope things are going well now.