please help - ectopic - surgery or methotrexate?

[tasmaniandevilchaser]

I can hardly think straight, consultant says I am a candidate for either surgery or injection of methotrexate. I can't decide what to do.

Cons of surgery - never had surgery before, don't know what to expect; what if they whip out a tube and the other one is blocked/scarred?; general surgical risks
Pros of surgery - if they whip out a tube then I can't have an ectopic in it anymore; not so many follow up appts

Pros of methotrexate injection - no surgery;
Cons of methotrexate - will never know how scarred tubes are and what chances of successful pregnancy is; might need surgery anyway; might need more than one injection; more follow up appts

Can anyone help me think straight please? I can do either tomorrow, so I don't have a lot of time.

Have you had a look at ectopic.org? excellent website and support.

just come from there! Don't get as many answers so quickly, mumsnet is good for that! Forgot one of the cons of methotrexate - can't TTC for 3 mths, though that might be a pro as well, considering the stress!

I had surgery (was in the days before methotrexate was an option) - 2 laparoscopies then laparotomy (big scar). Took a long time physically and even longer emotionally to get over it.

BUT - they gave me the option to try to save the tube or have it removed. I chose to have it removed. It had let me down and I didn't want it (made sense at the time)

thanks tispity, have been reading more about methotrexate, looks like horrible stuff, takes all the Vit B9 out of you and leaves you knackered. But I've never had surgery so I don't know what that does to you either. I didn't feel like this about the MMC and the medical management, I really didn't want surgery then. I feel differently now....not so sure

Hi again tas. Somebody asked this question a while ago in the miscarriage boards, so you might find helpful discussion there. I will try to find it for you in a sec.

I had surgery and was praised for choosing it by the hospital staff. They may have been trying to make me feel better about a tricky decision, of course, but what they pretty much all said or hinted at was that if the tube stayed in there there was a huge chance that any egg picked up by that tube in future and fertilised would stick there again. With the need to have that pregnancy managed out of you again (and not forgetting the threat to your own life).

They also said that if one tube is gone, the other tube can sort of whip across and pick up eggs from the other ovary, if it is that one's turn to ovulate.

So with that in mind, the only question for me was how I felt about surgery. As I'd had surgery recently for something else (my ovaries drilled, in fact), I knew what the procedure would be, and wasn't stressed by the thought of it.

thanks Northey that makes sense. I was very against having surgery for the MMC, but I don't feel that strongly with this EP. The thought of it happening again is awful, if the tube is out then at least the other tube can have a go. And if that one is f*ed then there's always IVF.....

hi thanks tilda, the decision has been taken away from me, as blood tests show hcg levels are over 3000 today. In a way I'm relieved, I don't like the thought of a dodgy tube just waiting to make this all happen again. I'd rather get rid of it. I feel so lucky in a way, 150 yrs ago, I'd die of this.

hi everyone, I'm back home now. Surgery went smoothly, they took out most of left tube and right tube looks fine, thank god. Though left tube didn't look scarred or damaged apart from the 'blob' in it. I saw the photos of my ovaries, tubes, womb and liver. DH went all faint, but I though it was amazing, I looked in tip top condition in there!! It was quite beautiful in a way, always thought I'd be too squeamish to be a surgeon, maybe not!

Good advice Tilda, I will be taking it EXTREMELY easy for the next 2 weeks, have cancelled everything possible and told work I won't be in for 2 weeks. I feel very fragile, physically, mentally and emotionally. I also didn't sleep last night in hospital, so am totally knackered. I was so tired I couldn't keep my eyes open but still couldn't sleep. The night was very long.

Well done! I'm so pleased you came through it all ok, and that nothing's hanging over you any more.

Yeah, sleeping in hospital is a bugger. Hopefully you can have a nap this afternoon. Is your DD back with you yet?

No DD is still with my parents, adoring grandparents. Apparently she said to my Mum last night "we've fallen in love!" and hugged her, how cute is that?! I'll probably go to them on Saturday.

I started off in a main bay on the ward but got so upset with the awful people next to me, that I just found a nurse said I was moving and burst into tears. Crashed into a side room with 2 beds and said to the old lady in there, 'can I share with you?' and flopped down on the empty bed. She was lovely, so sweet, been in there for 5 months!!!! The people originally next to me were so horrible, I'm normally not particularly judgemental but there was about 10 of them, talking non stop like machine gun fire, about taking drugs and driving their kids around, mashing up the doctors' faces, and best of all about an hour on pregnancy and childbirth. Which really was the last straw.

Oh God, you poor thing, what a nightmare experience! Thank God you found a spare(ish) room and that you are home now.