EPU scan today, holidays next week

[SunshineandPessimism]

Hi hive mind,

I’m wondering if anyone can help.

LMP 5th March 2019
Cycles variable - can be from 28-35 days and hard to tell given history!
First tested pregnant last week - very faint lines, getting darker gradually.

Long story short, I had a phone call scheduled with my doctor today to register pregnancy and request my referral to the EPU in two weeks time - as following a (2nd) MMC at 11.5 weeks in Dec 18 (and a long natural and complicated miss) they had offered to see me at 7 weeks.

My gut and conception dates (tho I could be wrong) suggest I’m early-mid five weeks Ish.

Doc referred me to EPU today as she was worried about etopic pregnancy. I had a scan Pregnancy “unknown location” - I.e. the nurse said frankly “I can’t see any signs of pregnancy in your womb”. 😭
HCG levels taken - measuring 486. 🤞

They want me back in next week. BUT I’m Irish living in London. Myself and hubby have had a fairly shitty year. We’re in Ireland with family Thursday-Sunday and then Crete in Greece Sunday-Sunday for a badly needed weeks holiday.

I’ve no other symptoms other than fleeting pain. Any recommendations for what to do?

Could I pop to hospital in Greece? I have my EHIC card and my letter from the hospital! I’m not registered with an Irish GP anymore and I’m in Ireland for a big family event so getting time away without the entire family accompanying me (my worst nightmare) will be difficult.

Am I really silly to want to go away? There is a large chance my dates are just out and this is a healthy pregnancy, there is also a chance it’s another early miss (I’ve had a few) and I know (sadly) there is nothing they can do.

Delighted to be pregnant but I wish the dam process was a wee bit less terrifying!

*hcg 496 and I meant symptoms of etopic. I’m feeling fairly miserable, tired, I’ll yet starving, and my boobs are sore. Oh and I’m bloated as hell and my jeans don’t do up. All typical signs of early pregnancy!

An ectopic isn’t life threatening immediately. Only when it grows big enough to rupture the fallopian tube / cervix / whatever else it’s attached to. You absolutely should get it treated before you even consider a holiday - your health matters more than a jolly!

If you had your hcg tested today ask for it to be tested Wednesday and friday, if it’s not close to doubling then you will know something is wrong. I’ve had an ectopic and was put straight in an ambulance to hospital, it was an awful experience and wouldn’t wish it on anyone, if you are having pain too then you definitely shouldn’t risk it as you can die if the tube ruptures. I hope it isn’t and you can enjoy your holiday x

Thanks TeddyBear. Your advice is helping me think things through!

And you’re right, if I was I’d 100% look after me first. But, currently I’m just confused!

Ireland is unmissable - unless I’m admitted - I’ve a family funeral and a big celebration in the two days. For me, the holls aren’t a Jolly, they are the one weeks annual leave I’ll have this year with DH. TTC has been a fairly miserable journey and we need the break. This pregnancy was somewhat unexpected (we were trying but not OPK using preseed etc and due to work travel etc. didn’t think it would happen).

I want nothing more than for all to be ok. All they want me back in to do is scan “just in case”.

My GP can’t understand the need for it to be in exactly seven days as statistically I’ve likely either had an early miss or I’m just too early to see anything on scan. They couldn’t see anything in my tubes either.

It seems strange but I am trying to think of my health. The last few months have made me so anxious about pregnancy. I’m worried staying in London “just in case” would just feed my fears.

I’ll have a car in both destinations and could take myself to hospital - I just don’t know how to arrange a scan in advance in either country!

I think I’m just confused. Positive POAS last week. Didn’t at all expect to be sent to EPU today. Am now in limbo. No symptoms of etopic other than an blank scan which could Ben totally normal at my stage given my cycles. My heads wreaked!!

In addition to some excellent advice you've been given, it would be very unusual to see anything on ultrasound with hcg less than 1000. Even then, it can be hit and miss. Internal ultrasound can see things before an external us.

Fingers crossed that the hcg doubles in 48 hours.

I also don't quite understand why it's suspected ectopic? Is it purely because of hcg levels?

Sorry OP but I've known people on forums rupture with a decreasing HCG level and as low as 5.
Ectopics are incredibly serious and being at altitude in a plane could be dangerous. I would ask your hospital for advice. I would also suspect your travel insurance would be invalid if you knowingly travelled whilst suffering from an ectopic x

@physicskate I don’t understand either! I’ve had some pain but nothing unusual. No bleeding. No arm pain. My cycles are long so I could just be early! I think they want to be safe as I was under their care and had an infection post miscarriage in Dec/Jan.

Thanks everyone for your time. Not trying at all to dismiss risk. Just feeling surprised, confused and kind of at sea...again!

I’ve rang my GP and asked to repeat HCG tests on Wednesday. And spoken to the local hospital in Ireland who have said they will see me if I begin to present as symptomatic (but not routinely). Trying to do all that I can.

Everyone is being lovely but the two nurses this morning said different things, my GP something else and in Ireland the consultant I spoke to wondered why I’m worried at all! Said she’d have no concerns at this point 😳🙈🤯

What a connundrum, I really feel for you. I'd also press for another hCG test and a re-scan on Wed.

It's very likely nothing, but that second scan may well put your mind at ease. Plus an ectopic can escalate very quick and is a big deal, including in terms of your future fertility. I had something similar in the autumn - quite a lot of pain in my side at c. 5 weeks, but dates all over the place with PCOS, so was hard to know if it really was 5 weeks. Went to A&E at night with increasingly severe pains as had had an ectopic a few months prior. They couldn't see anything on the scan, got worried it might in face be an ectopic. Asked me to come back to EPU in 24 hours, et voila, there she was! A tiny dot in the right place. I'm now 28 weeks and all is well. We now know that whole episode was at early-mid 5 weeks. It was also established that the side pain was an over-inflated luteal cyst, which is perfectly normal but can feel like an ectopic.

Best of luck to you and, if you do go, get travel insurance that covers pregnancy.

Hi @SunshineandPessimism I get your confusion...

For what it's worth I'm Irish too and if it was me I would get the HCG re-tested and head to Ireland. If for any reason you suspect there's a problem when you're at home then don't go to Greece. But I think you'll be safe enough unless something happens before Thursday to go to Ireland and then it's just taking a call from there based on your blood results...

Also without wanting to confuse you further, could your dates be out?

My LMP was 4 March and I tested positive on 28 March. Maybe you are not as far along as you think?

I'd go to Ireland and try to get a scan but I've had medical treatment in Greece and it was hard and very slow - I wouldn't expect to be able to get a scan there.

All the best

I've just had an ectopic and surgery (well in February) and to everyone saying the HCG levels wouldn't double - mine did. I was tested regularly for two weeks until they finally did a scan. I was 8 weeks gone and it was in my left tube. I'm lucky they found it but my point is only a scan can really tell you anything! Don't worry about the holiday - you either do the right thing as you can deal with the ectopic early, or you find out you're fine and pregnancy is in the right place, happy days! Just don't leave it xxxx

Thanks all.
@myheartisbroken I’m so sorry for your loss. Hope you’re recovering well. And thank you for sharing.

@anchordowndeepbreath love the username :) taking it as a tip! Thanks for the Greece advice. And the logical idea to split the trips. Helps me calm a lot!!

@agteacht my dates could well be out! I know my LMP was 5th March but ovulation/implantation could have happened at any time! I only tested positive last week!

But think I’m going to follow all suggestions, go ahead to Ireland. Check my bloods. Try get a scan in an IRISH EPU on Sat (if hcg levels double I should be visible >1500 by then) and make decisions when I know more.

Thanks a million everyone for support. I’ve 🤞 crosses the worries are all for nothing but also know I need to follow up! But having other voices has certainly left me feeling less scared and alone. Much appreciated xx

Good luck I hope it goes okay xx

Just to update. Have had three EPU scans due to pain, dates and pregnancy of unknown location, but finally today saw Baby and a heartbeat!! 😀 Measuring roughly 6+5 (+- 5 days) especially as bean is hiding in a corner of my womb and making it hard for the technicians/nurses.

Hasn’t been the easiest few weeks in limbo, and it’s still early days but, for now I’m delighted and finally allowing myself to be a little bit hopeful that this may be positive :)

Thanks for all of your support!

I’m updating in case anyone else is reading as I found deciding what to do very stressful! In the end I had 3x48hour HCG blood tests (results indicated good progression, which combined with my dates to reduce my risk BUT they wouldn’t clear me 100%). I did decide to travel, but only after a scan in Ireland (8 hours waiting in hospital!), in which they wouldn’t accept my bloods, cleared the risk of Ectopic and instead suggested high likelihood of a non-viable pregnancy. Given that there is nothing they can do for a miss, I decided to travel and I’m so glad I did! Being away solved the “should I be working while my head is a mess” dilemma, helped me be distracted and was good for my relationship.

Thanks a million for letting me sound out my thoughts!! :-)

Oh that's brilliant @SunshineandPessimism ! Great news. Glad you made the decision to go but more importantly, they've found a heartbeat! I'm 8+2 so not much further ahead. Hope your pregnancy goes really well