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Treatment.

Posted May 26 2014 11:30am
This is the third part of my ectopic pregnancy story. It will be a long read and some of it might be TMI for you, so you've been warned ;)

part 2
part 1  

My next 2 hospital visits were similar
August 3rd (2nd day at hospital): HCG levels up to 1788, nothing seen in the uterus. (but it could still be early)
August 5th (3rd day at the hospital): HCG levels up to 2738, nothing seen in the uterus.

The first doctor I saw at that point told me they suspected it was indeed an ectopic pregnancy and very briefly explained that I would end up having to choose between surgery or a shot of methotrexate to end the pregnancy.

I then saw another set of resident doctors who explained in more details what the options were
Surgery: I knew I wanted to avoid surgery - if they did surgery and found that there was something in my tube they could remove it and they may or may not be able to save my tube (if they couldn't they would have to remove the tube...) On the flip side, if it turned out the 'baby' was in the right place after all, they could leave it alone, and potentially let it grow into a successful pregnancy (assuming going through surgery didn't 'mess it up'...)

Methotrexate: I was a good candidate for methotrexate, with no signs of internal bleeding, a small sized 'ectopic', HCG levels that were low enough, good 'liver health' and being able to come to the hospital quickly, should complications come.

I have forgotten to mention something: my beautiful baby L was almost 35 months old at the time (yes that's a little over a month before he turned 3) and I was still nursing him, once a day, before bed time. And the occasional one time before a nap on the weekend... ok, back to the story...

Methotrexate would dissolve the pregnancy and I would get checked once a week to see that my HCG blood levels were going down until they reached less than 5, which is considered 'not pregnant'. BUT! Methotrexate would render my breast milk unsafe for L to drink.

I sobbed. I cried SO hard right then, because unknowingly, the night before, I essentially had nursed my boy for the very last time.

They left me alone for a little bit, to make my decision final and discuss this with my husband (obviously, I didn't mention him yet, but during this whole ordeal, I was updating my husband and getting his opinions and thoughts over the phone. We have no family or friends that live close enough to take over childcare on a short notice - it's only ever just the two of us! - so clearly, he had to take care of L while I was in the hospital... so at that point we both decided to go ahead with the shot)

Until... I met with the chief of OBGYN at that hospital. He basically just shook the whole thing up. I went from deciding to end the pregnancy to deciding, with him, to give this pregnancy one more chance, because he was not 100% convinced that it was abnormal.

Basically, he said he had seen normal pregnancies start this way. He also said that they were not sure where my pregnancy was located (there were signs that it might be in my left tube, but really nothing absolute or clear). He told me that since I was seemingly normal (minus the belly pain and the spotting, both of which were a bit less at that point) I could give this another 48 hours, go for another blood work and ultra sound, but that this time, he was going to do it 'out patient' - that I wouldn't have to go to the hospital and waist a full day there again (unless I was feeling signs of internal bleeding of course...) If I was still showing up with an empty uterus, I would be able to make an appointment to get the methotrexate shot in his office no problem.

Well, I went to another ultra sound, and did more blood work
August 7th: HCG: 5409
Ultrasound: I went to this private ultra sound place, and was not pleased with the technician. He declined to do an internal ultra sound.

Back to the doctors' office: He's still not convinced, and I am not confident that the ultrasound was done properly. This time, give it a week and see - by that point, we would REALLY see something if it was in the uterus, both based on the HCG levels AND based on gestational age...

August 13th: HCG: 16632
Ultrasound was done at the hospital, in the pregnancy 'area' (whatever it's called) with a technician who is trained specifically in 'uterus' ultrasound, and looking for babies in uteruses.

August 14th: The doctor called me and gave me the results from the 13th, it looks like we gave it a good shot, but there's no baby in the uterus and at 16632 we should really REALLY see something. The spot they saw in my tube that could be the ectopic pregnancy seemed to be slightly larger so at this point, he wanted to treat it and give me a methotrexate shot, and could I come into the office that same afternoon.

About breastfeeding/weaning: I spent the previous week preparing L and explaining that 'maman' had some 'bobos' in her belly and that to make maman feel better, the doctor might have to take out the bobos and all of maman's milk at the same time. Meaning that there would be no more milk available to drink for him. When the doctor called it was almost nap time, so, even if I was letting him call when he wanted to nurse at that point without suggesting it, I called him and asked if he wanted to nurse. I explained that I was going to the doctor's office and that he would take all my milk away to make me feel better, I explained that it was the very last time he would ever drink maman's 'bon lait', as we used to call it. And just like that, on August 14th 2013, I nursed my boy for the last time. I thought our last time would be a sweet tender and loving moment, but the truth is, in reality, at that point he was most of the time using nursing to delay having going to bed :) He was always half into the nursing, like it was natural and needed, and the other half was more of a drink a bit, get distracted and talk about something else, drink some more. And this last time was no different, and I kind of like that about it - I'm not sad thinking about the last time we nursed - I kind of laugh about it - he really was very close to choosing to wean anyway. And I'm so happy that I got a chance to verbalize it with him, and that he could understand a bit what was going on and why.

I put L to bed for his nap, kissed my husband, and left for the hospital pharmacy to get the meds, then arrived to at the doctor's office, more than ready to put this 2 week ordeal behind me.

We spoke about it a bit, then got ready for the shot. Turns out the pharmacy gave me too little of it, ha ha ha!

I went back, got more, drove back to the doctor's... he split the injection so he would inject me once in the back muscle over the left hip, once over the right hip (apparently it works best that way).

I was finally done with this. Or so I thought. Next post will be the conclusion of this story :)
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