Friday, April 13, 2012

Rupture

Right tubal rupture- good times! For whatever reason, after two rounds of Methotrexate my 1cm sized embryo grew to 5cm, even with a falling hCG. My beta last Friday was 3900, not a big decline from the week before, but not concerning, and my level yesterday at the ER was 1800- a nice big jump. Yet it kept growing...

Around 11pm Wednesday night I felt some left side aching in my back which spread to the right side. It became a bit strong so I took some extra strength Tylenol and gave myself two hours. I was worried about kidney stones since that's where the pain seemed to be emanating from, though the pain did eventually move to my right front pelvic region. A rupture never crossed my mind since my levels were dropping and we caught the ectopic at 6weeks- nearly five weeks ago (and since I was still getting a period I didn't notice that it had become more like real blood until later). By 1am I told J we should to go to the ER, so he called on a friend to stay at the house with Ally sleeping. 

Luckily this time the ER was empty so I was seen almost immediately. Same doc too, Dr. L- I doubt I'll forget his name now! Dr. L talked to us, did a belly exam and really wasn't sure what was going on, but did want to start me on pain meds, get a blood draw and urine sample. I was given Zofran to help with the nausea from the pain and the meds I was going to get. I don't remember exactly what I got- hydro.codon maybe? It took awhile for that to kick in, but definitely helped once it did, though I was still feeling a dull bit of pain. Lab came back with nothing of concern and an hCG of 1800. 

I'm not sure if Dr. L is just conservative in his care or cost, but he mentioned getting the pain under control then having me follow up with Dr. E. To which I thought "hell no." I told him I wanted to find out why I was in pain in the first place. So he decided on a CT scan since that would show stones, ovarian cysts, etc. Good thing I advocated for more info since the CT showed the rupture. Within an hour IVs and oxygen were started, and Dr. E and a team were there to get me into surgery. It all went pretty quickly, and everyone who took care of me was very nice. I was wheeled into Surgery, thinking "I haven't had real surgery since I was 3 years old." Pretty good run, I think :) Last thing I remember was the nurse anesthetist saying she'd be putting me to sleep... and I woke up 2 hours later in recovery. I had told Dr. E to take the tube no matter what, which she did, though thankfully that was all that was removed. She gave J pics from the surgery (!!!) and told me we'd go over them at my follow up appointment. She said something about my right ovary, though J doesn't remember what exactly, but didn't think Dr. E was overly concerned about it. So I'm thinking PCOS or Endo? Dr. E also said the left side looked great- thank goodness!

We were fortunate one of our sitters was able to be with Ally all day, and my mom was able to fly in last night- yay! That's one of the biggest draw backs about military living- the usual family support system isn't there. Though since we're all in the same boat military friends are there in a pinch :) I'm thankful this all happened at what turned out to be a convenient time- not sure what I would have done if J had been at class, unreachable, and I was alone with Ally. Not a good scenario. I'm also glad I went with my instincts, even though I was wrong about the cause I knew I needed ER care and that J needed to be with me. 

I was home a few hours after waking up in recovery, and have been resting in bed. J took care of everything before my mom got here. We'd both been up over 24 hours by the time we got home at 11am yesterday and there was a lot to do. And lest we forget when all this occurred: it fell on our 5 year wedding anniversary. All the nurses "awwww"-ed when they were wheeling me out and I said "happy anniversary" to J. Good times, indeed.

Tuesday, April 3, 2012

So Far, So Good

I had my 3rd hCG draw and a follow-up with Dr. E on 3/23. Thankfully my quant decreased from apx 10,000 to 6,000, and my last draw this past Friday 3/30 was apx 4,500.

At the appt with Dr. E on the 23rd I talked to her about what comes next, assuming the ectopic is taken care of, and her response was quite different from Dr. P's (whom I saw 3/16 since Dr. E was out of town). She felt that waiting 4-6 months was more appropriate since there are no good studies that show when it is safe to get pregnant after Metho. Whereas Dr. P said the drug is out of the system within a week, and the advice is to wait a cycle or two after the hCG comes back to normal just like any miscarriage (so apx 3 months). Hmmmm. Plus, Dr. P thought removing the tube and taking it out of the equation made sense, and has done so before, but Dr. E was hesitant about that idea and wants to do more research... I guess I appreciate Dr. E's conservatism, but at the same time I would have love some consensus so I don't feel like I'm floating out it no-man's land. I like a plan, and right now I have nothing.

Fingers crossed my quant this Friday is < 2,500!