As of the last post I had just gotten the second methotrexate shots due to my HCG levels not declining. The Wednesday after the second set of shots my HCG did fall to 2,384 and I was bleeding. That was good news until my bloodwork for that Saturday (12/8) came back and showed that my HCG had gone up again.
I got a phone call on Sunday from the nurse with the news and with the instructions to prepare for surgery and to come back in to the office for another ultrasound before the surgery. It was a complete shock and I couldn't believe what was happening. I spent over 4 hours at school getting things prepared for a sub for the week trying not to panic.
So on Monday we went back in and had the ultraound. It showed the ectopic in the tube measuring even bigger than the week before, but now Dr. J saw bleeding spots in my pelvic cavity. So we went over the procedure itself, she emphasized wanting to do as little possible to my tube, but wouldn't know until she got in there.
We went over right away. I had to get ready by myself and that was terrifying. After 3 painful tries, they finally got an IV in and Stu was able to come back before I went in. They gave me a shot of something and I remember it working quickly. One minute I was switching tables, the next minute I was waking up asking about my tube. Someone told me Dr. J couldn't save my tube.
I went in and out a bit but had a lot of pain in my chest and ribs. It really hurt to breathe. That was from the gas they put in me to visualize everything. After awhile I was released to go home.
The first few days were miserable... The breathing thing was the worst part. I took the pain medication that did help a bit the first couple of days. Not until four days after the surgery was I finally able to take a deep breath without hurting so much. After that I only needed Tylenol every once and awhile.
I did return to work after a week for four days before Christmas break. The kids needed me back for sure. It was hard the first couple of days back, more emotionally rather than physically, but by Wednesday, I was doing better.
Throughout all that time, I really didn't have time to process what happened. Now that I have time, the pain of this loss and the loss of my tube makes me feel like I want to panic or just cry. I have always had hope, but then again, I had 2 working ovaries and tubes. Now I just don't know. I know there are worse situations out there, but after 4 losses and over 2 years of trying, how does one continue to find hope on a situation that is less than kind of ideal?
Thursday, December 27, 2012
Sunday, December 2, 2012
Methotrexate Take 2
I got stuck in the butt again today. I went in for blood tests Wednesday and Saturday and rather than declining, my hcg levels doubled for Wednesday (2,692) and up another 200 to 2,890 yesterday. The Wednesday number was okay, I was advised that it is normal for the level to go up initially, but by day 7 should go down by 15% putting me around the 2,330 range.
So I got to meet Dr. M today, he's a nice guy, to the point and quite gentle. He found the gestational sac on ultrasound confirming an unruptured ectopic pregnancy. He did check other areas as well to be certain. So, he recommended two options-another dose of methotrexate or surgery. As the sac was still very small and there wasn't really anything to see in it, he was confident that another shot would do the job. This set hurt. A lot. Maybe it was the difference in nurses or maybe the site was still sore from last week, but it really hurt this time. Stu said she stuck the needle in all the way and plunged fast. Ouch! I also bled this time at the injection sites. I seriously don't ever want to do this again. So now we still wait.
It is weird that I am still pregnant and feeling pregnant even though my pregnancy was doomed almost 2 weeks ago. Today would have been 7 weeks. So as we speak, I am now having brown spotting which I can only assume is good. On my ultrasound photo, on the left side, you can see a white outlined gestational sac with a dark area around it (fluid)...it is the round one on top of a kind of oblong shape. To the right of the sac is my fallopian tube which looks like a straw going at an angle upwards. I will try to upload the photo in a smaller form but here is the link to my photo:Ultrasound photo
On another note, my suspicions of having a positive test for the MTHFR (or the motherf&@#3r gene as I call it) was confirmed. I am positive for a double copy (homozygous) of the C677t mutation. This is the bad one to have as far as I understand. It has everything to do with properly converting and producing folic acid in the body.
People with this type of mutation do not produce enough folic acid which leads to increased occurrence of neural tube defects. It also leads to increased homocysteine levels which lead to clotting factors. Both of these issue are troublesome for pregnancy and even though it is still controversial to say this, there is an increased likelihood of recurrent miscarriage.
So I've got the thyroid/MTHFR/ectopic/autoimmune thing to worry about for my next pregnancy. No problem...
So I got to meet Dr. M today, he's a nice guy, to the point and quite gentle. He found the gestational sac on ultrasound confirming an unruptured ectopic pregnancy. He did check other areas as well to be certain. So, he recommended two options-another dose of methotrexate or surgery. As the sac was still very small and there wasn't really anything to see in it, he was confident that another shot would do the job. This set hurt. A lot. Maybe it was the difference in nurses or maybe the site was still sore from last week, but it really hurt this time. Stu said she stuck the needle in all the way and plunged fast. Ouch! I also bled this time at the injection sites. I seriously don't ever want to do this again. So now we still wait.
It is weird that I am still pregnant and feeling pregnant even though my pregnancy was doomed almost 2 weeks ago. Today would have been 7 weeks. So as we speak, I am now having brown spotting which I can only assume is good. On my ultrasound photo, on the left side, you can see a white outlined gestational sac with a dark area around it (fluid)...it is the round one on top of a kind of oblong shape. To the right of the sac is my fallopian tube which looks like a straw going at an angle upwards. I will try to upload the photo in a smaller form but here is the link to my photo:Ultrasound photo
On another note, my suspicions of having a positive test for the MTHFR (or the motherf&@#3r gene as I call it) was confirmed. I am positive for a double copy (homozygous) of the C677t mutation. This is the bad one to have as far as I understand. It has everything to do with properly converting and producing folic acid in the body.
People with this type of mutation do not produce enough folic acid which leads to increased occurrence of neural tube defects. It also leads to increased homocysteine levels which lead to clotting factors. Both of these issue are troublesome for pregnancy and even though it is still controversial to say this, there is an increased likelihood of recurrent miscarriage.
So I've got the thyroid/MTHFR/ectopic/autoimmune thing to worry about for my next pregnancy. No problem...
Sunday, November 25, 2012
Ectopic Pregnancy
Just got back from our latest ultrasound. As of Friday my hcg had risen to 1024 and whereas it should have been a good sign, in my case with nothing being found at all in my uterus, it wasn't good news.
Ultraound today revealed the same small mass Dr. J had seen on Friday and that had not changed. But, on closer inspection, she did see a mass in my right tube measuring 6w1d. Today I am supposed to be 6 weeks. So, the mass combined with nothing again in my uterus, Dr. J was certain that I am having an ectopic pregnancy.
She looked and looked to make sure. Checked my cervix and all surrounding areas that an embryo could have implanted. So I have no doubt about the ectopic diagnosis.
So, I had to get the Methotrexate shots, one in each hip, intramuscularly. Stung a bit, but wasn't too bad. It is a chemotherapy drug that strips your body of folic acid and stops the growth of cellular tissue quickly. If I didn't get the shots then I would have run the risk of having my tube rupture and have internal bleeding. I don't want to lose a tube and I seriously don't want to hemorrhage.
So now, we have to have my blood levels checked on Wednesday and Saturday. If the levels are going down well, then I will just have blood tests weekly to monitor my levels to 0. If they are not going down well by Saturday, then I will have to get another dose of the Methotrexate.
After my numbers are at 0, I will have to wait another "normal" cycle before we can try again. So that puts us in around late January-February to try again. In the mean time, I am not to have any folic acid supplements or foods, as well as no ibuprofen or aspirin, alcohol or a lot of sun exposure.
So, as it is, am I the most unlucky person in the world?! Only 1% of the population will ever have more than 3 miscarriages, and about 1 on 50 pregnancies are ectopic. I don't anyone who has has an ectopic. I am a statistical nightmare.
But on the flip side, 85% of women who have 3 or more losses will go on to have a normal pregnancy and my risk for another ectopic is higher than the rest of the normal population, but not by too much. There's always a rainbow after a storm...I just have to find it.
Ultraound today revealed the same small mass Dr. J had seen on Friday and that had not changed. But, on closer inspection, she did see a mass in my right tube measuring 6w1d. Today I am supposed to be 6 weeks. So, the mass combined with nothing again in my uterus, Dr. J was certain that I am having an ectopic pregnancy.
She looked and looked to make sure. Checked my cervix and all surrounding areas that an embryo could have implanted. So I have no doubt about the ectopic diagnosis.
So, I had to get the Methotrexate shots, one in each hip, intramuscularly. Stung a bit, but wasn't too bad. It is a chemotherapy drug that strips your body of folic acid and stops the growth of cellular tissue quickly. If I didn't get the shots then I would have run the risk of having my tube rupture and have internal bleeding. I don't want to lose a tube and I seriously don't want to hemorrhage.
So now, we have to have my blood levels checked on Wednesday and Saturday. If the levels are going down well, then I will just have blood tests weekly to monitor my levels to 0. If they are not going down well by Saturday, then I will have to get another dose of the Methotrexate.
After my numbers are at 0, I will have to wait another "normal" cycle before we can try again. So that puts us in around late January-February to try again. In the mean time, I am not to have any folic acid supplements or foods, as well as no ibuprofen or aspirin, alcohol or a lot of sun exposure.
So, as it is, am I the most unlucky person in the world?! Only 1% of the population will ever have more than 3 miscarriages, and about 1 on 50 pregnancies are ectopic. I don't anyone who has has an ectopic. I am a statistical nightmare.
But on the flip side, 85% of women who have 3 or more losses will go on to have a normal pregnancy and my risk for another ectopic is higher than the rest of the normal population, but not by too much. There's always a rainbow after a storm...I just have to find it.
Saturday, November 24, 2012
More Waiting
On Wednesday my hcg was 669, and yesterday it jumped up to 1024. Crap. It didn't quite double, but now I'm seriously looking at the possibility of an ectopic. On ultrasound, most pregnancies can't be picked up until your levels reach at least 1000 which means in my case dr. J wouldn't have been able to see anything anyways.
I have to go in tomorrow (Sunday) for another scan. This time she may be able to see something. If it isn't in my uterus, the I have to go ahead with the methotrexate shot because it means there is something somewhere causing my hcg to continue to rise. So this is why I haven't started my heavy bleeding yet.
I'm so scared right now. I was really hoping that this would have ended quickly and not be drawn out like this with all the uncertainty. What I'm most afraid of is the shot. We won't be able to try for sometime afterwards because it strips your body of folic acid which could lead to neural tube defects in a subsequent pregnancy. And also, it's a pretty strong drug.
What if I see a baby in the right spot tomorrow? Could I really be that lucky? I'm guessing not since my numbers should have been rising faster than this. I will continue to hope that this all turns out well.
I have to go in tomorrow (Sunday) for another scan. This time she may be able to see something. If it isn't in my uterus, the I have to go ahead with the methotrexate shot because it means there is something somewhere causing my hcg to continue to rise. So this is why I haven't started my heavy bleeding yet.
I'm so scared right now. I was really hoping that this would have ended quickly and not be drawn out like this with all the uncertainty. What I'm most afraid of is the shot. We won't be able to try for sometime afterwards because it strips your body of folic acid which could lead to neural tube defects in a subsequent pregnancy. And also, it's a pretty strong drug.
What if I see a baby in the right spot tomorrow? Could I really be that lucky? I'm guessing not since my numbers should have been rising faster than this. I will continue to hope that this all turns out well.
Fourth Miscarriage Confirmed
Ugh, where to even start. Well, as of my last post, it is possible to get pregnant on the first try of Letrozole with trigger. I was that girl.
I got my first faint positive at about 14 dpo and of course yelled for Stu to see if he could see the line and of course he could! That same day I started spotting. I figured it was the proverbial "implantation spotting" which I had in my first pregnancy.
The next day I got an even darker pregnancy test line, but was still spotting. Monday came and I called to get my first blood draw and the bleeding picked up. At that point I was hanging on to hope by a thin thread. Tuesday's blood draw was 37, lower than what they wanted, but it was what happened in the next draw that mattered.
On Thursday my number almost quadrupled to 135!! Amazing! Still spotting, but it had receded a bit. I then had to go in for one more blood draw on Saturday and then I would be able to schedule my very first ultrasound. My number again surprised me and almost tripled to 398.
This past Monday I scheduled my ultrasound for Wednesday 11/21. Though the whole time my spotting/bleeding continued and I was really trying to hold on to hope that I could make it to my ultrasound. The ultrasound came on Wednesday and I was so nervous. After a wait, Dr. J came in. Immediately we did not see anything in the uterus, and Dr. J then started to look to see if there I was having an ectopic pregnancy. She did not see anything in any tube or by the ovaries. After the shock I was ushered to get more bloodwork. If the numbers were up, I would have to go back for another ultrasound and blood check.
My numbers had gone up to 669. So, at some point after Saturday I was still kicking out hcg. So another ultrasound and hcg test were scheduled for Friday.
I had a really good cry on Wednesday and promised that I would take things in stride. After my first ultrasound, I asked what our options would be for trying again and another pregnancy. Dr. J said if we did not have an ectopic and have to take the methotrexate shot, we could begin trying right away. Don't even have to wait. As for keeping the next pregnancy, she said that even though she is on the fence, she would allow me to try prednisone and/or Lovenox injections.
She warned me of the risks of both. Prednisone is a corticosteroid, which supresses the adrenal glands. It will help prevent my body from attacking the embryo/fetus if in fact I'm having an autoimmune response and my body is seeing my pregnancies as foreign invaders. With prednisone, I would have to start and stop it every cycle- and I can't just stop it, I'd have to be weaned off it each month I don't get pregnant. The risks/side effects are hunger, weight gain, low blood sugar, and obvious involvement with the adrenal glands.
Lovenox is a blood thinner that is injected. The theory for pregnacy use for those who have had multiple early miscarriages or even a second-third term loss of blood clotting is that early I pregnancy my body might be forming tiny clots where my placenta is trying to go thus restricting blood flow to the embryo/fetus. The Lovenox will stop that. The risks are a bit more severe in that if I were to get in an accident or get hurt, my bleeding might not be stopped.
I accept all risks I trying to keep my next pregnancy. Whereas I can't stop a chromosomally defective pregnancy, since we don't know if my pregnancies have been normal or not since I can't get far enough to test them, it is the best next move for us in trying to keep a normal pregnancy.
I had my ultrasound on Friday and there was still nothing in the uterus. Dr. J looked very carefully at my tubes and ovaries and did not see anything that resembled a gestational sac. She looked even closer at my right ovary and was certain what she saw was just a corpus leuteum cyst from where I ovulated. But she wanted to be sure. I had my repeat blood draw (for anyone counting, that's five blood draws in two weeks, got pricked 3 times on the left arm and twice on the right....ouch).
I am waiting for my blood test results today, Saturday. One victory I achieved was that I finally requested to be tested for the MTHFR gene and will get my results next week. I might finally know if I have a different underlying cause of my early miscarriages.
So still, I wait.
I got my first faint positive at about 14 dpo and of course yelled for Stu to see if he could see the line and of course he could! That same day I started spotting. I figured it was the proverbial "implantation spotting" which I had in my first pregnancy.
The next day I got an even darker pregnancy test line, but was still spotting. Monday came and I called to get my first blood draw and the bleeding picked up. At that point I was hanging on to hope by a thin thread. Tuesday's blood draw was 37, lower than what they wanted, but it was what happened in the next draw that mattered.
On Thursday my number almost quadrupled to 135!! Amazing! Still spotting, but it had receded a bit. I then had to go in for one more blood draw on Saturday and then I would be able to schedule my very first ultrasound. My number again surprised me and almost tripled to 398.
This past Monday I scheduled my ultrasound for Wednesday 11/21. Though the whole time my spotting/bleeding continued and I was really trying to hold on to hope that I could make it to my ultrasound. The ultrasound came on Wednesday and I was so nervous. After a wait, Dr. J came in. Immediately we did not see anything in the uterus, and Dr. J then started to look to see if there I was having an ectopic pregnancy. She did not see anything in any tube or by the ovaries. After the shock I was ushered to get more bloodwork. If the numbers were up, I would have to go back for another ultrasound and blood check.
My numbers had gone up to 669. So, at some point after Saturday I was still kicking out hcg. So another ultrasound and hcg test were scheduled for Friday.
I had a really good cry on Wednesday and promised that I would take things in stride. After my first ultrasound, I asked what our options would be for trying again and another pregnancy. Dr. J said if we did not have an ectopic and have to take the methotrexate shot, we could begin trying right away. Don't even have to wait. As for keeping the next pregnancy, she said that even though she is on the fence, she would allow me to try prednisone and/or Lovenox injections.
She warned me of the risks of both. Prednisone is a corticosteroid, which supresses the adrenal glands. It will help prevent my body from attacking the embryo/fetus if in fact I'm having an autoimmune response and my body is seeing my pregnancies as foreign invaders. With prednisone, I would have to start and stop it every cycle- and I can't just stop it, I'd have to be weaned off it each month I don't get pregnant. The risks/side effects are hunger, weight gain, low blood sugar, and obvious involvement with the adrenal glands.
Lovenox is a blood thinner that is injected. The theory for pregnacy use for those who have had multiple early miscarriages or even a second-third term loss of blood clotting is that early I pregnancy my body might be forming tiny clots where my placenta is trying to go thus restricting blood flow to the embryo/fetus. The Lovenox will stop that. The risks are a bit more severe in that if I were to get in an accident or get hurt, my bleeding might not be stopped.
I accept all risks I trying to keep my next pregnancy. Whereas I can't stop a chromosomally defective pregnancy, since we don't know if my pregnancies have been normal or not since I can't get far enough to test them, it is the best next move for us in trying to keep a normal pregnancy.
I had my ultrasound on Friday and there was still nothing in the uterus. Dr. J looked very carefully at my tubes and ovaries and did not see anything that resembled a gestational sac. She looked even closer at my right ovary and was certain what she saw was just a corpus leuteum cyst from where I ovulated. But she wanted to be sure. I had my repeat blood draw (for anyone counting, that's five blood draws in two weeks, got pricked 3 times on the left arm and twice on the right....ouch).
I am waiting for my blood test results today, Saturday. One victory I achieved was that I finally requested to be tested for the MTHFR gene and will get my results next week. I might finally know if I have a different underlying cause of my early miscarriages.
So still, I wait.
Monday, November 5, 2012
Getting Nervous
I hate/love this time in the cycle. Where you are definitely able to get a positive, but also definitely able to not get a positive. My trigger shot test this morning came out lighter than yesterday's but still pretty much there. I really hope that that in the next couple of days I will be one of those girls whose tests never go negative but get darker as time goes on.
The chances of me actually being pregnant on my first round of Letrozole and trigger? Probably about the same as any month, so I am really trying hard not to get my hopes up too much. I'm definitely hopeful, but trying to keep things in perspective. I mean, come on, who actually gets pregnant the first try on medication?!
But, good or bad, I am very glad that I decided to go the medicine route again. The knowledge that I am actually saving eggs rather than wasting eggs is reassuring to me. Plus, the medication has had such little effect on me, that I can only be thankful for a bigger chance at getting pregnant when having more follicles.
So, here I wait... testing again tomorrow... Keep your fingers crossed for me!
The chances of me actually being pregnant on my first round of Letrozole and trigger? Probably about the same as any month, so I am really trying hard not to get my hopes up too much. I'm definitely hopeful, but trying to keep things in perspective. I mean, come on, who actually gets pregnant the first try on medication?!
But, good or bad, I am very glad that I decided to go the medicine route again. The knowledge that I am actually saving eggs rather than wasting eggs is reassuring to me. Plus, the medication has had such little effect on me, that I can only be thankful for a bigger chance at getting pregnant when having more follicles.
So, here I wait... testing again tomorrow... Keep your fingers crossed for me!
Saturday, November 3, 2012
Testing out the trigger
So I have to say, the Femara has been wonderful to me!! So far the only side effects I felt were when I took the first couple of days of pills and had headaches and I was tired. I fully expected to have the hot flashes come after finishing the pills, but I haven't! What a wonderful drug!
So I'm still in the waiting game for this month... I am currently 7 dpo (days past ovulation) and am starting to get anxious about what my results are going to be this month. I have so much hope and I swing back and forth between thinking that we are going to be lucky this month and it's just another month, why would it be any different than the last 7 cycles... I hate this waiting game. I just want to know now so that if we have to move on to next cycle we can. Living life two weeks at a time for over two years is really starting to take it's toll.
Anyways, I have been testing out my trigger every other day and of course, the tests are getting lighter by about half. My plan is to test every other day until 11days past the trigger (which puts me at 10dpo) and then just start testing everyday. I imagine by 11dpt, it should be about out of my system, and even if it isn't I'll see if my tests get darker rather than lighter. Here's to hoping the lines just don't go away!
So I'm still in the waiting game for this month... I am currently 7 dpo (days past ovulation) and am starting to get anxious about what my results are going to be this month. I have so much hope and I swing back and forth between thinking that we are going to be lucky this month and it's just another month, why would it be any different than the last 7 cycles... I hate this waiting game. I just want to know now so that if we have to move on to next cycle we can. Living life two weeks at a time for over two years is really starting to take it's toll.
Anyways, I have been testing out my trigger every other day and of course, the tests are getting lighter by about half. My plan is to test every other day until 11days past the trigger (which puts me at 10dpo) and then just start testing everyday. I imagine by 11dpt, it should be about out of my system, and even if it isn't I'll see if my tests get darker rather than lighter. Here's to hoping the lines just don't go away!
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