Tag Archive | ectopic

I’m back! And I’m on the hunt for advice…

You know those bitches who disappear from their blog for a few months and then suddenly come back and they’re pregnant?

Yeah, sorry about that. Because I’m pregnant.

Seriously though I need some huge advice. I am freaking out and I don’t really know what to think or do. I suppose I should give you guys a quick recap before I get into the questions. That’s only polite.

First of all I want to explain the reason I left my blog. I never stopped thinking about you all, but I made a personal decision that was best for my relationship with my husband. We went through a rocky patch after my sixth cycle of IVF failed and he admitted during a disagreement one evening that he hated that I felt I was able to vent my true feelings on the internet but not to him. I was upset with him for thinking such a thing, but also desperate to mend our shaky marriage. So he made a request that I temporarily suspend my blog until such a time when our relationship was more stable, and I reluctantly obliged.

After that our relationship quickly improved (though I’m sure it had nothing to do with my lack of blogging, and more to do with the fact we both started seeing our therapists more regularly) and I would often think about returning here, but things have been very busy and I just never found the time.  

I am currently in my eighth cycle of IVF. You guys missed me moving to a new doctor, my entire seventh IVF cycle, another major laparoscopy where heaps of endo was removed, a D&C, more tubal studies, and another round of needle diathermy for my PCOS. Told you it’s been busy around here!

My new doctor is awesome, and so different to my last doctor. He swears a lot, which took a little getting used to. He said it was “fucked up” (his words, not mine) that a 27 year old had failed six cycles of IVF and no one seemed to really care or think I was important. He said decent fertility doctors would pay more attention to me because of my circumstances, rather than ignoring me to focus on older patients.

He took me on as a challenge, and even did my laparoscopy with no out of pocket expenses (even waived his surgical assistant’s fees) because he wanted to get me as healthy as possible as cheaply as possible. And because no young women should have to suffer what I’ve suffered through, and he wanted to make my life better. Just like that! Last time I had a laparoscopy it cost us around $5000 out of pocket so the saving was ridiculously massive. It was like falling in love all over again, except you know, not in a romantic kind of way…because he’s old…and I love my husband…

This doctor uses much more radical treatment methods, and pays close attention to studies coming out of Europe. He believes in throwing the book at IVF, rather than taking the ‘softly, softly’ approach that most IVF doctors in Melbourne seem to take. For example I was up to my sixth cycle and still wasn’t allowed to use embryo glue at my old clinic in case it resulted in twins! I mean honestly!

My previous doctor also kept refusing to test me for MTHFR gene mutations. She kept insisting I didn’t have it and the test was pointless and would cost us thousands out of pocket. I asked my new doctor and he said “sure go right ahead if you want to get tested I’ll write you a pathology request.” And guess what? The test only cost $65 out of pocket. And guess what else? I am a homozygous carrier of the MTHFR mutation. SURPRISE SURPRISE!!! I cried so much when I found out, because I’m so sure that fact at least contributed to my previous two pregnancy losses. Now I take blood thinners, and I feel better not only about the fact my treatment is more successfully managed but also hopeful this will lessen my chances of thrombosis in the future.

During my seventh cycle of IVF I experienced a fun new thing which I can add to my long list of fun new things. It’s called Empty Follicle Syndrome and it’s extremely rare in young women. Doc estimated I would have approximately 30 eggs picked up (he was deliberately overstimulating me to pick up as many eggs as possible, and then triggered me with Synarel instead of Ovidrel in order to prevent OHSS – I told you his protocols are more radical). But on egg retrieval day I only had seven eggs in the 30+ follicles.

When the doctor found out he didn’t dismiss it as “just something that happens sometimes” like my old doctor would have. Instead, he said “Well this is shit. Really shit. I’m really sorry. If we don’t get any fertilized eggs we will figure something out I promise. And I hope to God you have embryos on day five because I don’t want to deal with your wrath if you don’t.” It made me feel like he actually cared. I appreciated that.

In my eighth cycle we had some success and ended up transferring one perfect hatching AA graded blastocyst, with one lower quality blast tucked away in the freezer. Obviously we didn’t need assisted hatching, but we did use embryo glue.

And now we get to the part of the blog post where I ask y’all questions so please pay attention.

Last Monday (3dp5dt) I had a temperature spike and a tiny bit of pink spotting, which I thought might have been implantation bleeding. Then throughout the week I had bad headaches and ran a low grade fever but my boobs weren’t sore even though I constantly poked them. Last Friday I started cramping so I took a home pregnancy test and got a super super strong positive. Honestly I’ve never seen a pregnancy test turn so dark so quickly. Then on Saturday I had pink spotting in the morning and a small amount of red spotting in the evening followed by awful cramping. I was sure I was getting my period.

But on Monday (10dp5dt) I had my first beta test and my level came back at 330. I was ridiculously shocked to pull such a high number so early, particularly because in both my other pregnancies my levels were always so low. Not to mention the cramping and bleeding.

Two days later (yesterday) they did a follow-up blood test and I was so depressed and anxious. I was completely 100% convinced my numbers weren’t going to double so I went down to the supermarket on my lunch break at work to buy chocolate to console myself. As I was coming out of the supermarket, the nurse rang to tell me that my hcg at 12dp5dt was 805. I asked her to repeat that number like 6 times. “Sorry did you say 805? Can you just confirm 805? My number? For me? 805?”

The nurse said usually patients get numbers between 100 and 200 at 12dp5dt. So my numbers are pretty high and my doubling time was 36.14 hours which is also super fast am I correct? Like it’s the fast end of the normal range? She said my pregnancy seems strong and healthy. But come on. This is me. Things don’t go right for me. This can’t actually be happening for me.

My first thought was “Oh my god they’ve both implanted” and then I remembered we only transferred the one embryo, and put the other one into storage. So then I looked up identical twins and saw that the second embryo usually implants between days 10-14. Immediately I recalled the second lot of spotting I had on the weekend, which was 8dp5dt or technically 13dpo. So are identical twins a possibility? I guess so. My hcg levels don’t seem high enough for twins, but seem very high for a singleton.

All day today I have had a strong pain on my right side. It’s about 2.5 inches to the right of my belly button, but much further down near my pubic bone. It’s sort of a consistent twinging pain. Sometimes it’s on my left side, and sometimes in the middle, but mostly it’s on my right side. And now I am freaking out. I called the nurse and she said maybe it’s ligaments stretching but why is it mostly on one side?? Like I mean constantly twinging on my right side and occassionally mirrored on my left. The pain never leaves my right side.

So here are the questions:

1. For the IVF ladies who have had success…what were your hcg levels like in early pregnancy?

2. When my last pregnancy wasn’t located in the uterus, my hcg numbers were much lower than average and kept fluctuating up and down. Can I still have an ectopic pregnancy if my levels are higher than average and doubling nicely?

3. What does ectopic pain feel like?

4. Is this cramping normal? In women who have PCOS did the cysts on your ovaries react to the hcg increases and cause you pain? Could it be my ovary I am feeling?

5. If I have higher hcg levels with fast doubling times, does that mean I am more likely to have a normal healthy pregnancy, or is the actual number irrelevant?

6. I have an appointment with my doctor on Monday (I will be 5 weeks, 1 day pregnant) should I push for a scan or would it be pointless this early on because it’ll be too early to see anything?

I really can’t believe I’ve been away for months and now I’m coming back and asking for advice. Like, how selfish am I!

I really truly need assistance to calm down here. I know you all probably think I am overreacting, and I most likely am. But I feel like I deserve this one. Eight cycles of IVF is enough for anyone and it’s my 28th birthday on Monday. Please oh please can’t I just have a baby this time? 

Thanks in advance for your advice ladies.

 Sadie xx

p.s sorry for any spelling or grammar mistakes in this post – I didn’t have time to edit it I just wanted to get my post out there!

Advertisements

And you let her go

I’m currently up at the hospital sitting in a comfy reclining chair in the oncology unit.

I came here to receive an intramuscular methotrexate injection to end my pregnancy of unknown location. They can’t pick it up on any scans because it is too small, but it’s clearly there somewhere. Most likely in my right tube, but we’ll never know for certain.

In the ward each patient gets their own little nook with a big green recliner, visitors chair, tv and little table, but we can all see each other which is a little confronting.

Everyone else here has cancer. Everyone else here is receiving chemotherapy. Everyone else here is potentially dying. I am here just to end an unviable yet persistent pregnancy. I feel like a massive fraud. I feel unworthy to sit amongst these people. They are the true faces of strength and bravery.

The nurses are so lovely. They keep asking everyone questions like “can I get you a warm blanket?” “can I get you a tea or coffee?” “can I get you a sandwich or some biscuits?”

I would love a cup of tea but I keep politely declining. I don’t feel entitled to consume this food or drink. This level of care is not for people like me, it’s for people going through life threatening illnesses.

Other than that I feel calm and unemotional. I know this is the right thing to do. I wish my husband was with me, but I am coping fine on my own. I don’t want to weep or scream, and I am able to joke with the nurses. I am doing okay.

A nurse approaches me and picks up my chart. She’s probably 40 years old with cropped blonde hair and a friendly smile.

“Oh golly intramuscular methotrexate! Yuk!” she says sympathetically.

“It’s fine, I’m doing IVF so I’m used to being injected and poked and prodded.” I reply, replicating her friendly smile.

“I have a close friend who did IVF!” she gushes. “She got 6 eggs and ended up with 2 children.”

“That’s nice.” I say, understanding that she’s trying to be positive and helpful.

“How many cycles have you done?” she asks.

“Four.” I tell her.

“Wow!” she gasps. “So how old are they?”

“Sorry? How old are what?” I ask, confused.

“Your kids.” she says. “Your IVF babies.”

My chest tightens and my stomach drops. I’m sitting in a recliner in a cancer ward waiting to get an injection of a chemotherapy drug to end a much wanted pregnancy, and a nurse is asking me how old my children are? Seriously?

“I have no children.” I say soberly. “All of my cycles have been failures.”

For a moment she is silent, then she brings her hand to her mouth in shock.

“I’ve just put my foot in my mouth haven’t I?? I’m so sorry! I shouldn’t have asked you that!” she says frantically.

At this particular moment in my life I really don’t need to be having this conversation, so I quickly try to shut it down.

“It’s fine.” I reply hastily. “What you said was pretty low on the insensitivity scale.”

But in my mind I’m not so calm. I’m actually boggled by the fact this registered nurse standing in front of me clearly believes each cycle of IVF is guaranteed to give you a child. What the actual fuck.

After apologizing a few more times the blonde nurse scurries away and is quickly replaced by a brunette.

“Ok I’ll be taking your vitals.” she says. “Can you hop on these scales for me?”

I nervously do as she asks and step onto the scales. I watch the digital reader dance between 75.50 and 76.20 before finally landing on exactly 76.00kg. After 10 days of daily exercise and extremely healthy eating I have lost a grand total of 0.00 grams. Yay me.

The nurse then takes my temperature, and checks my heart rate and blood pressure. She is extremely surprised to see my blood pressure is ‘text book perfect’ for my age and weight, particularly as the hospital environment tends to have a significant detrimental effect. I told you – I am cool as a cucumber.

After a boring discussion about drug side effects and after care, the nurse disappears. I am left alone for some time to watch tv, while the pharmacy downstairs prepares my dose. Morning television blows. I flick channels until I find Antiques Roadshow. I stare at the screen but I’m not absorbing what I am watching.

After 20 minutes a new nurse comes to see me, pushing a silver cart. She opens a draw at the bottom of the cart and pulls out scrubs, goggles and a mask.

“We have to fully suit up when we’re administering chemotherapy drugs.” she explains. “Even though you’re not getting actual chemo.”

I want to tell her I don’t really give a damn what she wears, but I remain silent and smiling. I know soon this will all be over.

The nurse draws the curtain so the patients around me can no longer see me, adjusts my recliner so I’m lying almost flat and lifts my dress to my hips. Then she cleans my thigh with an alcohol swab and turns back to her tray to prepare my needle. It’s a much bigger needle than I’m used to, but I am not afraid.

“Do you want me to warn you when I’m about to inject you?” she asks, the needle hovering inches above my skin.

“No.” I say decisively, closing my eyes. “Just jab me.”

Once I feel the initial sting as the needle touches my leg, I open my eyes to watch with interest as she pushes it down into my thigh muscle. She then draws up on the syringe before slowly injecting a yellow liquid into my body. She holds the needle in place for a few moments to make sure the contents has been fully administered. I am used to this process because it’s a regular step in self-administering FSH injections.

Almost immediately a searing pain starts moving across my thigh muscle and down into my lower leg.

“Wow that hurts!” I gasp.

“I’m so sorry,” the nurse says. “There’s nothing I can give you to help the pain.”

“It’s okay.” I assure her. “I’ve had far worse pain on a multitude of occasions.”

I am left to sit for a while to make sure I have no adverse reactions. The nurse goes off to let my doctor know the dose has been successfully given and I am told that soon I will be discharged.

At the moment I’m feeling incredibly nauseous but otherwise fine. I don’t feel overwhelming sadness or grief or anything at all really. Apart from the aching in my leg I feel like maybe I’ve just been at the doctor for a check-up, rather than to terminate a pregnancy. I am numb to it all.

After they let me leave I’m going in to work. The nurses were shocked when I told them, but honestly I don’t have much of a choice.

On Wednesday night I started bleeding out of the blue so I went up to the hospital to get tests, and also sent my inconsiderate boss a text message to let her know I wouldn’t be in on Thursday. She responded at midday the next day, informing me that since I was at the hospital she would expect me to provide a medical certificate to prove I was telling the truth about my whereabouts. Upon reading the message I simply burst into tears. What an awful thing to send someone when they’re going through a crisis. I’ve kept her really up-to-date with my IVF progress, even though I am not legally obliged to. How appalling that she chooses to treat me with such disdain.

I don’t know how the rules work in other countries, but in Australia all government departments, statutory authorities, bodies and entities strictly enforce a policy that only requires staff to produce a medical certificate when they have been on sick leave for three consecutive days. I was asking for one day of leave in dire circumstances and she just had no right to make me feel so awful.

All of last night I was much more anxious about calling in sick again today than I was about the methotrexate shot, even though my doctor gave me the medical certificate my boss had requested. In the end I decided it was just less stress to drive in to work after I’m discharged, so that’s what I’ll be doing.

Yesterday I was informed I will be getting weekly blood draws until my hcg level drops below 5, and then the doctor said we can start planning our next FET cycle, which is promising news.

Doctor B told me she is extremely reluctant to consider removing my Fallopian tubes at this stage because I am so young, and removal of the tubes leads to decreased blood flow to the ovaries and also the risk of lower quality eggs. But she did stress that if I keep having problems the option is not off the table. I’m satisfied with that for now, but still feel uneasy about my risks in the future.

I guess I’m just going to focus on taking it easy this weekend and trying to move forward with my life. There’s nothing else I can do.

Flicking television channels just now I landed on a music channel that was playing the Passenger song ‘Let her go’. This is the song I listened to over and over when I had my first loss in April. I can’t believe it’s playing now as I haven’t heard it for months, but it really is quite fitting.

Only know you’ve been high when you’re feeling low.
Only hate the road when you’re missing home.
Only know you love her when you let her go…
And you let her go.

What is my body doing?

Latest blood test results show my hcg level has risen to 57.

So now we’ve had 35, 18, 25 and 57. That last level is a big jump and actually doubled in 72 hours. Well…great.

I’ve had a full (albeit very light) period, I’ve been off crinone for 8 days, I’ve gone back onto metformin and the medications that regulate my pituitary gland, I’ve stopped drinking 2.5L of water a day, I don’t have sore boobs anymore, I don’t have headaches or a heightened sense of smell anymore.

I do have pretty much constant nausea and constipation. Most importantly I’m still having consistent pains on my right side, where I imagine my right ovary is sitting.

Is my doctor concerned?

No, no she is not.

She says there’s still no need to come in to see her until my scheduled appointment Thursday afternoon.

My mother is now freaking out and convinced I am viably pregnant even though I have explained why that’s not the case at least 10 times.

My husband is away until Saturday night. Would be nice to have him around just at the moment.

Nothing I can do except wait until Thursday now.

Righteo. Great. Good times.

A twist in the plot

And my hcg levels have risen to 25. This time last week they were 35, but by the start of this week they had dropped to 18. Now they’re slightly back up.

I actually had to phone the nurse this morning to get my results. She seemed quite flustered when I said I was waiting for results from yesterday, and it occured to us both that I had been forgotten about. I hadn’t really given it any thought, or lost any sleep over the result because I was extremely confident I would get a number less than 5. But it still feels a little bit shit to know that I was once again overlooked.

Obviously 25miu/ml of hcg is not a viable level at 5 weeks, 2 days and more importantly I’ve had a full period. Granted the period was extremely light by my usual standards, but the blood was bright red. Red blood and ongoing pregnancy don’t mix.

“Sadie,” the nurse said sombrely. “I need you to know this pregnant has still failed.”

For a moment I couldn’t understand why she felt the need to say such a thing. I can’t imagine what it must be like for some women to get this kind of result. Women who have less support from medical staff, and who don’t have the opportunity to research widely. They would get that tingle of nervous energy that starts in your stomach and then zips up your spine and spreads across your whole body. They would start to smile, and gush and get excited. They would have hope.

Absolutely none of those things happened to me. I remained completely calm and collected. I knew immediately that my latest result had lumped me into a high risk category for tubal pregnancy, though the nurse did also spell it out for me.

“I’ve been getting bad pains on my right side.” was my carefully considered response. “Pain in my ovaries isn’t unusual when I get my period, because my cysts sometimes react badly to the hormone dump. But this pain has been quite isolated to my right side.”

“Ohhhh.” the nurse mumbed, and I could hear her shuffling papers. “This probably isn’t good. I’m going to have to contact the doctor immediately.”

“I have an appointment with Doctor B already scheduled for next Thursday afternoon.” I said.

“We may need you to come in sooner.” she quickly answered.

So she’s checking with the doctor now and she’s going to phone me back soon. I’m pretty sure this time I won’t be forgotten.

I can’t stop thinking about the day I found out my left Fallopian tube was partially blocked, and my right was completely blocked from endometriosis and scarring. My instinctive reaction was to request the right tube be removed. But apparently that’s not the done thing, even though the doctor warned I was at an increased risk of ectopic pregnancy.

I thought I was being pretty logical. If my tube was so badly blocked and it could never be unblocked, then it made sense to just get rid of it. Otherwise it was just going to sit there in my body like a surreptitious Venus Fly Trap, luring in my innocent little embryos then quickly snapping shut and gobbling them up.

It’s extremely common for IVF embryos to wander into the tubes, then back into the uterus in the hours and days before implantation. Especially day 3 embryos, because they don’t implant until day 6 or 7 so they have plenty of time to see the sights of my reproductive system. And I knew if my little ones drifted into a blocked tube they would almost certainly become stuck.

Of course there’s no guarantee that I am currently going through an ectopic pregnancy, and I probably won’t find out until next week. But just the fact that I’m now in a high risk category makes me angry. I want this tube gone. I want it gone before I have any more embryos transferred. I don’t want to have to stress about this any more!

Seriously. Why don’t doctors ever listen to me???

I should be a doctor! My nurses at the clinic already joke that I’m by far the most knowledgeable patient they’ve ever treated, and my husband complained recently that he can’t fill my mind with hope when I’ve researched everything so thoroughly and have a scientific answer for why hope almost always doesn’t exist. If only I didn’t faint at the sight of blood. That probably rules me out from attending doctor school, huh?

I’ll keep you guys updated when I have more news.