Ectopic-ness: Day 2

The Greek origin of the word ectopic means “out of place”.

This is part of my story of the ectopic pregnancy I had a year ago.  If you want to learn more about ectopic or tubal pregnancies, I find this website, Ectopic Pregnancy Trust, to be most helpful.  If there’s any possibility that you may be pregnant and you start experiencing pain in your lower abdomen that gets worse, see a doctor immediately as it could be life-threatening.  And it’s preferable that you don’t drive yourself like I did since many women feel light-headed and some even faint! You can read the beginning of my story here.

April 10, 2013

After the initial shock, I start thinking about resolving the problem. I wad up some toilet paper to stuff in my underwear while I wait. I feel like an unprepared high schooler again. I wash the blood off my hands and a cute and very energetic girl comes in with her mom and grandma. I smile at them too.

I definitely have an ectopic pregnancy. And I hope the lady nurse is at the desk.

I use my nice voice. “Is there some pads that I can use somewhere?”

The nurse looks unconcerned. “Did you just start your period?”

“No, I had that last week. I think this is associated with the pain.”

The nurse looks temporarily horrified. Finally, a real reaction to what’s happening to me as a guest. “I’ll find you some.”

It takes a while but she finally gets another nurse to come with an assortment of products. This nurse asks how heavy the flow is but it’s hard to tell. It’s not like I wear a measuring cup. I say it’s moderate.

I get what I need and go back into the dirty stall. As I come out of the bathroom, there is yet another nurse ready to take me back to where there are actual doctors who can tell me what’s wrong.

So I have to be bleeding and in pain to get any service. Noted for the future.

We go down and turn and turn and walk and walk and finally get to a place where there’s actual activity and I’m set in a room with those tents you’re supposed to wrap yourself in they call a robe. I see yet another nurse. She’s nice and concerned at all the right places in our short conversation. I wait for the doctor. The doctor seems fine too. After a now familiar round of questions and checking, he tells me nothing about what’s wrong. He ordered a pregnancy test and we need to wait for the results.

You do a lot of waiting to know if you’re dying or not. I already know that the test will come back positive and I’ll have an ultrasound to see if it’s ectopic. And that’s exactly what happened.

I do get a little freaked because the doctor started mentioning surgery. As soon as everyone leaves again, I call my husband. Twice, because he doesn’t pick up the first time. At least someone got to sleep a few hours.

I wait more. Cause that’s what people in mysterious awful pain like to do. The friendly nurse comes in a couple times for paperwork and payment. Yes, I hand over my card while I’m still lying in the hospital bed bleeding, in pain and clothed in a tent thing. It’s wonderful.

My husband arrives and we discuss what’s happened so far, what his mom had to say having to babysit at 1am on a weekday night and what might be happening soon.

Please no surgery! I don’t want surgery.

Finally the nurse is ready to wheel me in for a sonogram. I was surprised at how old the tech was. Was there even sonogram machines when he was college age? Was this a second or third career for him? How many times has he done this? Does he really know what he’s doing?

I’m usually not so age-ist but I give myself some leniency on account of my long pain and suffering with no sleep. The tech won me over with his honest sweetness. With him and the nurse, I joked around while he searched my abdomen for any signs of horrible-ness. We talked about my boys, how I must be a teacher because of my great bladder control (news to me), how well I’m taking the whole situation because they’ve usually seen very distraught women in similar situations. The whole time I had my eye on the sonogram like I could pinpoint my issue if we came across it. But the tech had me roll over away from the machine. It got pretty quiet and I felt a familiar dark pit in my stomach. He found it. I’m sure of it. We finish up and he leaves the room. For a long time. To pass the time, I relieve myself even though I have great bladder control.

Again, I’m waiting.

He comes back and says now we get to do a vaginal ultrasound. They want to get a better look. Fantastic. Luckily, it doesn’t take as long as the first ultrasound. In fact, it’s pretty quick. And now guess what I get to do? Wait again. At least this time I’m with my hubby. I try to rest as we wait for someone to interpret my sonograms and discuss the results with the OBGYN that’s on call. I can’t sleep. This is too nerve-wrecking!

I can tell it’s morning now. There are more sounds outside my room. Somehow there’s sunlight creeping in from somewhere. I think how I would be getting my boys ready for school instead of waiting for how bad the news was going to be. I would rather be at a real resort where I was a real guest.

After a million years, a buslting OBGYN comes in. She has a slightly concerned demeanor as she introduces herself as Dr. LeMon. I didn’t realize until one of my follow up visits how funny her name was. It’s spelled like lemon but the capital M suddenly changes it to a more sophisticated sounding name. I wonder if she made that change herself.

And this is where everything starts to get fuzzy in my mind, right when the situations gets very real. This doctor talks a lot but it takes even more talking to actually process the information she’s giving us. More than likely the pregnancy is ectopic. The sonogram revealed what they think might be the pregnancy in the left part of my abdominal cavity. It is so small though that they can’t say for certain. They don’t know how far along I might be because ectopic pregnancies grow abnormally though they would assume about 4-5 weeks given my last period. Since the pregnancy is so small and I’m not in danger of rupturing (aka dying), we have some options. They could shoot me up with methotrexate right now which will dissolve the pregnancy, we could wait 2 days and do more bloodwork to see what my hcg levels are or we can schedule surgery.

Doctors are supposed to be pragmatic thinking individuals, right? But now with intense concerns of being sued and/ or hospital policies, healthcare seems to be muddled. I was confused at why surgery would be an option if they weren’t even sure they’ve located the problem. I bring this up to Dr LeMon and more talking ensues. That would be the “most aggressive” action we could take, she says. Since even in my sleep deprived state I’m keen to nuances, I realize she doesn’t recommend it, though for some reason with all this talking she can’t seem to say those exact words. I feel bad for stupid people. They wouldn’t get it. Just say what you need to say so people can make well informed decisions!

We finally let the doctor go and more chatting between me and my husband happen. It seemed like the decision was in the middle of a gnarly knotted piece of string we had to untie. Surgery doesn’t make sense if they don’t know what they’re trying to remove so that gets untied quickly. But why would there be an option to wait and see what my hcg levels are? Is there a chance that this wasn’t an ectopic pregnancy? Would we be killing an opportunity to have a baby if I just agree to the shot now? Would we be killing me if we wait? Those are some heavy what-ifs. We asked the doctor back to grill her with some common sense questions now that we’ve processed everything.

How likely was this an ectopic pregnancy? How likely was this not? We couldn’t get any definitive answers from this lady! Everything was “possible” and “I really can’t guess to a percentage of likelihood”. I know I was frustrated. Isn’t the doctor supposed to diagnosis you? But here she is, making me guess what’s going on and make a decision based on that. In my heart, I was pretty sure my pregnancy was ectopic but this doctor was giving me a lot of room for doubt.

What would happen if we wait? That question actually had answers. If my hcg levels were abnormal, we would need to proceed with the methotrexate. If they were normal, we could continue the pregnancy with more monitoring.

After sending the doctor away again, it seemed like we finally unraveled the mess. If there was a chance that this was a viable pregnancy, we needed to hold off on the methotrexate. If we wait and are able to get more concrete information about what’s going on, then we would feel better about whatever the outcome may be. We told the doctor we wanted to wait to test my levels again. She seemed relieved that we made a decision and told us if I feel any more bad pain like I did this night, then I need to come to the ER again. I had no restrictions or special guidelines to follow. I would come to her office on Friday for lab work.

Ahhhh, now I can leave this place and hopefully sleep!

Well, not really. The supervising ER doctor had a few words with us before we got discharged. He looked like a good man, but he had nothing good to say.

“Where do all live?”

“In the city of Battlefield.”

He scrunches up his face in thought mumbling about what district we’re in and replies, “Let’s say you start having pain again and you call 911. It’s going to take them about 10-15 minutes for paramedics to come get you. Then you have about a 15 minute plus ride to the ER. In that time, you’re coming here dead and there’s nothing that we can do.”

Um, now I’m dying? But the OBGYN said…

“Don’t call 911. Don’t wait for a babysitter,” he looks seriously at my husband, ” you just get her here as fast as you can. Ok? Any other questions?”

Now I have a twisted knot as a stomach.

If that morning was a blur, then definitely the two days waiting for almost certain death was. I got home. I gave my 2 yr old a hug. I listened to my husband talk to his mom for a while about what happened. I excused myself to take a nap. Thankfully, I was able to sleep but it was a troubled sleep. Any twitch of pain from my abdomen real or imagined brought up the fear that I made a choice where I could actually die. When I awoke, I emailed my family to let them know what was going on and request prayers. I prayed. A lot.

I prayed that I would not have the bad pain again. I prayed that if I did, I would be able to get to the hospital quickly and that my children would be taken care of. I prayed that I would know what to do to not aggravate my situation. Most of all, I prayed for strength to get through these next couple of days.

1 in every 80 pregnancies are ectopic.

Symptoms can vary from person to person just like in a regular pregnancy.  Click here for some common ectopic pregnancy symptoms.  My only common ectopic symptom was one sided abdominal pain that did not subside though I did start bleeding in the ER.

Diagnosing an ectopic pregnancy can be difficult because the symptoms can relate to other health issues, blood tests need a baseline and are not measured again until after 48 hours, plus the pregnancy can be in such early stages that it can’t be positively verified even with a detailed sonogram.

80% of ectopic pregnancies occur in the upper part of the fallopian tube which are more prone to rupturing. If the micromass the sonogram found was the pregnancy, then mine was a more rare abdominal case which occurs in 1.2% of ectopic pregnancies and are not likely to rupture.

Prayer to my Heavenly Father communicates my needs to Him and gives me an opportunity to ask for blessings like emotional strength and comfort.


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