# What should I do? Please help.



## DanaBeth (Nov 18, 2007)

I need help. As my OB says, I'm in a box; she's given me two horrible options, and I have to choose one.

Some background: My pregnancy was confimed on November 5, but on November 6, I started to spot red and brown, then bleed like a period. I passed something that night as well; I'm not sure what it was, but it didn't seem like something from a normal period. My OB checked my hCG, and it was 35. Subsequent tests showed levels of 35, 36, and now 52. I went in to see the doctor today, and she thinks I may have an ectopic pregnancy, even though the ultrasound I had last Monday shows a clear uterus and tubes. (She said that my levels are too low for anything to show on the ultrasound). Now I have two choices, and I'm scared to death and crying about them both:

1. Methotrexate shot: I don't want this shot for several reasons. First, I'm breastfeeding my 9 month old. He won't take a bottle even if I had enough milk stored (which I don't -- I've never really had to pump because I'm always with him). His pediatrician says that I would have to pump and dump for 5 days after the shot, and I don't know what he would drink. As I said, he doesn't take a bottle, and although he plays with a sippy cup, he doesn't really realize he's supposed to drink out of it. I'm so afraid that he'll end up weaning himself in those five days, and I can't bear the thought of not breastfeeding him. I want to do so until he is at least 1. My OB has been pretty unsupportive of my breastfeeding and told me, "Oh, he's eating solids, he's 9 months old, just wean him." That upsets me so much.

I also am terrified of the shot. I'm afraid of needles, but my fear goes way beyond that. I'm afraid because this is a cancer drug, and I'm scared to put that in my body. I don't even take Tylenol. I'm afraid of the side effects, and I'm afraid because my doctor doesn't tell me anything about what to expect after the shot... I cry every time I think about this. Please, if you have experience with this shot, please tell me. Please let me know if it was worth it, what you experienced, anything that can help me...

2. A D&C is my second option, although my OB is really pushing the shot. She said the D&C would only be helpful if she finds chorionic villi (sp?); then she'll know that this is NOT an ectopic pregnancy (which is my feeling -- I truly don't think this pregnancy is ectopic). However, if she finds nothing, I will have to have the shot anyway, and she has told me that the risks of the procedure -- scarring, perforations, bleeding -- could be more than the risks of the shot. The D&C terrifies me too as I've heard it's very painful. The OB did say that she would give me a spinal rather than anesthesia so that I can continue to breastfeed. Please, anyone with experience with a D&C, please tell me how it was -- especially if you had a suspicion of ectopic.

I keep crying. I hate these options. I really am stuck in a box here. I worry about the side effects of both. I worry about my fertility. Please, please help me. I need to make a choice. My OB has me terrified that, even though I feel great and have no symptoms whatsoever, I'm going to rupture... Please help. Thank you.


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## cyrusmama (Oct 17, 2004)

for what you are going through. I had a d&c after hemorraging during a mc. Honestly, I didn't think it was that bad pain wise. It has only been about 3 weeks ago. I was put under for the surgery and afterwards, was given 600mg IB profen for pain but, I didn't end up feeling pain strong enough to take any of them.


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## alegna (Jan 14, 2003)

I would not agree to either at this point. If you're having no worrisome symptoms (pain, signs of infection, excessive bleeding) I would wait and watch.










-Angela


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## Cardinal (Feb 6, 2006)

I am so sorry mama. Can you get a second opinion? I know you'd need to get one quickly... do you know of another OB you could see that could give you his/her advice? I'd wait a little while before making the decision. I had a D&E (like a D&C but a little more invasive). It was not fun but it's not the worst thing to go through. My body recovered quickly. I am pregnant now with a healthy pregnancy.







I just want to give you some encouragement.


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## zonapellucida (Jul 16, 2004)

second opinion...


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## jmo (Mar 18, 2006)

I'm so sorry you're going thru this. I guess I'm not exactly clear on why you have to do anything at this point. If you aren't in any pain and it's not been shown that you have an ectopic, why can't you just wait for your body to m/c naturally? If it does come down to needing some intervention, I'd go w/ the d&c as it won't interfere w/ you bfing your son. But, yeah, second opinion for sure.


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## diamond lil (Oct 6, 2003)

I can't offer any advice, but I'm sorry about your loss.


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## MCatLvrMom2A&X (Nov 18, 2004)

At this point wait and see is your 3rd option. I would not agree to either the shor or d & c. You can get a u/s once a week or just watch the hcg #'s. No harm in waiting as long as you know what to watch for.

I would also strongly advise getting a second opinion.


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## ledzepplon (Jun 28, 2004)

I've never been in your situation, but I agree that a second opinion would be a good idea. Another doctor might have an entirely different take on the matter.


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## happyhippiemama (Apr 1, 2004)

second opinion.

wait and watch.

and if you end up with a d&c, I had one after my missed miscarriage in 2002, and pain-wise it wasn't bad.


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## Ruthla (Jun 2, 2004)

I don't have any advice for you but I'm so sorry for your loss.


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## meredyth0315 (Aug 16, 2007)

Hugs mama, I'm so sorry for your loss. But, I can try to help you b/c I went through the same thing and did have the methotrexate shot. The reason I went with the shot was b/c I didn't want anything invasive that may damage my chances of subsequent pregnancy. And with a D&C my doctor said there was a chance that the baby was still so small he wouldn't see it, so he'd be searching and basically tearing up my insides which I adamantky refused. I was bf'ing my 3 year old and wasn't told that after 4 days we could start again, so he was weaned cold turkey and that was just awful. I felt so horrible b/c here I am losing a new baby and putting my youngest through hell, a choice no mommy should have to make.

As far as the MTX shot, it is a thick yellow med and it requires a long needle, but honestly I didn't feel a thing. It is an IM shot which means into the muscle, so I got mine in my rear. Side effects were cramping, but I had barely any bleeding as my HCG was only 212. The higher your HCG is, the more likely you are to have a rupture that can be life threatening.

You also are limited as to what you can take if you do have pain. Basically everything is an inhibitor to the drug, so my heating pad was my best friend and did work well.

I was told to wait 3 months before TTC again as it depletes the folic acid in your system to inhibit the reproduction of cells. I stayed away from foods with folic acid the first week as well. It took about 5-6 weeks to get a BFN, and then 3 weeks later I had my first cycle.

I can't make your mind up for you, but if you think you should wait, then wait it out. My choice for my situation was to have the shot, and I think that if you don't like needles, then a surgical procedure would be the last possible option. One of the worst things I had to deal with through all of this was going to the pharmacy to pick up the MTX, I felt like I was carrying out a death sentence. Again something a mommy should never have to do.

I hope to G-d I never have to do it again, but I know now I would wait it out at home and let my body do what it's supposed to do. If you ever need to chat, I'm here mama. Hang in there


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## kristenyostdc (Aug 31, 2006)

I think I would get a second opinion. Especially if you're not having any other symptoms. No heavy bleeding or signs of some kind of infection.


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## greeba (Nov 30, 2004)

Hi Danabeth -

I'm kind of in the same boat as you are. I had my first M/W appt yesterday and she said my uterus was small and she didn't see heart activity. I had a better u/s and the tech told the m/w that the embryo measures 8 weeks and the embryo 6 weeks and again no heartbeat. I should be 9.5 weeks though. I don't think I'm off on my dates because we had unprotected sex and for some reason I kept the date in my head.

So the m/w said I have three choices---the cancer drug, D&C, or wait and let it happen naturally. I told her I would like to make absolute sure that it's not viable and then would opt for the D&C because I am nursing my 10-month-old. So did HcG yesterday and will do it again on Saturday and have another U/S late next week.

My only advice is for you to do what you feel comfortable with. If you are uncertain, get another u/s maybe? Why does your OB think you will rupture? I spoke with a m/w friend about this and she said there's no reason not to wait if I'm feeling okay but that there is a slightly higher risk of hemorhage if you wait a long time. SHe also said I could start bleeding any day.

I know it's tough to be stuck in this position. It happened with my son where my OB told me I would miscarry within days because of heavy bleeding and no visible yolk sac, but here we are and he'll be 1 year old in January. So I know for you it must be tough to really believe 100% that you don't have a healthy baby in there or that you have to do something invasive you don't feel comfortable with.

Follow whatever you feel is right.

Hang in there.

greta


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## heatherweh (Nov 29, 2007)

Tearful hugs to you. I am there too, faced with an awful choice. I am glad you posted and hope that everyone has helped you. i am too new to all this to be any use as far as advice. Your OB should be supportive and compassionate and if not, then maybe you can see another. The OB who told me the bad news has a notoriously bad bedside manner and that made absorbing the news even harder to me. I didn't even think about any of this having a possible effect on breastfeeding- ugh anther consideration. I can't possibly wean my son cold turkey, I am hurting so much right no and I couldn't stand to see him go through this, we would both be on the floor crying in frustration... There has to be a better way.


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## momoftworedheads (Mar 6, 2003)

huge







s mama! Get a second opinion.

Take care!


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