You know what’s cool about Methotrexate? Nothing. Part II.

Definitely recommend checking out Part I before reading this one! You know what’s cool about Methotrexate? Nothing. Part I

After getting my results of the HCG dropping on a Sunday, I figured it would be “business as usual”.  Go in again in 48 hours, see it’s still dropping, and that’s that.  But this time I had a fun new adventure (*sarcasm*).  I had to go back in on Tuesday to do more blood work, my Dr. was also out of the country on vacation this week so I was getting bounced around to covering doctors; all of whom were awesome by the way.  But just hard to be dealing with weirdness with people you don’t know.

Tuesday late afternoon I got a call from the office saying while my numbers had gone down slightly, they hadn’t dropped by much, which made them suspicious of a potential ectopic pregnancy-and essentially they just wanted to ‘rule that out’. An ectopic pregnancy is when an embryo implants in the wrong location, in the fallopian tube, ovary, etc.  It can be very dangerous because if the embryo continues to grow in the wrong spot, you could rupture.  So, they scheduled me for the next day to do an ultrasound and take a peek around…suuuuups pleasant experience by the way, def recommend it.  I wasn’t that worried, because I just assumed it was a precaution.

I went in there, spread eag, and the lady went about her business.  Checking out my insides aggressively with what I can only describe as essentially a light saber with lube on it.  Anyway, I am hyper-perceptive most of the time.  And I noticed her hanging out for significantly longer on one side than the other so I began to be suspicious.  Then she says “you can get dressed, actually, let me see if the doctor wants to come in and look first.” I was like, oh boy.

When I spoke with the doctor he showed me a mass in the area of one of my ovaries, it wasn’t clearly an embryo because I was still so early, but it was something.  And something I knew wasn’t there before because I had the same test in December when I started seeing the specialist.  It wasn’t enough to say it was definitely ectopic, but between what was seen on the scan and the blood work levels they were concerned.  He scheduled me for more blood work for the next day to check the HCG and also my liver and white blood cell counts to determine if I would be able to handle the medication if needed.  And scheduled me for a methotrexate injection, just in case, for Friday.  Depending on my blood levels, etc.

So, next day more blood.  I legit felt like I had no blood left at this point.  My mom nicknamed me pin cushion.  Just kept alternating between arms.  In the early afternoon at work, I got a call from the nurse.  My levels had barely gone down.  My covering doctor was in surgeries, so the doctor covering for him felt really strongly that there was enough evidence that it was ectopic and didn’t even want to wait until Friday for treatment.  They wanted to me to drive to Boston right away.

Side-note: Non-expert information.  There are several different ways to treat an ectopic pregnancy.

  1. Leave it.  Do nothing and hope it goes away on its own.  Obviously this is not recommended because the alternate result is some of your lady parts rupture and that is no bueno.
  2. Surgery. They can go in laparoscopically and try to remove the embryo from the wrong place.  What is challenging about this is it’s like trying to find a needle in a haystack because this early along what they are looking for is tiny and hard to find. It also could potentially cause scar tissue which makes future pregnancies more difficult as well.  And, it’s just surgery.
  3. Methotrexate injection.  Methotrexate, or as I affectionately call it, Meth, is a chemotherapeutic drug that attacks the rapidly reproducing cells aka embryo.  And helps flush it out of your system.

So, after my first scan we discussed the treatment options and decided my best treatment to start with was Methotrexate.  The amazing side effects of the drug include: feeling lethargic, exhaustion, mouth sores, skin rashes-so hot.  You also had to stop taking all your vitamins so that they didn’t work against the drug.  Because it gets processed through the liver, you have to avoid alcohol for several weeks after.  You also have to avoid exercise, which is not medicine related, but just a precaution to avoid possible rupture until it is cleared up.  And the kicker, because of how strong the drug is, you have to wait at least 2-3 months before trying to get pregnant again.  What the everyloving shit.

So I drove down to Boston, Kenny met me there, they brought me into a room to sign all these forms about this medicine which on paper sounded like I was swallowing an ocean of poison.  Then the nurse said she needed to prepare the medicine and came back in to the office in what I can best describe as a Hazmat suit, goggles, full-body, the whole 9.  To “protect herself”…from the drug you’re about to shoot in my butt cheeks?  COOL.

The shot was fine, felt like a flu shot, so not super fun but it was alright.  Then they just send you on your way.  Came home and let my supervisor know what happened.  Reason number 17384859283 why she’s the best; 15 minutes after we got home a random dude shows up on the porch and said he was delivering food…that we didn’t order.  She ended up sending us enough comfort food for an army which was the bomb.  And told me I was required to stay home the next day, which I needed, because I kept telling myself I am physically capable of workng, but mentally I needed a break.  Plus we had to head to NY for our nieces and God daughters’ Christening.  Which was great…but how I got through that weekend, I have no idea.  I guess the faces of the most adorable nuggets makes powering through intense physical and emotional pain more doable.

I felt pretty much the same minus the exhaustion.  Also they emphasized good oral health, flossing twice a day, the whole 9, because your mouth can be affected by the meds.  Luckily I am the queen of oral hygiene (#thanksmom) and still call my mom every time I get an amazing review at the dentist.  Yeah, I’m a loser, that’s fine.

Then Sunday, I would call D-Day, aka the day all the blood began to leave my body at an alarming rate.  Also, you could not use tampons. I realize some people don’t, but I typically do.  So, not having options while you feel like a tsunami is falling out of you (GROSS I KNOW. But if you feel gross reading it, imagine how I felt whilst it was happening).  It was like red alert, no pun intended, every 20 minutes for 3 days.  And the pain was incredible.

By Tuesday, I determined I needed to call the doctor.  it just seemed like more blood and more pain than they described was normal.  On my way home from work I called the office, got a call back from the nurse then the doctor.  Who to my surprise sent me to the ER.  She said she just didn’t want to risk waiting until the morning to see my numbers.  So I got to spend 7 hours in the ER sitting around, mostly doing nothing.  Ultimately because I didn’t meet the numbers they wanted in the projected time frame, they decided to give me a second set of Meth injections in the hospital.  They had told me at the first visit that a small percentage of people may need an additional injection, and another small percentage might still need surgery even after the injections.  So they gave me the surgery option in the ER and I really wanted to avoid that so I went back to injections.

I ended up getting my blood checked for the next two weeks every 48 hours to monitor the numbers going down by the appropriate ratio.  This is where the math major does come in handy!  After many blood tests, we went to meet wth my actual doctor.  While everyone else kept calling it a suspected ectopic, she was very confident that is what it was.  Because she was very familiar with my anatomy via my previous scans, she knew that the mysterious mass that was now there all of a sudden was definitely that. So that at least made me feel better that all this treatment wasn’t for nothing. But, she said if my number didn’t get below a certain amount by the next day, that I might need a third injection.  I was not about that life.  Luckily I made the threshold by 1!  She also told me I needed to avoid all foods with folic acid, because the folic acid tries to convince your body to do the opposite of what the methotrexate is trying to do.  So, basically the opposite diet of what most people who are trying to have a baby eat.

Essentially for the month I existed on a diet of primarily potatoes.  No leafy greens, no grains, no eggs-I practically became a potato.  And nothing makes you feel better about yourself when you’re going through a trauma than only being able to eat potatoes and not being able to exercise.  I had to cancel a bunch of fitness classes I teach and couldn’t teach dance.  It SUCKED.  And just knowing we were in baby making jail sucked too.  Even though less than 0% of me was interested in that venture at the moment, and the forced waiting period is probably a blessing, I still felt like it was a waste.

Finally my HCG got below a 10 which is what they would consider not pregnant, so they considered the ectopic pregnancy as resolved.  I could go back to my normal routine, diet, etc., except the booze, still had to lay off that.  But it was a good month or more where everything in my normal life was thrown upside down.  I was sleeping at like 7:45pm.  I felt like a sloth.  But, I finally started feeling a little bit like myself again in mid-March.  It was pretty brutal.

And, that’s where there is nothing cool about methotrexate. (Except for luckily avoiding surgery).

All the while during all the suckiness, I tried to keep perspective. I was still grateful that it was caught very early, that I didn’t get rushed into surgery, automatically, and that my tubes and ovaries were not in grave danger.

On to the next.

 

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