Ectopic? Miscarriage? Vanishing twin? WTF is going on??

[QuitcherBitchin]

I apologize up front for the novel...

So, as many of you know, I went to the ER on Thursday due to spotting.  I should have been 4w6d that day.  My beta the day before was 128, but when they checked it at the ER it had gone down to 75.  They couldn't see anything on the ultrasound, but at barely 5 weeks that's not uncommon.  They told me I was most likely having a miscarriage.  The following day when I had a follow-up with the OB, they still saw nothing on ultrasound, but my beta had gone back up to 101.  Having a fluctuating HCG level is common in ectopic pregnancies, so as of my follow-up appointment on Friday, they said they need to monitor me for ectopic pregnancy.

Here's where I'm confused.  I was spotting, but the spotting never turned into a full flow.  I've had very minimal cramping, which before I started spotting I had just attributed to normal pregnancy cramps.  The cramps are not painful at all (they're just noticeable), and they're not limited to one side or the other.  The spotting has pretty much stopped.  

From the beginning I was concerned about how low my betas were, even though they were doubling properly.  The beta base website shows that they've had HCG levels as low as 59 reported for twin pregnancies, on the same DPO that I got a 128 (though I realize this is extremely uncommon). The drop in HCG followed by the increase and subsequent potential diagnoses of miscarriage or ectopic have had me pretty much hysterical and almost completely resigned to the fact that this pregnancy is over either way.  I say almost, because deep down somewhere, I feel like it doesn't add up.  Barely cramping, spotting that has pretty much stopped, a beta that went down, but then 12 hours later was on track to double within 48 hours again. 

Am I setting myself up for failure in hoping that this is a vanishing twin situation, and I may still take home a baby from this?  My next follow-up is tomorrow, but I've been driving myself crazy all weekend.  I'm even still peeing on sticks, and the test line is still slightly darker than the control line on FRER.

I really hope some of you can help me sort through this.  I realize you're not doctors and can't see inside my ute, but if any of you have personal experiences that relate to this, I would truly appreciate it.

[IFinTN]

When I had my ectopic my numbers stayed low, less than 45 for over a week. I ended up getting a shot of methotrexate because the numbers went down then started coming back up. At 5.5 weeks there was still nothing visible on u/s and they diagnosed it as ectopic. With your numbers staying so low, I would personally not put too much hope into it at this point...but crazier things have happened.

They need to monitor you down to zero. If it continues to go up and nothing can be seen in the uterus on u/s, they will likely give you methotrexate, so be prepared for that possibility.

Big hugs!!

[QuitcherBitchin]

Thank you... I don't know why I do this to myself. Did you have cramping and bleeding?

[IFinTN]

Mar 1, 2015 13:31:15 GMT -5 QuitcherBitchin said:

Thank you... I don't know why I do this to myself. Did you have cramping and bleeding?

I am sorry, you are doing what most if us would in your situation. It's ok to hold out hope yet still be prepared for the worst.

I had no bleeding but I was crampy and also feverish and just felt unwell in general.

[DrHooch]

I am so sorry you're having to go through this. I agree, it doesn't add up, and you can't blame yourself for keeping hope alive. I hope you get answers soon, and that it's positive news. Everything crossed for you!

[luvboston]

It sounds to me like your just having a regular miscarriage that is hanging on and will eventually let go. The most important thing is to have the labs done at the same place. Having been through six miscArriages I can tell you that the best thing to do unless you are in physical pain is to wait 4 days and then go back and have blood taken and see if things start to happen otherwise it will drive you up a wall. Sometimes it takes time for nature to do its job.

[ProfessorChaos]

((hugs)) Fluctuating low betas like this are one of the hallmarks of ectopics, but it could also just be an early m/c. I didn't have pain, but I did have bleeding. I'm no expert, but I think the chances of a healthy pregnancy based on your betas is pretty unlikely. Do insist that your betas continue to be monitored. They told me I was just having a "normal" loss, but I bled for a month (kept calling, they kept telling me it was fine) and an ectopic mass grew to 4 cm and destroyed one of my tubes.

Sending big ((hugs)). This is a terrible place to be. Be very gentle with yourself.

[QuitcherBitchin]

Thank you so much for the feedback, ladies. I'm in denial.

Now I have to figure out what to do about the cruise I'm booked on that leaves on Thursday. I booked it with my sisters (this is our first sister vacay), assuming I'd either be pregnant, or not pregnant, therefore desperately needing to get away and relax after yet another BFN. I never thought something like this could happen to me. IF is shitty already, but this? This is something far worse than shitty.

[ProfessorChaos]

I think a cruise sounds wonderful, but you will definitely need to clear it with your doctor ASAP. I agree that this is beyond shitty. Most women only deal with infertility OR losses. It's a lucky subset that get to deal with both.

[QuitcherBitchin]

Ugh... my crazy ass just took a CB digital with weeks estimator. I got a pack of two over a week ago, and had the second one just lying around. I have no idea why I just took it, but... it said Pregnant 2-3. From what I understand, you only get that with an HCG level of 200+, which would mean that my level is in fact doubling again. I feel like a psychotic bitch right now.

[hbanana18]

I don't have experience with fluctuating betas, but just want to say I hope you get your answers tomorrow. It's terrible not knowing. I think the cruise is a great idea either way. IF is not fair, and neither is this. ((Hugs))

[QuitcherBitchin]

Mar 1, 2015 16:53:08 GMT -5 @ketchup said:

Mar 1, 2015 16:36:50 GMT -5 QuitcherBitchin said:

Ugh... my crazy ass just took a CB digital with weeks estimator. I got a pack of two over a week ago, and had the second one just lying around. I have no idea why I just took it, but... it said Pregnant 2-3. From what I understand, you only get that with an HCG level of 200+, which would mean that my level is in fact doubling again. I feel like a psychotic bitch right now.

FYI, according to the FDA study on them, you'll get a 2-3 weeks indicator for anything between 156-2600mIU/ml. That variation alone is enough to be skeptical of them, IMO. That's a huge fucking range. Granted, yes.. it seems like your levels are increasing, but taking that test did nothing for you other than fuck with your head, correct?

Don't feel like a psychotic bitch, but I am going to scold you. There is no good in that. Put the pee sticks away, stahp Googling and just try and make it until tomorrow. Just remind yourself that the answers you are seeking are far more complicated than a pee stick can answer and much too specific for an on-point Google response. No matter what you do, you are not going to get you a definitive answer an sooner than tomorrow's follow-up, what you will do is drive yourself even more insane. 

You are absolutely right  I needed that.

[snarkysparklefart]

My ectopic was atypical and with the only 2 + I've ever had I only have betas for this one to go on, so i have no real advice here, just hugs and hoping that the torture that is not knowing will soon come to a close for you either way. Perhaps the doc will okay your cruise and you can get away for a bit and clear your head. So sorry.

[hearthands]

So sorry that a situation that should be filled with such hope has turned into so much confusion & heart-breaking stress. Hoping that your follow up tomorrow brings better answers.

*It is common for women to have bleeding/spotting with ectopics. Almost as common to not have any symptoms at all until a pregnancy becomes more advanced. Creating a follow up plan with your provider is essential. Thinking of you tonight.

[mrswillie]

Ugh! I am so sorry you're dealing with this. I've had one confirmed ectopic or other suspected ectopics, but nothing could be seen on the u/s most likely because you can't usually see anything until hcg levels are much higher (I think over 1,500 or so).

With the confirmed ectopic, my hcg started out at 35 and doubled appropriately every 48 hrs. My u/s was scheduled for 5w6d. I had some pain on my right side a night or two before but thought nothing of it since my #'s rose appropriately, no bleeding and I was exhausted and nauseous. Unfortunately, the u/s showed an ectopic with a heartbeat in my right tube. I went into surgery immediately. My hcg levels were a lot higher.

With my other m/c's, it doubled with one, but nothing was seen on the u/s and had dropped when they reran beta. No bleeding then either. The others I had spotting that eventually turned into bleeding with low #'s that rose slightly and fell with pain on my right side with 2 of them. Couldn't confirm anything one way or another with hcg so low.

Sorry for the novel, but I did want you to hear of different experiences. While I wish it didn't happen to anybody, I know how it is to torture yourself with holding out hope. I would definitely stop peeing on sticks as it's going to totally f with your mind without any real hcg #. Definitely feel free to ask us any other questions you think of. I hope you get cleared to go on the cruise. I hope it helps to get away and relax.

[Smootiepie]

So sorry you are going through this. T&Ps for answers tomorrow and that this will be resolved in time for you to enjoy the cruise.

[sewfie2]

I'm sorry you're going through all of this. The only suggestion that I can give is to try to go to bed early tonight. You can't get caught up in thinking about all of this if you're asleep. That's how I deal with stuff that has no fix sometimes.

[daydreamernyc]

I'm so sorry you are going through this, especially with your cruise coming up. Hopefully you will find a great confirmation soon

My ectopic was not confirmed until 8 weeks and my beta was 7,000. They missed my beta and I went on to do another IUI while I was already pregnant. When they looked back at my earlier blood work, at 4 weeks I had a beta of 5 and I got a full period (hence why it was missed).

[lilyharper]

I just wanted to send some love. I haven't had any experiences with ectopics, but I've had wacky betas which have never been a good sign for me. I would say if you experience any pain at all (even if you think you're overreacting) get yourself to the Dr. I hope you get some answers tomorrow. I know the waiting is hard, limbo is maddening.

[viola]

Thinking of you! Try to hang in there. I'm sure every minute feels like an hour when you are in such an awful state of "in-between"
It's not wrong of you to hang on to hope. You will figure out how to let go of this pregnancy if and when that time comes. You will get through this. ::hugs::

[llm100811]

I'm so sorry you are going through this! Sending all the prayers, hugs, and good vibes your way.

[jessimi06]

I'm so sorry for your loss and that you're going through this. I hope you can get some answers before your vacation. I will second what IFinTN said about asking for meds if your beta doesn't resolve on its own. I had a close friend who was in a smililar boat as you and ended up losing one of her tubes due to a rupture. Lots of T&P headed your way!

[QuitcherBitchin]

Thank you, everyone. I had my blood drawn a little while ago, and my appointment is at 1:30 to do an u/s and go over lab results. I'll let you guys know what happens.

[DrHooch]

Thinking of you today.

[hbanana18]

Thinking of you!

[QuitcherBitchin]

My level is 345 today. I needed to be at about 305 to be doubling properly. The doc says we'll have a better idea if things are still doubling on Wednesdays, but as far as he's concerned right now it looks like a probable vanishing twin situation. I'm still very nervous about this whole thing.

[viola]

Well it certainly doesn't seem you are "naturally miscarrying" like the ER said. Were they able to see anything on the U/S today?

[QuitcherBitchin]

viola They didn't do an u/s. He said he would if I wanted it, but we know with levels this low there's nothing to be seen. I did ask him to do a pelvic exam to check on my cervix, and he said it's nice and closed.

[DrHooch]

This sounds cautiously optimistic. I can't even fathom the limbo you must be feeling. FX that the dr is right on this one.

[nomnom]

Oooooh, FXFXFX!