Ectopic Pregnancy

Tuesday 27th September 2014 I had surgery at 9.30am to remove an ectopic pregnancy and my left fallopian tube after it ruptured. You can read the story part 1 here and part 2 here.

I wanted to add a part to the blog about this because in truth how many of us know much about ectopic. The process the recovery and the emotions involved.

First some women have options if you are lucky enough to not have ruptured you can chose to have an injection called methotrexate to dissolve the pregnancy but even this option can end in surgery as sometimes it fails.

EARLY SYMPTOMS BEFORE RUPTURE

  • one sided pain that can be constant or come in waves
  • one sided hip pain
  • spotting or bleeding
  • cramps
  • sometimes shoulder tip pain
  • positive pregnancy test result

SYMPTOMS DURING RUPTURE

  • pain- may stay one sided or may spread
  • shoulder tip pain when breathing in
  • diarrhea
  • vomiting
  • dizziness
  • pale
  • tiredness

SEVERE SYMPTOMS

  • bleeding
  • passing out
  • struggling to breathe ( I had spasms)
  • pain when moving in abdominal area

AFTER RUPTURE

  • bloated feeling as your belly fills with blood
  • less pain- you may feel you’re getting better and if don’t know you’re pregnant may think it’s nothing
  • energy levels may return before you dip again
  • if haven’t already you may start spotting

Majority of women find out they’re pregnant first as miss a period. If like me you hadn’t missed your period yet you may seek help when start experiencing rupture symptoms. My doctor thought it was non urgent and was only being at hospital having regular blood count tests they determined I was losing blood coupled with a blank ultrasound it was easy for them to decide this was a ruptured ectopic.

SURGERY

Surgery is done at this point and is largely done by keyhole. You will have 4 incision holes one either side where tubes are located, one in belly button and one low down near pubic area where womb is located.

You will need to be under general for this which I found upsetting. I had found out I lost my baby within half an hour I was taken to surgery and left to wait on my own with curtains drawn and no comfort. I had never had a general and I was frightened too.

I woke to a conversation where surgery staff informed nursing staff what had happened. I felt rough when I woke dry mouth, tired and slightly in pain on the side I was laid on. To then find out I had indeed lost my baby and my tube when they weren’t aware I was awake was just awful.

RECOVERY

My blood count was continually checked to ensure they had stopped all bleeding but for me it wasn’t improving. They found me bleeding from one of my wounds and my blood count wasn’t recovering so I was back on fluids and a blood transfusion. I simply just felt super tired and wish they would let me sleep which they didn’t well not without waking me every half an hour.

By 1pm ( I had come out of surgery at 11am ish) I was awake, eating and feel much better. I finally was allowed to go to the loo and move about a little which also meant I could get dressed. Crazy how you have to be underwear free despite them not going ‘there’.

At this stage I was spotting a little but nothing major and it soon stopped before I left.

  • pain when moving from bruising at incision sites
  • bruising on skin
  • wounds
  • light spotting
  • tiredness
  • low appetite

I was allowed home after one night, more fluids and armful of iron tablets. Most patients are sent home with nothing not even pain relief. The pain is minimal for most and for others it’s barely there. For some though it is quite painful but soon fixed with over counter medicine.

RECOVERING AT HOME

This was the hard part I found after a few days the surgery caught up with me

  • shoulder tip pain from gas used to inflate my tummy
  • painful to move or even shift
  • sleeping was impossible due to pain
  • weeping wounds due to infection
  • super tired from the low iron
  • constipation from the surgery and iron tablets (psst I didn’t go for 3 days) and dark stools due to the blood
  • low appetite still
  • fairly immobile due to the pain

I had my plasters taken off at the hospital and was told to keep them clean by simply washing with water no soap. Mine got infected and needed antibiotics which has its own problems for some women.

A week in I started bleeding. Many think this is their first period and mine came around when I should have been due on but this is the womb lining shedding. You will notice it is different to a period. It will be slimy there’s no other way to describe it but it won’t soak into pads in the same way and may come out in form of clots or tissue.

For some this only occurs over a few days for others can last longer than a period and you likely will get strong cramps.

After 3 weeks I started to be able to move better, energy levels were back, appetite back and healing wounds.

However at this point you await your first period. Mine took around 6 weeks from surgery to arrive. For some women it can be as soon as 3 weeks and for others can take up to 12 weeks at which point you should see your doctor to give you a kick start. This first one will be heavy, it will be painful and you may even experience ectopic symptoms such as one sided pain and shoulder tip pain due to scar tissue and hormone levels.

At this point if you had surgery it’s good to start back in vitamins get your folic acid levels especially back on track. It is said to wait 3 months to recover physically and emotionally from this. You can however try sooner if you wish this is individual choice and you should consult a doctor about this choice.

Methotrexate

If you had the injection things can be different.

You may find it works for you but can take months for levels to come down enough to try again. Some take 4 weeks some take 8 and others a bit more. This can be emotionally draining as you want an end to the whole thing and part of you doesn’t feel the full loss till those hcg levels hit 0.

You can still rupture even with low levels so you are advised to hold off on vigorous exercise or activities including sex. You will have regular blood tests to check levels and if they stall or go back up you can have the injection up to 3 times.

This injection is often used in cancer patients to kill cells so it is a heavy drug to be having and completely depletes your body of  folic acid. Whilst your levels are elevated you can’t take folic acid and should avoid folic rich foods because this can help the embryo grow and make the injection pointless.

Until you reach hcg levels of 5 or under you must avoid folic acid and sex. After this time you can try and not be at risk of rupture anymore but you will have no folic acid store so it’s a good idea to take them for 3 months before trying again. Again this is  discussion to have with a doctor.

I didn’t have the injection but from others informations you can have symptoms on the drug that can be unpleasant.

  • aches and pain including increased rupture symptoms (if this occurs it’s important to get checked but can also be normal)
  • diarrhea and vomiting
  • bloating
  • dark stools
  • you may feel generally unwell and tired  again get checked you if you do

for more info

 

 

 

 

Advertisements