Beta rose again -methotrexate questionsFebruary 10 2014 at 5:15 PM
|Mrs.McIrish (Login Mrs.McIrish)|
I think I am just cursed when it comes to anything IF-related. My beta is now up to 856 (515 on Thursday) so RE wants me to take methotrexate. Has anyone gotten this while cycling OOT and if so, where? When I asked the nurse where they usually suggest someone get the shot when OOT, her response was that she's never run into this situation before... Great... Don't I need to be monitored to see if beta drops? I feel like no one is taking care of me at all and that I'm on my own to figure it out...It's after 5 locally so I can't call anyone until tomorrow.
Re: Beta rose again -methotrexate questions
|February 10 2014, 5:28 PM |
Oh, I wish they had better answers for you - Yes, you do need to be monitored to make sure beta returns to zero. Will they offer you misoprostol? It's a pill - I don't know the why or why not behind when it's appropriate versus methotrexate, but it would certainly be an easier first step.
|February 10 2014, 5:57 PM |
He didn't offer it but isn't that used to end a uterine pregnancy ? We couldn't see a sac or anything in my ute on Friday. I also already bled last weekend and my lining was at 6.5 so nothing really to expel from uterus. I asked about doing another u/s to look for something before we do MTX but was told no... Getting treated by an out of state doctor really sucks when bad stuff happens. I feel like I'm left to figure it out myself.
|This message has been edited by Mrs.McIrish on Feb 10, 2014 6:00 PM|
def need monitoring
|February 10 2014, 6:28 PM |
Oh Mrs. McIrish, I'm so sorry that this has become such a nightmare for you. Sending you hugs, but also wanted to say, absolutely you need monitoring after the methotrexate injection. With one of my ectopics, the mx didn't work- beta continued to rise, and I would up needing surgery to remove the tube. Not saying this will happen for you, but that it can, and it can become dangerous quickly.
Do you have a local RE you can see ASAP? I think it's wise to get an ultrasound. I don't want to be morbid, but if the sac can be found and there's a h/b, I think surgery is indicated. Plus, even if not, the methotrexate is a nasty injection (IM, but best to have administered by a nurse- and this is coming from someone who did her own IM progesterone shots).
Wishing you a speedy recovery...
|February 10 2014, 6:47 PM |
Since I'm not a patient at the local RE, they don't want to take responsibility for me. That's what they told me last year when we thought I might have an ectopic then. My PCP just called me and said to call gyn tomorrow/ go to ER if any pain. Hopefully my gyn will help me and do an u/s first. Since my HCG is still low (859, today is 7 weeks), I don't think I'm at risk yet for a rupture. But this is just miserable..
I am so sorry- (mc, pg ment)
|February 10 2014, 6:37 PM |
This is just unbearable and I am so sad and frustrated for you.
Who is your RE at RBA? Can he or she communicate with your OB at home? Or your GP if you don't have an OB?
My only oe pregnancy ended in a mc at 14 weeks. One week after the m/c, I had to be at a long term contract job on the other side of the country and my beta refused to drop as well. I think it took almost three months before it was back to below 10 and I had to see an OB in that town several times who communicated with my regular OB. I never knew the reason.
You do need someone following your healthcare.
I hope this resolves quickly and again, I am so sorry you are going through this. It just seems unfair.
|February 10 2014, 6:58 PM |
My GP just called and said she isn't trained in giving methrotrexate so she said to call gyn. I moved last summer so my gyn is an hour away. Guess I need to find one closer to home after this debacle is over..I have a call scheduled for tomorrow mid-morning with my RE at RBA and will ask him what to do if no one will treat me. I only spoke to a nurse today.
|February 10 2014, 9:10 PM |
but just wanted to say that I'm so sorry that nothing seems to be easy. You are an amazing woman with so much strength but I'm so sorry it has to be tested repeatedly. I wish you a speedy ending to this.
No advice either....
|February 10 2014, 11:04 PM |
But wanted to let you know I am thinking of you. I want this to be over for you, Tell rba that you need help with this. Maybe they know a doctor in your town they can call for you.
Mine was given twice
|February 11 2014, 7:34 AM |
I had the first dose at the hospital and the 2nd was a women's clinic IN the hospital - while I was away from home. Since its chemo - not every dr will carry it - so you may be sent to the hospital for the actual dosing.
I would ask for another scan as well - my gyn wouldn't make a call until they saw something or beta was over 2,000 - unless there was pain.
Mine was given twice
|February 11 2014, 9:06 AM |
I suspect my gyn will be the same about waiting to give the shot. I just gave the run down to the nurse ad was told,they need all the HCG reports and u/s from last week as they need to make their own independent assessment of the situation before they will give it to me. I also told the nurse that I was a little uncomfortable doing it without another u/s. I know the pregnancy isn't viable but I'd rather not take the drug if it was in fact intrauterine... I feel like the HCG level was too low to see anything last week..but maybe now we can as its closer to 1000... I'm just so tired of everything.
Just very sorry
|February 11 2014, 10:24 AM |
I feel inadequate repeating over and over how sorry I am about all of this. Wish I could say something more comforting.
I know this is all incredibly wearing, but I think it would be a good decision to wait it out a little. No advice on whom to see, but I think an OBGYN seems like a good choice.
Referencing the post above on misoprostol-- yes-- it is for IU pregnancies. It causes intense uterine contractions (I used it for one of my clinical losses-- dr was pressuring me to do a D&C). I would not use it again.
Mrs. McIrish, you have been through so much. I don't know the details of your whole story, if you are seeing a therapist, etc... If not, the right person might be helpful. I know it's not for everyone-- it has helped me a bit.
Take care of yourself- really. I hope you have something to relieve some of the grief and stress, even briefly.
Your regular Gyn
|February 11 2014, 9:59 AM |
Call your gynecologist and just say you are pregnant with a suspected ectopic. You need to be followed-- ectopics need to be carefully monitored. It really shouldn't matter how the pregnancy happened. They should see you immediately or send you to a specialist if they can't treat you.
Take care and I'm sorry. I've had an ectopic treated with Methotrexate and it's difficult. Be sure you ask about how long to wait for subsequent cycles as it takes some time to clear from your body. Sorry again for that news, but it would be worse not to know I guess.
At the ER
|February 11 2014, 12:13 PM |
My gyn sent me to the ER without seeing me. I've asked for another u/s before giving me the mtx. They are re-running hcg and checking liver enzymes before giving the medication... I'd just feel more comfortable knowing the pregnancy was located first. It's interesting talking with ER staff and explaining that I know this pregnancy is not viable as they prob have to give that news to most patients in this situation.
|February 11 2014, 12:47 PM |
I don't have much to say - except I am so very sorry. You deserve a break and this is not it....(((((hugs)))))
|AC in Boston|
|February 11 2014, 12:52 PM |
I hope you get another US. Under 1000 it will be tough to find anything IU. I wish they would let you hang in there another 24-48 hours. Are you having any ectopic symptoms?
I told my RE that I would not take the MTX unless they were beyond a shadow of doubt sure it was ectopic. They monitored me every 48 hours for a bit and then my HCG starting coming down. It was still up a bit last week so she did the endo biopsy to "move things along."
I hope you find someone there who hears your concerns and proceeds carefully. I'm so sorry you're going through this. HUGS
|February 11 2014, 1:24 PM |
This is a definite downside of cycling out of state. You are essentially no one's patient so it's hard to demand more monitoring.
You could ask your RE...
|February 11 2014, 4:43 PM |
...to fax them a prescription for more monitoring. Something like "HCG tests today, tomorrow and the next day, U/S today and two days from now" or whatever. As long as you've got an RX they shouldn't have any problem with the monitoring.
Local REs for monitoring bail out of ultrasounds as soon as there is a pregnancy
|February 11 2014, 9:23 PM |
They would still run HCG bloodwork but refused to do any kind of ultrasound, despite doing plenty of ultrasounds for lining checks and monitoring during the cycle.
I really needed help, had no idea they were going to cut me off like that just when I needed an important u/s the most. The local OB office techs don't have the same level of experience with early u/s (they either don't have a vaginal U/s machine or rarely use it, they aren't really used to doing u/s until 8 weeks or later abdominally).
So the local RE refused an u/s, and sent me to a crappy radiology clinic that didn't know WTF they were doing.
I agree with this
|February 12 2014, 11:34 AM |
I completely agree that they bail out if you aren't their patient. My RE can order all the monitoring in the world but its not always easy to find somewhere good to go. The RE who did my u/slats week spent about 20 seconds before declaring she couldn't see anything. They just don't care bc you aren't their patient. They don't want to be involved in that to get reimbursed $50 for an u/s thru insurance.