Quick! You Tell Me

Alas, no Miracles or even miracles over here today. I guess I must have been nurturing a tiny flicker of insane hope all this time because when the ultrasound was so conclusively blah I instantly became very very sleepy. This must be my defense mechanism. When in doubt, like a marmot, doze.

But we don't have time for my personal revelations. I need your assistance, instanter. We need to decide whether or not to travel tomorrow and I could use some anecdotal ectopic evidence to sway the vote one way or the other. I will accept: your own ectopic experience or that of a close friend/relative/co-worker. Or something you saw one time in medical school. Or a program you watched half of on the Discovery Channel, I guess. It doesn't matter. Just gimme something to work with here!

This is the dillio - the gestational sac grew about two days since last Friday. However, there is still nothing obvious inside it. No fetal pole, no gestational sac, no debris. So they are not able to say no, absolutely not, no, it is not ectopic. But I have had no pain, bleeding or spotting of any kind. I should be about 7.5 weeks and there is nothing to be seen outside the uterus either. I am waiting for today's hcg level; I will post it when I get it.

My OB said that they feel it is most likely not ectopic. However, she said that the safest course of action would be to stay home and come back next week for another ultrasound. She said she would be happy to write a medical order for me, or not. It is up to me.

So I am doing what I always do and I am handing it over to you.

Do ectopics ever just spring out of nowhere and cause mayhem with no prior symptoms? Should we stay home?

PS I would rather just stay home but I feel incredibly guilty about this fact (we have not been out to see my brother in five years AND my mom is flying out too) and am afraid my disinclination to travel is coloring my decision-making ability.      

Comments

[Anne]

I get sleepy when presented with bad news, too. It's the best coping mechanism ever! I just have to be careful not to have a cigarette in my hand when on the receiving end of bad news else I'd start a house fire.

Wish I had some assvice for you on the travel-or-not question. Blighted ova are my forte, not ectopics.

[Anne]

I take that back. I *will* offer you some assvice. If you feel like staying home, stay home. You can visit our brother some other time. You've been through the mill, so give yourself a break. And the possibility of an ectopic is just the excuse you need.

[Anne]

D'oh! I meant "your" brother. Typing isn't my strong suit.

[Jme]

I've read your blog for some time and it seems like whenever you've had a difficult experience you've also had something to do, somewhere to go, a vistor or your husband's taken a trip. And every time I think to myself, "geez that girl needs to cut herself a break".
Stay home. Get a pedicure.

[Amber]

my first ectopic snuch up on me and from minimal cramping around 4am progressed very quickly to throwing up because it hurt so bad by 12 noon. Rushed to ER at 12:30, u/s showed pregnancy in right tube at 12:45, was in the OR by 2. It was the most horrific pain I have ever known (and I have had gall stone, and an appendix rupture to compare it to. no child birth (c-section) so don't know about that.)

my 2nd ectopic, had light cramping, and some spotting. But I just didn't feel right. That one was caught earlier, and treated with the meth shot, and no one was the wiser.

Alot of help, huh?

The only thing I can say is if this is ectopic & lodged in one of your tubes, you will NOT want to be anywhere but home or the hospital on morphine.

BUT...I would wait for your beta results, because that will tell you more.

So sorry you are having to deal with this. xoxox

[Vix]

Instincts are a useful thing - I think you should probably go with yours. I'm guessing that brother and mother would not want you taking the risk.

[shannon]

No experience whatever, but it sounds like you don't feel good about going. So don't go, darlin'. Do what you need to do. Give yourself a break, put yourself first, and make sure your health is protected.

You can travel another time.

[Danielle]

Hi Julia,

My name is Danielle and I have posted here before. My assvice (and take it with a grain of salt, as I have never been through what you have, nor am I TTC, I'm just a single girl in NYC who thinks you're a great writer) is: if your doctor advises you not to travel, and you truly want to stay home anyway, then that is what you should do. I'm sure all parties involved would understand, and the trip could always be rescheduled. Put yourself and your health first.

[Elin]

Medically speaking (keep in mind, I have no professional basis for this advice) if you have no pain and feel ok you're probably in the clear and can travel if you want to.

The question is, "What does Julia want?"

[Alexa]

Hello my dear, I am sorry you still have nothing conclusive.
This is a friend-of-a-friend anecdote, so feel free to ignore: A friend of a friend was diagnosed with a possible ectopic--like you, there was nothing conclusive on ultrasound and no spotting, unlike you, she had some mild period-like cramps. They were in the process of "waiting it out" when at 8.5 weeks she had sudden stabbing pain and poof! she was in the ER having surgery. So I think you are perfectly justified in wanting to stay home. The situations aren't that similar (her HCG never got as high as yours, she had mild cramping throughout) but the sudden onset of the serious part in her case could at least give you something with which to assuage your staying home guilt.

I am thinking of you, obviously, and hoping you are as well as can be expected...

[VHMPrincess]

I say stay home...and send the boys on the trip, you could use a free weekend, goodness knows you DESERVE one!

[Lisa]

This is more of a question than an answer: What are the diagnostic criteria for a blighted ovum, which also presents with only a gestational sac and nothing in it? Is your doctor simply looking for a larger gestational sac? I just had a D&C for a blighted ovum a week ago. My hormone levels were significantly higher than yours and my sac was at a 7 week size - but otherwise there was nothing else to see. Even at my previous ultrasound a week earlier no one seemed concerned about the possibility of an ectopic. Would it help you to know what exactly your OB's criteria are for ruling out an ectopic? Or maybe you already know? The possibility of an ectopic strikes me as very remote at this point - but maybe it's still better to play it safe?
I am really sorry you are going through this. We got pregnant at almost the same time and when I read about your positive result I was so excited. I thought it would be fun to follow your pregnancy on your blog while experiencing my own. Instead I had my second miscarriage and you are going through an ectopic scare. I admire you for your good spirits - I myself seem to favor sadness, anxiety and rage these days.

[millie]

Well, I've had an ectopic so I guess I feel like I can share a bit. Actually 4 of my friends (3 from my RESOLVE group, 1 other)have all had ectopics in the last year. This is soooo not a club you want to be in.

Now, I'm going to share our stories with you but promise you won't freak out? Seriously you must promise me. Otherwise stop reading now.

I had cramps and spotting and it got bad quickly. So I guess I had a few symptoms but it did turn fairly quickly. I had emergency surgery and except for losing a tube all was well.

One of my friends was recommended not to travel (by car), did it anyway, ended up in an ER with an incompentent doctor and had to then travel very quickly back to her home doctor with the promise of calling 911. On Christmas Eve. She made it to the good hosptial just in time for surgery.

Another friend had the shot, didn't work and it got bad very fast for her. Emergency surgery cost her a tube as well.

Last friend had the shot, didn't work, was monitored very closely and had scheduled surgery. She's the only one who kept both tubes.

So my assvice would be to stay home. I've just had bad things happen to too many friends. Ectopics can be really, really scary. My husband would tell yours to just stay put because the worst day of his life was waiting for me to come out of surgery. Please don't feel guilty if you decide to stay home. Your family will understand.

To end on at least a slightly postive note, the 3 friends who had ectopics via an ivf cycle all got pregnant on their next ivf cycle (2 fresh/1 frozen) and things have been smooth sailing this time around.

[Rachel]

I would say if you want to go, go. But if you don't want to go, then the eptopic is just the "excuse".

Also, are you like me, you hate the travel, but when you get there it is a good change of pace and actually fun?

Just a thought.

Rach

[Claudia]

Stay home. It's not worth the risk. If things were to go wrong, they could go wrong very quickly.

My ectopic was missed, even though I had severe cramping, a fever, and vomiting and countless ultrasounds for two weeks before I had to have emergency surgery. In my research afterwards I learned that I was actually lucky to have had symptoms as much as I did - many women never do.

Unless they can 100% rule out an ectopic before you travel, it's not worth it, in my opinion anyway.

[ees]

Long-time lurker delurking to say that your description sounds very much like two of my three miscarriages - very slow growth of the gestational sac with nothing visible inside (or in one case, a very brief glimpse of what could have been a fetal pole which entirely disappeared by the next ultrasound). With the first one, my betas were even rising appropriately! I've never had an ectopic. Of course, ectopic or no, you've plenty of excuse to stay at home and take care of yourself, but hopefully this is somewhat reassuring.

Ugh. My one sort of experience with ectopics a friend who had one....she traveled and all the badness happened. Her fallopian tube did indeed burst and she was stuck in a hospital far, far away from home. It was B-A-D.

[Cat, Galloping]

I'm sorry that you even have to ask for advice on this... I have no ectopic experience, but live my life on the philosophy that if something bad were to happen, I would not want other people to be able to say, "why were you doing that anyway?" I use this as rationale to, for instance, take an expensive taxi ride home rather than the subway late at night. So if I were in your position, I'd make that trip another time. Why risk it, especially when you don't feel like going anyway?

[Sol]

My very bestest friend and IF sister had an ectopic last year and things went really badly really quickly. No real symptoms to speak of except a tiny amount of spotting and mild cramping the evening before she was sent to emergency surgery. The fact that she was able to got a lap so quickly was the factor that allowed her to save her tubes.

I would say don't risk it -- and if Steve and Patrick still decide to go so as not to disappoint the family -- just make sure that you have friend "on call" standing by for you.

Much love your way.

Ps.: I would certainly volunteer to stay with you if I did not leave in the other side ofthe world, you know. You are just so amazing!

[Dani]

Long time lurker who loves your writing and is constantly refreshing. I haven't had anything to add until now....

My mother had a total of 11 pregnancies that only produced my brother and me so she's had tons of stories to share over the years. The one that may apply to your situation:

Positive pg test then abnormal hcg counts. Was at the OB and had just been examined. Told "Let's wait and see until next week." Stepped down off of the table, took two steps and collapsed to the floor. Her tube burst without warning.

Yes, it can happen but I'm sure it's rare. My mother has never done *anything* in a typical way. :)

Me? I probably wouldn't travel. But that's because I live by Murphy's Law and rarely tempt fate.

Good luck and feel confident in whatever you decide. Only you (and your OB) know what's best for you.

Back into lurkdom....

[Heather]

I don't think it's ectopic. I'm thinking it's a blighted ovum. So sorry, my first MC was a blighted ovum, the second was at 10 weeks when we lost the heartbeat for genetic reasons.

But either way, I don't think you should be going anywhere. Any miscarriage whether it is a blighted ovum or ectopic is not a walk in the park. Stay home, do what the doctor tells you, and rent lots of movies. Make sure they are funny movies with no babies in them.

Big cyberhugs and so sorry nothing definitive is happening. Sometimes knowing nothing is worse than knowing.

[Tonya]

I'm sure they have a hospital (or even plural) where you are travelling, but the question is: if something goes haywire, do you want to shack up there? It sounds like what your OB is seeing is pretty firmly in the uterus. However, if everything gets royally effed up, whether ectopic or "just" garden variety blighted ovum (been there, ugh), where do you want to be cared for? Can you just send hubby and kiddo to do the familial trip? If so, would you WANT to be home alone? WWJ(ulia)D? {{{Hugs}}}

[libby]

I live in Seattle and while I would be thrilled just to know you were here, imparting your fabulosity, I would not want you to risk your health, your tubes, your possible future reproduction and/or your sanity just to have the aura of the lovely Julia floating above the Puget Sound. Trust your guts on this one, dear. I wish you well.

[Erin]

I'd say not to include the fear of a possible ectopic in your desicion to travel or not (excluding actual travel time, there are some very good hospitals in the Seattle area). I'm sure your family would understand given the circumstances if you choose to stay at home to heal/relax/recover. I will say that Seattle is a beautiful city to visit, if not now then another time (as someone that lives there)!

[liz]

Maybe I told you about this already, but I had my first miscarriage in the middle of my pediatric nutrition class. I had the U/S that morning confirming there was not hb. My dr. told me it would be like a bad period and would take a few days. It was the first day of the class and I had really been looking forward to it. In the middle of nutrtion for fetal development (yes, they were showing slides of various aged fetuses) I started coughing. Suddenly I felt a gush (no one told me there would be a water sac that breaks) and I was sitting in a puddle of blood. I didn't want to get up because I was in the front row and everyone would see. So there I sat for the next hour. When the class ended, I sat there pretending to be making notes until everyone but a friend of mine left. She went to the bathroom and got me a bunch of papertowels and I got cleaned up. I learned two things. First that this person would always be a true friend and second I should have stayed home. So from the person who is always pushing too hard. Stay home!

[Laura K.]

Ack - I don't have much to offer. They did methotrexate on me when I went to the ER last year and they *suspected* ectopic, but I was so early on there was no chance of rupture.

It really sounds like you could use a little down time, and I agree with eveyrone else - if you did have an ectopic issue, while you'll be somewhere with good hospitals, it's not the same as being home.

Do what you feel is right to do. How's that for assvice?!

[Heather]

Stick with your gut...errr uterus. Stay home. Relax, nap often and take care of yourself.

[wix]

"Do ectopics ever just spring out of nowhere and cause mayhem with no prior symptoms?"

yes. i could tell you about my friend and housemate who had no symptoms at all prior to doubling over in pain and hehmorraging as she walked up our driveway, but i don't want to scare you.

[Anita]

Jesus H.

I have no ectopic stories to share. none at all. I vote go and take a medical order with you. Can the schedule an ultrasound over there????

[reprogirl]

Don't go. I think the message is loud and clear.

[CA Suz]

You seem like you feel (physically) pretty good, but if there is a potential for an ectopic, staying home is probably the best plan. When mine ruptured it was after a week of general malaise and feeling wonky that I had written off to too much running. However, I went from feeling kinda tired to throwing up to passing out in the bathroom to landing in the emergency room with a ruptured tube pretty quickly once things started to go South. I'd err on the side of caution.

[Tine]

No ectopic experience here, but just want to say I think not wanting to travel is a VERY good reason to not travel. Add to that the risk of ectopic, and (for me, anyway) it's a no-brainer. I second those who recommend not being alone, too.

[Paula]

Cautionary tale? Assvice? You decide.

First the disclaimers: this happened for my first pregnancy, I was totally clueless, and I'm a HUGE wimp.

At the first OB appointment, the doc couldn't find a heartbeat at 8 weeks and the sac measured 3w3d. She told me to go to the lab and come back in a week for another U/S. Betas over the next few days showed dropping numbers, but before I could get back to my OB for a follow up, a relative died and I flew cross country for the funeral. The night before the funeral, I started to cramp and bleed. By morning, the bleeding had slowed and I thought it was over. Stupid me. By midafternoon after the funeral, the bleeding and cramping resumed. I thought I could tough it out, but by about 6 p.m. I decided to call my doctor who told me to go to the local ER.

While it wasn't an ectopic pregnancy and I received very good treatment, flying home two days later was really hard. Air travel can be a big drag under the best of circumstances, but post-miscarriage..... Oh, and I did this all by myself as my husband couldn't get off work.

Bottom line: miscarriages suck and they suck even more on the road.

[Crystal]

I'm still curious about the abdominal/transvaginal issue. If you remember at 7.5 weeks I was being told Michael is a blighted ovum by the RE. I can assure you, he most assuredly is not blighted, and not an ovum,

However if the beta is over 2k, or worse, 2500, and this is what they're seeing on a transvaginal U/S.... Then it's not good.

As for staying or going... If you're not seeing your OB for a week, why not go? It's not like she's going to be camping out on your doorstep to make sure you're not experiencing an ectopic, at this point, it may not even BE an ectopic, and I PROMISE you, you can probably get to an excellent hospital in Seattle as quickly as you can get to one at home, if not sooner, depending on where your brother lives (he's in academia, right? U Dub?). If you're in the Eastside, I recommend Evergreen, the US's first baby friendly hospital, and when you get devastating reproductive news, their MFM team is none better. Hopefully you won't need them but if you see Dr. Walker, say hi.

Then again, if you don't want to go, don't go. Guilt be damnned, Julia, you've got a lot going on, if you're not up to being sociable, so be it. There will be more get togethers. Or not. This year I'm taking every whirlwind trip I can cram in because I've had my eyes opened this year, and am not passing up "life" anymore for money, or time, or exhaustion. As far as I know, your life expectancy is normal, so don't live by my standards. : )

However Seattle is home to a woman I love more than just about anyone, who finally, after 10 years and 8 losses had her first child, her one and only little girl. Maybe she's spreading baby dust over the city at night and you can catch some. She's a miracle, multiple diagnoses that supposedly would never result in a child. They got their miracle.

Wishing you one too....

One last piece of advice. As a birthmother who placed her only daughter, I have spent a lot of time thinking about how I will feel throughout my life if we only have sons. How I'll feel only being the MIL, never mother of the bride, how I'll feel when we have grandbabies, especially given that cancer has taken most of my female relatives including my Mom.

Maybe now is a time to stop and think, and figure out just how much this is going to change your life if Patrick is your only child. You mentioned grief..... I think you must be going through this right now, but I've had to drag my husband along kicking and screaming every step of the way in our challenging reproductive lives, and trying to have a girl was never high on his priority list, only mine. Until cancer took my choices away. Now there's no longer any question about can we or can't we, or even should we or shouldn't we. He finally gets it, what a huge loss this will be for me to not have a daughter. It would have been a huge loss to me not to have the babies. But it took a lot of talking and discussing to get there, and reminding him of the fact that while my desire for a kid doesn't override his reservations, neither do his reservations override my desire for a kid.

Just sayin....

You'll always have questions, unlike me. There is a Patrick, who proves the theory. But there comes a point where the questions are quieter, and the yearning is louder, and in that time and space, maybe an answer that works for both of you will come. Or not. I hope so. I went into my cancer diagnosis 12 shades of bitter, and through talking and ranting and exploring the meaning of this and laying it out, we came to a decision together, one he'd never would have agreed to before.

Don't give up, on yourself, or Steve, or fertility. There are options, maybe they won't work for you, but don't stop trying until the yearning is quieter than the questions.

[T]

I'm more of an ivf failure with a dash of m/c rather than ectopic gal, however, I think if you're not interested in travelling right now - don't. Can you not see your brother another time? Postpone the trip due to medical issue?

I'll see if my friend that's had 6 ectopics can make it over and tell a tale or two.

[Febe]

As Libby and Erin previously mentioned, Seattle is great - but it's not going anywhere. Besides, the weather is supposed to be shitty this weekend. Stay home. Take Care.
Hope you get some resolution soon.

[B. Mare]

Good god woman, WHAT is going on in there? It is like the Bermuda Triangle- an embryo goes in, never to be heard from again. Not even a goddamn postcard.

Stay home, of course. Staaaaaaay. The Internets say so, and besides, I am way too fond of you to bear it if you expire, ectopically, at 35,000 feet.

[GiBee]

Okay ... for what it's worth, here's my opinion...

It seems like your doctor is not worried about an ectopic, per say, but IS worried about other things that are going on. That alone sends off enough red warning bells to make me question the wisdom of traveling at this time.

Just so you know, I am a person driven at times by guilt... so I can relate to the guilt of not seeing family frequently enough. But if you're a close family, I think your brother would be quite upset if you traveled and something happened while you were visiting him. Especially if you had been previously warned by your doctor.

The doctor has offered to write you a medical order... and with this lovely medical order, the airlines will refund you your expenses. Book the flight for later on in September, and stay home this week knowing that you will be able to rest easy and take good care of yourself. You still have a lot of hormones wandering around in your system, and you really should just TAKE IT EASY!

And don't send your husband without you. Keep him at home and have him wait on you hand and foot, loving you and caring for you.

What does your mom or brother think you should do? How about Steve?

[Kathleen999]

I think you should follow your instincts and stay home. there's no place like it when you are feeling lousy.

Tell your mom and brother to enjoy some quality time together and you'll see them next time when your medical and tubular future is not up in the air.

[Jenn]

I don't know much about ectopics, (unless you count the time on Melrose Place when Amanda had one- she got sick FAST, by the way) but I do think you should stay home and rest. You have been through hell. Take care of yourself and book a trip later in the fall.

[bihari]

ER nurse practitioner delurking to say ectopics can come as a big old surprise to all concerned, and who wants an unfamiliar hospital, and an ER at that, anywhere in vacation plans? Stay home, stay safe, and take care of yourself.

Why do we always feel guilty ("we" being women) when we do what our natural inclination tells us to do?

[Leslie]

long team reader, rare poster. I would stay home - get a medical order so you can refund your airfare.

I've had two ectopic pregnancies. Had no inkling of trouble until they both ruptured - first one while on vacation in the middle of nowhere - 30 mile ambulance ride to emergency surgery. Both times were life threatening emergencies with no warning. If you have an inkling that you may be facing this kind of problem it's just not worth it. I did have a child between the two ectopic pregnancies so it's not a given that one can't conceive afterwards although I was down a tube.

still - coddle yourself here would be my assvice - getting desperately sick away from home is no fun at all. You are being carefully monitored and it is a total bummer to miss a family event but it's not worth the potentially major risk!

[RachelH]

Okay, formerly I have commented just putting Rachel, but someone beat me to the punch (I'm the one who was in preterm labor and now that I've hit 36 weeks am just sitting around). My mother, who is a CNM/OB nurse, is now here sitting around (and staring at me). I ran the scenario by her and she says yes, ectopics CAN sort of "spring out of nowhere" and that it could be a "pseudosac" they're seeing. So there you have it, second-hand advice from someone with a medical background. My two cents (and permanent shitty outlook plus limited grasp of physics and air travel) lead me to wonder that if anything was in there that WAS prone to the possibility of rupturing, air travel might not give it that extra little "go ahead and jump" push? Incidentally, I was still holding out vague hope for the Miracle, capital M, and feel rather sleepy, too. Sorry.

[Lisa]

My ectopic took me off guard...had no idea I was pregnant until it suddenly ruptured (my OB estimated I was around 6 weeks). I had brown, light spotting ever since the time I would have expected my period and I just thought I was having a funky cycle. I was glad it didn't happen any sooner since I had just returned from Chicago to my home in Texas two days before. I really hope it's not ectopic, sounds like it isn't though.

[Peach]

Hmm... I'm wondering, if you have a m/c while in Seattle, will there be someone to make you floor cake and not judge you for it afterward?

So really... floor cake at home, or floor cake on vacation?

(And while it sounds like I'm making lgiht of the situation, I'm not.. because floor cake embodies the emotions and pain and all that of dealing with the loss... so do you want to deal with a possible loss while away or at home?)

[Jen (yup, another one)]

Sleep. Sleep, and stay home. That's what I think your body is telling you to do. Whatever you choose, hang in there. I'll be thinking of you.

[victoria]

Don't go.

[Jessica]

As assvice was requested, here it is: stay home. It isn't uncommon for ectopics to show "something inconclusive" in the uterus, spreading a sense of false security. And when it does make itsself known, it can do so in a matter of hours. Not the time to be in a strange place.

Since my assvice jives swimmingly with your own inclination, I offer it unhesitatingly.

[cherylc]

Well, I live in Seattle and I'd gladly make you floorcake, if necessary, but who wants that from a stranger? It sounds like you want to stay, so maybe you should.

I and my friend both miscarried at the University of Washington Hospital. We both felt that the ER staff was fairly callous, but the actual department doctors were very good. I did eventually have my daughter there, and they handled all our complications well. So, there are nice, qualified hospitals here, for what that is worth.

[Liz]

My experience....
not "trying" to get pregnant, late period - attributed to stress of moving, just didn't feel good for a few weeks, then boyfriend now husband drove me to ER because I was lightheaded.

What was ectopic aborted itself to my abdoment and I would have died from internal bleeding in about 2 hours had I not gone in. I resisted the entire drive to the hospital. The nurse who took my bp could not believe I was awake and talking.

Your health is THE most important thing. Take care.