Methotrexate wasn't enough

Last night I had a laparoscopy to remove a 10cm blood clot, yes ten centimeters, which seems huge to me! This is 3 weeks and 3 days after methotrexate. I had two injections (one dose split into two) on June 5th right after we found out our baby was in the wrong place, again (ectopic also occurred in 2020 ended Dec 18th and the methx did work fully that time).

My recovery after this time was much different, the scenario was slightly different too so I wasnt sure if that was why. First time, my hcg was at 895 on the day we ended it, which was at 9 weeks pregnant. This time the hcg was at 4400 at 7+1 weeks. The first time I had already been cramping and bleeding, the second time none of that besides slight one sided pain which we tried not to worry about (despite my intuition screaming something was wrong) because the hcg was doubling.

After June 5th it took me 5 days I think to start spotting, but the cramping started on day 3 or 4. Very severe pain and nausea, not like the first time. The pain did go away slowly and by the next week I went to work, which was a bad idea, I had to leave as soon as I started moving around which caused me intense pain again. Since the pain and nausea I was not able to eat solid foods, I was on liquids only and if I felt fine and chanced it with a solid meal, I would throw it up or be extremely constipated which was very painful.

I got a blood beta hcg done on June 7th and we saw the hcg go up to 5000... not a good sign to me that it was going up but my doctor said i did the test too early, was supposed to wait 4 days. So for some reason he tells me go again on Friday, the 11th, which was 4 days after the blood draw on Monday but 6 days after methx which confused me. But that lab came back showing hcg starting to fall, it went to 3400. On Monday I had a lot of pain and heavy bleeding which resulted in what looked a lot like the sac coming out, it was not a blood clot for absolutely sure, it looked like a flattened out ball of snake skin type white tissue covered in blood.

After that the pain decreased, the doctor said all of this sounds good, let's not do more blood tests for now. But off and on I was still having pain and light bleeding. It would go from spotting to bleeding to spotting again. Then the pain would come and go, never as bad as at first but it got weird because the ectopics were both on the left, and I started having a lot of pain on the right and into my right lung area even. I continued to not be able to digest solids.

This went on until Monday when I vomited again. I still went to work after, I was back full time from the point when I passed the sac. That was a bad choice but I can be stubborn and work myself too hard. Anyway when I got home from work on Monday I decided to call my doctor the next morning and explain all of this, because the recovery has been so long and hard and not like the first one where all the pain was in the first couple days and I got another period by week 3 post methx.

Tuesday the 29th I call my doctor's office at 6:15am and leave a message for him to call me. To my extreme surprise he call at 6:30. I thought he would not call til his office opened at 8am. Well I explained it all and he said we have two options. Follow the hcg more, or I go to the ER. Taking more blood work seemed too passive and I felt I really needed to know whatt was going on. So I went to the ER at 7am. By 9am I get bloodwork and an ultrasound. The sonographer tells me she can't tell me anything but she sees exactly what is going on with an external u/s, no transvaginal needed thankfully because at this point I was in a lot of pain.

After a couple hours the ER doctor comes in and tells me it looks like there is a bloodclot outside my fallopian tube, measuring 10cm, and my hcg is at 1500. He says they are trying to get ahold of my doctor but don't eat or drink anything, they are putting me on an IV, I will probably need surgery. My doctor calls me an hour later saying yes it looks like a clot but the only was to know is laparoscopy. I can choose to do that, or we can again follow the hcg and the blood clot may heal itself in 6-8 weeks. He and I agreed surgery is better, and best to take the left tube also because after two ectopics and a small rupture like this, chances of another ectopic there are extremely high.

My dear love, the baby's father, agreed that the tube should go and we should try

IVF

after healing. He suggested taking the right tube also but since I only ever had fimbrial blockage there and it seemed to resolve itself, I and my doctor both felt the right side tube can stay but the

IVF

is a good next step anyways since we don't know if the right tube will work.

We are two extremely natural, healthy people who do not often seek medical intervention. He and I both had only had our wisdom teeth removed and no "other" surgery, if that is even considered one. So this was a huge choice but the tube removal and

IVF

feel like our best, safest option to have our baby.

So at about 7:15pm finally I go into surgery. I come out of anesthesia by about 10pm and everyone is telling me it went well, the clot and the left tube are removed. I have bandaids on my belly button (a bigger one) and on each side near the pelvic bone (two small normal size bandaids). They tell me I can go home soon, but they want me to eat something so I can have a pain med. I ate apple sauce but I didnt want the pain med because I preferred my cannabis drops at home. They also said no shower because the heat can make me pass out when the anesthesia is still in my system.

Love took me home about 11:45, I finally drank some water and I had my drops, brushed my teeth and went to sleep by midnight. Woke up at 3:45am and can't sleep anymore so I'm writing this. At this point the pain is not bad, actually removing that clot seemed to help a lot and immediately I felt relief from that thing pressing inside me. I noticed too that my bloating is gone, which I had wondered about because already being pretty thin and being on liquid for 3 weeks, it seemed weird to me that my belly was like that, but I ignored that sign because I thought my body was just healing still.

The doctor told me two weeks before returning to work, and he has to see me first for a follow up. Said to just wash the wounds with soap and water. The recovery is supposed to be not that bad.

I hope this detail helps someone if you are experiencing any of this and wondering what to do. I'm really glad I finally went to the ER and I am hopeful that our next step to become parents will be a success 🙏❤️

Good luck everyone... I pray we all have our babies.