some updates

I have an hcg level of 182 as of Monday.  I had an appointment with the RE yesterday to discuss the current situation.  I was a bundle of nerves.  But thankfully Kara was able to go the the appointment with me.  She did a good job making sure I spent most of the time laughing. The alternative is crying!  The RE began the conversation by making certain that I understood that this pregnancy was not viable despite the fact that my hcg level continues to increase.  This I know.  And I have accepted this over the last week.  She also wanted to reassure me that there was nothing that I did to cause this miscarriage.  I didn't exercise too much.  And it wasn't because I didn't eat enough broccoli.  I appreciated that she took the time to say these words.  It showed me that she could understand the emotions that I was feeling at the moment.  And it made me laugh.  Because my hcg level continues to increase at an abnormal rate, there are a few concerns that needed to be addressed.  It is a possible that I have a normal uterine pregnancy and for some reason or another the pregnancy has failed to progress at the proper rate.  At some point my body would recognize the problem and my hcg level would begin to decrease.  I would then have a natural miscarriage.  However, there is no way to determine how long it would take for my body to recognize the fact that the pregnancy is not viable.  It clearly has not done that over the course of the last week.  The other concern is that I have an ectopic pregnancy.  An ectopic pregnancy occurs when an embryo implants itself somewhere other than inside the uterus.  It is most common for the embryo to implant itself in one of the tubes.  The major indication of an early ectopic pregnancy is an abnormal rise in the hcg level.  The abnormal rise in hcg level occurs because while the embryo is continuing to develop it is doing so at an abnormal rate because the embryo is not getting sufficient nutrients.  An ectopic pregnancy, if not addressed early in the pregnancy, can become a life or death issue.  Eventually the embryo would grow to a size not supported by the size of the tubes.  The tube could then potentially rupture.  Unfortunately, because my hcg level is still low, it was unlikely that the RE would be able to determine via u/s if the embryo implanted in my uterus or if the embryo implanted outside of my uterus.  And this ended up being the case yesterday.  The RE did an u/s and could not determine where the pregnancy was located.  Therefore, unless proven otherwise, because of the abnormal rise in my hcg level, we need to move forward with the assumption that I do in fact have an ectopic pregnancy.  We have decided to use the drug Methotrexate (MTX) to end the pregnancy.  This drug, commonly used as a chemotherapy drug, will attack the pregnancy tissue.  This should cause the cells in the tissue to stop multiplying and essentially end the pregnancy.  The drug is fairly potent but because I am receiving such a low dose of it the side effects should be minimal.  I am scheduled to go back to the RE today to receive the injection.  The RE will continue to monitor my hcg level over the next several weeks to make certain it decreases.  The drug should cause my levels to start to decrease in the next seven days.

Today will be the hardest day for me.  The shot will be the hardest moment.  Today I will end this pregnancy.  Today I am 5 weeks and 3 days pregnant.  I know that there is absolutely nothing that I could have done to have prevented this from happening.  But it doesn't make it any easier.  And I know that I need to move forward.  And I am ready to do this.  I will always think of what could have been.  However, I know there is a greater plan for us and I know that we will someday get to hold our baby in our arms.  It's just not today.  It's just not tomorrow.  It's just not nine months from now.

Mary