time to decide what to do

pepper73 · #1 October 25th, 2011, 08:05 PM

I agree...if the doctor's don't have all of the information, how can they possibly give you a well-informed option? I don't understand why they won't even take everything into consideration. You have reasons for wanting to take the steps you want to take. If you feel that strongly, then they should listen to you and at the very least, they should look at all of your history with this. I imagine you must be extremely frustrated.

I agree that you should request all of your test results so that you are in more control and have everything ready to show any doctor you wish to see. If you aren't totally comfortable with what these doctors are telling you what to do, then I would say to definitely go see your sister's OB. It certainly can't hurt. Sometimes getting a second opinion isn't enough. In this case, a third opinion could help you with the method you are most comfortable with.

I'm so sorry this whole thing has been such a nightmare for you. I understand how frustrating it is to have a doctor who refuses to listen to you, and to have two of them act like that must just send you over the edge. I hope the third doctor has the sense to really hear you. What does your midwife say about all of this?

JulieMc · #2 October 25th, 2011, 09:37 PM

So my hcg levels finally leveled off and didn't go higher. So that's a sign there is no new pregnancy. They were 693 on Thursday and 692 on Monday. Unfortunately, the 2nd opinion doctor (that the midwife also referred to me, who is also jaded by the 1st guy's opinion now) won't even entertain the possibility of using cytotec as a first attempt. He says D&C or methotrexate. I tentatively have an appt. set up with him, but I am thinking I will probably cancel it tomorrow. Cytotec and a D&C accomplish the same thing - evacuating the uterus. I like to try the least invasive means first, and that is not successful, move on to the next option. I don't understand why they don't want to prescribe that. I should have just taken the prescription when the first guy offered it to me when I first started bleeding...argh. Also, the 2nd opinion OB said that since I refuse methotrexate, if he did a D&C and was unable to find evidence of products of conception, that he'd then do a laproscopy to see if there was a pregnancy elsewhere. I would not approve of that either. Please tell me if I am crazy for wanting to avoid the D&C? And I won't take methotrexate instead of a D&C either...I don't want that drug in me at all. I see no harm in trying the medical route over the surgical route. I've done my research, and the worst that could happen (besides the rare chance that I might have a reaction to the medication) is that it wouldn't do anything and I'd still have RPOC and would then need a D&C. But I'd be okay with it in that case because I would know that I'd tried the least invasive means first.

I *know* I had a miscarriage. I had 10 days of heavy bleeding and a gestational sack was seen in my cervix ready to expel. A couple days later I did have some weird tissue like stuff in the blood. I just think a small piece is left in there. But...the 2 OBs that my midwife's office uses never saw that first ultrasound or even examined me while I was bleeding... I had been seeing another OB, but then my insurance changed and I could no longer see him so I went to the midwife I had used when I was pregnant with my daughter.

I am thinking of going to see my sister's OB, who is a D.O. rather than an M.D. I'm thinking she might be more inclined to listen and let me try things my way. Because I refuse to be bullied into something I don't think is necessary.

Any thoughts on this? I feel like this whole thing has been dragged on way too long. I want it over with so I can move on and try again...but I want it to end on my terms. I am not usually this determined and oppositional, but I feel a lot is at stake here. I've done a lot of research and have thought about this extensively. Cytotec, if successful, would allow me to return to TTC sooner than a D&C or methotrexate, and with fewer potential complications and risks to a fetus.

doremi · #3 October 26th, 2011, 12:00 AM

I think it is really important that you request the records from your first ultrasound and OB appt's be sent to you so that you can take them with you to whomever is continuing your care now. You can't blame them for reacting the way they do if they don't have all the pieces of the puzzle... kwim? I don't think you are being unreasonable in how you want to go about this. Did the OB give you a reason why he wouldn't prescribe the cytotec? I don't blame you one bit for wanting to avoid the methotrexate, especially since you are still bf-ing.

*SamF* · #4 October 26th, 2011, 07:57 AM

From what I have read the recommended wait time is about the same from taking cytotec vs a D&C.
But I agree getting all your records so you can present all the fact to a doctor is a good start. But I wouldn't put it off too long either retained POC can also cause infections, so it needs to be taking care of pretty quickly.
Hope you get answers soon!

acchickpea · #5 October 26th, 2011, 08:25 AM

what a situation... I would be no help here but wanted to wish you well. Many thoughts and hope everything works out...

JulieMc · #6 October 26th, 2011, 01:33 PM

I've decided that what I am going to do is keep my appointment tomorrow. If I cannot get him to let me try the cytotec first I will tell him I'm taking my business elsewhere. Then I will set up and appointment with my sister's OB, and go from there. My husband believes this is the appropriate course of action as well, and he definitely agrees that I should avoid the methotrexate at all costs.

With a D&C I believe the general recommendation is to wait 3 months to TTC. With cytotec it is wait one cycle.

ninja_mommy · #7 October 26th, 2011, 02:38 PM

I don't think what you are asking is unreasonable. Is there any reason they won't give you the Cytotec?
I think you need to stick to your guns. As much as you don't want this to drag on, it is very important that things happen on your terms. Giving in to what they say could have some great emotional damage down the road.
I hope they agree to try your route and things go quickly and smoothly for you.

junie22 · #8 October 26th, 2011, 02:47 PM

Quote:

Originally Posted by JulieMc

I've decided that what I am going to do is keep my appointment tomorrow. If I cannot get him to let me try the cytotec first I will tell him I'm taking my business elsewhere. Then I will set up and appointment with my sister's OB, and go from there. My husband believes this is the appropriate course of action as well, and he definitely agrees that I should avoid the methotrexate at all costs.

Sounds like a good plan. KUP. And good luck.

JulieMc · #9 October 26th, 2011, 02:49 PM

Control is the reason they won't. With cytotec, they cannot examine the stuff that is expelled to check for chorionic villi, which is what indicates a uterine pregnancy was there. They're still hung up on that. I don't know how many times to say it, but this is not an ectopic pregnancy. People have retained tissue and rising hcg...its not an uncommon thing. There's no need to jump to the worst case scenario when my history with this thing suggests a miscarriage and RPOC.

roziecakes · #10 October 26th, 2011, 04:48 PM

I think you are being totally reasonable and smart about this. I am looking forward to your update, and I hope that you find someone who will really care for you and your situation.