System Failure (or, what's wrong with me?)

So, the last three weeks have been long ones. A lot of you know part of a the story, a lot of you haven't heard, a lot of you don't care and a few know bits and pieces. The short version is, I've been sick, and we know one of the reasons why, and are trying to find out the other. Here's the long version:

On May 17th, I started having abdominal pain. Nothing major, just some discomfort. It seemed better or worse depending on how I sat or stood, but wasn't really impacting life too much. Sean and I went to a movie. We put the kids to bed and we went to bed. Then things started intensifying and I spent most of the night up and down, hurting. By 5 am I knew something was wrong and woke Sean at 6:30 to tell him he needed to help me get Cian ready for school and then we had to get to a doctor, quickly. The pain feels just like when I had a gall bladder attack, except that I don't have a gall bladder anymore. That left the premises two years ago.

Cian's teacher, Amanda, was a blessing and when I texted her to see how early Cian could come to school, she told us to go ahead and bring him and she would watch him. Declan's godmother, Rhonda, agreed to watch Declan, so Sean went off with Cian and got a shower and then took Declan down to Rhonda. At this point, the pain was so bad I could barely get Declan into the carseat. Sean and I then met at the emergency room.

Six hours later, we had not one but two diagnoses: the "doctor" (more on that in a minute) decided that since I had nothing out of the ordinary on my xrays or labs, that I had a duodenal ulcer. And oh, by the way, you're pregnant. (at which point the room was rather pregnant with the stunned silence of two people who thought they'd had a hallucination.)

Because, see, I had an IUD. A Mirena, to be exact. And the failure rate? Two tenths of one percent. And in a 35 yr old woman with polycystic ovaries, a history of infertility, and still breastfeeding a 13 month old? But, nonetheless, pregnant. And scared. Because as soon as the guy leaves the room, I start Googling and realize that Mirena pregnancies are a big deal. High likelihood of ectopic. Fifty percent miscarriage rate. Guy comes back in the room, and I ask for an ultrasound, because I'm concerned about tubal rupture. He thinks it's unnecessary and tells me that I'll have to wait hours. He makes it clear the pregnancy isn't his problem and he's diagnosed the other and now we need to leave. (Turns out he was a Physician Assistant, which annoys me, and that he made several very bad decisions about my care. I'm really hoping I get a survey from the hospital asking about my experience.)

The next day, I saw my OB, who announced that I was her first patient to EVER have a Mirena failure. She pulled the IUD and sent me back to the hospital for the ultrasound I wanted to begin with. The radiologist there says he can't tell yet if there's implantation and where, but he does note he can see the IUD, which is pretty amazing considering it had already been removed. This further convinces me that the hospital is trying to kill me.

So, the day after that, I start bleeding and it becomes pretty clear I'm having a miscarriage. The OB's office is having bloodwork done, and the HCG level (which is supposed to double every 48 hours) is rising initially, though not as much as we'd like, and then after I start bleeding, it falls. So we know it was a miscarriage. But then, a glitch. Because after 2 weeks, I'm still feeling crappy - cramping and nausea. OB orders another ultrasound and they see a mass in my right ovary. Could be a cyst, could be the remains of the pregnancy. (And, just in case you're keeping track - 95 percent of ectopic pregnancies are tubal, not ovarian. So here's another set of ridiculous odds.) We wait until the next day (June 2) and find out that my HCG hasn't dropped at all, which makes the likelihood of ectopic very high. I'm given two options: an injection of a chemotherapy drug, methotrexate, which will dissolve the mass so it can pass, or abdominal surgery, which has a high likelihood of causing a loss of the tube and/or ovary.

I opted for the shot. Got it that day. Had some nausea in the evening, with some very light bleeding, and then I start having abdominal pain. Again, Except, it's not going away, it's getting worse. By Saturday, it's bad enough that I called the OB. She's concerned about internal bleeding, but after a while, the pain gets better and I figure it's just side effects of the shot. Sunday, same thing happens again, except even worse. I am so miserable and realize that the only way I can keep from hurting is to not eat, which doesn't seem right, so I go to our urgent care center.

I got a great doctor at the urgent care center who quickly ran some labs to rule out pancreatitis and a couple other things, and then gives me a long talk about advocating for myself because something is wrong and he believes it's completely irrelevant to the pregnancy. There's not much he can do for me, except tell me to stay on liquids and give me a high potency acid blocker, but tells me to insist on a ct scan and that they find out what's causing the abdominal pain.

So, yesterday, that's what I did. I called a friend and parishioner who is a GI doctor and he got me right in and everyone seems to agree that something is not right. Dr. GI believes I have a dilated bile duct, most likely because there is a stone or blockage there. He ordered some bloodwork and the ct scan, which I will have tomorrow afternoon. In the meantime, I have another blood draw tomorrow for the ectopic pregnancy, plus an appointment Thursday with the OB to hear if she thinks the methotrexate did the job. If it didn't, I have to have another shot. Which I can hardly bear to consider, given what I've been through in the past week.

Also, I hope the CT scan will shut down the little voice inside my head that's worrying about pancreatic cancer. My grandmother died from it, and the symptoms are pretty broad, but I have virtually every one. The CT scan should rule that out, even if it doesn't do a good job showing the bile duct. If Dr. GI doesn't get a good enough view of the duct, then I'll likely have an MRI.

The good news is that after 24 hours on liquids, I felt well enough last night to eat some pasta and have not had the terrible pain. The area is still tender to the touch, but none of the crippling abdominal pains from before. So I'm grateful for that. I'm trying to be very careful to eat fairly bland foods and small amounts, lest I start something again.

So, there's you have it. Two major medical problems happening simultaneously, confusing everyone and myself, and making it difficult to sort out. I'm beginning to think I need to play the lottery, with the ridiculous odds of all this, but since my odds seem to all be in the negative category, I should probably not bother.