The immense weight of a tiny loss.

It’s taken me a full week to process what’s been going on in my life and in my body enough to be able to write about it.

I’d didn’t think I’d be so impacted by this. I’ve been through pregnancy loss before, I know how it goes. But that was before I knew my BRCA status, and things feel so different now.

Let’s rewind.

Last Monday afternoon I got a call from my doctor with my blood test results. Despite heavy, sustained bleeding my HCG levels were climbing slowly but steadily (117, 147, 170). Still WAY below what it would have been for a viable pregnancy at 6.5 weeks, but not dropping like it would with a “normal” miscarriage. All signs pointed to ectopic pregnancy.

My doctor and I talked through a plan of action. I’d go to her office after work, she’d write me out all of the orders and prescriptions I’d need, and then I’d hop across the street to the ER for treatment — an injection of methotrexate (a chemotherapy drug), that stops cell division, causes the embryo to basically disintegrate and abort through the tube.

From 6:30PM until 1AM my spouse and I sat in the hospital ER. Delay after delay kept us there while I waited for an injection that would ultimately take 30 seconds. First, blood tests & waiting for results (to see if my body was healthy enough for the drug). Then the OBGYN residents had two back to back emergency C-sections to attend to. Once I was finally cleared I had to wait for chemo nurses to be available to come administer the drug. Dinner from the vending machine. Hours upon hours of mindless TV. Oh, and the cherry on top…when they unhooked my IV for me to go to the bathroom they didn’t cap the port in my arm and I left a trail of blood down the hallway and leaked a grapefruit sized blood stain onto my dress before I realized it was even happening. After 6 hours of waiting, two quick shots, one to each butt cheek…and that was that.

I was prepared for terrible side effects from the methotrexate, the materials and speeches I got from nurses warned of nausea, vomiting, diarrhea, skin rash, dizziness, headaches. I preemptively took the next day off work, expecting to feel like shit and recognizing that at the very least it warranted a mental health day.

But much to my surprise, other than exhaustion from 4.5 hours of sleep, I felt totally fine. And physically…I still feel totally fine. For the past week there has been a gruesome scene going down inside me. Poison injected into me. A nascent life that was SO SO SO wanted is being lost. But my body reveals none of it. I feel totally, 100% fucking fine. So fine that it feels wrong.

But mentally, I’m not feeling so fine. I’m sad, I’m confused, I’m angry. I’m also really scared.

I’m sad that this pregnancy is not going to be adding a new life to our family and I’m sad that this experience makes it less likely that we will be able to biologically bring new life into our family (because of the detriment to future fertility caused by ectopic pregnancy and the delay placed on TTC because of the methotrexate).

I’m confused about why this is happening. I have none of the risk factors associated with ectopic pregnancy. And I’m angry in an adolescent pity party sort of way…wanting to know WHY IS THIS HAPPENING TO ME?! Can’t something just be simple? Hasn’t the universe dealt me enough this year…especially when it comes to fucked up shit going on in my reproductive regions?

And then there’s the fear. An unformulated vague sort of cancer-related fear. Fear that somehow cancer is at play here. That a small tumor in my fallopian tube caused the ectopic, or that it’s not really an ectopic pregnancy at all but a cancer (I should NOT have been googling ectopic pregnancy & ovarian cancer…but I did…and read some scary shit about ovarian tumors masquerading as ectopic pregnancies. Fantastic.) I’m also scared that the methotrexate treatment didn’t work, and that we’ll have to move on to a phase 2 treatment (more drugs or surgery).

At least I should find out the answers to that last fear today. I’ve had 2 more rounds of bloodwork since the methotrexate, and I see my doctor today for an update on how things are progressing. If the HCG is dropping significantly, that’s a good sign that things are resolving correctly. If not…well…who knows.

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