[Pregnancy Diary] [W4] HCG didn't double within 72 hours, 1st Ultrasound (spotting pictures included)

The week of 4/26 was a very scary week for me. Little did I know the blood tests on Sunday would mark the beginning of a worrisome week. I was so down and constantly worried from Sunday to Friday. 

The results came back on Sunday, just an hour after the blood was drawn. No one called me to discuss the results on Sunday. I just found out by logging in on kp.org. The hcg level found in my blood was quite low. On Monday, I called the hotline for early pregnancy with spotting and said I was worried about the hcg level being low. The nurse (Amanda?) said the number looks alright to her because it's still within the normal range for week 6, though she admitted it was close to the low end. She then said she could order another blood test for me to test for change in hcg. She ordered it for Wednesday, so the tests were 72 hours apart. So on Wednesday, I went to Westside and had the blood drawn and the result came back about 3 hours later. Like before, I got an email from Kaiser notifying a new lab result has arrived so I logged on kp.org to check the result. The number didn't double, it wasn't even close. So I was very concerned. I almost cried. I waited for about an hour. I was hoping someone would call and discuss what this meant. Meanwhile, I made a bad decision on googling "low hcg" and "hcg not doubling in 72 hours" and made myself even more agitated and was just scaring myself with other people's experiences shared on the internet. 

Picture taken a day after wiped. Spotting was light pink the moment it was wiped, then turned to light brown after it dried up.

Eventually, I called the hotline again and this time I spoke with a nurse named Elizabeth. My first sentence to her was "I'm worried that I have an ectopic pregnancy." Elizabeth immediately checked my chart and asked if I was passing clots and tissue and whether I had any sharp pain in the lower abdominal area. I said no. Then she told me to try to relax and acknowledged my hcg didn't rise as she would have expected, but it was also too early to determine anything. She said she could order an early ultrasound for me, though it needed approval from a doctor so she would try to get a hold of a doctor on her team and call me back asap. After we hung up, we took Duke out for a walk and I was trying very hard to mentally walk away from all the worries I had. While walking Duke, Elizabeth called back (she called back only just 10-15 minutes after we hung up). She told me the ultrasound has been put in order and that I would receive a call from Kaiser very soon to schedule an appointment for the scan. She also made a note that the doctor wanted me to get the scan not later than Friday afternoon. While we were finishing the call, another call came and Elizabeth said "that must be them, for the ultrasound, ok, just call me if any new symptom shows up..." and I answered the other call. It was Kaiser indeed and we scheduled for an early ultrasound for that afternoon, actually, for just an hour after the call. It was either that time or Friday afternoon and Elizabeth had said she wanted to discuss the results with me before the weekend and we wanted to make sure there's enough time for the results to get posted, so we decided Wednesday was better. 

Over the phone, I was told to drink 4 cups of water an hour before the appointment and go in with a full bladder. This was torture to me. I wanted to use the bathroom almost just 20 minutes right after finishing the water. 

Waiting inside the dressing room.

We waited at the waiting area for about 10 minutes and then were taken to a dressing room to wait for the doctor. The dressing room was very small but we sat on the bench just fine. I was uncomfortable at that time, not just because I was nervous for the scan, but because I really wanted to pee so bad. I felt like my bladder could explode any minute. Another 10 minutes went by, then the doctor came over and checked my name then led us to the exam room. The doctor immediately noticed the way I was walking and asked "are you full?" I nodded and asked if I could use the bathroom? She said "yes, you're too full if you can't walk." 

The ultrasound exam room was spacious. There's a bathroom inside the exam room so I went ahead to use that. That was glorious. Then I was ready (mentally was never ready) and lied on the exam bed. The doctor dimmed the lights and asked if it was my first time with an ultrasound scan, I said yes. W stood by the bed and watched us as the doctor started applying the "warm gel" on my belly. She was quiet the whole time. Not one word the entire time. The abdominal ultrasound didn't find anything. I was so nervous that it meant ectopic. Then, the doctor had me get up and wanted me to use the bathroom again before doing a transvaginal ultrasound. I was somewhat surprised, but I did as was suggested. 

Funny thing, the doctor had left the room to give me privacy for change, though there was only a bedsheet on the exam bed so W and I were like "what do I change into?" Then the doctor came in and asked if I was ready, but I was still fully dressed at the time. So I asked, "do I just cover myself with the sheet?" She said, "yep, just take off pants and underwear and cover with the sheet." Then she stepped out of the room again and this time I knew what to do. When she came back again, I was on the exam bed with the sheet covering my lower half of the body.

She asked if I knew what transvaginal ultrasound was and I said "I read it before." She said "ok" and took out the tool and began the procedure. She didn't explain how the procedure was going to go and remained silent during the exam. The tool looked...long and I was nervous when she poked around. There was no pain, but I had moments when I felt uncomfortable because of the pressure from poking around. My left groin also started aching in the middle of the exam. The doctor never said a word while measuring what she saw, what I saw, and what W saw. We all saw 2 black round-looking things on the screen. When I asked, "does this look normal?" Her response was "it's too early to tell" then remained silent for another 15 minutes or so.

Finally, the doctor finished the scans and said "ok I'm going to pull this out now" and off it went. She said I could put my clothes back on and started getting her things ready. I went to the bathroom to put my clothes back on and was prepping myself with all the questions I wanted to ask like "what do you think?" "is it ectopic?" "should I be worried?" When I walked out of the bathroom, she was gone! The doctor had left the exam room already! W said the doctor told him we were good to go. I was like "what? she didn't tell me anything about what she saw and didn't even say goodbye in person, she just left?" (Was I over-reacting? Even now, I seriously think any provider should at least tell their patient when to expect a phone call or provide some sort of guidance or at least say something in-person before leaving the room)

My left groin continued aching that evening. Then the next morning, I started having pink spotting again. Nothing was on the underwear. It was always just on the tissue when I wiped. The doctor called while I was in the bathroom so I missed her call. Then I called Elizabeth and she told me she read the doctor's notes and said the ultrasound scan results were "inconclusive." She said "it was too early to tell" and "the notes are ready online" and "nothing was indicative of an ectopic pregnancy" and wanted me to go back for another blood test on Friday to see if my hcg continues to rise. Elizabeth said she wanted me to call after I get the result back on Friday and said she's hopeful. I also told her about the groin ache and pink spotting. Elizabeth said they likely happened because of the ultrasound and said spotting for a few days after having a transvaginal ultrasound is normal.

Day after ultrasound. Tan-light pink spotting.

On Friday, I went to Westside and got my blood drawn at 10am. The result came back around 3pm. I called Elizabeth and she immediately recognized me. She told me the hcg result has been reviewed by the doctor and that the doctor had extra notes for the ultrasound. Apparently, by then, 3 doctors had reviewed my scans and their conclusion was "2 gestational sacs have been visualized." This could mean "a twin pregnancy" or "a single pregnancy with a hemorrhoid right next to it. Both measured under .5cm, 4 weeks and 2 days. The date didn't match with what I had expected. Elizabeth told me the doctor said the hcg had risen to an appropriate level, albeit being low. I was told the hcg range is huge and the doctors have seen pregnancies with numbers outside of the range yet resulting in healthy deliveries. She said the doctor wanted me to have another ultrasound in 10-14 days, and get another blood test on Monday. She wanted me to call back to check-in again on Monday. The pink spotting had stopped by Friday night.

HCG rising but slowly

Saturday and Sunday came with "tan-pink-ish discharge." While there was no more spotting, I noticed vaginal discharge that were a mix between tan and pink. I was worried about that because they never turned brown, which would've meant old blood. W called my tan discharge "boogie."

 

So on Monday, I went to Westside for the blood test. Hcg result came back about 4 hours afterward. I called Elizabeth but it went to her voicemail. I left her a message and wasn't expecting her to call back that day but she did. Elizabeth said my hcg result is lower than what she had expected, but she didn't know what that meant. She said she'd leave a note for the doctor and see if the doctor wanted more blood tests. She also told me Tuesday's her normal day off so I might get a response from someone else on Tuesday about what the doctor thinks. She reminded me to check in with her if I haven't heard from anyone by then. At this time I told her I was still waiting to be reached by Kaiser for making that next ultrasound appointment. Elizabeth said she'd like me to call because appointments could fill up fast and would rather make sure I got a spot within the timeline the doctor had noted (10-14 days since the last ultrasound). I called the number, but the person who answered said she couldn't help me. Turned out Kaiser automatically connected me with a specific line that works with members under W's company. So the person had me on hold and got the right line for me and introduced me to the right person. We made an appointment for next Tuesday at 9am. I feel this is "it." Next week's ultrasound is gonna be something very determinative. We hope for the best. 

I got a call from Elizabeth's team this morning (May 4). Her coworker Jennifer said the doctor wants me to go back for one more blood test either tomorrow or the day after (Wednesday or Thursday). Then we'll just wait and see until next Tuesday, the ultrasound appointment, and see how things are going. So we'll go tomorrow.