Elevated HCG, Morning Sickness, and Abnormal Bleeding 7 Weeks Post D&C

[wolffie]

Hello,

I had a D&C 7 weeks ago to the day (4/10/2009).  My pregnancy was about 9 weeks along.  My doctor never checked my HCG levels before/during the miscarriage, so I have no idea what they were before.  I only bled slightly for a few days post D&C.  I felt pretty good afterwards, but never felt like my body had returned to it's normal cycle.  

I started getting a little moody/bloated two weeks ago (5/12/2009) and took a pregnancy test out of curiousity.  It (and the 3 others I took after) turned up positive.  Since I hadn't had a cycle, I knew it could be left over tissue or it could be a new pregnancy, and I knew that only the doctor could possibly answer that question, but I was kind of hoping that maybe I was pregnant again.  My fiance and I had sex the following weekend (kind of rough, sorrry if TMI) and I started bleeding like a firehose and continued to bleed heavily for about 48 hours (much heavier than a normal period).  Pregnancy tests continued to be positive.  I went to my post D&C follow-up appointment on 5/19/2009 and described to them all of these strange symptoms.   They thought that some tissue could still be left inside of me, and was coming out with the blood.  The OB/GYN did a vaginal ultrasound, which revealed an empty uterus, thin lining, and "maybe" a little piece of something (~4mm) left over in my uterus.  In case it was a new pregnancy, he ordered HCG blood tests - one on 5/19/2009 and one on 5/21/2009.   The first one came back at 19.5, and the second one came back at 17.5, so his nurse called me and told me that the doctor believed the tissue was leaving my body.  

So now, a full week later (5/29/2009), I am still testing positive on a OTC pregnancy test and am feeling awfully morning sick.  I called the doctor and asked the blood be retested and he asked that I wait a week and them come back for a blood draw.  If my HCG levels have risen, then he will prescribe methoxorate to try to get rid of the tissue.  
This is super frustrating.  Has anybody else had an experiece with this?

My questions are:

If tissue was still left in my system and still remains in my system, what was all of that bleeding and why is the lining of my uterus still thin?  I thought the linings remain thick until HCG/tissue is gone.

He mentioned that my lining was thin, then off-handedly mentioned the possibility of Asherman's.  Could I have tissue left in my system and have bled like crazy AND have Asherman's?  

Is it possible to be feeling morning sick today just because of this left over tissue?  I just started feeling this symptom (e.g., was not present all at until today after the D&C).  

Is it possible that this could be some kind of weird chemical pregnancy since my HCG levels were only slightly elevated and appeared to be declining?  

Is there anything I can do (besides another D&C) to get my system moving normal again?

Thanks so much - I'll appreciate any response.  

[wolffie]

Hi,

I just thought I'd write in and give an update.  Got my blood drawn last Thursday (6/4/09) and my beta hcg was down to 8.8.   Slowly slowly falling.   I guess I have no choice but to wait 3 months!   Have your cycles returned to normal yet?
Wishing you all the best.  This time it's going to work for you, I can feel it!

[mikaelajo]

I'm not having any morning sickness, but didn't when I was still pregnant either. Have just had major hormonal-ness like bad pms. lol.

Yes, I have learned my lesson about the unprotected thing... Will definitely not do that again. Totally not worth the roller coaster of not knowing what's going on. We had been planning to wait 3 mos. like the Dr. recommended, but the 2nd preg must have happened a week after my 1st m/c started (I know it must have been then b/c my DH was out of town after that), so I totally didn't think it was possible yet. I will definitely be using protection after this, and will wait at least 3 mos. I think this two in a row thing has been really hard on my body. It is so hard, tho,  b/c we've been trying for over 2 yrs and this was my 3rd m/c. I hate having to wait even longer. But I want to give myself plenty of time to heal so we have the best chance it will work out next time.
Hope you feel better soon and that your hcg keeps going down naturally.

[wolffie]

Thanks for your repsonse - I am sorry for what you are going through too.  It does sound kind of similar to my situation.  Are you having any waning/waxing left over pregnancy symptoms (like morning sickness)?  
I guess that's why the tell you not to have any unprotected sex at all until you get another cycle, as this kind of confusion can drive you kind of bonkers.
Needless to say, it is frustrating.  I do want to get passed this and will be using full protection and until I can get back on track.  For my own sanity or for the DRs to be (hopefully) giving me better anwers.  
I'll update again on what is found next week with the blood hcg levels.  Hopefully, they continue to drop and your's do too.  Wishing you peace too.  

[mikaelajo]

I'm so sorry for what you are going through. I have had a somewhat similar situation and it can be so confusing and hard for the doctors to tell what's going on if you haven't had a cycle in between. Here is what happened to me and what my Dr thinks.

I had a natural m/c 4/24. 4/28 my hcg had dropped from >350 to 80something. 3 weeks later I was still spotting and they rechecked my hcg. It had gone back up to >150. That was on a Friday. My Dr. thought it was possibly another pregnancy, but ordered an u/s the following Monday to check for possible ectopic or something left in uterus. Over the weekend I had heavy bleeding again (so 3 weeks after 1st m/c, although bleeding from 1st m/c had never stopped completely). Then Monday on the u/s they found nothing in the uterus and the lining was thin (~3mm). Blood test that day showed that hcg had dropped back down to ~100. So your 1st q - yes the lining can be thin even if you still have hcg in your system, and you can still bleed if the lining is thin. It has been 2 weeks since then and my bleeding still continues, hcg level is continuing to drop slowly. The Dr. thinks that the second spike in hcg and the prolonged bleeding (now 5 weeks since 1st m/c) is that the 2nd heavy bleed was a 2nd (early) m/c. But she said that there is really no way for them to know for sure.

It sounds like your situation is similar but a little different because they found something in your uterus. Unfortunately sometimes there is no way for them to know for sure if hormone levels, etc., are left over from a previous preg or due to a new preg, esp. if they are dropping. They can just tell what direction it is going by the hcg levels. I don't know that there is anything you can do to get things back on track faster other than to rest and let your body heal. It takes time. I'm sorry for what you're going through. It's so hard when it drags on for so long, and the Dr.s can't give you clear answers. Wishing you peace.