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Misoprostol treatment ? (Page 1)

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Hi,

I went to the Dr. on Tuesday morning. He gave me 200 mg. of mifepristone to take orally while there. He also gave me a bottle containing (2) 200 mg. pills of misoprostol (400 mg. total). I was instructed to take them orally approx. 24 hours later which I did. That was yesterday at 10 a.m. After reading about this online I don't think this Dr. gave me enough of the medication to induce the abortion. I have had some very minor cramping since then but no bleeding. It's now going on 20 hours since I took the pills and I have not lost the baby yet. Is this normal? I read that most women start the abortion within 8 hours but on the fact sheet the Dr. gave me it said bleeding could start up to 48 hours later in some women. I now feel like I am going crazy waiting for this to happen! Should I find another Dr. who is willing go give me extra misoprostol or should I wait and see what happens? scared

Please reply for my sanity! I need to hear some opinions on what to do!
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replied July 24th, 2008
Extremely eHealthy
You need to call the doctor and explain that nothing happened.

Did you swallow the pills?

You are not actually supposed to 'swallow' them. You are supposed to place them between your cheek and gums and suck on them and let them dissolve slowly.
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replied July 24th, 2008
The Dr. specifically said to swallow the tablets 24 hours later. I have written instructions from him specifying this as well. Also, I have researched this online and see that this is a common method of taking the pills.

Anyway, in the meantime, I guess I'll wait the whole 48 hours and if I don't start bleeding by 10 a.m. tomorrow morning I'll call the Dr.
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replied July 24th, 2008
Extremely eHealthy
I think that you will notice that the directions say BUCCALY, which means suck on them.

I can show you countless abortion clinic websites that show that you should not swallow them.
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replied July 24th, 2008
Extremely eHealthy
I am a womens health RN, and I work in an abortion clinic. I know how abortion should be properly completed.

You can use it VAGINALLY or Buccaly, but just swallowing them does not work.

Did you go to an abortion clinic, or just a private doctor?

IF i were you I would go to a better doctor if that is what his instructions said...

This explains vaginal use of MIsoprostol for abortion

This is form an abortion clinic

6. How does the Abortion Pill work?

On the day of your appointment, you will take the "Abortion Pill" (Mifeprex) while you are in our office. You will be instructed by the doctor to insert 4 tablets vaginally (Misoprostol) 24-72 hours later. Most women will expel the embryo or "miscarry" within 4 hours after inserting the vaginal tablets. Cramping can range from mild to intense for approximately 4 hours. A follow-up visit is necessary in 2-3 weeks.

This is a reference to oral use
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replied July 24th, 2008
Carifairy,
First of all, you don't need to address me like I'm a fool. I have the instructions right here in front of me and they say "take 2 pills ORALLY" 24 hours after taking the Mifeprex. I understand that you work in a clinic or whatever but I know what the Dr. told me to do and I have the WRITTEN instructions right here. I also called the Dr. today to clarify that I took the pills as directed (ORALLY) and he confirmed that I did it as instructed. And yes, unfortunately I did go to a clinic but I now have an appointment with a REAL Dr. tomorrow.

BTW...Found this along with tons of other similar websites. This is exactly how I was instructed to take mine except my dose of Mifeprex was only 200 mg.:

US: FDA approved regimen

"The research that the FDA reviewed for approval was based on the original French regimen, developed more than a decade ago. The mifepristone/misoprostol regimen is approved up to 49 days' gestation. The FDA approved regimen specifies that a woman orally take 600mg of Mifeprex™ and 400µg (micrograms) of misoprostol one to two days later (orally). Approximately fourteen days after taking mifepristone, the patient is required to return for a follow-up visit to determine whether the pregnancy has been terminated."


Here's another:

The approved Mifeprex regimen for a medical abortion through 49 day’s pregnancy is:

* Day One: Mifeprex Administration: 3 tablets of 200 mg of Mifeprex orally at once
* Day Three: Misoprostol Administration: 2 tablets of 200 mcg of misoprostol orally at once
* Day 14: Post-Treatment: The patient must return to confirm that a complete termination has occurred. If not, surgical termination is recommended to manage medical abortion treatment failures.

So, my question is, if in fact misoprostol doesn't work when taken orally then why are so many women instructed to take it that way in the first place?
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replied July 24th, 2008
Well, it's working. I started cramping around 8 p.m. and am now starting to bleed lightly. Cramps are still mild but every once in a while I'll feel a moderate tightening in my uterus. I'm relieved that it's starting but definitely scared. I hope it's over before I know it. I'm still planning to keep my appointment with my OB/GYN tomorrow to make sure all is well. I never should have gone to a clinic in the first place.
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replied July 24th, 2008
Extremely eHealthy
I tell women that surgical is better... It is done in 3-5 minutes, and you are asleep with an IV.. Painless and done NOW.

Not all clinics are created equal. I work in a private GYN practice, just like a normal GYN, but we also offer abortions.

NOTICE that it says 3 misoprostol, then 2 days later... You doctor did not do that. He only gave you 2...
* Day One: Mifeprex Administration: 3 tablets of 200 mg of Mifeprex orally at once
* Day Three: Misoprostol Administration: 2 tablets of 200 mcg of misoprostol orally at once

He sounds like he does not know what he is doing.
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replied July 24th, 2008
Extremely eHealthy
http://www.reproductiveaccess.org/med_ab/m ife_protocol.htm

This website explains why Buccal use is better. Misprostol is more effective when administered slowly.
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replied July 25th, 2008
Well, I'm definitely well under way now. Bleeding is moderate although cramping is still light. I hope it stays that way. I'm a nervous wreck that this is going to hurt. I did manage to sleep somehow though. Probably due to the .5 mg of Xanax that I popped around 1 am. Knocked me out like a light until about 5:45 a.m. and trust me, I am STILL feeling it. It's only about 6:10 a.m. now and I have a feeling that once I lay back down I will be back to sleep in minutes. lol

Anyway,

Carifairy wrote:
I tell women that surgical is better... It is done in 3-5 minutes, and you are asleep with an IV.. Painless and done NOW.

Not all clinics are created equal. I work in a private GYN practice, just like a normal GYN, but we also offer abortions.

NOTICE that it says 3 misoprostol, then 2 days later... You doctor did not do that. He only gave you 2...
* Day One: Mifeprex Administration: 3 tablets of 200 mg of Mifeprex orally at once
* Day Three: Misoprostol Administration: 2 tablets of 200 mcg of misoprostol orally at once

He sounds like he does not know what he is doing.


Actually it says 3 Mifeprex on Day 1 followed by 2 Misoprostol on Day 3. Basically I did the same as described in the description except the Mifeprex was only one 200 mg. pill (not 600 mg. as I read works for most women) and only 1 day later was the 2 tablets of the 200 mcg of misoprostol orally instead of on Day 3.

However, I do agree with you that I don't think he's a very good Dr. I don't think he administerd enough of the Mifeprex in the first place. I've researched it and it shows that most women receive 600 mg. of Mifeprex to begin with. Not just 200 mg. like me. Also, to be fair, I did research the misoprostol and it does have better (and FASTER) success rates when inserted vaginally or buccaly as you mentioned. However, I read that a lot of Dr's are hesitant of the vaginal method due to the slight chance of infection.

Anyway, I told my husband that I believe this guy wants the medical method to fail so that women have to go back and have the surgical from him. That equals more $$$$ for him. I truly believe that's his method.

And also, by all means, he's not MY Dr. He was the Dr. at the clinic. I have a very good OB/GYN who I am seeing today. Only problem is that I didn't think he would have been willing to terminate this pregnancy so that's why I went to the clinic in the first place. I guess I should have at least seen my real Dr. first to see what his recommendation would have been but, like always, I jumped the gun and wanted to "take care of business" as soon as possible. Lesson learned.
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replied July 25th, 2008
Extremely eHealthy
Sad

I am sorry, I was not trying to talk down to you.. I was in a hurry to type something out before I went out..

At our office, if medical fails we do surgical with sedation for free.

IF it does fail, and you need a surgical abortion, I would hope that he would do it for free..
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replied July 25th, 2008
Carifairy,

NO! Please dont' be sorry! I'm just all emotional and stuff right now. I know you are only trying to help and I didn't mean to snap. I've been doing that for days now to EVERYONE. Imagine how my poor husband must feel at this point? LMAO

I'm finally starting to feel calmer now that the bleeding has finally begun. I'm actually at work because it really helps take my mind off of this whole thing. I'm cramping MUCH more now (but am not really in too much pain) and passed some yellowish looking stuff along with the blood earlier. It's scary but I'd much rather actually be going through it than WAITING for it to happen. The waiting is the worst part of this whole thing. I'm not a very patient person and when things don't happen when they should I tend to freak out.

Anyway, thanks again for all of your help and replies. I really do appreciate it even if I do seem like a b**ch. lol
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replied July 26th, 2008
This is definitely working. 2thumbs

My bleeding in moderate to heavy at times and I have expelled a couple of TINY clots (they look like the uterine lining that I shed during my regular period). Not sure if I've expelled the whole thing yet but I do know it's working now. The cramping is mostly mild, although every once in a while I'm hit by a more severe, but not horrible, wave of cramps.

My breasts are still extremely tender but I guess that's because it takes a while for the pregnancy hormone to leave the body.

Other than that, this really hasn't been bad at all. If anything it's LESS painful than my regular period, but maybe I'm jumping the gun by saying that. Like I said earlier, I'm not sure if everything is out so maybe the worst is yet to come. Geeze...I certainly hope not. lol
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replied July 26th, 2008
I just read through all the replies in this thread and wanted to say something about the clinic I went to. They charge $375 for the medical abortion. If it fails, you must go back and get the surgical. They charge you ANOTHER $310 for that. That's why I said that I think this Dr. is in it for the $$$. It's ridiculous. He only administers 200 mg. of Mifeprex, and although I have read some studies that say that dose CAN work, most places administer 600 mg.

Thankfully the pill is working for me but I wonder how many others have to go back and shell out more money to this guy. The clinic was located in a very wealthy town here where I live, but 90% of the people in there looked dirt poor. I can't imagine that a lot of them would be able to come up with $310 more for a surgical procedure if the first method failed to work. This Dr. is putting women's lives at risk so he can pocket his money. Makes me sick!!
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replied July 26th, 2008
Extremely eHealthy
That is horrible.

You'll know it is 100% complete when you pass a 'whiteish-grayish' blob. That is the gestational sac.

Do you have a follow up with anyone for an ultrasound just to be sure? If even a small amount of tissue is left too long, it can cause an infection.

Yeah, he sounds like he is in it for the money...
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replied July 27th, 2008
I'm really not sure Annie. This the first (and last) time I've ever used this drug. I would ask Carifairy.

And Cari, yes I am definitely going to get an ultrasound to make sure this is complete. I have insurance so it will cover it through my private OBGYN. I REFUSE to go back to that horrible clinic and let that Dr. touch me again. I am still bleeding and have passed some clots but not a "blob" yet. I have my bloodwork results from my GP right here in front of me and it says that at the time I took this pill I was 1.3-2 weeks gestation. Would I really see much of anything being that I was that extremely early in my pregnancy?
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replied July 27th, 2008
Extremely eHealthy
You will see a grayish looking blob, it is not going to be large at all, maybe the size of an apple seed.

Most women do not have to worry because their doctor is competent, yours sounds awful.

I would turn him in to department of health.

Your private OBGYN would be able to help you for sure, and if here is anything left they can help you as well..
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replied July 27th, 2008
I'm definitely thinking about reporting this Dr. to the Health Dept. My husband and I are not wealthy by any means, and although we have our financial struggles here and there, we're basically ok. However, most of the women that were at the clinic looked like they rubbed their last 2 dimes together in order to have the procedure. It makes me sick that a Dr. would try to benefit from their problems. I understand that everything comes with a price but to try to make more money from someone's suffering is inexcusable in my opinion.

BTW....is it possible that I could have passed "the blob" and not know? Maybe while I was going to the bathroom? If it's the size of an apple seed then that's tiny. I haven't been examining every specimen coming out of me although I do mostly try to see what lands in the toilet after I go. (So attractive....I know....lol). So far I haven't seen "the blob" but like I asked before, do you think I may have passed it without knowing?
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replied July 28th, 2008
Extremely eHealthy
Yes, you could have passed it without knowing, most women do not see anything but some bleeding.

Do you know the doctors name? The clinic he is associated with?

I can make sure I have it on my list of 'bad' clinics.

I keep lists of good clinics, and clinics I know, and clinics that women tell me about.
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