To be totally honest, I did shed a tear this morning.
What made me so overjoyed? I finally had that appointment with the hematologist that my GP had recommended. I have to admit, I have been an anxious wreck for a few days about this. I was fully expecting a replay of that awful appointment with the perinatologist. I even ended up crying to Mr. Rhody last night. It didn't help that I was out of town for work the night before and basically running on empty.
But the appointment this morning was exactly what I had been looking for. The doctor didn't treat my mutations as something he'd never seen before, though he'd admitted that he wasn't as familiar with the combination and he promised to do some more research on that. We talked about the treatment for when I was pregnant and when I was not, and he said, the next time I'm pregnant, he wants to start with the 40 mg Lovenox once a day. If I end up miscarrying again--and he made sure that I knew that was a possibility--then we'd talk about going to a higher dose and twice a day. I asked him about the baby aspirin in addition, and he did say they used to believe it helped, but the newer studies are saying that it does not have any additional benefit over the Lovenox and could cause problems in the third trimester.
Meekly, towards the end of the appointment, I did admit I had a scientific background and I had been reading the literature. He surprised me by telling me that I should do that, I should be my advocate, but I should also take it with a grain of salt before actually talking it through with a professional. That's exactly what I wanted to do.
He also wants Mr. Rhody to be tested for these mutations. While homozygous MTHFR mutants are around, we've seen very little mention of homozygous prothrombin mutants in the literature. The doctor cautiously mentioned that this may be a reason for the losses as well. If Mr. Rhody is also a mutant, I don't know what we'll do, but at least we'll be armed with that information.
So he's requesting all of the labs from my OB, which he didn't have for this appointmenet since my GP had referred me. He wants to see me again in 3 weeks, sooner if I happen to be pregnant again by then. He does plan to stick around for the pregnancy, which is reassuring.
Overall, it was much better than I expected. It was the first time in a long time I felt like I was being taken seriously by a medical professional, and I appreciated that.
Tickers
Thursday, August 27, 2009
Wednesday, August 26, 2009
Something has been bugging me recently
When I found out I had these two genetic mutations--the prothrombin mutation and the MTHFR mutation--I immediately invoked my scientific training and started searching for journal articles on the topic, reading anything I could to try to understand the news I'd just been presented with.
Of course, my reading all of these articles is what caused the problem when I visited the perinatologist, who, I soon found out, was not as on top of the literature as I was and who believed these mutations were really not so much to worry about. The doctor also seemed to take it personally that I wanted to discuss the literature with him, as he'd expected this to be a one-way conversation, where he'd pat my head and reassure me that there was nothing to worry about.
It is true that some people have these mutations and have no trouble conceiving and delivering healthy babies. But it also seems to be true, from the studies that are out there, that there are people for whom these mutations cause serious problems. The distinction lies, for me, on the individual level. Yes, for some people these mutations do not have any measureable impact; for others, they have a significant and very scary deleterious effect.
Which brings me to what is bugging me today. There has been a rash of later pregnancy losses on one of the Bump boards. I don't know anything about these women, and I am not pretending to understand their highly-personal situations. But it's refocused me on a key finding that I had read in the literature: these blood clotting mutations do not only cause early miscarriages. In fact, there is significant evidence that they are implicated in second and third trimester losses, as well as significant interuterine growth retardation.
How can anyone believe these mutations are not serious when faced with the evidence? Why do doctors seem to understand so little about the field of pregnancy loss? About the field of women's health in particular?
It is for this reason that I pushed for the Lovenox for if and when I do become pregnant again. Truth be told, I am not 100% excited about having to inject myself daily. I had dreamed of this low-intervention birth, whereas the I will now be induced at 39 weeks. But when I weigh the risks, the possibilities of what could happen, I don't know how I could not take this route.
What weighs on my mind is that I had to push for this. How many other women are out there who don't have the scientific background that I do? Who don't have access to the literature? Who have no choice but to believe their doctors when told that these mutations are really no big deal? How many women go through needless suffering?
This is haunting me today.
Of course, my reading all of these articles is what caused the problem when I visited the perinatologist, who, I soon found out, was not as on top of the literature as I was and who believed these mutations were really not so much to worry about. The doctor also seemed to take it personally that I wanted to discuss the literature with him, as he'd expected this to be a one-way conversation, where he'd pat my head and reassure me that there was nothing to worry about.
It is true that some people have these mutations and have no trouble conceiving and delivering healthy babies. But it also seems to be true, from the studies that are out there, that there are people for whom these mutations cause serious problems. The distinction lies, for me, on the individual level. Yes, for some people these mutations do not have any measureable impact; for others, they have a significant and very scary deleterious effect.
Which brings me to what is bugging me today. There has been a rash of later pregnancy losses on one of the Bump boards. I don't know anything about these women, and I am not pretending to understand their highly-personal situations. But it's refocused me on a key finding that I had read in the literature: these blood clotting mutations do not only cause early miscarriages. In fact, there is significant evidence that they are implicated in second and third trimester losses, as well as significant interuterine growth retardation.
How can anyone believe these mutations are not serious when faced with the evidence? Why do doctors seem to understand so little about the field of pregnancy loss? About the field of women's health in particular?
It is for this reason that I pushed for the Lovenox for if and when I do become pregnant again. Truth be told, I am not 100% excited about having to inject myself daily. I had dreamed of this low-intervention birth, whereas the I will now be induced at 39 weeks. But when I weigh the risks, the possibilities of what could happen, I don't know how I could not take this route.
What weighs on my mind is that I had to push for this. How many other women are out there who don't have the scientific background that I do? Who don't have access to the literature? Who have no choice but to believe their doctors when told that these mutations are really no big deal? How many women go through needless suffering?
This is haunting me today.
Wednesday, August 19, 2009
I just about cried at work today
A coworker of mine has a 22-year-old daughter whose life is a mess. She's an alcoholic. She doesn't come home for days. She barely finished high school because of all of her issues. Yet she has two beautiful young children, 3 and 2 years old. These are the kids that she leaves with friends or family, ostensibly for a few hours, before she disappears for days, not answering her cell phone and no one knows where she is.
One of these recent disappearances just ended today. My coworker is sitting there on the phone, trying to convince her daughter to enter rehab, telling her that these two children need her and will otherwise be taken away.
The injustice of it all strikes me over and over. How is it that people who never wanted or are not ready for children can get pregnant so easily, while there are so many people who are ready, have planned their lives for this next step, who cannot have those children that they want?
I am currently reading Moloka'i, the story of a woman growing up in a leper colony on Hawaii around 1900. At one point, the main character, as a small child, asks a nun caring for her "Why does God give children leprosy?" It's a question the nun struggles with, before finally coming to a conclusion that satisfies her. The question is universal, and something I think many people struggle with. Why do bad things happen to people who don't deserve it?
In less philosophical news, the antibiotics I'm on for this suspected infection are knocking me out. Worse than the infection is the feeling of nausea and general grossness. Hopefully, I'll feel better soon. I did get an appointment with a hematologist, next Thursday, to discuss the what the RPL screening came up with. Hopefully, he will be more helpful than the perinatologist quack I saw a few months ago. Finally, a few people have recommened this new OB/gyn group to me. It's not as small as I wanted, but since a few people have recommended it highly, I thought I'd check it out. Their next appointment is for October 8, just for an "interview" to see if I want to switch. We'll see how things go by that point.
I am thinking about cutting back on the baby aspirin this cycle. It's the main difference since I was able to easily get pregnant twice, and now, I have 3 cycles with awful periods for no apparent reason. I'm also concerned about the slow temperature rise I've had after ovulation recently, when I used to have a spike. I have heard some people say that baby asipirin can impede TTC efforts, though I've read other places it can help. Who knows, but I guess I can run my own experiment. I'll start taking it again when I'm sure that I've ovulated.
One of these recent disappearances just ended today. My coworker is sitting there on the phone, trying to convince her daughter to enter rehab, telling her that these two children need her and will otherwise be taken away.
The injustice of it all strikes me over and over. How is it that people who never wanted or are not ready for children can get pregnant so easily, while there are so many people who are ready, have planned their lives for this next step, who cannot have those children that they want?
I am currently reading Moloka'i, the story of a woman growing up in a leper colony on Hawaii around 1900. At one point, the main character, as a small child, asks a nun caring for her "Why does God give children leprosy?" It's a question the nun struggles with, before finally coming to a conclusion that satisfies her. The question is universal, and something I think many people struggle with. Why do bad things happen to people who don't deserve it?
In less philosophical news, the antibiotics I'm on for this suspected infection are knocking me out. Worse than the infection is the feeling of nausea and general grossness. Hopefully, I'll feel better soon. I did get an appointment with a hematologist, next Thursday, to discuss the what the RPL screening came up with. Hopefully, he will be more helpful than the perinatologist quack I saw a few months ago. Finally, a few people have recommened this new OB/gyn group to me. It's not as small as I wanted, but since a few people have recommended it highly, I thought I'd check it out. Their next appointment is for October 8, just for an "interview" to see if I want to switch. We'll see how things go by that point.
I am thinking about cutting back on the baby aspirin this cycle. It's the main difference since I was able to easily get pregnant twice, and now, I have 3 cycles with awful periods for no apparent reason. I'm also concerned about the slow temperature rise I've had after ovulation recently, when I used to have a spike. I have heard some people say that baby asipirin can impede TTC efforts, though I've read other places it can help. Who knows, but I guess I can run my own experiment. I'll start taking it again when I'm sure that I've ovulated.
Tuesday, August 18, 2009
Burnt out
Here I am again, CD2, and I have had a mentally exhausting past 2 days.
Yesterday, Monday, we got an email at work annoucing that our next mandatory departmental offsite was also to include a baby shower for our pregnant coworker. Nice. I guess I don't have to worry about the debate over whether or not to attend. I later found out that she and her deadbeat, unemployed husband are down to one car because his died and they don't have the money to fix it.
I am really trying not to be bitter.
I got home yesterday to another "Congratulations on your pregnancy!" packet from the local hospital. The same packet that I received a few months ago. The same hospital where both of my D&Cs were performed. Someone is not paying attention there. Mr. Rhody wants to call and yell at them, but I think I talked him out of that.
I think I have a kidney infection again. I went to the doctor's office this morning. He seemed a bit skeptical, but I told him I had had one before and had all the same symptoms, so he gave me a prescription for Cipro and took a urine sample. He said I could take the Cipro until the urine culture came back in 3 days. Oh, and since it's CD 2 he couldn't just check to see if there was blood in the urine because, chances are, there would be. The good thing about CD 2 is I don't have to worry about what drugs I can / cannot take.
But there is some good news.
We got a second dog. Everyone thinks we're crazy, but we think it's great. She's a shelter dog, like our first. It did occur to me how there are so many dogs at the shelter that you can get one for free, yet it takes tens of thousands of dollars to adopt a human baby. Hmmm. Not that human life isn't sacred, but it's a shame with little value we place on animal life.
Anyway, our new dog is a sweetie, and it's good to come home to two tails wagging at the end of the day. It sort of makes everything else that we go through more bearable. I imagine this is what it's like to come home to a child. Hopefully, I'll get to experience that soon, but, until then, I can know that I've made a difference in two lives already, even if they are "just" dogs.
Yesterday, Monday, we got an email at work annoucing that our next mandatory departmental offsite was also to include a baby shower for our pregnant coworker. Nice. I guess I don't have to worry about the debate over whether or not to attend. I later found out that she and her deadbeat, unemployed husband are down to one car because his died and they don't have the money to fix it.
I am really trying not to be bitter.
I got home yesterday to another "Congratulations on your pregnancy!" packet from the local hospital. The same packet that I received a few months ago. The same hospital where both of my D&Cs were performed. Someone is not paying attention there. Mr. Rhody wants to call and yell at them, but I think I talked him out of that.
I think I have a kidney infection again. I went to the doctor's office this morning. He seemed a bit skeptical, but I told him I had had one before and had all the same symptoms, so he gave me a prescription for Cipro and took a urine sample. He said I could take the Cipro until the urine culture came back in 3 days. Oh, and since it's CD 2 he couldn't just check to see if there was blood in the urine because, chances are, there would be. The good thing about CD 2 is I don't have to worry about what drugs I can / cannot take.
But there is some good news.
We got a second dog. Everyone thinks we're crazy, but we think it's great. She's a shelter dog, like our first. It did occur to me how there are so many dogs at the shelter that you can get one for free, yet it takes tens of thousands of dollars to adopt a human baby. Hmmm. Not that human life isn't sacred, but it's a shame with little value we place on animal life.
Anyway, our new dog is a sweetie, and it's good to come home to two tails wagging at the end of the day. It sort of makes everything else that we go through more bearable. I imagine this is what it's like to come home to a child. Hopefully, I'll get to experience that soon, but, until then, I can know that I've made a difference in two lives already, even if they are "just" dogs.
Tuesday, August 11, 2009
Screw this TTC stuff
7 dpo and I haven't posted in a almost a week. Crazy. Well, I'm convinced I'm not pregnant this cycle. I don't know if I just don't want to get disappointed all over again or what, but I just feel "eh" about the whole thing.
I am tired of this process. I am tired of worrying about getting pregnant, worrying that I might be pregnant, worrying that that I will miscarry, worrying that I will never have a child of my own.
So I am moving on with life. I thought about giving up temping / charting, but I can't seem to do that. I like too much knowing when I ovulate. I don't really want to go back to the days of having my period surprise me a few days early. So charting is in.
But worrying is definitely out. Mr. Rhody and I went out of town for the weekend and we relaxed. We rode a cog train up Mount Washington. We had hot, completely non-procreative hotel sex. We ate sushi. We watched Harry Potter while eating ice cream in a theater that was also a diner.
I have decided that I'm going to work on me for a bit. I gained a bunch of weight with the two pregnancies that I just haven't been able to lose. I'm going to lose that weight. Mr. Rhody and I joined the neighborhood YMCA. We've taken up yoga. I am working on my lap swimming. I am not letting myself be lazy any more. I finally heard back from those mentoring people, and we are having our first meeting next week. Mr. Rhody and I are planning a cross-country trip with some friends in October.
I still hang out with my TTCAL ladies. I love keeping up with them. But I find myself having less and less to say these days.
When the time comes for a baby, IF the time comes for a baby, we will accept that child gladly. Until then, I have a life to live.
I am tired of this process. I am tired of worrying about getting pregnant, worrying that I might be pregnant, worrying that that I will miscarry, worrying that I will never have a child of my own.
So I am moving on with life. I thought about giving up temping / charting, but I can't seem to do that. I like too much knowing when I ovulate. I don't really want to go back to the days of having my period surprise me a few days early. So charting is in.
But worrying is definitely out. Mr. Rhody and I went out of town for the weekend and we relaxed. We rode a cog train up Mount Washington. We had hot, completely non-procreative hotel sex. We ate sushi. We watched Harry Potter while eating ice cream in a theater that was also a diner.
I have decided that I'm going to work on me for a bit. I gained a bunch of weight with the two pregnancies that I just haven't been able to lose. I'm going to lose that weight. Mr. Rhody and I joined the neighborhood YMCA. We've taken up yoga. I am working on my lap swimming. I am not letting myself be lazy any more. I finally heard back from those mentoring people, and we are having our first meeting next week. Mr. Rhody and I are planning a cross-country trip with some friends in October.
I still hang out with my TTCAL ladies. I love keeping up with them. But I find myself having less and less to say these days.
When the time comes for a baby, IF the time comes for a baby, we will accept that child gladly. Until then, I have a life to live.
Wednesday, August 5, 2009
1 dpo?
Well I'm pretty sure that I ovulated yesterday, based on my temp spike this morning. I also noticed my skin was breaking out yesterday and my CM was starting to dry up. It's funny, I would never have noticed the correlation between breaking out and ovulation if it weren't for charting; now, I can see it's actually a really good indicator of ovulation day.
I told Mr. Rhody that we should still have sex tonight, just in case. In reality, I enjoy our marathon sex sessions. When we're not "trying", we tend to put off sex for lots of other things, even though we really enjoy it. It's just too easy to say, "We'll do that later."
I am a bit disappointed that, even with all of the Robitussin and grapefruit juice, I didn't have any EWCM this cycle. I did have a bunch of very slippery / watery days, so I am hoping that's enough. I am also hoping that having a real temp spike instead of a slower rise for this cycle is a good sign.
I guess we'll find out in approximately 2 weeks. Right now, I can say, whichever way it goes, I'm ok with it, but I know in a week or so, I'm going to feel differently.
I told Mr. Rhody that we should still have sex tonight, just in case. In reality, I enjoy our marathon sex sessions. When we're not "trying", we tend to put off sex for lots of other things, even though we really enjoy it. It's just too easy to say, "We'll do that later."
I am a bit disappointed that, even with all of the Robitussin and grapefruit juice, I didn't have any EWCM this cycle. I did have a bunch of very slippery / watery days, so I am hoping that's enough. I am also hoping that having a real temp spike instead of a slower rise for this cycle is a good sign.
I guess we'll find out in approximately 2 weeks. Right now, I can say, whichever way it goes, I'm ok with it, but I know in a week or so, I'm going to feel differently.
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