Follow-up

I feel the need this evening to follow up my last posts with some thoughts.

I read here that, "Approximately 44% of the population is heterozygous and another approximate 12% are homozygous for the MTHFR mutation." That seems like an awfully large percentage to me, and I doubt that many women have had the problems I've had. Maybe there are other factors in this MTHFR mutation that cause pregnancy loss that we just don't understand yet.

I also read on the March of Dimes site that, "There are no good estimates on the number of affected individuals in this country." I also read here that they won't even offer to test you for thrombophilias unless you've had a past blood clot (which I did not), or, "...a history of pregnancy complications, including two or more miscarriages, stillbirth or placental abruption due to undetermined causes," (which I obviously had). It's so sad though that I had to loose even one of our babies before tests would even be ordered to make this diagnosis. I know research is being done, and I hope someday soon there can be an easy way to screen all women for these potential complications.

Also, with the more that I read I am feeling more confident that it is the thrombophilia that caused the deaths of our babies. March of Dimes says that, "The thrombophilias also may contribute to pregnancy complications including fetal loss and placental abruption," (which I had one of each). I also learned that, "Pulmonary embolus is the leading cause of maternal death in the United States," and, "studies suggest that up to 80 percent of pregnant women who develop a pulmonary embolus or other VTE (venous thromboembolism) have an underlying thrombophilia." I would do anything for my children if it means saving their lives and nothing can make up for their deaths in my opinion, but maybe their deaths weren't completely in vain. Maybe with the awareness of my diagnosis due to their demise, they may have helped prevent my death caused by a VTE or pulmonary embolism. This is a rather morbid thought, but I know that even though we have been profoundly affected by the deaths of our babies, I know that my death would have a harsher impact on more people.

I would also like to say that maybe I was hasty in being so critical of my perinatologist on her not suggesting the Folgard (super duper folic acid and B complex vitamins) initially. Maybe I should take responsibility and view it more as a partnership and be glad that I found someone who is willing to take my concerns seriously rather than just dictating treatment especially with something that appears to be a new field of study. I have always considered myself an educated consumer, but paradoxically I have always struggled with being assertive in my concerns. I am always so concerned about offending someone, but I am learning to look out for my own best interest and the interests of my family. And I feel I made a big step in that direction today by educating myself and expressing my concerns to my doctor.

Waiting for Wednesday

I called my doctor today regarding the delayed arrival of Aunt Flow. I will be going in Wednesday morning for a blood test to see if I'm pregnant. The urine test this morning came back negative again. I don't know how long it will take to get the results back, but you can be sure I will ask!

I also called my perinatologist regarding checking my homocysteine levels and a possible increase in my folic acid intake from the normal prenatal amounts. She said that it is her experience that even with normal homocysteine levels, you can still have problems, so she didn't think it was necessary to check my levels since we are already going to do the blood thinners.

She did think it was a good idea to increase my folic acid intake and called in a prescription for the super duper supplement. This is what I wanted anyway, so I didn't push the homocysteine issue. But my confidence has been lowered since I feel she should have thought of this initially. I'm not a medical professional; I can't be relied upon to think and research everything! Needless to say, I'm a little disappointed.

I also mentioned to her that we flew the day before I started bleeding and maybe that started everything in motion. She may be trying to alleviate some of my guilt, but said it probably didn't. But I'm still not going to take any chances next time!


-- Post From My iPhone

MTHFR and flying

I ran across an interesting discussion board post this weekend that gave me chills (not the good kind). It was a lady discussing a similar clotting condition to mine but hers is more severe.

Bear with me while I provide some background on this particular clotting disorder.

I had a DNS analysis performed on the MTHFR (methylenetetrahydrofolate reductase) gene a while back. When they perform the analysis, they are concerned with two different DNS sequence mutations - C677T and A1298C. It was determined that I am heterozygous for the A1298C mutation.

You receive chromosomes from both your mother and father when you are conceived, and both copies make up your genes. I received the mutation from either my mother or father, but only one faulty copy making me heterozygous as opposed to homozygous (two alike copies). You are not at increased risk for vascular diseases when you only have one of this particular copy, and I do not have the C677T mutation. Some individuals can be homozygous for both mutations, increasing their risk of vascular disease substantially.

From the research I've done online, this mutation can affect the amount of homocysteine in your body. It is the increase in homocysteine that can lead to an elevated risk for clots and vascular disease. But more applicable to pregnancy it can also interfere with B complex vitamin absorption and cause clots. Clots during pregnancy can interfere with how well the placenta works. As you may know the placenta is the baby's lifeline, and any interference can jepordize the baby's life unexpectedly and quickly.

Folic acid and the other B complex vitamins are important supplements to have before and during pregnancy to decrease risk of neural tube defects and other birth defects. Often times, women with elevated levels of homocysteine are prescribed blood thinners and special vitamins with huge amounts of the B complex vitamins to decrease homocysteine levels and increase the amount of the vitamins available in their bodies. This is to help reduce the risk of clots and birth defects.

I'm not sure why they don't screen for this with every woman who wants to be or is pregnant. It would seem like a simple way to reduce the risk of complications and fetal deaths. But I don't know enough about it to speculate on how common place or rare it may be, and it maybe a new field of study.

Another issue with clotting disorders (or thrombophilia) is that certain things can increase your risk for blood clots - birth control pills, sedentary activities, and flying in an airplane being the foremost on my mind.

The woman in the discussion board posted how she miscarried soon after flying. After I read this, my mind went back to how we had just come back from our trip to New Orleans in which we flew. We had arrived back home on Saturday, and Garrett was born the following Tuesday. I don't think this is coincidence considering I also started bleeding that Sunday following.

During my consult appointment with my perinatologist, I don't think I mentioned that we had just flew prior to the incident. I'm also thinking that my perinatologist did not check my homocysteine levels since this particular mutation is not supposed to affect that. But I am going to ask my doctor to check mine to make sure everything is kosher.

I also mentioned all this to my husband, and we were both in agreement that I will not be traveling next time I'm pregnant - no flying or road trips, period.

Results?

I feel like a little kid waiting for Christmas to arrive; well at this point hoping that it doesn't arrive if we're talking about Aunt Flow.

I woke up this morning at about 4:40am, and I swear I honestly DID have to pee (which I take as another good sign that I could be pregnant). So I went to pee into a cup and got my handy dandy dip stick out. I busied myself with some mundane task after checking the time and waited for the results.

After about 5 minutes I didn't see any indication of a positive test, and the same after 10 minutes. But after about 20 minutes (which I remind you is after the 10 minute recommended viewing period), I did see an obviously faint line. My husband would probably look at me crazy for saying there is obviously a line since to see it at all you have to kinda squint your eyes, get it at the correct angle, and don't look at it directly; but it was there!

I realize I could be imagining lines here, and it did appear after the valid timeframe, so I feel my test is still inconclusive. I did check the expiration date on the tests, and they say 7-2010, so that shouldn't be a problem, but they are older tests...

I did use up my last super duper sensitive test, but if my period is already late I should also be able to get a positive result with any OTC test, but I guess that really all depends on how much hCG I'm making. So I'm going to try to get some more sleep and wait at least until the sun comes up so people don't look at me crazy and go pick up some more tests for tomorrow. Here's hoping, and I'll keep you posted!

-- Post From My iPhone

a case of raging PMS?

I have been feeling better since my last post. It's amazing how much better things look in the morning. I think the fact that I have to keep putting one foot in front of the other helps to get me out of those ruts. I don't have the option of just pulling the covers over my head and shutting the world out no matter how much I might want to sometimes.

I also suspect the extreme moodiness and weepyness might be related to being pregnant or raging PMS. I haven't missed my period yet, but I took one of those uber sensitive pregnancy tests I ordered online that I had left over from last time. It measures 10 mlU/hCG (human chorionic gonadotropin) which is one of the hormones produced when you're pregnant. The most sensitive you can get at the drug store will usually measure about 20 mlU/hCG.

Anyway, I took a test yesterday and today, and I swear I see a very faint line. It's so faint that I'm afraid I'm imagining it. You have to look at it cross-eyed to see it even! I know that it doesn't matter how dark the line is, if it's there you're pregnant. But I wouldn't bet the farm just yet because the line was most defintely more visible after the 10 minute recommended viewing period. So my brain doesn't want to believe it yet, but my heart does! Wouldn't it be so great to get pregnant so quickly without really even trying! I could skip the whole anxiously waiting prepregnancy anxiety stage!

I really want to be able to call my doctor and just have them do a blood test to check, but I'm trapped at home with the daycare. It's the only real frustration I have with the daycare - not being able to leave without extensive planning before hand. But if Aunt Flow hasn't arrived by Saturday, I'll take another test. I only have two left!

I'll keep you posted!

Fatigued

I've been rather surprised by the intensity of the emotions I've been feeling recently. I've noticed myself becoming more emotional as Garrett's should-have-been due date draws closer. I wasn't sure how I would react as the date approached, but my emotional reaction to the reminder of how things should be and what should have been has surprised me.

In the past, similar dates with Sierra did not trigger emotions this intense so I was all the more surprised. I know that these emotions are normal, but I can't help but think that I'm not handling it as well as I should. I also know this is an irrational thought not only due to my perfectionist personality but also because I am comparing it to the previous loss. I would imagine the fact that I'm going through this again only compounds the emotional reaction.

I am also noticing myself becoming emotionally tired and cursing my stoic attitude. I am tired of being strong and handling things so well. And I don't feel as if I've been handling things so well recently. My emotional muscles are becoming fatigued, and they need a break. But how do you get a break from grief and the painful reminders?

-- Post From My iPhone

food as an art form

I've always said that even though my daughter is the oldest child in my care, she is the messiest at meal times - messier even than the infant and toddler!

It might be because she brings a whole new meaning to "food as an art form"...