I wouldn’t say, exactly, that I am optimistic. I would say that I may be slightly edging towards excited for this evening’s physical extravaganza at the RE’s (this is likely because it’s for a physical (take that Jude Law! I don’t need you!) and not for anything that involves any real pain—that takes place tomorrow). I believe in this doctor. I am thrilled that the clinic actually has a program specifically for recurrent pregnancy loss (most do not) and that the good doctor seems thoughtful and thorough. This is the beginning of maybe, just maybe, getting somewhere.
I did find myself, however, for a moment, missing my OB/GYN as I was scheduling the sono-hysterogram yesterday (They are going to do what? Where? FOR AN HOUR? I’m sorry, did you say “cramping”?) as I am used to him and his gruff, humorless ways and his protruding belly and the fact that his wife seems to be giving birth every other day. I really did, though, miss him. Although he’s literally never asked me anything about myself (I suppose there may be no perfect time to ask someone where they went to undergrad (Arizona) or where they grew up (difficult to say, West Coast?) or their favorite color (green) or favorite artist (Sally Mann? Frida Kahlo? Picasso?) when you are staring at the fuzzy image of an embryo without a heartbeat) there is comfort in the familiar. And although he’s made me angry before when I was convinced that I was losing babies because of familial periodontal disease (not likely) or because of an as of yet diagnosed bleeding disorder I was convinced that I had (again, probably not) he’s always called to follow up and listened and been there. And when he’s told me something that I absolutely did not believe (a D & C is less painful than miscarrying naturally, for example), he’s been right. So, here’s to you, Dr. OB/GYN, may your thousands of children be healthy and happy and may we meet again under more auspicious circumstances.
Wednesday, November 29, 2006
Tuesday, November 28, 2006
More Poking and Prodding or a Little Glitter?
I have a physical exam scheduled with my RE for the same day as a movie premiere I was invited to where one Jude Law and one Kate Winslet will also be in attendance. Not that I have a clue as to what to wear (really, what does one slightly nerdy eco attorney/freelance photographer wear to these things?)— but I’d really like to cancel that physical (I have to have an HSG done this week, anyway) and move it to later on in December (even though that will likely mean I will YET AGAIN have to take time off of work for it—something I have been trying to avoid because I am still fairly new at this job (started in June) and subsequent to that start date I had a chemical pregnancy and then a miscarriage which meant many trips to the doctor and/or the hospital). Thoughts?
Sunday, November 26, 2006
Chinatown and Freaky Sunday
Blood work today. Yes, on a Sunday. At the only place in all of New York City and Long Island, apparently, that is open on a Sunday. Anyway, it was off to Chinatown yet again (I was there in early January - in order to detect the rapidly falling level of human chorionic gonadotropin (hCG) hormone in my system and its equally low achieving buddy, progesterone). In case you were wondering, and I know you were, I had the following tests administered (most of the info about the tests is from my old friend Dr. Google (disclaimer: I am absolutely not a doctor, nor a medical professional, haven't a clue, really, about any of it). I do have to say, though, that my doc (the good doctor!) did explain most of this to me at the time he wrote the prescription:
Antithrombin III activity: used to detect a problem with blood clotting and to help diagnose an antithrombin deficiency.
Blood type/Rh/antibody screen: I am Rh negative - if you really must know. Apparently I have some antibodies in my blood that they want to check out. I have had to get the lovely RhoGam shot every time I've miscarried (that would be three, three shots).
MTHFR: "5,10-methylenetetrahydrofolate reductase,": the MTHFR gene is responsible for absorbing folate. There are two different theories about the MTHFR gene and miscarriage: one theory claims that MTHFR increases the risk of blood clots, which could block nutrients from reaching the placenta. The other theory is that MTHFR causes lower folate and B-vitamin levels, which increase the risk of miscarriages. It's still pretty controversial I think. There haven't been extensive tests (i.e., medical trials) about this. My doc did say, however, that many of his "habitual aborters" have done well by increasing folate, but as he said, that's merely a "testimonial" - not really very scientific--but he believes in it.
Factor VIII: this is Von Willebrand factor--an essential blood clotting factor. It's possible that I actually clot more slowly than normal--which would be the opposite, essentially, to thrombophilia, as that is what one test showed back in August. My doc is testing this at my insistence--there isn't really a known connection to Von Willebrand's and miscarriage--but it is a hemophilia type bleeding disorder and hemophiliacs DO have problems with miscarriage. The problem with Von Willebrand's is that it is very difficult to diagnose--the Von Willebrand factor can increase because you are anxious, which generally speaking, people are when they are having blood draws. In addition, the Von Willebrand factor generally increases while pregnant which would decrease the chance, obviously, of it creating problems.
Estradiol: The estradiol test is used to help evaluate ovarian reserve. In combination with the Day 3 FSH test, the estradiol test can help to determine the quantity and quality of the eggs. By the way, my 41 year old sister offered her eggs to me. Sweet, really. But does the woman realize that she's SEVEN years OLDER than I am? I know, I know, she's so fertile she just LOOKS at her husband and well, you've heard this before from your sister, friend, mother, etc.
FSH (follicle stimulating hormone): again, this is used to detect ovarian reserve.
Homycysteine: I believe that this goes along with the MTHFR test. Anyway, this test is used to determine if a patient has a B12 or folate deficiency. The homocysteine concentration may be elevated in patients before B12 and folate tests are abnormal.
LH (Luteinizing hormone): used to test menstrual irregularities and to aid in the diagnosis of pituitary disorders or diseases involving the ovaries.
Prolactin: this tests pituitary function, low levels of pituitary function result in lowered levels of thyroid or adrenal hormones. Probably used to test for polycystic ovary syndrome (PCOS).
Testosterone: I believe they are looking at polycystic ovary syndrome with this test as well. Aack. Testosterone? Aaack. I don't really have any of the classic symptoms (except for weight gain) for PCOS. But really, weight gain? Having a miscarriage or two or three and then reaching for another cookie does not a disease make. I will be surprised if I am diagnosed with PCOS. But, one never knows.
TSH: (thyroid stimulating hormone): used to determine whether the thyroid gland is functioning properly. By the way, an underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods. Hmmmm. That is interesting.
Wow, there really isn't much more exciting than going on and on about blood work is there? Can you imagine what I'll be like when I'm 90?
Also, as we were on the platform waiting for the train (that would be the L) we saw Jody Foster walking by, fast. She was wearing (because I KNOW you want to know) all black and a rather jaunty pair of green plastic glasses. Her hair was quite blonde and tousled. Very hip was she. And in a SERIOUS hurry. I mean, that woman walks fast. She looked kind of worried. Or annoyed. Perhaps it was because we were staring at her.
After the big soiree at the lab, we walked on over to an incredible baby store. Because, you know, I enjoy self-torture. Such a beautiful store. Bu and the Duck. They have the most amazing dresses and little hats. And handmade toys. Sigh.
Antithrombin III activity: used to detect a problem with blood clotting and to help diagnose an antithrombin deficiency.
Blood type/Rh/antibody screen: I am Rh negative - if you really must know. Apparently I have some antibodies in my blood that they want to check out. I have had to get the lovely RhoGam shot every time I've miscarried (that would be three, three shots).
MTHFR: "5,10-methylenetetrahydrofolate reductase,": the MTHFR gene is responsible for absorbing folate. There are two different theories about the MTHFR gene and miscarriage: one theory claims that MTHFR increases the risk of blood clots, which could block nutrients from reaching the placenta. The other theory is that MTHFR causes lower folate and B-vitamin levels, which increase the risk of miscarriages. It's still pretty controversial I think. There haven't been extensive tests (i.e., medical trials) about this. My doc did say, however, that many of his "habitual aborters" have done well by increasing folate, but as he said, that's merely a "testimonial" - not really very scientific--but he believes in it.
Factor VIII: this is Von Willebrand factor--an essential blood clotting factor. It's possible that I actually clot more slowly than normal--which would be the opposite, essentially, to thrombophilia, as that is what one test showed back in August. My doc is testing this at my insistence--there isn't really a known connection to Von Willebrand's and miscarriage--but it is a hemophilia type bleeding disorder and hemophiliacs DO have problems with miscarriage. The problem with Von Willebrand's is that it is very difficult to diagnose--the Von Willebrand factor can increase because you are anxious, which generally speaking, people are when they are having blood draws. In addition, the Von Willebrand factor generally increases while pregnant which would decrease the chance, obviously, of it creating problems.
Estradiol: The estradiol test is used to help evaluate ovarian reserve. In combination with the Day 3 FSH test, the estradiol test can help to determine the quantity and quality of the eggs. By the way, my 41 year old sister offered her eggs to me. Sweet, really. But does the woman realize that she's SEVEN years OLDER than I am? I know, I know, she's so fertile she just LOOKS at her husband and well, you've heard this before from your sister, friend, mother, etc.
FSH (follicle stimulating hormone): again, this is used to detect ovarian reserve.
Homycysteine: I believe that this goes along with the MTHFR test. Anyway, this test is used to determine if a patient has a B12 or folate deficiency. The homocysteine concentration may be elevated in patients before B12 and folate tests are abnormal.
LH (Luteinizing hormone): used to test menstrual irregularities and to aid in the diagnosis of pituitary disorders or diseases involving the ovaries.
Prolactin: this tests pituitary function, low levels of pituitary function result in lowered levels of thyroid or adrenal hormones. Probably used to test for polycystic ovary syndrome (PCOS).
Testosterone: I believe they are looking at polycystic ovary syndrome with this test as well. Aack. Testosterone? Aaack. I don't really have any of the classic symptoms (except for weight gain) for PCOS. But really, weight gain? Having a miscarriage or two or three and then reaching for another cookie does not a disease make. I will be surprised if I am diagnosed with PCOS. But, one never knows.
TSH: (thyroid stimulating hormone): used to determine whether the thyroid gland is functioning properly. By the way, an underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods. Hmmmm. That is interesting.
Wow, there really isn't much more exciting than going on and on about blood work is there? Can you imagine what I'll be like when I'm 90?
Also, as we were on the platform waiting for the train (that would be the L) we saw Jody Foster walking by, fast. She was wearing (because I KNOW you want to know) all black and a rather jaunty pair of green plastic glasses. Her hair was quite blonde and tousled. Very hip was she. And in a SERIOUS hurry. I mean, that woman walks fast. She looked kind of worried. Or annoyed. Perhaps it was because we were staring at her.
After the big soiree at the lab, we walked on over to an incredible baby store. Because, you know, I enjoy self-torture. Such a beautiful store. Bu and the Duck. They have the most amazing dresses and little hats. And handmade toys. Sigh.
Monday, November 20, 2006
More info . . .
My sister-in-law was told that she has an increased chance of Downs because of her age, not that her child does in fact have Downs or even that they think that there is a strong likelihood of Downs. No tests have been done. It does make me wonder, however, if this, this possibility of Downs, is swaying her thinking more towards the idea of not keeping this pregnancy. I wonder too, if she is getting pressure from all of us, from her brother and myself and her parents - because WE all want this baby, and maybe she thinks that she should do it for us, even though she doesn't really want to go through with this herself. This is an incredibly personal decision and her own. And I must step back and let her do what she wants, give her what she needs and not be so selfish. To me, this baby represented something good from a year of pain, the pain of miscarriages and the very real possibility that I won’t be able to carry a baby to term. For my husband, I wonder if this baby represented a life with more direction for a sister that he worries about, a shove towards getting her life straightened out. And for their parents, I suspect, that this baby was perhaps their one chance at becoming grandparents. This is too large a burden for a child. A fetus, a baby, a child who is just over three months in utero. These thoughts are selfish, and naive, but real.
Friday, November 17, 2006
Sunday, November 12, 2006
As Fate Would Have It
The appointment went well with the RE. In a nutshell, I have to have a lot of tests. Fun, fun tests of the snagging bits of your endometrium kind and blood, much, much blood. But oh! I am used to the blood. How I used to be afraid of needles! And now, I proudly thrust force my forearm to be punctured by the nurses or the phlebotomists or the nurses and the phlebotomists. And did I tell you how they love using that one new nurse? Or that new phlebotomist? You know, the one who was just practicing on an orange? Well, they do. And oh, did I mention my tiny, tiny, pesky veins that they can never find? Oh, but what fun! What joy! And, oh, the bruising! But really, what's a little vampire action if we come away with a little one? Not much. Not much at all.
As fate would have it, not only is each and everyone of my friends pregnant (or just given birth) and all of my husband's myriad of cousins pregnant, but my husband's sister, my THIRTY-EIGHT YEAR OLD sister-in-law is pregnant. You know, the one who wasn't trying. The one who didn't necessarily want to have kids. Yep. That's the one. Part of me is really happy. It's exciting! How exciting! A new little being! My husband (and I) will have a new niece or nephew! And we will spoil her. And love her. And we will have her come out to our pad in New York. And we'll take her to Europe (hey, it's my fantasy). And we'll help with her college expenses (Columbia) and her pre-med studies (how exactly we're helping her with that isn't important!) and her trips to Africa with Doctors without Borders! Hey, I'm exhausted already. Part of me, however, is also mad. And jealous. And sad. That about sums it up.
As fate would have it, not only is each and everyone of my friends pregnant (or just given birth) and all of my husband's myriad of cousins pregnant, but my husband's sister, my THIRTY-EIGHT YEAR OLD sister-in-law is pregnant. You know, the one who wasn't trying. The one who didn't necessarily want to have kids. Yep. That's the one. Part of me is really happy. It's exciting! How exciting! A new little being! My husband (and I) will have a new niece or nephew! And we will spoil her. And love her. And we will have her come out to our pad in New York. And we'll take her to Europe (hey, it's my fantasy). And we'll help with her college expenses (Columbia) and her pre-med studies (how exactly we're helping her with that isn't important!) and her trips to Africa with Doctors without Borders! Hey, I'm exhausted already. Part of me, however, is also mad. And jealous. And sad. That about sums it up.
Tuesday, November 07, 2006
The Latest . . .
1. I forgot that I needed to vote today no less than fifteen times on my way home. I did, however, vote . . . eventually. And the lady sitting at the table twittered away about my last name (which is unusual and shared by a very famous singer) for a good five minutes before I was able to shut myself into the little booth and stick it to the GOP.
2. I think I may have unwittingly gone on a date over the weekend. A guy that I was working with (shooting the marathon) asked me out for a drink afterwards - the thing is, I'm so old and married that it didn't occur to me that he may actually be INTERESTED in me until half way through the night. Then I made a quick getaway. I have to admit though, that I am flattered, if not somewhat clueless. But hey, I've still got it! Actually, he was probably just bored.
3. My husband got a haircut this weekend. He's looking a tad Emo Phillips. This will have to be remedied, and right quick.
4. Speaking of my husband, he went to a bar with a friend on Friday. The (female) bartender bought him quite a few drinks. What can I say? We're a dashing couple wanted by ones of people.
5. I saw an acupuncturist yesterday. Even though I was told that they take my insurance, they don't really, shall I say, TAKE my insurance, in that they don't actually BILL my insurance. Instead, oh crafty ones, they give the poor slobs with my insurance a discounted rate. I did it anyway (I was there, I was curious, the drive was long and annoying). She prescribed weekly visits (of course!) until my cycle is more regular. Um, no. However, it was quite relaxing and painless, even for a wimp like me (OK, when the needle went in on the top of my foot, it was slightly uncomfortable, which, by the way, she forgot to remove, which left me stammering, "Um, did you forget one?", knowing full well that she had in fact forgotten it and with an irrational fear that years from now I am going to find a tiny acupuncture needle embedded somewhere odd).
6. I have an appointment with a new RE (I saw one RE but only for one visit and then got pregnant again and all looked well and so no tests were done, but well, it didn't end well) on Thursday. I'm excited about it.
7. I want to tell you how much I am enjoying Lisa Williams: Life Among the Dead, but it's too embarrassing to admit, so I will tell you that if you haven't seen HEROES, it's a must. Well written, beautifully shot, great actors, interesting story.
8. I must get back into running.
2. I think I may have unwittingly gone on a date over the weekend. A guy that I was working with (shooting the marathon) asked me out for a drink afterwards - the thing is, I'm so old and married that it didn't occur to me that he may actually be INTERESTED in me until half way through the night. Then I made a quick getaway. I have to admit though, that I am flattered, if not somewhat clueless. But hey, I've still got it! Actually, he was probably just bored.
3. My husband got a haircut this weekend. He's looking a tad Emo Phillips. This will have to be remedied, and right quick.
4. Speaking of my husband, he went to a bar with a friend on Friday. The (female) bartender bought him quite a few drinks. What can I say? We're a dashing couple wanted by ones of people.
5. I saw an acupuncturist yesterday. Even though I was told that they take my insurance, they don't really, shall I say, TAKE my insurance, in that they don't actually BILL my insurance. Instead, oh crafty ones, they give the poor slobs with my insurance a discounted rate. I did it anyway (I was there, I was curious, the drive was long and annoying). She prescribed weekly visits (of course!) until my cycle is more regular. Um, no. However, it was quite relaxing and painless, even for a wimp like me (OK, when the needle went in on the top of my foot, it was slightly uncomfortable, which, by the way, she forgot to remove, which left me stammering, "Um, did you forget one?", knowing full well that she had in fact forgotten it and with an irrational fear that years from now I am going to find a tiny acupuncture needle embedded somewhere odd).
6. I have an appointment with a new RE (I saw one RE but only for one visit and then got pregnant again and all looked well and so no tests were done, but well, it didn't end well) on Thursday. I'm excited about it.
7. I want to tell you how much I am enjoying Lisa Williams: Life Among the Dead, but it's too embarrassing to admit, so I will tell you that if you haven't seen HEROES, it's a must. Well written, beautifully shot, great actors, interesting story.
8. I must get back into running.
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