Happy

A few days ago I had my appointment with a specialist at a Maternal Fetal Medicine clinic in a hospital near Salt Lake.  It was a wonderful appointment and I feel like it was extremely productive in answering my questions.  The best part was- we came up with a plan. A plan! I know I still have decisions to make and research to do, but I don’t feel like I have these looming questions about what I am going to do and when.  Here is the non-medical jargon plan in a nutshell.

     1.  Go off of my hormonal birth control for now, to let everything even out and have my natural normal cycles.  This is what I wanted to do so I’m glad she agreed.

     2.  Start on the baby aspirin daily, right now.  My doctors have told me that because of my blood clotting risks I’m a candidate to take aspirin all the time, but I usually avoid medications unless it’s really necessary.  If I keep my blood thin for a few months before getting pregnant my chances are better.  The only thing I was worried about with the aspirin was that it could mess with effective implantation and give the pregnancy a bad start.  She told me that chemically that didn’t make any sense to her- and the aspirin shouldn’t affect the beginning placenta because of the way it attaches.  I’ve been able to get pregnant easily on aspirin before, and it seems like if it caused problems it would have taken me longer.  I was still on the fence then I was reading some clinical studies online and read that if anything the aspirin makes it easier to get pregnant and keep it because it increases uterine blood flow.  When I read that I felt confident that this would be a good choice for my body and not harmful to the baby.  I started on aspirin with Jack at 5 weeks 5 days and we noticed no negative results with him. So I started aspirin today.  Bring on the nosebleeds.  I’m also starting my prenatals again to feel nice and energized and healthy for a few months beforehand.

      3.  The Lovenox issue.  I mean, granted I hate the shots, but also I was wondering the effectiveness of them.  Every time I would lose a baby the OBs would say “more blood thinners! Stronger! Sooner!” But the more I learned about what’s going on inside my body and what science said, it didn’t make a whole lot of sense to me. I know that Lovenox is a miracle for many women, but I’m not sure if it makes sense for me. Talking to the doctors who knew more about it, their opinion was “since you’ve never had a blood clot, if you have a viable pregnancy the aspirin should take care of it.”  Fortunately for me the specialist agreed and shed some additional light. She said without a history of blood clots, and especially taking Lovenox in pregnancy, the drug actually acts as more of an anti-inflammatory rather than an anti-coagulant! Who knew! She said they’ve had the same anti-inflammatory results just from supplementing with progesterone! Which was my next question anyway, I really wanted to look into this supplementation.

      4.  Progesterone.  I’ve known that this helps prevent miscarriages way before I ever had one.  But they checked my levels with the last two and they were “fine.” However, I had severe back labor pains when I lost the babies and I’ve read that can be a sign of your progesterone dropping.  Without that hormone your body can’t keep the pregnancy.  The other wonderful thing about this stuff is that as far as risk versus benefit, there’s not really a risk (not when we’re talking high risk pregnancy anyway).  My question was, if it can’t hurt, might help, can I just do it?  While there’s not a huge amount of scientific proof available to say that progesterone works miracles, I’ve known people it has worked for.  You just take it during the first trimester usually.  She agreed with my logic and especially since it would act similarly to Lovenox in an anti-inflammatory way.  If it helps me keep the next baby, I’m willing to try about anything.  She wrote me a prescription and I picked it up to keep on hand.  She was amazing to do that.  Half my problem is that from the time I take a positive test to the time I lose the babies is usually 2-3 weeks.  It’s hard to get an appointment, call in, get the rx, etc.  So I just have it on hand.  That way as soon as I take a positive test, I can start supplementation the same day.  Amazing load off my mind. I was wondering about my progesterone anyway.  While it may have been fine with Jack, my body chemistry was very different back then.  My thyroid didn’t crash until I stopped breastfeeding so I can only imagine it changed all of my hormones and any balance I may have had in that area.

       5.  Tracking.  I told her that worst case scenario I was worried that if I have to lose my next baby, we wouldn’t be able to learn everything we needed to about when so that we could figure out the why.  If you do HCG readings a week apart you never quite know when the numbers drop.  Our plan is for me to call as soon as I’m pregnant- and they will do HCG blood draws every other day to check the growth.  Once I reach HCG 2000 I will have an ultrasound once a week until they see a nice strong heartbeat, at which time I can go back to my regular OB.  They feel if I get to that point everything will be fine.  What I wouldn’t give to see and hear and beautiful healthy heart on a monitor!!  They would also track my thyroid to make sure it’s not adding to the problem. 

We talked about that “luteal placenta shift” which is where I seem to lose the babies, and basically concluded if I can get past that little bump in the pregnancy that everything should do just fine.  I pray the progesterone would see me through that difficult transition to the placenta nourishing the baby and making the hormones.  I would hope the aspirin keeps the placenta healthy enough to do so.  All my lupus and APS antibodies came back negative recently so I am so thankful that is not a factor now. 

I feel happy.  I feel hopeful.  I feel validated.  I don’t feel like all is lost, I’m not despairing.  For the first time in a long time, I actually feel excited.  They told me I’ve been wise to wait to try again and now that it’s nearing the 6^th month mark, it’s fine with them for us to try again.  We are not quite there yet, but it is comforting to have the green flag from the doctor and have a plan in place.  I just need to remember to stay at peace- if it’s time, everything will be ok.  If I can just get past that point where I’ve lost them before.  I just need to trust my body can do the rest.  If I just need to sit and do nothing for the first few weeks, to mentally focus and “protect” my belly, my doctor told me that is totally ok!  They are going to monitor everything, so if I have to lose another, we should have the data to at least help us understand when.  I don’t have any huge disorders that are screaming “this is why you lost the babies” but I have enough small problems collectively that might continue to cause issues- even though they have ruled out causation for some of those problems.  I realize now that I might have losses sometimes and other times I’ll have healthy  children.  Hopefully.  And really, there is no good science for any of this.  We’re just trying our best.  I feel like I’ve done everything I can do.  The doctor complimented me on being wise in my thinking, asking good questions, and doing my research.  That helps put my mind at ease. 

Today God’s grace has filled my soul and  I feel His warmth, and that gift, at least for today, has taken my pain away and filled it with hope. 

I was so glad to have a doctor who is so experienced in this type of medicine, but also who clearly had a heart!  And actually, it was really comforting to talk to a woman, as most of my doctors have been men. 

Part of me has disassociated being pregnant with having a new baby.  So I really need to make sure I’m ready for another child, not just another pregnancy.  I need to be prepared for a miracle.  I know we need to make it a matter of prayer and really talk to the Lord about it so I know it’s the right time.  Only He knows what will happen, and only He really knows my heart and whether it is ready for either outcome.  I also want to pray about the “plan” to confirm I should feel good about every aspect. 

I can’t honestly say my fear is gone.  I’ll be in the middle of a happy thought and it creeps up and strangles it out of me but I don’t want to live in fear.  Blogging has been really healthy for me.  I’ve been considering whether or not I want to blog about my experiences if I do become pregnant sometime in the recent future.  Most of the time people wait to announce for privacy and in case of the worst- but that’s pretty much all out in the open with me!  I may write and just choose to publish those posts later depending on the outcome.  But I thank my readers because I can feel support in numbers alone and also in your comments.

I sat up in bed last night just crying- not a sad cry necessarily- just contemplating everything and all these decisions I need to make.  Tears just kept streaming down my cheeks for a long time.  I think it’s just because it's really important.  It wouldn't be so hard if it wasn't so important. Things have been working out and falling into place with all these new doctors and I have to take that as some sort of a signal that we are on the right path and doing what we are supposed to be doing now.  I need to trust that I'll know in my heart when it is time to try again, despite the crushing fear.  I have to trust that if God tells me it's time to try again if I so desire, that either the blessing of a child, or the struggle of a 4th loss will be what we need in our family at that time. I just need to trust that He knows when and why, and all I can do is all I can do.