Note: I welcome any and all readers. I hope that, if you find yourself here, you find comfort in our story as I have found comfort in the stories of so many other moms and dads who have traveled this lonely road.

Thursday 11 December 2014

A Good Doctor Appointment (Could it Be?)

Okay, so I am apparently not ready to let go of this blog quite yet. I wrote this post in my new blog, but realized before I hit 'publish' that I don't want to get too technical in that blog - I need it to be a place of healing, and cold, hard medical facts are not what I would call healing. Because I know I have followers here who may want to know about hyper-coiling, I will post this information here instead.

One note before you read on: I cover this in detail in my new blog, but I recently had a 10-week miscarriage. Yeah, I know. Our rainbow baby didn't make it. We're devastated. But...we are staying strong. We are going to try again. This is not the end.


It's not something I thought I would ever be able to say again, but there it is in the title, so it must be true. A GOOD doctor appointment!

Today was our Maternal Fetal Medicine (MFM) specialist appointment. It was scheduled at our post-birth follow-up around 8 months ago, so we have been waiting a LONG time for this. I really did my homework with Haven's cause of death, so I was confident in how I felt a future pregnancy should be managed. I knew that there was very little research out there regarding hyper-coiling of the umbilical cord (also called hyper-spiraling or torsion), and I was concerned that, due to the lack of research, a future pregnancy might be treated as "low risk."

It turns out that my apprehension was unfounded. The specialist was compassionate, but very to the point and knowledgeable. I am going to share the details here, in case another mama comes looking for this kind of information someday and it can be helpful. Or, if you want to know about it just 'cause, you are welcome to read on too!

Haven

  • We were surprised to find out that, not only was Haven's cord abnormal, it looks like her placenta had also been abnormal. Excess growth of blood vessels in the placenta indicated that not enough oxygen had been getting through, so it was trying to overcompensate. This may have caused Haven to be hyperactive, which may have caused the hyper-coiling. This is a little speculative because there is very little study on the subject, but it would explain a whole lot. They can't tell us why the placenta wasn't getting enough oxygen in the first place. However, they feel this was likely an isolated case.
  • She also mentioned that there were "fibrous kinks" in the cord, which wasn't really explained before. I am thinking these probably came from the last few times Haven switched sides in my belly. I had a bad feeling about the last turn she made, though I couldn't explain it. Now I think I had some kind of intuition that something was wrong (why can't intuition scream instead of whisper?)
  • In my bloodwork before delivery, they discovered that my Protein S levels were low. This has to do with how your blood clots. The specialist feels that it is probably just a normal variation, but I will receive further testing in a few weeks. There seems to be a correlation in a lot of these cases between clotting issues and coiling, so I am eager to have this testing done (it may not be cause and effect, but two factors working together in a negative way).
Recent Miscarriage
  • This is felt to be completely unrelated to what happened with Haven (as we already guessed).
  • We may decide to use baby asparin leading up to conception and after the first trimester next time. There are thought to be benefits in prevention of various placental issues with its use.

Next Pregnancy

  • Like the OB said, there is no reason we can't try again as soon as we feel ready. We will likely wait until I can be tested for the clotting issue in case the result is positive (it takes a month for results to come back).
  • The specialist and the pathologist felt that, due to me not having any underlying risk factors (hypertension, diabetes, thrombophilia, etc.) the risk of recurrence was <1%. Now, with the statistical unlikelihood of what happened to Haven, I take all numbers with a truckload of salt, thankyouverymuch, but I am going to try and live in the >99%.
  • Like with my recent pregnancy, I will begin seeing my OB as soon as I get a positive test.
  • Between 10-12 weeks, I'll have another MFM appointment to ensure all is developing okay.
  • They will do an 8-10 week ultrasound to date the pregnancy and assess for viability, then one at 18-20 for the anatomy scan, where they will do extra imaging to assess the blood flow from me to the baby, so they can see if anything looks abnormal. Assuming all is okay, I will start having biweekly scans at 28 weeks, then weekly scans at 34 weeks until delivery.
  • I will be induced at 39 weeks unless there are factors that indicate we should deliver sooner (or if I am an anxious and emotional basket case and tests indicate the baby is okay and ready). We'll do an amniocentesis to make sure baby's lungs are okay before proceeding.
  • Hopefully, we will finally get our "take-home baby." I'm daring to dream.



Now

Physically, I am feeling pretty good, though my hormones are bringing a surge of anxiety as they drop. However, my hormone levels seem to be dropping in a healthy way (hcg was only 130 on Monday!) Our OB will follow us until the numbers reach zero.

I spoke to our OB today when I called for my blood results, and she asked how I was doing. I kind of brushed it off, but she really wanted to know. She said "I am reaching through the phone to give you a hug! I want to see you with a big, beautiful belly!" I smiled as if she could see me and said, "I really want to see me that way too. I hope it happens." It is nice to know that we have such a supportive doctor.

That's it. Consider yourself updated. ;)


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