Posts Tagged ‘lovenox’

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My hematologist, etc

September 10, 2009

I saw the hematologist today and it took him over an hour to see me for what was a two minute consultation. He said I’m fine. Some stuff that was positive before is now negative though he doesn’t know why the change and he said that my miscarriages are not because my clotting issues. He said lovenox is pointless for me. I don’t know if I’m reading too much into this but these are the three areas that still showed up as issues, and his don’t worry about it mantra just isn’t sitting well with me:

MTHFR: This is a gene associated with higher risk of nueral tube defects and miscarriages. I have one mutation (C677t). Dr. F said since its only one mutation not two he’s not concerned. But- there are doctors who recommend lovenox and increasing folic acid and B6 and B12 for one mutation. Plus, Jack could have a MTHFR mutation, which when combined could give me two. He said there are no known ways to treat MTHFR. But, there are! Maybe the effectiveness is in question but there is a protocol.

Factor VIII Activity: Normal is 50-150. I’m 164. He said its okay since this clotting factor rises in pregnancy, except the lab results he gave me say these numbers may be elevated in late pregnancy. I’m hopefully six weeks today so how is this elevated due to pregnancy?

Plasminogen Activity: Normal is 78-130. I’m at 150. He said this nixes the Factor VIII so no worries.

I’m going to talk to my OBGYN about this but Dr. F said he’d tell my doctor I don’t need Lovenox. I strongly disagree and hope she maintains her stance. The veins and arteries the uterus are often microscopic and so clots that would be inconsequential to me would be huge to a growing fetus and if this can save this pregnancy I am taking it.

(The random aside):You might have noticed in my many blog posts about my friends- it seems I’m not having the best of luck. We were having a small dinner at our house on Saturday and four people are bailing TODAY out of eight people. We thought about who we could invite now and could think of no one. While I believe that quality matters in friends, not just quantity it makes me sad that I have no one else I want to invite. I could definitely be part of the community if I wanted but all the girls I know talk about are things I don’t care about and, this is just me, but I don’t feel they are genuine and what’s the point of being friends with people who aren’t sincere. I am sure I have a ton of flaws that people could point out, but one thing I am is a genuine and sincere person. I don’t fake it, and if I care about you and you hurt me I can’t get over it. I’m not sure if its hormones making me weepy, but I just feel sad. I quit facebook because I got tired of the constant birthing announcements and updates on every little thing junior did, but quitting facebook is akin to social suicide these days. I’d like to think a good friendship will survive deactivating facebook but it turns out I have few such friends. Add to that not attending baby showers for about a year- yeah. IF killed my friendships it seems. And today, this makes me sad.

(The self check): After that huge pity party I threw for myself (thank you for attending) I need to get a grip. Susan at sprogblogger does a daily days of grace list on her blog and I think I need to do a similar thing just to help myself get out of my funk, so here goes:

1. Having dinner with Jack at my favorite steakhouse to celebrate my “retirement” from work today.
2. I no longer have to work at my toxic work environment.
3. I can sleep in tomorrow and not feel a lick of guilt.
4. Today, I am six weeks along and as of now, to the best of my knowledge, I am still the P word.

Okay, that helped. Thanks for listening.

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Thoughts while treading water

September 2, 2009

Pregnancy discussed

Metal mouth. I feel like I’m sucking on a nickel. I think the raging hormones are emerging. Today, I folded my arms and told my boss I didn’t appreciate her giving me new assignments when I was quitting in four days. I felt this weird fury building up inside of me like I wanted to punch her. I never talk back to authority, I’m a sweet meek employee. My uterus is doing minor stretchy things which causes me to run in panic to the bathroom. Yesterday I drove home from work, gripped the banister as I climbed the stairs and collapsed in my work clothes into bed, out stone cold for three hours.  I have rational other explanations for all of these things, besides, how can I take comfort in those when I didn’t wake up to pee last night. The starting of nausea that trailed me all day yesterday is dissipating. The mild symptoms peeking at me give me hope but then they play hide and seek vanishing from my sight for hours or days at a time and I wonder if they’ll ever come back.  I want to know what’s normal. I want to know what to expect. My fingers enter and backspace into the blank space of the google search engine, because I don’t want to do the same old searching that induces sleepless nights.

I am not sitting around crying all day. I am busy closing out my job, visiting family, reading, writing, napping. And eating [I really need to get a handle on that one]. It’s in the off peak hours when I’m alone that the thoughts nag me. I’m a high risk preggo. My odds of a repeat m/c are higher. I remind myself that things are different this time: I’m taking lovenox. My egg is earlier so theoretically fresher. The lovenox remains a painful task. Strangely injections on my left side hardly bruise while my right makes me look like an abused woman. I asked Lovenox HQ  about this but they had no advice except don’t poke the area after. Thanks for that useful nugget. btw- can you carry on lovenox syringes? I’m flying Friday and can’t find information on this on-line.

It’s amazing how I see infertility everywhere. I just finished “A Tree Grows in Brooklyn” and one of the characters, Sissy, has ten babies who die minutes after birth. Finally she adopts, falls pregnant but for this birth goes to a hospital where they have the technology to save the baby. Instead of seeing this technology as the reason, Katie, her sister says see? she adopted and boom she has a live baby! that always happens without fail! I’m amazed this is in a book written in the 1940’s.

Kate at I can’t whistle said she feels she writes about the same stuff again and again. I feel that way too today,  like I’m saying the same thing ad nauseum. But each day each old fear feels  new. Each day I have to learn how to cope again. Each day I feel tremulous with wonder that I am still pregnant. Each day I wait for the blood as though its normal to anticipate such things. As many times as I may see it, the pain will never feel old.

To the person/people who submitted my news to LFCA. When I experienced my loss. And this past time, when I learned I was the P word again, thank you for caring and for helping me get support. Here I go repeating the usual, but it bears repeating, I am not sure I’d make it through this winding journey without you. Thank you.

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The paradox of hope and fear

September 1, 2009

Thank you to everyone who gave me feedback on lovenox. I know that many of you brave women inject yourself regularly and I’m in complete awe. I sat with the shot for a good hour until Jack walked in and insisted on doing it. The pain of the needle going in isn’t horrible, it’s more this strange burning sensation once the medicine is inside. And the bruising! I look like someone kicked my stomach in. Still, I am grateful if it’ll help this one stick.

I feel funny today. I’m scared to call it nausea. It’s saliva and its constant and it makes me feel funny. I keep trying to attribute to something else, perhaps I didn’t drink enough water, or slept too little, or maybe its just the way the moon is orbiting. But maybe just maybe its a symptom of pregnancy. A real, live symptom, imagine that. I’m scared to imagine.

My friend said to me I’m not saying its related, but your negative attitude of not accepting congratulations, not wanting to talk about it, saying ‘if’ in terms of the viability of this pregnancy isn’t good. You could negatively affect the outcome. I hope that’s not true. I think its hard for someone who has not dealt with loss to understand my emotions. I don’t like talking about it. I try to find other causes for symptoms I might get. I’m not even signing up for ICLW next month because you have to submit three words to describe your blog and I can’t bring myself to write the P word. I mean, ICLW starts towards the end of September, I don’t know for certain where I will be come September! That probably sounds absolutely horrific, but its true.

BUT-  underneath the doubt, the fear, the anxiety, and the sadness, there is hope. It is a candle on low burning in the darkness. The flames are so small you could doubt its existence were it not for the quiet nights when I lie still and can feel its warmth radiate through my body.  So yes, I am afraid.  I’m deathly afraid. And yes, I don’t want to fucking talk about it because there’s something about hearing my voice travel the sound waves that amplifies this fear in my heart, but no, I’m not feeling hopeless. Why else would I have dared to try again? Each and every one of us IFers are living proof of this paradox. I may live in fear, but I float on hope.

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Fighting Fear

August 29, 2009

I’ve been calm and blase about this pregnancy until yesterday. I think it was the first lovenox injection. Lying down and enduring that painful injection (it hurts more AFTER the injection) it hit me: I’m pregnant. I don’t feel pregnant: no nausea, no tender breasts, no exhaustion of any extreme sort, my acne is gone. As someone with two losses, both in which I felt hardly any symptoms, I don’t like this common pattern. My mom never had extreme symptoms, maybe I’m lucky. Maybe its too early, I’m only 4.5 weeks, but given my background I can’t help but be afraid. I’m trying not to be afraid. I’m trying to prepare myself for a miscarriage and tell myself I’ll be okay if the worst happens but then I fight this urge because surely there is power in positive thinking? I remember Katery talking about not having symptoms in her first trimester and the ambivalent feelings of pregnancy after loss and she is in her second trimester now. So its possible. It’s possible. I want to believe this one will work. I hate my trembling hands when I check for blood when I go to the bathroom. I hate the feeling of inevitability. I know I’m taking lovenox now, the egg is theoretically fresher since I ovulated on time. . . I just can’t shake the fear.  I wish I knew what I could do to ease these worries.  I’m waiting until September 14 for an ultrasound and until then I need to figure out how to cope. I apologize in advance to anyone reading because though I will try to cope, I’m sure there will likely be other fear filled posts like this.

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Lovenox *gulp*

August 28, 2009

After my first loss I asked my doctor to run any tests she had to find out why. She was kind of enough to oblige though I’ve heard some docs won’t run these until three or more. While waiting for these results I got pregnant again. She called me 5 weeks into my pregnancy and asked me to take a baby aspirin because I tested positive for lupus anticoagulent and referred me to a maternal fetal specialist to discuss lovenox. He ordered a series of 15 tests on me.  In the meantime I lost that pregnancy. A few days after the loss I learned my lupus anticoagulent was now negative though there were other numbers that were borderline high. She said next time I got pregnant to get lovenox immediately upon a positive test. True to her word as soon as I called in she wrote me a prescription for lovenox.

I waited to fill my appointment until the next day because I had an appointment with a hematologist. He said he didn’t think lovenox was medically necessary for me and that I should wait two weeks for him to run some more tests on me. I asked him why did I test positive for lupus first go around, and then negative the next go around. He said sometimes lupus anticoagulent follows one pregnancy but not another. I asked him if now I was safe in this pregnancy, he said I can’t be certain. So while he said I didn’t need to take lovenox he did say that if my OB  felt I should, I can go ahead and take it. I began leaning towards taking it since the thought of this lupus thing coming and going like an apparition trying to steal my pregnancies freaked me out. But I still hesitated. Dr. F said not necessary and he’s an expert on all things blood. Jack thought I should wait out the two weeks.

After fretting for sometime someone advised me the obvious: ask you OBGYN. The hematolist may be a blood doc but he works with cancer, this is a recurrent pregnancy loss issue, you should trust the people who work with the preggo people. So I e-mailed my OB-GYN last night and she said she wanted me on it on the advice of the maternal fetal specialist.

I’m freaking out now. I am hoping by listing my fears they’ll seem less scary:

1) Lovenox costs $1,000/month. My insurance covered it this go aroud but I’m switching insurance in October because my job ends. What if the new insurance gives me problems?
2) I got a positive pregnancy test TUESDAY at 13dpo. Now its FRIDAY 16dpo. I didn’t start too late did I? I’m so upset that I waited. I should’ve gone with my instinct and just started stabbing myself with the needles as soon as they were ordered. The hematologist just confused me. UGH. It’s always better safe than sorry.

Nope, still scared. Please don’t let it be too late. Please don’t let it be too late.

Anyone have any advice on how to take Lovenox?

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It lies under the surface

August 26, 2009

4am today Jack shook me awake. You were yelling Why?! over and over again, he said with a bewildered expression.  I have no recollection but Jack told me I’ve been having outbursts like this the past few weeks.

I thought I’ve been dealing with my second loss better. I don’t cry daily. I don’t sit and fixate on what happened. I felt relieved that somehow I’d manage to hurt less this go around. Today as I made an appointment I turned a page in my agenda and bug’s u/s picture drifted out and landed in my lap. It’s been a month since I lost bug.  Her presence in my womb while my numbers tanked shocked my doctors, but there it was, a fact I will never forget: My bug was a fighter. She wanted so badly to survive. For the time she lived, she beat the odds.

I keep telling myself not to mourn this loss. Missing bug makes me feel I’m missing a mirage. But apparently subconsciously I am missing bug like crazy. I’ve wondered for some time why I showed my mom the u/s pics when she visited me after my loss. She saw it and burst into tears and kissed the picture holding it close to her chest. I felt a weird sense of relief. Now I think I know why. I think its because I wanted someone else to care. If someone else cared, bug was real, bug mattered.

Today at my hematology appointment the doctor said how far along were you when you lost your two children, I’m sorry, I meant, your babies? I felt like someone jolted me. It took all I had to not to bite my lip from crying, not of sadness necessarily but relief. He got it. He didn’t try to negate my pain with neutral words such as “losses or incidents”. He called them my babies. No one IRL ever called them that before.

Long story short, the hematologist ordered THIRTY different labs on me. He said the current results don’t indicate there is a medical need for lovenox so wanted further testing. The results come back in two weeks. As I was leaving the med tech who drew my blood approached me. Listen, he said, I read your chart. What’s happened to you is horrible. I really hope that whatever is wrong we here will find out and fix it for you.

I’ve been so busy trying to move forward I haven’t really looked back. Yes I’m jolted by grief from time to time but I try not to look at it too deeply. I run, or put on music, or turn on the TV. I’ve learned something today: you can run from the past but it catches up to you, releasing from you like the steam from a volcano. What you hold in will either come out or destroy you from the inside. I’m grateful for being the P word again, and despite the past I remain hopeful and grateful for the opportunity to try again. Still, I will never forget who I lost, and today on this one month anniversary I’m allowing myself a moment to grieve my little fighter.

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Planning

August 26, 2009

Thank you for your well wishes on my previous post. I’d be lost without you.  My coping mechanisms surprise me. I expected to panic. I feel a bit pensive but very calm. I hope this feeling remains.

I see the hematologist tomorrow to talk about Lovenox. My OBGYN already called in the ‘script. I’m scared of side effects but we’ll see what the hematologist says. Jack thinks I should get my HCG and progesterone drawn to determine the viability of this pregnancy. A part of me considers this, but a larger part shakes its head no. Waiting for those results, the lack of sleep, staring at the phone, anxious shallow breathing- it was brutal.  I don’t want to go through it again. True the results could comfort me but I dread that wait. I don’t know if I can do that wait. The OBGYN’s office asked to schedule a confirmation visit. I stalled. Confirmation visit: pee on a stick, get brochures on pregnancy, have a pelvic exam where you’re told its too soon to see a heartbeat on the u/s so come back in two weeks. No thanks. I’m already getting the meds. I’m considering scheduling a visit in three weeks when we’d find a heart beat. My goal is to stay as peaceful as possible. Any tips on how you find peace much appreciated.

I e-mailed the RE to cancel next week’s appointment. My two word response: ok. canceled. I felt taken aback. No good luck? No, that’s good news? They deal with IF day in day out so I thought they’d give a friendlier response. I never felt more like a canceled business transaction before.

The evening is drawing to a close and I glance at my pregnancy test. I’m struck by the first thought that comes to mind as I look at the two bars. Will this time be it? Have I paid enough? Am I absolved? I’m surprised by these thoughts, but this year has felt like a sort of purgatory where I sit and wonder what I did. I hope the lovenox works. I hope an earlier egg is a fresher egg. I hope. I hope. I hope. I hope my penance is complete.