Wednesday, July 12, 2006

The second opinion day

What a day! My day started with a scare. When i arrived at work, a nurse had been assaulted walking from her car to the campus, a very short distance. I was then told this assault was the 4th assault in the last few weeks & there had been a series of muggings & assaults around the home. I didnt like hearing this at all. I leave & walk to my car when it is dark after work. I became quite afraid. These stories & happenings, I find, send my anxiety levels thru the roof (just what i need, not!), so that threw me & I suddenly felt that awful feeling of not feeling safe in the world, which ive experienced on & off over the last few yrs due to different experiences; a client assaulting me, a prowler in my house, a robbery etc....

Then my RE (my usual RE, as opposed to the second opinion RE we were seeing this arvo) called me this am to tell me some of my blood tests were back & i had an unusual result - low level thyroid antiboides, a normal thyroxin but a suppressed TSH & this was leaning towards hyperthyroidism. He didnt think this was a huge worry or directly causing my miscarriages but he said it could be connected so he told me he wanted to talk to a thyroid specialist & maybe i should see one. He knew we were seeing our second opinion RE this arvo so told me to talk about it with her. I sunk into my dark hole, thinking all the worst thoughts;
'finally they found something,
this is why ive been miscarrying, i knew it
i need to work this up,
what does this mean?'
I locked myself in an office & searched the net...& found conflicting advice as usual. Half the sites seemed to think that thyroid antibodies & recurring miscarriages are linked & i should take thyroid treatment etc, they even inferred that with thyroid issues, i would keep miscarrying. The other half said there was inconclusive findings on whether they are a concern...one site said "low level antibodies are the thyroid on the way to autimmune failure, not there yet but on the way"....just what i needed...more anxiety....& more....i rang A who didn't join me down my dark hole. A has a science background with a medical head on his logical shoulders so almost always applies the 'im a scientist, it must be a randomised, doubled blind placebo study before im convinced of anything' outlook & chose the 'wait & see' approach but did seem worried that i have antibodies. To be honest - i had no idea what it meant at all but knew one thing for sure - this was the first test where something other than 'normal' came back so my instinct was to grab hold of it & cling to it as the cause of my miscarriages & since the literature was agreeing with me (well half of it), i thought, theres gotta be something in this.

My RE also told me my cholesterol was way too high. It was 6.9 & should be below 5.4. He told me I had to start eating no / low saturated fats. I tried to explain to him that in fact before my miscarriages started I was a health friek, eating so strictly etc but since my miscarriages began, my eatings been out-of-control & the comfort food quick fix has been my crutch. He didnt comment. Its so unnnerving when so often he doesnt say anything on the end of the phone....youre left thinking hes disinterested, disapproving, who knows, i wish he'd comment.
I remained highly anxious. We were meeting our second opinion at 3.

On the way in the car to my appointment, my very close friend R called. His great uncle had a terrible stroke & was left lying in his house on the floor for up to 24 hrs alone ....terrible....R was very upset, they were close. He had been like a grandfather to R. Anxiety, stress, fear & tragedy...what else was going to go wrong today?????

I met A at our appointment. We didnt have to wait more than 2 mins - reassuring sign.
She was lovely, validating, human & all up - i think it was a great appointment....i think...The summary:

Of all of her recurring miscarriage clients -50% are unexplained -we are in that grp, most of those women still carry to term. According to her-we are in a 'good odds' group. Weird i know-dont ask me what bad odds is...oh thats right, bad odds is those couples who have reasons found that are bad -like translocation problems for instance. The fact ive had 4 pregnancies, is according to her - good odds for carrying to term - it tells her my body does get pregnant & implant quite easily. She actually said maybe my body isnt that good at filtering out the embryos with bad chromosomes ie: im getting pregnant too often as opposed to being more selective & only getting pregnant when the chromosomes are good. I told her what i truly believed-that my eggs are good, my embryos are good etc but she said - in almost all miscarriages -its the embryos -either the chromosomes, the genes or the mitochondria ie: the energy within the embryo. So she thinks what may be happening is -im getting pregnant because the placenta part of the embryo is happily implanting but perhaps the baby part of the embryo isnt continuing. She went thru all our history, our tests, & said we can redo some tests & order some remote new ones but our usual RE has done almost all. She understood my need to stop having miscarriages & research my situation & validated all ive done. She commended my level of research at one stage which felt good actually. Our usual RE gets the shits when im questioning him about all ive researched but she didnt. I asked about a myriad of treatments Id read about & she went thru each one & explained that they were a furfy or had been ruled out by the FDA or told me about the studies where they had actually been disproven or blah blah blah.....i did feel though, heard & understood. She suggested we think about PGD - pre genetic diagnoses. Its expensive but she explained since i make quite a good no of embryos, it would be worth considering doing a biopsy & testing their chromosomes. they can only test 7 out of 23 chromosomes but they are the most common chromosomal probs. then we would only implant the good embryos. at least we would know the embryos are probably chromosomally good. maybe this would reduce unnecessary miscarriages. though im leaning towards doing it (anythings better than more miscarriages) im scared about doing it too as...what happens if i keep miscarrying? then, is it me?
& we've already got 5 embryos in the freezer - that havent been pgd'ed.

She did say what our RE has said...that the pattern i most follow so far...is a recurrying miscarrier who is started on clexane & perhaps has a few more but then carries to term.....so i suppose i should be feeling positive & optimistic...but its so hard to buy that....its not that i have a vested interest in being negative but honestly after 4 miscarriages...when youve done all you could, herbs etc, diet etc...& youre not that old yet....then, i cant buy her optimism -i feel my doom & fear still. the only pattern i know is, we keep miscarrying - that is all i know. its easier to believe that the drs dont know everything about miscarriage yet & clearly they cant work out why i keep miscarrying & its obvously something they cant test for yet.

All in all, our usual RE didnt say anything different to what new RE said today but their styles are different; shes a woman for starters, she stylistically didnt mind the banter of interruptions & my many questions, she didnt mind my research with dr google & my neuroticsm & anxiety. she didnt mind the tearyness & the swearing. she wasnt silent on the other end.

After we left A & I talked about whether we shoulds tay with our old RE & we decided too for now. He has done the (almost always) right thing by us. He has the highest success rate there. & in a way now i have the best of both worlds. New RE said i can email or call her whenever i want to ask her anything which i cant do to old RE...so for now i think we stick with him but access her when the need arises.

She also said she cant see any reason why we wont get pregnant naturally. We werent going to try this month as were doing the endometiral biopsy but she said we can & we'l just do a preg test before the biopsy. I feel quite strange about trying naturally again....for starters this month ive been eating trash & not chinese herbing properly & not taking everything i normally take to assist the process....but A seems to think all the more reason to try naturally. ....& were going away so it will be a nice relaxedintimate w'end at least....anyway..we'll see.....

So, it was good i guess...or rather, it wasnt bad....who knows.....she doesnt know whats ahead, no one does, but for now i guess we are still on this course of trying to get pregnant & maintain it...& so we keep huddled in our bomb shelter & we lay low & conserve energy in anticpation for the next trauma or anxiety.....

two more sleeps & we head off to the blue mountains for the w'end...i know our escape will come & go so fast but i cant wait.

28 Comments:

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So there is a glimmer of hope in your writing after all. :)

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Anonymous Nikole said...

How frightening to hear of the nurse who was assaulted! I hope she is okay. And on top of other assaults, plus your own ordeals with being assaulted and robbed--wow! I hope that whole string of misfortune is over for you.

The thyroid antibody and TSH levels are interesting. It was my understanding that these were very linked to pregnancy, but I don't know too much about it. I hope the doctors give you guidance on this that you feel comfortable with. I know how it is to cling to the one thing that might make sense of all of this mess! What a strange world we're in when having something wrong becomes good news simply because it provides us with a possible explanation for what we've been through, and gives us hope that the problem can be fixed.

The other RE you saw sounds wonderful all around, and I'm glad you had that experience.

I'm so sorry about R's great uncle.

I hope you have a wonderful trip this weekend.

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