High Risk

(This post is in no way hinting that I'm pregnant.  I'm not.  I'm just trying to find the best doctors and facilities before I get pregnant.)

This has been a LONG weekend, but as promised, here is an update from my new doctor!

The facility is amazing!  Everything is brand new and part of the building is actually still being finished.  They have free valet parking and security guards on site to help in any way needed.  They even directed me to where the office I needed to get to was.

As I entered the office, I felt peaceful.  It was really beautiful and there were at least four preggo women sitting in the waiting area.  That was actually reassuring.  I listened as the nurses would call back mother after mother and greet them by name at the door.  Ask them how they were, compliment their maternity clothing, ask about their other kids or husband.  It was nice.  But as they exchanged pleasantries, I wondered what their stories were.  I mean, there was a reason that each and every one of us were in that room together.  In the waiting room of a High Risk OB.

I noticed that after about seven women got called back that we hadn't noticed any of them coming out and I began to think that we were going to be there a while.  Just then, the door came open and they called me by name.  My greeting was different.  I was the only on there obviously NOT pregnant and new to the facility, so they kind of tiptoed around the pleasantries until we were in a semi-private location to take my weight and blood pressure (both were fine).

The nurse asked me a few basic questions about both of my pregnancies and asked about and birth defects in my family.  Her eyes got big when I boasted about my 8 lb 14 1/2 oz son who was born healthy at 39 weeks and she lost eye contact when I mentioned how different it was to hold my 28 week, 1 lb 11 oz daughter.  Then, she walked us to the consultation room where I saw that amazing photo and things got more personal.  She asked lots of questions, but had obviously read through the forms I filled out before my arrival.  She talked about my extreme swelling and weight gain and any other odd symptoms I had.  Then she said the doctor would be right in.
Immediately when he came in the room I knew Dr. BC would be the "one".  He greeted us while a smile and a handshake and got right to business.  I had two pages of questions to ask him, but decided a lot of the Lovenox questions could wait until I actually was ready to use the blood thinner.  So here, to the best of my ability, is a brief summary of what we decided.

*More than likely, I also suffered from pre-eclampsia that sat in between my 24 and 28 week Dr. visit (that is why it went un-noticed).

*I will take aspirin until around 18 weeks of all subsequent pregnancies and at that time add Lovenox blood thinners to the Rx.

*I will also need 1mg folate in addition to regular prenatal vitamins to counter the MTHFR.  Since I am heterozygous for the C677T variation, he did not think I am in need of extra B-6 or B-12.

*Dr C (who is my regular OB and only about 45 minutes from home) will see me every 2 weeks from the very begininng of subsequent pregnancies and at around 22 weeks I will see Dr C. one week and Dr BC (High Risk OB 2 hours away) the next week.  So I will see some one every week.  At around 30 weeks, I will see Dr C once a week and Dr BC once a week (for example: Dr C at 30 weeks and Dr BC at 30 1/2 weeks, then back to Dr C at 31 weeks and Dr BC at 31 1/2 weeks).  At this time, I will probably start having non-stress test and fetal monitoring at every visit. 

*Dr BC will do ultrasounds to monitor blood flow and if at anytime past 24 weeks he detects a clot, we will be monitored and delivered soon there after.

*If I reach 37 weeks with no signs of labor, clotting, and/or fetal distress, I will stop the blood thinners, an amnio will be done (to check fetal lung development) and if the baby's lungs look ready, I will deliver then.

*He said I could call anytime with questions and I feel very sure he is very proactive and hands-on.

So, over all, great news.  I know that there will be lots of driving near the end of future pregnancies, but it will all be worth it and I will have the peace of mind of being monitored very closely.

I just realized that while I am gushing over this new doc, I don't think I have ever blogged about my other experience with a perinatal specialist...

Ugh.  To summarize...back in October, just 7 weeks after my daughter was stillborn, Dr. O told me I would never know what happened to her because I chose not to have an autopsy.  He told me that, "If what I was telling him is true..." my son should be dead and I will probably experience this again.  He treated me like I was lying and told me that he would only see me 3 times in future pregnancies and never before 12 weeks because he didn't consider anything before 12 weeks a loss and basically didn't want to waste his time.

So after having something to compare the new Doc to, you can see why I'm so excited to be listened to and treated so compassionately! 

Now I know that when the time is right and God does bless us with another baby, I will have access to the best care available and two great Christian doctors.  I am so thankful to find both Dr C and Dr BC.

A New Diagnosis

On Good Friday I had a busy day planned.  It was seven months to the day that Shyla had been delivered.  She had been gone as long as I carried her.  But I was in a surprisingly good mood.  I had an meeting scheduled with a reporter to write our story for a feature in the Common.weath Jour.nal and then I had a follow up appointment with my regular OB.

The interview with the reporter went well.  I was able to share our story and what we are doing with th
March of Dimes.  I shared some photos with her and had a good feeling about the article. 

The appointment I had with the OB was to just check up on me and see how I am healing.  We discussed the Perinatal specialist that I had seen in October and that I really wished not to see him again.  He had several comments that were almost accusatory and very harsh words for me because I had chosen not to have an autopsy performed after Shyla's birth.   I now have an appoinment with a different specialist next month! Can I just say I {heart} my OB.

While the Dr. was talking about some things he mentioned something I had never heard before about my medical diagnosis.  MTHFR.  As a friend of mine said,"It almost looks obscene!"  So apparently, I am positive for it in addition to FVL.  I'm heterozygous for the gene and my Dr. showed me my chart where it said in nice fine print, "One copy of the gene does not increase the likelihood..."  So now we are just waiting to see the Specialist in May and going from there.

I was actually rather disheartened after I left.  After getting the new diagnosis, I asked him if he thought, medically, it was ok for us to start trying to get pregnant again.  The short answer, was "no".  My body needs more time to heal.  I was ok at the time, but on the 45 minute drive home, I cried and prayed and cried some more.  I feel like both my husband and I are as close to emotionally ready as we will ever be and just really looking forward to being pregnant again.

So moral of the story, God's timing is always best and we will know when we know about how to best take the next steps.

...And then I smiled.

Today is the 2nd! 
Shyla's would have been one month today, so after a relaxing morning at home, we stopped at the cemetary.  As soon as we pulled up to the back gate of the cemetary Ethan said, "See Shyla?" Ben and I looked at each other and then to the carseat where Ethan sat.
"Did you tell him where we were going?" I asked Ben.
"No, did you?"
I just smiled, we both know we didn't tell him. He just knew. And as we walked to her small grave, Ethan almost running, he said, "Happy Birthday Shyla!"  God knows just how to comfort us doesn't He?  If ever there has been a time when we recognize how close He is to the brokenhearted is has been through the observations and comments made by our son over the past month.  We had mentioned to him early in the morning that today was Shyla's 1 month birthday, mainly because he just loves any reason to sing the birthday song, but I never imagined he would really remember or understand what we were doing today.

Her plot looks so small.  Someone had brought some pink and white flowers and placed them by her marker.  We brought a small bronze dragonfly garden decoration and placed it there (I will explain the signifigance of the dragonfly later) and after a few moments, we just looked at each other and knew it was time to go.  We turned to make our way back to the van, but when Ethan realized we were going to leave, he turned to run back saying, "No, see Shyla...see Shyla!"  He didn't want to leave.  He tried running back to her grave, but Ben picked him up and hugged him and we walked on to the van.  He was ok after that, but obviously he was not as ready to go as we were. 

We dropped him off with his Nana and made our way to Somerset for my 4 week post partum check-up.  We must have been anxious because we were there a hour before our appointment so we decided to go to the Christian Bookstore and look around.  We found a book called, I'll Hold You In Heaven, by Jack Hayford and decided to buy it.  It is referenced several times in a devotion we have, so I thought it would be good to read.  While I was browsing, I also saw a Bible case that had Phil. 4:13 stitched on the front with Ladybugs and Dragonflies scattered around the scripture.  That was my God wink today.  If any of you know me, you know that ladybugs are kind of my symbol.  I have collected them since I was young and anytime a close friend sees one, they automatically think of me.  Well, dragonflies are Shyla's bug.  But that is another post entirely.  On to the appointment.

It was odd being back in the office.  The last time I was there was the day before the surgery to deliver Shyla.  I saw on the ultrasound screen, lying there, motionless and thought that I may never smile again.  But I have.  I smiled today in that same office. 

The Dr. said I was healing beautifully.  Everything looked great.  Then he brought out all the tests results.  He listed each one.  Which after a minute just began to sound like, "Blah blah blah...Negative....Blah blah blah...Negative..."  I had been negative for any medical cause for my baby to not be here today...until...

"You tested positive as a carrier for Factor V (five) Leiden."

Positive...wait...you found a cause?  I had become fully prepared to accept the fact that I would never know a medical reason why Shyla died.  Ben and I prayed before we went into the office today that whatever would bring Him glory is what we wanted.  Knowing or not.

The doctor went on to explain that Factor V is a genetic blood clotting disorder that is often found for the first time during pregnancy.  He explained that usually when stillbirths occur and the mother is positive for Factor V, a blood clot probably formed in the placenta or umbilical cord and usually a taking a bloodthinner in a subsequent pregnancy could amost guarantee having a successful outcome to pregnancy.  He also said that having this clotting disorder, if not detected in pregnancy, is usually not found until it causes a major problem such as stroke or pulmonary embolism (where a clot travels to the lungs or the right side of the heart).  Thats when it hit me...

Shyla could have just saved my life...AND...she saved the life of her future sibling(s)!

Wow.  Talk about being blessed by Shyla Joy. 

And then I smiled.





To read more about Factor V Leiden from the Mayo Clinic's website, click here.