I am NOT a Drama Queen

Well, I am officially off of bed rest for now and I’ve made it to 13 weeks and that is another reason to say “so far, so good.”  Thank you all for your well wishes.  I have had no other spotting or bleeding since the first incident and am taking it very easy from now on.  I went to my ObDoc for a routine appointment on Thursday.  I was weighed (hard to accept that gaining a pound in a couple of week is a “good thing”), we got culture samples and my ObDoc checked my uterus. We were able to hear two separate heartbeats at 149 and 155 bpm on the doppler gizmo so that gave me a little bit of breathing room.

Before I get to the next part of my tale, I just wanted to state this for the record.

I am NOT a drama queen.

I hate drama, I don’t want drama.  Keeping drama to the movies I watch is the only place I want that shit in my life.  I don’t thrive on it.  I am not an attention hog.  I want to be normal and boring and typical when it comes to this stuff.  I’m not a person who goes out of their way to create tension or strife.  Hell, I’m even a happy drunk…BTW…“I love you man.”  I like zany, I like snarky, I like laughing ‘til my face hurts.  I like good food and drink, fun conversation and a night of playing board games. 

Imagine my face then when three days ago my ObDoc’s office calls and lets me know that after my big bleed episode of the prior week (I had 12 vials of blood taken for various tests) it seems that I was tested and have come back positive for a blood clotting disorder, specifically for compound heterozygous MTHFR. 

MoTHerFuckeR.

Here is an awesome blog I found that has a good tutorial.  Here is a good page on Thombophilias from the March of Dimes website.  The ObDoc’s office immediately put me on a prescription for FOLGARD taken twice daily.  Each pill is a mega-dose of folic acid 2.2mg, B-6 25mg, and B-12 1mg.  I have also been put on low-dose aspirin.  Hopefully these things will help.  If you have a MTHFR mutation your body does not absorb folate properly and you are also at greater risk for blood clots affecting you and baby.  MTHFR mutation complications and risks (some mutations are more serious than others) published in scientific papers in peer reviewed journals have been linked to multiple miscarriages (including early 1st, late 1st and 2nd term loss), implantation problems, congenital heart defects, preeclampsia, and clots that affect baby’s placenta, causing growth problems and pre-natal death. 

Great.  Think at 41 you make it to 13 weeks with kiddos looking fine you can perhaps maybe breathe just a little bit easier.  F-You IF Optimist, what do you think?

<Sigh>

I am NOT a drama queen.

Here is what I am.  I AM a bit ticked off that no one found this out earlier so I could have taken better precautions, I mean I was tested for just about everything under the sun between my RE and my myomectomy ObDoc.  I AM grateful for my current ObDoc, a fine and intelligent lady.  I AM happy that even though I have this, it isn’t the most dangerous form of the mutation and can be managed by doctors.  I AM concerned because I have read of ladies losing their babies in the late part of their pregnancies because of clots in the placenta or umbilical cord.  I AM relieved to know that most of those who had tragic losses were untreated for their MTHFR and once they were aware, properly monitored and treated, went on to have healthy babies.  I AM worried because remember me having to take off to Florida to take care of my brother?  That was because of deep vein thrombosis (a blood clot in the leg) leading to a pulmonary embolism.  I AM glad that although my brother had this serious condition, he was a two-pack a day smoker while I have never smoked (he has since quit smoking).  I AM glad that although they found the MTHFR mutation, currently my homocystine levels were normal.  I AM extremely happy that I have made it this far in the pregnancy.  I AM also very glad that the NT scan looked good, so I hope I am doing OK for folate absorption. 

As I said earlier, I found out about MTHFR on Tuesday so both MrBeep and I were spending a lot of time on Dr. Google, NIH and PubMed to find out more, make sure we understand the dangers, etc.  I didn’t want to post until I had a much clearer understanding of my current situation.  I did come up with a list of questions for my ObDoc.  I now have a little red moleskin notebook that I will take notes and write questions so I don’t forget for my doctor’s appointments.  After our routine exam was completed, here were the questions I asked her:

Q:  My brother was just hospitalized for 6 days due to a deep vein thrombosis and subsequent pulmonary embolism. He is 1.5 years older than I am.  He is also 80 lbs overweight and a 2 pack a day smoker.  While my homocystine levels tested normal, does this put me at greater risk? 

A:  (At this information her face dropped a little and her tone became more serious) I want you to call the MFM specialist, get an appointment and let him know this.  I think we are good with the extra Folgard and the baby aspirin, but he may want to put you on lovenox.

Q:  I am curious to know what prompted to you test me for MTHFR?  Was it the big bleeding episode?

A:  Actually, it was because of your chemical pregnancy back in June.  We also tested you for other common clotting disorders including Factor V, Protein C, Protein S, Lupus, etc.  You tested negative for all other clotting factors which is a very good thing.

Q:  Do you think that my big bleeding episode last week was caused by the Total Previa or the MTHFR issue?

A:  Previa.  MTHFR doesn’t normally cause that type of bleeding, even with the clots you had.  Also it is a common thing with a total previa, even in early pregnancy.

Q:  My homocystine levels were normal.  How often will this be tested to make sure there is no increase?  Also, I was not fasting when the blood was taken, are you concerned about this?

A:  We’ve found that these levels rarely change this far into pregnancy.  I’m not concerned about the fasting, studies show no difference.

Q:  I have been reading about people with this condition getting Lovenox.  When is this prescribed versus just extra Folgard and baby aspirin.

A:  Typically it is prescribed if you have had several losses, have had  known clot or thrombosis yourself, or if you have more than one clotting disorder. 

So, my friends.  That was my week.  I have a call into the Maternal-Fetal medical specialists who will consider whether or not I should also receive injections of Lovenox in addition to my current vitamins.  While I don’t like having additional factors to worry about, I am actually really glad we caught this early.  I am very very happy that I found a good team of doctors who are proactive and on the ball.  I get to decorate the house for Christmas tonight with MrBeep, my MIL and FIL.  My ObDoc (I promise to write more about her later) has been able to put me at ease with her great personality, superb knowledge and professionalism.  She did say this to me, “well won’t it be great to have these two kiddos out for Christmas next year?”  I was so happy at that thought I could cry.  I just said, “I hope so.  That would be really wonderful.”