Wednesday 15 June 2016

Rheumatologist Conclusion

I had my follow up appointment with my rheumatologist Dr Andrew Harrison. Based on my list of body complaints (symptoms) and blood results:

+ ANA Speckled (always)
+ Lupus Anticoagulant (when in a flare)
+ PTT
Complement C3C Low
Complement C4 Low

he has diagnosed me with Lupus. So there you go!

He spoke about what we'll do during this pregnancy and is really calm and relaxed about all approaches so I feel very at ease in his care.

This is the short of it:

Plan A: Continue with the aspirin, seems to be working.
Plan B: If baby growth is questionable start daily heparin injections.

Follow up before birth to check blood work, stress dose of steroids during labor an option.
Start hydroxychloroquine after birth to help lupus symptoms.

I am not surprised or upset by the diagnosis, I mean obviously I've always had it so now it just means I'll receive care, rather than having 20 perplexed doctors tell me they can't find anything wrong and basically make me feel crazy.

Happy Days.

Currently CD120 / 105DPO

Tuesday 7 June 2016

So far to go

A few months behind...

The short on updates:

Scan Update #4

Scan number 4 was at 11 weeks exactly and baby was measuring 11 weeks exactly. Miracles do happen <3 Heart still beating, baby rolling around and movements have been intermittently felt since 9w3d.

Scan Update #5

Scan number 5 was at 13 weeks exactly, I didn't get the measurement was too focused on the NT Scan (Nuchal Translucency scan, first trimester combined screening) details. Good nasal bone, fluid measurement at the back of the head was less than 2 mm (0.164 cm). We found out the gender :) our sonographer, Sally Agar from Valley Ultrasound is excellent, her measurements are always spot on (told us our son's weight exactly, 3 days before he was born) and she is very experienced and professional, highly recommend.

Scan Update #6

Scan number 6 was an impromptu scan (14w4d) while we (hubby and I with our MW) were at our OB appointment. I was needing reassurance as after feeling quite a bit of movement from baby for the last 2 weeks and then felt nothing. Cheeky baby had moved, still lot's of room in there to hide. I did only ask to hear the heartbeat on the doppler, but since Dr Cook had a portable scanner (what is the actual name?!) in his office, he offered. Anyway, picture wasn't great, but baby was wriggling around happy enough.

Placenta is growing at the top/back of my uterus. Hoping this will protect my ribs this time around!

Next scan is at 20 weeks exactly. 5.5 weeks from my last scan. The longest wait yet. Thankfully I have been feeling movement again and last night felt movement strong enough to bump my hand. Then will be the next longest wait, 8 weeks; fortnightly scans start at 28 weeks to 38 weeks to monitor growth. Bringing the total number of scans to 13, provided everything goes to plan. (I had 8 with my son, due to spotting, then hemorrhaging, growth scans, fluid checking).

4 weeks until I see you again.

Currently CD112 / 97DPO

Wednesday 27 April 2016

and the Paranoia starts to seep in

Scan Update

Third scan came back with a fetal pole measuring 23mm, 9w. Heart still beating.

I should of been 9w1d, so measuring 1 day behind. Is this the divine intervention I've been hoping for? It seems to good to be true..

Going by that growth I am 9w6d weeks today (instead of 10w).

I was reasonably happy after that scan, a week ago.

Now the paranoia is starting to seep in. I've felt bubbles and pops the last few days, but I felt them in my last pregnancy before baby died. The constant nausea (which is the worst it's been since my first MMC) is starting to wear off during the day and is now only bad at night time. Does that mean my baby has died, or it's just getting better because everything is working as intended.

I desperately want to get the Harmony blood test done, as I wish I had of done it with all my previous pregnancies. It would of given me more closure knowing one way or the other if there was anything to be found in my babies chromosomes. Unfortunately, this test is not yet funded in NZ and costs $675. There is no chance I can afford that. Sometimes I wish I had started one of those give a little or fund me pages a long time ago. My husband is a very private man however, and proud. We are not poor, I guess we are an average working class middle income family, we don't need anything. But we certainly cannot afford anything extra.

Trying to explain why a blood test that cannot essentially change the outcome of anything is such a big deal to me is hard. I do not think anyone who has not experienced multiple loss has the capacity to understand. I'm not even sure my husband understands. The depth of my grief is a bottomless void, nothing will ever fill it, but as many answers that I can gather sure help alleviate the pain.

My next scan is in 7 days.

Currently CD71 / 56DPO

Sunday 17 April 2016

New Years Resolution #2 - Rheumatologist

A few posts back I mentioned I had two New Years resolutions.

The first sorting out my infertility problem after the D&C in April 2015.

The second was to look after my health and see a specialist regarding all my symptoms compiled.

I have for a long time thought something was up with my immune system, but before actively trying to get pregnant never bothered to look into it further. Now with having a son who I want to see grow up and be in his life for as long as I can, it's important to me that I make sure I'm around.

So I googled the best rheumatologists in the Wellington region, emailed both private hospitals that came back with good references and booked myself in with the one who didn't need a GP referral. Self referral is the best thing since sliced bread. Even though that douche GP in December 2015 said he'd refer me if I wrote the referral myself... what's the point if I can just skip out the middle man!

I booked in, sent through all my latest blood test results and a list of body complaints. I saw Dr Andrew Harrison, very professional and lovely Dr. He has a long waiting list, always a good sign. He went over my history, my results and symptoms and evaluated he could draw no conclusion without further testing. He suspects APS/Hughes (I know I already suspect and have blood results for that, but I'd really like a specialist to say one way or the other before I commit myself to that diagnosis) and/or Lupus.

Interesting.

I had more blood tests to check my liver, kidney and other blot clotting/inflammation tests that I haven't previously had done. Still waiting on those results. My follow up appointment is mid-May.

Update on Pregnancy Scans

My second scan came back with a fetal pole measuring 11mm, 7w. Heart still beating.

I should of been 7w4d, so measuring 4 days behind at that point.

Going by that growth I am 8 weeks today (instead of 8w4d).

The next 10 days will be crucial. My babies normally pass away between growth showing of 8w4d and 9w3d.

Currently CD61 / 46DPO

Thursday 31 March 2016

Scan Update

A fetal pole was found and measures 2mm, 5w3d.

I should be 6w1d.

However, in an usual occurrence this scan differs from my other 3 missed miscarriages. Normally at the first scan there is no heartbeat, yet.

There was a heartbeat today.

I am hoping that means this little one is strong and will pull through.

I will schedule a follow up scan for a weeks time.

Also got yesterdays hCG levels back:
6w: 24,538

Laparoscopy and Hysteroscopy

So I had two New Year's resolutions, I will address the first one in this post.

The first goal was to sort out my infertility. I was convinced I was rendered infertile after my D&C in April 2015. I was convinced it was due to scar tissue and that I had Asherman's Syndrome.

I went to a GP, Dr David Heard to ask for a referral to see a specialist. I won't be seeing him again. GP's are excellent at regular health issues, but as soon as you step outside of the norm they seem to dislike seeing outside the square and the fact this is beyond their knowledge. He told me my cycles looked normal (durr, I knew that), he said it looked like I was ovulating (durr, I was certain of it), told me it was normal to miscarry and have D&C's his wife had 3 of them and she was fine (I am not your wife buddy, don't quote stats to me I know the book off by heart), told me it was a waste of money and time but I could do whatever I wanted with my own (I fully intended to, thanks for your input, not). He seemed to find the idea of being infertile impossible if a cycle looked 'normal'.

In the end he said he would refer me to Dr David Cook (OB-GYN) at my expense, and he did.

I however started doing my own research, I cancelled the appointment with Dr Cook and self referred to Dr Andrew Murray FRANZCOG, CREI. Luckily he doesn't require a referral from a GP (thank goodness, and I actually don't understand why some do - if someone wants to spend money going to a specialist, they are going to think good and long about it before they do, it's heavy on the wallet - unless you have insurance).

Dr Murray is a legend in New Zealand for his work in infertility, he specialises in advanced operative laparoscopy. In forums and support groups I've seen him referred to by many names, McDreamy, Silver Fox, Dr Beautiful and Mr McHotty. I think it's safe to say it doesn't matter how 'good looking' you are, you have to be exceptional at your job to get your genetic lottery acknowledged to that level!

After talking to Dr Murray's PA she booked me in super quick and I had an consultation appointment on the 15th of January. This was the best doctor appointment I've had in my life. Dr Murray listened to my husband and I, he took in our whole journey and created a plan of action right away. After I left feeling overwhelmed with confidence in a medical professional finally, I realised I had forgotten a question, I emailed his PA and she responded quickly and put my questions to rest. I cannot praise Dry Murray or his team enough, after even just the initial contact and first appointment.

I was given forms for Day 2 and Day 21 Bloods and booked in for a laparoscopy and hysteroscopy scheduled on the 1st of February.

Day 2 Bloods included:
CBC, Hep B, Hep C, H.I.V, VDRL and TPHA, Rubella, Blood Group, Red Cell Antibodies, Glucose - HbA1C, Thyroid - T.S.H, F.S.H, Oestradiol and Prolactin.

Day 2 bloods all came back normal except for my usual antinuclear antibodies, Positive 1:160 A - homogeneous/speckled and a new abnormal result of showing a low thyroid stimulating hormone. Both of these are borderline and not questionable on their own (that's another story to do with NY's resolution #2).

Day 21 Bloods:
Progesterone. Result on the 10th of March was: 51.0 (this is a good number and shows I ovulated)

The surgery was a great success, short story first, I was right, I was rendered infertile after my D&C 10 months prior to this surgery and I did have scar tissue. But it turns out I had had an infection (hence the pain and thinking I was dying in the first 76 day cycle after the D&C which was falsely diagnosed and passed off as a ovarian cyst). The infection had caused scar tissue to form outside my uterus, interfering with my ovaries, tubes and bowels. Luckily, thankfully, as the scar tissue was all on the outside of my uterus I did NOT have Asherman's as that is classified only as scar tissue within the uterus and is by far harder to treat and repair.

Dr Andrew Murray was able to successfully clean out the scar tissue and put everything back where it belonged (my ovaries and tubes especially as they were stuck in the wrong places).

I also had endometriosis (in two areas, Stage 2 and Stage 3), who knew! Well I've always had bad period pain but for some reason assumed it was never as bad as others.

Surgery Note:
Significant and server adhesions were confirmed. These involved both tubes and ovaries with the ovaries both stuck to the pelvic sidewall. On the right hand side in particular the right tube and ovary were buried under adhesions. On the left hand side the descending colon was also adherent to the tuboovarian complex with adhesions. The adhesions looked to be due to some form of previous infective or inflammatory process.

We were given the all clear to TTC right away, Dr Murray was confident our infertility problem was solved! Four weeks after the surgery we had a follow up appointment where everything was explained in more detail. We left the office under recommendation to come back in 6 months (August 2016). If we were not pregnant by then, IVF and PGS (Pre-Implantation Genetic Screening, an IVF procedure designed to examine your embryos for chromosomal abnormalities - thinking this could help with my recurrent loss issues also) were possibilities for our future. I was confident we would be pregnant before August and left the office ecstatic.

I am currently CD44 / 29DPO
I got my BFP at 10DPO on the 13th of March
EDD 24 November 2016, a spring baby <3

This was the first cycle after the operation with Dr Murray. I ovulated on the 3rd of March, although I am wondering if the egg was not fertilised until the next day with our early morning tryst. So baby could be a day behind.

My bloods are lower than my 'usual', I am hoping it is a combination of being 1 day out and also the placenta not having to fight my blood clotting due to now taking aspirin.

The results so far are:
3w6d: 79
4w1d: 233
5w: 2928

They are still within the normal statistical range:
Early hCG Levels by Week

I have my first scan today, today I will find out if the baby's growth is on track. With my 3 MMC the growth is always up to a week behind. I can handle 1 day, maybe 2. Anymore than that and my hope will be dashed.

Come on universe, let this little baby thrive. Please.

Tuesday 16 February 2016

Miscarriage - What Happens, Part One: Early Miscarriage

Mainly so I don't need to write my experiences over and over again (not that I really mind) or really just for convenience, since I've been asked and seen people ask so many times....

What happens when you miscarry?

What should I expect?

Well, I can only give you my experience and can touch on lightly what I've heard from others.

Uniquely I can also give you an experience of the 3 different methods offered in New Zealand for dealing physically with a missed miscarriage as well, since ... unfortunately I've tried them all!

Let's start with the smallest event physically (however by no means emotionally)...

Early Miscarriage

Early miscarriage is the first face of the bitch that is miscarriage. Some will call it a 'chemical pregnancy', meaning it was only ever seen as a chemical, the hCG pregnancy hormone that turned your pregnancy test positive or that gave a result of over 5 in a blood test, and that you never made it to the ultrasound with something to show.

To me, I class an early miscarriage as being complete before 6 weeks. As in, your little bloom of life passed away and out of your body before or on when you would of been 6 weeks pregnant.

Most people never know they had an early miscarriage, if the person isn't actively trying for a baby they may not be counting the days in their cycle or they may be in denial if their period is late.

For those that are counting though, or for those that for whatever reason take a pregnancy test between weeks 4 to 6 of being pregnant and see those fantastic double lines and then know the heartbreak of early miscarriage well this is how it goes for me:

Personally my body seems to take offence at being pregnant and even more so if it's going to be an early miscarriage. It starts by giving me toothache, headaches, sore throats and the runs (gee thanks body). My miscarriage starts anywhere from 4w3d (a period 3 days late to a novice) to 5w1d . It comes very heavily, way more than usual and in a rush. The cramps are stronger then my normal period and last longer and the bleeding lasts around 2 days longer. My drug of choice is Naprogesic - it works miracles for my pain!

In regards to my cycle post miscarriage, this early on it is unaffected and I ovulate on my usual day.