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Saturday 26 October 2013

Fragmin frenzy (all for nothing in the end)

This story has a very happy ending, thank the gods, but for a while there on Thursday and Friday, it was panic-induced, ugly crying central over here again. It all started on Thursday afternoon, when I was finally able to track down some now moot blood work results. (For the record, all looked well; I would have been able to carry on with IVF at our original clinic. Of course, I'm doubly fortunate that as [amazing, magical, can-still-hardly-believe-it-myself] events transpired, we didn't need to go down that road.) I got my results and I hung up.

Five minutes later, my phone rang again: Hi, I've just seen a note in your chart and it looks like Dr. M (the RE we'd been seeing at the subfertility clinic) would like you to go on Fragmin. Can you come in tomorrow so we can show you how to do the injections at home?

There was more about how the doctors had discussed it and it was quite commonplace and it was just a precaution and not to worry and...(I'm not worried about taking the meds, you twit, I am worried that my failure to do so for more than four crucial weeks at the beginning of pregnancy might have killed my baby!!). Truth be told, I didn't really absorb anything further at this point, as my mind was already racing with the tragic inevitablity I was sure we were being led toward. That, and it took all the strength I could muster not to verbally assault the woman on the other end of the line, with her cavalier tone, who seemed to be treating the care of my hard-fought-for unborn child as a kind of afterthought, oblivious as to why such news might make someone in my situation anxious.

Now for those who don't know, Fragmin (or heparin solution) is commonly prescribed for patients with a history of recurrent miscarriage, but we'd reviewed my repeat bloodwork again and again, and since I don't carry the MTHFR mutation, and because of my cancer history and the risk that blood thinners pose to my already vulnerable platelet counts, it was decided there was really no need in my case. I spoke about it with Dr. B (the MFM) during that first, nervous terrified telephone consult.

If you know anything about the MTHFR mutation and its treatment though, you'll know that treatment with heparin is indicated as beneficial to preserve pregnancy at the earliest possible stage, from the moment of a positive pregnancy test, through the first trimester. Cue panic, more raw, mucousy wailing and a feeling of dread and certainty that I and my caregivers, through neglect of the most horrible and obvious kind, had surely killed my baby. <And then I got up, left for work, and had to sit through and pretend to care even a smidgen about a looong meeting on the changes to asylum law which was little more than white noise> I don't know why exactly this particular news threw me so badly - I suppose any such forgotten 'detail', sprung on me so thoughtlessly, probably would have - but for those hours, I was convinced I was once more carrying a dead baby in my useless womb.

So off we went yesterday afternoon, and I won't bore you with the agonizing details, but suffice it to say that several screamy, demanding phone calls back to the clinic, in which I insisted on having our next u/s moved up from next week so that we could see the damage, resulted in a long meeting with Dr B, a reprimand to the nurse who handled the phone call, and best of all <drum roll please> another peek at our little seedling, very much alive and thriving and measuring ahead now at 8 weeks 3 days, having transformed from adorable grey blob to unmistakably human: giant adorable head, arm and leg buds all present and accounted for. And all 1.9 cm beautiful to behold. We found a strong heartbeat immediately with the abdominal u/s (the transvag invader having weilded its last).

I won't be taking the Fragmin, as originally agreed. Dr. B reviewed all my files, and still feels that it's not warranted in this case, especially as (music to my ears) my 'pregnancy seems to be progressing beautifully and you have a beautiful, healthy baby in there'. I trust him. The RE who put that note on my file (truly it seems as an afterthought) apparently makes a habit of that protocol, and I am suspicious of any approach to treatment that deals with patients by rote, irrespective of their individuals needs and histories. Dr. B kindly but firmly encouraged me to relax and enjoy as much of this as I possibly can, and it's medical advice I'll certainly (try to) take to heart. He ordered the scan I had demanded, just as reassurance: he is the first doctor we have dealt with who understands that when he is dealing with patients who have our reproductive history, it's as much about treating the parents and their wounded nerves as it is about caring for their baby. 'We understand that this is not just about the common cold, and you're entrusting your hopes for the future with us'. Melt. I wanted to hug him just as much as I wanted to strangle the RE and his stupid nurse for freaking us out in the first place.

But as promised - and despite unhealthy levels of adrenalin and cortisol having doubtless being released in the interim - a happy ending. Which just leaves me to make introductions.

World, meet little seedling. Little seedling, mee...well, I guess you don't need to worry about any of that right now. Plenty of time for all those introductions soon enough. Today (again) just joy and relief.



38 comments:

  1. Ahhhh, so frustrated that they put you through that panic. I'm so glad that seedling looks good and is thriving though!!!! Fantastic news!

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    1. Yes, we were certainly delighted (and relieved) with that outcome of the appointment. I'm getting a bit more comfortable each week, I think. And I'm so hopeful for you too! Really excited at your news!

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  2. I'm sorry you were put through all that stress over what turned out to be nothing. At least they partly made up for it by giving you another peek at your precious seedling!

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    1. That more than made up for it! Each and every peek is a precious gift (even if I'd rather do without the drama).

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  3. Sounds like a lot if stress! That is one very cute seedling!

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  4. Aaaaaand breath. I'm pretty sure the adrenaline and cortisol have minimal effects...Don't add inadvertent release of those into your blood add to your worries! Remember, we grew babies in the wilds where we must have been stressed and scared on a near daily basis.
    I want to punch the woman who freaked you out. I'm so glad the seedling is looking happy in there xxx

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    1. I think if that conversation had been in person, someone would have had to restrain me. The nurse got lucky this time though! Thanks for cheering me on Nomi, I know you get it!

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  5. Whew! Good thing you asked the questions and were able to do without the Fragmin, but I'm sorry that you've had to work so hard to advocate for yourself.

    Congrats on "graduating" to the abdominal u/s. And hello there, little Seedling! :)

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    1. You know, it's moments like that when I am actually glad I'm such a neurotic, pushy control freak...but you're right, you have to be your own advocate in these circumstances. Luckily, it was all worth it once we got to see our little seedling growing and doing so well :)

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  6. Oh that is just infuriating. It makes me angry that the doctor made a prescription by pure protocol, and it makes me angry that you have to go through even more worries with this pregnancy.

    I'm so glad to hear that everything is ok right now!

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    1. I think it's disgraceful actually how many doctors work on auto-pilot like that. I'm just glad that we managed to bypass his 'advice' and get the more personal, understanding care we need. Thanks for your wishes!

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  7. Wonderful news, Sadie! I'm so sorry about all the stress, but thank goodness it all turned out well. Your little seedling is just GORGEOUS :D

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    1. Thank you Annie, we couldn't agree more :) As for the stress...this kid, at least, seems to be resilient!

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  8. Oh Sadie! What a horrible experience. I'm so glad you pushed for the ultrasound and that your little one is fine.

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    1. Thanks Lisa. Not gonna lie, it was terrifying there for a while, but the u/s almost made up for all that. I hope you're hanging in there too, I know you've got a big move coming up!

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  9. Dr B. sounds great. I am so glad to hear your pregnancy is "going beautifully" and that seedling is growing oh so well. Hugs.

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    1. It was all so reassuring! I'm feeling a lot more hopeful since that appointment (even if that doesn't stop me from counting the hours until our next u/s...) Hugs back to you!

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  10. What a gorgeous sight!! You made my day with your u/s. I'm so glad you finally received some compassion from an RE.

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    1. That level of compassion makes all the difference. And yes, we think it's a gorgeous sight too, thanks for saying so :) I can't wait for you to have your own moment for introductions. So excited for you!

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  11. My heart is filling up for you with this picture, Sandie. What a lovely little seedling.
    (And as for that thoughtless RE . . . whew. I am glad that was straightened out. Thank goodness for good doctors who can see beyond the chart.)

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    1. Thank you so much for sharing in our happiness Catherine. I know you've got so much going on both physically and emotionally, and I'm touched that you take the time to stop by. I am sending so very many positive, healthy thoughts your way. I just know you're gonna beat this and live to enjoy the presence of many delightful children in your life :) You are truly an inspiration!

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  12. oh I am so so so happy for you!! What a beautiful little seedling you have there. I'm sorry you had to go through that stress, but glad everything worked out in the end.

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    1. Me too, me SO too. And thanks, we think it's adorable. I bet your little one is as beautiful as its parents too! So excited we're on a similar timeline :)

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  13. Cute photo! Also, the positive nature of this post made me feel better for tomorrow.

    I'm taking Lovenox (blood thinners) despite the fact that all my clotting tests were normal. It is a little weird, because I pretty much don't need it, and I know that, but I'm crazy paranoid and willing to try anything. Here's the difference, though: if we had conceived on our "break" and never done this third round of IVF, I wouldn't be on it. I'm pretty confident of that fact. So, like you, I'd be trying to just live and let live if it was a natural pregnancy. Don't feel badly about that! So far everything is going perfectly for you, and your body knows what to do. As I take my giant stack of pills every morning, get a shot in the stomach at night and... ahem... insert my lovely suppositories before bed, I often wonder, "How much of this is REALLY necessary?" Who knows? Probably none of it.

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    1. Aside from the gluten thing, I'm feeling really confident that my body is doing all it should right now, (and the very strong symptoms are helping in that department too). Still, I'm glad to have had ALL the monitoring prior to this, because we know that my progesterone levels are just naturally through the roof and I have no clotting mutation issues. If we didn't know that stuff, I'd have worried and wanted the Lovenox/Fragmin and progesterone suppositories too. In my case it's a bit different anyway, because of my medical history the risk of pre-term bleeding is as high as any clotting problems, so without the diagnosis it just doesn't make sense.

      Anyway, I'm so glad I provided you with some comfort going into your Big Day. And so delighted with your news! One day at a time my friend.

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  14. Sadie, I've nominated you for a Sunshine Award. :) Details are here: http://there-is-a-crack-in-everything.blogspot.com/2013/10/sunshine-award.html

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    1. Thanks Hope, I'll stop by to check it out soon!

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  15. Oh look at that little bean! So very thrilled for you.

    But man, what a dreadful worry you were put through, so glad it is all worked out and was nothing in the end.

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    1. So so good that it was nothing in the end, but it was hella scary for those 24 hrs. Seeing the little seedling was enough to drive that all away though :)

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  16. What a precious little seedling! So happy to hear the ultrasound went so well.

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  17. Hello Seedling! So fun when you can start to see the gummy-bear appendages, huh? Sorry you went through so much stress and frustration with the clinic, but it sounds like your doctor really understands you and is providing you with good, individualized care. Take heart - all is going well right now!

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    1. I was so bouyed by that appointment, both because of the doctor's attitude and understand, and even moreso having seen that little gummy-bear. That's a perfectly apt description!

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  18. So glad that everything worked out, but I hate, hate, hate when you get all up in arms over something (rightfully so), just to have it mean nothing. Blech.

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    1. Thanks Brianna! As awful as it was to have all that anxiety, I'm so so glad it meant nothing in the end!

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  19. So relieved that everything is okay!!! I have so many good thoughts about this pregnancy... I'm so sure that this baby is going to make it home <3

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    1. Even though none of us can predict the future, it feels so comforting just to know that there are others out there rooting for this little one, and keeping the faith that this time, it'll make it home healthy and alive. Thank you Catherine, you're doing more than you can know.

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