I feel like this is an ongoing column. "Dear Dr. A."
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Dr. A:
Thanks. I appreciate you taking the time to respond. And I really appreciate your kindness. Just so you know...I'm not really trying to make a decision at this point...just gathering information. I am, by nature, a researcher.
I am a bit confused how a blood thinner would have anything to do with a uterine infection. I mean, I understand that infection can cause inflammation which can, in turn, prevent oxygen exchange with the fetus. But what about the infection itself? I'd really like to know what's going on in my own body...and then worry about how it might affect a pregnancy. I read about viral infections and they all sound pretty nasty. Is there an infection lurking about in my uterus just waiting to pounce? (sorry...morbid humor gets me through the days some days). I mean, do I have something I should worry about? Or is it "just" chronic inflammation without an infection? (which I personally would feel better AND worse about). Is this something that could affect me in other ways besides just the obvious reproductive issues?
Also, you mentioned that Dr. E. suggested a test. What test? For what? I'm curious what he thinks. What exactly are we testing for (in layman's terms, please).
I have read a lot online about clotting disorders and viral and bacterial infections...and I really feel the need to get to the bottom of my issues before taking that leap of faith again. And since I'm not getting any younger (I will jump into the "advanced maternal age" category come February), I really want to do what I can do right now. That way, when I AM ready to make a decision, I don't have to start from the beginning and waste valuable time. Surely you can understand that?
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Telephone call response:
The gist is that I have the most honest and kind doctor on the planet. He doesn't know. And the peri doesn't know. Here are the high points...
The placental pathology would lean toward an indication of a viral infection. But none of the other signs of viral infection were noted on the ultrasound or in my presentation. Also, all my bloodwork came back negative. There is a possibility that that could change, so I will get some re-testing done to test for antibodies to certain viruses...particularly parvovirus (the human kind...not the dog kind). I have read about this and asked if I could be predisposed to have it because I have a child in daycare...could he have brought it home? It's possible, but it's also possible to pick it up at the grocery store or anywhere else...from anyone else. Unfortunately, the test will indicate whether I've had it in the past, but will not indicate WHEN I had it in the past.
Given the lack of other indicators, there is a strong possibility that it was not an infection. Therefore we're going to look into blood clotting disorders. Again...more blood tests. Either way, if we decide to try again we will plan on prophylactic doses of blood thinner. If the test shows a coagulation disorder, we will do full treatment doses. There is no way to tell if this will work. So that's what I'm sort of stuck on. It can't hurt...but nobody actually knows if it will really help.
So that's that. I told him I needed time to digest this information. I will call next week and set up the blood tests, since they take time to do. That way we don't have to waste time waiting for test results if we make the decision to try again. It might be nice to know what's wrong with me.
6 comments:
Kate,
After Travis was born, were you tested for CMV (cytomegalovirus)? After my son was stillborn I tested for high IGM and IGG(?) titers indicating I recently had the virus, but Theron did not test +. CMV can cause placenta failure. My doctors were not willing to say that was the cause for our s/b because it wasn't present in the placenta, but I believe it was. Anyway, it's similar to Parvovirus, easily transmitted esp. through preschool children (my older son had just started ps during my pg) and really doctors do not test for it because it is so common that most people have been exposed to it. Of course, it is most dangerous if first first aquired while pg. The good news is that it wouldn't be dangerous in a sub pg.
I agree that you have a great doctor. I hope you can find some answers since I know that the unknown is awful.
I usually just lurk (you can thank MB for sending me over here), but I have to say you have some wonderful doctors!
And I hope you find Rosie. We lost our foster dog and I searched for her forever (unsuccessfully). It was hard. But in searching for Susie, we found Molly, who now calls our house home.
Catherine-
I'm homozygous MTHFR and Protien S deficient. Did they test for these with you (yet)? I've done a fair amount of research on these and Factor V ifyou're interested. My peri says this is what caused our miscarriages and the loss of Audrey. My OB disagrees, but I tend to lean with the peri....
That's a lot to think about. And tests. For an answer...maybe. Blrgh what a crap shoot!
You do have the cream of the crop as far as doctors go. It can't be easy trying to weigh all of these rather speculative factors. You're doing a great job of informing yourself, though. You might want to consider a career in medical research!
Catherine,
I can really relate to this as my plan of action if I ever get pg again is blood thinners without any guarantee it will work. I was diagnosed with the clotting disorder Antiphospholipid Antibody Syndrom but had confusing bloodwork results. My Ob was really looking for + Lupus which she said was more likely. Apparently Lupus is the cause of many stillbirths. Dr A sounds amazing. He's a keeper.
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