Sunday, June 10, 2012

The Follow-up Appointment

Josh and I went to see our doctor at U of M as a follow-up to my miscarriage in April.  Lately, because I always have to be moving forward, I have been reading and reading and reading about miscarriage so that I could 'arm' myself with more knowledge to ask better questions and maybe seek out more testing or something

I did some research on the Internet, but also read two books, which were wonderful by the way...
  • Preventing Miscarriage: The Good News by Dr. Johnathan Scher
  • To Full Term: A Mother's Triumph over Miscarrige by Darci Klein
I took lots of notes and had 2.5 pages of questions and topics to talk with my doctor about. One of the main things I learned, besides about a slew of hormonal, immune, and biological abnormalities, was that there isn't much government medical funding put towards miscarriage research so it is a policy that people don't do deeper testing until a person has suffered three miscarriages in a row without having a successful pregnancy in between or anything.  This news fed fuel to my fire and I found myself angry before even going to the appointment expecting them to tell me they wouldn't give me any more tests until I lost another child.

While at the appointment, I was refreshed again as to why I LOVE my doctors in Ann Arbor.  First, we met with the doctor we see most often, even though he's not technically my doctor.  We call him "Tall Fellow" because he's extremely tall and happens to be a fellow (residency typeish thing).  We spent about 45 minutes with him going over a slew of things. 

The first piece we went over was our baby's pathology report.  Our baby had a trisomy (A condition in which an extra copy of a chromosome is present in the cell nuclei, causing developmental abnormalities).  So our baby had an extra '16' chromosome.  At my present age, I was told, each pregnancy has a 1 in 400 chance of this happening and I was unlucky.  The good news is that this is the most common reason for a miscarriage that they see; that helps us to be reassured that there isn't anything chromosomally wrong with Josh or I.  It is also helpful to know the cause was random and not likely to happen again and that it was nothing about my body that did not help grow a healthy baby. 

We also found out our baby would've been a girl.  Josh and I did NOT want to know this, but the paperwork on the pathology report showed that our baby had two X chromosomes instead of an X,Y making it a girl.  However, like Tall Fellow explained, this chromosome abnormality our baby had is not and would never be compatible with human life.  My baby would've never grown female parts or wouldn't have grown body parts at all with this abnormality.  I happened to research that more 'girl' babies are miscarried than 'boy' babies.  Tall Fellow had never heard of that before so maybe I taught him something new :)

He was extremely patient letting me ramble on about all my questions and answered them carefully, detailed, and easily for us to understand.  As expected, I am not getting tested further for other defects or abnormalities just yet.  I did come out guns blazin at first, but then Tall Fellow told me something that made so much sense.  He said that maybe I did have some kind of auto-immune disorder or a clotting disorder or something like that.  However, nothing like that showed up on the pathology report and we have no idea what happened my first miscarriage because no tissue got tested.  If they gave me medicine to help the clotting disorder the next time I got pregnant, let's say, that medicine has its own risks.  In fact, a medicine to fight a clotting disorder usually ups your chance for a miscarriage.  So he doesn't want to put me on medicine for something that may not even interfere with a pregnancy and then add more risks and stress to my life as a pregnant mommy-to-be.  So for now, nothing is going to change with my care.  I'm at peace with this decision.

Stress became the other topic of conversation.  Even though my prolactin levels have always looked normal, I read in one of my books that if you are stressed, your prolactin can get higher and put your baby at risk.  Tall Fellow looked at Josh and asked him, "Okay, how do you want me to answer this question for her?"  We laughed and then he went on to explain that stress is a very difficult thing for them to combat.  He asked me if I was seeing anyone like a counselor or therapist and I told him I was.  We also talked briefly about my job, as he knows that it is stressful.  Josh answered back that even if I didn't have any stress in my life that I was "seek it out somewhere; that's just the kind if person she is."  He is so right :) 

Tall Fellow then asked me what I do to relieve stress and I gave him a few items: eating :), watching TV, reading, spending time with people I love, running, etc.  He then said to me that usually when we try to get rid or stress or change something about your daily life that helps you combat stress (like if he told me to stop running because maybe that's why I wasn't ovulating on my own, for example), it usually makes people like me even more stressed out.  Ding Ding Ding, I thought.  So usually, they leave the stress alone and make sure you have plenty of ways to make yourself feel better.  He also said that if I was not doing anything about the fact that we weren't pregnant yet, I would probably be most stressed out about that, but I am doing something about it so Ann Arbor has taken some of that big stress away from me.  He makes so much sense :)

Finally, we spent some time with my real doctor who said many of the same things.  He still remains "incredibly optimistic" that we will get pregnant and go on to have lots of babies.  All in all, we were there for about an hour and they made me feel completely better about what was going on.  They were also fully supportive of our trip to Europe and asked us a lot of questions about it and were willing to try and get another cycle in, as soon as my period started, before we left or go back at it as soon as we returned from Europe. 

As horrible of a situation this all has been, I cannot be more thankful for doctors who show they care, never give up, and will entertain two Type A personalities with all their questions and concerns for over an hour.  Our decision to start going through U of M for my care was the absolute right decision.  

I hope this teaches, heals, and connects...

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