***Unfortunately, it looks like Manuela's first IVF cycle didn't work out. She's not looking for condolences, but I think it would be nice for people to stop by and offer a kind word or two.***
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So after two months of waiting, I finally saw the hematologist. The appointment was last Friday morning, and when I left the house my biggest concern was beating traffic, not what I would learn from this new doc. I left an hour in advance, because you never know how stuck you're going to get. Thankfully I made it into the city in about 30 min, and even though I drove around Kenmore Square a hundred times (because I'm so pitifully bad at finding my way), I made it. I arrived at the office three minutes ahead of time and in a great mood because of it. I checked in at the desk, chatted briefly with the friendly receptionist, turned around, and headed for the waiting area.
I knew that by going to that office I was no longer in IF land. I was in the hematology/oncology section, and most of the patients were there for cancer or HIV/AIDS. There were only a couple of people in the waiting room. Both women, one wearing a cute little hat with no hair visible underneath, the other with a very close-cropped cut. They both gave me a little nod as if to say, "If you're here you must be sick, and we understand what it's like." That threw me for a loop. I gave a slight nod back (what else could I do?) and took my seat. A few minutes later, another woman in a hat came in, and then a woman with a 10-year-old-ish child. The child was wearing a knit cap, and I couldn't tell from the cute, fragile, androgynous face if it was a boy or a girl. At that point I started to feel quite overwhelmed. I had understood the seriousness of the place, but I wasn't prepared for that scene.
I didn't think my distress was obvious, but apparently it was, because one of the women came over and asked if I was OK. I tried to explain in a hushed tone that I was there because of a miscarriage/clotting issue, and I was feeling rather small for wallowing in self-pity for 2+ years after being confronted with...then a nurse started calling my name. Over and over. I could only finish with "sorry & thank you" before I had to rush off. I'm KICKING myself now for not asking the nurse to wait a minute, so I could exchange details with the woman and follow up with her later. Kicking myself.
Sigh. Anyway, after I was weighed and had my BP taken (which was unsurprisingly a bit high) I got to meet with Hemadoc. For about three minutes. She told me the same thing I'd learned from Doctor Google two months ago. In my last round of tests, my protein S level came back abnormally high, but that doesn't mean much. It's only a problem if you have a deficiency of protein S (an anticoagulant), because that can lead to clotting issues. Having too much protein S, for the most part, indicates nada. She suggested we re-run some tests and take it from there. "OK," I said. "Whatev," I thought.
Sooooooo, I headed up to the lab to have my blood drawn. I submitted my paperwork at the desk, and the receptionist handed me a slip with the number 59 and a note that said my estimated wait was 35-40 minutes. I noticed a digital display on the wall reading #47 when I sat down. After a half an hour it was on number 50. After an hour, 53. People in the waiting area started to look at one another, shrugging and rolling their eyes. The pace was slowing to about 20 minutes between each new number. When it turned to 58, I told the technician it was the lady sleeping in the wheelchair. She had been in front of me in line. Then everyone in the waiting area knew I was next. When the number finally turned to 59, the lady across from me said "It's you, it's you - 59!" I stood up, pumped my arms in the air, and people actually clapped and cheered. "Wow," I thought. "How often do you get that sort of camaraderie amongst strangers in the city?"
I was in and out quick. Eight tubes of blood - wham. bam, thank you, ma'am, and I was on my way. The whole trip had taken five hours from start to finish, and I got home basically back at square one. No real clues as to why I keep losing babies. I did have some nice interactions with some kind-hearted strangers, though. That gave me a bit of a lift. Just call me Blanche Dubois.
OK, so that was a week ago. Five days after the appointment, Hemadoc called me. She said this time all my labs came back normal. Prothrombin mutation: no. Lupus anti-coagulant: normal. Protein S: high range of normal. Good, I guess, but that means we're still in the dark. Hemadoc wondered if we should we go with the treatment anyway? I feel that we probably should, because even though the labs don't support it, there is anecdotal evidence that I might have a clotting problem:
--miscarriage at 12 and half weeks caused by a subchorionic hematoma (a blood clot!)
--miscarriage at 16 and a half weeks likely caused by an infection from amnio, but the pregnancy made it quite far, and I was taking baby aspirin to thin my blood
--miscarriage at 10 weeks, not taking baby aspirin (new nurse practitioner didn't think I needed it until the 2nd trimester) and the sac measured small at the 8 week ultrasound. Possibly not thriving due to clotting issues?
Hemadoc agreed that all three cases brought up the clotting question - they just couldn't come up with the numbers to prove it. But, she said, if the fertility specialist feels that it won't hurt, maybe we should go with aspirin and low dose Heparin, anyway. Certainly the baby aspirin. She said she'd call him and pass on the info. He'd figure out next steps.
So, that's where I am. I don't have another appointment yet, but I'm assuming M. and I are OK to start trying again around Christmas time. What'll happen after that is a big ole question mark. Love those question marks, don't we?