I hope you'll forgive the foray into Spanish curse words, but hijo de puta, I'm tired. We've all been sick the past few days, presumably as divine retribution for merely thinking--not even saying!--that we had been really healthy all winter. I am a firm believer in the smackdown attraction of hubris.
Lately, I've been trying to keep up with my "maintenance," so in the past week, I had appointments with my eye doctor, OB/GYN, and primary care doc. My contact and thyroid prescriptions are up-to-date; I've been pap smeared; and apparently, I have high cholesterol (I blame my mother, both for her own high cholesterol and the love of butter she so thoughtlessly passed along to me. Thanks, mom!).
When I saw my OB/GYN on Thursday, I finally worked up the courage, almost three years after the fact, to ask for the results of the pathology exam of the placenta from my pregnancy with Andrew. You see, my old OB couldn't be bothered to talk to me about it after he was born, and I was so exhausted, and relieved that we were both okay, that it really wasn't on my mind.
When I got pregnant with Andrew, I had had one positive test which showed the presence of antiphospholipid antibodies. For my RE, that, coupled with one early pregnancy loss, was enough for him to start me on Heparin and aspirin during my IVF cycle. I now know that I was a few criteria short for a diagnosis of the syndrome (APAS); usually, they like to see two positive blood tests, at least several weeks apart, plus one "clinical event" (multiple miscarriages, blood clot, etc.). Because I'm lucky that way, however, I now definitively meet the criteria for the diagnosis.
When I was about 12 weeks with Andrew, though, I was sent to a maternal-fetal medicine doctor because of the APAS quasi-diagnosis. She glanced at my lab work and history, muttered something condescending about my RE, and told me to stop the Heparin. I got the distinct impression that she considered me another example of the pet diagnoses or issues that my doctor tested for, to assuage his neurotic clientele, but that were not usually clinically valid. And at the time, of course, I didn't know any better; all I heard was "you're just fine" and "you can stop the Heparin shots."
But then, throughout the course of my pregnancy, I had scary complications: I bled at16 weeks, and 36 weeks, and finally at 38 weeks, when I went into the hospital to have him. Andrew was born fairly small; when I arrived at the hospital to deliver, the doctors were perplexed by my low platelet count. He had trouble breathing after he was born, and I hemorrhaged pretty badly. All of these things were scary and weird, but they just seemed to be part of the bad luck I had to go through to finally hold him in my arms.
Recently, though, with the miscarriages, I'd been reading up on APAS and its effects in pregnancy. And every source I read kept talking about complications of untreated APAS late in pregnancy, almost all of which mirrored those that scared me so badly with Andrew. I also read a few too many frightening articles relating terms like "infant mortality" with APAS.
So I decided that, for my own curiosity and sanity, I now needed to know whether the APAS was the cause of all, or at least most, of the problems in my pregnancy with Andrew. As soon as I sputtered out the request, in two minutes, my doctor had the lab report up on the computer, and printed off a copy for me. Sure enough, it described my placenta as "abnormal," with an "infarct" and "intraplacental hematomas."
As best I can tell from the pathology report on the placenta, I was right in thinking that most, if not all, of the problems that Andrew and I experienced, were due to problems in the placenta, which were likely due to my untreated APAS. In theory, if I had continued taking Heparin, most of these problems with my placenta should have never developed.
So this news, which I'd hoped would bring me some sense of closure, instead leaves me feeling oddly conflicted. On the one hand, I am reassured that if I ever make it into my second trimester, my doctor and I will be aggressively treating this, and hopefully can avoid the frightening complications of last time. On the other, I am really angry that I was so easily dismissed by so many medical professionals last time, that at least part of the terror I experienced during my pregnancy and delivery could likely have been avoided. My OB from last time, whose care initially just appeared to me to be casually slipshod, now appears to have been woefully negligent.
Most of all, as I watch my mischevious little blond boy race around the backyard in his footed pajamas (after having climbed through the dog door to get outside), I stop, and catch my breath again, at how close he came to not being here, and yet how gloriously, beautifully perfect he is now, and what tremendous luck brought him to me.
