Wednesday, March 4, 2009

Appointment With Dr. Google

As you can imagine, I have racked up quite a few hours googling anything related to second-trimester miscarriage, loss, cause and the like. I have a pubmed password and a research-librarian friend who can get me almost anything else that needs a subscription. I have slogged through countless articles, not because I'm looking for some magic aha! nugget of information that will somehow explain my loss, but hoping for a better understanding of what to ask about, test for, or consider in the vaguely possible scenario that I actually get pregnant again.

I have found THE SITE, the holy grail of actual useful medical information when considering recurrent miscarriage or a fetal demise. And, it's not even password protected! Plus, the writing is lively and the categories are well-organized. So, here it is: Early Path - a reproductive pathologist's understanding of the various things that can go awry in a pregnancy. This may not be useful for most of you, but it so perfectly encapsulates so much of what I have had to dig through, I just had to link to it, if for no other reason than to be sure I can find it later.

I am not a sentimental girl. I am emotional, sure, maybe even overly teary at times - but in the end I am practical above all else. I am happy to have actual reasons to test for things, wait a certain amount of time, and try new therapies on the off-chance that they may work. This site gives specific reasons to wait a few cycles before trying again - reasons having to do with the uterine vessels cleaning themselves out of the debris from a miscarriage - which is so different from what you usually hear. People talk about getting your "schedule" back to normal, which seems to have more to do with ovulation, or checking E2, which is more about the lining. The idea that the vessels may need to repair themselves is a whole new consideration. But I can tell you, if there is the chance that my vessels may not be sufficiently recovered, I am not going to risk another IVF cycle.

I have an appointment (pants on) with my RE tomorrow, just to go over my last cycle and discuss what we might do differently. I figure the chances of actually getting pregnant again are fairly slim. But the chances of a late miscarriage are <5%, and excluding cervical problems are more like <1%. So, I'm already operating in the realm of the very few. At this point, another round of stims doesn't even seem like a big deal. And, if I wait two more periods before starting the dreaded BCPs, not only will my vessels be ready, but I should even be able to fit back into my regular pants again. And at least that seems like an attainable goal, regardless of whatever else may or may not happen.


Midlife Mommy said...

Thanks for the link!

Lisa DG said...

Hope your appointment goes ok. I'm thinking about you.

Wombded said...

Hi Loraine, I just popped over to check you out after getting your message. What a terrible time you've had. I'll keep you in my thoughts.

GL with your "regular" pants.

Lifeslurper said...

Hi Lorraine: Thanks for your comments! So glad to discover your blog, albeit at an extremely difficult time for you. Hope you don't mind, but I have added you to my blogroll...always on the lookout for great "elderly" bloggers who double as would be 'breeders!'

MamaSoon said...

Thanks for your comment on my blog. I've come to meet you and I see you've had quite a horrendous experience. I am so sorry for your losses, including your late loss not so long ago. Like you, I am practical and appreciate having a set of clear directives on what to do and when to do them. I like to understand the why without dwelling on it. I am not sure how that helps the overall outcome but it is how i survive. i think maybe it is how you survive too.

Kami said...

I went to that link. Is it possible they are just trying to make money on false hopes?

I didn't look that much, so I could be way off. I saw that their goal is to help the next pregnancy not give some peace to past ones so I didn't spend a lot of time.

I read the book "Coming to Term" and that author who has looked at the latest research believes that most miscarriages are due to fetal issues and we can't fix those yet.

He also gives hope in the book saying that most people will be able to have a healthy baby without medical intervention. Of course, he is talking about people whose only issue is multiple miscarriages.

I hope you get some answers at your next appointment that help.

Lorraine said...

I think it IS a business that may be catering to women who are pursuing legal action against their OBs. Or OBs trying to defend themselves against litigation.

Of course, that is only a guess based on how many boards I found (whilst googling around about late miscarriages) that were aimed at practitioners protecting themselves. I think that a reproductive pathologist is kind of a fetal CSI agent, and there is bound to be a lawyer involved in there somewhere.

I just like to have as much information as possible while trying to figure out how to continue in this process. I love knowing as much as possible, since otherwise I am just left with hope, and that is like clinging to air...

In any case, thanks for looking out for me!