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Sunday – The Day of the Doctors: Help me prep!

8 Apr

Ok, so here’s the deal: I’m a mess.

No, seriously. I’m a complete mess. The last week or so I’ve been detached, I’ve had middle-of-the-night anxiety attacks (something that hasn’t happened to me in months), and two uncontrollable crying fits in the last 48 hours.

Something’s up.

I mean – duh, of course something’s up. What I mean is, too much is up. I think my anti-depressants aren’t working. And I think it’s not a coincidence that I started having panic attacks as soon as AF showed up.

So I decided to make Sunday my Day of Doctors. I already mentioned making an appointment with Dr. Twofer. That’s happening at 6pm. At 3pm I have an appointment with my GP just to go over some blood tests and get my mega-vitamin-D prescription renewed. So – I decided to go all out and add Dr. Happy Pills to my appointment list at 11am that same day. I’m a woman on a mission. By the end of sunday, I want to know what the hell’s going on with my body. I don’t care if it’s me being control-freaky. It’s time.

And for that – I need your help!

I’m about to spew a very long list of concerns and problems I’ve been quietly not thinking about or talking about. Once I’m done with them, I want all of you guys to chime in – I want to hear your opinion. What tests and workups should I be asking for? What am I missing? Am I exaggerating with anything? Should I just shut up? Because I tried shutting up with Dr. Blunt, and with all due respect, it just made me sit around and wait to have another miscarriage. I really want to feel like I’m in control of my body.

So – this is something I don’t think I’ve actually done on this blog before, but without further ado – here’s my whole sordid history:

Age 17 – first bout of depression and anxiety – periods start to become irregular. Go on BCP. (I think these two may be connected. More on that later)

Age 22 – Diagnosed with PCOS – stay on low dose BCP. No other action taken. Anxiety and depression still come in bouts.

Age 27: Lose the pill. Meet Shmerson. Periods incredibly irregular. Use condoms as Birth Control. Anxiety and depression still there. Still (somewhat) under control.

Age 29 – present (halfway to 31):

Because of Jewish Laws and such, I needed to make sure that AF was done a few days before me and Shmerson’s wedding, so that I can go to the “Mikveh” and the wedding would be recognized by the rabbinical institute here (long, annoying patriarchal story).

Anyway, because AF wasn’t regular, and the wedding was coming up, I took provera for 3 days to jump start AF. It worked. Because AF was irregular leading up to the wedding, Shmerson and I had decided to TTC right away (as in during the honeymoon). I was completely clueless even about ovulation at that point. Turns out those rabbis know their stuff, because the way they time it, you ovulate right around your wedding day. Clever bastards. So (I assume) due to that AF jump start I ovulated on our honeymoon and tada! Baby made. Didn’t find out I was preggo until I was around 5 weeks because I was so used to AF not being regular. I POAS on a whim and got a BFP.

Betas were normal. First US at 5 weeks showed a small sac.

I go and get my genetics tested to make sure all is well. I get the all clear so shmerson is told he doesn’t need to test for hereditary diseases.

Second U/S was scheduled for 8 weeks. 4 days before that I started bleeding, diagnosed with a blighted ovum. I ended up getting a D&C on the day we were supposed to see a heartbeat.

Anxiety and depression get worse. I decide they will get better if I get preggo again (really smart of me).

Surprisingly, AF shows up exactly when it’s supposed to – 30 days after D&C. Positive OPK on CD20. BD from CD 15-CD 21. Faint BFP on CD 27.

Now this m’dears is when things get complicated. Here’s where I share some stuff I haven’t shared here before, probably because I was too scared to think about it, let alone write or talk about it. It’s only in the last few days that this whole affair has started to come into focus for me.

So – Faint BFP on CD 27. Time to get a blood test to confirm right? Wrong. A perfect storm was brewing. It was Rosh Hashana – which is Israel’s equivalent of everyone else’s “Holiday season”. Two weeks of EVERYTHING being closed. Between that and my total state of denial I kept on putting off the blood test. I figure I would just go “after the holidays”. Denial is a wonderful thing.

But I knew I was preggo. I kept on getting BFPs. I peed on many sticks during those two weeks. Another fun fact: My anxiety was through the roof. This is when I started waking up in the middle of the night with anxiety attacks (this was every night. and they were BAD).

So, holidays are wrapping up, and I start bleeding. I call my obgyn. He brings me in that same day. He does an U/S, and he doesn’t find a thing. No sac. Nada.

He actually believes I’m either not preggo or I got my math wrong. I assure him: Positive OPK on CD 20. I’m almost 6 weeks along. Trust me.

He tells me that I need to get my betas done so that he’ll know whether he needs to go looking for that fetus. (In other words, there’s a chance this may be ectopic).

So the next morning, I get my Betas. They’re in the high 900’s. Bleeding still going strong. OB says to wait 72 hours and get another beta. I can’t wait that long. 48 hours later I get a second beta. it’s 1200. Numbers aren’t doubling. I call the doctor. By the time he calls me back I’m already passing clots. I know it’s over.

I come in two days later, he sticks his magic wand in my hoo-ha and says that all is clear. I say ok. I’m destroyed.

I don’t think to ask why the hell he didn’t see a sac in the first place, and why he’s only looking at my uterus and not at my tubes. I don’t think I want to know. I don’t think about the fact that this could have been ectopic.

Anxiety and depression become unbearable. AF becomes a clockwork 29-30 day cycle (this is the first time since the age of 18 that this happens without the aid of pills). Ovulation happens always between CD 17 and CD 20 (usually closer to 20).

I break down emotionally in December and decide to go to a shrink as Shmerson and I pick up the pieces and decide it’s time to figure out what’s up.

In the meantime, I start having a slight sense of cramping on my right side during AF and up until ovulation. Then it goes away. This happens every month. I decided to ignore it (oh god please don’t let there be something wrong with my tubes. please don’t tell me my last pregnancy was an ectopic and this pain is because of that).

I go see Dr. Blunt. I don’t tell him about the pain because I’m stupid and I’m in denial. He sends me to do a clotting test. My MTFHR says I’m a Heterozygote. Dr. Blunt says that means that I’m fine and I don’t need anything. He suggests progesterone supplements after a BFP. I ask him to do a hormonal workup (all I’ve had checked is my thyroid) he says I don’t need it. I’m uneasy with this, but in the spirit of “letting go of control” I go along with it. And in that same spirit, he doesn’t give me an US or anything.

In the meantime, I go to my GP for a general blood workup- high blood pressure and a vitamin D deficiency, and also, elevated lymphocytes, which are basically antibodies. That usually happens right after a sickness, but for me I’ve always had it. Doctor wants to monitor lymphocytes. I have no idea why and whether that has anything to do with anything.  I start taking prescription dose vitamin D and decide to quit smoking because that will obviously help with the blood pressure thing. And yeah, I should really quit smoking because of all the other stuff too.

I quit smoking. Shmerson and I start TTC again. Ovulation not monitored but guessing it was on CD 17. AF starts on CD 30 and that freaking pain on my right side comes right along with it (worse than ever).

And on the night before AF starts,  I wake up with an anxiety attack. The first time that’s happened since I started meds. And then the next night it happens again.

And the last two days, I’m pretty much as much of a wreck as I was right after the second miscarriage.

I have realized that it was all nice and good while Shmerson and I weren’t TTC, but now that we are again, I need to take control of my care. I cannot wait around to have another M/C.

I also can’t spend another TWW like I did this one. I also cannot handle being back with all of that anxiety and non-functioning depression. So when I go to my day of doctors on Sunday (in case you’re curious, sunday is Israel’s monday), I want to come armed with everything I need to tell them, everything I want to ask, and a list of every test me (and possibly shmerson) need to take.

I’ve got a few guesses.

I think that maybe – just maybe my PCOS is causing a hormonal imbalance that has resulted in increased anxiety, and that the meds may be masking that.

I think my second pregnancy was an ectopic that cleared, though I have no proof of that except the beta numbers and that stupid nagging pain on my right side that was never there before.

I think that if I have another miscarriage I may go insane.

And now I need your help.

What do I say to Dr. Happy Pills? Should I stay on the anti-depressants if they’re not working for me? Should I just detox off of them and hope that balancing out my hormones will do the trick and take xanax until that happens?

What do I ask Dr. Twofer? The man’s a gyno and an endocrinologist, and I’m paying for a private consultation, that means, everything is on the table. Every test in the book. I just don’t want him to think I’m crazy. Am I imagining this ectopic? What affect would a prior ectopic have on TTC at this point?

Have at it ladies – I need all the help I can get. I need to come in armed with a plan and take control of this Biyatch.

So – theories, personal experiences, debunkings, lists of tests, screaming at me to shut up, lists of questions – all of it. Lay it on me.

Thanks!!

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14 Responses to “Sunday – The Day of the Doctors: Help me prep!”

  1. Hemlock April 8, 2011 at 22:54 #

    For one, I think it’s entirely possible that the depression/anxiety are linked to the PCOS. I know they are with me. I don’t do Happy Pills, but I do Salmon Oil. Seriously, this stuff is amazing. It keeps my brain in order and it’s even making severe headway into DH’s OCD and depression/anxiety. It’s amazing to see the difference in him. He’s now been off of his Happy Pills for 4 months I think. He still swings a bit, but it’s manageable and he’s much more stable.

    As to bloodwork, the reason why they’re wanting to monitor your lympho-whatevers is because sometimes you can get a false positive on those (happened to me… went in 2 weeks later for the same test and came up normal *shrug*).

    I also started taking a new prenatal vitamin that is absolutely amazing. I can’t believe how much better I feel on it. I never noticed a difference when taking my other vitamins, but this stuff is just amazing: Rainbow Light Prenatal Just one… or something like that. There’s no synthetic anything in these pills and I believe no animal by-products (I think they may be Vegan?).

    As far as testing goes… I’d have them test your estrogen levels. My estrogen/progesterone are out of whack and that’s supposedly most likely my issue with holding on my my pregnancies. My endometrium is chronically thin around O time (at least it was with 4 of monitored MC’s, and the first was a blighted ovum). Every monitored cycle I’ve needed an estrogen boost and then BLAMY I’ve got a uterine lining.

    *hugs* We’re all here for you, and no, you’re not crazy!

    • mommyodyssey April 9, 2011 at 01:09 #

      thanks that’s helpful. I’ll be sure to ask the shrink about natural alternatives.

  2. jjiraffe April 9, 2011 at 00:13 #

    Wow. I’m so sorry you’ve gone through all that.

    I don’t have PCOS, but based on the way you described the second pregnancy, I would recommend that you ask the RE about something called a hysterosalpingogram, which is an X-ray that examines your Fallopian tubes and makes sure they are clear. It’s part of the standard infertility write-up that I had done here: that, the blood tests looking at FSH, TSH, LH, estrogen, prolactin and progesterone. My husband did the sperm count and motility tests. All that helps to rule out lots of things.

    In terms of the depression, anxiety related to your cycle, in the last few months I’ve started to have the same problems, which I didn’t before. I would tell your RE about this, and perhaps those hormone tests I described will help pinpoint what’s going on, or perhaps he’ll want to order different ones. It seems hormonal, based on what your describing. I need to do the same thing, myself. It’s been pretty miserable.

    Wow, this is a novel. I hope this is helpful. I’ll be thinking of you on Sunday. Good luck!!!!

  3. AK April 9, 2011 at 00:36 #

    I have never wanted to smack you so much in all my life (and that’s saying something). In what universe is it helpful to withhold information about what your body’s doing from the people who are trying to help you figure out what your body’s doing? ALSO: No matter how empowered and educated the internet has made you, the doctors are the medical professionals. You tell them what you can feel is wrong, ask all the questions you have, demand the best care … for gods’ sake lay it all out there for your doctors, you’ve already told the internet. Tell the people who can actually help you medically. Oh the horrible hard part! You have to trust somebody (Trust you silly control freak! Remember how in filmmaking you explain what you want and your team helps to bring your vision to life? You actually know how to do that!) who is trained to do so to evaluate/test/diagnose/establish a medical plan of action. Stop making up stuff in your head or asking the internet to postulate as to everything you need! Dammit, you ARE being crazy right now! *Punch.*

    • mommyodyssey April 9, 2011 at 01:08 #

      I love you and always appreciate a good old fashioned smacking
      HOWEVER
      This is about re-taking control in a healthy way.
      I’m not saying “hey internets give me medical advice”
      I’m saying hey people who’ve been through this what kinds of questions should I be asking so that I cover all my basses?
      I am a complete idiot for not telling doctor blunt about the pain. That was me not listening to my body.
      This is me (somewhat crazily) trying to rectify that. (hopefully).
      Love you!
      (and good point about the filmmaking. I”m making that my mantra)

      • AK April 9, 2011 at 01:35 #

        I know, you’re not, I was just annoyed at you for being dumb (Yes, dumb. Cause you are so smart!). I figured there needed to be a contradictory point to the “I must test for everything ever even though it might not be helpful at all because I’m grasping for control of something that not really in my control,” speculation. Questions = good. Obsessing over every possible thing scenario before getting any actual answers = bad.

        • AK April 9, 2011 at 02:28 #

          Oh, and I love you. Don’t give up.

  4. Kristin April 9, 2011 at 04:33 #

    Ok, I haven’t read the other answers so forgive me if I’m repeating anything.

    1) Get an HSG. You need to have that tube checked.

    2) Your cycle is pretty regular but, if you are ovulating near day 20, you have a short luteal phase. A shortened luteal phase can be indicative of luteal phase disorder which can manifest itself in many ways…low progesterone causing insufficient lining (most REs consider anything under 10 to low to support a pregnancy), or normal progesterone but lining isn’t reacting properly to it, etc, etc. If there is even a slim chance that progesterone is an issue, demand progesterone staring 3 days past ovulation…anything after that isn’t in time to combat luteal phase disorder.

    3)Even heterozygote MTHFR is often treated with with lovenox when no other explanation for repeat miscarriages is present.

    4)Ask for, strike that, demand a complete repeat miscarriage workup…there is a standard battery of bloodwork. Among other things, it checks antiphospholipid antibodies and the pTT, both of which are possible causes for clotting issues. Literally, the only issue I tested positive for was an shortened pTT (faster than normal clotting) and, when I asked, I got lovenox to treat it and, after 6 losses in a row, I finally had Gabe.

    Ummm, I think that’s it but, if I think of anything else, I’ll be back.

  5. Marie April 9, 2011 at 05:45 #

    I know NOTHING.

    But I didn’t want you to think I was ignoring you.

    Hang in there, kid. Good luck on Munday (that’s Sunday crossed with Monday). Love you.

  6. deepdreamer April 9, 2011 at 06:39 #

    The follow up medical stuff?? Cannot offer you any advice, other than, keep going back. That is how I finally got a diagnosis, and I wasn’t crazy. I just kept saying something was wrong.
    If you’re sufferring again from attacks then a chat with the doctor about changing your meds/getting off them could be worth while. Good luck Mo! I hope you get answers.

  7. Kira April 9, 2011 at 07:29 #

    Hey *hugs*

    Well, one thing they could do is an HSG (Hysterosalpingogram) which is an x-ray of the uterus and fallopian tubes. It would show if a tube is blocked (A possible result of a damaged tube from an ectopic pregnancy) An ectopic can effect TTC, because an ectopic normally causes scarring which can result in a closed tube (adhesing to itself) or at the very least causing a change in texture that encourages a fertilized egg to attach to again. I’m sorry I can’t remember the statistics of it off the top of my head.

    I’ve struggled with depression, and middle-of-the-night-panic-attacks (the only kind of panic attacks I ever have actually) if the meds you are on aren’t working, I say you need to try something different. There are some medications that are safe (or safer) during pregnancy so I would talk with them about trying to get one something like that and see if it helps.

    And maybe it’s just because of some of the blogs I have been reading but with your repeated miscarriage it may be time to look at chromosomes. See if there is a hereditary condition, maybe a translocation, that is causing the problems.

    That’s what I have off the top of my head. My thoughts and prayers are with you, and I am on pins and needles to hear how it goes.

  8. Christina April 10, 2011 at 14:41 #

    I agree with previous posters – HSG, complete RPL testing, and it might also be good to get some hormonal monitoring through out your cycle to see if you have too much or this or too little of that. I also ovulate later (~cd20) but only had 27-28d cycles, so 7-8d LPs. I have been taking various meds to help my luteal phase defect and my progesterone levels are a bit more normal now.

    As for the depression/anxiety, you have to talk with your Dr. I know I had to go through some various pill combos and dosing changes to find something that worked and kept me from feeling like I’m crazy. I’m actually thinking I may need to revisit my happy pill concoction in light of our TTC struggles to keep the black clouds and insane worry away.

    Good luck!

  9. mommyodyssey April 10, 2011 at 15:36 #

    Thank you everyone!!! checkup today to determine what’s next. I’ll be updating later!

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