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Back to Dr. Twofer We Go

10 May

I’ve been in a bit of a cocoon for the last week. Truth be told, I haven’t been doing so well, and I’ve mostly kept away from the blogs and thrown myself into getting my business up and running to keep me distracted.

I guess it’s been because I was hoping to have some answers by now. But alas, because Israel celebrated memorial day and independence day this week (yes, they are one after the other – an explanation of that will come at another time), I couldn’t get an appointment with Dr. Twofer as early as I’d hoped. And I hate limbo. Limbo is the suckiest thing ever.

Tomorrow evening, three weeks after That happened, and a week after my betas hit zero and I got what I think was AF, Shmerson and I will finally be in Dr. Twofer’s office.

Here’s the deal ladies:

I’m going to be one of THOSE patients now. I’m done letting other people steer and tell me not to worry. I’m going in there tomorrow guns blazing, getting as many answers as I possibly can, and asking for every test in the book. And I mean EVERYTHING. No fucking around this time.

Let me explain: Israel has universal health care, and I have a very nice supplemental plan. So even if I don’t technically “need” it at this point, I’m going to demand it, because it’s covered. And I refuse to go into another TTC attempt with any blind spots that may possibly be avoided.

So – I already know to ask for an HSG (which Dr. Twofer already told me we’ll be doing, so there’s really no need to ask for that). But what else? I have no problem putting my body through the ringer. I’d rather have stuff stuck up my cooch from here to tomorrow and at least know we’ve had everything checked out.

For those who forgot, or those who are new, here’s my history:

PCOS (though luckily I do ovulate and so far we’ve had no problems with sperm meeting egg. mine is of the can’t-lose-weight-and-need-to-wax-a-lot-of-places variety)

1st MC – blighted ovum at 8 weeks.

2nd MC – naturally miscarried at 6 weeks. The old OB/GYN didn’t see a sac, Dr. Twofer suspects it was ectopic according to the beta numbers. I’ve had occasional stabbing pains in my right side ever since.

3rd MC – also suspected ectopic at 6 weeks, since again, no sac was found. Implantation bleeding lasted 3 days and I thought it was AF.

Tests Already Done:

All of the clotting tests. They’ve come out a OK except my MTHFR being heterozygote, and I’m taking extra folic acid and B12 for that.

Regular prenatal genetic testing of my blood early in my first pregnancy gave the all clear on that front.

Thyroid working fine.

B12, Vitamin D and all of the normal “blood workup” stuff A-OK (except high cholesterol which is genetic, and a high lymphocyte % which I’ve had forever and I don’t think means anything, and neither does my GP – though who knows, maybe it is a factor? It means my immune system works slightly more than most people’s)

My Paranoia:

I’m kind of afraid my eggs are effed up and this is part of the problem, or maybe something about Shmerson’s and my cocktail may be off.

I’m a bit scared that the ectopics weren’t tubal, so an HSG will come out all clear, and I’ll go through this crap all over again.

I’m thinking maybe I have endo? I don’t know. All the waiting is making me paranoid. Is there any tests to check for that apart from a lap?

Back to the immune system thing. I’ve heard it’s possible that your body can actually attack an implanted egg as if it were a virus. The high lymphocyte count I mentioned above is making me overly paranoid that this may be happening. Is this a stupid bit of misinformation or legit?

I haven’t had a full hormonal workup (and I don’t know if there’s any point to that).

So – lay it on me, because your experience is a helluva lot better than Dr. Google.  Are there tests to check egg and sperm quality from a chromosomal standpoint? Is there a super secret super expensive magic 8 ball test that will predict my future?

What other things should I be demanding be shoved into my uterus?

Should I insist on a full hormonal workup? Will it make any difference?

Remember – money is not an object thanks to universal healthcare and kick ass supplemental insurance.

And I don’t care if any doctor deems anything “unnecessary at this point”. Screw them. I want to know what I’m up against. All of it.

So – lay it on me. Dream workup – money not an object. Don’t care how many instruments get shoved in my body, how many needles I get poked with, how much blood gets drawn, and how many funny liquids get injected in my cooch.

Gun’s Blazing. The battle is on. Give me some cover.

(or some other metaphor that makes sense)

Or in other words:

Bring on the info storm – now with more paranoia! I eagerly await your words of wisdom.

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6 Responses to “Back to Dr. Twofer We Go”

  1. Julia May 10, 2011 at 23:46 #

    Have you had his Sperm Count/Quality checked? That would be the next thing to do, along with the HSG.

    At a certain point, we also decided to go to an IUI route, and I also had a laproscopic surgical procedure done to check for endo etc.

  2. rachel May 11, 2011 at 02:17 #

    I’ve just had 2 m/c in 4 months, both a blighted ovum. The 1st test I had done was an SHG (sonohysterogram) to see if I had a septate uterus, which turned out all clear. Next up were a million blood tests which revealed I have hetero factor V leiden & PAI-1 clotting disorders. I’m not sure if any of the blood tests checked for autoimmune disorders, but I definitely think it’s something to look in to. I just read a post about this on another blog (the comments have a lot of info too…): http://the2weekwait.blogspot.com/2011/05/mothering-myself.html

    My husband also had genetic testing done, which came back normal, but he never had a SA & I didn’t have an HSG because the RE said “we know his boys can swim and your tubes are open since you can get pregnant.”

  3. Baker May 11, 2011 at 02:19 #

    I forget what the technical name for it is, but we recently had bloodwork done – hubby and I – to see if everything was okay from a chromosomal standpoint. Doctor wanted to rule out those abnormalities as reasons for recurring miscarriages.

    Good luck!

  4. missohkay May 11, 2011 at 02:55 #

    I’d get Karyotyping on you and Shmerson to check for translocations. Also, my understanding is the killer cells theory is legit though not all doctors believe in it. I find this site helpful for explaining a variety of things, if you haven’t seen it already: http://www.rialab.com/miscarriages_prevented.php

  5. Kristin May 11, 2011 at 06:13 #

    Ok…here’s a list…

    1. Make sure you know whether your pTT is normal. All my other clotting factors were normal but a shortened pTT is indicated in repeat early miscarriages.

    2. Make sure you are evaluated for luteal phase disorder. That is also a common cause for repeated early losses.

    3. A full chromosomal work up for you and Shmerson might be in order. I am pretty sure genetic issues usually cause problems further along but sometimes things like balanced translocations can cause issues earlier.

    4. Absolutely, positively get evaluated for immune system issues. A great place to go and read about it is the web site for The Alan E. Beer Center for Reproductive Immunology & Genetics. Dr. Beer was the trailblazer in the field of Reproductive Immunology and his coworkers are carrying on with his work. The Beer Center does do long distance consultation if Dr. Twofer decides that is recommended.

    • jjiraffe May 11, 2011 at 08:26 #

      I would recommend the hormonal testing (just blood tests). Rules out lots of stuff, around egg quality issues. I did all of these.

      Luteinizing Hormone
      Follicle Stimulating Hormone
      Estradiol
      Progesterone
      Prolactin
      Free T3
      Total Testosterone
      Free Testosterone
      DHEAS
      Androstenedione

      And if Shemerson hasn’t done a sperm sample already, now’s a good time. GOOD LUCK!! I really hope you get some answers ASAP!!

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