Thursday, December 2, 2010

The Gift That Keeps On Giving

Roccie has nudged me into putting in a post - thank you!

The title refers to a nice little article I read on my as I tried to relax over an eggn.og lat.te and toasted frui.tbread (guess where I had elevenses today?!). As if losing multiple pregnancies is not upsetting and scary enough, this article in the BBC news online today suggests that those of us who have had more than 3 miscarriages are at a 500% increased risk of having a heart attack in middle-age or after. Although they pussy-foot around a bit about causation, I'll eat my hat if clotting is not the link here. It seems on the evidence of this pregnancy that my main problem was bad eggs and that having a donor fixed that problem. BUT who's to say that, if I had done a donor cycle without aspi.rin (125mg) and Cle.xane (40mg), I wouldn't have lost this pregnancy too - possibly at a later stage, since my clotting condition (Fact.or V Lei.den) tends to be a 2nd/3rd trimester issue. I know at least three people who have been diagnosed with Hug.hes Syn.drome (Anti-phos.pholipid An.tibodies) through testing for recurrent miscarriage and more who have, like me, an additional unidentified clotting issue which was identified through a TEG ( I'm now off my aspirin so that it doesn't affect the baby or bleeding during labour, but I intend to get back on a low dose ASAP afterwards - it helps to control my migraines and I can only hope it might help to protect me from future heart problems.

I am still here and still pregnant - 35 weeks now. I am still anxious too, but things seem to be going well. In a way, I wish I didn't know the stories of several bloggers who lost their babies at term, during labour, or my own friend's story of how she lost her two week old baby girl to Group B Strep. These were avoidable losses and reminders that, however far I get past the time of my own losses, I could still lose my precious baby for some totally unrelated reason. In another way, I feel thankful to these girls, who have used their blogs to educate and inform so that hopefully others might push hospitals to check things they might otherwise have ignored. I spoke to the senior registrar who was taking the high-risk clinic last Friday about my anxieties and pessimism and she was lovely. She said that of course nobody had a crystal ball and nobody could promise me that nothing would go wrong, but these things were rare (though she and I both acknowledged that they still happened more often that they should). She also didn't belittle my fears, saying that with my history it wasn't at all surprising that I was anxious. She is referring me to the hospital's consultant midwife to talk about my fears about giving birth.

My various health issues are conspiring to make labour and birth even more scary and complicated. I saw the anaesthetist on Friday and she is very keen for me to have an early epidural, as they have the convenient side-effect of reducing blood pressure - convenient for me at least, since high BP is one of my issues. My BP is also labile - it goes up even further when I am stressed or in pain, which are givens while in natural labour, so it would help with that too (protecting my blood vessels from BP surges). BUT - I can't have an epidural if I've had my Cle.xane in the previous 12 hours because of the risk of bleeding - nor could I have a spinal if I needed a C-section. So, if I go into labour within the 12 hours after my Cle.xane dose (7.30 in the morning), it's a natural labour or a C-section with a general anaesthetic for me. AND, because of my sleep apnoea - if I have a general, I would then be at risk of stopping breathing during recovery and I'd have to spend time in the ordinary high dependency unit, not the maternity one, because the maternity one isn't set up to deal with apnoea patients, and I'd be separated from my wee boy. I also would not be allowed any heavy-duty op.iate pain-killers because they affect the breathing centres in the brain.

To me, then, the obvious thing seemed to be to schedule a C-section or an induction. That way, I would know when not to take my Cle.xane and everything would be more straightforward (barring disasters or early labour). But no - they explained that a C-section is not ideal (major operation, increased risk of clotting for me, restricted movement after birth etc) and nor is early induction (if my body and baby weren't ready to go, it could lead to slow, unproductive labour, a distressed baby and an emergency C-section). They really would like me to go into labour naturally, as they feel that is my best chance of a good labour and birth. The consultant assured me that most women manage to get the Cle.xane timing right and that most first labours have a long, slow first stage so, even if I had taken the blood thinners, there would be time for them to work through my system before I needed an epidural. Well, I don't know if labour runs in families but my mother was in labour for 12 hours in total with me and when my sister gave birth to my niece, she went from twinges to birth in an hour and a half!! I can only hope that they have other ways of controlling my blood pressure, should I follow my mum and sister!

I really must get round to writing the second half of my "Why Donor Eggs?" post. All I can say just now is that I cannot imagine being any more bonded to a baby than I am to this one. I love him completely already and feel so protective of him, regardless of genetics.

1 comment:

Rebecca said...

I saw an article on that study today too, and had the same thoughts you did about there must be a clotting connection. Just what we need, another issue to worry about...

I didn't realize an early epidural would lower BP. All the more reason to get one! :-)

During one of my pregnancies, the ob's nurse (who clearly hadn't read my chart) asked if I had thought about a birth plan. Ha! I looked at her for a moment, realized she wasn't asking the question in jest, and then explained my four-part plan:

Get everybody through it (in order of priority):
1) alive
2) as healthy as possible
3) with as little pain as possible
4) as quickly as possible

Whatever the hell they need to do to accomplish that, fine by me. If there are copious amount of pain-preventing drugs involved, all the better as far as I'm concerned, so I really hope you're able to get your epidural.