Because no one can, not even them. Met with the new MFM today and while I felt it was a very thorough and complete consultation and I really liked him, I walked away from the appointment without a lot of answers.
He didn't think the Dandy Walker and pre-e were related so unfortunately we're looking at two separate issues. As for the DW, he said our reoccurrence rate is so low that we probably wouldn't need to have genetic testing done. Jim and I talked about this tonight though and we think we'll still have it done just to be on the safe side. It was a concern that Jack had low set ears, which usually indicates a chromosomal issue (although none was noted with him). Its a possibility, which is why we're thinking of having genetic counseling anyways, that DW was part of a separate syndrome that wasn't diagnosed yet. That scares me.
Regarding the pre-e/HELLP, he reiterated the fact that it was very bizarre to have it happen so fast and severe starting at 19 weeks. Certain things that have been linked to Pre-e are... APA or ACA(Antiphospholipid Antibodies/Anticardiolipin Antibodies), Kidney or liver disease, Diabetes, Pre-existing Hypertension, or Lupus. I've already been tested for APA/ACA and it was slightly elevated which he thinks is just a false positive. My Hematologist put in an order last month to have them redrawn so that was done today. Although my mother has kidney issues (two time kidney cancer survivor) , that is not something that is an issue with me that I know of. I'm not diabetic. I have always had excellent blood pressure. Finally, I've had been screened for lupus anticoagulant and it was normal. However, there are a number of tests to rule out lupus completely so he ordered a panel for that as well. Basically, if I don't have lupus or ACA then no one has any ideas about what happened. Not that I want a disease or something wrong with me but... I kind of hope I have lupus. At least I have an answer. At least I know there is *maybe* something I can do next time around to prevent this.
Interestingly enough, while at one point Factor V Leiden was thought to increase chances of preeclampsia, studies are now showing it has nothing to do with it. Matter of fact, this MFM says that so many woman are placed on anticoagulants like Lovenox and don't even need them. Ironically enough, my Hematologist told me the same thing when I first got pregnant....yet I stayed on them for fear of losing the baby. Well, haha on me. Both him and the MFM have now both told me I don't need the Lovenox at all for my next pregnancy. Yay! One less shot!
He also warned me of an increased chance of having pre-e again in a future pregnancy. Double that risk of reoccurrence in a pregnancy with multiples. I've been going back and forth recently about electing for a SET (single embryo transfer) and that just sold me. He said that their office is bombarded with twins and triplets from the infertility office down the hall (my old RE, lol) and the women he sees without half my complications have all sorts of troubles. If I were to get pregnant with twins he would immediately advise on selective reduction to only carry a singleton. At that rate, I might as well only transfer one as there is no way I'm "reducing" an embryo. If it were to split, we'd just commence freak out mode and trudge forward. Although, prior to all these issues, we were concerned about multiples anyways. Our house isn't big enough for two of everything, our finances are barely big enough for one, and omg, where in my body would two babies go anyways, LOL.... so yeah, I'm taking the Drs. advice and doing a SET for sure. When I got home, Jim and I talked about it and he's on board with this plan now too.
So basically just waiting for the bloodwork to come back. If its positive for lupus I'll need to see a Rheumatologist. Other than that, a baby aspirin is the magic pill that everyone seems to "prescribe" to ward off this pre-e. If I remember tomorrow, I'll be making an appointment for Jim and I at the genetics counselor at Edwards who is familiar with our case. Then...we go from there!
Ummm, yay??
Funny story to end my blog post for tonight. My veins are awful....like take the worst veins and multiply by 10, those are mine. The lab techs at the hospital know me well...like first name plus details of my life kind of well. I haven't been there in a year but they asked how school was going (last year I was starting pre- reqs to try and apply for nursing school) and they remember what gauge needles I need since my teeny tiny veins. Anyways, the new lady got me first. I told her I was a hand draw to which she started singing "I can draw the hand, I can draw the hand" and said "Oh wow , I just made a little song about it". Then as she was looking for my vein she said "Jesus help me" and started another little song "I need a miracle, I need a miracle." Needless to say, she poked me once....didn't get it , and I moved on to a new tech's chair. LOL Just thinking about it makes me laugh so hard. I swore there had to be hidden cameras somewhere in there, haha!!
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