So I fired my OB

I will be 30 weeks on Monday and last week I fired my OB. Sensational title - I know, because I am still under the care of an OB just not the one I saw for the first 30 weeks of this pregnancy.
Since having E in 2009 and the conversation that followed with my community hospital OB I planned on having a VBAC. However, my community hospital does not support VBACs. But my OB gave me instructions of how to increase my chances of success. I waited the two years for my scar to heal completely. And then I transferred to the "bigger and better" hospital for care during this pregnancy, where they would support a VBAC.
My entire dilemma during this pregnancy was that I loved my community hospital OB. I met her when she delivered my son. She had this amazing way of keeping me calm when I really should have been freaking out. And then she was by my side in 2012 when I lost Tristan.
The practice at the "bigger and better" hospital had 6 doctors that I would rotate between. At first I thought I'd like it. And in the beginning I did. I had access to a great Reproductive Endocrinologist. Also, during those early weeks they had a small in office ultrasound machine that helped ease some fears. But then it turned into 6 different opinions, a lot of blowing things off that I thought were of concern, and not feeling like I could discuss anything with them. Add in a couple of insurance issues, "bigger and better" also meant way more expensive and therefore less coverage. I was paying more out of pocket for a routine pregnancy ultrasound than I was paying for my monthly car payment. I also had some non-urgent pregnancy issues that came up that took my 50/50 chance of a successful VBAC down to more like 20% chance of success.
So I was left with a choice. Do I stick it out with a practice that I wasn't comfortable with, to attempt a VBAC that my chances of success had been significantly lowered and not knowing who would be there to deliver and how they are during delivery? Or do I return to my favorite community OB who I am comfortable with?
At 28.5 weeks I pulled the trigger and fired my OB, then called my favorite community OB and re-established myself with her. I had my appointment this past Friday and I am so glad I did this. And while the local community doesn't "support VBACs" - it only means that they wouldn't induce me for a VBAC, but if I were to come in in labor and was far enough along, they wouldn't stop me just to do a c-section. That being said they do have to plan ahead, and they plan a c-section for the week prior to my due date in expectation that I wouldn't go into labor on my own.
But my favorite recent quote is "want to make a baby laugh? Make plans." We shall see what the next 10 weeks hold.

16 Weeks (Actually 20 weeks); Taking a Deep Breath

To explain the title; I have been trying to write this blog post since I was 16 weeks pregnant. I am now 20 weeks, soon to be 21 weeks and I think I finally know what I want to say. I've written, erased and rewritten this post a number of times. 16 weeks was my big milestone, the place in pregnancy that I needed to get through until I started to feel safe and confident. But then 16 weeks hit and I have to admit, confidence was not there. Even now, at 20 weeks I worry about things; is the baby moving enough? are these cramps normal? Am I spotting? Of course, everything is going just great. I'm no longer miserably sick, I'm feeling movement and we had our big anatomy scan a few weeks ago revealing that our baby is Boy #2. Names are being discussed but we're not ready to share them just yet. I'm looking forward to in just a few short weeks B&E will be able to feel the baby moving.

Losing Tristan Revisted - One Year Later

Reflecting on the loss of Tristan a little over a year ago. I blogged about the loss the day after it happened, and rereading it I can feel how disconnected I was from the whole experience. It took a few more weeks, after the shock wore off, before my emotions hit. However, it was not devastation or depression. I'd been through this before, I knew a miscarriage was possible - compared to how I was so naive during my first pregnancy I thought it could never happen to me. During my pregnancy with Tristan I felt that maybe something was wrong. Particularly after my supposed 10 1/2 week ultrasound that showed the baby to be 8 1/2 weeks. Instead, I was left with anger. Anger that burned and destroyed. I put on a good face, smiled when I needed but inside I burned. The target of my anger was for the situation; not myself, nor God. But my arrow would miss the target and burn those around me. Why so angry? Well, after my first miscarriage it took 5 years before I got pregnant with E. During my 6 week follow-up after having E, I asked my OB when I could try for another one and was told after 6 months. I switched OB's within that same year and went back for my annual exam. I asked my new OB the same question. She was the doctor who delivered E, so she was more familiar with what happened. She knew I was upset that I had a c-section. She advised that if I waited 2 years for my c-section scar to heal, I would be a perfect candidate for a VBAC. The next baby could be due on E's 2nd birthday. So, we waited until December 2010. The first few months were fun "oh! If we got pregnant now we could have a baby around this time. Or we could announce this way!" But after 6 months I began to worry that my fertility issues were going to repeat, and this would be tougher than we thought. I will also touch briefly on how stressful 2011 & 2012 we for us, due to other circumstances. A year went by, I started thinking that maybe I needed to look into Clomid. But I was terrified. I decided instead to start tracking my cycles. I downloaded an app on my phone. Another six months went by, and after determining my cycles were normal I decided to try ovulation kits. In August, the most stressful event of all occurred. E had to go for dental surgery. I was a mess. After his surgery, I felt dramatically better, like I could breathe deeper. I also had a feeling that I would be pregnant soon, and I knew the baby's name would be Tristan. I won't go into the details of mother's intuition. I tested the end of August and got a big fat negative, preparing myself for another month. A week later, on September 7 I just wasn't feeling right so I took another test and this time I got a positive. When my due date was changed after my ultrasound and my new 10 1/2 weeks arrived and the cramping and spotting started, I hoped for the best but knew this was the end. The ER doctor commented on how dry my mouth was; it was fear. The second I pulled into the parking lot, I was struck with fear. So back to why I was so angry...I was angry that I had to go through trying for 18 months, to finally get pregnant only for that pregnancy to end. Even now that doesn't fully explain it. All the frustrations of trying to conceive before getting pregnant with E, repeating themselves. Plus, on paper my pregnancy with Tristan looked perfectly normal. My OB wasn't even worried about the difference in due dates after my ultrasound. Am I still angry? Yes, a little. But it is no longer burning, seething. This is partly due to the help of the support group I joined after my loss. It took a while. Why post this now? I felt that it was important for me to move on with my life. Important for me to enjoy this new pregnancy.

6 week update

I've made it to 6 weeks, 1 day. I had my ultrasound today and everything is looking great and is measuring right where it should be. I also got to see my sweet baby's heart beat. And confirmed that there is only one in there.
I had HCG and Progesterone levels run at 3 weeks, 6 days and repeated at 4 weeks, 6 days both with normal results.
The specialist released me to my regular OB/Gyn and I have an appointment with her the first week of November.

Chasing Rainbows: The Last Puzzle Piece?!

Monday was a very exciting day. I got a positive pregnancy test. Yes! A POSITIVE pregnancy test! Actually, two tests. And then I went to the Reproductive Endocrinologists office and had a couple blood tests done. They confirmed I am pregnant and my HCG and Progesterone are both within the normal range. I am four weeks pregnant. I go back next week for repeats of these tests to make sure my levels are rising.
I truly feel that learning about the MTHFR mutation, and then treating it has answered quite a few problems. Or as my post says, I found the last puzzle piece. And because of this, God heard my prayers; I did not need to start Clomid! Can I get an amen! Because, I was very scared to start it.
Pray for a sticky baby (I don't know, it's an internet term for a baby that makes it to term).

I recognize that I have a very small readership on this blog but I also felt this was an important post for those following our story. We are planning on sharing this news with family after my 6.5 week ultrasound. And making a bigger announcement after the NT scan around 13 weeks.

I have 12 more weeks before I will feel like I'm in my "safe" zone.

Busy Brain

Since Thursday I have been in research mode about MTHFR A1298C, and it's given me a lot to think about.

First and foremost is this just continues to reenforce that my son E is a miracle! The fact that I had this diagnosis since 2006 but did not know until now, did not use any of the treatments and had a baby that survived is just beyond astonishing.

Secondly, that God is good. And he has heard my prayer for answers and he's been providing them to me. It's been puzzle pieces as I mentioned before. But I like puzzles. For the most part I'm very reserved in medical treatment. I look for the most natural approach to my situation. But I also acknowledge that sometimes we need medical intervention; that the medical intervention may be part of God's plan in helping us heal.

This diagnosis also encourages me to keep following the Blood Type A diet. Not because I want to lose weight, it's never been about that. For years I have had chronic stomach issues. Do you know what is on the list of possible conditions caused by MTHFR? IBS. Well, that's bunch of acronyms but hopefully you can follow along. Do you know why MTHFR may be the explanation? Because of this genetic mutation, my body has a hard time removing toxins. And according to the Blood Type diet, certain foods are toxic to certain blood types. I've found a lot of relief following the guidelines in D'Adamo's book. Although I'm having a really hard time giving up olives. Maybe I'm the only one that makes sense of this.

The last thing I realized was that I needed to forgive the OB who delivered my first loss in 2003. On Wednesday I was reminded of where I was 10 years ago; at the hospital delivering the baby I lost. I had many emotions rambling around which I shared previously but I held out on one; bitterness. I was bitter towards that doctor for her terrible bed side manners and the mistreatment of my baby. Her behavior was so terrible it even shocked the nurses, and I received so many apologies from them trying to make up for it. I learned a few years later of what was going on in the L&D floor that may have contributed to her behavior. I just wish she would have left that bad mood at the door. I could go into details, but I don't want to ruin her career. And I think if I put it out there, it would just make the bitterness live on. So, Dr Juicy Fruits (not her real name)...I forgive you.

Another puzzle piece

I tried to describe to someone what my fertility journey has been like. It's been like trying to arrange a puzzle, realizing there are missing pieces and then finding the pieces lost all over the house and putting them back one by one.

Where to start...there are a few things on my mind.

Saddest first. Today is the 10 year anniversary of my first miscarriage. Ten years later, I cried today. Do I cry every year, no. Unfortunately, September 11th is a big reminder of what the date is. 10 years ago on September 11th, I had my 16 week prenatal appointment. It was 2 years after the attack on the twin towers and I felt like there was a curse on the day and was worried about my appointment. B and I sat in the waiting room for an hour and a half before being called back. The doctor got out the doppler and couldn't find a heartbeat, and then she tried the in room u/s machine. She told us our baby's heart had stopped and that it was a couple weeks ago - a missed miscarriage, then told us to go home to gather our things and go to the hospital. I chose to be induced and delivered Jacob on 9-12-03.

This year, on the 10 year anniversary I went to a Reproductive Endocrinologist. There were so many emotions tied to this appointment.

Anxiety - over what the treatment options would be. What if they are too invasive? Am I really willing to do them?

Anger - at the medical community who kept telling me I was too young, not trying hard enough, or not trying long enough and blowing me off for so long.

Grief - writing out my medical history brought up those feelings of grief over my losses.

Fear - that the Doctor would tell me that we are a hopeless case.

The good new is the Reproductive Endocrinologist (RE) was the nicest doctor I have ever met; kind, compassionate. He listened to my concerns, read my history (I wrote it out at home and brought in 4 pages typed), and gave me options. He told me we could be as reserved or aggressive as we want. He does not want to push us into doing anything we didn't want to do, and it was his job to educate us on the options and help us find a good fit for us.

He didn't have a magic answer that explained exactly why I was having a hard time getting pregnant. I wish it was that easy.

He calmed my fears about taking clomid. I had many; I was worried about the side effects that I would feel, and if it would cause issues with my child's fertility. He educated me on the drug, explaining that it's been around since the 1960's and that we have seen children conceived using clomid, now go on to have healthy pregnancies with and without clomid. And he did offer me a second drug option that has less side effects for me, if the clomid makes me feel terrible.

I left the office feeling comfortable with the treatment plan.

The last and most confusing thing is I discovered I have a genetic mutation which may explain my miscarriages. I am Mthfr 1298(A->C) heterozygote. How did I discover this? I requested my file from my previous OB be faxed to the RE. I mentioned specifically that I was looking for some genetic testing I had done in 2006. I remember my old OB telling me that she ran this testing, everything came back normal. But that there was one result that was slightly abnormal but it was nothing to worry about. I asked to see the test result while in the RE's office. I recognized the MTHFR mutation because a couple of girls in my support group have the same thing. I messaged them asking for translation; It causes microclots between the placenta and baby which causes the baby to die (missed m/c) due to lack of nutrients and blood supply. The MTHFR mutation causes a reaction with the folic acid cascade in your body so you're at increased risk for neural tube defects.

I asked the RE about it, and he said that he really has no concern over it. He said I could take additional folic acid to cover the deficiency caused by the mutation.

In some ways this gives me peace, knowing that there was a cause. But because it is something that isn't really researched in the medical community, there's not a lot of support in helping me treat it. Looks like I have my research cut out for me.