Saturday, April 02, 2005

R.M. (Reproductive Musings)

Come on, admit it, you want the medical details. Just how hopeless is this case? It ain’t good. Here’s the thing. Somewhere between one and two percent of women will be diagnosed with recurrent miscarriage. Of those so diagnosed, about half will eventually be found to have some underlying medical issue (a clotting problem or autoimmune disorder, a hormonal imbalance, an anatomic abnormality, or lesions, adhesions or damage from anything from endometriosis to a botched D&C.) But another half will be “idiopathic,” meaning that the idiots making the diagnosis can’t figure out what the idiot patient did to get the Idiot in charge so pissed off. That’s my case folks, the ugly angry half of the last percent: idiopathic recurrent miscarriage.

Allow me one more longer aside on terminology. I vastly prefer the term recurrent miscarriage to HSA. Take the politically-charged A-word. I support a woman’s right to choose without reservation; I’d just like keep it crystal clear that, when it comes to miscarriage, no choice is offered. “Spontaneous” is accurate as far as it goes, but come on. My idea of spontaneous is a quick skinny dip on a hot day in a sparkling secluded lake. Miscarriage, on the other hand, is a plunge into despair. And habitual? Please. Just because something happens over and over doesn’t make it a habit. Surfing blogs? Now there’s a habit. Drumming your fingers? Yeah, OK. Chocolate? More please, my favorite addictive habit! But miscarriage? I promise you, I am not addicted to losing my dreams. Quite the opposite, in fact. So let’s all play nice and agree we’re going to call it RM and leave it at that.

Right. So. My husband and I are ready to try again and we’ve consulted with a slew of doctors. There’s Dr. Smart-Cookie Sweetie-Pie, my personal favorite, one we’ve been seeing for a while. She couldn’t stop my last miscarriage, but then again neither could God. I think I’d like to keep working with her, even though she doesn’t take my insurance. (Here in Manhattan, where M.D. stands for Material Development and R.E. stands for Really Enriching, it seems that no one does take my insurance.)

Then there was Dr. Awards-All-Over-the-Walls, a bad combination of insecure and arrogant in my opinion. Plus I didn’t like his advice. Among other dumb ideas, he recommended I do a Clomid-challenge test. As another doc put it, 3 genetically normal fetuses are all the proof you need that you ovulate. After him came Dr.Well-Connected, who knows everyone and everything, but still couldn’t come up with anything very new in the way of treatment suggestions. Also he thought the ultrasound wand was a light saber. He was so aggressive with the wand that when I finally screwed up my courage for a hysterosalpingogram or HSG (that’s the Hot Searing Green dye test for anyone lucky enough to remain among the unitiated) it actually wasn’t half as bad.

Finally I went to see Dr. Eminence Gris, bringing my complete fat file of negative results from all of the tests the first few doctors had ordered and hoping to get some definitive recommendations. He turned out to be a graying old guy who instructed me to strip completely for my exam (my husband wasn’t there for this one) then opened my paper gown to the waist, pulled it down off my shoulders in a fetching “oh my, this crinkly lingerie just keeps slipping off on its own” pose and left me hanging there in the open air for several minutes while he checked my pulse, listened to my breathing, etc. Amazingly, that routine did not lead him to any stunning new insights about the causes of my miscarriages. Instead he, like the others, said “well, since we have no clues it must be autoimmune. So let’s give you heparin.”

That is where the treatment plan stands, pending another consultation with Dr. Cookie Pie. I’m around day 21 of this cycle (we’ve taken enough precautions that there will be no anxious testing this month, I promise) and am already starting to feel incredibly keyed up about the next one. Day 14 (or 16 or 18, my body will not be rushed) is D-Day as in do the deed day. This is where you come in. Please, if you wander by and read this blog any time in the next few weeks, leave me a comment and tell me your story. I’m especially interested in hearing the one about your aunt’s friend’s sister, who had a great and wholly unexpected success with delivering a live baby in the fourth attempt. Cause from what I hear, and yes I've become a statistics junkie, my chance of another miscarriage now hovers somewhere around 60%.

4 comments:

Milenka said...

Well, shit, now I wish I had a good story for you! I'm sorry that you fall into the "unknown" category of R.M. We *think* we know what caused the 4 I've had, and supposedly my weight loss and improved health will make it better. Yes, let me keep my delusions, at least until #5 rolls along, right?

Sandi said...

I have use IUI and IVF and actually only had success with regular old conception. I have had 6 pregnancies. The first 3 result in m/c, the 4 resulted in my beautiful daughter Annie, my 5 was yet another m/c and the 6th I am pregnant with now and am at 35 weeks. Hopefully all will go well. #1,2 and 5 were all late first trimester m/c. #3 was a stillborn at 24 weeks. My darling daughter Elizabeth. I wanted to leave you a comment to tell you about my daughter Annie and this baby I am currently carrying. Annie was a very tiny follicle and they would not do IUI or IVF with her. I was told that that cycle was to be canceled. My husband and I had decided that her cycle was our last for some time so we did the HCG trigger shot anyway and set to work ourselves;) She is now a thriving 17 month old. #6, who we affectionately call Little Bit, came as a surprise to us. She is an amazing miracle and I am happy to be carrying her.
I wanted to share these stories with you from one habitual miscarryier to the next. There is hope out there. I hope that you find it.

Anonymous said...

Sandi-
Thank you so much for your story. So glad you have your little Annie. Hope all goes well for you and Little Bit. Let me know!
-Anne

Anonymous said...

I don't know if you've ever been to my site, but I am the person who has had three miscarriages, and fingers crossed, god willing, anytime now, will pop out a live baby on try #4. I'm due on May 18th. They don't know why I miscarried before. They tried telling me weight. I had gastric bypass, lost the weight. Lost another baby, the third, after starting ttc again. This time, only thing that they did was put me on progesterine suppositories, the wonderful white waxy bullets, even though there was no proof that was my problem.

Well, I have my little boy inside, waiting to come out, and he stuck really really well for undiagnosed recurrent miscarriage.

Anyhow, there it is, and it's first person, not your sisters aunts brothers best friends dogs mama. :)