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%.


Like so many others out there in the IF ether, I've been inspired to start this blog by the great triumvriate: Julie, Tertia, and Grrl. Julie's was the first blog of any kind I'd ever read. I found her two Christmases ago immediately after my first miscarriage. I was in shock, I was in grief and I was in pain looking at all the cherubic Christmas photos of children sent by friends and acquaintances. None of them knew about the miscarriage, which was a deep secret in those days.

In the midst of all-night google misery madness, I magically stumbled onto Julie's blog and her sarcastic Christmas letter. My God, the relief! I became an instant fan and constant lurker. After Julie came Tertia—what grace, what strength, then Grrl—what sheer brilliance. I admired them all immensely, but I thought that I'd been through so little compared to them I didn't really have the "bonafides" to be part of the pack.

Is fate still laughing at that? Or could it be fresh laughter from my first reader? Yeah, be careful what you wish for. More than a year later I have 2 more miscarriages under my belt (beneath my sash? under my skirt? In my panties?) and an official diagnosis as a Habitual Spontaneous Aborter. HSA! Huzzah! Hurrah! Hooray for me! Part of the pack, like it or not, I think I'm now ready to blog.

By now, real world friends know all about my sorry saga. Trouble is, most of my dear old friends can’t really relate. In fact, half the time they can’t even come to the phone, what with Little Miss crying to be fed and Junior trying to feed peanut butter to the dog. I’ve met some wonderful women through a support group. There the problem is that they can relate too much. The first one of us to become pregnant knows she’s going to inadvertently cause all the others’ pain. I’d like a place where I don’t need to be discreet in either joy or sorrow.

Over time, I’ve begun to read more and more and more blogs, as infertility has suddenly become my all-absorbing hobby. When I first started this entry, I thought I’d try to include a dedication to each blogger that has really inspired me. But I had to stop in terror when I got to 17, realizing that there are so many amazing women out there that I’d hate to accidentally leave one out.

Anyway, many many thanks to all the members of the IF blogosphere, from those that are just day-tripping here, to those like me who feel they’ve embarked on an impossible round-the-world expedition in a leaky canoe, and to those who’ve found their destination. If I can add the smallest spark to Julie's heart & humor, Tertia's tender courage, or Grrl's megawatt style, I’ll be proud to count myself a member of the barren bitch brigade.