Diagnosis: Clotting

Dr. Peng's office closed at 4 on Friday so I was the only one in there.  I was in a daze when they took me back, which turned out to be a bonus because I didn't even flinch when they drew my blood.  Not even when she took the needle out too fast and the blood rushed out of my arm.  I just put the gauze on there, bent my arm and went into the consult room and then Dr. Peng came in.

Thanks to his 10-point check, he found that I tested positive for a Protein C deficiency and anticardiolipin antibodies.  These are clotting markers and are the smoking gun for the miscarriages.  While I was so thankful that he found a reason for my losses, I started to fade out when he talked about what was next.
Clotting disorder....works fast...have to start now....proven solution.....heparin injections....until 36 weeks.....nurse will show you....prescription waiting at the pharmacy......will only fix clotting.....if there's something else, can't help.....congratulations, you're due April 15

I couldn't even focus but I wasn't panicking.  I wasn't anything.  I saw the nurse demonstrate on her stomach where the injections were to go, I saw her draw up the syringe, I saw her inject it into the simulation pad thing.  I saw it, but I still hadn't made the connection that I was going to have to do it to myself.  They asked me a couple of times if I was getting all this.  I just nodded my head and half-smiled.  When it was my turn to demonstrate I did it without flinching.  On the simulator.

With my promise that I would call my OB, that was it.  That jarred me back to my senses.  I felt like he was breaking up with me.  I even asked him if I could call him, but he thought I was serious and told me it would be best to call my OB from here on.  He said to be sure to bring my baby in to visit once it's born.  Wha?  My baby?  My baby?  My baby?  What are you even saying right now?  I do not understand the words that are coming out of your mouth.

I walked out a little after 5 and made my way to the pharmacy in the building.  It was all waiting for me and I faded again when she started counting out the syringes.  There were so many and I still felt like they were for someone else, there was no way I was going to be able to stick those in myself, in my stomach.  It felt like I was just there picking this up for a friend.

I drove home in silence, not thinking, barely breathing.  I walked in the door, dropped the bag on the dining room table and went straight to my bookshelf.

After the second miscarriage, I bought a couple of books but hadn't gotten past the first couple of pages of either of them.  I found the book, scanned the table of contents and there, in Preventing Miscarriage:  The Good News, Chapter 8 - Immunological Causes of Miscarriages:  Is There a Mismatch Between You, Your Partner, and the Baby?, page 182Thrombophilias (bolding mine) I found:
"Hereditary thrombophilias occur in women with strong family histories of high blood pressure, strokes, or heart attacks...The most important ones for our purposes are protein S, protein C...."

"Acquired thrombophilias, also called antiphospholipid antibodies, or APAs, are being actively reserached, and new types are still being added to the list.  They include anticardiolipin (the most well known, though certainly not the most important)....."

"About 50 percent of women with recurrent pregnancy loss have antiphospholipid antibodies...The antiphospholipid antibodies can act in different ways.  The most usual is to cut off the blood supply (by clotting) to the developing embryo or fetus and cause the heartbeat to disappear, usually resulting in a missed abortion (my first loss.)  They may 'unglue' the cells of the growing embryo and cause very early pregnancy loss (second one), before the level of HCG has had time to rise very high before falling.  They may also damage the implantation of the embryo, as it tries to attach to the uterus around days 21 to 24 of your cycle.  This is a very important cause of unexplained infertility, as pregnancy tests are never positive in such cases."

A few pages later, in the 'Treatments for Immunologic Disorders'  I found Heparin, right after low-dose aspirin:"Most experts recognize blood clotting as a proven, treatable cause of recurrent pregnancy loss...They are stopped before labor, as you may not be able to have an epidural if you go into labor while taking either medication...Heparin does not cross the placenta and is safe in pregnancy.  It must be started soon after ovulation, before you miss your period and are diagnosed as pregnant, to be maximally effective."

So not only did I have a hereditary issue, something else got turned on the first time I got pregnant that told my body that getting fat was not an option - size 2 forevaaaaa!!!  No babies for you! (You have to laugh to keep from crying.)

I was encouraged by what I was reading.  Well, as encouraged as you can be when you realize your body is a killing machine.  I know bodies themselves don't have feelings and emotions, but I couldn't help imagining my immune system as a sinister and hostile army, attacking and killing my poor babies.  To realize that it was getting better and better at destroying the embryos to the point that one day I would stop getting positive pregnancy tests - it was enough to send chills down my spine.

I tried to change my way of thinking.  I tried to see my immune system as an innocent bystander just doing its job of keeping the place clean and no one gave it the memo that babies are welcome here.  I tried to think of the Heparin as the twice-daily reminder notto kill the babies (May I have your attention please:  Do not, I repeat, do not kill the bay-bees.  Sincerely, Management)  I even tried to give him a happy face and call him Captain Heparin - like in that movie Osmosis Jones.  I think the hero was a tylenol, but that's what came to mind.

But then I read that last sentence and wondered if I was already too late and got depressed all over again.  I didn't even know this was the issue, I couldn't have started the heparin at ovulation even if I wanted to!  What if it was already coming unglued as I laid on the bed reading?  I knew I was supposed to do my first shot that night but I was so worn out and dejected and in shock that I didn't.  'It's probably already dead anyway.'

With that, I turned out the light and went to bed.