I
Feel
Validated!!!
It isn't often that a doctor cries in front of their patient, but that is just one of the many wonderful things I experienced at this pre-conception appointment.
I'm too excited to write down everything tonight, so I'll stick to the basics.
Sheri Hamersley treats that 2.5% on either end of the normal curve. That 3rd standard deviation. Women like Me, that don't fit the mold of standard medical care. And she does it because she is one of us; she lost multiple babies, too.
The most validating part of the conversation was our discussion regarding Jackson's autopsy and the treatment we'll be pursuing. The portion of the report that I'd researched led me to believe that he had passed away due to a clotted placenta. Dr. Hamersley confirmed that I was correct. When I asked if it meant that my lovenox dosing was to blame, she stopped short of condemning the doctors I had seen with, "Hindsight is always 20/20 but we will be monitoring you much more closely. Your anti-Xa levels will be checked regularly and we'll have you on a different dose."
How different a dose? I had not known that lovenox is prescribed on a weight based scale in addition to anti-Xa levels. Based on my current weight of 153 lbs, the dose I've been prescribed is 60 mg each morning. This will begin immediately and will be taken during my luteal phase along with the prometrium I already take. If I get a negative hpt on 14dpo, then I stop both and wait until ovulation again.
Lovenox, in addition to thinning the blood, has anti-inflammatory properties. I had already figured out that APS is immune based and anyone with an autoimmune problem knows that inflammation is a bad thing. So by taking lovenox during my luteal phase, it will reduce inflammation at the time it is most critical to do so: when a fertilized embryo would try to implant and begin to grow. I will not take it during my follicular phase.
During my pregnancy with Jackson, my dose was 40 mg once daily. My new dose, if/when I get pregnant, will be 60 mg twice daily with regular monitoring to adjust the dose as needed. Why twice a day when I was only on once a day before? Because lovenox has a short half-life. She says the medicine is already half broken down by the body within 4 hours of injection. A once daily dose during my luteal phase will reduce inflammation, but the twice daily dose will prevent clots.
Does that make sense?
She also wrote out an Rx for a prenatal vitamin that has her preferred amount of 5-methyltetrahydrofolic acid (a naturally occurring form of bioavailable folic acid) as well as a comfortable amount of DHA. In 11 years of ttc, this is the first time anyone has ever written a prescription for a prenatal for me.
I also have some blood work to get done that I'll research soon. I believe it's another antibody test that Shady Grove did not run.
The last Rx is for Metanx, a medical food generally used to treat problems with diabetic neuropathy (numbness in extremities due to nerve damage). One of the ways it functions, according to Dr. Hamersley, is to "open" the circulatory system. It increases blood flow throughout the body and increases nerve density.
I am super excited to move forward. I'll also be removing my biggest stress in a month to help reduce my cortisol levels. The swimming pools have opened and I need to swim, alone, three times a week. I love to swim and this will give me the three hours of exercise a week that I need as well as a time to just breathe. Count my strokes and breathe.
If you're a swimmer, you might just understand what I mean. I can imagine that runners feel the same thing about the sensation of their feet hitting the ground. I'd probably like running if my knees could handle it.
So I swim.
I will also be going on an anti-inflammatory diet. No more potatoes or white rice, limited whole grain noodles and bread, lots of vegetables. She recommended kale to increase my vitamin K levels, which should help with the bruising from the lovenox.
Oh!! And SHE USES ESSENTIAL OILS!!!!
Yeah, I think she's going to be a fantastic fit for me, both personally and medically.
Can I get a HOO-RAH?!?!?? (said in your best R. Lee Ermey voice)
