Saturday, September 18, 2010

A future of being poked...

and a *probably* high risk pregnancy is headed my way. Perinatologist, here I come.

Issue # 1 : Thyroid - I have anti-thyroid antibodies- in addition, my TSH was 2.86. For the thyroid savvy, that is still in normal range, but that is a bit higher that one would want it to be during a pregnancy. I'm going to need a fair bit of thyroid hormones and a LOT of blood tests to monitor hormone levels. And thyroid insufficiency is a funny thing- I remember one glaring thing from my pregnancy- I was so cold, so often. 3 days after my IUI, I was just folding clothes, I'd been fine all day and suddenly I was chilled to the bone, a trend that continued on and off throughout that shortlived pregnancy. I'd sleep with sweaters on, something I never ever did before.

Issue # 2: Possible autoimmune clotting disorders too. I got cardiolipin and lupus anticoagulant back- I'm just straddling the far boundary of normalcy for both and the scariest thing is it is documented that it can sometimes increase during pregnancy. So I'm looking forward to very regular blood tests in that area as well and immediate treatment in case the levels increase.

I'm really getting angry with the OB who managed me. She is a lovely person with an excellent bedside manner, but her reaction to everything is, oh, lets not test, these things just happen. I want a super aggressive perinatologist to go with my super aggressive RE- UCSD is supposed to have a very good one.

I'm so utterly glad all of this is coming out now, and not after I have had another loss, which was definitely possible had I listened to everybody around me and left all of this alone. I'm also so utterly grateful I can understand and process all these tests and jargon so easily, it would be so much more scary if that was not the case. Although I now have good doctors, its so useful to understand what is happening so you are not entirely at some MD's mercy.

But it might not be so bad. Possibly I might not need more managing other than the thyroid. Lets hope it stays at that. Otherwise- bring it on, heparin, aspirin, even steroids- I'm ready.

And after that brave last statement.. I'm rethinking Lovenox(that is the heparin injection), it has to be taken 1-2 times a day in the stomach?!?!? Which sadistic SOB dreamt that one up?!?! OH praying I don't become more autoimmune with time!


  1. You sound very calm and ready for what may come. So glad you got some answers. Wishing you the best.

  2. My TSH was 11 when I was diagnosed. I was one of those people that got it managed quickly. No one seems too concerned right now because my blood tests have been close to normal. I know I am early on with this pregnancy but no one is acting like this is a major issue and they aren't rushing me to the lab every week. I am remaining hopeful.

    I know I am getting better because I have more energy know than last year, so I can drive without pulling over to rest, have an extra afternoon coffee, feel freezing and my hands stopped hurting. Funny thing, I just thought I was working too hard.

    I can imgaine with a loss, you are finding it hard not to worry. I would switch OBs. You will probably be referred to an endrinconologist to look at your thyroid besides your RE. Then ask them for a referral to someone they work closely with.

  3. I'll agree with Selkie Baby - once your thyroid is treated, it's no big deal. I check thyroid tests at conception, six weeks after, and then the second and third trimester. Most OBs do it on their own, I just see my own patients who want me to continue to manage their thyroid. I have no patients with thyroid disease only who see a perinatologist - and once you have your labs retested, you may not need to continue to see one, either.

    To answer your other question - I don't know if I have any patients who have antiTG abs who aren't on thyroid hormone while pregnant. It's not something that routinely is checked.

  4. Yeah, the poking thing seems to be a common occurrence, no matter what your situation is. My arms are starting to look like those of a meth shooter lol. Thankfully I have pasty-pale arms and big, juicy, blue veins.

  5. Jay.. I'm sorry to hear this. I would see an endocrinologist so they can monitor and treat your thyroid.. I am sure it will be fine and you will be on your way to your IUI.

  6. Thanks all. Just a clarification- its NOT my thyroid I'm worried about, that is a simple issue with a simple fix.

    Since first finding out these results though, I've been worried about other things, basically other autoimmune antibodies that can cause clotting issues. When we tested that, it looks like I'm in very unclear territory there, you can't really tell if its an issue, but you definitely cannot rule it out either. This is why I really need a perinatologist, to monitor it aggressively and start treating if need be.

    My current OB would do wonderfully as an agony aunt, but when it comes to the science, well, there I don't feel so certain.

  7. Jay, I am sorry that your journey to motherhood is not an easy one. I hoping for the very best for you.

  8. I'm so sorry you are having to deal with all of these issues! I recently found out I am hypothyroid. And I also have a genetic clotting disorder that will require Lovenox/Heparin during pregnancy. So we are in a very similar, and very sad, situation. I hope that you don't need the Lovenox!

  9. Mrs Unexpected, I'm so sorry- clotting issues suck, and the treatment(the heparin) sucks even more. Its funny though- many women WITH clotting issues who never receive any treatment have can have normal pregnancies, but I don't think you or I would be brave enough to take that risk. Which one do you have- Factor V leiden or MTHFR?

    About the hypothyroidism- that one is an easy fix so I don't think we have to worry too much about that one. Thank god for small mercies!