Thursday, September 30, 2010

The universe has some explaining to do..

And it has a seriously messed up sense of humor. I'm going to have to move to NYC in January! My boss sprung on me last week that the move is going to happen much earlier than I expected, and asked for a decision. I frantically looked for every possible escape route- there were none, from a professional standpoint.

There are some silver linings- I get NYU subsidized housing very close to where I work, and they will pay me a 1000$ extra a month to go towards housing, so it becomes pretty affordable. Yes, I'll have to kiss my car goodbye, but I can get stuff delivered and picked up( including laundry and groceries) and I'll be using the money I save for cabs. So the wheels have been furiously turning searching for practical ways to make life easier, and there are a lot of choices.

But- if I TTC now, I'll be around 4-5 months pregnant (hopefully) when we move. Not easy. Granted, I plan to get movers to pack (and possibly unpack) everything for me- money is not an object and my boss had better cover it all. Still,even with a lot of help resulting in me having very little to unpack and set up, it is still bound to be stressful.

My family has told me I would be nuts to TTC now, to wait till I'm there and settled to try. I'm definitely not ok with waiting 5 months, but I can see where they are coming from.

So what do you guys think- cross country move possible when 4-5 months preggers? Feel free to take your gloves off when replying:)

PS : Just for a lark, I googled 'moving cross-country while pregnant'. Found this page - its kind of empowering!

Friday, September 24, 2010

I'm a gloom and doom kinda gal and....

I need a BIG rap on my knuckles for it! I've been an impatient and overanxious knucklehead. I've had my scary test results for over a week now (because I made them give it to me), but thanks to the inefficiencies in communication between my OB-GYN's office and my RE's office, have not had the official medical interpretation until today. The part that was driving me nuts was my cardiolipin antibody levels (slightly elevated, but nowhere near the big, scary danger zone) and the fact that I could not interpret my lupus anti-coagulant test results by myself, with no reference ranges. Its a complicated test, I I think even docs would have a hard time with that one. Btw- its called the 'Direct Russel Viper Venom test'- kinda cool.

Anyway, I finally got the verdict from my doctor- I don't have to worry about clotting issues!!! They will retest if I make them (and I will) but right now its nothing to worry about. Most people trust what their doctors say implicitly but with my training and my neither-here-nor-there knowledge of medicine and science, cannot help second guessing them, which can be both a good and a very bad thing.

I still have the anti-thyroid autoantibodies and I start synthyroid before pregnancy to see how I respond. Its quite amazing how we adjust to new realities. When I first found out about this, I was a mess (with guilt and fear) but now I'm shrugging it off.

Finally- its CD2 of my new cycle and looking at my day 1 and day 2 temps (low, low, low) I know I'm going to ovulate early this cycle(by day 15-16) and its probably going to be a pattern similar to the one I conceived and lost in. I had sworn I would avoid such a pattern again because I thought there was something wonky with it, but now I'm not so sure it had anything to do with the egg and I'm sick of waiting. Oh for a crystal ball!

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!

Thursday, September 16, 2010

Subclinical Hypothyroidism?!?!?

My thyroid hormones (TSH and T4) test results are back- all still in normal range, when I clearly have anti-thyroid antibodies! Just tells you that if I had not run this test, I would have never known. If everything else (Lupus Anti-coagulant and anti-cardiolipin autoantibodies) come back as normal, then I guess I will be put on thyroid hormones during the next pregnancy, though managing it will be tricky.

The thing that is making me very nervous is that these anti-thyroid antibodies are known to go hand in hand with T cell dysfunction and other B cell dysfunctions too, in which case you have an immune system running amuck- VERY difficult to keep it from kungpao-ing your baby :(

Praying its not this, and its just this one isolated autoimmune issue. I get hypothyroidism from both sides of my family, so its logical that I might have this problem.

Just a note for all mommies to be- if you have a family history of hypothyroidism, maybe its worth getting this test run, because as I am clearly demonstrating, this problem might not show up if you just test for thyroid hormones.

Wednesday, September 15, 2010

Not 'normal' anymore

Every single blood test I have had so far has ended up with values smack dab in the middle of the 'normal' range. Well, that no longer stands. The first of my test results are back- I have anti-TPO(thyroid peroxidase) autoantibodies, with a high but not too insane titer of 107, with the normal range being 1-9. The presence of such antibodies is strongly correlative with first trimester pregnancy loss- sound familiar? Now we need to figure out if these are the only autoantibodies I have or whether my immune system has truly gone nuts.

I should be grateful I badgered my doctor to test the products of conception and the results of that led to this being tested by my super proactive RE. But right now, when I get emotional and unscientific, all I can think is this- my body killed my baby.

Don't know what is in store for me, whether its going to be hard or easy. I have my worst case plan ready already- surrogacy in India, where it costs a measly 12000 dollars to do it. I get to supply the defect free embryos :(

Friday, September 10, 2010


Hate them. I want to flop down on the floor and indulge in a good limb-flailing session. Here is the background- I'm a postdoc whose work situation was super stable because I had just gotten a 2 year fellowship (its a deal where your salary is funded by an external source, for two whole years). This gave me plenty of time to TTC. Now my boss just informed me that he is being 'courted' by NYU and wants to take me there with him. Its a great university and a pretty nice professional opportunity, but I want none of it. I'm happy in San Diego. I really dislike the idea of living in Manhattan- its cold, you get a little hole in the wall for an exorbitant amount of money, you have to go to laundromats to wash clothes, you walk everywhere because you have to give up your car- I've done all of this for 6 years already, and I was finished with it. And all of this is much harder to do if pregnant and alone.

If I don't go with him, I will most likely lose my fellowship. Then I have to job hunt again, and settling in a new lab is always stressful. There is one possible solution, and that has to do with timing- get pregnant ASAP and deliver by the time he is about to leave- then I can just pack up and go live with my parents in India for 2 years. This has always been my plan (because of violent opposition of my family to daycare in the start), but pulling it in a constrained time frame makes it all so much more stressful.

Don't know what to do, but I guess the number 1 thing is not to stress out. All will be well, I just need to adjust better to new realities.

Thursday, September 2, 2010

Being kind to myself

Its been a few days of serious mental conflict. After first deciding that I'd go ahead with insemination this month, I realized I just couldn't. You cannot do something so potentially life-altering when your mind swings like a pendulum every 2 minutes. I don't know if this guy I'm interested in could feel the same way about me, but I've realized that if I later discover that it is indeed the case, it would be a pretty messed up situation. One more month should be enough to figure out how he feels. I honestly don't think he returns my feelings, but I need to rule out the possibility before proceeding.

Plus, I just want to have some fun. These past few months have been grueling mentally. I went from somebody who has never experienced death to losing a child (thank god only at the embryo stage) and then 2 days ago, my beloved labrador was put down because of kidney failure and arthritis. I'm having visions of my dog meeting my baby in heaven, and its pretty funny because I'm agnostic.

But, boy is there conflict. There is a part of me that is saying, enough punishment, time for a little respite and then there is the other part of me that desperately wants to try again, wants to be pregnant RIGHT AWAY, and more than anything, wants to find out if I am capable of actually sustaining a pregnancy.

But the one thing I do have a lot of, is time. I met my new RE- LOVE him! Had the most seriously painful ultrasound which helped determine that:
a) my uterus has normal structure (slightly arcuate but still ok, according to the doc). No fbroids or anything else problematic.
b)I have so many antral follicles (16 in each ovary!!) that he is having me tested for PCOS. I have no symptoms nor family history of PCOS so I'm only slightly nervous about this blood test.
c)He wants my miscarriage investigated further by running an autommune (anti-cardiolipin and lupus anti-coagulant) panel, because he says the fact that the chromosomes came up as normal is a little suspicious. Quite a change from all my other docs who looked at the normal karyotype result, shrugged and said, just try again!

So I'm being sensible, taking myself off to New Mexico this weekend instead of sitting around in town trying to keep myself away from the Doc's office. I'm getting blood tests done next week. And after that, until that next ovulation rolls up, I'm going to have FUN. Maybe a trip to Vegas with the new gang!