Antithrombin III deficiency and pregnancy

This post is a bit of an educational one and is perhaps more relevant to the infertility warriors out there than the pregnant mammas.  But keep reading pregnant mammas as maybe you’ll learn something hear that one of your friends might find interesting.

As part of my investigations into possible causes of my multiple miscarriages, I was tested for something called Antithrombin III deficiency.  The results showed that I did in fact have a mild deficiency which, put very simply, means I am more prone to thrombosis or blood clots than the average person.

It is good to be aware of if for no other reason that if ever I am having a major surgery I can let my medical practitioners know to take extra precautions to prevent blood clots forming.

What makes it a particularly big deal for me is that it may have been a contributing factor in my infertility and multiple miscarriages.  It is also a big concern when you are pregnant as a blood clot is generally considered a bad thing for both mother and baby.

I am really happy that I went and saw a haematologist separately to my IVF doctor as haematologists are more specialised in this and I found my IVF doctor was and still is sceptical as to the relevance of antithrombin III deficiency.

The treatment that I have been given to offset the risk of thrombosis has been a daily, self-administered injection of a blood thinning product, in my case it is Clexane.  Many IVF doctors do give a low dose of Clexane as part of the embryo transfer process (you usually start a daily dose a couple of days after your transfer), but in my case I needed a higher dose in order to combat my deficiency.

So yes, I have been jabbing myself every single day with a blood thinner since mid-November last year and I will continue up until the birth and then for six weeks afterwards!  Let’s just say that with the IVF injections and now the Clexane, I am not at all squeamish about giving myself injections anymore.  In fact, I am incredibly efficient about it – it probably takes me less than 2 minutes and that includes unwrapping the injection from it’s packaging.  I am a pro at injections these days!

At about six weeks pregnant my haematologist checked my antithrombin III levels again and found that the dosage of Clexane was sufficient at the time, but she did caution me to come back to be tested again once I’d gained some weight with the pregnancy.  Weight gain and increased blood volume can impact the effectiveness of the dosage.  So back I went to be tested a week ago and I was freaked out to learn on Friday that I need to almost double my dosage of Clexane as I am back into the risky zone for thrombosis.  Eeeeek!

Actually I expected to have my dosage increased as I had noticed I stopped bruising so very easily which I did at the start of my pregnancy.  It was a sign that my blood was not so thin anymore.  I don’t know why, but I felt kind of sad for 24 hours after hearing I had to up my dose.  I think I’d gotten to the point where I felt like all my struggles to conceive and failure to be a “real woman” had started to melt away and this was just a reminder that this pregnancy is a miracle of science as much as anything.

But really it’s fine.  It’s important I do everything in my power to keep baby and me healthy.  So what if my dosage is increased? So what if I have a couple of bruises here and there? This will all be forgotten in the sands of time.

Moral of this story though is that if you too have had multiple miscarriages, especially missed miscarriages like I did, then I suggest you go and also have your antithrombin III levels tested.  It’s a very specialised test and so regular blood clinics might not do it.  It’s also expensive, but it’s probably some of the best money I’ve spent during this whole process.

 

 

Week 28 – Third trimester hot mamma!

Helllooooo third trimester! If I’m honest, I had gotten to the point in the IVF road last last year and I really thought I’d never be pregnant or have a baby ever so hitting the third trimester is even more exciting and incredible than I could ever have imagined. I’ve looked back at old posts and this time a year ago I had just gotten the news that my second pregnancy was also not viable. So that was two missed miscarriages within about 5 months. I think I actually got worse mentally after that before I got better, but overall it was an epically awful time.

Yet here I am a year later – and seriously, it feels like just yesterday all that happened – and there is an actual, live, kicking baby inside of me. For so long I wondered if IVF was just a big scam, but then it worked. IT ACTUALLY WORKED!! For any of the IVF warriors who are reading this and are questioning the whole journey (god knows I was) then I hope this gives you some kind of inspiration to keep going.

Even after all the trials of getting pregnant and IVF, it’s almost comforting to know that you can still have disagreements over a lot of baby decisions! Hubby and I have been in a battle for some time now over the name of the baby, our son (wow, it still feels weird to write “son”). We ended up each asking one close friend for their opinions without the friends knowing which name we each favoured. Just my luck though that both friends went with hubby’s choice. I think I have officially lost the battle. In good news, the baby now has a name and hubby says I get to choose the name if we have another baby and it’s a girl (I assume if we have another boy the battle will recommence). This does feel like an empty victory for me, haha!

During the whole naming process I have had some regrets about my past though. It’s very hard to choose a baby name if the names you like are those of ex-lovers. I would give some advice to my 20-something self to only date men with names I don’t really like as I have had to rule out several names based solely on the fact that I had longish and memorable relationships with them. Not something you’re thinking about when you’re getting hot and heavy with someone new when you’re 20-something!!

On to this week’s summary…

Weight gain: Minimal this week! Phew! I continue to feel like I’ve gained a lot of weight though. When I’m on my feet for any length of time I feel the extra 10kg in my feet. When hubby makes fun of me needing a rest or a sit down, joking that he doesn’t believe I ever ran marathons (I damn well ran 6 of them!!) I want to strap 5kg ankle weights to each of his ankles! I probably would if he wasn’t still recovering from his knee surgery. Just so he shuts up!

Symptoms: See my previous post for a more detailed summary, but occasional dizziness continues, as does generally feeling sluggish and being out of breath. Sometimes baby sits really high up right under my rib cage and I kind of have to wiggle into a strange position to feel like I can breathe properly. It’s more of an irritation than anything. Most of the time I feel pretty fine, if a bit slower than usual.

Eating: I continue to more or less eat the same but I think I am a bit more hungry in general these days. I try and eat every few hours as I can get a bit dizzy and bad tempered if I don’t. However, I really don’t seem to be struck by crazy cravings like you hear about. There are no pickled onions with peanut butter for me. I almost feel disappointed in myself that I don’t have to send hubby out at 2am for some kind of chocolate chip ice-cream and salsa concoction. Also because it’s hot I think this affects what I want to eat. Maybe if it was winter I’d want to eat all the carbs in the universe at this point of the pregnancy.

Sleep: What’s normal at 28 weeks of pregnancy for sleep? I wake up at least once a night to pee and sometimes twice a night. I’m so well-practiced at it now though that I’m barely awake when I’m doing it. I continue to sleep better in the first half of the night so I just try and get a good 4-5 hours in before I move to the restless-half-awake kind of sleep that seems to happen in the last few hours before getting up. I do go to bed earlier than I used to pre-pregnancy and hubby – who is a bone fide night owl – seems also to be coming to bed earlier as a result. He usually spends an hour or so doing his own thing after I go to bed before he joins me and since I now go to bed earlier, so does he! This has also started to mean he gets up earlier. I swear my hormones are getting to him!

Movement: The baby has moved on from being a ninja to now being a velociraptor. They’re the small but really aggressive dinosaurs from Jurassic Park. I’m not trying to suggest he is a mean baby, but rather his movements are STRONG these days. Sometimes they even startle me or make me wince. I thought this happened later on in pregnancy so I’m starting to wonder what the kicks and punches are going to feel like closer to the end. Sometimes he gets so active that my whole belly is jolting. It is funny, but it is so, so weird!

Emotions: This past week has not been great for me. I’ve been emotionally drained and feeling really down. Hubby and I had a ridiculous and upsetting conversation on Thursday night about what to do about the room which is due to the baby room / nursery. The details of our conversation are so boring, but I was overly sensitive to everything he was saying and just sobbed and sobbed and sobbed. Even by Friday – my day off work – I didn’t feel better (the discussion was not resolved you see). It was the worst day I’ve had in a long time, but I think a lot of it was rooted in tiredness.

It’s been a tough week at work and it’s been hot weather too which has contributed to how tired I feel. I think it’s the time of year where companies are trying to get a lot of stuff done before the summer break, but also I think both my boss and my clients are freaking out a bit about me going on maternity leave at the end of June and so are trying to front load my schedule. Lucky me!

In good news I’m doing better today and I am so grateful to be carrying this lovely baby inside of me.

Missing: This is not a new one, but I am really freaking out about how tiny my support network is around me. I am a very capable, independent person, hubby is awesome (he really is, despite what I occasionally write here) and his parents are kind and generous, so I’m sure everything will be fine. But his brother and wife annoy me which makes family gatherings not relaxing for me. My family is so far away and they’re not very proactive with support at the best of times so I just get sad about this stuff occasionally. I don’t see anything changing with any of this so I just need to get over it really.

Purchases:  I got online again and bought a pair of shorts, a swimsuit and some new summer sandals. Yay! Do you know I really only look nice in blue and grey shades at the moment.  Pretty much all of my maternity clothes are in shades of blue, grey and white.

We also collected the stroller today (which is grey) but we asked them not to build it yet so we can keep it stored in its box for another couple of months until baby comes.

Looking forward to: Finally resolving the baby room situation and my husband not being totally annoying about it all. I guess when the baby furniture all arrives in a few weeks and he realises there is no where to put it then he might do something. Enough said.

Best moment of the week: There have not been a lot of highlights this week, but I do have a funny story! On Thursday evening I was hot and tired when I came home from work so I took all my clothes off except for my knickers and I had a little rest on the bed in the spare room. I was lying on my side on the bed, obviously without a bra or top on, and my littlest kitty came to say hello. She spotted my nipples, which are now dark brown saucers rather than the petite little things they used to be, and thought she’d give them a little pat with her paw like she would a toy. It was so funny and surprising, if a little unexpected. I laughed and laughed!

Also, I saw Beyonce wearing one of the maternity t-shirts I own this week and it’s about as close to Beyonce that I will ever be! Hahaha!

Exercise: This week walking was the focus, with only one session of yoga. I could have gone for the second yoga session on Friday but I was too miserable and tired to be bothered. I did go for a walk instead so I wasn’t a complete lazy bum.

Bump update: The bump is now starting to get a LOT of attention. It’s gotten to the point where people have started to touch it without permission. Not many people do this – perhaps I give effective F-off vibes – but we went to see our architects designing our house yesterday and one of them (a woman) went for the belly touch. I don’t know if I gave her a look of death, but I probably did because I know what I was thinking in my head and it was not friendly! She did back off quickly so hopefully she got the message. She then started quizzing me about the usual stuff (is it a boy or girl, when is he due, how are you feeling) and I kept giving very short answers so that was the end of that. I am delighted to talk about my pregnancy to people who I know well, but this woman gets on my nerves so I think I went into full defensive mode. The house looks good though so that’s something.

I’m also confused by how the size of my bump rates as some people, such as my father-in-law, keep telling me it’s huge (thanks very much) and others (usually women) telling me it’s compact and neat. I have decided that men just have NO IDEA and should not offer any opinion on the matter!

The kitties have joined the photo shoot again this week as they seem to be more popular than my bump photos are!

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The most pregnant I’ve ever been

This is the time of year when you reflect on all that has gone by in the past 12 months and, yes, this year has been really tough going at times. On the flip side, this time last year I had just had a D&C after my first miscarriage and I was in a world of mental pain, but jump forward and today I am at the opposite end of the spectrum. Earlier today we went for our almost 9 week scan (I’m 9 weeks tomorrow) and everything is just as it should be.

The baby is now a foetus rather than an embryo, and I got to have my first external scan! No dildo wand for me!  (I was genuinely a bit let down as I had made a special tidying up effort last night in anticipation) This time on the screen we saw something vaguely resembling an actual baby.  We could make out its head, its body and its tiny little micro-limbs.  The foetus was even having a little dance in there as we could see it jiggling about. At one point I thought it looked more like a kitten than a human – and said so – which caused the doctor to inform me that it was illegal to transfer animal embryos into humans.  Aaaah okay, that wasn’t what I was suggesting had ACTUALLY happened!

In any case it was a lovely appointment and far less stressful than any other appointment I’ve had ever. The foetus measured at 2.26cm CRL and had a heartbeat around 160 bpm – all normal.  I think my doctor was actually really delighted by how well we’re doing.  This is the most pregnant we’ve ever been which is super-exciting! I am actually feeling really good about Christmas and just things in general. I know we are still a long way off, but you have to quietly celebrate the good milestones when they come.  If another speed hump does come along further down then we will deal with it as we have every other hurdle, but for now everything is okay.

We have decided we won’t come for another scan until The Big One in mid-January, which is when they do the Nuchal Fold test, which indicates Down’s Syndrome, and the blood DNA tests that check for other chromosomal issues.  Of course if anything pops up along the way, such as bleeding or whatever, the Doctor said I should come straight back in and we’ll check it out.  This works for me.

I had told my Mum our initial good news when we had the positive blood test way back weeks ago, but today I gave her an update including the scan.  She is delighted and I really do think it cheered up her pre-Christmas.

In the interests of reporting all side-effects, the past few days I have been REALLY off all things meat, and just generally off food in the evenings. There’s been no vomiting but I have felt quite nauseous at times!  I’m hoping some acupuncture tomorrow will ease this off a bit!  In the meantime all things savoury/salty and citrus are the best when I’m feeling a bit off.  Helloooooo crisps and clementines!! I’ve been feeling a bit tired at times, but nothing debilitating. I think I’ve so far gotten off quite lightly.  Anyway, every time I feel a bit gross I am actually delighted about it as it helps me to believe that things are happening as they should be.

8 weeks 3 days

Here we are at 8 weeks 3 days and as far as I know I’m still pregnant. I’ll know for sure on Thursday when we have our next scan. Given that I went a bit nutso at my doctor a few weeks ago he now seems keen to placate me at every opportunity so has not even tried to suggest I come for scans less often. 

I still don’t really recognise myself as “being pregnant” as the fear still looms large but hubby and I have allowed ourselves brief chats where we’ve discussed the concept of sometime in the very distant future shopping for big ticket baby items. The risk of jinxing ourselves is real though so we talk about things in a conceptual way as though it would be what other people would do should they be pregnant. 

Symptoms-wise I have observed some pretty feisty heartburn today, some low grade nausea that I would describe as “feeling blah” rather than wanting to puke, and (TMI warning) my “gas” situation is into a new dimension. I always thought the myth about husbands not wanting sex with their pregnant wives was down to their changing shape. Now I’m pretty sure it’s down to their farts. 

This is also joining together with regular progesterone-led bloating so my midsection is just a little thicker than it normally would be. My super-skinny jeans are now totally out of the question, but regular skinny jeans with a low rise waist are seeing me through so far. I’ve not felt super tired the past couple of days thanks to a relaxing weekend but I did go to a birthday party on Saturday night and my eyelids were closing on behalf of the rest of me by 11.30pm!

The party was at a sushi restaurant so not only did I have to avoid questions about why I wasn’t drinking but also I had to find creative reasons why I wasn’t eating any sushi. The couple sitting with us who met us for the first time ever at the party must think I’m the weirdest eater ever because I told them I don’t eat shellfish or raw fish because I’m kind of vegetarian (I’m not) and also I told them I was not drinking because I was driving home. Home was less than 2km away and I refused even one drink.

At one point the girl referenced my lack of drinking as “unless you’re pregnant” to which I just laughed excessively but didn’t actually respond to. At the end of the night they happened to leave at the same time as us so I had to hiss to my (not drunk) to give me the car keys so I could drive and keep up the story!! The things we do…

Right now I have one of my cats curled up on my belly. I think he knows our secret as he keeps cuddling my little bloat belly and showing it his love. Either that or he’s really cold. Haha!

Happy Birthday to me!

Tomorrow is my birthday and I got my present a day early… My scan went as perfectly as I could have hoped for!

I had so much anxiety leading up to the appointment that the morning seemed to pass by like an eternity. By the time I got to the clinic I had gone through every negative possibility in my head and had prepared myself for the worst. 

On arrival, the doctor asked how I was and I don’t think my answer of “So stressed my anxiety has reached a new stratosphere” was what he was expecting to hear. 

Into the scan room we went and hubby has learned from previous (bad) experience that it’s not good to be standing for this kind of news so went straight for the chair. 

And then on our screen we saw a lovely mass of something or other that is our embryo. I can’t say it truly looks like a baby, but maybe more like a dinosaur at this stage. In any case, our little baby dinosaur is now 12mm and had a heart rate of 143bpm, which is bang on what it should be for 7 weeks 3 days!

It was actually really funny as I pretty much demanded to know the heart rate so the doctor took some time to work it out. I’ve had problems in the past where the heart rate was a bit low – an indication that the embryo was failing – so when he confirmed 143 I burst into tears knowing that normal is between 120-160 at this stage. 

I am officially an IVF nerd. 

After leaving the clinic hubby asked me if I’m happy. I guess so but it still manifests itself in relief. I think happy must come a bit further down the line if we manage to get there. But for now everything is good. 

Everything. 

Is. 

Good. 

Please remind me of the fact that everything is good when I no doubt have a failure of confidence some time in the next few days.

Happy Birthday to me! 🎉

This is The Week

As the title says, this is the week for us where it all happens.  This is the week where we have previously encountered some problems and so it’s fair to say that it feels like life is on hold until we get past this period.  Even planning Christmas and New Year is next to impossible because I need to know whether I’m going to be pregnant still in order to know if I need to somehow come up with a way to disguise my lack of booze consumption.  I know that sounds a bit grim, but I’ve got history so I feel like I need to be ready for every eventuality, even the not good one.  Monday is my scan so I am crossing everything that is crossable that our little embryo is growing nicely in there.  Please, please be growing!

After my mini-meltdown earlier this week I have realised what caused my symptoms to mellow and it most likely had nothing to do with the embryo’s success or failure but rather that I’d told my acupuncture guy about the heartburn and so on Tuesday night he had given me a needle to ease it.  Turns out it works and I just forgot he’d done that!  So stupid of me!

So I am now officially 7 weeks and 1 day pregnant (unless told otherwise, I am forcing myself to refer to myself as pregnant even though I am still in denial) and I’m now feeling a bit more tired. I had a big day out yesterday with a client that involved me driving for about 3 hours behind the wheel, not to mention all of the “performing” that is required when you are client facing.  When I got home at 7pm I was way more tired than you would expect of the kind of day I had had.  Even today I’m still feeling a bit rundown so it’s been a very quiet one for me.

I’ve also got a bonus thing going on in the periphery of my life right now.  Someone close to me who has been trying for a baby for some time , including a round of IVF, has told me she just found out she’s pregnant naturally (she’s literally just passed 4 weeks). She disclosed the information to me because she knows my situation and she thought I would understand her fears and what she’s going through.  So it’s a massive compliment that she would share something so deeply personal and private with me.  At the same time it’s a lot for me to take on board as it means that – all going to plan for both of us – we will be due just a few weeks apart. Or worse… if one of ours doesn’t work out then one of us will be all in the other’s face.

I know this is going to sound weird, but I would have liked her good news to be a bit spaced out from mine. This person is already a mother to kids who are tweens so in many ways it would be good to have a buddy going through the same stuff who has some idea of what to do.  At the same time, I’m the kind of person who likes a bit of space to find my own way and I can’t help but feel a bit sad about this whole possibility of either sharing my pregnancy with her or having to watch hers grow and blossom if mine fails. Full disclosure: the latter is what is freaking me out the most.

I might change my tune later on, but it’s a bit like when you tell someone something great and they just turn around and tell you something even greater.  It makes you feel a bit miffed that your fabulous news didn’t get the reception it was due.

 

Losing my mind

Everyone bangs on about the two week wait, but I have to say that was a piece of cake compared with the past few days of wondering if my little one is going to make it this time. I pride myself on being the kind of person that can handle stuff really well.  I’m successful at work, manage multiple projects and deadlines more or less seamlessly, but this waiting game is BRUTAL!

I know pregnancy hormones are meant to bring out the see-saw hormones anyway, but I don’t even know if I can fully blame them for my current mental state of affairs.  I am just so scared.  So scared of having to go through the same loss/grief process as before and on exactly the same timeframe as last year.  If I wasn’t going through IVF again at this period in time I would still be thinking of everything that’s happened (and not happened) in the past 12 months, but now I am doing that and wondering if it’s going to happen again. It’s like the most messed up deja vu situation possible.

For the past 24 hours I have been full-scale panicking that I’m losing all of my pregnancy symptoms. This is mainly based on having lost my heartburn.  Who would thought anyone would actually be excited to have heartburn?!  I then decided my boobs were smaller than the day before and less sore, but I might have imagined that because they’re still feeling pretty darned sore today!  Tonight I started to wonder if I was imagining feeling nauseous but then I got that weird thing in my mouth where the saliva started overproducing so maybe it was for real. I found me a breadstick and felt much better! 🙂

On the medical front, I had my thyroid tested yesterday and it’s still too high, dammit! It came in at 3.9 and it’s meant to be under 2 during pregnancy.  Ugh. I think this was the trigger for my latest panic as underachieve thyroid is a contributing factor to miscarriage.  I don’t need any help in the miscarriage department so my mind started leaping wildly to conclusions, my heart racing and my fingers typing into Google faster than you thought was humanly possible.

Both my super-awesome haematologist and endocrinologist (both women) are really supportive and have told me it’s a little too high a score than we would like at this time, but it is not really bad either so I am feeling a bit better.  Both of them were all very much of the opinion that staying positive is Very Important, so I am doing my best to listen to the advice.

Hubby has also been reassuring saying I am pregnant until someone tells him otherwise (that someone is not me it seems).  I am almost in total denial that I am pregnant and he asked me how far pregnant I have to get before I’ll acknowledge it.  I suggested maybe when I’m in the delivery suite!  Haha!

So now I have to hang on / endure the days between now and Monday.  And stay positive.

Must.

Stay.

Positive!