Tests and firsts

I just heard back on the tests we had run late last week, much earlier than expected. Don't worry, I requested a paper copy, just to be sure they actually did them. Everything came back normal. Info from here on what we did.

"Autoimmune testing for RPL:
•Anti-phospholipid Antibodies (yet to run)
•Anti-cardiolipin Antibodies
•Lupus Anticoagulant

Note that anti-cardiolipin antibodies (ACA) are part of the group of anti-phospholipid antibodies (the other six are Phosphoethanolamine, Phosphoinositol, Phosphatidic acid, Phosphoglycerol, Phosphoserine, and Phosphocholine). It is fairly common to test for ACA, but a full work-up includes all seven anti-phospholipid antibodies being checked for three markers: IgG, IgA and IgM markers (so 21 different markers in all).

These tests diagnose a condition that can cause mainly 2nd trimester losses due to blood clots forming in the vascular system of the placenta. The condition is also responsible for some late 1st trimester losses, after heartbeat is identified and some intra-uterine growth retardation has been observed.

This is the cause of about 10% or so of RPL. The treatment usually involves low-dose aspirin and heparin."

Other tests we are doing...

"•Chromosome Testing on Fetal (Miscarriage) Tissue - done (normal)
This can only be done right at the time of miscarriage. It is an analysis of the genetic makeup of the fetus. It can indicate genetic problems that lead to RPL. Many miscarriages are caused by chromosomal abnormalities that are unlikely to repeat. To know if the problem is likely to recur, it is necessary to study the genetics of both parents as well. (N.B. our testing was just of the chromosomes, not the genes)

•Karyotyping of Parents
Chromosome analysis of blood of both parents. It can show if there is a potential problem with one of the parents that leads to miscarriage, but often has to be done in conjunction with fetal testing to provide answers.
These tests help rule out the 3% or so of partners that carry a "hidden" chromosomal problem called a balanced translocation.

•Thyroid panel (TSH)
Thyroid problems can result in both fertility problems and miscarriage. If a problem is found, your physician will in many cases attempt to regulate the thyroid before another pregnancy is achieved.

•Hysteroscopy
This is usually done under local or general anesthesia. Your cervix is dilated in order to insert a tiny scope which the doctor uses for viewing the inside of your uterus. Often carbon dioxide gas is used to expand the uterus for better viewing. Minor abnormalities may be fixed during this procedure, and it is sometimes done in conjunction with a laparoscopy, hysterosalpingogram, and/or an endometrial biopsy. Timing within the cycle varies -- alone it might be done at the beginning of a cycle, with a laparoscopy it is usually done around ovulation, and with a biopsy it would be performed a few days before your period. Expect some discomfort and cramping afterward, spotting, and some shoulder pain if gas was used. It's probably a good idea to take the rest of the day off and relax. Have some over-the-counter pain relief available or ask your physician for a prescription."

Moving on in fits and starts...

At the prompting of my acupuncturist on Saturday, I had my first steak since the m/c this weekend, though I've eaten other meat in the last few weeks. She said that my blood deficiency (exacerbated by the massive and extended blood loss) was likely contributing to my chronic fatigue and headaches (which my nurse wouldn't let me take Excedrin for). She also started me back on the "Precious Sea" herbs that she had first given me last summer to help build up my blood (one of the only remaining IF meds I hadn't given away). It's silly I know, but I had a steak the night before the m/c and I was still having a negative association that I had to get over.

Also, now that I'm no longer bleeding (finally, yay!), I'm finally going back for a massage for the first time since the loss. I had had my first of the prenatal variety the weekend before it (after my not so relaxing family Christmas weekend), and while I know there is no connection and it was absolutely wonderful, it takes awhile to go back and retrace steps, if you KWIM. Totally irrational, I know, but there is little about any of this that is.