What's normal anyway?

I've been frequenting message board about loss and the trials and tribulations of losing a baby.  And I've found that the most commonly asked question is "When will this get better".  Now that is a heavy question, and the answer is even worse; "Who knows?" .  Its hard for me to write a lot of advice on loss and coping because coping is such a personal thing. There are so many emotions that a woman(or couple) can go through after a loss.  Feelings of failure, embarrassment, anger, jealousy, and outright rage.  Of course there is also simple sadness, which turns out its never simple. 

With my 2nd and third loss my main emotion was embarrassment. I wasn't aware that a woman could FEEL embarrassed by losing a baby. But I was. I had been excited and hopeful, all of those things that a new mom should be, but I was such a fool. I should've been skeptical and cautious.. Not happy.  I realize now that this was me being a normal Expectant mom! Not a deranged fool, but you could've fooled me then.

My best advice?  My last loss was in January of 2010, so its easy for me to sit back and say this, but I will anyway; Let time do its thing. Cry when you're sad and feel normal when you can, and just let the days pass until you feel ok with your new normal.  

The techincalities of a loss. Aka the Gloom Post.

I've called my D&C(Dilation and curettage) The easy part of losing my babies, and for me it was. A D&C is defined as the dilation  of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping. It sounds harsh when it comes down to it, but for most people D&C's are not only fairly painless, but quick an easy as well.

Of course as with any medical procedure it goes without saying(but we'll say it anyway) that it is not without its complications, these complications can include risk of infection, bleeding or uterine perforation.

Like I said, for me personally My d&c's were pretty uneventful, the worst part of them was the waiting around and the knowledge of what was about to happen.  I had very little bleeding with the 1st and the 3rd d&c I had, and some period like bleeding with my 2nd d&c.

The emotional aspects of it were the worst, and there are a few things you may want to be aware of.  I do not know if this is the case with all hospitals, but the hospital I had my d&c's were Catholic hospitals. Bbirth remains were viewed as a life and I needed to make a decision about what to do with the remains.  Disposing as medical waste wasn't an option, and I'm pretty sure that I am ok with that, seeing as they were my BABIES.  They offered burial at a mass grave in the catholic cemetery near the hospital, another would be a private burial at our expense. We had no choice but to opt for the mass burial, private burials would be a bit more than we could afford.  There is something calming about knowing they were buried together though.

We were given some good advice from the hospital staff, the best advice we got was that we should name the baby. We didn't know the sex of any of them, but we were pretty sure they were boys.  It felt good to give them an identity and I recommend that to anyone who has lost a baby.  Saying "loss #1" and "loss #2" isn't as personal as saying "Tyler" or "Dylan". 

The best advice I can give anyone suffering a loss is to let time do its thing. Cry when you feel like crying, and don't beat yourself up when you are having a good day. There is no time range for healing, none at all. Keep in mind the people that love you, they may do & say things that you find insensitive, but they just don't know unless they've been through it themselves.

Blood blood! I'll try not to get too technical.

When my Specialist told me that I tested positive for 4g4g polymorphism of the pai 1 gene, he got blank stares in return, and if I was to guess when he realized this was my issue, he gave the lab results the same blank stares because he doesn't seem to know a whole lot about it.  It isn't rare, but its just not commonly heard of, as in it has only just begun its revelations in the scientific world. There isn't much data about it and when I googled it I got a lot of Mumbo jumbo that I couldn't really decipher. 

I do remember this from my "blank stare" conversation with the specialist; THROMBOSIS.. Thrombosis is  defined by dictionary.com as : intravascular coagulation of the blood in any part of the circulatory system, as in the heart, arteries, veins, or capillaries.  And if it helps intravascular is "within the blood vessels."  And Coagulation is defined as "to change from a fluid into a thickened mass; curdle;congeal:"   So if you add all of that together Thrombosis is a clotting of the blood inside of the veins.

*Stay with me here*

Since I didn't get a lot from googling "4g4g polymorphism of the pa1 gene" I just googled Pa1 gene.  Basically this is the gene (located on the 7th chromosome for the record)  That releases a substance in your blood referred to as Tissue plasminogen activator  or "tPA". tPA is a protein directly responsible for breaking down blood clots. tPA is commonly used in clinical medicine to treat only embolic or thrombotic stroke.(*Source wikipedia)

Now 4g5g polymorphism is more commonly known and it referred to in this wiki article . But it doesn't mention the 4g4g specifically.  LIke I said 4g4g is more newly unearthed..  From what I gather (read: I am not a Doctor so who cares what I say, this is just what I understand from reading)  4g5g decreases clotting capabilities in your body 4g4g increases your clotting capabilities. 

I don't know what the normal #g#g is, or if there is no normal, you're just one or the other.  I do know this I have 4g4g blabbity blabbity, and therefore I am more likely to clot, which having eliminated every other blood clotting disorder we can only conclude this is what is responsible for my 3 lost babies, and is responsible for my slow growing (IUGR) baby that I am carrying now. *sigh*   

I think I got a little more technical than I intended, but like I've said my goal is for someone to type in 4g4g and get a real explanation.  I know I didn't and I've been dealing with the realization that I know *nothing* for 4 weeks.  I feel a little more informed and hopefully, if you googled and got me, you feel more informed too!


My hope is, in the end, I can say "I have this, and it stinks, but I took the blood thinners and my baby made it.. So even if they tell you there "may be no hope", there is."

Lets talk progesterone

Healthywomen.org says

"Progesterone is one of the hormones in our bodies that stimulates and regulates various functions. Progesterone plays a role in maintaining pregnancy. The hormone is produced in the ovaries, the placenta (when a woman gets pregnant) and the adrenal glands. It helps prepare your body for conception and pregnancy and regulates the monthly menstrual cycle. It also plays a role in sexual desire."

I had never heard of a women having low progesterone. After my first I waited a year to get pregnant again, the first thing I did when I found out I was pg was call my Dr. He had me come in to have my progesterone checked. Typically during pregnancy they like to see your levels at 20, mine were at 9. Although this wasn't my answer in the end, I feel like progesterone is a huge place for anyone suffering repeated losses to start. It such a simple fix, pills, cream, or a suppository are the most common methods of use(i've heard of injections as well, but I don't know how common that is). There is some debate as to which is better, I've used both pills and suppositories during my pregnancies and found pills to be the easier method since the suppositories require 30 minutes of lay down after insertion.

Among the debate is when to start and when to stop taking it. Obviously If You know your progesterone is low you should start taking it ASAP. Many suggest after ovulation even. Do you know though? I didn't. I started taking it at 10 weeks during the pregnancy in question, 2 days before my missed period during my next pregnancy, and my current pregnancy I started at 4 weeks, give or take. The first two were losses, and I've been off of the progesterone for quite some time at this point in my current pregnancy. My suggestion is to become familiar with your doctor and most importantly your body and you can make the best decision for yourselves.

As far as stopping, most Practitioners will humor you and allow you to continue to take it past the 12 week mark, however if your baby is growing properly up to that point your placenta will take over the job of the progesterone and it becomes taking the meds for the sake of taking it. I stopped at 12 weeks this time, reluctantly, but my dr assured me that it wasn't necessary anymore. Talk to your doctor about how you really feel about it. A good relationship with your doctor is priceless when you are a repeat miscarriage offender.

Ok so like I said in the end progesterone isn't my real underlying issue, but it was an issue to look for in a big way.

** And as a side note I was told during this pregnancy that Progesterone is the little devil that causes morning sickness, which explains why I've never suffered from morning sickness!  So if you're puking your guts up, take heart, thats a good sign.. :-\

Pregnancy complications 101

My goal with this blog is to help other women who've gone through what I have gone through, what I am going through. When you google 4g4g polymorphism, I want for someone to come to this blog and be able to understand what's being written about this blood clotting issue. I am not a doctor, and my words are only my experience, and at this point largely speculative.

My husband and I are expecting our 3rd son, this is my 6th pregnancy. We have had 3 heartbreaking losses and we are just starting to understand why. I have 4g4g polymorphism of the PA1 gene. Unfortunately not much is understood about it, and while it is not uncommon(25 out of 100 will test positive for it) it is not commonly tested for therefore commonly undiagnosed. I've lost 3 babies to this mutation and I intend to learn as much about it as humanly possible.

In each post I'll talk about issues I've been through in hopes that it will help SOMEONE Out there.