What next? Oh what the heck lets talk about Blood again..

I've grown to have a love/hate relationship with blood over the last few weeks. I mean on the one hand you depend on the junk, you're not a whole heck of a lot without it, now are you? On the other hand it can cause so much trouble if you don't understand it, whats going on, or how to fix it.  I've got the "whats going on" part down, you can read my previous entry about the dreaded 4g4g Polymorphism if you'd like.   I wanted to write about a few of the other blood troubles that I've met(although not closely dealt with) along the way.  I also want to write about the "How to fix it" part of the above mentioned dilemmas.

First of all, clotting.  When I first started being tested for issues, my original Doc threw our a cluster of probably causes of fetal loss.  Most of them were thrombosis issues(read: clots) And there quite a few to choose from.  First there is "Antiphospholipid syndrome", "Factor V Leiden",  "Lupus Anticoagulant" and then of course there is the 4g4g polymorphism(which he did NOT mention, but its probably because he didn't know), which has no wiki-link. I have become jealous of those of you with wiki-links to go along with your diagnosis.. *SIGH*  All of the above accomplish the same sinister goal, coagulation of blood, in one way or another.  No sorry, not just "coagulation of the blood"; OVER coagulation, unnecessary, and excessive coagulation of the blood.

Why is this problematic, specifically for pregnant women(not only, just specifically)?  Well, when you are pregnant your body naturally produces more clotting factors, making a pregnant woman SIX times more likely to develop a blood clot than normal..  Not only that but your uterus is growing and expanding, Pushing and moving which can compress important vessels in your body, slowing the blood down and creating the potential for clotting.(click for source)   There are actual benefits to your body creating these extra clotting factors, you lose less blood during delivery. I think in a way its a lovely design... Unless of course you have an ugly friend in your body(see list of ugly thrombosis issues above).  There are ways to prevent clots, and to speed up the blood flow, and thats where my next topic of discussion begins.

"The Fix"

i was under the impression when I started taking baby aspirin that I was going to be lucky enough to not need anything but that tart tablet every day.. Boy was I wrong.  At 24 weeks my Dr started me on Lovanox. I got the Non-optimistic, Non-pessimistic, merely REALISTIC speech "This is for your benefit, not the babies since at this point in understanding 4g4g we just don't know if it will benefit HIM at all"  Not exactly a vote of confidence, but I'll take it.  The shots are taken twice daily. I've been on them almost a month and I will say its 70% mental 30% painful which are decent odds if you really think about it.  I've learned to inject in certain spots faster than others, because those hurt the most. So unless you're going for the long slow torture method, you just really wanna go "balls out" for those areas.(IMO the higher you go the more it hurts, just my opinion though ;) ) I've also come to learn the spots that I don't feel at all, but I've abused those spots in the last few weeks, so they're bruised and unpretty.. So I'm going for the fast shots right now.  All in all its pretty simple, make sure you're in a reasonably clean environment, get your hand sanitizer and your alcohol prep pads out.. I pinch the area on my belly that i'm about to "shoot up", then make sure you activate the safety shield once the shot is out of your body and dispose. I use an empty detergent bottle for my leftover goodies, they hold a ton of syringes!   I usually sit still for a moment or two because I have to "reforget" what I just did or I can't go on with my day with shuddering at the thought. lol I am pregnant after all, so dramatics come easy for me!

Anyway take heart if you're going through this with me.. Its not something I'll soon forget but in the end I hope we can all say "It was SO worth it!"

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."

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.