It's a bit like going to the gym, blogging, I've found. You get out of the habit and it becomes hard to see how you ever managed to post every couple of days or so. I have been ill, and I have been travelling, but still, there are the 20 minutes before I go to bed, or the 15 minutes waiting for a meeting, surely I could have filled those with an update. No? Well, here I am. I decided, just like the gym, to type SOMETHING, just to get myself back in the loop again.
The cold was really awful. It was just a cold, I don't think I ever had a temperature (funny how we English say that. I mean, I always have a temperature of some sort, but we describe having a raised temperature as just 'having a temperature.' Doesn't really mean what it says), but I felt absolutely awful for a few days. You can tell it's a bad day for me when I don't want to either watch television or read about how all of you are doing. Despite this I stupidly struggled to work on any day that wasn't an actual holiday. It's been a really busy time and it was hard to justify the time off, despite feeling like death warmed up. It's been nearly 3 weeks since I started feeling bad and I'm just now shedding the final symptom, which is a hacking cough that makes me sound as if I've been smoking for 60 years.
The really bad weekend in terms of how I was feeling was 2 weeks ago now. Last weekend, despite the coughing, I had a fun time in US City, including buying rather a lot of pairs of shoes at an exceptional sale, getting my nails done, going to the theatre with a colleague, and having a relaxed morning in my hotel room with the New York Times, some french toast, and half a season of ANTM. Despite having had a perfectly fine time, this weekend I'm home and it's distinctly preferable.
The passenger is doing very well. We had a scan on Friday to see how she was doing and how blood was flowing through the uterus, to see if I could come off the clexane (LMW heparin, same drug as Lovenox). The answer is she measures bang on track, and already weighs 750g or 1lb9oz. That feels big, although as H pointed out, she's going to hopefully at least triple in size before she makes an appearance. Which makes me a little nervous given how big I feel already. My blood pressure was 85 over 50 (??!), the blood flow through me, the passenger and the placenta all looked fine, the resistance in the arteries was low, which is good apparently, and so the advice of Dr OB was that I stop the clexane.
This made me a little nervous. If everything looks fine while I'm on the clexane, isn't that a sign that I should stay on it? Apparently not. Given that there are no controlled studies on this situation, they don't really know what good looks like or how to tell what treatment is really needed. So the fact that the blood flow is normal is taken as a sign that the clexane has done its job and I don't need it any more. The hypothesis is that at this stage the placenta has thoroughly invaded the wall of the uterus and there's no more work for the clexane. Given what Julie's placenta looked like when Charlie was delivered this feels a little unconvincing, but then her mutation is Factor V Leiden, not MTHFR so perhaps that explains the difference?
"Of course, if you feel psychologically dependent on it, I'm ok to keep you on it for another six weeks or so," he said, reassuringly. "But leaving you on it til full term increases the (very low) risk that you'll get bone thinning problems, which can be severe, so I don't feel happy about doing that." I don't know if he was TRYING reverse psychology on me or if that sentence just came out that way unknowingly, but either way it was effective. I agreed to leave the surgery without a new prescription. I know that he wouldn't take me off clexane if he didn't think it was the right answer, the best answer for both me and the passenger. I know that he knows more about pregnancy with MTHFR mutations than anyone else in the UK. It is still nerve wracking. However, clearly not that nerve wracking as I still had 2 syringes left, and thought I'd use those to wean myself off, but it's Sunday mid morning now and I haven't used them. My last injection was Friday. My stomach is already thanking me.
I'm still on baby aspirin, "can't hurt, might help" according to Dr OB, and the mega folic acid, so the passenger still has some protection. I will return every 3 weeks from now on to check in on both me and the passenger to make sure we are doing ok ("we would have done this anyway," he said. "But you can come in every week if you want."). Dr OB wasn't completely reassuring however. "You may get complications," he said. "Your age, the genetic profile you have, and the fact that the blood tests that have been done show that you have a high concentration of red blood cells in your blood, all these are risk factors for pre-eclampsia. But if you get complications we won't know if it's due to coming off clexane or not." Cheers, then, I'll just go away and relax now.
No, really, I feel ok. I do trust the doctor, and I do know that the passenger is doing just fine. She's very reassuring. Every time I worry that I haven't heard from her for a while, she'll deliver a beautifully timed poke in my stomach, and I know she's ok. She seems to move around more just after I've eaten, but whether that's physiological and she's reacting to an increase in nutrients, or just psychological on my part and I'm more aware of her just after a meal, I don't know. But I do know that eating a couple of tropical fruit flavour life savers just before a scan makes the sonographer's job a lot harder.