I have better equipment than my OB

All I can say is, thank heavens for home dopplers, and thank heavens that I am no miser and bought the top-of-the-range home doppler which shows you the speed of the heartbeat. I decided last night to listen to the heartbeat. I thought it was a little silly, as we had the doctor's appointment this morning, but I wanted to, and so I did. I found it quicker than I ever have before, and it made me very happy.

This was a good thing because the doctor really struggled to find the fetal heartbeat today. He used both of his (rather poxy-looking) dopplers, and only once or twice got a quick burst (1-2 seconds) of what was clearly a fetal heartbeat. He wasn't worried, but I would have been had I not heard it last night. So that's my MO for every appointment going forward, listen the night before so I don't have to worry.

The vast spectrum of blood tests that he carried out last time showed that everything is mostly fine. Annoyingly they didn't run the Protein S assay, which he wanted to give some indication as to whether I would stay on clexane or not. Protein S is part of the blood clotting cascade, and is usually lower (sometimes deficient) in carriers of the MTHFR mutation that I have (C677T). Since pregnancy can lower protein S anyway, he just wanted to see if it would come back within normal ranges, which would indicate I might be able to do without the clexane. They just didn't do the test, despite having kicked up a big fuss when I turned up for all my blood tests about how inconvenient it was, etc. etc.. It was funny to see him talking to the lab trying to chase this. He has a very low-key exterior, but you could see the cartoon steam coming off the top of his head as he struggled to stay cool. The tone of his voice didn't change at all, however. H mentioned afterwards that he'd hate to meet doc in a dark alley when someone has REALLY upset him...

The one interesting thing the blood tests showed was that my haemaglobin is on the high side of normal. Normally this would be a good thing, but given the MTHFR issues, it might indicate that things are not entirely wonderful, risking the kinds of clotting problems that can cause problems later in pregnancy. So given this, he has decided to leave me on clexane at least until 24 weeks, and then reevaluate by doing a blood flow test to see if there are any likely problems. The risks of staying on clexane til then are pretty low. The two risks he mentioned are (i) a situation where you become allergic to the heparin, which sounds pretty nasty, and (ii) severe bone weakening leading to fractures. He says that at the dose I'm on for the length of time I'm on it, these are very very rare complications indeed. He did test my vitamin D, to make sure bone loss isn't imminent, and it came back fine. So my stomach, which is a veritable patchwork of blue, purple and yellow, is just going to continue to look unsightly.

Doc also did a urine test while I was there today, and it showed no protein (good) but a bit of blood which might be ok but might also indicate a UTI, so he's sent it off to be tested. My blood pressure was also a reasonable 130/68, so nothing to worry about there, although as someone who has always had surprisingly low blood pressure til now, it's a bit shocking to hear anything other than: "105/58, are you sure you don't faint often?"

We left with an appointment to come back on 10th May for our 20 week 'anomaly/morphology' scan, and a request that we don't hesitate to come in sooner if I feel nervous. At the moment I'm feeling fine, so I don't know that I'll need to come in any sooner, but we'll see. Thank heavens for home dopplers, again.

15weeks

Comments

[serenity]

Funny - I have low blood pressure as well and get the same comments on it. I'd think that 130/68 for me would be high. :)

Good news that the doppler alleviates some worry. (I am mentally filing that away for futher use at some point in the future.)

[Kath]

Dear Thalia, I can so imagine how relieved you were to know the baby was fine! There's nothing like being at the doctor's and having the equipment fail... Anyway, every time I read about your Doppler I think maybe I should get one too.

I'm sorry about the Clexane, but it does seem to be a good idea to continue it. Are you on calcium supplements for your bones? And I hope that if you do have a UTI, it clears up very soon.

Funny, I get the same comments about my blood pressure being freakishly low. Could it be that you were a bit agitated at the time they took it today?

I commented on your last post earlier today (I've been in Munich), but Typepad was having a few really bad hours and I suspect it got swallowed. I just wanted to say that I was so sorry to hear about your colleague. Could you maybe send over some home-cooked food? Those kinds of gesture mean a lot. She and her husband are probably not thinking about buying and preparing food right now.

[Pam]

Glad to hear everything seems to moving along well. Maybe after you should donate your Doppler to your OB after the baby arrives so that he doesnt have such antiquated equipment. :)

[susie]

I loved my doppler too. I always used it before a doctor's visit. It really alleviated a lot of fear.

[Leggy]

Thank God for the doppler. Maybe you should bring it to your appointments? It might spark him to upgrade.
My RE never mentioned this but my high-risk OB put me on 1500 mg of calcium (500 mg/3 times a day to space out absorption).
Is clexane just regular heparin or is it once/day like fragamin/lovenox?

[LEB]

I was always much better at finding the FH than my OB or midwife - they figured that out eventually & just asked me to do it.

I was told (by OB) that the loss of bone density from clexane throughout pregnancy is approximately the same as the loss from breastfeeding for a year (wasn't given any evidence for that though). I've breastfed for much longer than a year so that didn't seem like a big deal to me.

I'm glad it is all going so well :)

[Mary Ellen]

I am so glad that the baby doppler is relieving some of your worries. I am so happy that everything is going so well!

[Dee]

The doppler saved my sanity on many occasions--glad to hear it's doing the same for you :-) Worth it's weight in gold I tell you....

I am thrilled to hear that things are going well and the spotting has gone (never to come back I hope).

15 weeks? Wow, time flies--especially in other people's pregnancies (I remember thinking that mine was crawling along). Glad to hear things are going well!

[Lut C.]

15 weeks PG and still chasing doctors and labs to do their job.
But, you ARE 15 weeks PG and doing well. I'm so glad.

[Drowned Girl]

My haematologist has done some studies into the bone density thing, and says the reported problems were with the old heparins, rather than the Low Molecular Weight ones like clexane.

I'm glad things are going so well for you. I start clexane today at the same time as BCP (to protect me given DVT history).... joys!

[My Reality]

15 weeks - fantastic news!

[MB]

That's it, I'm getting a doppler. 15 weeks! Wahoo!

I guess I didn't know you were doing the LMW heparin also. I've got the Lovenox variety, I guess they are the same. I'm homozygous MTHFR (I don't remember which one, I was to say like 1866 or something, I'll have to go look...) and am protient S deficient. They didn't test this pregnancy, but did when we lost Audrey. I've heard that testing at the end of a pregnancy can skew the resullts, but I've decided not to argue if the docs are willing to treat it.

I was told they'd keep me on the Lovenox until two days before delivery and then do 2 doses of Heparin before my c-section since it's half-life is 12 hours. I was a little suprised that they will stop yours at 24 weeks.

We should compare bruised bellies! Mine actually doesn't look too bad at the moment, but it has certainly looked bad at other times!

[Cat, Galloping]

once i had the home doppler, most of the office visits became pretty boring! of course, boring is good. remind me again why you are holding back listening with it as often as you want?

[Stephanie]

YAY for your home doppler!!!! My 15 week appt, the dr. took 20+ min to find this baby's heartbeat, and I was freaking out and crying my eyes out, he finally did find it, but it was wayyy too long....then I had an u/s and found out that MY dates were on, and the stupid LMP wheel was wrong, and I was 2 weeks LESS pregnant than THEY said...so NO WONDER it was hard to find the HB!!!
ANYHOO....I'm glad your pregnancy seems to be going so well!!
I'm here, cheering you on!!! (from a sitting position, of course, so my big 31 week belly doesn't knock someone over!!) hehe!

[Sami]

Home dopplers are a life saver aren't they? Congrats on the good appt and I will keep my fingers crossed that things continue to go smoothly.

[Betty M]

I never had a doppler but I can see why it works for you. At the FMU at my hospital they always had one of those old ear horn type heartbeat listeners lying around for days when modern technology just failed to do the business. They were also dubious about the merits of electronic BP monitors in pregnancy too and always went with the old stle pump ones. Really glad everything is going more smoothly for you and looking forward to more standard steady as she goes posts for the next few months.

[Sarah]

so glad everything is going so well!

[elizabeth]

Thalia-I am so happy for you that everything is going so well.

[Samara]

I hate the fact that you have to be on so much medication. But God will protect the baby from the medicine and all will be well. It sucks that you're having so many complications while pregnant...problems that I've never even heard of. Try buying the book "What to Expect When Expecting" by Heidi Murdolf. This should give you some reassurance. I've read it in my first 2 pregnancies and I'm reviewing it even in this one.

Best of Luck.

[T]

15weeks! Congratulations T - hope all continues to go well.

- a fellow c677T mutant.

[Jane]

Glad to hear everything is okay Thalia. Have been reading your story for some time and hoping and keeping my fingers crossed for you.
To your colleague that experienced the loss at 24 weeks, I don't think I would do anything more than you have already done. After all, she did say in the email that she didn't wish to talk about it.
I think as we get older we tend to appreciate the joy of pregnancy and a safe birth more and more. I have been very lucky and fell pregnant relatively easily, but this does not mean that I didn't appreciate every second or treasure every moment. I was very aware that there were never any guarantees that everything would go smoothly, despite how good I felt. I have many friends who have experienced miscarriage - both early and late. I tried really hard to enjoy the entire pregnancy, but also kept in mind that it was never a sure thing. I was really lucky and am very aware of this.
Good luck!

[Overwhelmed!]

Thank heavens, indeed, for home dopplers.

I'm so glad to hear that all is well so far.

[luolin]

I still panic a little if the nurse doesn't find the heartbeat right away, even if I've felt the kicking just a minute before.

[Tonya]

Such wonderful news that all is going well for you! I relied so heavily on my doppler, even after I started feeling movement. And FWIW, I was on Lovenox/Arixtra until 32 weeks (due to homozygous MTHFR C677T). I'm rooting for you and will be checking back!

[Carrie]

Wow, the 10th of May for your 20 week scan. That's not very long. How exciting,
I'm glad you got the doppler. Anything that decreases the stress is surely welcome.
I'm curious how you came to know about MTHFR mutation. I'm having real difficulty with the NHS and their reluctance/ refusal to test for anything. Even privately it seems a one size fits all approach.

[Rella]

Hi Thalia,

I'm so happy to hear the heartbeat vicariously. I am in a similar situation (newly pregnant, MTHFR homozygous) and wondered which brand of doppler you are using. Are you renting? thanks for any advice.

Rella