Wednesday, September 4, 2013

Chicago Part 1

I am back from Chicago. Let me first start off by saying, wow what an absolutely amazing and beautiful city! I will get to our actual sightseeing in another post. Today I want to stick with my appointment with Dr. KK.

When we first got there I had to have about 16 vials of blood drawn.  I was so nervous about making sure my bladder was full that I forgot I wasn't suppose to eat breakfast. Luckily the nurse was fantastic and told me it wasn't a big deal. The three test that I was able to get yesterday is mainly sugar levels, insulin etc. and I have a script to get them here this week. 

Our second appointment was the ultrasound. Let me tell you how amazing this machine was. Please forgive me if I don't get all the information 100% accurate, but I promise to get it very close. Anyone else who has seen Dr. KK could probably help me out with all this technical stuff. Here are some of the things found and discussed while having the ultrasound done:

  • I was on cd 17 and still haven't ovulated. I had one 14 mm follicle on my left ovary. 
  • She found many cysts on both ovaries and especially the left. I was asked how long has it been since I did a medicated cycle. My answer was over two months. Right away she asked if I had ever been diagnosed with PCOS. (If you remember I asked my RE last year and he said that there wasn't enough to diagnose me and if he did, it would be a "soft" diagnosis). Well she was 100% certain that I had PCOS. The amount of cyst they found on my ovaries should only be seen when you are having a medicated cycle for a larger amount of follicles. 
  • I was then asked about my thyroid. (If you remember my blood test came back within normal ranges). Well here is the problem with a "random" thyroid test, it is not accurate. 30% of woman who have a thyroid problem will test negative on the blood test. You need to have a scan of your thyroid to really know. So that was suggested by her at the time.
  • Good blood flow to both ovaries
  • Thin Endometrium lining. She told me that most doctors will measure the thickest part of your lining and therefore most patients have good numbers. Your lining goes from think to thick and thin again. Therefore you should measure and get an average on the lining. She said that some woman will have a polyp or something behind the lining making it seem to be thick, but in reality it is thick in a bad way instead of good. My lining yesterday was 8. This was " okay".
  • The blood flow to my uterus was very bad. On a scale of 1-5 with 5 being what they like to see, mine was a 2. (I will go into the effect of this later).
  • The actual new blood vessel development that is suppose to happen each month in the uterus to supply filtered blood for an embryo was also way under pare.

This is a wrap up of the ultrasound.

Next was the physical exam and questions by the Gyn before seeing Dr. KK.

  • She felt my thyroid and said it was bulky. Suggested a thyroid scan when we get home. 
  • Breast exam went fine
  • Basically asked me more questions about all the miscarriages, immune issue symptoms I have etc.
The consult with Dr. KK and let me say what a amazing woman she is. So kind and caring. She also knew her stuff!

She basically explained to me the three reasons for my miscarriages:
1.Underlying Immune Issues
2. Blood Flow Issues
3. Was Immune related with T-Cells etc.

She told me that the chances of a woman with multiple miscarriages having a genetic disorder that causes the wrong amount of chromosomes are MUCH lower then an average woman. That studies have shown the recurrent miscarriages are usually because one the listed above. She did explain that the PCOS is messing up my hormones and causing to much male hormones. The blood flow to my uterus is probably the biggest thing right now. Because of this, it will be merely impossible for implantation  or even supplying a growing embryo with the filtered blood needed to grow. So without medications, the chances are very low. She also went on to draw diagrams of how important the blood is to a embryo until the 20th week when they can start going without all the new blood of a mother. She also talked to my about the thyroid and told me to get my scan  as soon as possible here.  Basically that is all we know as of this point. We have a follow up phone consult with her on September 25th at 1:00pm. At this time she will give me my blood work results and create a plan from there. I was told that until we start on medications, she doesn't want us trying to get pregnant. As she feels it will result in another loss.

A lot of information and a lot of answers! Like I said, this woman is amazing and I would recommend her to anyone in our position with the miscarriages. Anyone who's doctor has given up on them. As much as this field of medicine is under scrutiny, it works for many people who couldn't get pregnant through other treatments. Oh and before I forget, we talked about ivf and Al and I didn't even need ivf. Dr. K told us that the main reason to go the ivf route is DOR, sperm issues, or for woman who can't ovulate and/or have no tubes. Otherwise it is a matter of finding out what the underlying problem is and treating it. 

I won't sit here and play the blame game. It has been years full of many emotions and treatments. I know that after our last miscarriage, my doctor knew there was nothing further he could do for us and therefore referred us out to CCRM. I researched and went with my heart knowing that ivf was not the route to take again and decided on a different approach. For me it was the right decision and I feel very confident that there will be a baby Rapp within the next year or so.

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