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Wednesday, April 20, 2016

What Comes Next?

Let me preface this by saying that I’m a highly logical person. When confronted with a problem, I focus on finding a rational solution, not addressing the emotional aspects. In fact, my reaction to stress is to start making lists of what needs to be accomplished and getting hyper-focused on resolving the issues that are creating the stress.

In light of that, it’s not surprising that I pushed my doctor to start with RPL testing. I should note here that “my doctor” is a bit inaccurate. My original OB, Dr. P, was perfect for me. She was also logical, research-focused, and pretty aggressive in her treatment approach. When we met, she gave me statistics, treatment options, and addressed my concerns about being AMA. Unfortunately she left the practice group between miscarriage #1 and miscarriage #2. She hadn’t been available the day of the d&c, so another doctor, Dr. A, had performed it. I was therefore, by default, assigned to be Dr. A’s patient. Dr. A is a nice, caring, emotionally focused person. He’s also a wait-and-see person. I am not. I am a “test the shit out of this and treat it ASAP!” type of person. Thus, I had to push him for the RPL testing. After reminding him I was 36, had a history of irregular menstruation and thyroid problems, and had now suffered back to back losses, he agreed to order a blood panel and saline sonogram to look for structural issues.

When I went for the bloodwork, I discovered he hadn’t ordered the TSH (thyroid) test, even though I’d had radiation treatment for my thyroid years ago. When I asked, the nurse informed me that thyroid function is unrelated to miscarriage, which is completely untrue. I pressed for the test anyhow, and she agreed. I couldn’t schedule the sonogram right away because it needed to occur between days 6 and 12 of my cycle, and I wasn’t entirely sure when that would be.

To my surprise, the blood work all came back within normal parameters. My TSH was 2.43, which just missed the treatment cutoff of below 2.5, but was reasonable. Dr. A told me I could take low dose aspirin just in case I had a clotting disorder they’d missed, and also told me to come in to have hcg and progesterone tested as soon as I got another bfp at home. With my short luteal phase, progesterone seemed to be a reasonable explanation for my issues. Next up was to be the sonogram, scheduled after a business trip I had to take out of state.

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