Put on your Medical Hat...

I've just returned home from visiting Dr. Korotkin to plan out what a future pregnancy would look like. He was so kind and very personable, kind of like a grandpa=) Dr. K really took his time with us and asked lots of questions. He wanted to know about all 3 of our pregnancies, how labor went with the 14 week loss in April 2006, what the events looked like leading up to Brooks' death, how the pregnancy went, how many ultrasounds I had, etc...I really liked that he was analyzing all of the details. He was sweet to ask about Brooks; what his name was, how much he weighed, and how we were holding up. He seemed genuinely interested in Denny and I.

One sad thing that really stuck out to me while we were talking about who was going to be my OB for the next pregnancy was that the midwife group did not watch me close enough. Considering my history, he was pretty stunned that an ultrasound wasn't performed the week before I delivered Brooks. If you've read the beginnings of this blog, you'll remember I did go to the hospital on 9/10/08 because the baby had not moved very much that day. They hooked me up to the non-stress test machine to monitor his movements. It took about 20-30 minutes, but the baby did eventually start moving around. The nurses showed the test to the midwife and everyone agreed that Brooks was doing well and I could go home. No further testing was done. Looking back on that now-it was not the best decision. It's hard not to dwell on what could have been and on how things could have gone so much better, but I'm trying to focus on the future and push those thoughts away. I am struggling to accomplish that today.

Anyways...onto the hopeful news. Dr. K is very confident that we will be able to have a healthy baby in the future. He recommends waiting until February before we start trying again. I am to remain on the baby aspirin, folic acid, B vitamins, and pre-natal vitamin throughout the entire next pregnancy. I should start taking metformin again now and will remain on that until I am out of the first trimester. Metformin is the diabetes type medication I take since the infertility specialist once told me I have PCOS. The medication does something between ovaries and insulin, I can't remember, but it does help me have more regular cycles. Dr. Korotkin also advised me to go ahead and take Prometrium to jump start my cycle since it's being quite stubborn and hasn't shown up yet.

Something I found quite interesting while speaking with Dr. K has to do with the mutation I tested positive for making me half way positive for MTHFR (see previous post). Like I mentioned previously, to completely have MTHFR a person must test positive for both mutations; A something and C something. I have tested positive for the A mutation. People with the blood clotting disorder, MTHFR, usually test positive for the C mutation. This information led him to believe I probably do not have MTHFR. So that is a positive:)

For our next pregnancy I will be followed quite close. Here's the plan:
-From the beginning I will be seen 2x per month. The 1st visit of the month will be with the regular OB, the 2nd visit of the month will be with Dr. K. During the visit with him an ultrasound will be performed
-Starting at 28 weeks I will be seen 2x per week. The 1st visit will be at the OB and a non-stress test will be conducted. A NST is a test to monitor the baby's movements. The 2nd visit of the week will be with Korotkin. A detailed 4D ultrasound will be done to look at the baby, the cord, the blood running through it, and to measure the baby's weight.
-I will be delivered before 40 weeks. Dr. K said "You'll be delivered at 39 weeks." After he watched the color drain from my face, he quickly added, "or sooner if you're brain can't take it!" That second statement made me feel better. I really don't ever care to see 39 weeks again. I prodded Dr. K a little bit asking him when he would be comfortable inducing me. His response was 38 weeks and a couple days, or if I agree to do an amniocentesis and the lung function comes back good, he would deliver me at 37 weeks. Having a giant long needle inserted into the sac where my baby is growing does not sound fun to me, so I'd be okay with a 38 week delivery.

Korotkin was not comfortable making the decision today on whether or not I will need the Heparin shots. He wants to send my pathology slides and placenta specimens to Carolyn Salafia in New York City. She is out of the Early Path Medical Center and is board certified in pediatric pathology. The reports North Fulton Hospital passed to Dr. K do not indicate any blood clots, so he wants Dr. Salafia to do her own testing and investigation into that possibility. This sounded like a great idea to me. The way Korotkin made it sound is that his office staff requests the pathology slides and they send it to "his friend" Carolyn to get a second opinion. Come to find out that's not the case! Shortly after I arrived home from the consultation, K's nurse called me to let me know how to get my specimens to Carolyn. Basically, I have to fill out several forms, fax my insurance cards and do all the leg work in getting the slides to her. I was probably being naive in thinking there wouldn't be a cost on our end in getting this second opinion, but of course I was WRONG! I still haven't looked into whether or not she takes our insurance, but just glancing at her website I'm quite sure we won't be able to follow through on this 2nd opinion plan. A 15 minute phone call or a 500 word email consultation with Dr. Salafia is $350!! OUCH! So I'll do some investigating to see if this little plan is a go or not.

That's the gist of where we stand now. I feel pretty good about it. I'm still fighting a lot of sadness about what could have been if a few things had been done differently, but I guess that's normal. Thank you for praying about the appointment. I really appreciate the phone calls and emails=)