Tales from the Diaper Bag



Damn. Damn. Damn.

I knew I was a little too lucky. My pregnancy has been pretty uneventful– enough annoying or uncomfortable or strange stuff to create grist for this blog mill, but nothing major. Until this week. During my appointment, my doctor told me that I have a Factor V Leiden genetic mutation. What is it? Well, you could google it and get a much better explanation, but essentially, I have a genetic mutation that increases the tendency for my blood to clot. I have the less severe version of this disorder (I won’t bore you with the genetics lesson) so this isn’t actually as bad as it sounds. I can never be on birth control or similar hormone-type drugs (turns out, I’m one of those women they’re talking about in the muttered disclaimers you hear in those birth control commercials) but a baby aspirin a day and an active lifestyle pretty much ensures me a normal life.

But, alas, pregnancy complicates it all.

Pregnancy, by itself, increases a woman’s risk for blood clots. Being pregnant–what with the supporting the growth of another human being and all the extra weight that comes with it–puts a lot of strain on your circulation. Add in my genetic predisposition and you’ve got Big Trouble in Little China. So, what to do? Well, that’s complicated.  My regular OB/GYN was not all that familiar with the condition. After she told me I was a Factor V carrier, I had the somewhat unsettling experience of watching her flip through a medical research guide to determine if there were any medications I should take while pregnant. You know what you never want to see? Your doctor essentially wikipedia your diagnosis. Not confidence-inspiring, believe me.  To be fair, she knew she didn’t know enough to chart a course of action, so she called a specialist and talked it over with him. They initially agreed–based on my uneventful medical history–that it wasn’t the end of the world. However, I needed to start seeing the specalist on a regular basis and take a baby aspirin a day to keep my blood from getting too thick. I was not that thrilled with the aspirin idea, because there is a possibility of aspirin crossing the placenta, which can cause heart development problems for la bambina. I decided to hold off on that bit of advice until I met with the specialist in person and talked it over with him.

Oh, but then the plot thickens.

Even as I was digesting this news, my doctor called me the next day and told me that she thought I should go on a more hard-core blood thinner–Lovenox. She came to this conclusion after talking to a colleague who had a patient with my same condition suffer a “late-term fetal demise” (aka the baby died in the womb. I hate doctor-speak. I hate when they try to take a tragedy and reduce it to some dry medical term so that they can talk about in a detached manner. I really hate it when they use that language with patients. I’m sure it helps them do their job, but it still stinks).  She thought that the Lovenox stood a better chance of preventing this to happening to me.

She told me that the Lovenox has the benefit of not crossing the placenta (they think– there aren’t a lot of fabulous studies out there about this yet) and it would keep me from having blood clots during the pregnancy and during the six weeks immediately after. All good news. There are a few negatives, however. First, I can’t be on the blood thinner when I deliver, because it would preclude the use of pain killers (I was NEVER going to do this without drugs. I’m a wimp, but at least I know it) and it would increase my risk for hemorrhaging during delivery.  Yikes. So to prevent the complications, they would schedule me for an induction a little earlier than my due date and take me off the blood thinner a week before my scheduled induction. Inductions have their own drawbacks, so I wasn’t thrilled to hear that induction was a part of the plan. Still, sounds better than a painful, bloody delivery mess. HOWEVER, this advice is still coming from my regular OB/GYN who admits that she has minimal experience with my condition. . .so I decided (with her blessing) to wait until I talk to the specialist next week before I start injecting myself full of blood thinners.

I don’t know how to feel about all this. I would be lying if I didn’t admit that my initial feeling was pretty close to blind panic. I cried after I got the diagnosis, and not a little bit. I then made the situation a lot worse by going home to google “Factor V Leiden” and getting a lot of hits for websites authored by people who were diagnosed with the condition after having had clots. Their online stories were terrifying and they made me feel like there was a pretty good chance I’d drop dead tomorrow.  A couple of hours (and a box of tissues later) I realized that  A LOT of people have my genetic predisposition and never have blood clots and have pregnancies that go off without a hitch, but those people don’t feel compelled to create websites discussing their genetic issues, so the view from the web is alarming– but not terribly representative of reality.

For now, I’m trying to focus on the fact that, this diagnosis aside, both la bambina and I have had a great pregnancy. We’re healthy. Our weight is good. Her heartbeat is strong and my blood pressure is low. I’ve had no clotting problems–ever.  I’ll go to the specialist. I’ll do what I need to do to ensure that this good pregnancy stays on course. . .but there isn’t much else I can do. I can’t re-write my genetic code. I can’t cry and complain my way into a pregnancy where this won’t be an issue. I just have to be smart, not freak out and pray for the best. . .so that’s what I’m doing.

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Comments

  1. * Margaret says:

    It sounds like you are doing exactly what you need to do and thinking exactly what you need to think. I know you and the baby will be fine, especially when you have all your friends harnessing the power of the universe and sending all those good vibes your way. This just means you’ll have to take some extra precautions, but we’re all here for you and I know everything will be ok!

    | Reply Posted 8 years, 9 months ago


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