I must say that I was pleasantly surprised to get a phone call from the new RE this week. He called to discuss my higher than average progesterone levels during my prior pregnancies. At our initial consultation, he told me he would look into the levels and discuss them with a few colleagues at his practice. He never said he would be calling me anytime soon about it, and so I assumed it would just be discussed at our next face to face meeting. I was wrong-he did call on his own accord, and that was impressive to us!
After collaborating with a few other professionals in the field, he feels confident that my high progesterone levels did not negatively affect any of my previous pregnancies, meaning the levels are unrelated to my miscarriages. However, he did say since my body is doing such a “fine job” (a compliment about my body for once!) absorbing the progesterone, there is no reason I need so much of it. For example, 2 Crinones per day, plus 3 Prometriums per day would not necessarily be needed. Of course, we need to monitor these levels closely once pregnant to be absolutely sure (since every pregnancy is different), but so far the pattern of high levels has remained consistent over time. As you know, we are trying to be as non-medicated as possible for our next FET, so this is truly wonderful news that we may be able to cut back a bit.
I also had a chance to see a family doctor this week, which is good because I haven’t been to one in years. RE appointments have basically hogged all of my time in the appointment department. The Dr. I met with was great! I went over my history with Dr. L, focusing mostly on our infertility and recurrent pregnancy loss. She listened intently and inputted information into the computer as I talked. I explained how anxiety has been getting the best of me since RPL. I also expressed how this panic and fear is even worse when I see the pink lines. Dr. L could relate, she also miscarried several times and didn’t get to finally bring her babies home until her late 30’s.
Before the appointment with Dr. L, I called OTIS, the pregnancy hotline number that the new RE gave me. I called to see what meds they propose to be the safest during pregnancy as I knew this was a topic I wished to discuss at the family Dr. It would be important to note that obviously no category is guaranteed to be safe, so I guess I should say categories with the least risk, or considered the most safe during pregnancy. They informed me to stay away from anything in category D, which the RE and Dr. L ended up saying as well.
I told Dr. L that I prefer not to go on an everyday anti-depressant, rather I would like to have an anxiety medication available to me on an as needed basis. For example, before an ultrasound, after a spotting episode, or when something like prayer, yoga, acupuncture, or homeopathic remedies do not work. Ideally, I envision it to be more of a “back-up” plan than anything. If I have learned anything throughout this process, it’s that anxiety is the REAL DEAL. It’s not as simple as thinking happy things like unicorns and roses and all turns OK. And while I understand anxiety doesn’t come from God, I also know that sometimes it doesn’t just disappear after traumatic experiences either.
Dr. L found my request for anxiety only medication on an as needed basis to be reasonable, but warned me that since my anxiety can be so overwhelming once I am pregnant, I might find myself taking it everyday anyways. This is not what I want to do, or intend to do, but I think she makes a good point here. Something to at least consider. Most importantly, Dr. L and I both agreed that to have come this far and then take something that could substantially increase the chances of birth defects is simply just not worth it. She thinks looking into a category B drug could be an option for us. Specifically, the anti-anxiety medication, BuSpar (I believe that is what she called it, but not 100% sure).
However, Dr. L recommended we do 2 things before we make any final decisions:
- She wants to consult with both my OB-Gyn and the new RE. She wants to have a consensus about how we can get me to achieve the healthiest pregnancy possible without me bring a total train wreck during it, with stress and blood pressure levels through the roof. I really love that she wants to speak with both of them to discuss other patients who have been on anxiety meds, their experiences, risks, benefits, outcomes, etc. She thinks everyone needs to be on the same page with this.
- She wants me to do a urine test. This is a 24 hour test that I have never done before. I know, believe it or not, I have not had this test! LOL. Anyways, I pretty much pee in a bucket for 24 hours (gross) and then drop it off to be analyzed. She wants to check some things further with how I process insulin, and this test will do that. She said it is important and I figure, why not! I will do it sometime later this week.
I will go back in after the urine results (she said they will squeeze me right in next week) and she will have consulted with my OB and the RE by then. Dr. L gave me a hug when we finished up. She was very empathetic and I appreciated the kindness. I also loved that she didn’t want to jump the gun and make any rash decisions about something so important. She could have easily written me a script for some medication today as many do, but she did not. Not like I would have taken it anyways, but that’s not the point here. Knowing and carefully weighing out all of our options is the point. Leave no stone un-turned!