Seeing an MFM on Thursday!

Are you considering having another child after preeclampsia? Trying again after preeclampsia can be an emotional challenge. You can find support with others who share your concerns here.
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kerisue
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Re: Seeing an MFM on Thursday!

Postby kerisue » Fri Apr 06, 2012 10:35 pm

So glad you found someone who will listen to you and doesn't mind a ton of questions! Her recommendations sound similar to my docs recommendations. Don't be too worried about the "no lovenox" thing. It does seem like a lot of folks around here take it during subsequent pregnancies, but I've seen two MFMs and both, independently of the other, have said no to that too- just not enough research supporting its benefit over its risk I guess. Like yours, my docs also suggested 12-18 mos. before trying to conceive. one of them told me why he thought so- physical healing from the classical c-sec, reduction in inflammation from the preeclampsia, and emotional healing from the trauma and loss.
Mama to Millie
born June 2010 @ 24 wks. gestation due to my severe PE and CHF
lived 25 days, loved and missed

LalaPants
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Re: Seeing an MFM on Thursday!

Postby LalaPants » Fri Apr 06, 2012 11:37 am

I'm so glad your appointment went well and that you liked this doctor!

[url]Spectrum Essentials[/url] makes a non-fish oil DHA supplement (it's actually produced by algae; my husband did some of his PhD research with the company that makes it and has friends who work there). When I was taking it (stopped because my lupus doc says that it can be bad for people with lupus), this is the brand I took.

I was reading something on lovenox the other day (I have lupus with APS so definite clotting disorder) and being on it can be really bad for your bones, like early onset osteoporosis bad, so it makes sense that your doctor doesn't want you on it without a clear reason to use it.
mom to Leonardo, stillborn April 2011 at 22 weeks due to HELLP/severe pre-e

I have lupus w/ APS
Planning on TTC in early 2012

sam10
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Re: Seeing an MFM on Thursday!

Postby sam10 » Fri Apr 06, 2012 09:41 am

I am glad your appointment went well. :) My doctor told me also no lovenox for me, since I don't have a clotting disorder. He said there is not enough evidence to show that it helps. He also reminded me that lovenox is a potent drug and hast its own risks and should not be used by default. So, I decided not to sweat it and trust my doctor on that one and how much nicer not to have to inject every day :D
~Julija (42)
MC 3/2009 and 3/2011
H (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
M (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/

lisa112
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Re: Seeing an MFM on Thursday!

Postby lisa112 » Fri Apr 06, 2012 08:34 am

I am so happy for you that your appointment went so well!! Sounds like the doctor you found was very encouraging and hopeful. From what I've read on the forums it looks like not many doctors prescribe lovenox unless there is an underlying reason for it, but I'm sure someone with more experience can answer that better than I it just seems to be what I've been seeing. I'm crossing my fingers for the same type of news. Just wondering, was this the first MFM you saw? I have two appointments set up with different doctors in two weeks and finding it a little nerveracking and overwhelming on picking doctors to meet with, but I think it's just an overall anxiety about everything.
Lisa, 31
Samantha Grace born 1/12/12 @ 30 + 3, 2lbs 2oz, severe PE with HELLP, IUGR
lived 17 days and passed due to complications after surgery because of NEC

flori
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Re: Seeing an MFM on Thursday!

Postby flori » Fri Apr 06, 2012 03:41 am

Forgot to add- we went to Costco afterwards and I bought their generic LDA, which said it was comparable to Bayer. Is there another brand I should look into instead? I forgot to ask doc.

Also, my OB wanted me to stay away from fish oil but to keep taking omega-3s. I bought a super fancy one from Target and saw just recently that the main ingredient is fish oil (d'oh!). Can someone recommend anything? I'm kind of ignorant about these things, but is the DHA/EPA stuff they sell packaged with prenatals okay? I always thought that it was for pregnancy only. Is fish oil okay until conception? OB worried about mercury levels and what not.

Thanks again for everything, lovelies. I appreciate it all.
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

flori
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Re: Seeing an MFM on Thursday!

Postby flori » Fri Apr 06, 2012 03:34 am

I'm back!

I really liked this doctor, she was very thorough and patient. She answered all of my questions (some before I even asked them) and didn't make me feel like I was being a pest by asking so many things and quoting things I'd read online. Here's a recap:

She said she would never say no to trying again, but did say it had its risks
Changed my bp meds to pregnancy safe stuff (eliminating an ACE inhibitor)
My liver, kidney, and thyroid function is all normal
Wants me to get a flu shot
Quoted me a 30% chance of developing preeclampsia again, 5% chance as severe/early and 5% chance of HELLP
--- said it will likely come later (yay)
LDA @ conception, but said starting prior wouldn't hurt
No lovenox :? (unless I test positive for lupus or APS ((kind of fussy OB didn't order that lab already)))
Clomid okay
Working okay
Exercise during pregnancy ok
Early bedrest probably won't help and would actually end up being more harm than good
Ultrasounds monthly unless growth issues suspected/found
Agreed to co-manage pregnancy with OB, but okay being the primary doc
Repeat C at 36-37 weeks (not a fan of VBACC, but would agree if I was insistent)
Will be the delivering OB if delivery is scheduled
Didn't think more weight loss would change my odds, but definitely recommended it for general pregnancy health
Doesn't believe in extra supplements (no vit A/C/D)
Wants me to stay on omega-3s and prenatals
If HELLP shows up, immediate delivery


Husband asked about the two year window I'd told him about and she said she believed more in giving my body 18 months from the Gracie's birth to conception of Rainbow. I googled it and only found that info on the March of Dimes sites. Anyone have any extra insight on this?

I am so glad I finally took this step. We won't be trying until June/July-ish but it feels good to know what I can do and what will happen. I left feeling so excited and hopeful for the future. ALTHOUGH, I am kind of nervous about her "NO LOVENOX" approach. I can't remember if there have been any posters who've been on it but not had a clotting disorder. Angie maybe?

I know Jean carried her rainbow on only LDA, but can anyone remember if there was anyone else? (Yes, I know Lovenox is not the answer, but it would help me to see that it CAN be okay without it.)
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

MomTimesThree
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Re: Seeing an MFM on Thursday!

Postby MomTimesThree » Thu Apr 05, 2012 12:53 am

I think those are great questions. And I am hopeful that having a specific plan written out will allow you to feel comfortable moving forward. We were terrified when it came to TTC #2 and those first few weeks pregnant until we had a solid plan in place... it made all the difference, and having a team you trust.

Only other question I can think is asking her what else she thinks you should know that perhaps you didn't think to ask.

I hope it goes well!
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w

sam10
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Re: Seeing an MFM on Thursday!

Postby sam10 » Thu Apr 05, 2012 11:12 am

It seems you got all the right info and know the threads as well where to find them. :D

Good luck and let us know how it goes.
~Julija (42)
MC 3/2009 and 3/2011
H (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
M (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/

flori
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Location: Hawaii

Re: Seeing an MFM on Thursday!

Postby flori » Thu Apr 05, 2012 04:09 am

Thank you for all of the replies, well wishes, and hope.

My appointment is tomorrow afternoon at 330 and I am getting more and more nervous!! The day after Gracie passed I was still in the hospital (c-sect recovery) and the MFM who saw me towards the end of my pregnancy came to my room to offer his condolences and we talked for a while. One of the first things he said was "There is nothing preventing you from getting pregnant again" and it was such a ray of light to me at the time. I had my 6 week postpartum with him and he talked more in depth with me about it and again told me that I could try again, after I allowed a year for recovery.

I loved that doctor. Hubs and I seriously contemplated not moving out to Hawaii just so he could be our MFM again in a subsequent pregnancy.. lol. Good thing we did anyway, because shortly after I got here I received a letter saying he left that practice.

Here's a list of what I have so far, please let me know if there's anything you asked at your appointments that you think I should add:

Her thoughts on what happened with Gracie (I'm not sure if my old hospital set my records over, but I will write out a quick summary of the events leading up to the end, just in case)
Whether TTC is an option or not
Recurrence
Her experience with early onset/severe pre-e/HELLP patients
What my care would consist of during pregnancy (MFM visits? OB visits? frequency?)
TTC prep (LDA? more weight loss?)
Diet prior to conception and during
Clomid (could it have affected anything? would a natural conception be better? TWINS?)
Supplementation during (extra folic acid? LDA? vitamin D?)
LOVENOX
Working full-time
Bedrest
Delivery timetables


Julija, I typed my questions out and then searched the forum and found a thread that Christa started where you posted all of your consult questions. I had almost all of them except for the European approach. :) I wonder if I read it previously and just remembered it? Or maybe I've read enough "what should I ask my MFM" threads to remember... ;)

OK so after yoga and a trip to the beach, I will check the forums one more time tomorrow and add any questions you guys can think of. Thanks for your help!
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

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cmccaffrey
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Re: Seeing an MFM on Thursday!

Postby cmccaffrey » Wed Apr 04, 2012 04:16 pm

IF the mfm were to say that you would know without a doubt that he is NOT the mfm for you! So many women have had similar situations as you and gone to have a successful pregnancy. It's not black or white. I think finding an amazing and supportive MFM is key. So if this person is not even willing to try with you, then he's not the one. I am thinking positive thoughts and praying that you find a doctor who can help you bring home a baby! <3
Christa (25) & J (26)
Mommy to:
Mason born 10.11.10 @ 30+3 wks due to Severe Pre-E. Only lived 2.5 days
Noah born 2.1.12 @ 38 weeks thanks to lots of doctors visits, LDA, Lovenox and no preeclampsia!

learn more about our story... http://tinyurl.com/7a979vy


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