by KetchupSpud (22 Posts), Mon Nov 17, 2014 08:37 pm
I lost my twin boys this summer due to severe pre-e that was turning into HELLP. I had a c-section at 23w5d. Logan, 1 lb, survived for 3 days and Bryce, 1lb 4oz, for 3 weeks. It's horrible to go through and I'm so sorry that you know that all too well.
We aren't cleared to try again for another 6 months, but we just recently decided that we're going to. I was dead set against it in the beginning because I refused to do the same thing again and hope for a different outcome. (After all, the definition of insanity is doing the same thing and expecting a different outcome. Obviously it's not as simple as that, but you get the idea.) The loss is enough to bear, but I don't know how I'd get through it if I also felt guilty.
For a little background, I also didn't spill protein until I called my doc and asked to get checked again. I'd been in 2 weeks prior and had no trace. My bp, though, had been elevated, but not enough to trip any warning bells. (I usually have very low bp, but in office it's usually right around 120/80 and at ~16w went up to 138/89 and stayed there for 6 weeks.) I started swelling pretty badly and realized that I had gained 14lbs in 12 days. I went to the hospital that day with a bp of ~160/95 and 8g of protein (pre-e is 0.3g). Lasted 5 days before I had my c-section. Since I was having twins, I was already seeing both my OB and an MFM, so when I got put into the hospital my MFM took over all of my care.
When I saw him for my 6wk pp check-up, he said, "See you next pregnancy!" He could tell by the look on my face that I was not ok with that kind of response. He said that the research he "liked" said I had a 50% chance of recurrence with a 15% chance of it happening before 28w. That felt like terrible odds to me, but he said, "So the odds are in your favor!" Well, the odds of me having twins were much lower than 15%, and the odds of me getting severe, early pre-e were much lower than 15%, so 15% felt really high! He said he had someone else who lost a child early and she had diabetes and went on to have one a 33w and one at 26w, so that was a success. I didn't feel like having a baby at 26w would be a success, even if everything turned out ok in the end. It certainly wasn't what I was shooting for. He finished it with, "Some people think aspirin or calcium make a difference..." So basically, do the same thing again and just hope.
I went back to my OB who referred me to a different MFM and an RE (to talk about how we avoid twins in the future). The RE said we'd be fine, said we'd "for sure" make it to at least 30 or 32 weeks, and that babies born even at 26 weeks are fine and just stay in the NICU for a while before coming home. Again, not ok with his attitude. No one can say anything for sure, and the NICU is not a hotel!
The other MFM, though, is amazing. She talked about our odds of having a successful pregnancy (which she thinks are really good), which she said is a healthy take-home baby. (Unlike other doctors who were considering live birth a success.) She also believes in bp meds to help control it, which my other MFM didn't do last time, and wants to do aspirin and lovonox, even though my thrombophelia panel came back clean. She maintains that it doesn't test for everything and I show no other reasons for why it may have happened so, as she said, once someone's been through what we've been through, you want to try anything and everything to make it better. I agree - if I'm going to do this again, I want to know that I tried everything. That's the only way I can do it again and have any hope of not feeling super guilty if things go poorly.
So, after all of that, my point is, find a doctor that you agree with and feel comfortable with. My OB and new MFM are two of the nicest women I've ever met and they both get it - they realize there's a huge emotional piece to all of this and understand that they'll be treating that as much as my pregnancy. They've offered h/b or u/s checks if I'm worried, even if they're not scheduled, and recognize that this will be a very stressful pregnancy. My MFM says, "Every day is going to be a long day and every week is going to be a long week." They're going to be aggressive in treatments (be it bed rest, bp meds, etc) and have said they wouldn't blame us if we didn't try again, but that they wouldn't recommend it if they didn't think we could be successful. It's amazing how just the right support can change your outlook on a situation.