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March 10, 2013

On Pain and What Ifs

The pain...sneaks up. It's like it's a stealthy little varmint that picks the time I can least defend myself. Tonight, I was driving the kids home from an activity...and my thoughts turned to my conversation with my doctor yesterday...

I asked him, "Have you ruled out progesterone deficiency as a cause?  I mean, did we stop the injections too soon?" And so he gave me an "introductory" answer, first, in which he assured me how outside the mainstream he is for treating progesterone deficiency during pregnancy at all.

I assured him, "Well, I'm fairly certain if you didn't treat me for progesterone deficiency all these years and monitored it so closely, I would have miscarried one of my other children." And, the doctor agreed with me and mentioned going over my records and agreeing with the treatments in the past as well as with the first trimester treatment this time.  And he reiterated that some association of OB/GYN had declared it not necessary and he was considered "fringe"  -- kind of "out there" for being willing to treat it at all. And he also mentioned that there are few studies -- like there hardly exists any evidence he can use -- to point to the fact that it truly helps.  And there's nothing out there that says it wouldn't cause birth defects with continued use.  And my doctor is nothing, if not cautious and focused on treating and caring for both mom and baby throughout pregnancy.

But...then...then, he said all I probably needed to hear on the topic:  

"In the future, if I have an older patient -- perhaps someone approaching 40 or in the forties -- who has had trouble, I would probably double-check myself before stopping the treatment, or in the very least monitor it closely while stopping the treatments." (Paraphrasing from my memory)

And it was those words that rang through my ears as I began to cry tonight.  It is those words that are causing the tears to resurface.  Right now, the thought that we might have stopped treating my progesterone deficiency prematurely, which may have caused me to lose Gregory is breaking my heart all over again.

I'm not naive.  We could have continued to treat my progesterone and I may still have lost Gregory.  I know that. But right now, knowing how hard we worked to get through the first trimester...God...I would have taken injections for as long as they were needed.  I would have.  Sure, I complained a bit and honestly, I suffered some skin irritation around the injections sites that made me happy to set the injections aside.  But my number had increased -- not to the level it increased to when we stopped injections with Vincent...but we thought we should be good in the 2nd trimester.  

But...we weren't, possibly.

I don't understand why something that has been so helpful to me (progesterone supplementation) is not embraced by the medical community that is supposed to help women save their babies.  I find that I dislike it very much that my doctor thinks that he's a "fringe" doctor simply because he does what he has learned helps to save babies and save mothers from pain like I am experiencing.  I know not all miscarriages are due to progesterone deficiency.   But I also know many doctors won't even consider treating progesterone deficiency in pregnancy unless a woman has had a miscarriage before.

There are still many tests out that my doctor hasn't received the results to yet.  He mentioned a couple of genetic blood clotting disorders that he's awaiting results on.  But I pressed him:  "But nothing points to me ever having a clot, does it?" and he admitted that was true.  With no evidence of a clot, it really doesn't matter if I have genetic tendencies for clots or not in this case.

So, I'm left with my "advanced maternal age" and my progesterone deficiency.  My damn body that won't make enough of a hormone required to maintain and nourish pregnancy.  And now I miss my baby.  Now, I start crying on the way home with absolutely no apparent prompt whatsoever.

I'd be angry if I weren't so freaking sad.



6 comments:

  1. Obviously, I'm not a medical doctor, but isn't the purpose of progesterone in pregnancy to support the endometrial lining during and after implantation, and (subsequently) the placenta? It seems to me that if low progesterone was the culprit, you would have suffered a partial placental abruption, or bleeding, or similar.

    It seems equally as likely that Gregory had a heart defect, perhaps chromosomal, that caused his death.

    Regardless, you CAN'T blame yourself. You made the best decision with the information you had available at the time, as did your doctor. That's all any if us can do.

    You remain in my prayers, Michelle, and I'm so sorry you're in pain.

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  2. Most importantly hugs and prayers! I understand the need for answers but be gentle with yourself; as you have described what happened this was not a progesterone failure, meaning you didn't start bleeding or contracting.

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  3. I'm so sorry that you're hurting! I'm praying for you!

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  4. I agree with JoAnna - you can't blame yourself, this baby was loved, their was not a moment where he was not loved and if you knew you had to the injections some more (if that was the case), you WOULD HAVE DONE THEM NO QUESTIONS ASKED. I too, think it might have been chromosonal given the timing. I too have had major progesterone issues and was on progesterone injections 2/weekly until 37 weeks with Elizabeth and I was on them again 2/weekly with Mary up through her miscarriage. We miscarried Mary and 12 weeks and although my first inclination was "what more could I have done", there wasn't anything more that I know of...and it turns out we found out later she did have chromosonal abnormalities which most likely caused miscarriage. Miscarriage sucks enough just to experience it, don't feel guilty for what you did or didn't do! More prayers coming for you!!!! Love you!

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  5. Hello - I stumbled onto your post via another Catholic Blog and have to say that my heart is with you. We have 5 boys, I am nearing 40 and want to have another baby so terribly bad. Over the past 4 years, I have struggled horribly with hormonal issues (low everything, and thyroid and adrenals). Trying to find a doctor who will listen to me when it comes to needing progesterone assistance is incredibly difficult. EVERY woman needs to have her levels tested, no matter what her age is, and progesterone levels need to monitored throughout the entire pregnancy if they were low at onset.

    The sad thing is is that most women don't view life and fertility the way that we do (and many other pro-lifers do), so doctors don't have to work with their female patients in this unique yet reasonable way. We have to keep pushing them to help us! Thank you for sharing your heart with us. I will keep you in my prayers!

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  6. My heart is just broken for you--I remember so well those first days and weeks after we lost our baby--and how your mind goes crazy thinking of all the what-ifs and replaying everything over and over. I remember how I would just start crying suddenly, with or without something to prompt it.

    I, too, am progesterone deficient and was on supplements during the first trimester of this pregnancy. I've got to say, hearing of your loss makes me very very scared.

    There are a few things you've got to remember right now:
    1. You are allowed to cry at any time, even without a reason. You are allowed to grieve however you need to and whenever you need to.
    2. Your mind will play many tricks on you, and Satan will do everything he can to invade your heart and mind right now, because you are vulnerable. St. Michael the Archangel is you friend right now.
    3. No doctor will ever feel the way you feel about Gregory, and it will be infuriating. It's ok to be mad about the fact that they didn't value his life in the same way you did.
    4. No matter how far away He seems, the Lord IS there. He does care. He feels your heart breaking. Even if all you can do is get out of bed in the morning, offer it up to Him as an act of faith that He still loves you. Right now, every move forward is an act of Faith.

    My heart just goes out to you, Michele, and I am praying for you so much.

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Thank you for reading. I enjoy reading other perspectives, please feel free to share yours. :)