Friday, April 20, 2012

Hematologist Wrap-Up

Wednesday I had my appointment with the hematologist.  E couldn't come with me. I really wish he had because it's always nice to have another set of ears and someones hand to hold.  

The first interesting thing about the appointment was that it was at a cancer center. Apparently hematology and cancer go hand-in-hand but it's not entirely obvious the the outside world - well that's how my doc described it.  

This place was like a well-oiled machine...4 check in counters, 2 check out counters. They were calling patients left and right.  It was very different than the waiting room at my fertility clinic, or any other fertility clinic I've been too (which has been a lot) for that matter.  I spend a lot of time in waiting rooms so I took 15 mins to scan the setting. The biggest difference - I felt lucky to be infertile.  When people around you are getting called for chemo sessions, infertility doesn't seem like that big of a deal.  I know psychology often likens the pain and depression felt by infertility to that of a cancer patient...and I can attest to the fact that I've felt extreme depression, sadness, frustration etc.  But I never once thought infertility could kill me.  Being in that waiting room helped me gain a little perspective to say the least.  

On a happier note, the other major difference was how amazing all the staff was. I mean like the friendliest people I've ever encountered in a doctor's office. I suppose it's a job requirement for an office of that nature.  Sure was nice for a change.  

Anyway, I had the most amazing consult with my doc.  I was hoping to get a clear "yes" or "no" on the lovenox issue but I didn't.  Still I say the appointment was amazing. This doctor spend an entire 45 minutes talking with me about my "case" which he admitted he found extremely interesting.  He went through each blood test that RE #4 had flagged with me.  Unfortunately RE #4's office hadn't faxed over the entire set of results - but J to the rescue. I pulled out my binder of medical records and we were able to continue the conversation. 

I should seriously think about going to med school. I can talk to doctors who have been practicing 20+ years about c-reactive proteins, homocystine levels, genetic mutations, ICSI - all sorts of things. This doc talked to me like an equal, well almost, only slowing down when it was clear from the look on my face that I had taken a wrong turn in my brain. 

I will try to sum-up the appointment.  

Basically he said my compound heterozygous MTHFR mutation wasn't a big deal at all because my homocystine levels are normal.  Only when the homocystine levels are not within the normal range, does this mutation matter.

Next, we talked extensively about my PAI 4G/5G mutation which RE #3 said didn't have any reproductive significance.  The hematologist wasn't sure which was to go on this. He said we could try lovenox but it wasn't necessarily needed because I wasn't considered in the recurrent pregnancy loss category.  He discussed extensively all the risks associated with this drug as well as the controversy over when to start taking it. 

Then we talked about my elevated CRP which he'd like to retest as it's a marker of inflammation as is a positive ANA.  Unfortunately I only had a qualitative ANA done, not quantitative so I don't know "how inflamed" I am.  We're going to retest.

Another one he wanted to retest was Factor 8 which was just borderline low. [Since the appointment I did get results saying the test was normal.] 

Well I really liked this doc mainly because he asked me the one question no other doctor besides my therapist asks me, "How do you feel?" "Do you feel healthy?" I mean how simple is that? Just having someone who was willing to listen and discuss every little nitty gritty detail with me was so refreshing. 

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