The Specialist Appointment

Yesterday, we had the appointment with the specialist. It was actually the exact opposite of the atmosphere of the private appointment which was calm and serene, the office was modern and spacious and empty, besides me and the receptionist. The NHS appointment on the other hand was in a separate building and clinic, in a cramped area, buzzing with activity and needed a paint job and more seats. The whole process took well over two hours was filled to the rim with couples, nurses, technicians, doctors and interns and felt a bit like the DMV.

Aside from getting stuck in rush hour traffic because we didn't leave early enough, being somewhat rudely given directions to the NHS clinic when I mistakenly thought the appointment was in the private clinic because I was never sent an appointment letter so I went back to where I had my previous appointment - there was a reason that I was never sent my appointment letter - I apparently didn't have an appointment yesterday. There was a part of me which was going to call to reconfirm as I never actually spoke to someone at the RMC it was the nurse at my GP's office who confirmed the appointment but I stopped myself as my husband took the day off from work and I couldn't wait any longer if for some reason they said oh no, you are not booked in for this day and postponed again. I knew if that had happened I would have had a slight meltdown, so I took my chances showing up without a letter. And guess what, they didn't have me down for an appointment... but thankfully, they fit me in anyway. Probably because she saw that the look on my face, which looked something like a permanent grimace by the time we arrived ten minutes late after a traffic ridden, hour long scooter ride through the city and then holding back the tears, biting my lip after going to the wrong clinic and being given directions by Cruella Di Ville (nice bedside manner lady, who ever you were) to arrive and be told nope, sorry you are not on the list. PLEASE. CHECK. AGAIN.

I was given another internal sonogram, my height and weight was checked and scales are not my friend these days, had another consultation with the doctor (the one I already saw in January not Dr. Reagan which is neither here nor there), another blood test and then to the chemist for drugs I need to take before (one up my bum, the fun is never ending) and after I have an HSG (an x-ray in which they inject die into the womb, and along the fallopian tubes. The flow of the die is then tracked on an x-ray television -- cool, I am now tie dying my insides!)

The doctor checked the original tests I took in January and as I had already surmised myself from the results (negative, normal), I don't have Lupus and my blood clots perfectly normally. I need to do another two tests for other types of disorders which lead to thrombosis (blood clotting disorder) as well as have a HSG to check that there are no blockages in or damage to my tubes or malformations in my uterus which there is the possibility there might be. From the internal scan, which after having had so many this past year that stated that my uterus was normal, I was surprised that they found that the shape of my uterus is like a heart which could be normal or I could have a septum which is an extra wall which hangs down a bit in the top middle of the uterus and could be the reason why I miscarry. The theory is that if the embryo implanted at the top of the uterus, behind or on the septum it doesn't get enough blood and therefore enough nutrients to allow it to grow properly. This apparently can be rectified through surgery. On the one hand I am hoping that this is the answer, on the other hand how ridiculous to be hoping for a malformation which will lead to surgery. But the good news is that apparently the miscarriage rate among women with recurrent miscarriage who have this problem and have surgery goes from a whopping 80 - 90% to a mere 10 - 15 % after treatment which is well, the normal miscarriage rate.

If the HGS comes back normal and the blood tests find that I don't have any of the other thrombosis disorders (which is usually treated by injecting Heparin daily normally until week 34 of a pregnancy and orally taking baby aspirin) that's pretty much all they've got for me. It doesn't seem that the NHS pays for checking your chromosomes so we'll need to check them ourselves if we want to know for certain, not that there is any "cure" its only an answer to why if one of us has a translocating chromosome, I miscarry. This clinic does not believe in hormone therapy, their research has shown that it doesn't make a difference to give an already pregnant woman progesterone because if progesterone is going to have any affect it's got to be before your pregnancy implants. I know that this is pretty controversial but as unwilling as I was to listen to it in beginning, this clinic specialises in miscarriages and is constantly doing controlled studies with their patients so I trust their data.

Another interesting fact for anyone who is struggling with having had one or two or three or more miscarriages as we all know how much we love to learn about statistics - is that it's actually only 1% of all women who have recurrent miscarriage (which is defined as three or more consecutive miscarriages) and within that 1%, 40% will occur because of random or sporadic reasons, normally chromosomal problems with the embryo and not because you or your partner have a genetic or chromosome disorder or any other problems but because unfortunately, that's the luck of the draw. I guess no matter what the answer I feel we pulled out the short straw -- but are trying to turn our "luck" around.