What would you do? Deciding about TTC or not with my history

[queencarr]

Dh and I had an appt with the perinatologist last week, and now we are left with deciding what we want to do.

Background:
I am 29, have chronic high blood pressure, with no real family history of it. I have had every test known to mankind to figure out why, and they show nothing. It was borderline since I was 21-22, and was considered chronic HBP after ds was born when I was 24. With ds, my bp was not well controlled the whole pg; constantly increasing meds, staying one step ahead of it being high, etc. I developed preeclampsia at 28 weeks, and ds was born by emergency cs at 30w2d. Ds was in NICU for 6 weeks, has done very well, but has had some health problems assoc with being a preemie. I know first hand the difficulties of being the parent of a preemie/special needs child, and realize how much worse it could have been, and how fortunate we are that it was not.

Fast forward to last year. My dr estimated that I had a 20% chance of recurrance of preeclampsia. We know that some of the medical care was not all it could have been with ds, so felt we had a good chance of handling a problem should it occur. My bp is well controlled with meds, I am otherwise fairly healthy (overweight, mild asthma, but no real problems), so we decide to go for it. I have a great pg, bp low to low normal, until 28w5d. Diagnosed with pe again, and my baby has died, although ironically not due to the pe, she died of a cord injury and was unaffected by the pe. I also ate a high protein diet both pg, although more strictly with dd.

At the visit with the peri last week he says that we have a 50% chance of recurrance by 30-34w, with a 5-10% chance of it being between 24-28w. Almost guaranteed that a baby would be born before 37w, but with steroid shots, good NICU, not a huge concern after 32-34w, esp since neither baby had IUGR, which is common with pe. Some risk to me, including the possibility of stroke, heart attack, and death, but mostly a situation of being preterm and deciding to deliver to save my life at some point. The gamble is how early it would be, and whether the baby could be saved and how sick it would be. The dr's main concern was the possibility of having to have a very early preemie. He said he had taken care of women in far worse health and situations than I would be, but that it would be considered risky. He said the question was "You have to decide, how badly do you want more children?". I have had all the genetic tests/clotting disorder tests that would indicate a "cause" for recurrant pe, all negative, so no potential treatment except baby aspirin if I can tolerate it (I have aspirin sensitive asthma, so I would have to try it out first) and of course bp meds. With dh gone again until March, he asked us to think it over until then and contact him one way or the other next spring. Any pg would be followed by both my regular OB and the peri, with a very stepped up schedule of visits and lots of monitoring, etc.

So, my question is this--What would you do? I always wanted at least 3, possibly more, children. That is out of the question, barring a cure being found. But do I risk it this one more time? It took me almost 4 years to get up the courage to try again after ds. It would be a hellaciously stressful pg right up to the end (we had jsut begun to relax with dd when she died), with likely bedrest and/or hospitalization. Both of our families are against it. Dh is willing to go along with whatever I decide, but has asked that if we do get pg, this be the last time, no matter what happens, as he is scared of losing me, being a single parent, etc. I waffle constantly, but know in my heart I want more children. We have talked about adoption for years, even before ds, but we cannot afford it, especially with me staying home. I worry about the ethics of intentionally having a child that will be preemie with all that goes along with that. I worry about dying and leaving ds and dh (and possibly a newborn). But I think about never having any more children, and it breaks my heart. I think about ds and how excited he was to be a big brother. I think about labor and death and birth all mixed together and going home with no baby, and how I want to erase the feeling of that, knowing in my heart that I need a "positive" pg and birth to continue to heal.

If you have read this far, thank you. Any thoughts, input, perspectives, would be greatly appreciated.

Carrie

[XM]

Wow... what a heartbreaking choice to have to make.

Is there any way that you can see a naturopath or a herbalist? I have moderate bp that my peri was not able to affect, despite at one point raising my meds to a dose that caused me to pass out. My midwife for ds's pregnancy, OTOH, brought it down from 140/100 to 110/75 by having me take nettles, alfalfa, and flaxseed oil. DS was bornat 42 weeks and 7 1/2lbs. By all means, don't quit your meds yet... but perhaps by trying herbals to support your body, you will get better results from your current treatments.

Perhaps if this works as well for you as it did for me (whose bp did not respond to meds at all), then this decision will become easierto make. I hear you on adopting, we briefly thought about it after Xiola's death... were we willing to risk that pain again?... but realized that it was beyond our means. And if I were to be told that ds was to be my last baby...oh, I'd be so sad.

Baby hungry, gotta go... :hugs to you, mama.

XM

[queencarr]

There are no naturopaths or herbalists in my city :( The closest would be at least 2 1/2-3 hrs away. Thanks for the reminder of the the option, though, it will be something that I consider before I decide what to do. I think my dr's would be okay with it, they are both fairly easy going overall (my OB was the one who okayed an induced breech VBAC for dd, without batting an eye).

Looking again at our finances, with the adoption tax credit, we probably could afford to adopt, although just barely. But I am not sure we are up to all that entails, home studies, dear birth mother letters, etc. AARRGHH! I just don't know what to do. After ds, I was hoping that a cure or treatment would be found, but there hasn't been to much progress in the last 5 years, and I'm not getting any younger. Although research is continuing, no one really knows much more than they did before.

Thank you for the support and hugs. You are one of the few people that have not been totally against trying again. Let's me think, even if only for the moment, that I am not entirely crazy to even consider the possibility:)

[madrone]

Carrie,
What are your thoughts on it now? Have you been able to try any herbals for your bp? Whatever you decide, I wish that you find peace in the decision.

[queencarr]

:wave

Hi! Hope things are going better for you lately and that guy is leaving you alone...

We are leaning towards adoption at this point, mainly because ther stress of deciding what to do was really hard on both of us. I am considering a visit to the naturopath when Rick gets back, but am not sure how practical an option that is for us, givein the distance. It would be difficult to travel that far for check ups while pg if he was able to find something that works.

With the tax credits, it would be just within our reach to consider an adoption, and we have been going over agencies while we wait for Rick to come home. We have it narrowed to two domestic infant programs. We had talked about adoption before ds, looking in to intl adoptions then, and when I got pg, considering older domestic adoption when ds was older. So the idea is one that we have been interested in for along time, just not in the path that we are looking into it now.

The deal that I made with dh, however, is that if a cure or treatment is found, that I WILL get pg again if I choose, even if it is much later in life than we had planned. Our general life plan had involved dh working until all kids were school age, then he stays home while I work full time, so that would need to be modified. But making that decision has given me a lot of peace about the whole thing--until I reach menopause there is no finality to the decision, if that makes sense. It lets me pursue adoption with a much more open heart.

Anyway, thanks for checking in on me:)
As you can see, things are crystallizing, but not firm yet. Oh, and I can take the baby aspirin :), so that makes me feel more optimistic, too, if there were ever an accidental pg (not likely, but you never know 100%)

[madrone]

I'm glad that you are figuring out what to do and that you seem pretty okay with that decision. Also really happy that adoption might work out for you guys. I don't know what I would do if I were in your position.

Once Rick gets back, will he be there for a while? I think a lot of naturopaths are very willing to work with other doctors. If you start seeing one, you could probably manage to only see her every few months or so after the initial work up and if you have another doctor to help monitor. I know my naturopath here really considers her job to be to work with other doctors. Cannot say that about the one I had in the states, but I really had other issues (my weight and bfing) with him also.

I'm doing better here. Thanks for asking. The weird man had been doing well on leaving us alone, but then had a set-back and called us 6 times in one week-end. We've now had 2 week-ends where he has left us alone, so hopefully this will continue. Other than that, I'm thinking I may be preg again and hopefully have one that will stick this time.

Take care. - Tiff

[queencarr]

Rick should be here for at least a year before they would send him off anywhere again. *theoretically* I just looked up the naturopath and can't find anything about him, now I am not sure if he is still even practicing. The next closest would be even further away...I need to get another business card from the health food store and see if he is still listed.

But I really think that we need to pursue the adoption idea at this point. Although not fully convinced, there is something that is pulling me to it, my biggest hesitation has more to do with practicalities than anything else, things like how do you calm a non-nursing baby?!? I always just nursed Jimmy and he calmed down. And the whole "wait to be selected by the birthmother" process.

Wishing you :dust and a sticky baby (we need a glue smiley). I don't think I realized that had been a problem for you...take it easy.

[madrone]

I think you should pursue the naturopath for your own sake, even if you adopt. Just so that you can be as healthy as possible for your DS and the baby that you might adopt.

My DH started smoking as a teenager but was stopping about the time we met. Moving back to France was very stressful and he first was working at a place that took everyone to lunch everyday. French lunches last 1 1/2 hour. Lots of smoke breaks times between courses, etc. He ended up starting to smoke again between the fact that he was eating too much and stressed. I've been upset about this since. The way we got the weird man in our life was because I asked him where he got his pipe. We got one where he got his and DH smokes that very briefly 3 times a day now and tries to do less. I still don't like it but at least pipe tobacco hasn't been so manipulated by the tobacco companies to make it more addicting. I really worry about his lungs after a year of smoking again. I worry that he has reversed the 10 years of non-smoking. I worry that he will not be around to see DS as an adult because of this.

I'm not saying that high blood pressure compares to smoking. But I thought high blood pressure was something linked to strokes and heart attacks. I think you should really pursue the natural things because of that. So that you can be the healthiest possible and be an active part of their lives into adulthood.

Thanks for the glue wishes.

[queencarr]

My only concern about using a naturopath before an adoption would be that they go over you life with such a fine tooth comb. I already know that some of my parenting/lifestyle will be considered "out there" and I don't want to give them a reason to decide we are not what they want for their program. Our choices in our area and price range are very limited.

OTOH, my BP is very well controlled with very small amts of medications when I am not pg. Even in the last pg it was well controlled, until the last couple of days. As I understand it, the risks of high blood pressure go (statistically) away if it is treated. Unmedicated, my bp runs around 140/90, so it is only considered "mild", and I respond really well to treatment.

Between that and the fact that we knew it wasn't managed well in my first pg was why my Dr. felt I was a good candidate for my second pg. I still feel in my heart that the PE in the second pg was a stress response to the cord injury and not "true PE", as one of the nurses suggested, but no else thinks so. Physiologically, it makes sense to me, a disruption in circulation at the microscopic level is thought to be the reason for PE, why wouldn't a serious disruption in circulation like a severe cord twist cause the same response, esp in someone predisposed to respond that way?

[madrone]

I think it would make sense also that it wasn't true PE if it happened after the cord injury.

I hope that once you are approved, then maybe you will go to a naturopath. That's kind of sad that being AP and doing things naturally could be a negative towards being appoved for an adoption.

Take care. - Tiff

[queencarr]

I'm glad the idea makes sense to somebody else. It looks like they happened almost at the same moment, within a few hours at the most. There is just too much overlap to make me think they are not related, and looking back there were movement changes that happened before my bp went up. (At the time, I thought she was just settling in, 3rd trimester stuff, as she rarely moved much anyway). Plus when I had it in the 1st pg, I had problems the whole pg, that got worse after ds was born before they got better. The second time, it was very quick, and then it was over almost immediately after she was born.

I agree that having to be careful about what I do and say sucks. I really think this is something I need to look into, and my plan is to get it lined up, and then go as soon as an adoption is approved. I keep hearing such wonderful things that naturopaths can do for people, and I feel like it is something that I haven't looked into well enough yet, and cheated that there is not one close by. I tried herbal supplements based on what I could read myself, but didn't really know what I was doing, and felt wierd, so I stopped.

Any baby news yet?!? You have got to be on pins and needles!

[madrone]

Haven't gone to take a test yet. I am not really certain on the location of either of the labs and would prefer to wait until Friday afternoon when DH can drive. I think like an American in squares when it comes to locations and the roads here are round and twisty and I get lost very fast. I can get lost just a kilometer from my house. DH is the opposite. He's never really lost here even if he has never been someplace before and could get lost going to a close friends house in the states even after driving there for 6 years. He thought everything looked the same and couldn't manage to count roads.

[queencarr]

I'm glad I am not the only one who waits for DH to drive me places:D I do in-town driving, but it makes me a wreck to drive in unfamiliar places or interstate driving with traffic. And if the rest of France is anything like Paris, I would never drive there--I was scared enough just to have to cross the street! We foolishly crossed the street to the center of the roundabout where Marie Antoinette had her head chopped off to read the plaques and such, and realized when we went to cross back, that we couldn't see ANY of the oncoming traffic. I swear there were 10 (unmarked) lanes of traffic--it was like trying to cross through the Daytona 500!

[madrone]

The 10 lane rond ponts are the exception. In the city that isn't far from here, they have 3-4 (All of them are unmarked. People somehow just figure it out. I get honked at quite frequently.), depending on the traffic. I would NEVER drive in Paris. Going into the city near here is bad enough for me. I prefer just to go to into out little town. And I still get honked at occasionally there. Like today. And I was to the circle first. Just don't drive fast enough for them.

[queencarr]

Is it true in France that motorists, not pedestrians, ahve right of way adn can be sued for causing accidents? This is what we were told, but I wasn't sure I believed it.

Also, can't find any info on the ND that I was thinking of. TX doesn't require licensure, so I am a little leary of how to find someone reputable. BUT, then I found an MD listed in the yellow pages under physicians--naturopathic, here is blurb I found about him.

http://www.apothecure.com/doctors/HMDWebSite/Metabolic%20Typing.htm

Does this sound reasonable, not too far "off the wall"? i mean, does this sound like waht a regular ND would do? I have so little knowledge about all this, I was really hoping that TX requred a license and I could just find somebody by looking them up. But I am thinking that since he is an MD, even if he treats naturapathic, that it wouldn't look so "alternative" in a home study?

I am intrigued by the insulin resistent metabolism category, I have been diagnosed as having this, along with PCOS, and it is possible linked to a higher risk of PE.

Any baby news yet? I am guessing that it is early Friday morning if I converted times right...

[madrone]

I think he sounds pretty good. At first I thought he might not be that natural because of his education, but now I don't really think so because of the way he ended up becoming a naturopath. He might be a great balance with some things. He probably does an extensive blood work up on every patient when he first meets them (read expensive). Just from reading that, I think he sounds like a good choice.

And pedestrians do have the right of way in France. If they have a walk light, vehicles turning must yield to them, although some of them get really upset about this. I don't think road rage is a new thing here. They are more aggressive.

[queencarr]

I knowI gave every car the right of way:D Our saying was "the green man lies"--I can't tell you how many times the walk light would be green, and the traffic light was too! We finally just ignored the walk/don't walk signs and watched the traffic lghts, then ran for all we were worth. We had a great weekend there, though. Saw lots of art, ate ourselves silly, it was really a lot of fun.

I am wondering if I could get my insurance to cover the bloodwork, I was thinking it sounded extensive, too. Since he is an MD, if it was coded properly, it should be covered, as should the visits. I have been able before to get visits with certain dr's covered, even though the reason for going/treatment itself was not covered. It helped balance out the cost some. Sometimes I have to pay out of pocket and get partially reimbursed, but at least it is something.

Well, I need to wait for Rick to come home anyway, before I set off out of town (he would be about 2-3 hours drive away), but at least it gives me something new to investigate. I tried to talk to him about it last night, but he got busy and didn't email me back:( I think he would go for it, esp. with the MD after his name. He usually goes along with whatever I want re healthcare stuff, but is a bit skeptical at times of anything other that "standard" medicine, altough he doesn't trust that much either.

Have a good weekend!

[madrone]

Mentioning insurance always makes me grateful to live in France. I hope you can get your insurance to cover it some. Care there is so expensive.

I hopefully will have a good week-end. It's our tenth anniversary and I'm + !!!

If the boards are down for more than two weeks, have a great time in Korea with Rick!

[queencarr]

Congratulations!!!! That is wonderful news:)

And Happy Anniversary!

Somehow I missed the notice that the boards will be down, but have seen it mentioned here and there. I will be SO behind in reading when I get back!

Our insurance is military insurance, so what it covers, it covers well. But when it doesn't...usually, I can get around most things if we work at it hard enough. I have learned to play the insurance game with ds.

Have a good anniversary weekend, and hopefully morning sickness will wait until after you've had a chance to celebrate:)

[madrone]

Thank you Carrie! :love