Supplements

I was looking at the link I posted a while back about the supplementation CCRM recommends to increase quality and quantity of eggs.  The poster was taking quite a few other things, so I decided to pare it down to the ones she said were on the list.  Ideal supplementation is 3 months prior to transfer, stopping all supplements (except prenatal vitamins) when cycling meds begin.  It also says Melatonin is contraindicated if you have thyroid issues because it can increase T3 and T4 levels.

I've also read a lot of anecdotal support for royal jelly (bee pollen).  I've taken it as an immune booster before.  Those bees with their miracle cure-alls...

Anyway, just tucking away these nuggets of information.

And one bit of personal info to tuck away as well-- first day of my first cycle after delivering was Friday, 11/16.  4.5 weeks after 21w3d delivery.  It's a little crazy to me that my body could jump back to normal so quickly, but I'm thankful for it.

Pycnogenol	100mg	1x
L-arginine	1000mg	2x
Omega 3 fatty acid	1000mg	1x

Vitamin E

200iu

1x

Vitamin C

500mg

1x [am]

Myo-Inositol

2g

2x

Coq10 [Ubiquinol]

200mg

3x

Melatonin

3mg

1x [@ BT]

More

A friend of mine who lost her son at a similar gestation had a phone consult with Carolyn Salafia, a perinatal pathologist, and said it was really helpful.  So that's something else to consider.  Just noting it here so I don't lose track of the name.

And, exciting only to me, I think the bleeding has finally stopped!  4 weeks exactly.

Have I mentioned here that I started running again?  The girls and I are running in the mornings on Monday, Wednesday, and Friday and then I run with Andie on Saturday and Mariela on Sunday.  We're doing Couch to 5K, to prepare for a January 1 5K.  On Tuesday and Thursday mornings, we have a dance party.  Good times in the Denson house.  I'm glad to be building up my cardio again.  Gotta get healthy before I grow another baby.

Results

I got a copy of the autopsy report in the mail on Saturday.  I had to share it with some nurse friends to make heads or tails of it-- just a lot of terminology that I didn't understand.  Here's the portions I shared with them, with my questions interspersed:

"A few of the chorionic plate vessels, which are fetal vessels, show nonocclusive to partially occlusive fibrin thrombi. Recommend considering evaluating the parents for a hypercoagulative state." Translate that first sentence? I've been tested and cleared of clotting issues-- the doctor said this would be something genetic from the parents that the baby inherited-- does that make sense? Also says the cord was "focally hypertwisted" (does hyper necessarily mean too much?) and "There is an area of narrowing in the cord which spans 2.8 cm in length and measures .6 cm in diameter. ... Cross sections through this area show only one vascular structure. No true knots, false knots are seen" (problem?). "The decidua basalis shows a very prominent chronic inflamation" (related to the subchorionic hematoma - SCH- I had?). "The fetal membranes shows rare pigment laden microphages, the significance of which is unclear" (just throwing that out in case it means anything).

What jumped out to them are the cord issues.  With a little more research, I've come to believe that cord torsion (hypertwisting) and cord stricture (narrowing) caused the death.  The clots (partially occlusive fibrin thrombi) can be a result of decreased blood flow, which would come from the problems with the cord.  One vascular structure is a major problem, since there should be three-- two arteries plus one vein.  5% of the time, there is only one artery, but to have only one vein or artery is necessarily fatal-- it wouldn't allow for blood to move to and from the baby.  My guess is that the torsion caused the other two vascular structures to collapse, which caused the death.

 

There are some theories that cord issues like these are genetic, but that's likely not something we could test for.  One of my friends who is well-versed in genetic issues also had this to say:

 

"With so many findings, I'm guessing baby had a syndrome of some sort. The occlusions don't strike me as the only cause of death, as they're referred to as "nonocclusive to partially occlusive"... meaning the fibrin thrombi are present but not large enough to actually occlude blood flow (although certainly partially occlusive thrombi could be enough to cause IUGR and ultimately death if present in enough quantities, but it doesn't sound like that to me based on the wording). The single vessel cord also points to syndrome. They may not be able to diagnose this with just a general chromosomal analysis, since many of the congenital syndromes are at the gene level and not the chromosome level. (One source I read even mentioned Zellweger syndrome, which is a form of leukodystrophy)."

 

The report did say the chromosomal analysis is still pending, so it's possible we'll get more information with those results, though I doubt it.  When we do get those results, though, I'll make an appointment with Dr. Berry to talk through it all and get his opinion about what we should do next or differently.

Mail

Mary called today.  The autopsy report is in the mail.  She told me a little of what she recalled about it, but I want to read it myself.  I should have it tomorrow, probably-- Monday at the latest.

She did say that the chromosomal study is still out, so the results are incomplete.  And Dr. Polon wants to talk to... I think she said an embryologist?  Someone.

Bleh.

Nothin'

Nothing happening here, but I wanted to check in on my poor, neglected blog.  Still bleeding a bit (so much for being on the early end of 2-6 weeks)-- hoping that's all done by Monday/4 weeks.  I can talk about the loss now without ugly crying, so that's an improvement.  And I really, really want to get pregnant again.  Wishing I could fast forward just a bit, so we could jump right back in to things.

Two weeks 'til Thanksgiving extravaganza.  Woohoo!