Friday, November 19, 2010

I’m not just negative, I’m RH negative, and sensitized.

Throughout my life, I’ve grown up under the impression I was just like my parents. I had the blood type A. And I was positive. Since my family was in the military, we were all seen by their doctors. I was too young to tell you what they did and when they drew blood. I know they poked my finger a few times throughout my youth, but thankfully I don’t recall much else.
You see, I hate doctors. I like to say that it’s because I was unlucky enough to get the most incompetent doctors at a very young age, coupled with my family’s own unfortunate encounters. Perhaps we were just cursed I suppose, into always having the worst experiences, the wrong results, or inaccurate solutions to our problems. I grew so accustomed to questioning everything and avoiding appointments altogether, that I am flabbergasted when people tell me they completely trust any professional. Just my luck, one of those people happens to be Vincent.
However, Vincent’s loyalty to the claims of the medical field is not what bothers me today. In fact, we find that when the matter arises, I get very heated, he gets very uninterested in the debate, and in the end I decide, “Just forget it. I will handle any medically related decisions myself.”  My own experiences have made me wary, and rightfully so, of anything every professional says to me. I don’t care who you are, what titles your name has, or what subject you claim to have studied intently to earn a degree. If what you are saying doesn’t make sense to me, or if I feel information is being withheld, I don’t trust what you say. And why should anyone? With the advantages technology offers, the greatest being the internet, a plethora of information is available to everyone with the will. I am perfectly capable, degree or no, of investigating a subject I don’t understand until I feel informed enough to make a decision.
Yet I can’t help but feel as though the gods are pointing their fingers at me. “Gotcha!” and they giggle outrageously at their poor joke.
Seems I can’t escape these doctors. If it were my own health, I would be tempted to walk away, as I have done in the past. However, it’s not my own, and there are no natural alternatives.
Seeing as how I was brought up to believe I was A positive, you can imagine my confusion when my nurse told me at my last appointment (11/10/10) that my blood work had come back and there was a little kink. I was so happy and will be eternally grateful that I am disease free, so in that sense I can’t be too upset. Yet mild shock overcame me as the nurse confirmed aloud that I am RH negative.
Negative? How can I be negative? While this not only was uncommon (at least 85% of the population is positive), it aroused curiosities which I handled like anyone who was unfamiliar with the issue would.
What did being RH negative mean for me? Well, blood types are designated as being first A, B, AB, or O. The Rhesus, or RH, indicates whether or not a type of protein is on the individual’s red blood cells. Obviously, positive means yes, negative means no. This really isn’t an issue, and nothing most people think about on a day to day basis. Under typical circumstances, unless it directly involves you, no one goes around thinking about their blood type or if it’s + or -. The problem potentially arises in pregnancy, specifically when the woman is negative. Apparently it is of no consequence if the man is negative as long as the woman is positive.  
Now, typically during pregnancy the blood between baby and mom don’t mix, except here and there. When that “here and there” part takes place though, the problems start, but not in the first pregnancy. This is because by the time the blood actually mixes, the body isn’t equipped to deal with this foreign substance (aka the baby’s blood, assuming she’s RH positive via daddy) and only then begins to produce antibodies. To put it metaphorically it’s somewhat like getting a vaccine, the first baby being akin to the vaccination. Before you’re pregnant, your body isn’t protected against this particular invader. After the introduction of the vaccine (the first baby) your body reacts and prepares, but by the time it is ready the first baby has already been born. However, in future pregnancies, the antibodies are automatic to react, because your body already has a defense in place. This can lead to anemia and brain damage, worst case scenario being heart failure and death for future babies.  
How was this possible? The nurse first claimed that one of my parents had to be negative for myself to be, however, upon further investigation, turns out that’s not true since neither of my parents are negative (both are A+). Since being negative is a recessive gene, it was probably existent in both my parents, and lucky me, I just happened to get those genetics.  
Should I be concerned?
The nurse told me that during the first pregnancy it had no effect; because the body would not be sensitized yet. Every month they would take a little blood just to be sure no antibodies were forming, and at 28 weeks as well as after delivery, I would need a shot, the only of its kind. This shot, called Rhogam, prevents the formation of these antibodies, but must be taken before the body recognizes the “situation.” Once antibodies have started to form, Rhogam is ineffective. However, since this is my first pregnancy, she brushed the topic aside as something that I shouldn’t be concerned about, emphasizing that it was her job to worry.

Yesterday started out normally. I had just bought a new purse since my own had shredded and outworn its appeal. An early Christmas gift from my mother. I couldn’t wait to start putting new things in it. As I was at the checkout line, my phone rang, and it was the doctor’s office.
The nurse’s voice crept out over the line. My latest blood sample had come back. Seems that between last month and this, my antibody count was positive. Alarmed, I immediately began to ask questions. I can only assume that the nurse, unprepared, was just looking at the paperwork, since she suddenly said, “Well, I need to investigate something. Let me research this a little more and call you back before we do anything.”
What was that supposed to mean? Why any practitioner would make a phone call without having all the appropriate information, or being prepared to answer questions, I don’t understand. I waited patiently, having instructed her to call me back ASAP.
Finally I get a call, and it’s her, insisting that my antibodies have already begun to form, and thus, a series of questions by me and attitude from her ensue. To begin with, she tells me that she has already faxed the forms to a specialist who will be calling to request an appointment with me soon. I ask what the specialist is going to do.
“They are going to monitor the baby.” Now any skeptic knows that the word ‘monitor’ is very unsatisfying. To me, ‘monitor’ means you are observing. Nothing is being done, just a checklist being completed. So I ask, to be fair, “Yes but what will they do? Like if something’s wrong?”
“Well,” and by her tone I knew her to be irritated already, “You’re just going to have to trust them, they are the best at what they do.” Foolish! Again, experienced individuals know better than to just trust everyone. It’s thanks to cautious parents that children avoid being loaded with pills, unnecessary surgeries, and shots.
Okay, so since that question wasn’t being answered, in my disgruntled state, I ask another, and this particular question probably upset her because I called her competence into question. But in my defense, she was upsetting me too. “Well… I thought you said this wasn’t supposed to happen in the first pregnancy.”
“It’s not. Are you sure you haven’t miscarried before or terminated a pregnancy?” I tell her no, never. “Sure you never missed a period and then got it a few weeks down the road?” I’m certain that’s never happened. “Suuure?” I know she probably didn’t mean to offend me, at least I try to think that, but her response did take it a bit too far. First, I didn’t enjoy information being withheld from me. If she didn’t know what was going to happen, she could have simply acknowledged that she was unfamiliar with this situation. Yet then, to try to imply that this was somehow my doing, that I was a liar, withholding information from them concerning my history, well that was extremely unnerving.
Needless to say, after our phone conversation I was sent over the edge. The normally calm, serene peace that pregnancy has brought me had been shaken again by someone who wanted to frustrate me. I seem to have a boiling point, and whenever I reach it, it’s as though suddenly hormones are reacting like crazy where at once they were still waters. So for the rest of the day I was understandably distraught.
I spoke with family, friends, coworkers, Vincent. I vowed to do my own research since none of my questions were being answered. I shunned the silly warnings people like to give pregnant women, despising their ignorance whenever they said, “Don’t research. It will only scare you and stress you out. It might be better to just let them handle it.” HAH! Such foolishness. Better to be scared and aware, to arm oneself with knowledge than be caught off guard.
And I have to say, despite the disappointing findings, I do feel better. Having obtained my own information, I can now better assess the situation. In fact, the situation itself doesn’t bother me so much. It’s the lifestyle change it may require. It’s the fact that I have given up so much already, beyond drinking, smoking, being active. I have now made huge adjustments to my diet, and above all else, it’s the more doctors and more needle pokes I will have to endure. Jealously I watch little girls, or careless women walking around with big smiles, letting their protruding bellies gain all the attention they can muster. I watch their boyfriends, clearly as careless as them, and think, “Why was it so easy for them? Why, my whole life and now, has this been so difficult?” I had always felt blessed because of the timing. I felt the Goddess smiled on me. Today, I felt a little down, confused as to why this was happening. If anything goes wrong, it is my fault. Oh sure, the chipper counselors would assure me I did everything I could, but it’s my body launching the attack. Somewhere along the way I became sensitized, a potential aggressor to any little life source. I literally must  have a doctor at this point, or my baby could suffer from all sorts of problems, even if she did live. I’m dependant on them, and without one, any future pregnancies would only get continuously worse.
My mother asked me today, “Well, would you rather be some unknown cog? Someone just in the system, no one special, who no one cares to look at?”
“Yes, actually!” Came my reply. “I hate doctors, and I hate the system. I just wanted to be normal and enjoy my pregnancy by myself. I wanted to grind my teeth through my normal appointments once a month. Not have more eyes looking at me, not have more needles probing me.” The very word ‘examination’ might as well be offensive to me, as it strike images I don’t care to share.
Still, in retrospect, there is always something I have to be grateful for. Something that has to drive me forward. I can compare myself to those who have it worse. I can have my pity party and work out my sorrow until there’s none left. I just have to do something to get myself back, or things will only get worse. Besides, the world doesn’t need to see my face in tears. Too many people depend on me to be strong, and it would be almost selfish to demand they look at a sobbing, whining girl.
It’s unnecessary because there’s always something else to be considering. This time, it’s that I will get through this. I don’t have enough information about how high my antibodies are yet, or anything else in particular. I have gathered as much information as I can about what’s to come based on the information I have available. I have made my appointment time and know now what to expect with that. I’m powerless to do anything else, and as much as that pains me, I just have to keep doing what I’m doing, and eventually the rest will come.
Sigh...


Above: My father, who generously agreed to go with me to the specialist and really make sure everything was being properly taken care of.  Below: My mother, who I try to whine to, but insists I need to stay positive.


Thursday, November 11, 2010

Letting off Steam... and Weight

My second meeting with my doctor for the pregnancy was yesterday (11/10/10), early in the morning. I left my home feeling very confident, more concerned that there might be an issue with my blood than with me. Turns out, that when things seem too good to be true, the usually are. I really can't be envious of anyone. My personal experience thus far has been wonderful, even with the setback mentioned in the article before this.
However, my moment of shock came when I stepped on the scale. I thought I might see, at best, a small fluctuation, but nothing dramatic. I had been weighing myself fairly regularly via Vince's scale, and expected that I was in relatively good shape. Well, you can imagine my discontent as the nurse clicked her tongue. I figure she must have practiced her response carefully, perhaps over a hundred times. How could she not? To this day, I have still not met a woman who has managed to stay within the recommended limit for weight gain during pregnancy. The average, it seems, skyrockets over that. In fact, just today I read an article about a model who gained fifty pounds during pregnancy, and I would think she would have access to the best quality foods and exercise programs.
Still, other moms don't make any difference to any doctor in this particular situation. It's not about your friends, your family, those you've heard about, or what you've read. It's about their averages, and how they compare you to their charts. In this case, I started out with a weight problem and therefore was projected to gain only fifteen to twentyfive pounds to remain within their limits. In this particular month, let me begin by saying that not only does Vince's scale vary (as I understand, home scales are off from those at the office, naturally) by at least five pounds, but that at some point I had managed to tag on about eight from one month to the next.
The nurse mumbled, or I should say rather that she simply told me while her back was turned, that I had gained more than they would have liked, and then left the room after retelling me my start weight.
Next comes the head nurse, who cleverly dodges the subject entirely. That's only because she has other bad news. It seems I'm not A positive blood type as I had believed my entire life. I got the recessive end of the genes from both my parents, and am Rh negative, meaning that my anitbody counts must be monitored montly, and at 28 weeks I will receive a shot to prevent my body from trying to form weapons against a possibly Rh positive baby. Sounds fairly casual, right? It's really nothing to worry about, except that I despise doctors to begin with, and more than that, giving blood or receiving any kind of injection. Pair that with the fact that my iron level is .1 away from becoming anemic, and I was feeling... well.. still incredibly upset about my weight.
It's amazing to me that as women that bothers us so very much. I imagine it's because it's the most visible. When you look at me, you can't see my iron is low, you can't tell that if my baby has positive blood I will become sensitized to it. You can't see if my bones are losing calcium or if I am gotten enough fiber for my diet. The first thing you notice when you look at someone is their shape. From close up or afar, it is their outline that sets the shape up for us to fill in the rest of the image. I'm short, tall, fat, skinny. And apparently, I'm fat.
So next comes the doctor. And guess what? His concern is the same thing. Of course. Having a conversation like that is the worst, because, as the patient, you know they are skeptic of every defense. It's as though when you try to explain yourself, they are saying, "Suuure... riiight... fatty," in their minds. I could just picture it as I told him that I had weighed myself often, that I had somehow made a mistake but had a decent diet, that my family has weight problems. His face remained on the paperwork, and he was, at the very least, mildly sympathetic I suppose.
So, I got straight to the point. "I want you to understand," I told him, "That my diet doesn't consist of McDonald's. I'm not pounding cakes. That's not my diet."
His advice? Cut the carbs then. Carbs, he said, are in everything. Stick to meats and veggies.


Pregnancy has done one thing for me. It has made me more serene. Oddly enough, when encoutnering upsetting words, my initial reaction may be that of stubborn denial, but after a few minutes I manage to process the information and put it to good use. I don't have the typical angry outbursts that I did before I was pregnant, so perhaps, this is more of a blessing than I thought. 
So, while the weight gain isn't my proudest admission, there is no sense in denying it. I can only guess the change must be obvious, and while my friends have been good enough to blame the pregnancy, I didn't see any reason not to fess up to what was really said at the doctor's appointment. 
So, here comes the frustrating part (and after careful consideration, I have to say that this is not a hormonal rant!). Women always complain that men never listen. We say, we don't want a solution, we just want someone to talk to. Someone to hear our problems or listen to us vent as we work out our emotions. So why then, when this complaint has been passed down for generations, do we insist on not following our own darn advice? Even now, I can admit that I am guilty of it (though I like to blame that on the many male influences I had in my life, thus making me a bit more masculine). Yet it seemed like every girl I described to had instant advice. 
"Be careful, they say lots of pregnant women become obese..." or "Hmmm.. try this diet instead," or "Watch how much you eat," or my favorite, "Just stick to veggies! They are good for you."
So now, I have to say with full confidence, that part of me wants to shout back, "You know what? F@!% you," followed by one of the next available options:
-"...you gained lots of weight when you were pregnant. When you get it right, then you can come back and lecture me."
-"... You're not me, and you don't know anything about my metabolism or what I do and eat every day."
-"...You've never even been pregnant! Try it out and see how you fair."
-"... I see what you eat every day and it's way worse. Try changing your diet drastically then come talk to me."

Of course, since I am lucky enough not to have raging hormones, I didn't say any of those things. One learns during pregnancy that everyone has advice about everything, and at times it can be quite contradictory. So the best thing to do is evaluate the facts, and the ideas, against the You (who you are, what works for you, and how you feel) factor, and go from there.
In the end, my best option? Listen to my doctor's advice. He doesn't have a bad idea, and trimming my carbs won't hurt. As I explained painfully to one of my friends, if I don't at least try, I don't have any excuse at all. I am responsible for my choices, and if I walk into the office unprepared next month, I'm only going to feel that much worse.
So... I turn my disappointment in rage, which then channels itself into a focus. My focus? Write down everything I eat every day, and monitor it closely. Trim out the carbs, leaving Sunday and the occasional major holiday as my free days. This way, if I do gain weight, I can show the doctor exactly what I've been eating. If I maintain it, all the better.
Either way I win out, and to me, that's too good to pass up.