an apple a day

After some discussion with the husband, we decided Danny should come along to my post-mthfr-diagnosis appointment. Aunt flow started her visit the day before my appointment (way to go lady parts for being consistent!) making things a little bit harder for me to handle. He met me at the doctor's office with candy, cookies, and a piece of cake from a birthday party at his work. This one's a keeper! One thing Danny also does very well is not take things too seriously. While we were waiting in the exam room for the doctor, he kept playing with the heat lamp and trying to get me to put my feet in the stirrups. In the moment sometimes it seems like he’s so annoying. But today it was greatly appreciated.

We talked about my diagnosis, what it is, and what it can mean for me. It was good for Danny to hear this straight from the doctor’s mouth. For one I wouldn’t have been able to repeat it exactly. And I felt like hearing it directly from the doctor would help him to realize it’s a little bit bigger of a deal than he might have originally thought. Unfortunately, I was a little bit more of a pushover than I had wanted to be. We didn’t do any blood tests. Nor did she think Danny needed to be tested for the mutation because the baby having it wouldn’t really affect things. She wanted me to definitely start taking a prenatal vitamin. I had found one I thought looked good and was a good deal at Costco and taken a screenshot of the nutrition label on the back to show her. She thought for ttc-ing it looked fine. She told me to start taking a baby aspirin daily. And prescribed me an additional folic acid supplement. I asked her if there was any difference between synthetic folic acid and methyltetrahydrofolate (active form of folic acid). (No, I didn’t refer to it as that in the appointment. Yes, I’ve done THAT much research to be able to call it that.) Unlike what the internet had told me, she said the only difference is the price. After I got home, I priced both subscriptions through my health insurance website. The active form is like 4 or 5 times more expensive than the synthetic.

Then we talked about how this treatment would change once I get the BFP. One silver lining that I am very excited about is that she wants to see me as soon as I get a positive pregnancy test. Many obgyn’s do not want you to make an appointment until you are 6-8 weeks along. Imagine being all excited about peeing on a stick and seeing the positive! and jumping up and down! and celebrating with your husband! but then not being able to do anything else about it for another 4-6 weeks. Boo. That would be torturous. Thanks to mthfr, I get to be seen right away. To me, that’s a perk and I’ll take it. Especially when you hear what else is going to happen thanks to mthfr. When I see her at that first maternity(!) appointment, she is going to start me on daily injections of Lovenox, a blood thinner. That’s right. Every day, Danny or I will be stabbing me in the stomach with a needle. Hu-fucking-rray. We’ll do this through the first and second trimesters. When I start my third trimester, we’ll discuss my options. I knew there was a fine line between preventing blood clots and bleeding to death during child birth. At my appointment, we learned that blood thinners can also cause an epidural to not work properly. I like paid meds. That shit aint cool. So preventing blood clots for the last trimester and before delivery gets a little more tricky.

One of the biggest reasons I’m really glad Danny was there was so he could hear the last thing we talked about, a woman’s cycle. They did a really good job scaring him during sex ed in high school because up until this appointment, Danny up was absolutely positive that a woman can get pregnant at any time, even during her period. Now he realizes that the window, while sometimes unpredictable, is much much smaller than that. Sperm can live 3-5 days inside a woman’s body and the egg is viable for fertilization for about 24 hours. Meaning there’s really only one day a month when the stars align. He still doesn’t think sex every other day is necessary to give him time to “reload,” but at least now he knows the facts. And to be fair, I learned something that Danny had been trying to tell me for a while. From being on the pill, I was so used to my period coming like clockwork every 28 days. According to my doctor, it’s completely normal for my cycle to differ in length from month to month for up to 7 days. (Had to apologize afterward to Danny for my more than slight freak out when I was maybe 1-2 days late.)

Overall, we left feeling pretty good about things. I of course went in to “research all the things!” mode. I found a good deal on baby aspirin and now have enough to last me like 2 years thanks to Costco. And we got my first bottle of otc prenatal vitamins. You should see this pill. It’s like the size of my pinky. I spent a couple of days obsessing over which folic acid I should take. I had a prescription for the synthetic filled and waiting for me to pick up at the grocery store. But I still wasn’t quite sure if there was some chance my doctor was mistaken about whether or not there truly is a difference between synthetic and active form folic acid. I did even more online research about methyltetrahydrofolate concerning how it is different, where I could buy it, and if I could find it cheap enough to afford the 4 extra mg a day she wanted me to take. I went as far as listening to a podcast of this doctor who’s a supposed mthfr expert. When I found myself listening to him rant about the blue food dye in a certain brand of prenatal vitamins, I had a come to Jesus moment.

Sometimes you just gotta trust people. The reason I originally picked this doctor as my gynecologist was because I was looking to establish a long term relationship with the hopes that she would turn into my obstetrician. I completely understand that, at times, big red flags come up and it is important to be your own advocate and be informed and a part of treatment decisions. But in order for this relationship with my doctor to work, I was ultimately going to have to trust her on these types of decisions. Especially when it came down to choosing to trust some stranger on the internet who had a big problem with blue food dye, or the doctor who was directly responsible for treating me. This was going to be an even longer and more stressful journey if I didn’t trust my doctor. So I went to grocery store and picked up my way cheaper prescription for synthetic folic acid supplements.

Now I compare myself to Dr. House. I spend my days popping pills. Specifically, 2 folic acid tabs first thing in the morning, 1 more at lunch, and 1 more at dinner. Then 1 baby aspiring and 1 prenatal (that also contains folic acid) at bedtime. That’s 6 pills a day, 42 pills a week, and approximately 180 pills a month. Taking the prenatal before bed works well. I don’t have any side effects. I hide everything when anyone comes over to keep any sleuthy family members from figuring out our plans. And every time I find myself starting to complain about all these pills, I remind myself that this is nothing compared to daily injections in my stomach that I have to look forward to when(!) I get pregnant. Perspective.