coagulation obfuscation
Hematologist's appointment this morning was not very exciting. The doctor (Dr. S) was very nice, though, and his office staff was EXTREMELY nice. I assume this is because it's a hematology/oncology office, but I still appreciated the difference in the way the staff operated, given my past experiences with Dr. K's office.
Dr. S looked at my test results and asked why I'd had the tests done, and what stage my losses occurred. He then explained the MTHFR variant to me (even though it was all old news) and said that he wanted to order a homocysteine level on me. That was drawn at the end of the appointment.
Plan of attack right now is to put me on 2mg folic acid daily, and re-draw the homocysteine level in a month at my next appointment (12/21). By then I'll have had my surgery, so if there were any need to start anticoagulant therapy, I'd be through that, at least.
Regarding that, though, he said whether I will need an anticoagulant is still up in the air. Depending on my homocysteine levels both pre- and post-folic acid therapy, and consultation with a clotting specialist, and possibly additional homocysteine checks during pregnancy, it may or may not be required. I don't have any of the other clotting factor genetic mutations such as Factor V Leiden or prothrombic gene variant, and while I have a slightly abnormal lupus anticoagulant level (1:40, when normal is <1:40), he isn't sure that will necessarily mean that I will need anything more than the folic acid. I think that a lot will depend upon what my level was today.
I will probably be on high folic acid for life, though, and when he heard that my dad was a former smoker with CAD, and my younger brother is a current smoker, he recommended that they be tested as well (and that I try to get my brother to quit -- I've been trying that for years). I will try to have my mom tested as well but it doesn't seem that she has as many risk factors, and since it's a genetic test it may or may not be covered by their insurance. We'll see.
posted by Lisa P. at 9:58 AM
11 Comments:
Sounds like you're in good hands there, Lisa! It's good to know you will be monitored so closely, and that there's no automatic need for heparin.
I hope you're feeling better now. Migraines are grim.
Lis - I'm just feeling more positive for you now. I'm glad that you are getting somewhere with this. :)
Well, that sounds really hopeful! Fingers crossed that you won't need the injections after the folic acid has kicked in.
Right then - surgery next and then you're nearly done! (just that little matter of the pregnancy...)
Wow, sounds like you covered a lot of bases today. When I saw a hematologist, he was wonderful. I got so many answers and so much more one-on-one care than ever before. Looks like the ball is officially rolling, and picking up speed! :)
i have so little idea what that was about, but it sounds to me like the new doctor is ON IT! that can only mean good things!
Glad to hear you have a doctor who seems to genuinely care about what's going on.
Good news :)
Hope you can avoid the shots. Sounds like your new Dr. is on track.
Wishing you the best of luck.
Mmm, we like the folic acid plan. Harmless little magic pill. What could be better? Of course we know that with IF, life is rarely so simple (and creating life can seem almost impossible...). Still, here's hoping this is the answer.
I just came across your blog today, while searching for bloggers dx with MTHFR. I'm compound heterozygous (one mutant copy on two different genes) and have elevated homocysteine (11.4). I've been taking 2mg folic acid and vit B6 and B12 and hoping for the level to drop. Will know in a few days my test result. I too have had 2 mcs this year and since they can't find anything else wrong with me, am hoping that treating this will help with the next pregnancy. I've also been told that heparin in a potential treatment, but that it probably won't be required for me since I don't have any other factors.
I wanted to send an email rather than post all this here, but couldn't find an email address on your blog. so if you don't mind , please email me at genanny at yahoo period com.
Nani
oops, my email is genanny74 at yahoo period com.
I've got one on my wife's pregnancy with MTHFR... we treated with vitamines and bloddthinners resulting in a healthy baby boy.
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