The Plan

I make plans. I love planning and lists and lists of plans, and planning lists. I plan to plan. I plan for future events, I plan for possible future events. I plan out everything. And of course some plans go swimmingly, and others, well, life happens or, um, doesn’t.

Today was another appointment – this time with the Maternal Fetal Medicine consultant (MFM). It was the main preconception appointment to check off our list. We went to a Reproductive Endocrinologist (RE) in February, and she wanted to wait until the MFM appointment to set a plan.

Well, we have a plan in place, and now it feels like our future has been set in motion. No one knows the end of this trajectory, or even if we will stay on course, but it feels like we are rolling forward. And it’s scary. To be honest I’m terrified of the forward motion, but I’m also terrified of staying still. So here we are.

My plan incorporates the doctor’s plans and my personal plans for diet based on the idea that diet can play a role in managing inflammation, maintaining a healthy placenta, and the immune system in general. If nothing else the diet plans can reign in the power of the placebo effect, right? In the end, I just need to know that I gave it my all, and I believe this plan is my best shot at having that peace before moving on to surrogacy and adoption.

CHI Prevention

Chronic Histiocytic Intervillositis. I am going to do everything in my power so that those words don’t appear on my placental pathology report. Pregnancy won’t be a lighthearted affair this time. It will be a war, battling myself to protect my baby. What a mind boggling thought. I am going to do everything I can to support myself, but my dumb, confused immune system can take a hike. CHI belongs nowhere near my next pregnancy. I will fight with everything I have to make sure it stays away.

My Diet/ Exercise Plan

I will be committing to drinking a glass of pomegranate juice each day, as well as ginger and turmeric tea. Other main staples of my diet will include kefir for probiotic benefits, avocados for omega-3s, and celery.

Like I said, any of those foods may help, or they may just be a trick for my brain to keep my anxiety entertained with something else. Why not give it a go?

As for exercise, I am currently running with some yoga and pilates, but once I am pregnant I will likely switch to walking and yoga. My doctors have all said exercising is fine, but I want to keep it as low impact and strain as possible for my peace of mind. I’m also trying to get into the habit of walking every hour because my job is so sedentary.

My Medical Plan

Preconception and throughout pregnancy – baby aspirin (81 mg), prenatal vitamin plus extra folate.
Positive pregnancy test – progesterone until 13 weeks
Scan at 6/7 weeks to confirm heartbeat and that it’s not ectopic – Will start Tacrolimus, Heprin, and Calcium & Vitamin D supplements and will these continue until delivery.

I mentioned to the MFM that the RE had suggested scheduling the initial appointments with her office in order to get in for a 6/7 week scan a bit easier. He thought that was funny, as his office can accommodate early scans as well. He told me to call both offices when I get a positive test and see who can get me in first. He wants to see who will “win.” Being ornery myself, I think I will oblige and see who does win. After all, I do want to be seen as early as possible. So, I win too, right?

My MFM suggested doing a round of steroids and magnesium when we have achieved viability at 500 grams, even if things are looking good and we are still on track to our goal to get to 36 weeks. I suppose this is a safety net in case things go sideways, and I appreciate the forethought. We will do another round at 35 weeks, if I make it that far, and then induce at 36 weeks (but definitely no later than 37 weeks).

I will get scans every two weeks until about 18 weeks or whenever I request to go to every week. My MFM won me over when he said I could have as many scans as I want, every day if that is what I need for a little peace of mind. Obviously we won’t be doing growth measurements that often – the plan is to measure growth every 3-4 weeks. I can go in for scans to check fluid and doppler flows as often as I want, though.

Ready, Set…

Wait. We are flying to Vegas in June, so we are waiting to start trying until after that. I’m already a high-risk, anxiety-riddled mess, so I don’t need to add flying during pregnancy on top of that. So now we wait. And plan. And add to the ever growing list of questions to ask at our next appointments.

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