WTF Meeting Results

So, today, I thought I was going up into the stirrups and being checked for physical healing, but no. It was the WTF meeting. I'm kind of glad that I'm seeing more of Dr G right now, he's a lot more comforting than Dr Wonderful. Dr W is great getting down to business and making action plans, but Dr G is better at the comforting.

So, Dr G asked about pain and if I could pee etc... and declared me fit to resume normal activity (the hubs will be delighted). He then moved straight to the what happened and where do we go from here. There was an annoying intern in the room who was bouncing his knees like crazy, but whatever. I managed to tune him out. So, I supposed you want to know the verdict...

What Happened: Baby was fine, no apparent structural abnormalities. We did not allow any testing on the baby, so no way to tell if there were chromosomal abnormalities, but probably not. So, because of this and the fact that it looked more like the placenta detached or broke away he's leaning more toward believing it was in fact my body that rejected the baby, and not a problem with the baby. So, which problem with my body? Well... not the auto-immune. He thinks we controlled that as well as possible. To my swollen knuckles, hip and sternum he says (and I quote) "That's normal... about 1/3 of women with RA get better, 1/3 get worse, like you, and the rest don't change. It doesn't really affect the outcome of the pregnancy." But for real?!?! OK, then what happened? Insulin.

Now, before I go further, I do have hyperinsulemia. My blood had like 3x the highest "normal" amount in my last test and I take med's to regulate it. It's like reverse diabetes. Also, my Dr is Jeremy Groll author of the book Fertility Foods which I understand is popular amongst the PCOS* having community, because insulin and PCOS are his specialty and he's really good at getting women with PCOS knocked up. So, I knew he was going to say we have to get a better grip on the insulin. I didn't expect him to name it as the CoD.

Where was I, yes, Insulin (which is the devil). So, he feels that 1) my insulin reducing drugs aren't helping enough. He upped the dose of one and added another and then stated that he hated to just pile on drugs when there were better ways of controlling the insulin, especially when it doesn't look like the drugs are helping much. Huh? Well, despite following his diet plan and exercising (Wii Fit is AWESOME) and walking, I'm not losing weight. He thinks I should be losing weight and the fact that I'm not means dunh, dunh, dunh the insulin is preventing it.

Where do we go from here: We have to further reduce the insulin. For this we have three approaches:

1) More drugs: Not favorable, but doing anyway
2) Sleep Apnea study and wear c-pap: Doing, and glad to be doing, I've been concerned about this for a while
3) Roux en Y bariatric surgery: Have to wait a year before resuming fertility, has the biggest chance of impacting the insulin from the source, G will not approve

So, he says sleep apnea causes an insulin cycle, because every time you suffocate your body produces insulin to be able to fight and more insulin causes more soft tissue, which worsens the apnea which causes more insulin. So, c-pap is job #1. Plus, he thinks it will help with feeling tired all the dang time.

I've looked into Bariatric Surgery before. About 10 years ago. My family doctor told G a horror story about a patient of hers that got BS in the 80's and now lived in a nursing home being feed via IV because her body was unable to process food through her GI tract. Nice... G is 100% ANTI BS, now. I'm a little more apt to give it a try. For one, if the insurance will cover it, it seems like a good way to physically jump start weight loss, which will have the natural effect of reducing insulin. But Dr G says it goes beyond that. He says the surgery itself physically alters the way the body signals the need for insulin, so before the weight loss even begins, the insulin reduction has already started. He is VERY PRO BS. Of course the downside is that is it a MAJOR surgery, it takes months to recover and a year to stabilize. Not only that, things change very quickly and it can be emotionally grueling.

There you have it, insulin = bad. Wait, didn't we already know that?


*PCOS: Poly Cystic Ovarian Syndrome... aka The Devil