Stay Inside Baby!: NK cells

Showing posts with label NK cells. Show all posts

Sunday, 18 December 2016

38w4d in denial about being pregnant

I found out I was pregnant at 3w2d and went to the doctor straight away. My betas were 11 and they did my first round of IVIG but were hesitant to offer any congratulations, saying that I needed at least a 50 on the betas. I knew that 11 was low, but I also knew that I found out I was pregnant pretty early. Three days later my betas were 80 and I was officially declared pregnant and told my due date was 28 December 2016. For the first 12 weeks I was scared of miscarrying even though I was on IVIG, baby aspirin, and progesterone cream. They say 1 in 3 women miscarry and with high NK cells I'm sure my odds of miscarrying were higher.

After 12 weeks I was feeling better and just hoped to make it to 24 weeks, which is considered viability. Then at 20w7d I started leaking fluid. After a few stressful hours in the early morning in the ER I found out that everything was ok.

I made it passed my second trimester and was smack dab in the middle of my third when I found out at 34w7d that the baby, who had always been at or ahead of dates, was now a few weeks behind. I know that at that point measurements can vary by as many as 4 weeks. However, it's not very comforting when everything was measuring fine before then. Two weeks later, the measurements were better, but still didn't match up so they pushed the due date back until 6 January 2017. The doctor seemed not to worry and induction was never mentioned. I know in the US they seem to induce by 39 weeks at the latest when there are immune issues involved. I guess Korea is different. I'm honestly surprised I got this far. My water broke with my daughter early in the morning at 37w2d and she was born at 37w4d. Now I'm 38w4d and I have a feeling I will be late.

I think due to the miscarriages I had before I don't want to get my hopes up. I know I'm pregnant, but I'm in denial. It's hard for me to connect to the baby. It feels weird to think that there's a little human inside of me. I definitely don't feel as excited as I did when I was pregnant with my daughter. I just want to get this all over with and have a healthy baby. I only got sick once in the first trimester and started wearing maternity clothes in my first trimester. I had some bad leg cramps in the second trimester. I've also been having Braxton Hicks throughout the third trimester. I haven't gained much weight. In fact, I haven't gained any weight since 21 weeks, but my belly keeps getting bigger.

I've finally started taking some photos of me being pregnant, but nothing like when I was pregnant with my daughter and took weekly photos. I feel more cold and objective. I file all the paperwork and organise the ultrasounds so that I can make a claim with my insurance. I have all the paperwork we need to get the baby's American passport, CRBA, and SSN as well the the Peruvian passport, DNI, and birth certificate. But the excitement's not there. I'm just holding my breath hoping that everything will be ok. My doctor is supportive. Surprisingly they haven't said anything about me having a home birth.

I also feel like a part of my freedom is being taken away. My daughter just turned 5 a few months ago. She was breastfed until she was 4 and we co-slept until she was nearly 4.5 years old. She still sneaks into my bed in the morning. But now she's independent. She can get dressed, get herself food, I can leave her alone in the bath, she picks up her toys. I can have some me time. Once the baby comes, all that will go away. I'll be starting over for the next 5 years. This baby was very much planned and wanted, but I still have mixed feelings about the whole thing. Soon, this pregnancy will come to an end and we will have another little human in the house.

For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Friday, 29 July 2016

18w2d IVIG #6

Today I was told that I would not have anymore IVIG treatments. I was supposed to go to 23 weeks and I'm only at 18 weeks. The doctor said that since I started at 3 weeks instead of at 5 weeks and that the baby is measuring ok, I should be fine. I am very wary about stopping 5 weeks early and with only 6 treatments instead of 7, but they said I could do intralipids (which is egg, soybean, and other things) next time.

Stats

BPD is 4.31 cm (19w1d).
AC is 13.33 cm (18w7d).
FL is 3.13 cm (19w6d).

This appointment
Again, I was told that it was a girl but my husband is still in denial. Intralipids is often done instead of IVIG because it's cheaper. It also has similar results as IVIG, but only in the case where there is no known reason for miscarriages. Since we know that I have high NK cells, IVIG is supposed to be better. This is IVIG #6 and my last treatment. The IVIG is a 5% solution of 300 ml, which is 15 gr of IVIG.

I'm taking fish oil and Wobenyzme N, both of which are supposed to suppress NK cells and some people have said it's a natural alternative to IVIG or intralipids.

Money

Today I paid 381,410.
Doctor's visit: 32,260.
IVIG #5: 289,150.
Ultrasound 60,000.
Tricare (my insurance) reimbursed me for 33,942.
Out of pocket was 347,468.

More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Wednesday, 6 April 2016

NK cell results

I got my NK (natural killer) cell results today. The norm is 12 and below and I have 14. This means that my body attacks the babies since it views them as invaders. Right now I'm on prednisolone for 5 days. I'm taking 4 tablets of 5mg in the morning and again at night. It's a steroid and is cheaper than the IV, which I'll need later. I'm paying about 13 cents (USD) a pill. In the USA the same pill would be $10 each. That's insane. The US really needs to fix their medical care.

I've been told that they'll do an IVIG, which is intravenous immunoglobulin, which is a blood product, once I get a positive HPT. I just bought 50 Wondfo early pregnancy tests (they're the blue and white ones) off eBay and hopefully they'll be coming soon. Once I get a positive, I need to go immediately to the doctor to get the IV. I know that some hospitals use IL, which is intralipids, which is a fatty IV and has similar results as the IVIG. It's also much cheaper, so I'm hoping we can do that. Some people only need one IV and some need it every 2 weeks throughout their pregnancy.

They did an ultrasound to make sure the lining was ok and it is.

Money

Today I paid 113,260.
Doctor's visit: 32,266.
Ultrasound: 75,000.
Prednisolone: 6,360.
Tricare (my insurance) reimbursed me for 107,260.
Out of pocket was 6,000.

I didn't claim the prenisolone because it seemed more trouble than it was worth so I didn't get an English translation of the prescription.

More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

Monday, 28 March 2016

First tests at Pyeongtaek St. Mary's Hospital

I had my third miscarriage on Friday. I got a positive pregnancy test on Tuesday, then started spotting on Wednesday, ended up bleeding on Thursday, and spent the morning in the ER on Friday where both blood and urine tests came back as negative. Betas were 4.

I had had enough and decided I needed to get some type of drugs to stay pregnant. I had been taking B vitamins (to help with low progesterone) and low dose aspirin (to help prevent blood clots) but those weren't enough.

Later on I actually bought OTC progesterone cream to help with a suspected LPD. If you use progesterone cream make sure it comes from natural sources. Emerita is recommended by Wray at Progesterone Therapy. On Amazon, Smoky Mountain Naturals is a best seller.

I went to Pyeongtaek St. Mary's Hospital today. The women in the international clinic speak fluent English. One of them worked in the US as a nurse for 20 years and the other spent a few years in the US, also as a nurse. There's one more, but I haven't been formally introduced to her.

They ran blood tests for natural killer cells and said my husband wouldn't need to get tested. Something that I don't agree with since there could be a chromosomal issue that causes miscarriages.

Money

The total costs for today was 143,700.
Doctor's visit 42,900.
Blood test 100,800).
Tricare (my insurance) reimbursed me for 61,609.
Out of pocket was 82,091

More info
For more info, you can see how much this has cost, I also have a summary of dates, as well as my Rx protocol.

About

Updated 25 September 2017
I started this blog in late March 2016. I've recorded the costs for Pyeongtaek St. Mary's on this page. It includes testing and pre-natal care, but not the birth. I wanted to have a home birth with Danica the midwife and Jinny the doula from Mamas Birth Center. However, I ended up with an emergency C-section at Pyeongtaek St. Mary's.

Research and Online Support

I've put together a list of useful websites and articles that discuss immunological issues related to miscarriages. I found the Yahoo group immunology support to be very helpful. They also have a secret Facebook group called reproductive immunology support. In order to join the Facebook group, you'll either need to ask in the Yahoo group to be added or have someone already in the group add you.

Infertility Treatment in Korea

You can read more about these hospitals and clinics at Infertility Treatment Centers in Korea and Birthing Centers in Korea.

My Medical History

First Pregnancy

I got pregnant the first month I tried in 2011. My daughter was born in October of 2011 at
Kim Ok Jin (Rosa) Agitanseun Natural Birth Center (김옥진조산원) in Ansan. I got divorced shortly after she turned 2 and I re-married in the summer of 2015. My husband has no children from his previous marriage.

First Miscarriage: Chemical Pregnancy

I had a suspected chemical pregnancy in November 2015. I didn't take a test, but I was late and ended up bleeding for about 10 days. Looking back on it now that I have more experience with miscarriages, I'm pretty sure I was pregnant then.

I went to Dr. Yoo Women's Hospital (유광사여성병원) in Seoul in early November 2015 to make sure I was ovulating. They did an ultrasound and checked my lining as well as did some blood tests and everything seemed fine. I never went back because I found out I was pregnant a few days later in late November 2015.

Second Miscarriage: 6 Weeks

I went to the doctor at Soonchunhyang Hospital (SCH) in Seoul at 6 weeks in early December. The baby was measuring about 6 days behind what it was supposed to, but they assured me everything was fine even though my cycle was not based on 28 days.

I had a sinking feeling about it and went to IMom Obgyn in Pyeongtaek 2 weeks later in December 2015 to get a cheap ultrasound (you get what you pay for). There was dried blood on the sofa in the waiting room. The doctor there had a horrible bedside manner and just said, "miscarriage" and literally shooed me away, telling me to go back to Seoul.

Back in Seoul at Soonchunhyang Hospital (SCH), I was livid. I found out they had entered the wrong information about my medical history and then said then said that they had thought something was wrong at the previous appointment but neglected to tell me. When I said I wanted to file a formal complaint, they told me to email. Since it had been about 3 weeks since the baby had died and my husband and I weren't living together, I decided to get a D and C in January 2016 so I didn't risk hemorrhaging at home. I did it at SCH and to add insult to injury the paper I signed said I was getting an abortion (big difference), even though three ultrasounds had confirmed the baby had died.

I would never recommend Soonchunhyang Hospital (SCH) or IMom Obgyn due to the inexcusable mistakes and horrible bedside manner of the doctors.

Third Miscarriage: Chemical Pregnancy

In March 2016 I got pregnant again, only to have a chemical pregnancy three days later and end up in the ER on Osan AB due to hemorrhaging. During this time they decided to draw 4 vials of blood. At this point I figured something was wrong, despite the doctor telling me it wasn't my fault and that it was bad luck. Three losses in five months just isn't normal.

What Could Have Caused the Miscarriages

All of these issues can cause implantation failure. Since my miscarriages occurred before or around 6 weeks, I thought that if I could stop my body from attacking the baby during implantation, then I should be able to carry a baby to term.You can see a list of everything I took/was given, such as IVs, hormones, vitamins, supplements, and medicine on my my Rx protocol.

Anatomical: Uterine abnormalities
Anything that is not normal is a uterine abnormality. Things such as the shape of your uterus, uterine scarring, and incompetent cervix (horrible name, it means weak cervix), can be it hard for the baby to implant and/or thrive.

Genetic: Chromosomal defects
Neither my husband nor I had been tested for anything so we didn't know if we could have been carriers, however, chromosomal defects in the baby could have caused miscarriages

Genetic: Thrombophilia

I thought I might have a type of thrombophilia disorder, such as antiphospholipid syndrome (APS), Factor V Leiden, or methylene tetra hydro folate reductas (MTHFR) because they can cause sticky blood and blood clots. This means that nutrients to the baby are cut off. That could explain why I had such early miscarriages.

Some people believe as many as 50% of the population has a type of MTHFR gene mutation (there are different kinds, such as homozygous and heterozygous). People with MTHFR cannot metabolize folic acid (the synthetic form of folate), so they should take folate. MTHFR living has more info on how to prepare for pregnancy if you have a MTHFR mutation. In order to thin my blood I started taking low dose aspirin at night before I went to bed. Taking pills at night cut down on my nausea. The doctor told me to stop using it at 10 weeks, but I continued throughout my entire pregnancy. I figured that if it wasn't broken, why change?

Hormones: LPD (Luteal Phase Defect)
Since my cycle was down to 23 days, I thought I might have a LPD. This means that the uterine living sheds too soon and the baby does not have enough time to implant into the lining. I took progesterone cream in order to help with this. It can also help so you don't get blood clots. If you use progesterone cream make sure it comes from natural sources. Emerita is recommended by Wray at Progesterone Therapy. On Amazon, Smoky Mountain Naturals is a best seller.

Here's some info on how to use progesterone cream by Wray Whyte. She has a bunch of information about progesterone therapy. I didn't use as high of a dosage as she suggested though. I only used 1/8 of a teaspoon twice a day. What works for me might not work for you.

B vitamins are also said to help with low progesterone. I was taking those as well.

Hormones: PCOS
I really didn't think I had PCOS (Polycystic Ovary Syndrome) because I had no symptoms; however, I know that not every woman has symptoms. PCOS causes you to have too much testosterone as well as irregular cycles and difficulty in having the endometrium lining to develop properly.

Infectious Disease: Mycoplasma hominis
Another plasma issue is mycoplasma hominis like ureaplasma urealyticum can be responsible for RPL (recurrent pregnancy loss). I tested negative for this but your body is constantly changing.

Infectious Disease: Ureaplasma Urealyticum
I also know I have a high level of ureaplasma urealyticum and that might be responsible for RPL (recurrent pregnancy loss). However, when I went to the doctors, I wasn't tested for it.If I still had a high level it didn't affect this last pregnancy, but maybe that's because the IVIG did something and lowered it.

Immunological: High NK Cells
I also found out that high NK cells might cause RPL and attack the baby. Some doctors believe high NK cells are caused by inflammation, such as endometriosis or an immune-related disease, such as lupus. I was not tested for either.

Traditionally, prednisolone/prednisone (steroids), IVIG, and intralipids have been used to treat high NK cells. These are available by prescription only. There are natural OTC alternatives to prednisolone, such as Licorice root (buy it from Amazon), Maca (buy it from Amazon), and Wobenzym N (buy it on Amazon). Wobenzym N actually has been proven to help with immune related pregnancy loss.

Sixth Doctor: What I Was Tested For

I then went to Pyeongtaek St. Mary's Hospital in Pyeongtaek since they were close and they had fertility treatments on their website. I later found out that they have a very high success rate for IVF (53.6%), have fluent English speakers in the international clinic, and are famous for fertility treatments. I am not a candidate for IUI or IVF. I can easily get pregnant on my own. I just have trouble staying pregnant. I'm seeing Dr. Jeongrae Lee, who is supposed to be a famous infertility doctor in Korea. He works a lot and is very nice. Never heard him speak a word of English, but they provide free translators, so I don't care. (ETA: I finally heard him speak English after my emergency C-section.)

They tested me for high NK cells, thyroid issues, and did an HSG test (I asked for a shot of ketorolac in the butt, it made the HSG painless for me, but I know other people have gotten the shot and it hasn't done anything. It cost me 5,000 won so I thought I would try). Only my NK cells were high; the other two tests came back negative. I was told that IVIG would help.

My Rx Protocol

I used progesterone cream (to help with a suspected LPD) and low dose aspirin (to help thin my blood). For my high NK cells, I was given prednisolone, IVIG, and intralipids. The doctor also suggested I take two OTC medicines. The first one was progesterone cream to help with a suspected LPD. If you use progesterone cream make sure it comes from natural sources. Emerita is recommended by Wray at Progesterone Therapy. On Amazon, Smoky Mountain Naturals is a best seller. The second was low dose aspirin to help thin my blood.

The doctor also suggested I take two OTC medicines. The first one was progesterone cream to help with a suspected LPD. If you use progesterone cream make sure it comes from natural sources. Emerita is recommended by Wray at Progesterone Therapy. On Amazon, Smoky Mountain Naturals is a best seller. The second was low dose aspirin to help thin my blood.

I had been taking both of those since I found information online from women who said it had helped them (which beings me back to the message I posted above about being proactive). I also took supplements. To find out more about the dosage of my prescription and over-the-counter medicines and when they were taken, please see my Rx protocol.

Summary of Dates

November 2015

Early Nov: Suspected CP (pregnancy #2: miscarriage #1)
Mid Nov: Confirmed ovulation
Late Nov: Positive HPT (pregnancy #3: miscarriage #2)

December 2015

Mid Dec: Baby small for dates but assured everything was fine at Soonchunhyang Hospital (SCH)
Late Dec: Told had a missed miscarriage at IMom Obgyn
Late Dec: Found out Soonchunhyang Hospital (SCH) had entered wrong medical information

January 2016

Early Jan: D&C at Soonchunhyang Hospital (SCH)

March 2016

Late Mar: Positive HPT (pregnancy #4: miscarriage #3)
28 Mar: First tests at Pyeongtaek St. Mary's Hospital
30 Mar: Painless HSG test

April 2016

6 Apr: NK cell results
15 Apr: 3w2d positive HPT on Wondfo. (Pregnancy #5). Confirmed at hospital (betas were 11). I was told they were low (even though I was only about 10 dpo) and I needed to come back Monday and be at least 50. IVIG #1.
18 Apr: 3w5d betas were 80
29 Apr: 5w2d visible yolk sac at 5w2d

May 2016