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11/07/2005

Newly-minted mutant music

I called my OB's office last week for a couple of reasons. First, I've been having breakthrough bleeding on the birth control pill I'd been prescribed, and wanted a different prescription. Second, I wanted to know whether my bloodwork results had come back. So after seventeen minutes on hold, I spoke to a nurse-practitioner. What follows is an accurate transcript of the conversation.

Nurse-practitioner: I see here you want to talk about your birth control prescription...

Julie [still humming the hold music]: Yesssssss. [Sotto voce.] All the sweeeeeet, greeeeen icing flowing dowwwwwwn...

N.-P.: ...and the pre-conception consultation you had.

Julie: Yes. [Not-so-sotto voce.] Someone left the cake out in the raaaaain....

N.-P.: Well...I'm confused.

Julie: Yes? [Now warbling loudly.] I don't think that I can take it...'cause it took so long to baaaake it...

N.-P.: You're trying to get pregnant but you're on the pill?

Julie: [Brightly.] Yes. Is there a problem with that?

N.-P.: [Long pause.]

Julie: ...Gotcha! Aaaand I'll never have that recipe agaaaain! Oh, no! No! Oh, nooooo!

For that, I was punished with another eleven minutes on hold.

...

My OB returned my call while I was out. She left a breathless message on my answering machine telling me she really wanted to talk to me, that she'd also try my cell phone. This was at 4:30 on a Friday afternoon, so by the time I knew I needed to, it was too late to call back.

I knew there had to be something interesting going on. No doctor on Earth calls back just before the weekend only to say, "I'm taking you off Ovcon 35" — though, in fact, that's the first thing she said when I finally spoke to her this morning. "You need to come off the pill," she said, before she even answered my friendly greeting. (On the other hand, maybe she didn't recognize my enthusiastic mooing of "I am a lineman for the coun-teeeeee" as a greeting.)

My bloodwork came back positive for Factor V Leiden, a genetic mutation that increases one's tendency to clot. (Brooklyn Girl's explanation is excellent. Shout out to my fellow mutant.) It means that it may be easier for women with Factor V Leiden to get pregnant, but it can be more dangerous for us to do so. Risks during pregnancy include pre-eclampsia, miscarriage, and stillbirth, coupled with the more mundane but potentially lethal possibility of deep-vein thrombosis and pulmonary embolism.

Happily, there is treatment for Factor V Leiden that can make pregnancy less risky, primarily in the form of heparin injections. What this means for the percentages I was quoted two weeks ago, I'm not sure; what it means for the rest of my life, I won't know until I've managed to seduce an unwary hematologist with my inimitable song stylings.

And the Wichita lineman...is still...on the liiiiine...

...

Factor V Leiden is hereditary. I'm heterozygous, which means that I inherited one copy of the gene. My father, I'm sure, is the culprit.

Several years ago, he was hospitalized for blood clots in his leg and his lung, and has been on anticoagulants since.

At the outset of this pregnancy, I was asked whether these clots were the result of any underlying condition — oh, say, something like a thrombophilia, perhaps? I duly passed the question on to my parents. The answer was no, every time of the several I asked.

I can only conclude that my father didn't have that test run among his extensive battery of bloodwork. This seems very strange to me. But the alternative is that they did know and didn't tell me, and that is simply impossible.

I'm helplessly, aimlessly, uselessly angry. Had I known about this condition — which is, remember, inherited — we would certainly have managed my pregnancy with Charlie differently. There is no guarantee that it would have gone better. But there's a chance.

Platelets tumbling. Liver flipping. Placenta dying. Ten weeks early. Maybe that didn't have to happen.

Well, I'll never have that recipe again. Oh, no.

[Instrumental interlude. Fade.]

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