“You have loosed my sackcloth and clothed me with gladness.” (Psalm 30:11)
What a wonderful trip to New York we had. I have to admit, I was a little apprehensive about the idea a week or two ago, given my history of “bad luck” and “omens” in NYC (an old college thing I really don’t need to get into), but the Big Apple has redeemed itself for me.
Last Tuesday, I filled out my online patient questionnaire for my August 15th phone consultation with Dr. Jeffrey Braverman, a reproductive immunologist in New York. Much to my surprise, he called me about an hour or so later, even though it was only the 7th! I said, as the kids were running wild through the background, “Oh! I didn’t expect your call today!” His reply was a very friendly, “Most people don’t.” I can only assume he goes ahead with phone calls as soon as he has read the medical history and has a free time slot.
On that phone call, he told me that he didn’t think my MTHFR genetics were causing me to miscarry, as that would have caused every pregnancy to fail. I felt a slight disappointment inside, but then he said that he definitely thought there was something immunologic going on. He told me to go ahead and come to New York, maybe go see a Broadway show, and let him worry about the rest.
When he put me through to his scheduling desk, they told me that they had an opening on Thursday (as in, two days away), or that they could see me on September 4th. I whispered to my husband that they could see me then, and he said, “Go for it!” So commenced the scramble – the phone calls to family, the Internet searches for hotels and how best to manage getting in and out of Manhattan, the packing, and finding someone to watch the cat. My friend with a AAA membership got me two tour guides and a series of New York/New Jersey maps. Wednesday morning, I drove my two-year-old (whom I love dearly but who rarely behaves) an hour west to meet her Nana and spend a few days with her and Grandpa. Wednesday evening, we drove to Maryland to spend the night at my mom’s. She and my 17-year-old sister came to NYC with us the next day.
Thursday, August 9th, we hopped into the car – me, my husband, our 5-year-old son (who expressed his enthusiasm best when he said, “I’ve never been to New York in my whole big life!”), my mom, and my sister. I am so grateful that these two ladies came along. It would not have been the same without them, and we’d probably be lost in Brooklyn to this day.
We drove from their house to Port Imperial in Weehawken, New Jersey, to take the ferry across the Hudson River. It was windy and hard to get a picture, so eyes closed is what we got.
From the ferry terminal, we rode a free bus to the corner of 57th Street and 5th avenue, one block from F.A.O. Schwarz. I had memories of being there as a kid and was really excited to take my son. Unfortunately, it is much smaller these days (only two levels), but he still had fun picking out a couple of battle droids. From there, my husband and I rode the subway to 23rd Street to go to Dr. Braverman’s office, while my mom and sister took our son to Central Park.
The meeting with Dr. Braverman was great. I couldn’t have asked for anything better and I wouldn’t have changed a thing. I am not even sure if I have fully comprehended the amazing thing that occurred there. It’s still sinking in: a doctor told me he would help me. A doctor me he could help me. A doctor said, “Whatever’s wrong, we will find it.” He knew what he was going to test me for, and he knew how to fix it. A doctor told me he would be able to treat me, and that I would have more children. Oh my word!
All the other doctors have left me hopeless, waging war against unknown odds… sending me out the door with no words but “Keep trying!” Telling me that I will have more kids but not being able to tell me why I keep failing at it. The more I have read from women like me, the more I hear a resounding frustration with the current medical approach to recurrent pregnancy loss. In fact, it’s not even very “current” at all, since the mainstream protocol among reproductive endocrinologists is based upon guidelines from 2001. A lot has changed, and it’s time the American College of Obstetricians and Gynecologists caught up!
Dr. Braverman was a very likeable fellow, and seemed to me more like your average, well-dressed, New York resident than a doctor! He didn’t wear a white jacket, he made jokes about me having violent tendencies (upon seeing my husband’s arm in a sling – a softball injury, just for the record!), and pulled an iced coffee from a paper bag while we sat with him. Falling asleep during our appointment “would be embAArrassing,” he said (and you have to put that New York accent on the “A,” just like everyone does when they say my name, “SAAra.”)
Looking at my history, he told me he was going to test me for a few different things: HLA genes, HLA antibodies, inherited inflammatory conditions, and some sort of sugar test. I won’t attempt to explain what HLA genetics is all about, but if you’re interested, you can read about it and watch his video on their Web site. It basically affects how a mother’s body recognizes the baby – whether as “self” or “foreign.” And if the right message doesn’t get through, the immune system will go after the embryo just as it would a virus or cancer cells.
When I asked him his thoughts on me being sick with the two 16-week miscarriages we had, he said that it’s logical I would have felt ill if my immune system had been activated. All other doctors said, “Usually it’s a good sign if you’re sick,” but in my gut, I always felt it was related to my losses, since I wasn’t sick with the children who survived. For once, a doctor resonated with what I had always intuited as a mother.
Before I left, Dr. Braverman also performed a sonogram to measure blood-flow in my uterus. He showed me on-screen that the blood was having a hard time moving through the wall of the uterus. He said the vessels there seem to be very restricted, and it’s a finding we need to keep in mind for the future. He explained that inflammation, brought on by an immune response, would constrict the vessels, or that it could be a sign of endometriosis. It will require more analysis later.
We left his office that day very encouraged and feeling hopeful for the first time. It literally does feel like a “sackcloth” has been removed. A weight has been lifted; we aren’t carrying around this heavy cloak that feels like impending death for all future pregnancies. And I don’t just say that to be dramatic or something… it’s just how it feels when you’ve miscarried so much it almost becomes a way of life.
And so, as we left the city that night, having gorged ourselves on homemade food in Little Italy and traipsing through Soho and Times Square, I felt at peace. The city, scarred yet standing resilient above her ashes, looked beautiful and vibrant to me. The breeze on the top of the ferry was cool and refreshing, and I thanked God. I thanked Him for leading me to this doctor, for the fun memories we were making, for the beauty and fullness of life we were enjoying. New York now holds happy thoughts for me … and now it’s up to her – she’s got the key that may figure this whole big thing out.
“But You heard the voice of my pleas for mercy when I cried to You for help.” (Psalm 31:22)