This morning after prying open my garage door frozen shut with a recent thaw/freeze cycle I came across not one or two but three large white hares as I made my way to work in the wee hours (necessitated by my spending the day at home yesterday with the Miracle Toddler who was battling a wicked cough and some bug he appears to have caught with the same thaw/freeze cycle). I have previously written about how I love hares and that I associate them with positive events to come in my fertility/recurrent pregnancy loss journey. I have even dreamed of hares teaching me things on this journey.
Let’s face it, it’s hard not to love a bunny (unless you’re a farmer or an avid gardener, I suppose). To spot three of them – and have to stop my vehicle and issue each of them a warm greeting as I gave them room and time to find a new path to travel safely out of range of mine – within minutes of each other got my day off to an amazing start.
The bunnies also reinforced the good news I got late yesterday from Dr. Braverman. Without further ado, here it is:
· Almost all of my cellular inflammation has come down from the very elevated levels found in my late December blood work.
· One notable exception is my level of IL-10, which is a marker for serious third trimester complications for which we are already watching and about which we are already painfully aware. Thankfully my IL-10 level is still hovering at normal range despite having risen.
· I am to start halving my dose of Prednisone weekly until I get to 2.5 mg on which I should stay for a final week.
· I am to continue weekly Intralipid IV treatments until 28 weeks.
· No more trips to New York City for blood tests or to pick up Intralipids (smart move on my part stockpiling IL bags during my last trip!).
Dr. Braverman’s view is that the aggressive treatment with high Prednisone doses and more frequent Intralipid infusions has made the difference. In his opinion more immune panel blood work and monitoring will not change the outcome even if I have a further immune flare in the third trimester. He has asked that I keep him in the loop and feel free to consult him about any new developments even though any medical decisions are mine to make. All of this means that I do not need to return to New York or make other arrangements to do any more blood work through Reprosource. That is a relief and another major financial expense eliminated. This advice of course is premised in part on the promise locally to continue monitoring this pregnancy, my placenta, baby’s growth and development and general wellness and regular testing and monitoring (by me and my local doctors) for those pesky “serious third trimester complications” for which I’ve got plenty of markers.
I will be honest. As much as I am relieved by this news and as much as I despise the side effects of Prednisone, I am afraid to go completely off of it. Heck, I’m afraid to wean from the 20 mg I am currently taking. I am afraid of things going sideways. Nevertheless, I will continue weaning. I will start early next week (because I just weaned to 20 mg this week). I think I may go down from 20 mg to 15 mg first and then to 10 mg, 5 mg and finally 2.5 mg. I am currently 22 weeks so this will keep me on a low dose of Prednisone past the 24-week mark by which Dr. Braverman originally wanted to ensure I was off this drug. Even he acknowledged a while ago I would not get off this drug completely by 24 weeks.
One of my concerns is that I have had rebound reactions when I’ve dropped too quickly or too much at a time below 20 mg and I would really like to avoid that this time since the stakes here are so much higher than on any other occasion when I’ve taken this steroid. Plus my OB a few weeks ago speculated that the Prednisone may increase my chances of avoiding a repeat of the Cholestasis I developed in the MT’s pregnancy. He is not aware of studies confirming that but it’s his gut feeling. And we all know I am rather big on gut feelings.
I need to get back to work and thus bid you all a Happy Humpday for now. I also leave you with some rabbit art I did last year. Who wouldn’t love this bright and cheery bunny?