The results from Dr. Kwak-Kim

So, the gist of it is that the bloodwork from Kwak-Kim does not match the bloodwork from Coulam.  :( 

Kim's bloodwork showed my NKC's to be low or normal!  She does not recommend IVIG.  (Which I'm glad about because I wouldn't have done it anyways!  I'd stick with the intralipids.  But, since it doesn't appear it's going to come up, I won't have to battle her!) 

She found a positive result for antithyroglobulin antibody.  Coulam ran the same test and found it to be negative.  This particular antibody is one that attacks the thyroid over time.  Currently my thyroid levels are completely normal.  Kim feels that the stress of a pregnancy may be more than the thyroid can handle, the antibodies start to win and I become hypothyroid (have low thryoid levels).  Luckily the only treatment plan for this is to check my thyroid levels weekly through early pregnancy.  Fine with me. 

By the way, I trust Coulam's tests more.  Coulam's tests gave an actual level, whereas Kim's test just said normal or not normal.  That just doesn't seem as accurate to me.... 

Also, both Kim and Coulam tested about 30 different antiphospolipid antibodies.  Coulam found none of them to be elevated (and had precise numbers as to what each of them was at).  Kim stated that almost all were normal and one was considered borderline and one was considered elevated.  Again, she didn't have actual numbers, just the test results that said elevated and borderline, so I don't really know what the numbers were.  Kim's treatment for that would be Heparin.  I'm starting to lean toward taking the Heparin anyways.  Many studies seem to show that it falls into the we-don't-know-if-it-helps-but-it-can't-hurt category. 

So, that's the gist of Kim's findings.  She wants me to do Heparin and prednisone daily from cd6 and test my thyroid regularly.  Coulam wants me to do intralipids about every 4 weeks from ovulation onwards. 

My plan is to do Heparin and intralipids and to NOT do the prednisone.  I have some concerns about taking a steroid.  Last time the dexamethasome really screwed me up.  But, if we have another loss, I'll certainly be revisiting the steroid issue. 

That's it for now.  Now, I'm still waiting for my period which should show up any day now....






http://scholar.google.com/scholar_url?hl=en&q=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2125731/pdf/9022487.pdf&sa=X&scisig=AAGBfm2i5-VGN_VD2PMB7u6SY23P7pdrog&oi=scholarr

http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1999.tb08208.x/full