The nurse came in backwards, using her rump to bump open the door. As she turned around to greet me, I saw why: both of her hands were full, clutching an alarming number of glass vials. They clinked cheerfully as she deposited them in to a little basket on the counter next to me. There were at least a dozen and they all had my name on them. My palms started to sweat.
“You’re kidding me, right?” I squirmed in the hard plastic chair. “I’m not going to have any blood left in me!”
I don’t do needles well. I mean, judge me if you want, but I’ve never even donated blood. The very thought of it nauseates me. And here I had thought the standard few vials I had taken at the outset of the pregnancy were bad; they had nothing on this.
“You got plenty to spare, sweetie,” the nurse said.
At four months pregnant, I was being tested for a smattering of obscure-sounding disorders and genetic abnormalities that I’d never heard of, and none of which were necessarily indicated by the perfectly healthy baby growing in my belly. No, these were the ghosts of pregnancies past, of those months where cells had joined and multiplied and progressed enough to turn a pee stick pink but never made it much further.
Habitual Aborter, that was what the diagnosis on the paperwork said. Naturally I was highly offended the first time I saw it, until I realized it was simply the clinical term for recurrent miscarriage. You’d think they could come up with a better way of saying it. Oh yes, my bad habits, I had chuckled bitterly. Picking my cuticles, forgetting to replace the toilet paper, and aborting fetuses.
I closed my eyes as the nurse tightened the elastic band around my arm, my nails digging into my clammy palm as I obediently clenched my fist. I couldn’t bear to watch her stick me. I knew it wouldn’t be painful, but it was just…gross. Needle in my flesh. Ew.
Initially, I had bristled at my doctor’s suggestion that we pursue these blood tests, known as the recurrent loss panel. Why does it matter now? I had asked. I’d just come from my big 20-week ultrasound and seen our perfect little fetus – a girl! – wiggling and kicking away. All her pieces and parts were in their proper places. I didn’t want to revisit the past, those clusters of cells that never made it. I wanted to focus on the one that eventually did.
They just wanted to rule out any possible problems, the doctor had explained. A clotting disorder. It was unlikely, of course. But just in case…
So I had agreed.
As it turned out, the lab nurse was correct and I did, in fact, have plenty to spare. Life went on normally without those dozen vials of blood. A couple of weeks passed. My belly grew rounder; I started to feel the baby thump and kick, hard enough even for my husband to feel it from the outside. We giggled and marveled as I’m sure all first-time parents do at such milestones. I was 25 weeks when I got the call that the labwork was in. At that point, I’d almost forgotten about it.
“There are a couple of things we should discuss,” the doctor began.
That’s not how these conversations start when everything’s fine.
“You have a genetic mutation, heterozygous MTHFR,” he continued.
The what? The motherfucker gene?
“And you have a functional protein-S deficiency.”
A protein deficiency? But I eat lots of protein…
“Taken on their own, neither of these things would worry me much. But when we look at the whole picture, including your history, I believe it’s possible that you may have a genetic clotting disorder.” He paused, perhaps to give me time to process. I flipped through my copy of the lengthy document provided by the lab, pages of acronyms and unfamiliar terms. Someone had pen-marked each of the offending parties, the motherfucker gene and the delinquent S protein, with a circle and a sloppy asterisk.
Genetic mutation. It was the stuff of comic books and superheroes, of fantasies on the evolution of the human species. As in: somewhere, deep in the bowels of her coding, a switch gets flipped and all of a sudden she can fly! Or regenerate wounded flesh! Or snap pencils with her mind! By comparison, having slightly thicker-than-average blood seemed not only disadvantageous, but downright mundane.
The doctor went on to explain the course of treatment for clotting disorders, which he recommend pursuing as a precautionary measure for the rest of my pregnancy. It was a pros-vs-cons game, of course, but the lineup on one side had some pretty heavy hitters: low birth weight, late-term miscarriage, stillbirth. The opponents were fairly flimsy: bruising easily, inconvenience of dealing with a daily injection of blood-thinning medication….
Of course I would treat it. Even though the treatment would involve needles. It wasn’t even a question. I caught my first glimpse of what parents mean when they say they’d do anything for their kids. I would jab myself with oodles of needles every single day if that’s what my little girl needed to grow properly and come out safely.
Still, it is unsettling to learn that there may be something wrong with you when you feel perfectly fine. I mean…seriously, blood clots? Never crossed my mind. I’m healthy. This pregnancy has been easy and uneventful. I run and I eat my vegetables. How can there be something wrong with the blood that circulates my veins and arteries completely unbeknownst to me?
It seems so nefarious and unfair. But I guess that’s the nature of symptomless diseases.
We still don’t know for sure whether I actually have a disorder. Pregnancy hormones, it seems, can mess with the contents of your blood and make these things difficult to diagnose without a baseline. Next year, after baby’s born and the pregnancy hormones have left my system, I’ll see a hematologist and figure out what’s going on, whether this motherfucker gene and defunct protein thing is for real.
But for now, every night before bed, I close my eyes as my husband sticks me in the side with a thin, inch long needle. It doesn’t actually hurt much, and I can do it myself if I need to, but I prefer not to watch. Old habits die hard.