I have no idea.
Here's what happened (with a bit of a backstory so you fully understand).
I was diagnosed with compound heterozygous MTHFR gene mutation in December of 2009 after my second miscarriage. My RE had flat out refused to run any testing on me prior to my next IVF
Anyway, I was taking a prenatal vitamin called Neevo while I was pregnant that contained a metabolized form of folic acid that was readily available to be used by my body. I felt great while taking it. I was also taking baby aspirin - one a day - during my pregnancy. I still had some Neevo at home and I had continued to take it along with my baby aspirin after my girls were born. I ran out of Neevo two weeks ago. I quickly became
Then I thought about what had changed. I had run out of prenatals and had switched to a different brand that didn't have them metabolized form of folic acid that the Neevo did. So I requested more Neevo from the pharmacy. The pharmacy contacted my OB's office, who DENIED the request. Really? Denied? It's a prenatal vitamin, not a controlled substance for Pete's sake! No worries I thought. I had seen my OB multiple times since the girls had been born because my body just wouldn't stop bleeding after my C-section. I ended up having not 1, but 2 D&C's post partum, the last one being on New Year's Eve day and being ultrasound guided to make sure that my OB "got it" - a necrotized piece of something (not placenta, and not cancerous) that had literally grown into the wall of my uterus and was refusing to come out with "simple scraping". I had my post D&C follow up visit (from D&C #2) with my OB yesterday. I figured I would talk to him about the Neevo, it would be no big deal, he would refill it, and I would go on my happy way.
This is what happened instead:
Me: "What should I be doing in terms of supplementation of folic acid or taking prenatals now that I'm not pregnant?"
OB: "Nothing. There is no need for you to supplement anything."
Um, okay. That wasn't in my plan. So I reminded my OB that I was compound heterozygous for MTHFR and I asked him what I should be doing in terms of supplementation of folic acid and the other B vitamins as my body still can't metabolize folic acid, so I know I still need to do something.
Me: "But I have the MTHFR gene mutation - I thought I needed extra folic acid at the very least - regardless of if I am pregnant or not".
OB: "No, there is no reason for you to take any folic acid at this point".
Me: "Really? I thought I had to always be on folic acid, and I really liked the Neevo that I was on while I was pregnant. Could I get more of that?"
OB: "No, there is no need for you to be on that"
Okay, so lets add another layer to this story. Si and I have made the decision not to prevent future pregnancies at this time (mostly because I am breastfeeding and I don't want the hormones to mess with my milk supply), so there is a very very slight possibility that I COULD get pregnant on my own. You know, the way a one tubed, stage IV endometriosis, infertility and recurrent loss patient could. . .I think my quoted chances of getting pregnant on my own - less than 2%. Yeah, I'm really not concerned. And if it did happen, we would definitely consider it a miracle and a sign from God that we were obviously supposed to have another child. But that's not the point.
I figured at this point he would say oh yeah, since there is a possibility you could get pregnant you should stay on a prenatal. Instead, this is how the conversation went. . .
Me: "You know, we aren't going on any sort of birth control, so I suppose there is a very slight possibility that I could get pregnant. . ."
OB: "Oh it could definitely happen. I've seen it happen many times before"
Me: Blank stare. . .
OB: "After you get pregnant next time we will start you on a prenatal again. There's just no need for you to be on one, or anything else, right now."
Me: Blank stare. . .
OB: "You do need to make sure you are taking your baby aspirin every day though. And any time you fly you need to take an entire aspirin to try to prevent clots."
Me: "Okay, I get that. I've been so tired though lately, and I suspect it's because I no longer am taking my prenatal"
OB: "You are probably tired because you have twin babies at home and have had 3 surgeries in 12 weeks. You should be tired."
Me: Again - blank stare. . .
I mean, what do you say to that? I have never had 3 surgeries in 12 weeks before, so I guess I don't know how tired I should be after that. But don't you suppose that if this was just a "normal" tired for me that I wouldn't bring it up? I mean of course I'm tired! I have twin babies that keep me running 24-7! But I'm used to that. And it's
Okay, so let me review
Besides, isn't it standard procedure now to put women of child bearing age on a a prenantal REGARDLESS of whether or not they are trying to have children, just "in case" they do get pregnant??? It thought that was the new standard reccomendation. I know I was on a prenatal the entire time we were TTC/not preventing. . .so for 6 years before I was actually pregnant. And he had no problem writing the script then.
I am so confused. And now I have to figure out what my next step is. I was taking the metabolized form of folic acid, which is what I need to make the folic acid readily available to my cells. And of course, it isn't available without a prescription. Sigh. Now what? My PCP maybe? I am so mad at myself for not pushing this more with my OB yesterday. I really do love my OB, and I
I know that many of you aren't in the same shoes, and may have no idea what MTHFR is, but do you have any thoughts on what you would do in this situation? I guess I just don't understand what the big deal is to give me the prenatal, so I'm lost at what to do next, or who should be next on my contact list. I'm most definitely not going to do nothing. . .