How I overcame ‘Apas’
My immunologist described the condition simply as ‘the immune system attacking the baby thinking it’s an enemy’
One of the medical cases featured in the K-drama “Hospital Playlist” is antiphospholipid syndrome, or antiphospholipid antibody syndrome (APS or Apas). This is how actor Kim Dae-myung as Dr. Seok-hyong explained the condition: “To maintain a healthy pregnancy, your blood has to flow well. But with this syndrome, it’s hard for your blood to circulate. Forming a placenta and maintaining your pregnancy can be difficult.”
Thus, causes miscarriages. While it is not advisable to believe everything you see and hear in K-dramas, the description of Apas is accurate.
I was diagnosed with Apas a year before I got pregnant. My immunologist described the condition simply as “the immune system attacking the baby thinking it’s an enemy.”
It’s a very scary thing to hear and yet, I considered myself lucky that I found out early. Most women learn about their condition after having had a miscarriage. My husband and I had been married for two years but had yet to conceive. Two years is usually too long when you’re trying.
I’ve known that I had polycystic ovary syndrome (PCOS), a hormonal disorder, since high school. My gynecologist asked if my husband and I would like to do further tests before we dealt with the PCOS. We agreed because we thought that it would be better to be done with the tests before we tried to conceive. My doctor also told me to lose weight; losing weight is a struggle for women with PCOS.
She referred us to an immunologist and I had a series of blood tests in two hospitals while my husband did a semen analysis. One of the tests even showed that I might have lupus.
I didn’t. But Apas being concomitant to lupus meant that I will always be positive in some of the blood tests for the latter.
Support group
I joined a support group on Facebook (FB). That’s when I got to know other women like me. I also got to know their sufferings.
Some shared the pain of losing their pregnancies multiple times, while others shared their success stories. Rainbow babies are especially celebrated. They are babies that come after a miscarriage.
My immunologist and my gynecologist worked out a fertility plan for us. All activities were scheduled around my fertile days. For PCOS, I was injected with a medicine that boosted my egg cell production.
For Apas, I had to take a low-dose aspirin to interrupt blood clots. We also chose to undergo Lymphocyte Immunization Therapy (LIT). This is a treatment where white blood cells (WBC) are extracted from my husband. The WBC were then injected on my arms.
The theory behind LIT is that it would acclimatize my antibodies to the foreign cells of my husband. Thus, when I conceive, my antibodies would not attack the fetus.
We did all of this for three months and we were still unsuccessful. It was expensive, taxing and very unsexy.
Our gynecologist asked if we would like to consider artificial insemination. We were not against it, but we were exhausted at that point. We told her that we would like to take a break.
Work took me to India and I extended my trip to a week. I walked a lot, ate delicious vegan food, and the sauna-weather made me lose 10 to 15 pounds. I credit the weight loss and my relaxed disposition as factors of getting pregnant when I got home. It’s either that or the temple visit to an Indian fertility goddess really worked.
Heparin shots
Upon learning about the pregnancy, our doctor prescribed heparin shots on top of other vitamins and medicine. Heparin is an anticoagulant drug. It has to be injected on the tummy area every day until one week before cesarean delivery. I did the injections on myself most of the time. I numbed the area by putting ice. Sometimes I got bruising from it.
I also had to undergo an ultrasound every other week. Normal pregnancies only require five times or less throughout the pregnancy. The baby’s growth was monitored religiously.
I also underwent intralipid infusion twice. The infusions lasted for at least three hours each time. My immunologist told me to think of intralipid as fetus food. It was made up of fat, protein and egg yolk.
Apas babies tend to be smaller than normal babies. Intralipid helps them to stay within the range of normal growth inside the womb.
The slightest bleeding and I was ordered bed rest. However, I was also recommended to eat lots of meat. This one I enjoyed a lot for it meant I had a reason to indulge in steak.
Then I had a friendly showdown with my gyne. She wanted me to give birth at 35 weeks. I told her I would hold out for another week. I wanted my baby to grow a little longer inside me. I won, and at exactly 36 weeks, I gave birth.
Hearing my baby’s cry for the first time was the sweetest thing I’ve heard. All the expense and the pain were worth it. I finally understood why women in our FB group would post pictures of their babies with all the empty heparin syringes. There is an incredible sense of gratitude of being able to deliver a baby successfully.
It is the awareness that other women suffer heartbreaks and disappointments silently that makes me more conscious about asking couples if they want to have kids. Some don’t. Some do, but can’t. Asking them about it for the sake of small talk stings.
In the K-drama “Hospital Playlist,” the conversation ended with the doctor trying to console his patient. He told her, “miscarriage isn’t a disease. You did nothing wrong. This can happen to anyone. But now that you know, you can do things to keep your baby safe. ”