Over the last couple of days my eyes have been opened to differences of opinion within the medical profession when it comes to an aps diagnosis.
I'm currently 35 weeks pregnant. I'm taking a low dosage of Fragmin, combined with aspirin. Prior to my pregnancy, I experienced 5 miscarriages, pre-term birth, a retained placenta caused by clots as well as a myriad of odd symptoms (poor circulation, pins and needles etc). Whilst both blood tests for aps came back as positive, they fell within the lower grey area of positive. Luckily, given my history and results my haematologist surmised that I have "probable aps" and has treated me as an aps patient. Subsequently, I'm now further in my pregnancy than I've ever reached and am at the point of discussing birth plans (an induction at 38 weeks has been advised).
Yesterday, we visited a different hospital to explore the possibility of having our baby outside of our catchment. We met with a haematologist. Perhaps rather naively we assumed he would simply follow the care plan as outlined by our current consultants. He completely disagreed with my diagnosis, claiming that my blood results were not high enough for an aps diagnosis despite being outside of the normal range. My history wasn't enough for a confirmed diagnosis either and if we were to have the baby at this particular hospital, the pregnancy would be allowed to continue with labour commencing naturally and they wouldn't recommend Fragmin injections afterwards. Essentially he was totally dismissive and said "you do not have aps".
I am so very grateful to have found a haematologist that listened to me, that has considered the middle ground and for getting me this far in the pregnancy. Needless to say, we will not be having our baby at the other hospital. We met with our current haematologist today, discussed our experience and he even apologised for what happened with the other consultant, stating many haematologists are too rigid when it comes to a diagnosis. He reiterated his reasonings for my diagnosis and I left the appointment feeling that I have the best person looking after me.
I just wanted to share my experience. I am startled at how two different haematologists can be so opposing with the same set of results. I guess if nothing else, it highlights the importance of finding the right person for your care.