APAS FAQs: Tests, Meds, and Expenses

Ever since my blog post about my pregnancy was picked up by Smart Parenting, I’d been getting a lot of queries regarding my whole experience. Every week, I get PM’s from different women telling me about how they’ve been trying to conceive for years or how they’ve suffered recurrent miscarriages. They ask about my condition, how I found out, where I got tested, who my doctors are, and how much did I spend to sustain my pregnancy.

I know I’ve already written a lengthy and detailed post about APAS, but here I will consolidate all questions I’m being asked for the sake of those who want to know–those who are afraid that they may have the same condition; those who are daunted by the thought of spending a huge bulk of their savings just to get a shot at a successful pregnancy; and those who are clinging on to the hope of having a child.

As long as I can help, I will never stop sharing my story. So, here are 10 frequently asked questions* about my APAS journey:

1. What is APAS?

According to medicine.net: The Antiphospholipid Syndrome (APAS) is a disorder of the immune system that is characterized by excessive clotting of blood and/or certain complications of pregnancy(premature miscarriages, unexplained fetal death, or premature birth) and the presence of antiphospholipid antibodies (such as anti-cardiolipin or lupus anticoagulant antibodies) in the blood.

To put simply, my blood was too thick. And because a baby gets nutrients from his mother through the blood, if it’s too thick then the baby might not get enough nutrition to sustain it inside the womb.

It is interesting to note that APAS is just one of the five Reproductive-Immunological Disorder (RID) categories. Other women test positive in two or more categories.

2. Does it have symptoms? How did you know you had it?

The main symptom is difficulty conceiving and sustaining a pregnancy. After my second miscarriage in 2016, my OB brought up the term APAS but I shrugged it off because I truly did not want to try to conceive anymore. In July 2018, I was shocked to see two pink lines on a pregnancy test–and went straight to the lab to get tested for APAS.

According to some medical websites, there may be symptoms of APAS unrelated to pregnancy such as migraines and blood clots in the legs. But personally, I’ve never had any inkling I had it except for my recurrent miscarriages. 

3. Where did you get tested for it?

I had the test done in Hi-Precision. But for the other RID categories, I did it at St. Luke’s Global.

4. How much were the lab tests?

I paid around P5,000 for the APAS panel at Hi-Precision. The other test I had done was to check my Natural Killer Cells–and if I remember it correctly, it was around P9,000 at St. Luke’s.

5. Do I go straight to an immunologist, or shall I consult with my OB first?

I went to an OB first. She was the one who referred me to an immunologist.

6. Who are your doctors?

My OB-GYNE is Dr. Jocelyn Bambalan. She’s also a perinatologist (one who specializes in high-risk pregnancies) and sonologist so she conducts my ultrasounds as well. My immunologist is Dr. CJ Gloria. Both of them have clinics St. Luke’s Global.

7. What medicines did you have to take during your pregnancy?

Aside from the prenatal vitamins, these meds were prescribed to me to manage my APAS and sustain my pregnancy:

-aspirin, daily until 32nd week

-Heparin injection, daily until 35th week

-Prednisone (steroids) for a month during my first trimester

-two brands of probiotics everyday

-progesterone, both oral and vaginal suppository

-monthly intralipid infusion (done through IV)

8. If I have APAS, does that mean my pregnancy will be as complicated as yours?

I don’t think so. Personally, I know some women who have APAS and other RIDs and have had very smooth pregnancies. They even were able to travel while pregnant! 

Although my immunologist did comment at one point that the complications I had were a way of my body trying to reject the pregnancy due to my APAS. Still, I think that what happened to me was just purely coincidental.

9. If I am pregnant and have APAS, must I undergo a C-section?

Pregnant women with RIDs are automatically branded as having high-risk pregnancies. This goes into your medical chart so resident doctors and nurses know how best to deal with your case. But personally, my OB encouraged me to try for a vaginal birth even up to the last minute.

10. How much did your medicines and treatments cost?

Sorry, I forgot the exact amount of the medicines I took; but these were the ones that stood out, mainly because they were the most expensive ones!

-Heparin: a pre-filled heparin syringe cost around P470. The vials were much cheaper and they were less painful to inject, too! Tip: if you have a senior citizen in the family, ask your doctor to make the prescription under his name so you can avail of the discount.

-Probiotics: My doctor prescribed two brands. The one I got from Healthy Options, and the other is Culturelle. It is not being sold in the country but there are many resellers online. Beware though, and make sure what you’re buying is the real thing. I got mine from my immunologist’s clinic. It was around P1,000++ per box (good for one month).

-Intralipid Infusion: this is to help my baby grow in the womb. APAS babies tend to be smaller and have a very high chance of premature birth. This costs P15,000 per session at St. Luke’s Global.

*Please note that my answers are all based on MY own experience. As each pregnancy is different, your doctor may instruct you to do things differently.

If you have trouble getting pregnant or have had multiple miscarriages, I strongly encourage you to consult with a specialist. I always say this: having APAS may be difficult and expensive to manage, but it is better than being in the dark.

As they say, baby dust to all you moms-in-waiting! I am believing with you for your own rainbows. <3

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