A Cerclage Removal Story

9/15/09 – Today was one of the most important days of this pregnancy.  At 36w2d, Dr. G took my stitches out  in the L&D operating room, to be as sterile as possible.  The procedure was scheduled for 10 am (originally 0930) but an emergency walked into the ER and I was bumped to around 12:15p.

Prep: I was not allowed to eat after midnight.  So they starved me for like 12 hours.  However, I did sneak some peanuts and sips of water while at home because the hunger was unbearable.  I checked in at around 0930 after calling the floor to see when to come in.  Because of my dehydration  and stronger contractions, they gave me an IV fluid and a shot of Terbutaline sub-q (ouch, that stings!) to quiet my uterus for the procedure.  I was also given IV Ancef as a precautionary antibiotic. We saw MeMe on a bedside ultrasound just to make sure she was doing well and got hooked up to the baby/uterus monitor. We sat and watched the “Newborn Channel” and answered some health history questions before it my time to go to the OR.  My mom and husb were with me.  Some of my mom’s coworkers were working  and almost all of them had no idea her daughter was pregnant or that she was expecting a grandchild.  The last time I was L&D at my hospital was when my water broke with the twins so mom only wanted to give good news this time. I love having mom with me because she makes sure everything is taken care of.  Husb is equally supportive so its like having two people wait on you hand and foot all day!

Procedure: Signed the consent, of course. Doc said no anesthesia this time and I stupidly refused IV Ativan thinking I could tough it out.  I wished I took it to calm me down because the pain was EXCRUTIATING! I almost jumped off the table and Nurse Annie, who was holding my hand, almost had her fingers broken.  People who say it is “uncomfortable” are barely touching the surface.  All that cervical manipulating, the hard speculum, and the manual check for leftover stitch material is NOT COOL. Gotta remember, nothing large or wide has been in my cooch for months so the muscles in there were not happy to be messed with.  I was tense and needed to be coached to breathe from Annie.  All in all, it took about 10-15 minutes to make sure both stitches were out.

Aftermath: My cervix did the unexpected.  Dilated a fingertip and 50% effaced.  MeMe is high, not even engaged.  I also have some bacteria growing up in there so I have to put Metrogel in my cooch for the next 5 days.  Ladies with cerclages are more prone to BV because of the increase in secretions caused by the cerclage. Go figure.  I should expect some bleeding, but having seen any yet. I finally got to eat after the procedure. We stayed in the hospital and was monitored for about 2.5 hours.  For a while, my contractions seemed stronger and had gotten to be about 5 minutes apart, but then subsided, spread apart, and felt like normal.  Annie sent me home with my prescription and said to call or come back if my water breaks, stronger contractions…etc. Typical labor stuff.

These are what the stitches looked like, but I didn’t get to take a picture of my actual stitches. Looked just like little pieces of blue wire with huge knots. I can see why Dr. S said husb would cut himself if he got close to those things. Ouch.

Placing bets: Husb’s hor0scope said he’ll get great news on Friday, today is Tuesday.  Mom still says by her birthday (9/24).  A says by next week.  Dr G would like MeMe to stay until at least 37 weeks (9/20) but won’t stop her from coming now. We’ll see if these contractions start to make my cervix act right. Next OB visit is on 9/22 at 1150.

I bet my medical chart is exciting reading.  All the things we’ve been through from 1/08 until now.  Everyone is excited and proud we made it this far.  MeMe has a crowd eagerly awaiting her arrival.

Countdown now at 3…

3 more days until snip snip! Super duper YAY! I’m getting excited with everyday that goes by.  I made an executive decision to quit my 17-P shots a little early because I figured the docs aren’t gonna stop me now if I go into labor so why should I be taking the shots to help relax my uterus anymore and delay the inevitable. The shots did their job in preventing me from having really early pre-term labor and from laboring with the stitches in.  They are cutting the stitches in 3 days since they know my body is already gearing up for the big day.

Thank you 17-P, but your job is done and I am eternally grateful. Next on the chopping block is the cerclage.

I was recently thinking of all the things I’ve learned while pregnant that I didn’t know.

• Hyperpigmentation. In certain areas, I have demarcation lines of where my skin got considerably darker.  Even in places that don’t usually see the sun.
• Loose hips.  My hips are sore all the time.  Getting out of bed is a painful.  I feel like I need a bilateral total hip replacement.
• Skin growths, such as skin tags or this tiny little wart on the left side of my nose that was never there before.
• Overwhelming fatigue, even when doing nothing at all.  I have spent many days in bed (such a wonderful luxury to not work) only to pass out watching a great show.  I keep missing the end!
• Too much time on your hands isn’t always a good thing. I had every intention to read and be more knowledgeable regarding work stuff, but I’ve been off for 20 weeks and haven’t looked at anything work related. Baby girl is all that matters.

But still, I am very grateful to God to get this far (35w6d) and the overall experience is a blessing.

I  have a few more little things to add to what I already have and then I can truly kick back and wait.

30 weeks of luck!

MeMe is in her 30’s now. I’m so unbelievably happy to have made it this far. She is a big girl. According to BabyCenter, she should be like 3 pounds. When she moves, she’s rearranging my abdominal organs and stepping on nerves here and there. I can play the touch game with her where I poke her and she moves in response. I’m so amazed!

I got a copy of my prenatal record from the Dr S’s office and learned how truly lucky and blessed we are. Timing is everything! If I hadn’t decided to get the cerclage when I did I definitely would have lost baby girl. My operation notes said that when I was on the table about to get stitched, my cervix had shortened to 1 cm and was starting to open from the bottom. The double cerclage enabled the docs the close my cervix up and add length. Whoa! Absolutely mind-blowing to know that even waiting another day could have cost MeMe her life.

I had no contractions or pain and the only thing I felt was some pressure to the point that I felt like I had to pee every 5 min when I was in the hosp prior to the surgery. True IC indeed. I am very lucky.

My goal is to think more positively from now on. We’ve dodged so many bullets, just like Neo.

29 weeks and switching

My insurance ends today, but I didn’t get my notice until yesterday.  How lame is that?  So I had to call my husb’s insurace company to make them aware so that they don’t act like they don’t have to pay for anything because they think I still have the other insurance.  I found out the specialist is covered and I don’t need authorization to see him since it is a PPO.  But I want to see my regular OB.  Even the lady on the phone asked if I had a doc that will deliver me because the peri won’t do it.  Then I realized, I really need to get back in touch with Dr M.  This is nuts that I’m like almost 10 weeks away from my due date, 7 weeks from stitch cutting and my OB has no idea what’s going on with me.  Just didn’t seem right. So I made an appointment with her for Monday, when I’ll be 30w1d.  I also have to make sure my chart gets to her office.  I’ll put Dr. S on the backburner for now. I figure, my cervix has been pretty stable for months now.  The stitches haven’t fallen out into the toilet,  no bleeding (a sign of cervical changes), no regular contractions, and baby is moving around alot.  If trouble comes, I’ll probably be on total bedrest.

I know I have been very blessed to have not had any more issues since the cerclage surgery and to have had the opportunity to see a peri, but he’s like rain on my parade. He comes in the room all serious with a kinda “so what are we doing today” attitude. I’m just a patient, but I think you should check the baby and my cervix.  Then he’s like, “everything’s okay….for now.  Come in 2 or 3 weeks, whatever you’re comfortable with.” It’s up to me because it’s like he doesn’t care either way.   He’s nothing like my other peri who called me “darling” every time he saw me and was just an dynamic character.  His bedside manner was unbelievable.  He made the worst days of my life more bearable. 

Oh Dr S, parting is such sweet sorrow.

25 weeks and counting…

Last week was a busy one, my husband’s cousin was coming to town for business but wanted to hang with us for a few days.  So we had a hell-of-a time getting the guest room ready for her.  The house was a mess for like 2 days trying to go through what we don’t need and reorganize.  Since we’re renting rooms from my folks, it doesn’t always make for lots of space to put our things.  My parents have been great letting us save tons of $ for our infertility treatments and our future dream home. Anyway, I was packing stuff in big plastic bins and my husb had to put them in storage.  I think I packed at least 6 bins full.  But the guest room was beautiful when finished and there’s tons of space for MeMe now.  Also, pops was painting the kitchen and left the downstairs a mess, so thankfully mom cleaned that for me. 

We took our cousin shopping and to the County Fair to walk around and get some of that yummy fair food.  Very fun! But all that walking made me almost need to be carried home!  My feet were burning. Husb was walking too fast at times and I had to yell at him to slow down. He calls me “roley poley” and said that while I was walking, it was the first time I really looked pregnant.  He was soooo proud and keeps rubbing my tummy. Cousin said I still look heavier than normal, but could get away with not looking pregnant.  The only thing is that I wish I got something personalized like engraving or airbrushing, but there’s always next year.

I had an appt. with Dr. S.  on Monday, this time I went by myself.  BP great with weight up 4 lbs in 4 weeks (I weigh as much now as I weighed at 16 weeks with the twins). Dr. S. checked MeMe’s heartbeat via US and she gave us another shot of her bottom.  Definitely a girl.  He left it up to me to check my cervix.  Yes, please.  So he used the coochie-cam and could see it’s still long and closed measuring a good 4 cm.  He’s very pleased at my progress and told me to continue light activity.  I asked if I could go back to my regular OB after 28 weeks and he said that at this point there is less chance of complications and that it’s totally up to me.  He is comfortable letting me go.  I’m going to have one more appt. on 7/23 at 28w4d and do another 1 hr glucose screen, which I passed the first time.  Dr S is awesome, but these appts are boring and the drive down there is not fun, especially if I’m gonna be doing it every 2 weeks until the stitches are cut. I’d rather see Dr M and know that I will deliver at the hospital I work at which is very close to the house. If I stay with Dr S, I would have to go to a hospital like 45 miles down south where I had my cerclage done.  I only want to go there if I deliver super early (like between now and 30w). 

So with all this cleaning and painting, it got me and husb really wanting to set down some roots and buy a house.  I want us to move northeast where the houses are big and cheap, but he wants to stay here by the beach.  If we move up and out, I would have a 30-35 mile commute and can always drop MeMe off here so mom could watch her.  If we stay here, my commute is like 5 minutes and the convenience of seeing grandma and grandpa all the time is great.  But I think we can still drive down here on the weekends or they can come see us since it’s not like we’ll be 2 hrs away.  I will need my mom to watch the baby at least once a week due to my and husb’s work schedules.  So, I’ve been daydreaming and drooling over these fabulous houses and husb wants to keep checking around here where the houses are smaller, older, and expensive.  Boo! 

Husb finally b0ught his plane ticket, but he’s going alone.  He decided it was best to leave Dom behind with his mom, especially if he might be sick.  But I also think it’s because he wants one last freedom-trip before baby comes.  As long as he doesn’t do anything stupid that will cost us $$, then I’m cool with it.  He’ll be gone for 10 days.  During the time he’s gone, my aunt is coming to stay here and I’ll be doing some driving tours with her.  This is her first time in the U.S and in California, so it’ll be fun taking her around. Plus I don’t think she knows I’m pregnant so she’ll get a nice surprise.  My mom has been tight lipped about it, but finally told 2 of her friends at work.

One last thing, mom gave me my 17-P shot yesterday and hit a blood vessel.  I bled all over my new white/grey dress.  She freaked out, but it finally stopped. It was the first time she’s done that in years so I think it hurt her pride.  It’s okay, the medicine is in and that’s all that matters.

22 weeks of belly kicks

MeMe is kickin’ my ass!  I’m getting beat up here!  She likes to kick me when she’s hungry, when she’s bored, or when I’m ready to sleep.  It’s awesome but weird, kinda feels like a random muscle spasm right at my bikini line or below my bellybutton.  Go baby go!

I’ve decided to do a baby registry online again.  I started one for the twins and never looked at it again.  Now it’s all new, but I can use my old account to login.  My husb made a great point that if his family wants to get something for the baby, that’s the best way to know what to get.  We are expecting my MIL and older SIL to come visit MeMe sometime this fall.  I’m still iffy on having a baby-shower.  Partly because I look terrible in pictures now (ha ha) and I would rather have people see the baby after she’s born.  Baby showers kinda make me nervous.

 With the help of Face.book, I met up with some coworkers for dinner and drinks for two people’s B-days.  It was fun seeing some people I hadn’t seen since April.  Some people had no idea I was pregnant.  I wanted it that way, I told people after the twins “that the next time I get pregnant, nobody will know, I’ll just disappear for months.”Looks like it happened just like that.  While everyone was drinking their beers and “Endless Summer’s” (the official yummiest drink of the night), I had to settle for raspberry mint lemonades that clearly said NO BOOZE.  I miss drinking and partying, but I wouldn’t trade being pregnant with my sweet ass-kickin baby for nothing.  But one drink would’ve been nice, especially since everyone was raving about the yumminess. After dinner, the funky bunch went to a bar and nightclub, so I had to call it a night.  I was tired and it would’ve been no fun watching them drink allllll niiiiiiight.  Bunch of lushes! Would’ve been funny as hell and I wasn’t trying to be someone’s DD at 3 am. It was nice to get dressed up for a few hours. Many more B-days are coming this summer, yay!

I’ve been looking at breastfeeding, baby care, and childbirth classes at my hospital. I figure we’ll take it in August (right around 32 weeks). I’m so happy that MeMe is going the distance.

Welcome ICLW

Welcome and hugs! Just wanted to show some love to everyone dealing with the common thread of infertility, pregnancy loss, and high-risk pregnancies; I feel you on many levels. My husb and I have been trying to have a child together for 3.5 years. I have PCOS and a sluggish thyroid gland. Luckily, my husb can make babies. We used injectables and IUI in 2007 and was pregnant with twin boys, but lost them due to an incompetent cervix that caused my water to break at only 16 weeks (1/08). Devastated at our loss, we stuck together and ended up with a natural BFP, but had an early miscarriage in 6/08. 2008 was just a horrible year for our family. We decided to do the injectables and IUI in Jan of 09 and are now pregnant with a singleton. I have to deal with another high-risk pregnancy because my cervix started shortening and thinning at 16 weeks AGAIN! I now have a double cerclage in place and am blogging my days away until baby is born.

My bionic cervix – cerclage story

Here is the story of my surgery:

No food since 0130 and was starving! Husb and I checked in @ 0700 and they took us back to a room to get changed. The charge nurse asked some questions and started my IV, I guess my assigned nurse didn’t come in until 8. We heard baby’s heart with the doppler. A doc informed me about the procedure and I signed the consent. A bunch of docs introduced themselves to me since they would be in the OR room.

My case is rare. IC occurs in like 1% of pregnancies so seeing a cerclage is a learning opp for some of the docs. It took a while for stuff to get started because 2 ladies came in laboring and my official doc (Dr H) had to attend to them. As soon as 1 delivered, my show started at around 0930.
The anesthesiologist gave me pepcid & reglan to prevent nausea, then I had to drink some weird med to prevent reactions to the spinal. Then they gave fentanyl in my IV before she stuck me in the back. That stuff made me so high I barely noticed the spinal. It took a few minutes and my whole lower body went numb. I couldn’t feel my ass or move my legs. The nurse and tech had to move them for me and put them up in the crazy stirrups. My cooch was wide open to the world! They did a lot of prep. Dr H came in and he was confident and jovial. He was teaching Dr T about the procedure and they did it together. I couldn’t feel anything! But I could see the blood they suctioned out and it seemed like a lot.

After they were done (total of 15 to 30 min), they told me I really needed the cerclage and that things went well. I have 2 heavy-duty stitches keeping baby on lockdown. I was back to my room at 11 am and started drinking apple juice. Next I had to be monitored for contractions and I had none. The spinal med took like 7hrs to wear off enough for me to walk and pee on my own. I had some belly discomfort at 1330 and needed a catheter to drain my bladder. I took motrin for pain. I ended up being discharged around 1545 and was wheeled to the car. My mom came to see me in the hosp preop and stayed until noon.

Overall I feel fine and but my insides are sore.

Peri visit #2…caught in the act!

My new peri is cool as hell.  His name is Dr. S and we should be seeing him for the rest of my OB care visits for a looong time. He has been an MD for almost 20 years and MFM doc for 8 yrs.  He is an attending doc, not one of those interns or residents and his partner is a professor at UCSD.  He first tried to give us the run-around about how research data doesn’t support the use of cerclages, but he is “pro-cerclage” and performs them often. He wanted to check my cervix and go from there…

 Saw baby! Great hearbeat and measuring to date.  Moving a little, I think it was sleepy time for baby.  Baby still hanging out by my cervix and we couldn’t find out the gender.  Booo!!! We should be scheduling that scan soon.  First things first!

Now my cervix, bad girl!  We caught it being naughty and had shortened to 2.7cm, down from 4 cm 3 weeks ago.  According to Dr. S., that is concerning.  He left the room, did some stuff and came back to discuss his findings.  Turns out, he also scheduled my surgery for 4/29 @ 9am!  If my cervix had started at 2.7 and stayed there, not too bad.  But the fact that it was much longer earlier and the rate of change, my risk for pre-term delivery has gone way up again.  As baby is getting bigger, my cervix is getting weaker and could eventually dilate.  Of course he offered the watch and wait approach, but then said “I can tell you guys want the cerclage, so on Wed.  my partner will perform it, be at the hospital 2 hours early, here are the labs I want you get drawn.” He did some vag cultures and gave me a prescription for 17P shots and pre-op azithromycin.  My mom  gave me my first IM shot in my hip and it was painless.  I have to take it weekly until they tell me to stop.  After the surgery, I should see Dr. S every 2-3 weeks.

I like this doc, he knows what to do without prompting and answered some questions before I could even ask.  He also is gonna take me off of work like I requested, so I can stay home and collect State Disability Leave checks!  Yay!

16 weeks…HALLELUAH!

Gummy bear is now 16 weeks. FANTASTIC acheivement!

Authorized to be officially be considered “HIGH RISK” so I have an appt. to see a new peri at UCSD 4/27 @ 10am.  From there, we should get to see baby again and know when to get stitched.  Maybe sometime this week. I have another appt. on 5/7 to see the NP at the same care center.  I am so glad the HMO realized I am not one to be messed with!

There is a free seminar on High-Risk Pregnancies being held on 4/30 by the docs I’m gonna be seeing so that’ll be some really good information, especially about how they treat high-risk stuff, the hospital and their NICU.  I think my mom and I are gonna go, husb. has a class that night. 

I’ve been at peace for the last 2 weeks with the baby and the outcome.  I was originally dreading this time in my preg. but I feel so much calmer about it.  Husb is getting excited about finding out whether baby has a hot dog or a bun. I told him we could find out in the next 2 – 4 weeks. I’m happy I’m off work for the next 2.5 weeks and told my bosses I might not be coming back depending on what the doc says (more like the amount of convincing I do!).  Some of my coworkers wanted to throw like a party or something, but I said they can throw me a party the closer I get to my due date.  I promised to waddle into work, big belly-n-all.