Incompetent Cervix - my story so far- part 3

Sunday April 19th, 2015. After having been admitted to the Women's Hospital the day before and fasting (on my head) overnight. I was waiting for the Operating Room to open up so I could have my rescue cerclage placed. The day before my cervix was a scant .77cm and 2cm dilated. (For reference it should normally be between 3-5cm and no dialtion!)

This was such a hard day emotionally for me because at the exact time I was in the OR I was missing the memorial service at our church for my sister who had recently passed. Being in the hospital, trying to save my baby is probably the only thing that could have kept me away. 

So. What's it like to get a cerclage? Here are the details. I hope you don't find yourself in this position, but just in case, maybe this will help. 

After a night in trendleberg position, fasting and having my blood tested for assorted things, I was taken to the OR. I received spinal anesthesia, which was honesty the most painful part of all (bee sting?? Yeah right) the nurses were all so nice. They could tell I was terrified and kept asking me things about myself. The spinal did make me nauseated, but they were able to give me IV meds that worked within minutes. 

"See this is why we don't let you eat!" A nurse said.

Once numb, your legs are put up in very high stirrups and they use an assortment of tools to hold you open while the doctor works. Luckily you can't feel a thing but pressure. 

Dr. Harraway-Smith arrived and prepared for surgery. She had told me that morning that she would not know how it went until she "got in there" but that she would stop if things looked iffy at any point. 

It only took her about 15 minutes to stitch my cervix closed. This was such a strange experience, because yes, I could literally feel her tugging and working her way around the cervix in there. Again, thankful for anesthesia!

Immediately afterwards she told me that while there had been a lot to "grab" it was relatively thin, but she did her best. 

They placed a catheter (ouch) and wheeled me to recovery. 

Incompetent Cervix - the past 30 days

With this 5th post, I'll hopefully get my story up-to-date!

It's been about 30 days since I came home from the hospital. I've been out of work and on bed rest/taking it easy/couch potato mode ever since. Only leaving home for my doctors appointments and occasional quick trip to Target or Starbucks for the sake of my own sanity. 

I have had weekly cervical length checks and OB visits through 24 weeks. My length has remained between 1.1-2.0cm each week until this past week. It was .89-.98. The doctor did not seemed concerned and I'm hoping it was just a fluke and praying for a better measure next week. 

I'll be switched to bi-weekly length checks and OB visits until, I believe they said 28-30 weeks.

In the middle of this week I received the two beta methasone injections to mature the baby's lungs. 

Today I am 24w5d! 24 weeks being the point of viability, the point at which they feel comfortable resuscitating the baby if he is born this early. 

Do I want him to be born this early? Of course not! Do I worry a little less about it each day? Yep. I'm so very thankful that we live just minutes from the women's hospital and exceptional doctors and nurses. At my last OB visit I told the doctor, I have no complaints, I am happy to still be pregnant, and happy about each week I get to come back here. 

So what's next?

5/24/15 - 25 weeks milestone!

5/26/15 - next length check

5/31/15 - 26 weeks!!

6/2/15 - baby growth scan 

Thank you for reading and feel free to send me a message if you have any thoughts or questions! I hope these posts may help someone who has just been diagnosed or is not quite as far along as me. 

Incompetent Cervix- my story so far- part 4

After two hours or so in recovery, I could move my feet again and I was starving. I finally got to go back to the room and see my husband. Poor guy, people had been texting and calling him and he didn't know anything about what was going on with me. 

I was observed and kept on procordia (to stop contractions) for 12 hours I think. I am not sure when I went home, but it wasn't too long after. 

Sometime in the next 48 hours after being sent home, I had what was a good amount of clear fluid come out of me. Knowing this was one of the potential risks of the whole ordeal, I asked Erik to take me back to Maternity Amissions. (This is the third time in 4 or 5 days, if you've lost count)

I was admitted and prepared to do an "amni-sure" test to check for amniotic fluid. 

In the longest 45 minutes or so of my life, we waited for the results. The doctor is very sorry. The test was positive. Your baby isn't viable yet and we'll come back later to discuss your options...

Admitted to a L&D room and so confused. They did a different test where they look for amniotic cells under a microscope. They couldn't find any. 

I stayed overnight to wait and see a Maternal Fetal doctor in the morning.   

Moving from sad to very confused overnight, the maternal fetal doctor offered us quite a bit of hope. He had ordered an ultrasound, read it and said, even if it is fluid, the baby still has plenty, and a slow leak can stop itself. He said we could do an amniocentesis dye test and know for sure, or repeat the microscope test 24 hours from the first one. We decided against the amniocentesis, ultimately deciding since it wasn't going to change, it was an unnecessary risk. 

On a new doctor's shift, she repeated the swab test. "Your vagina is actually very dry! I don't see anything, but I'm taking it to the microscope." Best thing I'd heard in days!!

The test is negative for fluid. After 5ish days in the hospital, we can finally go home. 

Incompetent Cervix - my story so far - part 2

On April 17th, 2015 my husband left work early to go with me to our anatomy ultrasound. The clinic I started going to is located in the Women's Hospital. Where all of the babies in our city are born. 

The technician was very friendly (as they have all been). We found out we are having a boy! Which had been our daughter's guess all along. At the end of the ultrasound the technician began to get quiet. She said... "OK this is your cervix. It should be closed, but it's starting to open. See that Y shape? And it is measuring about 1.25cm. I'm not supposed to talk to you about it, but I wanted to let you know. I'm going to take you to admissions now and get a doctor, OK? I'm sorry for the bad news."

This was the first time I had ever heard of a cervix being "too short" and honestly had no idea how bad the news actually was...

I'm can't even remember any more what happened for the rest of this day. I was prescribed bed rest and progesterone and sent home. Mainly because of the timing, they told me they do not like to do cerclages unless there are no other options. 

I spent the next day in bed at home, but something just didn't feel right. I was uncomfortable all day with a backache that i couldn't get rid off. By the afternoon I was asking my husband to take me back to Maternity Admissions to be checked again. 

This time they admitted me, checked my cervix again and would not even tell me the results. It was a midwife who checked me and afterwards she was gone for a very long time. I knew this had to be bad. I overheard her on the phone outside the door, calling someone saying that "the length is now .77cm". She had to wait for the doctor on call to be able to see me and they came back in together.

Terrified and still knowing next to nothing about cervical incompetence, they gave me the news the way doctors do. Straightforward and with all of the (soul-crushing) facts. At 20 weeks exactly, I was still too late for an elective cerclage and too early for viability. 

The next part is a little blurry, but I know they decided to keep me overnight in trendleberg position (on an incline, feet above head) with no food in case I had a procedure the next day. I believe they were waiting for their Maternal Fetal specialist to arrive in the morning so they could get their opinion. 

The next morning, Sunday April 19th, I saw Dr. Harraway-Smith. This was the first glimpse of hope since we had arrived. She explained to me that the doctors had spoken and she could perform a "rescue cerclage". She told me all about the mechanics of it and the risk factors. I ultimately decided that if I didn't do it, I would always be wondering "what if". She assured me by saying she has preformed many hundreds of cerclages in her career and had only had membrane rupture happen once. That (and infection I guess) being the biggest risk with the rescue type. 

Note

There are two types of cerclages: preventative (or elective) when you have had a previous loss due to short/incompetent cervix. It is placed at 12-14 weeks and is left in until sometime after 36 weeks. Bed rest and progesterone are not always used in conjunction, from what I understand. 

Rescue or emergency cerclages take place after 20 weeks when the cervix has mostly thinned and sometimes started to dilate. Doctors normally proscribe some for of modified activity, progesterone and some times another medication to stop contractions. 

To be continued....

Incompetent Cervix - my story so far - part 1

Flashback

In September of 2014 my husband and I agreed to start trying to conceive a second child. Our daughter would turn 2 in December and the timing seemed right. Naomi was a very emotional, high-needs child from birth (I now like to refer to her as "assertive", "self-confident" and a good leader) and around this time, we finally felt we could start to deal with that again in case the next baby had a similar personality.

On January 10th, we were on our way out the door for a day trip to Virginia and I felt that something was different. I took a pregnancy test without warning my husband first, walked back into our bedroom and couldn't think of anything to say except "HAPPY PRIZE!!" Which is what our daughter says when she means to say "surprise". We felt very blessed to conceive so easily a second time.

The next 6-8 weeks were spent working on getting passports for my daughter and I (in addition to my regular working) so we could visit my terminally ill sister in Alberta, Canada. About 2,000 miles away. We were finally able to visit for two weeks in March. (I was 14 weeks pregnant at the time, and due to problems getting my Medicaid card, I had not yet been to the doctor. Despite applying for it 6 weeks earlier.) my husband had stayed home because he was hired for a full-time job and needed to start while we were away. 

Sadly about three weeks later, my sister passed away. My parents (who had stayed with her) returned to North Carolina the following week. And this would be the week of my first doctors appointment. 

On April 13th I had my first OB appointment at 19w1d at the clinic in the women's hospital because they were the only office in town who would see me with my Medicaid still pending. It was a pretty routine exam, they even did an external exam and told me I looked fine. I scheduled my anatomy ultrasound for Friday the 17th after work. So relieved to finally find out the baby was fine.