I reached viability this week! As of today I am 24 weeks and 2 days. It's an amazing feeling. I honestly never imagined making it to this point. It has always seemed so far away; so out of reach. I know that this is just one small milestone in long journey, but it has done so much to ease my worries. Holden and Parker were still alive when my water broke. If I had made it to 24 weeks before it happened, then maybe they wouldn't have died. Right now I feel like if history repeats itself, which I'm really hoping it doesn't, at least my little girl will have a chance. That's one thing I can give her that I couldn't give her big brothers. She still needs to bake for another 3+ months though, so stay in there little one!
We finally started looking at baby stuff online- cribs, car seats, pack 'n plays, etc. We've been terrified to do it all pregnancy, and while it's still scary, it has been so exciting to make it to this part of our journey. It's nice to be able to experience a little bit of normalcy and just be happy expecting parents.
I really appreciate all the support and encouraging words I've received along the way. I'm also glad I've been able to follow along all the blogs talking about their rainbow pregnancies. It gives me a lot of hope, especially after reaching the 24 week mark, that I may just get to bring this baby home. For now I'm just trying to take it a day by day and a milestone at a time. Next up, 28 weeks! Keep growing, baby girl.
Tuesday, September 20, 2011
Cerclage Placement and Recovery
The cerclage was a success! I figured I should write an update of how it went and how I'm doing now.
The morning of the cerclage was kind a a blur; we were rushing around to get ready and get everything together for our overnight trip. We got everything packed up and took the dogs to my mom's for the weekend. I hadn't been able to eat or drink anything since the night before, which I was worried about since my hunger usually wakes me up in the morning, but I was too nervous to be hungry. We were supposed to be at the hospital by 9:00 AM and Google maps was telling us it was an hour and 45 minute trip. We ended up leaving about 20 minutes later than planned and the whole time my stomach was in knots. Somehow we still made it to the hospital right on time, got registered, and headed up to Perinatology by 9:30 AM. They gave an overview of the procedure, after surgery care, etc., and checked for urinary/vaginal infections. Then we got to hang out until surgery prep time.
At 11:00 AM I was taken back to the pre-OP area where I was garbed in a lovely yellow hospital gown and socks, got my IV in, had some blood drawn to make sure that the Lovenox was out of my system, and had to take some antibiotics and anti-inflammatory meds to prepare my little cervix for the trauma it was about to endure. Maybe it's just me, but I don't understand why they tell you no solids AND FLUIDS, and then hook you up to giant bags of saline. They always make me have to urinate a ton. Andrew was able to come back then and we just talked and I tried to remain calm until the 1:00 PM surgery time. The clock was behind the bed so I kept having to ask him what time it was and it was never more than 15 minutes later. Time seemed to go so slowly!
It was finally time to say goodbye to Andrew and I was wheeled into the operating room. Having had a cerclage once before, I felt a little more calm and prepared this time. They did a spinal/epidural combo (epidural for after surgery pain management) which was different than before. I did not like the crampy feeling when they put the epidural catheter in. Once it was in they taped it and there was no more discomfort. It seemed to take forever for the spinal to fully kick in though, just like last time. The anesthesiologist did comparisons on my shoulder to lower abdomen and thighs to see if I was losing sensation and after awhile got pretty forceful with her pinches and pokes. I had a bruise on my shoulder the next day! And of course there was the added bonus of being stuck on my back, legs spread open and fully exposed to the world to make me feel nice and vulnerable.
When I was all prepped the Peri came in and started the surgery. For awhile, everything was fine. I was chatting with the anesthesiologist and trying not to focus on what they were doing "down there." Then I started noticing that I could feel more of what was happening on the right side. The anesthesiologist told me that was normal and that I might feel pressure but it shouldn't hurt. Then it started getting uncomfortable and I had moments of biting my lip to compensate for the discomfort and trying to determine if it hurt or not. At that point I realized it was more than just pressure and was becoming painful. Tears started forming in the corner of my eyes and the anesthesiologist decided to put something in my IV. While waiting for that to kick in I started bawling. She was so sweet about it. She was wiping my tears away and told me to try not to cry, she needed me to breath deep for the baby, and that the pain meds would kick in soon. Within a couple of minutes I noticed my eyelids were feeling heavier and I realized the pain meds were working. The rest of the surgery went by smoothly. All in all it was 20 minutes.
When the Peri was done he told me it was a hard stitch to place, not the hardest, but one of the more difficult he's done. He then went to tell Andrew how it went and told him that because of the trauma done to my cervix, it was a very challenging cerclage to place and recommended that we may consider keeping the cerclage in and doing a c-section. In the mean time I was wheeled into recovery and stayed there for about an hour. They checked my leg responsiveness and while I could wiggle the toes on my right side, lift my leg, bend my knee, I could pretty much just flex the ankle on my left side. My spinal had worked lopsided which is why I started feeling pain during surgery. I was having quite a bit of cramping so they started the epidural right away and that helped tremendously.
I met Andrew up in L&D and we got settled in for the night. It was a long night with little sleep. They cleared me for a regular diet so I ordered hospital food which was amazing at the time because I was starving, but gave me terrible gas pain and constipation the next morning; that's not good when you have pelvic pain and can't exert a lot of pressure in that area. They came in to change out IV bags, give me medications, and check on the baby's heart beat every so often. They also left the blood pressure cuff on and I guess I would bend my arm weird in my sleep and it would alarm, and I normally have low blood blood pressure, so when I sleep it's even lower, and that set off the alarm as well. Plus hospital beds really aren't that comfortable. The Foley catheter they placed started bugging me in the middle of the night so they stopped my epidural around 3:30 AM and then took the catheter out around 5:30 AM. I was up within 20 minutes to go to the bathroom. It felt great! Unfortunately all the blood and antibacterial wash they had used kept dripping out for a few hours. I was able to eat some breakfast and we had to wait for one of the Peri's to get in and clear us to check out. They said that would happen by 9:00 or 10:00 AM. A nurse finally came in around 11:30 AM and asked if we had seen the Peri yet and then she left to find her. She came in about 30 minutes after that, it looked like she just arrived or was on her way out, asked how I felt, "fine," and then said we were ok to go. Andrew and I looked at each other like "I can't believe we had to wait for that."
The nurse was supposed to give me a percocet before leaving because the epidural had completely worn off and I was cramping quite a bit, but forgot. Thank goodness Andrew had decided to fill my prescriptions before we left, so I was able to take one while waiting for him to find our car. We had used valet parking when we arrived on Friday but apparently they didn't run on the weekends. We finally got on the road but with all the detour signs we ended up going the wrong way on the interstate. At this point I was in a lot of pain and really uncomfortable even being reclined in the car, and really had to pee thanks to all the fluids they had given me. I started crying and it was making him really anxious. When the percocet kicked in I was feeling a little better and more calm, so Andrew quit freaking out. We stopped twice on the way home so I could pee. We met Andrew's parents at one of the gas stations and they gave us a cooked meal and some other food. So sweet of them.
That first day I was feeling pretty miserable. I crawled on the couch as soon as we got home. My mom brought the dogs over and a meal she had cooked too. What great family we have! Then I took a nap. When I woke up I was feeling significantly better, probably because I finally got some sleep, but still crampy. I was using percocet regularly the first 2 days but was able to ween myself off by day 5. Recovery seemed to be going smoothly and I was feeling better each day. Then Friday, a week later, I had a little scare. I was having some stabbing pains and then had some bright red spotting. Had an exam and u/s and my cervix looked amazing, 1cm longer even, and baby was great. They said the bleeding was probably just from the cerclage and because of the Lovenox.
I had my scheduled u/s with the Peri 4 days later and they looked more at the cervix and stitch and the baby. She was measuring a few days behind which they assured me was normal as babies grow at different rates, and the cervix was measuring around 3.2 cm! We talked a little bit more about doing a c-section and that is something I need to talk to my OB about. We will have one more u/s with the Peri group at 26 weeks and then I graduate out of their care! I've been able to resume mostly normal activity but still taking it easy. Two and a half weeks later and things are still going great.
The morning of the cerclage was kind a a blur; we were rushing around to get ready and get everything together for our overnight trip. We got everything packed up and took the dogs to my mom's for the weekend. I hadn't been able to eat or drink anything since the night before, which I was worried about since my hunger usually wakes me up in the morning, but I was too nervous to be hungry. We were supposed to be at the hospital by 9:00 AM and Google maps was telling us it was an hour and 45 minute trip. We ended up leaving about 20 minutes later than planned and the whole time my stomach was in knots. Somehow we still made it to the hospital right on time, got registered, and headed up to Perinatology by 9:30 AM. They gave an overview of the procedure, after surgery care, etc., and checked for urinary/vaginal infections. Then we got to hang out until surgery prep time.
At 11:00 AM I was taken back to the pre-OP area where I was garbed in a lovely yellow hospital gown and socks, got my IV in, had some blood drawn to make sure that the Lovenox was out of my system, and had to take some antibiotics and anti-inflammatory meds to prepare my little cervix for the trauma it was about to endure. Maybe it's just me, but I don't understand why they tell you no solids AND FLUIDS, and then hook you up to giant bags of saline. They always make me have to urinate a ton. Andrew was able to come back then and we just talked and I tried to remain calm until the 1:00 PM surgery time. The clock was behind the bed so I kept having to ask him what time it was and it was never more than 15 minutes later. Time seemed to go so slowly!
It was finally time to say goodbye to Andrew and I was wheeled into the operating room. Having had a cerclage once before, I felt a little more calm and prepared this time. They did a spinal/epidural combo (epidural for after surgery pain management) which was different than before. I did not like the crampy feeling when they put the epidural catheter in. Once it was in they taped it and there was no more discomfort. It seemed to take forever for the spinal to fully kick in though, just like last time. The anesthesiologist did comparisons on my shoulder to lower abdomen and thighs to see if I was losing sensation and after awhile got pretty forceful with her pinches and pokes. I had a bruise on my shoulder the next day! And of course there was the added bonus of being stuck on my back, legs spread open and fully exposed to the world to make me feel nice and vulnerable.
When I was all prepped the Peri came in and started the surgery. For awhile, everything was fine. I was chatting with the anesthesiologist and trying not to focus on what they were doing "down there." Then I started noticing that I could feel more of what was happening on the right side. The anesthesiologist told me that was normal and that I might feel pressure but it shouldn't hurt. Then it started getting uncomfortable and I had moments of biting my lip to compensate for the discomfort and trying to determine if it hurt or not. At that point I realized it was more than just pressure and was becoming painful. Tears started forming in the corner of my eyes and the anesthesiologist decided to put something in my IV. While waiting for that to kick in I started bawling. She was so sweet about it. She was wiping my tears away and told me to try not to cry, she needed me to breath deep for the baby, and that the pain meds would kick in soon. Within a couple of minutes I noticed my eyelids were feeling heavier and I realized the pain meds were working. The rest of the surgery went by smoothly. All in all it was 20 minutes.
When the Peri was done he told me it was a hard stitch to place, not the hardest, but one of the more difficult he's done. He then went to tell Andrew how it went and told him that because of the trauma done to my cervix, it was a very challenging cerclage to place and recommended that we may consider keeping the cerclage in and doing a c-section. In the mean time I was wheeled into recovery and stayed there for about an hour. They checked my leg responsiveness and while I could wiggle the toes on my right side, lift my leg, bend my knee, I could pretty much just flex the ankle on my left side. My spinal had worked lopsided which is why I started feeling pain during surgery. I was having quite a bit of cramping so they started the epidural right away and that helped tremendously.
I met Andrew up in L&D and we got settled in for the night. It was a long night with little sleep. They cleared me for a regular diet so I ordered hospital food which was amazing at the time because I was starving, but gave me terrible gas pain and constipation the next morning; that's not good when you have pelvic pain and can't exert a lot of pressure in that area. They came in to change out IV bags, give me medications, and check on the baby's heart beat every so often. They also left the blood pressure cuff on and I guess I would bend my arm weird in my sleep and it would alarm, and I normally have low blood blood pressure, so when I sleep it's even lower, and that set off the alarm as well. Plus hospital beds really aren't that comfortable. The Foley catheter they placed started bugging me in the middle of the night so they stopped my epidural around 3:30 AM and then took the catheter out around 5:30 AM. I was up within 20 minutes to go to the bathroom. It felt great! Unfortunately all the blood and antibacterial wash they had used kept dripping out for a few hours. I was able to eat some breakfast and we had to wait for one of the Peri's to get in and clear us to check out. They said that would happen by 9:00 or 10:00 AM. A nurse finally came in around 11:30 AM and asked if we had seen the Peri yet and then she left to find her. She came in about 30 minutes after that, it looked like she just arrived or was on her way out, asked how I felt, "fine," and then said we were ok to go. Andrew and I looked at each other like "I can't believe we had to wait for that."
The nurse was supposed to give me a percocet before leaving because the epidural had completely worn off and I was cramping quite a bit, but forgot. Thank goodness Andrew had decided to fill my prescriptions before we left, so I was able to take one while waiting for him to find our car. We had used valet parking when we arrived on Friday but apparently they didn't run on the weekends. We finally got on the road but with all the detour signs we ended up going the wrong way on the interstate. At this point I was in a lot of pain and really uncomfortable even being reclined in the car, and really had to pee thanks to all the fluids they had given me. I started crying and it was making him really anxious. When the percocet kicked in I was feeling a little better and more calm, so Andrew quit freaking out. We stopped twice on the way home so I could pee. We met Andrew's parents at one of the gas stations and they gave us a cooked meal and some other food. So sweet of them.
That first day I was feeling pretty miserable. I crawled on the couch as soon as we got home. My mom brought the dogs over and a meal she had cooked too. What great family we have! Then I took a nap. When I woke up I was feeling significantly better, probably because I finally got some sleep, but still crampy. I was using percocet regularly the first 2 days but was able to ween myself off by day 5. Recovery seemed to be going smoothly and I was feeling better each day. Then Friday, a week later, I had a little scare. I was having some stabbing pains and then had some bright red spotting. Had an exam and u/s and my cervix looked amazing, 1cm longer even, and baby was great. They said the bleeding was probably just from the cerclage and because of the Lovenox.
I had my scheduled u/s with the Peri 4 days later and they looked more at the cervix and stitch and the baby. She was measuring a few days behind which they assured me was normal as babies grow at different rates, and the cervix was measuring around 3.2 cm! We talked a little bit more about doing a c-section and that is something I need to talk to my OB about. We will have one more u/s with the Peri group at 26 weeks and then I graduate out of their care! I've been able to resume mostly normal activity but still taking it easy. Two and a half weeks later and things are still going great.
Thursday, September 1, 2011
Cerclage
Tomorrow morning Andrew and I are off to Englewood, Colorado to get my cerclage placed. After weeks of ultrasounds with great cervical length measurements in the mid 3cm range, we found out on Tuesday that it had shortened to 2.05cm. Ideal range is 3-5 with anything below 2.5 being very concerning.
I know we had been doing ultrasounds every two weeks just for this very reason but I was still upset by the news. Things had been going so well. I really thought the Lovenox was the solution to all my problems. Now this. I'm trying to be optimistic. I have a lot of confidence in the perinatologist doing the procedure. Their group has just been wonderful in monitoring me.
Even though I did this before with Parker, I'm still so nervous for tomorrow. I know the cerclage experience I had with him makes this all the more scary but knowing what I know now, I absolutely believe that his and Holden's losses had nothing to do with my cervix and everything to do with the clotting disorders. This time I have a very typical presentation of cervical incompetence. No pain or bleeding this time, just a shortening cervix which was still closed as of Tuesday. I hope it still is.
Wish me luck! We have to stay overnight to be monitored to make sure I don't start having contractions or anything. I hate being so close to viability yet so far. I'll be 21 weeks 5 days tomorrow so I just need another 2 weeks and 1 day at the minimum for this little girl to have a chance at life if something were to happen. I really hope the procedure goes smoothly tomorrow and that in another 4 months I get to bring my baby girl home.
I know we had been doing ultrasounds every two weeks just for this very reason but I was still upset by the news. Things had been going so well. I really thought the Lovenox was the solution to all my problems. Now this. I'm trying to be optimistic. I have a lot of confidence in the perinatologist doing the procedure. Their group has just been wonderful in monitoring me.
Even though I did this before with Parker, I'm still so nervous for tomorrow. I know the cerclage experience I had with him makes this all the more scary but knowing what I know now, I absolutely believe that his and Holden's losses had nothing to do with my cervix and everything to do with the clotting disorders. This time I have a very typical presentation of cervical incompetence. No pain or bleeding this time, just a shortening cervix which was still closed as of Tuesday. I hope it still is.
Wish me luck! We have to stay overnight to be monitored to make sure I don't start having contractions or anything. I hate being so close to viability yet so far. I'll be 21 weeks 5 days tomorrow so I just need another 2 weeks and 1 day at the minimum for this little girl to have a chance at life if something were to happen. I really hope the procedure goes smoothly tomorrow and that in another 4 months I get to bring my baby girl home.
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