Exhausting

Where do I even begin?
I was released from my MFM to my OB on Monday, February 18th. It wasn't the appointment I hoped for. I brought my daughter along thinking I'd get a final look over meaning checking by ultrasound that placement of the cerclages were good, a final check of the cervical length and to make sure baby's fluids were good where they should be.

What I got was a nurse practitioner asking how I felt, and that I wouldn't be seeing my doctor because he was out on vacation or any doctor because there would be no exam done unless I had a concern. I did, I wanted my discharged checked to make sure all was normal. So the on call doctor came in and she checked my discharge all was normal and my stitches looked good. I expressed my concern about a final ultrasound check and I was refused one so I left pretty angry and hurt due to my history.

Fastforward to Thursday at about 3am I get up to pee with a pretty good soreness in my bladder. I go to work and it doesn't let up I end up cramping off and on all day with no relief after peeing. I leave work a little early to see my OB, at this point the pain really isn't there too much but I keep my appointment. They take my urine, do a speculum exam and tell me that my cervix and stitches look fine and I'm free to leave.

Around 7pm is where the pain hit me again and it's rolling pain come between 3 and 4 minutes apart. I call my OB after hours for the on call OB and get her opinion. I tell her about my symptoms and my visit earlier and she instructs me to go to L&D. They would be able to get a fast turn around on my urine to see if anything is up. I go down and give my urine, after waiting a while the doctor comes in and states there is nothing much they could for my cramping or anything due to me being so early at 22 weeks they wouldn't do anything to help me or save my baby (which is bullshit since the NICU works on 22 weekers). They perform a speculum exam again and all looks good to them. My urine comes back fine and I'm free to go without any explanation or solution.

Wednesday Follow Up

My follow up appointment on Wednesday wasn't a good one. The ultrasound showed baby with a great heartbeat and being cute as anything. As soon as she inserted the trans-vaginal ultrasound I saw the funneling right away. My cervix shortened from 2.8cm to 2.1cm.

I rememeber saying "Oh, that's not good," while the tech replied "You still have some length left though." That doesn't help when you've already been there and done that.

The doctor came in shortly after I broke down for a second and said "So we will be considering a cerclage, is that right? I replied "Yep." The surgery was scheduled 2 days later (Friday) at 20 weeks 1 day. I quizzed him on everything I have come across, studies and what not.

I brought up what type of stitch he would be doing and if it were possible to go higher than a macdonald, a cerclage pessary combo, double cerclages, administering antibiotics, bedrest. I was shut down by their aren't any studies that have proven this or this works BUT I did get my way with a couple requests.

Surgery day I go in fill out all the paperwork and finally speak with the doctor once again. We agree in antibiotics, and he agreed to place 2 macdonald cerclages but after his "studies this and that and higher risks speel" I was on the fence. he left and came back and asked me if I wanted the two because if I did he would do it for me. I told him I was on the fence still, he then said well if you don't say ONE I will do two. He ended up doing two.

Here I am 3 days POST OP and just like before I'm terrified of everything. I have no idea what cervical length was left at placement. I never got to see baby surgery day but I did hear his heartbeat. I have no idea if there is any less funneling or more. I don't know how high he got the stitches. Maybe it's better not to know?

I will go in tomorrow for my follow up and if things look good in his words I will be released to my OB and continue about my pregnancy, no extra monitoring because they have done all they can for me and the hope is that I remain asymptomatic until delivery.

11 weeks since my last scare (LONG POST)

The night of January 29th I had some cramping but I ended up sleeping it off. Yesterday, the 30th I had cramping off and on all day. I put an email in that morning to be seen (cervical check) and they couldn't fit me in until 3:00PM.

I worked all day and made it to my appointment. Baby looked great but my cervix measured just about a cm less at 2.8cm when it was 3.7cm just 6 days earlier at my anatomy scan. I was instructed to begin vaginal progesterone suppositories, and to go over to L&D to be monitored. I told them I would be back for the monitoring.

I came back about 6:30PM, still cramping off and on. My OB ended up being the first doctor I saw (whom I still am not very fond of). She gave me a speculum exam and stated my cervix looked long and closed and that it was "very posterior" which I am told is great. Next came the even more painful part...the manual exam. She felt around and pressed so hard because it was hard to reach my cervix (also a good thing I hear). She tried sticking her finger in my cervix and stated I was probably about a centimeter to a centimeter and a half dilated.

I asked about being monitored for my cramping and she said it isn't something they do because it is so early. That they don't usually intervene until 22 weeks at the earliest. While I am aware of this, I was only being asked to be monitored and if in fact I was contracting or that is something they are picking up it could be something they could surely stop. 

She said she would consult with my MFM doctor on what he would like to do regarding a possible rescue cerclage and that in the meantime she would have one of the senior residents perform a second exam to see if they felt the same thing. The resident said she agreed about my cervix being really high/very posterior and difficult to get to. She also stated being that the exam was so difficult to perform was a good thing. (Oh so painful though) she said that I might be maybe a half a centimeter dilated. 

The resident asked if I was cramping while I was here and I said I was and I don't know why no one is looking into it or monitoring it. She said it might not be picked up because I'm not that far along but we tried it, and I appreciated the effort rather than doing nothing. 

The Toco didn't pick up anything and my MFM doctor decided against a cerclage because if I am in fact cramping it wouldn't be a good idea to place it then, which I agree with. So I have my regular scheduled OB appointment on Friday. (I really need to switch my OB) and then my follow up scan on Wednesday which I plan to consult with the doctor at that point and see what the new game plan is.

I've heard things about the pessary so maybe that would be an option as well to avoid the surgical route...Well it is Thursday morning hello 19 weeks.

AT THE 12 WEEK MARK

Because I am SUPER paranoid I requested a cervix length check, could you blame me?
That was yesterday at 12 weeks, happy 12 weeks to me! From past ultrasounds at 7 weeks and change, my cervix measused at 4cm for the most part. I know at 12 weeks the baby weighs pretty much nothing and no real change would happen until about 14 weeks on, but even then I wanted some reassurance.

They started the ultrasound abdominally, after a while into that and looking at the baby I asked (since I know abdominally isn't as accurate) for a trans vaginal check and I was quite suprised. There was a whole cm difference between the two. Abdominally I was measuring 5.4cm and trans vaginally I was measuring 6.4cm. 6.4cm!? How the hell? That is such a HIGH measurement. Last time I never even heard a number above 3.5cm. Needless to say I can relax right now.

I literally had the most awesome ultrasound tech. I did not expect all the ultrasound photos or to even see much of the baby, only to check the cervix. She took a bunch of photos and even let me watch baby bounce around for a while, it was too sweet.

I have my MFM appointment next Wednesday, Dec. 19th and I am hoping they will do their own exam and we'll come up with a game plan from there. I LOVE my preemie to death but I AM NOT TEAM PREEMIE this time around.