32 weeks and 3 days - Ultrasound and appt

Today was our 32w3d appointment with the OB.  Wow, that's a lot of weeks, isn't it?

First we had the ultrasound.  Baby A looks amazing.  Even though I showed to be almost a fingertip dilated at last week's manual exam, my cervical length is still holding out at a little less than 3 cm, and there's STILL no funneling.  I am so amazed and grateful.  Heartbeat was 150 bpm, and she's just lovely.  She had her little hand up over her eyes like it was all just too much - so cute.

I had gained 2 lbs since last week - however, I'm still only up 11 from the beginning of when they started tracking.  They want me to gain some more weight, so I'm apparently going to deep-fat fry some chocolate later or something.  I need to get a belly pic taken and posted.  Measured at 31 weeks, so that's within normal limits.

I saw the OB after that.  The first thing I asked him was my dumb question.  Everyone I've told about this looks at me like I'm crazy, but occasionally I hear a clicking/popping sound when she kicks super-hard, up in the top part of the belly.  It's only been happening for a week or so, but it's there a couple of times a day.  He reassured me I was normal - she's obviously pretty big at this point, and her feet are right up in my ribs.  He said that, with all of my joints being weird right now because of the Relaxin, my ribs are moving a little bit whenever this happens and just making noise.  He was actually disappointed that I didn't have a weirder question.

Then I asked my big question.  I've had a little drama this week.  My peri had told me when I last saw him that he wanted me to call at around 32 weeks or so to discuss taking out the Shirodkar cerclage.  I'd done a lot of research and talking with my OB since then, and we'd decided to leave it in (I'll be having a C-section already, anyway, for other reasons).  I called this past Friday and told them that at the peri's office.  The PA called me back and said that the peri "strongly recommended taking it out around 36 weeks."  I mentioned that I'd be doing a C-section, and so she talked to him again - he still recommended taking it out.  This kind of freaked me out - there are several reasons that I want to leave it in.  I've already confirmed that my IVF clinic can do another frozen embryo transfer around it.  The rest of my reasons are more practical from a personal standpoint - it was pretty expensive to do, first of all.  It didn't exactly feel awesome - a Shirodkar is pretty invasive due to the incision, there was a hospital stay and a catheter involved, and there was a decent amount of pain/cramping (it wasn't as bad as, say, my radiation, but I am not lining up for one if it's unnecessary).  On top of all of this, why put another baby through the risks of a cerclage (including rupturing the membranes) if the previous one can just be in there?  Well, I told all of this to my OB - and he demonstrated why I love him so much.  He just agreed with me and said, "Well, why?  You have a Shirodkar, they're permanent - why take it out?"  I explained that I never got a reason, but didn't know if the fact that my exterior cervix was only about .5 cm at the time of the cerclage mattered.  He said, "Well, we'll find out" - he proceeded to pull his cell phone out of his pocket and leave a message for my peri right then and there.  I'm still waiting for a call back letting me know what's going on after he hears back from the peri, but my OB is one of my favorite people on Earth. 

I've been missing Maddie horribly the last few days - I just wish she could be here with us during this, that I could hold her and kiss her. 

So Touched.

I just got a chance to catch up on the day's blogs after work, and noticed that someone had thought of me to submit me - I'm just so touched, I can't even say.  Thank you to all of you who think of me - I truly have tears in my eyes.

We'll be 20 weeks tomorrow.  It's so hard to remember that Maddie was born at 21w3d - I know that this cerclage is doing a great job, but I just didn't realize how hard these preceding few weeks would be, worrying and anticipating.  Then I realize how very blessed I am, and God lets me know to just be still.

Let's see... updates.  I kind of freaked out on Tuesday.  Baby Jota has been kicking a lot (which is great!), but it has felt like some of the kicks were in my cervix (which could be imagined, you never know).  I called my OB and he got me in immediately (he encouraged me to come as often as needed) - he didn't do an ultrasound, but the manual exam showed that the cervix was still firm and tight, and quite long.  Our ultrasound is on this coming Tuesday - we'll get a glimpse at my cervix, and we'll do the whole obstetrical exam.  (Hopefully Baby J will be cooperating and also show us gender!) 

I think I've also been having Braxton Hicks contractions.  My belly gets hard, and I feel just the slightest bit of tightening - not painful at all, just... tight.  It really freaked me out the first several times that it was silent contractions or something, but then I realized that my body is SUPPOSED to be practicing - the cerclage will keep the cervix from dilating.  I will ask my OB again on Tuesday, though, to make sure that's what I'm actually experiencing.

I just wanted to thank everyone again for all of their support of me, my friend MM, Maddie, and everything else.  I am just so blessed.

Hunh.

You know what feels awesome?  Sneezing with a cerclage in. 

Not much new.  OB appointment again on Wednesday, but he's only doing a manual exam.  I may ask about ultrasounds frequency - I know scheduling only once a month is supposed to not irritate the cervix, but it just seems so long in-between. 

It's been a hard few days thinking about Maddie.  We turned 18 weeks this past Saturday - it was at exactly 18 weeks (also on a Saturday, since that's how the embryo transfer was scheduled) with her that we had her Level II ultrasound.  It was so magical to see her little face, to see her nestling into me, to see her sucking her thumb.  I am so very grateful for this baby, but I just miss my little girl.  In another life, she would be wiggling next to me on the couch.  That type of thinking doesn't accomplish much, but I can't help it every once in a while.

A Bit of Relief

Well, so I posted yesterday that my peri appointment had to be moved to Thursday due to snow.  (Since I'm a huge planner and incredibly impatient, this did not sit incredibly well.

So, of course, last night I started having some really odd, sharp pains that weren't normal, right around 9:45 or so.  I've had lots of pressure and some cramping/pains since the cerclage, but this was new.  It was sharper and I just wasn't comfortable with it.  Since the snow was coming down hard, there was no way we could make it to the ER at the hospital that's 15 miles away, and the hospital just down the road from us is totally unprepared for my types of issues (they only have about 10 patient rooms, as it's a really small town).

I called the regular OB this morning, since they're way closer than the peri.  I described my symptoms to a nurse, and she said that we should probably come in just to be safe.  We got to the appointment, and they did an exam.  Thank goodness, they're pretty sure it was just some really sharp ligament pain (apparently my ligaments are likely connected all of the way to the external organs, so I am feeling these much sharper than usual).  The really good news is that my cervix was nice and long.  She didn't do an ultrasound, but the examinations (both visual and manual) were positive - it sounds like I may have gotten some length back on the outside.  I asked if she thought we should stay on the bedrest - she wants me to check with the peri, but it sounds like she thinks it's helping, and not worth stopping. 

I feel like I can breathe for a bit - I know that I said a huge prayer of thanks for this blessing.  It's too bad that we had to do the appointment on my husband's birthday right before he had to work - I'm sure he would have rather spent his morning relaxing!

Just Chill...

Over the last several years of infertility treatments, as I've mentioned before, a lot of people have seen parts of me I'd rather not share.  I don't just mean "a lot" - I mean a lot.  Probably dozens.  Having a high-risk pregnancy has ramped that up to the point where you kind of wake up every day knowing, "There's an outside chance a stranger is going to see my girl parts today."

After all of the panicking the last few days, I called my peri and left a message last night about the pains I've been having.  Every time I hurt, I panic - yes, my total cervical length is over 4 cm (or was last week), but if I only have a half-centimeter on the outside... wouldn't that logically mean that the part on the outside is going to funnel to the stitch first?  What happens then?  I woke up this morning wondering if I was going to go down and get checked out sometime in the next few days (my next appointment isn't until next Tuesday, so I didn't know).  The nurse called me back, though, and let me know that the pains I'm describing are probably pretty normal.  Oh, well, that's great.  But, as Michele from My Life After Loss just said (and she knows a thing or two about Shirodkar cerclages!), I have to just settle down and trust in the cerclage.  It's there to do what it's supposed to do.  Now I just have to breathe until next Tuesday.

29 weeks - Dr's Appt

Well, that was a little anticlimactic.  I was all worked up about getting to the perinatologist this morning due to the blizzard we got yesterday and last night.  My husband and I made it down there, and had the ultrasound.  It was great - baby looked perfect and is just as active as ever (and still not showing us his/her goodies).  Length was about 4.10 cm, and it was probably a more accurate measurement than we got in the hospital.  So, I asked if we'd be going right in to see the dr, since he'd said he'd see us (I wanted to show him the red dots, ask about continuing bedrest, etc.).  I found out that he wasn't in yet this morning, and either he or a nurse would call me.  Oh.  So, nobody's checking out the red dots that still cover me (although they're getting better), and I am just biding time.  I called again a little before noon, but he'd just stopped in and had to step right back out.  So, back to waiting.

I've had time lately to think a lot about doctor's appointments, however, and I've come to a decision about gyno/OB appointments.  I've decided that it's the best thing possible if they don't remember my whatnot.  These doctors see thousands and thousands of women, and I'm pretty sure they don't say, "Oh, that Sally Jones, she had a really great vagina."  I'm pretty sure that the only reason that they remember your body parts is because of something bad.  I don't want them to say, "Oh, yeah, she had that really strange bump," or anything like that.  I'd like to be as non-descript as possible.  Same goes with my cervical issues here - I want my cervix to be unmemorable.  I don't like that it was "really short" during the surgery.  I hope that the rest of our appointments serve to be totally blase for all involved.

28 weeks and 6 days - Little Updates

A smattering of updates...

So, I've developed an interesting symptom the last several days.  I have little red dots (not bumps, just dots like when they use the blood pressure cuff too tightly) covering my entire body (other than my face).  I called the nurse's hotline yesterday, and she said to call my peri.  The other dr was on call, so I updated him about the situation.  I let him know about the morphine reaction, what they look like, etc.  He said that, if I'm not running a fever, that we could probably watch it until my appt tomorrow.  I normally run around 97.8 or so, but have been between 98.4 and 98.8 - I figure that probably doesn't count as a fever to anyone, so I'm just playing connect the dots currently and waiting patiently for tomorrow.  Every cramp and all of the pressure (which is pretty constant) kind of send me into a tizzy, but I'm just trying to be calm.

I guess I had forgotten to say much about the actual surgery.  Obviously I had wanted general, and could still have done it, but they strongly advised spinal for the pain management.  So, I was awake during the surgery (and that's when I heard the doctor tell me how short the cervix was, and I kind of silently freaked).  What I forgot to mention was all of the talk of venison during my procedure.  "Did she say 'venison,'" you ask?  Yes.  Deer meat.  The anesthesiologist sat in on the procedure to watch my vitals, and started talking about how he'd been hunting and needed to pick up the meat, which launched a discussion of all of the uses of deer meat (in which I actually tried to take part).  I guess the good part of this is that he was not on the business end when he had this discussion - I don't know that I would have wanted him to be looking anywhere at me and have venison be the first thing that comes to mind.  I am willing to bet I have one of the only cerclage stories ever that involves discussing venison, however.

I told my mom yesterday.  It ended pretty much exactly how I thought it would.  I hate being right sometimes.

I turned 31 yesterday.  I have such an amazing husband - he ordered me a new (purple!) laptop, brought me some roses, and got me a big chocolate cake, in addition to waiting on me.  He is just so very kind and thoughtful.

My check-up is tomorrow morning at 8:30 CST.  I hope to get some answers and insight at that time, but I know at this point that all we can do is wait.  I don't like that my outer cervical length is so short, even though the inside is great - I actually feel more scared about everything than I did before the surgery, which is the opposite of what I wanted to happen.  Sorry - just having a hard time with not worrying.

I'm missing Maddie a lot today.  I just wish I could have all of my babies here with me.

28 weeks and 2 days - Slowly, Slowly

Just a quick status check.  Still on strict bedrest at least until my peri checkup on Tuesday morning.  Luckily I'm allowed to work from home starting today, so it will keep me more entertained.  My mother-in-law has been visiting since Sunday, which has been AMAZING - she's a moral support, and is such a help with all of the things I can't do (which is pretty much everything).

There have still been some things that worry me quite a bit.  Without getting into any details, I'll just say that it's stuff that is pretty normal, but I panic.  The baby was just so beautiful and active again on Tuesday when we had the ultrasound.

28 weeks - Better Day

Just a quick update.  Yesterday and last night were really rough.  I was in a bit of pain from the cerclage (apparently the Shirodkar cerclage is considered major surgery, and that's why they kept me overnight), the short cervical length was FREAKING ME OUT, and I couldn't stop throwing up from the morphine.

This morning, however, went a lot better.  The peri came in before we had our cervical length ultrasound, and we talked a bit.  He's ordering complete bedrest through next Tuesday at least (when I see him again) - I'd been planning on going back to work this coming Thursday, but we're changing that.  The ultrasound went fantstic - apparently I have almost no cervix on the outside of the uterus, but I measured between 4.5 and 5 cm total.  It was a huge relief.  Baby looked fantastic, was wiggling and measuring two days ahead, and so on.

I'm going to try and catch up on blogs, etc. - but I'm just beat!

27 weeks and 3 days - Pre-Cerclage

Not much new going on – just impatiently waiting for the cerclage on Monday. I’ll be in the hospital overnight, so I probably won’t be able to post any updates until at least Tuesday afternoon (maybe later). Every time I do anything that I deem bad in the meantime (stretch too far, lift a little bit too much, etc.), however, I’m taking special care to worry about obsessively, apparently.


I’m a little weirded out by the thought of staying in the L&D department overnight, in all honesty. I know it will be a very good thing, but it’s just a little odd to think about hearing babies crying all night. I can deal with (and am happy for) my pregnancy and those of others who have lost their children, but encountering random babies is still a little weird for me. I’m so very happy for the others, but it’s just a little strange still. (I just realized how horrible that sounds.) A pregnant friend who lost her son this summer and I were chatting last night about how you feel bad talking about the pregnancy with loss friends who aren’t pregnant, but non-loss friends are just a little too positive and flippant about everything. They’re so very sweet, but it’s so hard for anyone – even our husbands – to understand the worry that comes with a high risk pregnancy after a loss.

Wow, I hope this all didn’t make me sound like a bad person.

20 weeks and 1 day - What to Choose?

I will be 6 weeks on Saturday (or Sunday, depending on how I measure). I’ll have two ultrasounds next week – one with my OB on Wednesday morning, one with my RE on Thursday afternoon. Praying and hoping that all goes well, we should see the heartbeat both times, and I’ll discuss plans for my 14-week cerclage with my OB. Unfortunately, I don’t know what kind I want yet.


I kept telling myself that I wasn’t going to over-research things during this pregnancy, but I’ve broken that rule about cerclages – and, unfortunately, haven’t been able to find a clear-cut answer on which type is best for treating incompetent cervix. I’ve looked at tons of studies, and there isn’t a clear statistical difference between using Shirodkar and McDonald, at least not in any studies I can find. All I find is anecdotal evidence and preferences.

Here are my choices. I absolutely LOVE my OB, and trust him with the world – he’s wonderful. He only does McDonald cerclages, and we live in a relatively low-population area, so I’m not sure how many he does. There are two high-risk OB’s about 60 miles away – one does Shirodkar, one does McDonald. I’m not sure if I should go with my local OB and get the McDonald, or if I should go to one of the doctors who does them more frequently. If I do, I don’t know which style to get, as there are different risks to each. I’m just torn. I’m thinking about just asking my OB if he would prefer to do it, or would prefer referring me out, but I don’t know. Does anyone have any experience with the different types of cerclage?