What a big day! First of all, I'm now 35 weeks and second, I received my last P17 injection this morning! I never thought I would get through all 20 shots and here I am, all finished!
I saw Dr. Davis this afternoon. We really didn't have much to discuss and my cervix wasn't even evaluated. My fluid level is holding steady at 10.5 and my NST was good - baby was reactive and no contractions were detected.
Concerned about my increased irritability, I asked Dr. Davis how I would know if I was going into labor. He said whenever I'm unsure just go to the hospital like I did over the weekend. He said I might go back six times between now and my scheduled c-section and that it is okay to be evaluated and sent home.
Baby Boy remains breech, frank breech to be exact. It seems like he's been in this position for as long as I've been evaluated. Of course this brings with it new worries for me such as his hips and possible need for braces or physical therapy after birth. But it's nothing we can't handle.
Oh, and he may just have a name. We are keeping it under wraps...
Showing posts with label TAC. Show all posts
Showing posts with label TAC. Show all posts
Thursday, January 29, 2009
Wednesday, January 28, 2009
Moving Right Along
Yesterday was another big milestone for me personally - at 34w 5d, Baby Boy has officially had an additional 10 weeks in utero than his Big Sissy.
My lung maturity amnio is just two weeks away and based on the time of day right now, in two weeks, it will be over (unless the doc is backed up). I was told they can get a feel for the results based on how the sample looks. Hopefully this doc will give us his off-the-cuff opinion.
The Terbutaline has been working, for the most part. With taking it every 8 hours, I felt a surge of symptoms six hours into my pill. Additionally, at about the same time, I developed chest pressure and shortness of breath. I was confused because I know Terbutaline is an asthma medication. This prompted a call to the service last night. The covering doc felt that my asthma symptoms are worse than I thought and that the Terbutaline was working on both my asthma and my uterine irritability. I was told to increase the Terbutaline to every six hours and have been doing so for three doses now. So far, so good.
My lung maturity amnio is just two weeks away and based on the time of day right now, in two weeks, it will be over (unless the doc is backed up). I was told they can get a feel for the results based on how the sample looks. Hopefully this doc will give us his off-the-cuff opinion.
The Terbutaline has been working, for the most part. With taking it every 8 hours, I felt a surge of symptoms six hours into my pill. Additionally, at about the same time, I developed chest pressure and shortness of breath. I was confused because I know Terbutaline is an asthma medication. This prompted a call to the service last night. The covering doc felt that my asthma symptoms are worse than I thought and that the Terbutaline was working on both my asthma and my uterine irritability. I was told to increase the Terbutaline to every six hours and have been doing so for three doses now. So far, so good.
Tuesday, January 20, 2009
33 Weeks 5 Days - Nine Extra Weeks!!!
As of today, I am the most pregnant I've ever been by a whopping nine weeks! At this gestation in my first pregnancy, My Girl was already alive for 63 days. She had just tipped the scales at 3 lbs and began sprinting on the nasal cannula. In fact, at a corrected or gestational age of 33w 5d, I held my daughter on my shoulder for the very first time (all other holding sessions were either Kangaroo Care/Skin-to-Skin or swaddling) sans vent or CPAP. The photo below depicts a NICU mood as I am watching the monitors to make sure My Girl is able to keep her sats up while in my arms for the first time on cannula, not to mention making sure she is able to handle the position of being on my shoulder.
33w 5d has been a much different experience with Baby Boy. For one, he is still inside, where he belongs. Today his measurements calculated a weight of approximately 4.5 lbs - that's My Girl at the same age PLUS what she weighed at birth (1 lb 6 oz). I've said it before and I'll say it again, it's amazing how much a baby can grow when it doesn't have to focus on staying alive in the process.
My fluid was around 10 today, a little less than last week but still acceptable. My cervix is still closed and shows no signs of funnelling even with fundal pressure. My lower uterine segment was once again evaluated by Dr. Davis himself and confirmed to be fully intact with no visible signs of thinning or separation.
Today Dr. Davis mentioned scheduling my amnio. I was under the impression this would be done at the hospital where I intend to deliver. In fact, I have a consult scheduled for Thursday. Dr. Davis assured me that in the 25 years he has been doing amnios for lung development (which he performs quite regularly) he has never had an issue with nicking the cord, which was my main concern. In fact, he said that other doctors will refer tough amnio situations to him, and said although he can't walk and chew gum at the same time, is really good at navigating a needle into really small spaces.
I asked what were to happen if my membranes ruptured or I went into labor as a result of the amnio. I was surprised to learn he would let me drive back to PA to get to my hospital. Hubby is not so comfy with this idea and I have a feeling if either were to happen, I'd be delivering with Dr. Davis right then and there.
So it looks like we are tentatively scheduled for my amnio in three weeks at 36w 5d gestation. Dr. Davis informed me that he felt Baby Boy's lungs had a 10% chance of being mature enough for delivery but based on the values would be able to predict when he would be mature enough to deliver, waiting anywhere from one to two weeks. So much for the plan I had of delivering at 37w on February 12, 2009!
My plan is still to meet with the local doc as he is specialized in genetics and I have some questions about evaluating the amnio sample for some blood clotting disorders my husband is a carrier of. I already called my pediatric hematologist only to get the run-around from the woman who answered the phone. The doc, if I could have gotten to him directly, would have answered my questions. Why do so many doctors have bitchy "gate-keepers"?
Finally, I met the woman (and her husband) Dr. Davis asked me to call last week. She had her TAC surgery yesterday and looks like she's making a fabulous recovery! She is currently 10 weeks pregnant and I wish her another uneventful 27+ weeks! It is amazing what the TAC can do and I look forward to following her pregnancy.
33w 5d has been a much different experience with Baby Boy. For one, he is still inside, where he belongs. Today his measurements calculated a weight of approximately 4.5 lbs - that's My Girl at the same age PLUS what she weighed at birth (1 lb 6 oz). I've said it before and I'll say it again, it's amazing how much a baby can grow when it doesn't have to focus on staying alive in the process.
My fluid was around 10 today, a little less than last week but still acceptable. My cervix is still closed and shows no signs of funnelling even with fundal pressure. My lower uterine segment was once again evaluated by Dr. Davis himself and confirmed to be fully intact with no visible signs of thinning or separation.
Today Dr. Davis mentioned scheduling my amnio. I was under the impression this would be done at the hospital where I intend to deliver. In fact, I have a consult scheduled for Thursday. Dr. Davis assured me that in the 25 years he has been doing amnios for lung development (which he performs quite regularly) he has never had an issue with nicking the cord, which was my main concern. In fact, he said that other doctors will refer tough amnio situations to him, and said although he can't walk and chew gum at the same time, is really good at navigating a needle into really small spaces.
I asked what were to happen if my membranes ruptured or I went into labor as a result of the amnio. I was surprised to learn he would let me drive back to PA to get to my hospital. Hubby is not so comfy with this idea and I have a feeling if either were to happen, I'd be delivering with Dr. Davis right then and there.
So it looks like we are tentatively scheduled for my amnio in three weeks at 36w 5d gestation. Dr. Davis informed me that he felt Baby Boy's lungs had a 10% chance of being mature enough for delivery but based on the values would be able to predict when he would be mature enough to deliver, waiting anywhere from one to two weeks. So much for the plan I had of delivering at 37w on February 12, 2009!
My plan is still to meet with the local doc as he is specialized in genetics and I have some questions about evaluating the amnio sample for some blood clotting disorders my husband is a carrier of. I already called my pediatric hematologist only to get the run-around from the woman who answered the phone. The doc, if I could have gotten to him directly, would have answered my questions. Why do so many doctors have bitchy "gate-keepers"?
Finally, I met the woman (and her husband) Dr. Davis asked me to call last week. She had her TAC surgery yesterday and looks like she's making a fabulous recovery! She is currently 10 weeks pregnant and I wish her another uneventful 27+ weeks! It is amazing what the TAC can do and I look forward to following her pregnancy.
Friday, January 16, 2009
Discomfort and Discharge
Last night was a rough night with tremendous pelvic pressure. I just couldn't get comfy and come morning, my symptoms were still lingering. In fact when I got up with My Girl, I experienced a streak of discharge falling into my pajamas and down my leg. It was reminiscent of the morning at 24w 1d with My Girl that caused me to go to the doctor to learn my membranes were bulging.
Today was a scheduled appointment with my new group so instead of calling and trying be seen sooner, I just waited until my 1:45 time slot, taking the morning to push through my discomfort and clean my toilets, pick-up my house, do laundry, make a casserole for dinner and start a crock pot of soup for the weekend. Call it nesting, perhaps.
My mom came over to be with My Girl who is under the weather with an ear infection, runny nose and cough. She is just not herself and with her asthma it's just too cold to take her out - my car read 17 degrees this afternoon. Anyway, she is holding her own and not requiring any oxygen and we hope it remains this way.
I haven't had much of an appetite all day but when I met Hubby at his office felt like a Dunkin Donuts hot chocolate and munchkins, which I ate on the way to my appointment.
Dr. Einhorn is the third doctor I've met from my new group. She was just as nice, kind and understanding as the first two docs I met. It is so refreshing to see a woman! After much talking about my symptoms and after she reassured me that it was okay to examine me, I consented to a fFN swab and an internal. Yes, my symptoms were that bad that I really wanted to know the "status" of things. I was almost certain this baby was on his way today. Also, I've once again encountered that each OB has their own philosophy and that no two docs will agree on anything. There is just something about the way this doctor delivered the information and explained things that made me feel comfy, even though it was probably (well, I know it is) not what Dr. Davis would have suggested or done.
In order to perform the fFN swab, the doctor had to place a speculum. She evaluated my cervix visually first confirming it was closed and that yes, I did have a tremendous amount of what looked like normal pregnancy discharge. It is not amniotic fluid nor does it look like I have an infection. Good news so far.
She took the swab which I need to prepare myself if it's positive, doesn't mean there is anything to worry about. A negative result almost guarantees that I will not deliver in the next two weeks. The swab is being sent to the lab and it's likely that the results may not be ready before the close of business today.
She then did an internal (again, Dr. Davis would probably not agree with it but I just need to know what's happening!). My cervix is closed and long, although she admitted that it does feel different with a TAC in place. The baby can be felt low in my pelvis so she feels he has started to drop, possibly causing the great pressure and discomfort I am having.
The group is on-call this weekend and she told me if anything changes: bleeding, increased discharge, rupture of membranes, contractions, just an off-feeling, to call and go to L&D. She also wants me to take it easy and reduce my activity, being sure to hydrate well.
Oh, I should mention prior to my exam, she prefaced things with, "if you are at all dilated, you will be having your c-section today." She then went on to reassure us that the difference between a 24 weeker and a 33 weeker is night and day. Something we know, but will admit it's nice to hear and we will never tire of the positive thoughts.
As we were leaving the office, Dr. Barsoum, the first doc I met from the group popped her head into the room to say that she had a lengthy conversation with Dr. Davis just the day before. She wants me to schedule my c-section which once I meet with the doc about the amnio next week, will be able to put it on the calendar. Hubby and I marveled at the idea that in exactly four weeks from today, assuming Baby Boy's lungs are mature, I will be sitting in my hospital bed recovering from my surgery with our son in his open crib next to me. Crazy! It's just crazy! We're so close to reaching our goal of full-term!!!
So, I left the office feeling much better than when I had arrived, mentally speaking. Tonight I am off to book club and tomorrow I am going for a facial (thanks to my mother-in-law). I reason with myself that those are not stressful activities and I should be okay to pull them off.
Here's to charging forward!
Today was a scheduled appointment with my new group so instead of calling and trying be seen sooner, I just waited until my 1:45 time slot, taking the morning to push through my discomfort and clean my toilets, pick-up my house, do laundry, make a casserole for dinner and start a crock pot of soup for the weekend. Call it nesting, perhaps.
My mom came over to be with My Girl who is under the weather with an ear infection, runny nose and cough. She is just not herself and with her asthma it's just too cold to take her out - my car read 17 degrees this afternoon. Anyway, she is holding her own and not requiring any oxygen and we hope it remains this way.
I haven't had much of an appetite all day but when I met Hubby at his office felt like a Dunkin Donuts hot chocolate and munchkins, which I ate on the way to my appointment.
Dr. Einhorn is the third doctor I've met from my new group. She was just as nice, kind and understanding as the first two docs I met. It is so refreshing to see a woman! After much talking about my symptoms and after she reassured me that it was okay to examine me, I consented to a fFN swab and an internal. Yes, my symptoms were that bad that I really wanted to know the "status" of things. I was almost certain this baby was on his way today. Also, I've once again encountered that each OB has their own philosophy and that no two docs will agree on anything. There is just something about the way this doctor delivered the information and explained things that made me feel comfy, even though it was probably (well, I know it is) not what Dr. Davis would have suggested or done.
In order to perform the fFN swab, the doctor had to place a speculum. She evaluated my cervix visually first confirming it was closed and that yes, I did have a tremendous amount of what looked like normal pregnancy discharge. It is not amniotic fluid nor does it look like I have an infection. Good news so far.
She took the swab which I need to prepare myself if it's positive, doesn't mean there is anything to worry about. A negative result almost guarantees that I will not deliver in the next two weeks. The swab is being sent to the lab and it's likely that the results may not be ready before the close of business today.
She then did an internal (again, Dr. Davis would probably not agree with it but I just need to know what's happening!). My cervix is closed and long, although she admitted that it does feel different with a TAC in place. The baby can be felt low in my pelvis so she feels he has started to drop, possibly causing the great pressure and discomfort I am having.
The group is on-call this weekend and she told me if anything changes: bleeding, increased discharge, rupture of membranes, contractions, just an off-feeling, to call and go to L&D. She also wants me to take it easy and reduce my activity, being sure to hydrate well.
Oh, I should mention prior to my exam, she prefaced things with, "if you are at all dilated, you will be having your c-section today." She then went on to reassure us that the difference between a 24 weeker and a 33 weeker is night and day. Something we know, but will admit it's nice to hear and we will never tire of the positive thoughts.
As we were leaving the office, Dr. Barsoum, the first doc I met from the group popped her head into the room to say that she had a lengthy conversation with Dr. Davis just the day before. She wants me to schedule my c-section which once I meet with the doc about the amnio next week, will be able to put it on the calendar. Hubby and I marveled at the idea that in exactly four weeks from today, assuming Baby Boy's lungs are mature, I will be sitting in my hospital bed recovering from my surgery with our son in his open crib next to me. Crazy! It's just crazy! We're so close to reaching our goal of full-term!!!
So, I left the office feeling much better than when I had arrived, mentally speaking. Tonight I am off to book club and tomorrow I am going for a facial (thanks to my mother-in-law). I reason with myself that those are not stressful activities and I should be okay to pull them off.
Here's to charging forward!
Wednesday, January 14, 2009
Eight Weeks Longer... (So Far!)
Yesterday I celebrated 32w 5d! This means that Baby Brother has officially had an additional eight weeks in utero than his Big Sister did - and we're still cooking!
I saw Dr. Davis yesterday for my weekly scans and testing. My fluid level is remaining fairly consistent at 11.24. My cervix is continuing to shorten (as part of the normal pregnancy process) and is now measuring with a total length of 2.4 and a functional length of 2.1. The important thing is that it remains closed, which thankfully, it is.
Dr. Davis and I discussed the plan for scheduling my c-section and it was decided (which we knew this part all along) that if active labor starts at any point in time and can't be stopped, I will be taken in for delivery. If by 37 weeks (which is four weeks away from tomorrow!) I have not gone into labor, then an amnio should be performed to confirm Baby Boy's lung maturity. Dr. Davis feels I should deliver at 37 weeks if Baby Boy's lungs are mature as opposed to pushing it and waiting for labor to begin on its own.
The question of confirming lung maturity was addressed and I explained our position in our willingness to deal with transitional breathing issues if need be. Dr. Davis explained that this is common thinking for parents of preemies who have been through the NICU experience. What Dr. Davis continued to explain, that no one else has (although I think the new doc I saw last week alluded to this fact) is that near term babies have different issues with regards to respiratory status. He said that if a near term baby goes into Respiratory Distress and begins to experience Bronchial Spasms (both things we dealt with with Our Girl) their bodies respond by going into something called "Persistent Fetal Circulation". My understanding of this is that the blood does not circulate through the lungs once the baby is born and this causes major issues in oxygen saturation, persistent pulmonary hypertension and possibly death.
My next question was about complications from an amnio - that if Baby Boy's lungs are not developed but my membranes rupture, I go into labor or the umbilical cord is compromised, then what? Dr. Davis explained that all of those involve "stress" different from "distress" which works in aiding lung development.
So yesterday, Dr. Davis hit home our need to stay with the initial plan of confirming that Baby Boy's lungs are developed enough for him to enter this world by having the amnio prior to my scheduled c-section at 37 weeks.
With 33 weeks at the door in less than 12 hours, meeting our Little Boy is just four weeks away! I can't believe we are coming in on the home-stretch!
And speaking of home-stretch, I feel as though I am stretched to capacity. My maternity shirts are no longer fully covering my large tummy and last week my flush belly button officially began its journey towards becoming a full-fledged outie.
Finally, Dr. Davis asked me to call one of his patients who is scheduled for her TAC surgery on Monday. We spoke last night and I wish her well as she undergoes this life-changing, life-saving procedure. To anyone out there who has experienced a loss or early birth due to IC, PLEASE, PLEASE, PLEASE consider the TAC! Dr. Davis is an amazing doctor and person and I know I wouldn't be this far into this pregnancy without him and my TAC!
Oh, and since we've really moved into baby-prep mode, Our Girl is so fascinated with all the baby things we've pulled out that were once hers. She is also even more excited about Baby Brother's upcoming arrival and asks several times throughout the day when Baby Brother will come play with his toys. When the dogs bark and she thinks someone is here, she now says, "Baby Brother here, Mommy?"
I saw Dr. Davis yesterday for my weekly scans and testing. My fluid level is remaining fairly consistent at 11.24. My cervix is continuing to shorten (as part of the normal pregnancy process) and is now measuring with a total length of 2.4 and a functional length of 2.1. The important thing is that it remains closed, which thankfully, it is.
Dr. Davis and I discussed the plan for scheduling my c-section and it was decided (which we knew this part all along) that if active labor starts at any point in time and can't be stopped, I will be taken in for delivery. If by 37 weeks (which is four weeks away from tomorrow!) I have not gone into labor, then an amnio should be performed to confirm Baby Boy's lung maturity. Dr. Davis feels I should deliver at 37 weeks if Baby Boy's lungs are mature as opposed to pushing it and waiting for labor to begin on its own.
The question of confirming lung maturity was addressed and I explained our position in our willingness to deal with transitional breathing issues if need be. Dr. Davis explained that this is common thinking for parents of preemies who have been through the NICU experience. What Dr. Davis continued to explain, that no one else has (although I think the new doc I saw last week alluded to this fact) is that near term babies have different issues with regards to respiratory status. He said that if a near term baby goes into Respiratory Distress and begins to experience Bronchial Spasms (both things we dealt with with Our Girl) their bodies respond by going into something called "Persistent Fetal Circulation". My understanding of this is that the blood does not circulate through the lungs once the baby is born and this causes major issues in oxygen saturation, persistent pulmonary hypertension and possibly death.
My next question was about complications from an amnio - that if Baby Boy's lungs are not developed but my membranes rupture, I go into labor or the umbilical cord is compromised, then what? Dr. Davis explained that all of those involve "stress" different from "distress" which works in aiding lung development.
So yesterday, Dr. Davis hit home our need to stay with the initial plan of confirming that Baby Boy's lungs are developed enough for him to enter this world by having the amnio prior to my scheduled c-section at 37 weeks.
With 33 weeks at the door in less than 12 hours, meeting our Little Boy is just four weeks away! I can't believe we are coming in on the home-stretch!
And speaking of home-stretch, I feel as though I am stretched to capacity. My maternity shirts are no longer fully covering my large tummy and last week my flush belly button officially began its journey towards becoming a full-fledged outie.
Finally, Dr. Davis asked me to call one of his patients who is scheduled for her TAC surgery on Monday. We spoke last night and I wish her well as she undergoes this life-changing, life-saving procedure. To anyone out there who has experienced a loss or early birth due to IC, PLEASE, PLEASE, PLEASE consider the TAC! Dr. Davis is an amazing doctor and person and I know I wouldn't be this far into this pregnancy without him and my TAC!
Oh, and since we've really moved into baby-prep mode, Our Girl is so fascinated with all the baby things we've pulled out that were once hers. She is also even more excited about Baby Brother's upcoming arrival and asks several times throughout the day when Baby Brother will come play with his toys. When the dogs bark and she thinks someone is here, she now says, "Baby Brother here, Mommy?"
Monday, January 12, 2009
Some Funny Feelings...
Yesterday in the late morning, I started to have some not-quite-right feelings/sensations. These feelings have continued as I have intermittent low abdominal cramping and lower back pain along with a feeling of heaviness and pressure. I have a slight increase in discharge but nothing too much and certainly no bleeding, otherwise I would have called the doctor or gone to the hospital. I am not having contractions although as my next dose of Procardia is coming due, I feel an increase in my uterine irritability, causing me to take my next pill anywhere from 30-60 minutes ahead of schedule.
The more days I clock in this pregnancy, the less-worried I am over things such as this. I informed my husband of my discomfort and he too feels the same way. Although my real reason for telling him was to enlighten him to the fact that I suppose things could change at any moment and we may end up needing to get to the hospital.
I have taken it easy today, only driving to school to pick up My Girl. Thankfully Hubby is flexible enough to meet me there, run in, get her and put her in the car for me. She was a true dream today and in spite of the coughing incident that caused her to throw up in her bed, cutting nap time short and requiring stripping of the bed and a bath for her, we had a lovely day together, snuggling in my bed as we "rested" (no nap). I even commented to Hubby that Our Girl seems just a little more mature today, like she's just growing up.
Tonight Hubby came home from work on the early side so we headed to the basement to pull out all the baby things we'll be needing in a few weeks: car seat, bouncy seat, swing, pack-n-play, etc., etc. This really sparked a heightened interest in Baby Brother for Our Girl. She is running around the house saying, "Baby Brother is coming!" In fact, a car pulled up out front and she asked, "Baby Brother in the car, Mommy?"
The more days I clock in this pregnancy, the less-worried I am over things such as this. I informed my husband of my discomfort and he too feels the same way. Although my real reason for telling him was to enlighten him to the fact that I suppose things could change at any moment and we may end up needing to get to the hospital.
I have taken it easy today, only driving to school to pick up My Girl. Thankfully Hubby is flexible enough to meet me there, run in, get her and put her in the car for me. She was a true dream today and in spite of the coughing incident that caused her to throw up in her bed, cutting nap time short and requiring stripping of the bed and a bath for her, we had a lovely day together, snuggling in my bed as we "rested" (no nap). I even commented to Hubby that Our Girl seems just a little more mature today, like she's just growing up.
Tonight Hubby came home from work on the early side so we headed to the basement to pull out all the baby things we'll be needing in a few weeks: car seat, bouncy seat, swing, pack-n-play, etc., etc. This really sparked a heightened interest in Baby Brother for Our Girl. She is running around the house saying, "Baby Brother is coming!" In fact, a car pulled up out front and she asked, "Baby Brother in the car, Mommy?"
Sunday, December 21, 2008
Doctor Update
I spent Thursday and Friday researching different OBs in the area. I have decided that I don't want to drive into the city for care or delivery since I am already driving pretty far to see Dr. Davis. My search for a new doctor has been limited to the suburban hospitals, specifically Main Line Health.
There was one group that came highly recommended - as in everyone who commented on my run-in post, gave me the same name/group of docs. I have an appointment scheduled to meet one of the male doctors in January. They only deliver at Paoli and since Paoli only keeps babies born at 32 weeks gestation, I didn't think it was really necessary to push the issue and see the group sooner. I will be just a few days beyond 32 weeks when I have my consult.
I called around to a few other groups who insisted on knowing where I got my care to this point. It would have been easier for me to have just relocated to the area instead of leaving a local group. When I pushed the issue, I discovered that these other groups don't want to take anyone who is "high risk".
I made one other appointment with a group of women doctors who deliver at Lankenau. After speaking with three different people, one of the doctors personally called me to better understand my situation. She was very nice, explained they have had other patients with a Transabdominal Cerclage (TAC) and was curious to know who my surgeon was. Her big concern was sending me for testing as the MLH Perinatal Testing Centers are usually run by my old group. I assured this doctor that all my testing is able to be completed by Dr. Davis. She didn't seem to mind that I would also be followed by Dr. Davis. I meet this group on Christmas Eve.
So now I need to come up with a list of questions about philosophies and office procedures. For example, the Paoli group delivers their own patients as one of the five docs is always on-call. I am not sure the same is the case for the Lankenau group but I do know that Main Line Perinatal is not one of their covering offices.
The big thing that I go back and forth on is where do I want to deliver. Paoli is much closer to home and where Precious Miracle was discharged from. Lankenau is where Precious Miracle was born and spent the first 85 days of her 105 day NICU stay. Both have meaning, just in different ways.
There was one group that came highly recommended - as in everyone who commented on my run-in post, gave me the same name/group of docs. I have an appointment scheduled to meet one of the male doctors in January. They only deliver at Paoli and since Paoli only keeps babies born at 32 weeks gestation, I didn't think it was really necessary to push the issue and see the group sooner. I will be just a few days beyond 32 weeks when I have my consult.
I called around to a few other groups who insisted on knowing where I got my care to this point. It would have been easier for me to have just relocated to the area instead of leaving a local group. When I pushed the issue, I discovered that these other groups don't want to take anyone who is "high risk".
I made one other appointment with a group of women doctors who deliver at Lankenau. After speaking with three different people, one of the doctors personally called me to better understand my situation. She was very nice, explained they have had other patients with a Transabdominal Cerclage (TAC) and was curious to know who my surgeon was. Her big concern was sending me for testing as the MLH Perinatal Testing Centers are usually run by my old group. I assured this doctor that all my testing is able to be completed by Dr. Davis. She didn't seem to mind that I would also be followed by Dr. Davis. I meet this group on Christmas Eve.
So now I need to come up with a list of questions about philosophies and office procedures. For example, the Paoli group delivers their own patients as one of the five docs is always on-call. I am not sure the same is the case for the Lankenau group but I do know that Main Line Perinatal is not one of their covering offices.
The big thing that I go back and forth on is where do I want to deliver. Paoli is much closer to home and where Precious Miracle was discharged from. Lankenau is where Precious Miracle was born and spent the first 85 days of her 105 day NICU stay. Both have meaning, just in different ways.
Wednesday, December 17, 2008
A Bad Day...
Where do I begin? I had two appointments scheduled today to deal with issues surrounding both of my children. The first was a prenatal appointment and while I was planning on discussing some pretty significant concerns surrounding my care, felt it would go relatively well. The second appointment was the annual IFSP for My Girl's Early Intervention Services. This meeting was slated to be a challenge as I was prepared to "fight" to keep her SLT and OT services on a weekly basis. My preparedness was all backwards and I am sitting here still recovering from the hearty cry my first appointment of the day caused.
What I am about to write is my interpretation and take-away from my appointment this morning with my local group. I realize every story has two sides, that each party has their own reality and views any particular situation through their own personal lens. My personal documentation of today's events is in no way intended to defame or smear.
I will admit there was no rehearsal on my part nor did I have a list of notes with me to keep me on track. This meeting was sincerely a "heart-to-heart" and those were the words I used with Dr. C when he entered the room. My agenda, so to speak, was strictly to convey my concerns, fears and wishes as a patient in a thoughtful and sincere manner.
My first point was that it would mean a great deal to me if Dr. C was the physician who delivered my baby. I should have known when I got a lecture about how over-worked he feels that I should have packed up my stuff and left. I mean, how professional is it to unload the burden of your hectic work schedule on your patient? I learned he is on-call 50% of the time. He is scheduled to work the weekend before Christmas (although he mentioned he was traveling with his family this weekend too), the weekend after Christmas, New Year's Eve and New Year's Day. The only time off he is getting this year is Christmas Eve and Christmas Day. The practice is responsible for six hospitals, dealing with high-risk calls coming from the home base of Lankenau, sister hospitals, Paoli, Bryn Mawr, Riddle and two others, Pottstown and Montgomery. He needs to be on-call for transports and in fact, has women right now on antepartum who could deliver at a moment's notice. He even told me he is considering not delivering any longer, it's just too much.
Okay, well, sorry I asked. So the bottom line is unless my c-section is scheduled, there is a 50/50 chance that Dr. C will be the one on-call to deliver me.
The conversation transitioned to my amniotic fluid level and the non-stress tests that Dr. Davis feels should be preformed weekly. I explained that while I expressed concerns about my contractions and uterine irritability to Dr. G, I was always brushed off, given the same canned answer about more than five contractions in an hour. I explained to Dr. C that while I've really tried to like Dr. G, realizing he is regarded as a fine doctor and that I need to put my personal differences and opinions aside, always feeling as if I am being talked down to with a condescending tone is hard to take week after week. Not to mention the fact that I felt like my concerns were never properly acknowledged and always minimized.
Because of this, I made an appointment to be evaluated by Dr. Davis. His team happened to, as part of the normal protocol, scan my baby (which my local group hadn't done since 20 weeks) and check my fluid level. I explained that since this discovery of borderline fluid last week, I have increased my fluids and started the Procardia around the clock. This combination has helped curb my uterine irritability.
Somehow, the conversation turned to the fact that I was not recommended by my local group for a Transabdominal Cerclage (TAC). That I was spearheading my care, which is unheard of and not a good way for anyone to seek medical care. The doctor is the doctor, not the patient. The literature does not support a woman like me to have a TAC. Dr. C then indicated that I should have tried a TVC and if that failed, then consider something more drastic. I was flabbergasted! I pushed him back asking him if what he was saying was that I needed to have another micro-preemie or worse yet, lose a baby due to a failed transvaginal cerclage?! I reminded him that I sought other opinions and that Dr. Davis was not the only physician to confirm my lack of "stitchable cervix". In fact, Hubby later reminded me that it was Dr. C who gave me the name of the doc downtown who was ready to perform a TAC on me as well.
I told Dr. C that not once did he check me to confirm that a TVC would be feasible. He then went on as usual, quoting literature stating that there is no way to confirm cervical competency in a non-pregnant woman. At this point I mentioned my instinct, that I knew in my heart the only way to carry a pregnancy to term (or closer to term than last time) was with a TAC. Dr. C informed me that my instinct was worthless and the only reason Dr. Davis placed my TAC was because I was dealing with Post Traumatic Stress.
Basically, something that women on Abbyloppers do all the time, consult an MFM along with a primary OB/Peri, was seen as a personal slight against my local group. Dr. C indicated that the relationship should be based on trust to which I responded that it's a little hard to trust someone who I sought help from on a Tuesday only to learn on a Friday that my membranes were bulging. I told him that pregnancy for me is HELL, that I trust no one and nothing and that my faith in the TAC has only truly become concrete as I've seen each passing week, beginning with the week I delivered my daughter.
It looks like my group never supported me, never valued me as an educated patient involved in my own care. They were offended that I would continue to see Dr. Davis, that I would put two doctors against each other. I defended that by explaining to Dr. C that he and his own colleague can't even agree, that their differing opinions are as good as being seen by two independent practices right there.
For some reason, stupid me allowed Dr. C to finish the exam. I allowed him to check my fluid level, to check my cervix. He wrote me orders for weekly AFIs and NSTs. I cried the whole time. Dr. C tried to scare me into thinking it was unrealistic to rely on Dr. Davis to be available to deliver me. How ridiculous for me to call him when it's time and expect him to meet me at the hospital and perform my c-section. How ridiculous.
So while I didn't officially blow up, didn't storm out with my chart in hand, didn't stop the Director of Development on my way out as we passed in the hall (thankfully he was distracted and didn't notice me) I left with tears streaming down my face, confused and torn yet knowing in my heart it's time to find a new group if I want to deliver in the system.
My emotional ties to delivering at Lankenau are many. The most important thing for me is the NICU team. This is where My Girl was born and while I could go to the other three hospitals in the system and end up with the same neonatologists, the nurses would all be different. I wanted the comfort of familiarity in the event we ended up with a significant NICU stay. Thankfully, with each passing week, the level of care is slowly (in theory) diminishing. Once I get to 32 weeks, I will no longer require a level 3 nursery.
Last week upon leaving my appointment I ran into a woman from the Development Office. She told me to call when I am ready to deliver, that she would hook me up with the brand new, top notch suite on the new L&D floor. Ironically, it sounds like the room that the part of the NICU where My Girl spent her first months of life, overlooking the seminary: a view that brought us great comfort.
And finally, coming full circle, I really wanted to breastfeed Baby Boy in the Lactation Room off the NICU that is named for and dedicated in honor of My Girl.
Lankenau Hospital has always held a special place in our hearts. It is the place where Our Girl was born far too early, the place where her life was stabilized and the place where she fought so hard to live. It is the place that we are forever indebted too, the place where our charitable hearts are. We take pride in knowing that our story has been instrumental in assisting the hospital secure $1,250,000 in donations for the NICU. It's hard to leave this behind and deliver elsewhere.
I called my support mom, Lori, the woman who helped me through My Girl's birth. Her son was born 12 years ago at 23 weeks. Lori and I talk several times a week and she was just the person I needed to help me through today. She had me pull over as I was driving in hysterics. She calmly helped me through and eventually I stopped sobbing.
Tomorrow, once my head is a little less foggy, I need to reassess and decide what course I am going to take. Do I deliver with Dr. Davis, all the way in New Jersey? Do I stick with the group that clearly doesn't value me as a patient? Or do I find a new group in the system?
What I am about to write is my interpretation and take-away from my appointment this morning with my local group. I realize every story has two sides, that each party has their own reality and views any particular situation through their own personal lens. My personal documentation of today's events is in no way intended to defame or smear.
I will admit there was no rehearsal on my part nor did I have a list of notes with me to keep me on track. This meeting was sincerely a "heart-to-heart" and those were the words I used with Dr. C when he entered the room. My agenda, so to speak, was strictly to convey my concerns, fears and wishes as a patient in a thoughtful and sincere manner.
My first point was that it would mean a great deal to me if Dr. C was the physician who delivered my baby. I should have known when I got a lecture about how over-worked he feels that I should have packed up my stuff and left. I mean, how professional is it to unload the burden of your hectic work schedule on your patient? I learned he is on-call 50% of the time. He is scheduled to work the weekend before Christmas (although he mentioned he was traveling with his family this weekend too), the weekend after Christmas, New Year's Eve and New Year's Day. The only time off he is getting this year is Christmas Eve and Christmas Day. The practice is responsible for six hospitals, dealing with high-risk calls coming from the home base of Lankenau, sister hospitals, Paoli, Bryn Mawr, Riddle and two others, Pottstown and Montgomery. He needs to be on-call for transports and in fact, has women right now on antepartum who could deliver at a moment's notice. He even told me he is considering not delivering any longer, it's just too much.
Okay, well, sorry I asked. So the bottom line is unless my c-section is scheduled, there is a 50/50 chance that Dr. C will be the one on-call to deliver me.
The conversation transitioned to my amniotic fluid level and the non-stress tests that Dr. Davis feels should be preformed weekly. I explained that while I expressed concerns about my contractions and uterine irritability to Dr. G, I was always brushed off, given the same canned answer about more than five contractions in an hour. I explained to Dr. C that while I've really tried to like Dr. G, realizing he is regarded as a fine doctor and that I need to put my personal differences and opinions aside, always feeling as if I am being talked down to with a condescending tone is hard to take week after week. Not to mention the fact that I felt like my concerns were never properly acknowledged and always minimized.
Because of this, I made an appointment to be evaluated by Dr. Davis. His team happened to, as part of the normal protocol, scan my baby (which my local group hadn't done since 20 weeks) and check my fluid level. I explained that since this discovery of borderline fluid last week, I have increased my fluids and started the Procardia around the clock. This combination has helped curb my uterine irritability.
Somehow, the conversation turned to the fact that I was not recommended by my local group for a Transabdominal Cerclage (TAC). That I was spearheading my care, which is unheard of and not a good way for anyone to seek medical care. The doctor is the doctor, not the patient. The literature does not support a woman like me to have a TAC. Dr. C then indicated that I should have tried a TVC and if that failed, then consider something more drastic. I was flabbergasted! I pushed him back asking him if what he was saying was that I needed to have another micro-preemie or worse yet, lose a baby due to a failed transvaginal cerclage?! I reminded him that I sought other opinions and that Dr. Davis was not the only physician to confirm my lack of "stitchable cervix". In fact, Hubby later reminded me that it was Dr. C who gave me the name of the doc downtown who was ready to perform a TAC on me as well.
I told Dr. C that not once did he check me to confirm that a TVC would be feasible. He then went on as usual, quoting literature stating that there is no way to confirm cervical competency in a non-pregnant woman. At this point I mentioned my instinct, that I knew in my heart the only way to carry a pregnancy to term (or closer to term than last time) was with a TAC. Dr. C informed me that my instinct was worthless and the only reason Dr. Davis placed my TAC was because I was dealing with Post Traumatic Stress.
Basically, something that women on Abbyloppers do all the time, consult an MFM along with a primary OB/Peri, was seen as a personal slight against my local group. Dr. C indicated that the relationship should be based on trust to which I responded that it's a little hard to trust someone who I sought help from on a Tuesday only to learn on a Friday that my membranes were bulging. I told him that pregnancy for me is HELL, that I trust no one and nothing and that my faith in the TAC has only truly become concrete as I've seen each passing week, beginning with the week I delivered my daughter.
It looks like my group never supported me, never valued me as an educated patient involved in my own care. They were offended that I would continue to see Dr. Davis, that I would put two doctors against each other. I defended that by explaining to Dr. C that he and his own colleague can't even agree, that their differing opinions are as good as being seen by two independent practices right there.
For some reason, stupid me allowed Dr. C to finish the exam. I allowed him to check my fluid level, to check my cervix. He wrote me orders for weekly AFIs and NSTs. I cried the whole time. Dr. C tried to scare me into thinking it was unrealistic to rely on Dr. Davis to be available to deliver me. How ridiculous for me to call him when it's time and expect him to meet me at the hospital and perform my c-section. How ridiculous.
So while I didn't officially blow up, didn't storm out with my chart in hand, didn't stop the Director of Development on my way out as we passed in the hall (thankfully he was distracted and didn't notice me) I left with tears streaming down my face, confused and torn yet knowing in my heart it's time to find a new group if I want to deliver in the system.
My emotional ties to delivering at Lankenau are many. The most important thing for me is the NICU team. This is where My Girl was born and while I could go to the other three hospitals in the system and end up with the same neonatologists, the nurses would all be different. I wanted the comfort of familiarity in the event we ended up with a significant NICU stay. Thankfully, with each passing week, the level of care is slowly (in theory) diminishing. Once I get to 32 weeks, I will no longer require a level 3 nursery.
Last week upon leaving my appointment I ran into a woman from the Development Office. She told me to call when I am ready to deliver, that she would hook me up with the brand new, top notch suite on the new L&D floor. Ironically, it sounds like the room that the part of the NICU where My Girl spent her first months of life, overlooking the seminary: a view that brought us great comfort.
And finally, coming full circle, I really wanted to breastfeed Baby Boy in the Lactation Room off the NICU that is named for and dedicated in honor of My Girl.
Lankenau Hospital has always held a special place in our hearts. It is the place where Our Girl was born far too early, the place where her life was stabilized and the place where she fought so hard to live. It is the place that we are forever indebted too, the place where our charitable hearts are. We take pride in knowing that our story has been instrumental in assisting the hospital secure $1,250,000 in donations for the NICU. It's hard to leave this behind and deliver elsewhere.
I called my support mom, Lori, the woman who helped me through My Girl's birth. Her son was born 12 years ago at 23 weeks. Lori and I talk several times a week and she was just the person I needed to help me through today. She had me pull over as I was driving in hysterics. She calmly helped me through and eventually I stopped sobbing.
Tomorrow, once my head is a little less foggy, I need to reassess and decide what course I am going to take. Do I deliver with Dr. Davis, all the way in New Jersey? Do I stick with the group that clearly doesn't value me as a patient? Or do I find a new group in the system?
Monday, December 15, 2008
Hiccups and Other Twinges
After my last pregnancy, women who didn't necessarily know my circumstances, would try to compare pregnant-mommy notes. For some reason, a popular topic was fetal hiccups. I was never really sure that I ever felt them with My Girl and now that I most certainly have felt them with My Boy, know that hiccups were something I never got to experience the first time around.
Baby Boy has had several bouts with the hiccups recently and there is no mistaking that the rhythmic bumps coming from my insides are just that. It's a strange feeling and I find myself counting them once I realize what they are.
Speaking of strange feelings, nothing compares to the twinges that occurred last night around my cervix. Baby Boy was sleeping soundly, as was I, until I needed to use the bathroom. Well, that was enough to wake him and keep him awake for a little playtime. My cervix was his trampoline and I swear he was either bouncing off my stitch with his feet (he's been breach) or he was strumming it like a guitar with his little hand. The sensations were so uncomfortable that I woke Hubby to let him know it felt like Baby Boy was about to burrow himself out of me. I tried changing my position several times but he was very determined to keep the fun going at my expense. It was so bad at certain points, I was prepared to move tomorrow's appointment up to today.
Otherwise, I've been feeling pretty good. In fact, I've once again pushed myself a little more than I should have this weekend, although the consequences of such have not been as debilitating as weeks' past. Saturday was another busy weekend day with yet one more visit with Santa Claus and dinner out for a friend's 30th. Yesterday was a down day though and offered some time to rest and rejuvenate as I prepare to tackle the week ahead.
28w 4d and counting...
Baby Boy has had several bouts with the hiccups recently and there is no mistaking that the rhythmic bumps coming from my insides are just that. It's a strange feeling and I find myself counting them once I realize what they are.
Speaking of strange feelings, nothing compares to the twinges that occurred last night around my cervix. Baby Boy was sleeping soundly, as was I, until I needed to use the bathroom. Well, that was enough to wake him and keep him awake for a little playtime. My cervix was his trampoline and I swear he was either bouncing off my stitch with his feet (he's been breach) or he was strumming it like a guitar with his little hand. The sensations were so uncomfortable that I woke Hubby to let him know it felt like Baby Boy was about to burrow himself out of me. I tried changing my position several times but he was very determined to keep the fun going at my expense. It was so bad at certain points, I was prepared to move tomorrow's appointment up to today.
Otherwise, I've been feeling pretty good. In fact, I've once again pushed myself a little more than I should have this weekend, although the consequences of such have not been as debilitating as weeks' past. Saturday was another busy weekend day with yet one more visit with Santa Claus and dinner out for a friend's 30th. Yesterday was a down day though and offered some time to rest and rejuvenate as I prepare to tackle the week ahead.
28w 4d and counting...
Saturday, December 13, 2008
Yesterday's Appointment
I will admit that I was not looking forward to my appointment yesterday. It was scheduled with Dr. G and I called earlier in the week to see if it could be rescheduled with Dr. C but he was booked for the week. I feel like I've hardly seen Dr. C and feel like we need to have a heart-to-heart. I have decided after much thought that if he is unable to deliver me, I will do my best to get to Dr. Davis to have him perform my c-section. My hope is that this delivery does not occur on an emergent basis, that I am able to confirm Baby Boy's lungs are mature and then schedule my delivery from there. Dr. Davis is aware of my desire to deliver this baby as soon as he is ready, preferably not a moment sooner and not many moments later. I need to convey this to Dr. C and also inquire about his willingness to be available to deliver me regardless if he's on-call or not.
Anyway, back to yesterday. I am really trying to take it easy but felt it would be okay to meet two friends for lunch. My mother-in-law came over to watch My Girl and I left a couple hours in advance of my doctor's appointment. It was nice to have a meal with adult conversation without having to entertain, cut chicken fingers or make frequent trips to the restroom on the heels of the words, "I go potty poop".
In fact, I planned my time so well, I arrived about 1/2 hour early for my appointment. I had my book club book with me and was looking forward to "free-time" to just sit, relax and read.
I entered the office and checked in with the receptionist. I informed her that I had a scare on Saturday night with some contractions, bad weather, no child care and this panicked feeling that I would need to call an ambulance as Hubby would have to stay home with Our Girl and I most certainly couldn't drive myself, and therefore, for peace of mind, would like a copy of my chart as my local rescue organization is not going to drive me to a hospital almost an hour away when there are two, no three within a few minutes from my house. She informed me in her usual tone that my local hospital affiliated with the same health care system will not deliver me. I snipped back that I cannot labor and the worst case scenario would be that oh, yes the would have to deliver me and I'd like my chart on the off-chance this happened. She was non-committal, saying I'd have to speak with the doctor or nurse about it.
I decided not to argue and went to my usual seat in the waiting room, almost right in front of the desk and most certainly within ear-shot. The phone rang and her voice lowered and well, you know that feeling you have when you think some one's talking about you, well I had it. My first thought was that the doc was in the back of the office and that he heard me talking and called up to find out was going on. I decided to brush it off, I mean how paranoid can I be. And who really cares if they're talking about me. So I headed off to leave my routine urine sample.
When I came out of the restroom, I learned that my instinct was correct, I was the subject of this "secret" conversation. The receptionist informed me that Dr. G was running late as he had a "procedure" to do. He wanted her to call me and let me know he needed to push my appointment back. Well, here I was, 1/2 hour early for my 2:30. Having had lunch out and rush hour traffic not too far off, I really didn't feel like hanging around that long for I knew my symptoms of overdoing it would soon surface. Not to mention my book would be finished in no time and I hate to be idle.
Since I was just evaluated by Dr. Davis on Monday, I reasoned with myself in a matter of seconds that I could forgo the cervical exam. The main reason I was there was really to get my amniotic fluid level checked. I made my proposal: if the nurse is able to give me my progesterone shot and check my amniotic fluid level, I can skip my appointment with the doctor altogether. Well, I opened another can of worms by suggesting my fluid level be checked. After the perplexed look I received, I volunteered that I had visited my other doc, the doc who placed my stitch, and that because I was having contractions, I was thoroughly evaluated. My fluid level was low and after my week-long drinking binge, I was to have it rechecked.
Long story short, the nurse was able to do all of the above and even managed a quick weight check (oh gosh!) and a blood pressure reading as well. I sensed that I had overstepped by visiting Dr. Davis as she defensively inquired why they would check my fluid levels. Must I explain this again?
My fluid supposedly measured 15 but I really question the methodology used to obtain the measurement. I am not a doctor, nor am I a nurse or an ultrasounographer (although many of My Girl's physicians ask me what medical training I have) so I can't say for certain, but my hunch was that when she didn't know which buttons to press on the machine, my measurement might not be totally accurate. Based on my observations, reading and research, I would have taken measurements from different starting points too, again leading to questionable accuracy. But again, this is just my opinion and you know what they say about opinions...
I will keep sucking down the water and wait things out until Tuesday when I follow up with Dr. Davis again. I am feeling tons of movements from Baby Boy and apparently when there is dangerously low fluid, movements are very difficult to detect. His nudges, flips and kicks are very reassuring to me.
On another note, my glucose screen came back normal.
So, I didn't have a full appointment yesterday, which was probably a good thing. I am really not in the mood to defend myself as it will just get me worked up and that is not something my body needs nor does my baby's.
Finally, in my heightened emotional state, I couldn't help but wonder what "procedure" the doctor was detained with. My wandering mind settled upon the idea that there was a woman out there receiving at that very moment, a rescue transvaginal cerclage. My heart ached for her and her baby and the horrible thoughts that were most certainly dancing though her mind about the safety and well being of her unborn baby. It is moments like these (real or imagined) that I am really, really thankful for my Transabdominal Cerclage (TAC), for Dr. Davis and for my own desire to pursue something my heart was telling me was absolutely necessary in spite of other doctors telling me I was crazy.
Hubby and I were in awe of my reaching 28 weeks and my growing bump (dare I share these photos of my most pregnant tummy to date?). We both acknowledged that without my TAC, Baby Boy wouldn't have had a fighting chance. And he has this fighting chance thanks to his brave, strong and determined big sister who endured her own undeserved hell to help her sibling.
Anyway, back to yesterday. I am really trying to take it easy but felt it would be okay to meet two friends for lunch. My mother-in-law came over to watch My Girl and I left a couple hours in advance of my doctor's appointment. It was nice to have a meal with adult conversation without having to entertain, cut chicken fingers or make frequent trips to the restroom on the heels of the words, "I go potty poop".
In fact, I planned my time so well, I arrived about 1/2 hour early for my appointment. I had my book club book with me and was looking forward to "free-time" to just sit, relax and read.
I entered the office and checked in with the receptionist. I informed her that I had a scare on Saturday night with some contractions, bad weather, no child care and this panicked feeling that I would need to call an ambulance as Hubby would have to stay home with Our Girl and I most certainly couldn't drive myself, and therefore, for peace of mind, would like a copy of my chart as my local rescue organization is not going to drive me to a hospital almost an hour away when there are two, no three within a few minutes from my house. She informed me in her usual tone that my local hospital affiliated with the same health care system will not deliver me. I snipped back that I cannot labor and the worst case scenario would be that oh, yes the would have to deliver me and I'd like my chart on the off-chance this happened. She was non-committal, saying I'd have to speak with the doctor or nurse about it.
I decided not to argue and went to my usual seat in the waiting room, almost right in front of the desk and most certainly within ear-shot. The phone rang and her voice lowered and well, you know that feeling you have when you think some one's talking about you, well I had it. My first thought was that the doc was in the back of the office and that he heard me talking and called up to find out was going on. I decided to brush it off, I mean how paranoid can I be. And who really cares if they're talking about me. So I headed off to leave my routine urine sample.
When I came out of the restroom, I learned that my instinct was correct, I was the subject of this "secret" conversation. The receptionist informed me that Dr. G was running late as he had a "procedure" to do. He wanted her to call me and let me know he needed to push my appointment back. Well, here I was, 1/2 hour early for my 2:30. Having had lunch out and rush hour traffic not too far off, I really didn't feel like hanging around that long for I knew my symptoms of overdoing it would soon surface. Not to mention my book would be finished in no time and I hate to be idle.
Since I was just evaluated by Dr. Davis on Monday, I reasoned with myself in a matter of seconds that I could forgo the cervical exam. The main reason I was there was really to get my amniotic fluid level checked. I made my proposal: if the nurse is able to give me my progesterone shot and check my amniotic fluid level, I can skip my appointment with the doctor altogether. Well, I opened another can of worms by suggesting my fluid level be checked. After the perplexed look I received, I volunteered that I had visited my other doc, the doc who placed my stitch, and that because I was having contractions, I was thoroughly evaluated. My fluid level was low and after my week-long drinking binge, I was to have it rechecked.
Long story short, the nurse was able to do all of the above and even managed a quick weight check (oh gosh!) and a blood pressure reading as well. I sensed that I had overstepped by visiting Dr. Davis as she defensively inquired why they would check my fluid levels. Must I explain this again?
My fluid supposedly measured 15 but I really question the methodology used to obtain the measurement. I am not a doctor, nor am I a nurse or an ultrasounographer (although many of My Girl's physicians ask me what medical training I have) so I can't say for certain, but my hunch was that when she didn't know which buttons to press on the machine, my measurement might not be totally accurate. Based on my observations, reading and research, I would have taken measurements from different starting points too, again leading to questionable accuracy. But again, this is just my opinion and you know what they say about opinions...
I will keep sucking down the water and wait things out until Tuesday when I follow up with Dr. Davis again. I am feeling tons of movements from Baby Boy and apparently when there is dangerously low fluid, movements are very difficult to detect. His nudges, flips and kicks are very reassuring to me.
On another note, my glucose screen came back normal.
So, I didn't have a full appointment yesterday, which was probably a good thing. I am really not in the mood to defend myself as it will just get me worked up and that is not something my body needs nor does my baby's.
Finally, in my heightened emotional state, I couldn't help but wonder what "procedure" the doctor was detained with. My wandering mind settled upon the idea that there was a woman out there receiving at that very moment, a rescue transvaginal cerclage. My heart ached for her and her baby and the horrible thoughts that were most certainly dancing though her mind about the safety and well being of her unborn baby. It is moments like these (real or imagined) that I am really, really thankful for my Transabdominal Cerclage (TAC), for Dr. Davis and for my own desire to pursue something my heart was telling me was absolutely necessary in spite of other doctors telling me I was crazy.
Hubby and I were in awe of my reaching 28 weeks and my growing bump (dare I share these photos of my most pregnant tummy to date?). We both acknowledged that without my TAC, Baby Boy wouldn't have had a fighting chance. And he has this fighting chance thanks to his brave, strong and determined big sister who endured her own undeserved hell to help her sibling.
Hubby's view of his children at 28 weeks gestation:
Baby Boy 12/11/08
Our Girl 8/17/06
Monday, November 17, 2008
Busy Weeks?
I think I may have figured out why, for two weekends in a row, I've felt the need to take it easy, confining myself to my bed. Today being Monday, my usual routine kicks into gear. Luckily Mondays and Tuesdays are school days for the Miss. Gosh, I love Mondays and Tuesdays. Hubby and Darling Daughter leave for school around 8:20 and from there I catch up on things, such as emails and what I refer to as "lite" housework. I take a leisurely shower, throw in a load of laundry and then before I know it, it's time to pick up My Nut.
I usually pack a lunch for My Girl to eat on the way home. Today was a 1/2 of peanut butter and jelly sandwich on whole wheat bread, a big cup of milk and American cheese, with pretzel chips for "dessert". She is usually starving when I pick her up at school and if I don't have a lunch packed, usually pull through the Burger King drive-thru for chicken tenders. I know, not the best choice but if I don't present her with the promise of food on the way out the classroom door, she'll ask me for chicken.
Anyway, the point of feeding her in the car is number one, she's hungry and number two, it's the only way to keep her awake until we get home. There are days when she dozes, mid-bite, and I do my best to wake her up by pointing out the cows or horses out to pasture. Sometimes it works and sometimes it doesn't. Then my plan turns into a wish for an easy transfer to nap.
Most days, I am very lucky. She is awake when we get home, we do a potty visit before nap, I change her into other clothes (clothes after three hours of preschool are just plain gross) and do a full facial and digital wipe-down. We read a couple of books, "The Mommy Book" and "Corduroy" still top the list, snuggle and she asks for her "bed". I tuck her in, always blessing her and head off to enjoy three peaceful hours: after I use the bathroom, walk the dogs, finish the laundry, make some lunch and catch up on emails.
My plan is to structure most of my mornings in the fashion of either school, Kindermusik, therapy or playdates, so I can achieve the 1:00 free-time a great nap affords me. On the days when we have Musik class, I am running from here to there as my OB appointments sometimes follow our dismissal by the mere skin of my teeth.
I find myself very active once nap is over, making dinner, entertaining My Girl, dressing her, dressing her and dressing her, as for some reason we need to totally strip to use the potty (not sure how socks interfere with one's ability to pee and poop but oh well) and cleaning up once more. I find myself up and down the stairs, although it has gotten to the point where if My Girl wants something, I make her go upstairs to her room to get it herself. But, nonetheless, there are always reasons why I need to race up or race down, the most common being I forgot something in my failed attempt at being efficient.
So by the end of the night, such as now, after I've already laid out her clothes for the next day and prepared just as much as I can for a fairly easy morning, including picking up my entire house, I am feeling very fatigued, tight and crampy with an occasional contraction.
Perhaps my very long-winded point is that my days are crazy and by the time the weekend rolls around my body just needs a break. Thankfully, I have a fabulous Hubby who can make that happen. And speaking of Hubby, he does bath almost every night (with the exception of the nights My Girl and I shower together), puts PJs on and does the majority of the bedtime routine. Although lately, I must confess, we've been in a bit of a "Mommy" zone and poor Daddy gets cried to the curb.
One of the great things about my TAC (best is getting to term!) is that for obvious reasons, I am way busier this pregnancy than I was last pregnancy. If with my limited activity last time, I only got to 24w 5d (tomorrow), I can only imagine when my body would have failed me this time around had I not had my pre-pregnancy TAC placed. It is an amazing thing and for a busy mom like me, couldn't imagine this pregnancy without it.
Tomorrow will be a difficult day for me, there is no question. I have a plan on how to best make it through, to memorialize it, if you will. And I will admit, the cathartic experience of purging my memory, especially Friday, the day of my hospital admission, has proved to be an amazing relief and even more beneficial than I once hoped or even thought it could be.
I usually pack a lunch for My Girl to eat on the way home. Today was a 1/2 of peanut butter and jelly sandwich on whole wheat bread, a big cup of milk and American cheese, with pretzel chips for "dessert". She is usually starving when I pick her up at school and if I don't have a lunch packed, usually pull through the Burger King drive-thru for chicken tenders. I know, not the best choice but if I don't present her with the promise of food on the way out the classroom door, she'll ask me for chicken.
Anyway, the point of feeding her in the car is number one, she's hungry and number two, it's the only way to keep her awake until we get home. There are days when she dozes, mid-bite, and I do my best to wake her up by pointing out the cows or horses out to pasture. Sometimes it works and sometimes it doesn't. Then my plan turns into a wish for an easy transfer to nap.
Most days, I am very lucky. She is awake when we get home, we do a potty visit before nap, I change her into other clothes (clothes after three hours of preschool are just plain gross) and do a full facial and digital wipe-down. We read a couple of books, "The Mommy Book" and "Corduroy" still top the list, snuggle and she asks for her "bed". I tuck her in, always blessing her and head off to enjoy three peaceful hours: after I use the bathroom, walk the dogs, finish the laundry, make some lunch and catch up on emails.
My plan is to structure most of my mornings in the fashion of either school, Kindermusik, therapy or playdates, so I can achieve the 1:00 free-time a great nap affords me. On the days when we have Musik class, I am running from here to there as my OB appointments sometimes follow our dismissal by the mere skin of my teeth.
I find myself very active once nap is over, making dinner, entertaining My Girl, dressing her, dressing her and dressing her, as for some reason we need to totally strip to use the potty (not sure how socks interfere with one's ability to pee and poop but oh well) and cleaning up once more. I find myself up and down the stairs, although it has gotten to the point where if My Girl wants something, I make her go upstairs to her room to get it herself. But, nonetheless, there are always reasons why I need to race up or race down, the most common being I forgot something in my failed attempt at being efficient.
So by the end of the night, such as now, after I've already laid out her clothes for the next day and prepared just as much as I can for a fairly easy morning, including picking up my entire house, I am feeling very fatigued, tight and crampy with an occasional contraction.
Perhaps my very long-winded point is that my days are crazy and by the time the weekend rolls around my body just needs a break. Thankfully, I have a fabulous Hubby who can make that happen. And speaking of Hubby, he does bath almost every night (with the exception of the nights My Girl and I shower together), puts PJs on and does the majority of the bedtime routine. Although lately, I must confess, we've been in a bit of a "Mommy" zone and poor Daddy gets cried to the curb.
One of the great things about my TAC (best is getting to term!) is that for obvious reasons, I am way busier this pregnancy than I was last pregnancy. If with my limited activity last time, I only got to 24w 5d (tomorrow), I can only imagine when my body would have failed me this time around had I not had my pre-pregnancy TAC placed. It is an amazing thing and for a busy mom like me, couldn't imagine this pregnancy without it.
Tomorrow will be a difficult day for me, there is no question. I have a plan on how to best make it through, to memorialize it, if you will. And I will admit, the cathartic experience of purging my memory, especially Friday, the day of my hospital admission, has proved to be an amazing relief and even more beneficial than I once hoped or even thought it could be.
Thursday, April 3, 2008
Too Much, Too Fast
As I am back into the full swing of my life post TAC surgery, I can see that I didn't quite recover as quickly as I thought I might. For the first two weeks, my mother took care of Precious Miracle. I don't know what I would have done without her help. Precious Miracle is at the stage where she requires constant attention and interaction. She is into things that she shouldn't and climbing where she ought not to (stairs and furniture). She also likes to be snuggled, typically between the hours of 3 pm and bedtime. These are all things a person with a freshly cut hole in the stomach can't handle. So with that, I must say, "Thank you, Mom!"
Perhaps part of my slow recovery is the fact that I pushed myself instead of taking it easy. Five days post-op, I held an egg hunt in my neighborhood. I picked up heavy items, walked a distance and went up and down the stairs without thinking about it. And what did I get? Here I sit, over three weeks later, still putting pressure on my incision as I sneeze.
The third week of my recovery was spent in sunny Florida and once again, I did things that I probably shouldn't have. I wore my jeans (I'm still very swollen) and carried heavy items, not to mention I walked all over the airport. I had no idea that closing the hatch on an SUV required so much abdominal work until I did it with freshly cut abdominal muscles. Perhaps that's what put me over the edge. I ended up in a walk-in, no appointment necessary, doctors' office, where they prescribed antibiotics for my red, swollen incision.
My greatest fear has been and still is infection. But for some reason it's not stopping me. I put my jeans on again this morning to attend Story Time at the local library. Sitting on the floor in tight jeans is no fun period. This was much worse. I could feel parts of my incision pulling, tugging. I would grab a belt loop to pull my jeans away from my waist to relieve the burning sensation. When I got home, I put my sweats on as soon as I walked in the door.
While on vacation, as I tried to fall asleep in my twin bed, I wondered quietly to myself if I had made a mistake. "Should I have waited to have this surgery? Did I jump in too quickly?" Then I thought of what my mind would be saying if I hadn't had the surgery. "I should've done it. It would be over by now. We would be that much closer to growing our family."
So all in all, I am happy where I am. I learned a lesson my body has been trying to tell me for sometime now - take care of me!!! Slow down!!! Much easier said than done.
Perhaps part of my slow recovery is the fact that I pushed myself instead of taking it easy. Five days post-op, I held an egg hunt in my neighborhood. I picked up heavy items, walked a distance and went up and down the stairs without thinking about it. And what did I get? Here I sit, over three weeks later, still putting pressure on my incision as I sneeze.
The third week of my recovery was spent in sunny Florida and once again, I did things that I probably shouldn't have. I wore my jeans (I'm still very swollen) and carried heavy items, not to mention I walked all over the airport. I had no idea that closing the hatch on an SUV required so much abdominal work until I did it with freshly cut abdominal muscles. Perhaps that's what put me over the edge. I ended up in a walk-in, no appointment necessary, doctors' office, where they prescribed antibiotics for my red, swollen incision.
My greatest fear has been and still is infection. But for some reason it's not stopping me. I put my jeans on again this morning to attend Story Time at the local library. Sitting on the floor in tight jeans is no fun period. This was much worse. I could feel parts of my incision pulling, tugging. I would grab a belt loop to pull my jeans away from my waist to relieve the burning sensation. When I got home, I put my sweats on as soon as I walked in the door.
While on vacation, as I tried to fall asleep in my twin bed, I wondered quietly to myself if I had made a mistake. "Should I have waited to have this surgery? Did I jump in too quickly?" Then I thought of what my mind would be saying if I hadn't had the surgery. "I should've done it. It would be over by now. We would be that much closer to growing our family."
So all in all, I am happy where I am. I learned a lesson my body has been trying to tell me for sometime now - take care of me!!! Slow down!!! Much easier said than done.
Wednesday, March 12, 2008
My Shiny New Cervix
Well, it's in! My pre-pregnancy transabdominal cerclage was placed by Dr. George Davis on Monday, March 10, 2008. It was discovered during my surgery that not only do I have a short cervix but I also have a small uterus. Dr. Davis feels based on this new information that it is realistic to assume that I can carry to 32-34 weeks as opposed to the 37-39 originally thought. Not exactly what I wanted to hear but hey, 32 is much better than 24.
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