Friday, October 29, 2010

Are you Serious?

I don't often feel well after my appointments due to the ultrasound, anxiousness, and activity but I know it's going to be this way and it no longer worries me if I have a few pains afterwards. Only last week it lasted for several days. I called the doctor on Saturday but all I could say is I have some discomfort down there blah, blah, blah...I don't even know why I called but I was hurting and my post-appointment discomfort doesn't usually last that long. Sunday morning was good but by afternoon I was in pain again. I knew I didn't want to go to the hospital but what could it be? I had TOIAW inspect for an infection of some kind but all he said was, "It looks blue-ish purple." I had no idea what that meant but I didn't have any signs of infection so I just rested (like I don't do enough of that already). Same thing Monday morning: fine when I woke-up but pain 1.5 hours after waking. And it wasn't just pain, it was a burning sensation. It had to be an infection, I thought, so I called my OB and she said she wanted me to see the MFM to have him check my cervix just in case.


TOIAW came home and we went to the doctor's office. My OB and MFM no longer share an office so I went to see him first and then, if need be (like if the pain wasn't caused by my cervix), they were going to send me to see my OB. Good plan only I had to wait for quite a while. The good news is, I met a lovely woman who was also waiting and we had a great discussion about affordable housing. She is a property manager at an affordable housing complex so she had a lot of insight. I was inordinately excited to talk about an interesting topic with someone. I hope she didn't notice. Also, it was nice to be distracted because I was really scared. It seemed the symptoms got worse every time I got up or went to the bathroom which concerned me that it actually was my cervix and I was just feeling it on the outside since there aren't a lot of nerve endings around the cervix. Finally it was my turn and the ultrasound showed the the usual less-than-stellar cervical length but, once again, it appears to be stable. So why do I feel like I used sand paper rather than toilet paper? The MFM didn't even examine me, he just said to try an over-the-counter yeast infection cream. Fine. We stopped at a pharmacy on the way home and got the necessary supplies. I followed the directions and felt some relief for about 5-10 minutes...until I got tears in my eyes and told TOIAW I was pretty sure someone tampered with the package and replaced the regular cream with acid. I was in so much pain!

I eventually fell asleep but the next morning I called my OB. She suggested "airing out the area" and made me an appointment for her next office day (Thursday). Guess what she found? You'll never guess unless you've had this issue before (and I so hope you haven't). This is what I have. It's not the best link, but you get the idea. Surprisingly, a combination of cortisone cream and trying not to irritate the area have helped a lot.

The good news is my cervix was closed when she looked at it and "there's some thickness to it" whatever that means. It would seem that if it were normal she would have said that outright but I know I'm not normal. What is normal anyway?

Friday, October 22, 2010

Steady-ish?

Yesterday's appointments went pretty well. First I had a cervical check, which showed maybe a slight shortening from last week but I'm not open beyond the stitch (praise the Lord!). It's difficult to get an accurate measurement when it's always a different person performing the ultrasound and you would think that in a small office that wouldn't happen but different nurses work different days and sometimes the doctor does it himself so there is some margin for error. So last week my cervix was 1.6 cm and this week it was 1 cm which seems like a big difference to me--especially for just one week--but no one said anything (except my OB but I'll get there in a minute). TOIAW says it's been at 1 cm before and we already know it changes so I'm trying my best to hang in there and not freak out and think about thinning and softening and the like...

We briefly spoke to the MFM before he went down to confer with my OB. I will see him on Wednesday next week and the following Wednesday I will see him and then go to the hospital for admission because that's the day my OB is on call. We had a pretty short appointment with her but she was the only one who pointed out that the difference between last week and this week. Maybe no one else said anything because there isn't much point? I don't know.

Of course last night I had quite a bit of discomfort/pain that bothered me but I'm kind of getting used to it. It goes away when I sleep and it's here and there today but nothing like yesterday. I'm not sure if it's all the activity or the exam or both but it often happens on appointment days. I only have to hold out for 11 more days and then I get 2 ultrasounds a week and they'll travel to me...how awesome is that?

I've enjoyed having my brother's family here this week for their yummy food and even better company/entertainment so I'll be sad for them to leave tomorrow. It's going to be so quiet! We then have about a week on our own before my aunt and cousins arrive and they will stay until I'm admitted...or should I say committed?

Saturday, October 16, 2010

Holding Steady

Let me just say that I fully intended to write this update Thursday morning, however, I have a horrible case of tendinitis in my right arm and typing is rather painful. Thankfully, it is better today but I don't want to push it so this will be short.

I did not feel well Wednesday at all. I hadn't slept the night before and then I began cramping (right after I wrote my last post) and it would not go away. I called to see if there were any openings and even though there weren't, they did "work me in" which meant I was seen after all the other patients. It looks like things are still holding steady at 1.7 cm although I have no idea what that means other than there is no change from the previous week. It's altogether possible that I open and close daily which makes the cerclage my first line of defense. In other exciting news, my doctor suggested we go out to dinner on our way home. We did, it was great, and I remembered how to behave in public. I wonder if the same will hold true when I attempt to apply make-up again?

My brother, sister-in-law, niece, and nephew will be arriving in a few hours. They'll be here for a week. If nothing else, they will provide plenty of entertainment and it is doubtful I will be bored or lonely with them around.

I'm off to nurse my tendinitis some more. I use my computer once every 2-3 days which makes me think this injury is more likely from playing games on my phone. So incredibly pathetic...

Wednesday, October 13, 2010

Feelings

Yesterday afternoon/evening and today have been really rough and I'm not even sure why. The most obvious reason would probably be that I had some sharp round ligament-like pains yesterday which, when combined with the [nearly] omnipresent cerclage pulls, tugs, and twinges, are never good for my psyche. Then there's the issue of my frail psyche who was feeling lonely and sorry for itself. Even though TOIAW works from home as much as he can, he's nearly always studying and while it's awesome to have him here "just in case," he's not much of a companion. So when he came down last night for a study break and I told him what I was feeling (physically) and he kind of laughed and said something like, "It's always something!" I dissolved in tears. He wasn't being a jerk; he was trying to make light of the situation. But it's NOT FUNNY when all you do ALL DAY LONG is lie (or is it lay? I never remember) around and FEEL everything.

I've done some very unscientific experiments to prove that the vast majority of the things I feel are innocuous (I mean sure, bad things could be going on in there but the likelihood of me feeling them like I think I'm feeling them is not very high). For instance, if I'm having cramps and I get up to go to the bathroom, I rarely notice them and they usually disappear by the time I get back to the couch/bed. The same is true with most of the twinges I feel. If I get up or change positions, it usually alleviates the problem which would lead me to believe it's not so much of a problem but that never stops me from worrying. The same is true for when I think I feel pressure and, even though I'm not an expert in physics, I'm pretty sure that pressure would be magnified when standing up as opposed to reclining. Granted, I could go into my appointment tomorrow and have my worst fears confirmed but the truth is I've had nearly all these "feelings" for 5.5 weeks now and there has yet to be a correlation between them and what's happening inside.

Speaking of my appointment, I both dread it and look forward to it. It's so twisted. And I don't know which version of my doctor is going to show up on any given day. The somewhat optimistic one or the compassionate, give-me-a-hug-and-a-you're-a-nice-couple-who-doesn't-deserve-this-speech-and-I'm-so-sorry one.

On a completely different note, if you need any information on Massachusetts or New Hampshire political races, please let me know. Most of my knowledge is based on commercials and debates although I have done the odd web search just to satisfy my own curiosity. And, because I clearly have way too much time on my hands, I've even reached out to the campaigns of 2 different candidates from own party to tell them I think their ads are arrogant and hostile and I cannot possibly see how they could be beneficial (on any level). All that did was get me on their email distribution lists. I've never run a political campaign but it would seem to me that the most effective strategy would be to promote yourself rather than trashing your opponent. If retailers did that we would be outraged. Can you imagine a Target commercial where all they did was trash Wal-Mart for 30 seconds? Would that entice you to shop there? Yet we allow it in politics because that's "just the way it is." I hope the elections in your area are more civil.

Okay, enough procrastination on my editing work. It's very interesting to edit papers on topics about which I know nothing. Who really needs to read 7-8 pages on the assimilation of mountain cultures as it pertains to the frontier expansion of Russia and China? Not me.

Friday, October 8, 2010

Roller Coasters and [extremely tentative] Plans

When last we left off, I couldn't go 5 minutes without breaking down in tears. That was most of last Friday and early Saturday morning. I doubt I slept more than an hour that night. I then woke-up to increased vaginal discharge. I had mentioned it to the doctor at my appointment and he said normally he would attribute it to the cerclage, but in light of the funneling beyond the stitch, he was inclined to take it as a more ominous sign. So of course I called once I realized it was not going away. I managed to make it through the call to the answering service but as soon as the doctor called me back I was in tears and handed the phone to TOIAW. The on-call doctor felt I needed a manual exam--something my doctor had not done the day before--so off we went. A part of me truly felt it was over.

I was seen quickly by the high risk OB and the sweetest resident who we met earlier in the week. Her family immigrated to the U.S. when she was a teenager and they live very close to TOIAW's parents. First, they did the speculum exam which showed a closed cervix with no pressure on the stitch followed by a manual exam that confirmed no dilation. Then they performed an ultrasound that showed me open to the stitch but not beyond it. The doctor explained that a manual exam is far more telling at this point and she proclaimed me "stable."

Then we waited for an hour or two for my discharge paperwork during which time I slept and TOIAW did homework. We made it home and I slept some more while he did homework. Our neighbors hosted a party that began around 4:00. TOIAW went to get my mom at the airport and we all went to sleep to the sounds of the drunk revelers next door. It was so much better than the day I thought I was going to have!

The remainder of the week was uneventful with me getting plenty of time in bed and my mom taking care of everything. My main project has been following up on a home health care aide. Our insurance has approved it but the woman who handles the referrals has not been able to find a company willing to do the work (light housekeeping, cooking, shopping, laundry, etc.) so that's still not settled.

The big event of the week was my appointment yesterday. I absolutely dreaded it! By the time we arrive I was sick, as per usual. I was dry heaving as I signed in and of course I had to pee but you can't ever "just" pee at the OB's office so I had to complete the 14 steps necessary to give my sample and somehow with the nerves, nausea, and smells it didn't turn out so good but, whatever, I'm used to it. Thankfully I had a short wait and the cervical check showed I'm still funneled to the stitch but not beyond. I was hoping for a miracle, but I'll take it. The nurse had just started to look at the baby when the doctor came in. He proclaimed the baby to be in a bad position to see her heart and brain so we left it at that and began to chat.

The first thing we discussed was the results of the manual exam. He dismissed the findings of the manual exam saying they were skewed because of the cerclage. I'm going to chalk that up to a difference in medical opinion. He was open about the fact that he can trend towards the negative but I get that because I know he's trying to be realistic with us. On the other hand, he admits that we know a lot more about this than some people and he feels we are realistic as well so he said he also wanted to talk to us about his plan should I make it another 4 weeks. At that point, he will admit me to the hospital for the duration of my pregnancy (or until I make it a lot further along) and the decision we have to make is do we want to resuscitate before 25 weeks (after which it is the hospital's policy to do it no matter what). This decision will be the determining factor in then deciding when I will receive steroids to aid in lung development and hopefully help prevent brain hemorrhaging as well. If you will remember, Sarah had a massive brain bleed that likely would have greatly influenced her quality of life. It's a lot to consider but at least this week I wasn't the patient who left the office in tears.

Today I'm going to email one of Sarah's neonatologists because TOIAW and I both feel like we need to talk to someone with his perspective. He's awesome and we really respect his opinion.

And just to touch on a few things that have been raised in the comments (and, by the way, I am thankful for every single kind word, prayer, and piece of advice), the reason we are not opting for hospital bed rest at this time is we don't really feel it would make a difference this early. Also, so far, I haven't experienced any [noticeable] contractions so as long as my uterus stays relaxed, my cervix--with the help of the cerclage--stays closed. The medications you are typically given in the hospital are to stop contractions but, again, I'm not there yet. Additionally, many doctors now feel that these medications should be used sparingly as the body develops a resistance to them over time and they are most useful when trying to stave off labor until steroids have had a chance to become effective. So that's where we are on that. Expect my attitude to change dramatically if I start to contract.

Thanks again for all your love and support. It really helps keep me going!

Friday, October 1, 2010

Not Well At All

Just a little background before I copy and paste an email update I sent my friends...things haven't been great but they haven't been horrible either. At my appointment last Friday I was once again open to the stitch but my doctor didn't seem too concerned because he had seen it like that before. My cervix measured 1.89 cm. On Sunday and Monday I had some cramping and when it didn't go away I called and was sent to L&D triage. The same doctor I had seen the week before did an ultrasound and speculum exam and he said everything looked the same (not open beyond the stitch, no pressure on the stitch) as it had so he didn't think there was cause for concern regarding the cramping and he measured my cervix at 2.2 cm. The following is what happened today...and my emotional ramblings to along with it:


Just kidding, Blogger won't let me copy and paste or I'm doing something wrong and I don't feel like messing with it so the short version is at my appointment today I am opening beyond the stitch and am likely 1 cm dilated. This has been a quick progression and things don't look good. Also, I'm beginning to have increased discharge which is likely a sign of labor. I'm 19w1d today and nothing can be done now in terms of medication or other interventions. I called my previous MFM in Oklahoma and he said he would follow the same course in terms of home bed rest and progesterone shots and he also said the situation is not without hope.

My MFM here was very sweet today which helped a little, I guess. I know he and his staff care a great deal and I do still feel like we're all doing everything we can at this juncture. We're just praying for a lot more time or God's grace and mercy...or both.