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!


Rachel said...

I have been so worried about you! I am glad that your doctor is talking seriously about the options, and it seems like such a good sign at this point that he is talking about things that will happen weeks from now. I cannot believe how hard this pregnancy has been for you already, but we are thinking of you and praying for you.

Tracy said...

Oh, Rachel. I've been reading your updates, but have never seemed to have enough time to reply properly. I am so very scared for you, but am keeping you in my thoughts and prayers. These prayers remind me of the ones I said during my early pregnancy...desperate, pleading. That was such a scary time as I just waited to see if I would make it; if my baby(ies) would make it. (Not sure if you remember, but I had a 4cm separated placenta at 14 weeks.)

I know that this time will crawl by for you...and you will feel such angst as you pray to get just one more day, one more week, one more month under your belt. You hang in there.

Praying. Miracles can and do happen.

N said...

I am so grateful for this post - I've been worried about you, too. I'm glad that this seems, at least, to be a bit more optimistic plan, and I hope hope hope that 25 weeks comes and goes and you won't have to make some of those really hard decisions.

Thinking of you. ♥

MrsH said...

I am so glad to hear you are doing well, as well as can be. Stable is good. Hang in there!

Soapchick said...

Thank you for the update Rachel. I am praying for you every day and night. You are such a strong woman and I hope and pray the next several weeks are filled with good things. I pray that Sarah is using her angel wings to convince God to keep her sister on earth. Stay as relaxed and strong as you are. I'm happy that your mom is there with you.

AKD said...

I have been praying for you every day - I pray that God gives you a healthy little girl, full-term and amazing. I want this to be your miracle.

Hugs and more hugs.

Nick and Kristi said...

Just so stressful:(......I guess all you can do is take it easy and cont to pray for the best....My mom has also been helping me while on Modified Bedrest....and my cervix has stayed the same as far as funneling goes and its still a 3.2cm and closed.....but I dont have a cerclage and Im 20wks so I still have major fears in the back of my mind but Im trying to do what I said to you above....Its really hard to be bed bound...but it will be worth it in the end....Take Care!!

Jennifer L said...

Continued prayers Rachel. For you, your hubby and your sweet little girl.

Kristin said...

Praying hard for you. I hope everything remains stable and you aren't faced with making the tough decisions.

Marianne said...

Here from LFCA...keeping you in my thoughts!!!