Wednesday, April 4, 2012

Me, Myself, and My Incompetent Cervix

On August 3rd, 2011 at 21 weeks pregnant, I was told my cervix was dilating and that I would deliver my daughter prematurely. 10 days later, my cervix was dilated to 10cm, despite bed rest and absolutely no discomfort or pain.

I was told immediately that I had an incompetent cervix. Or, as I heard it, my cervix was a good for nothing deadbeat mother-f-er. They asked me if anyone in my family had ever had this problem. I laughed, um, no. Every single female in my family had very easily had babies. I'd never had an abortion, a LEEP procedure or any "trauma" to my cervix that I was ever aware of. They seemed troubled that there was no explanation, but diagnosed me nonetheless. Of course I began researching what that meant and what I could do in the future.

It was during that 10 days that I first heard of a "cerclage". I'd never heard that word in my life and had no idea what the procedure was. Over the last 6 months I've learned there are a few different versions of this cervical "stitch", but the most common is the McDonald Cerclage. In simple terms, it's a purse string stitch used to cinch my cervix closed so that it will not open prematurely.
On March 31st, I had this procedure performed by my perinatologist. I arrived at the hospital's labor and delivery floor at 730 in the morning. The nurse set me up. I could tell she was either new, or had not participated in many cerclage procedures. She tried for 20 minutes to find my baby's heartbeat with the doppler. After 15, I told her she was making me nervous. So she finally stopped and convinced me it was ok, as the baby was still so small and hard to find. I told her right where my baby was, but she was still unsuccessful.

At 830, my peri walked in and reassured me. When the nurse was gone, he whispered that these nurses were not very experienced with little 13 week babies, and he'd wanted to do an ultrasound anyway. So he did, and there was our baby, moving all around. Probably starving, as I hadn't eaten since 10 the night before. Heartbeat was great.

The Dr. looked at the dead twin's sac, and turned to B and I and said he'd be willing to wait one more week to see if I would miscarry the twin. I looked at him confused and said, "I'd thought you'd told me we were doing this today no matter what?" he nodded and said, that was still his opinion but he wanted to give me the option. I told him I wanted to move forward with the cerclage. I just felt that I would not miscarry and also felt like I wanted this stitch in sooner than later. He said worse case scenario was that I did miscarry the twin and he would then remove the cerclage to allow for that miscarriage and would then put the cerclage in again. I did not like this scenario, and just prayed that we would not have to do that.

At 9am I walked into the "overflow" operating room. The anesthesiologist told me they sometimes did C-sections here but it was mostly used for D&C's and cerclages. It was so cold. I told the nurse I did not want a play-by-play of what the Dr. was doing. I told her my eyes would be closed and I'd be mentally picturing something else and just wanted to disappear from the room. She understood.

I received a spinal epidural. It hurt, but only for 2 seconds. They laid me back and lifted my numb legs into the biggest stirrups I'd ever seen. They put warm blankets on me and soon I could feel nothing. On queue the Dr. walked in, with lots of energy. He got to work and, thankfully did not say much. About one minute in, I turned to the anesthesiologist and told him my face felt numb. He quickly wiped a wet cloth on my face and I told him it felt cold. He then rubbed it on my chest, between my breasts and I told him I could not feel it. I was getting worried as my chest felt heavy and I was feeling nauseous. Before I knew it, the Dr. exclaimed that he was done. I had felt absolutely nothing. They marked the time. It has taken 7 minutes!

They got me cleaned up and lifted my dead legs out of the stirrups. The sight of that was seriously one of the scariest things I'd ever seen. To not feel any sensation and watch your own legs move without your consent was not cool. At that point my nausea was more intense, and I told the nurses and anesthesiologist. They lifted me as best as they could and placed the container on my chest. I was still so numb, I had no reflexes to barf. Such a weird feeling. Finally it all started coming out. It was the darn drink the anesthesiologist had given me to reduce my stomach acid? It was a horrible tasting drink and tasted even worse coming back up. I kept apologizing. I hate getting sick.

I was then wheeled into the recovery room. I recognized the room, as it was the same one B's cousin had recovered in after her c-section with her son. There was not one single soul in the room. I fell asleep for over an hour and when I woke up I could wiggle my toes. A half hour later I was walking and was able to go to the bathroom. I kept asking why no one was in the room? I guess not one person had a c-section that morning. I felt like I had the whole hospital to myself. They wheeled me out and that was it. I was in really high spirits. The Dr. said all had gone well, told me I'd have some spotting and to take it easy, but that I'd probably feel fine the next day. We grabbed some food and drove home. By the time we made it off the freeway, I was hovering over in pain. Just severe discomfort. I couldn't find a position that was comfortable.

The Dr. had written a script for hydracodone but I told B I refused to take a narcotic. He went to CVS anyway and had it filled. He also got some tylenol because I told him I would be willing to take that.

I laid in bed and eventually gave in and took the Tylenol. I slept for several hours, ate dinner, watched a movie and passed out again. My lady parts just felt swollen and odd. Using the rest room was different and once I laid down it was just like very, very low cramping pains.

I woke up the next morning feeling amazingly better. I didn't take any meds again, thankfully. I did sleep a lot that day, but also felt fine being up and around. I took Monday off work, but realized I definitely would have been fine. I felt great on Monday. I had zero spotting until that night, when I noticed a mucousy discharge that was slightly pink. The next day my toilet paper was bright yellow when I wiped. I'm hoping all is well. I've had no more discomfort since the night of the procedure. I can definitely feel like something is inside me, but I'm getting used to it.

I have my follow up on Thursday, and I'm praying that everything looks normal. All I can hope for is that this procedure works for me. I just hope my bastard of a cervix cooperates!

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