Monday, May 18, 2009

Noah and Mina's Story-The Cerclage-Open content warning

Ok, so we got through the first trimester in the last post. I must admit at this point we were all unsure whether or not this pregnancy would make it. The major bleed that I had at 12 weeks was continuing. No doctor would do a cerclage while the woman is bleeding. A cerclage is a purse string style stitch through the cervix that is pulled tight to keep the cervix from being able to dilate. If a woman is bleeding, there is a big chance she is miscarrying and the cervix will need to be open in order for her to do so. I was told that a cerclage would have to wait until the bleeding stopped.

This news was devastating because we knew I could not carry the pregnancy without the cerclage. The problem is that the further along you do a cerclage, the higher the risk of losing the pregnancy because of complications from the procedure. The optimal time is between 12 and 13 weeks. They won't do it earlier because most miscarriages occur in the first trimester. Any later and complications occur such as your water being broken during the surgery and causing you to lose the pregnancy because of the procedure being do to save it. My scheduled cerclage was put on hold and that was scary.

We had known that I would do bed rest in the last trimester. However, with the loss of blood and no end in sight, my OB put me on strict bedrest effective immediatly. I could lay in bed or on the couch, but that was it. I was alloted a 10 minute shower every other day, and allowed to microwave meals. That was it. After a week of bedrest the bleeding began to slow. It took three weeks, but it finally stopped. Finally at 15 weeks and 3 days the cerclage could be put in.

It was a nerve wracking day. The risks to the babies had been put to me in a open, but terrifying format. I was so afraid that the cerclage would hurt them and I would lose my babies that day. I was not ready to say goodbye. Also, the would be giving me an epidural for the procedure which was just daunting. An epidural when you are in massive pain from labor does not sound that bad, but getting one when you feel totally fine just seemed more scary.

I was prepped for the OR. Apparently not a lot of these procedures are done each year as this condition only affects 1% of women. This made me the freak of the day and everyone wanted to see this. I had interns, nurses, residents, and other OB's that wanted to watch this procedure. When I agreed to let them observe, I had no idea what I was going to be allowing them to see.

I was wheeled back for the procedure and Jake was left to worry in the hallway. The epidural was given-Owww!!!! and I was laid on the table. Once it was established that I was numb, my legs were strapped into stirrups that were hanging from the ceiling and spread wider that I have ever been able to do without an epidural.

At this point I am flat on my back with my legs open for what felt like the whole world to see. I remember hoping I did not have any underwear fuzzies anywhere embarrasing. Then the nurse takes the cover off the tools that they would be using. It looked like midevil torture devises. There was one tool in paticular that looked like a hooked spatula with a metal ball on the end. I made the mistake of asking what it was for and I was told it was a weighted speculum. Basically they insert the hook part into your vagina and the weighted metal ball pulls down opening you up for the doctor to get in there. I thought that's it, I will never be the same after this and felt a little sick to my stomach. After that I did not ask any more questions.

The instruments were in place and the procedure began. I held my breath the whole time, praying that my water would not be broken. At one point I heard dripping, but was reassured that it was just blood. I have never been so relieved to be told "Don't worry, you are just bleeding.". After the longest 30 minutes, they announced that it was done. A sonogram maching was brought over to make sure the babies heartbeats were still good. They were. I was wheeled back to a pale Jake to begin recovery.

Not begin the part where the epidural wears off. I began to have the worst itching imaginable, but I couldn't feel the scratching. So I would itch, I would scratch and no relief. Then I began to have terrible cramping, but I was told this was normal. After several hours I was told everything was fine and released to go home back on bedrest. I was not totally out of the woods because of infection causing labor, or the stitch being broken, but the babies were as close to lockdown as they could get. Next time..more about the second trimester.