Mason's story-The Aftermath Part 5

The day after Thanksgiving was Mason's funeral. We had a dear family friend keep James and Linda because we felt that they were just not emotionally prepared to deal with the funeral of their little brother. We drove to the church, and I wept on the way. I just didn't want to have to do this, I just wanted so badly to close my eyes and have it all go away. We were the first people at the church. Mason's tiny casket was at the front. We went up their and sat in front of it, I wept some more. The lady from the funeral home came over and asked if I would like her to open the casket one last time. I said no. I am not sure why, I think I was just so overwhelmed that I couldn't take anymore. I wish now I would have said yes though and that haunts me sometimes.

We walked up to and placed our hands on his casket. We both prayed silently for Mason and for strength to endure. My family began to arrive. I can't remember what happened after that, the next thing I remember is being seated and the first song we selected began. The song is titled "Cry out to Jesus". It may seem like an odd song for a funeral, but we knew that there would be unsaved people at the funeral and we wanted to show them that even though we were broken, we still had faith. We wanted them to wonder how they could have that too. Later in the story I will not be so strong when tested. There was one line in particular that seemed like it was sang for us. I am not going to type the whole song, just the parts that spoke to us.

For every one whose lost someone they loved
Long before it was their time.
You feel like the days you had were not enough,
when you said goodbye. ....

There is hope for the helpless,
rest for the weary,
and love for the broken heart.

There is grace and forgiveness,
mercy and healing.
He'll meet you wherever you are.
Cry out to Jesus, oh cry out to Jesus.

The first stanza is pretty obvious on why we chose it. The refrain however spoke especially to me. Hope for the helpless, I felt so helpless when they told me what was happening. I knew I was doing everything I could do, and it still wasn't enough.

Rest for the Weary. I was tired in every way a person could be tired. Physically, emotionally, spiritually, and mentally. Every time I closed my eyes, I saw his precious face. In my sleep I had viscous night terrors about the trauma. I was exhausted to a level I have never been to this day.

Love for the broken heart. When something like this happens, you truly feel like you will never be able to be happy again. Love is happiness. You have to allow your broken heart to feel again to be happy.

Grace and forgiveness. Every mother I have ever talked to who has gone through a loss related to IC feels partly, or wholly responsible. It is our jobs to protect our babies, and to have a perfect baby pass away because your body did not do its job leave you with a profound feeling of guilt and failure.

Mercy and healing. I needed to accept God's mercy before I could forgive myself and begin to heal.

He'll meet you wherever you are. Wherever I was. Even if that meant in the pit of depression and anger, God would meet me there all I had to do was Cry out to Jesus. Although it would take months for me to do this, it later becomes an important part of my healing. Something so simple as crying out for my savior changed my life forever, again. More later.

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The TAC

Before I start this post I this post I want to make a few points clear. I am not in the medical field. All of the information I post is based on my own experiences, information from my doctors, and my own private research. It is not intended to be medical advice, nor to replace your own research. It is simply just for the sake of knowledge.

After we lost Mason there was numerous opinions on what route would be best to proceed for us in the event of another pregnancy. My OB that I had at the time we lost Mason was very blunt and said that he felt that if I had a trans-vaginal cerclage I would just break through it and lose another pregnancy. Just as a refresher, the TVC (trans-vaginal cerclage) is a band or a stitch placed at the top of the cervix during the pregnancy through the vagina and is in most cases removed before labor begins. There are many studies on the TVC that show varying success rates from 75-85% for a singleton pregnancy. The rate is even less for twins. There are many possible complications from infection causing pre-term labor to the cervix dilating through the stitch tearing the cervix. This is what my OB was afraid of in my case. He referred me to the fertility clinic that we had used to concieve in for a consult on the TAC(trans-abdominal cerclage).

At the consultation, the Fertility specialist said that they don't usually do a TAC until a TVC has failed. In my case I was so dilated with Mason that a cerclage was not possible. He also stated that he did not feel that I needed to go as extreme as the TAC and referred me on to a perinatologist. The peri I saw happened to be the same specialist that was called in to consult when I was in the hospital with Mason. She is the woman who told me my cervix was too dilated to do an emergency cerclage and held my hand and cried with me when she told me there was nothing that could be done to save Mason.

I went to my appointment with her to gain more information. She is a very by the book person. She told me that she would not do a TAC without having a TVC first except in cases where part of the cervix had been removed for cancer. She went on to tell me that she was not even sure that I had IC, she was wondering if my clotting disorder caused the loss of Mason. I left feeling very frustrated and went home to do my own research.

In case you are wondering what the big deal is about the TAC I will explain it. Basically, it is major abdominal surgery with recovery compared to a c-section. In layman's terms they make an incision and then using a stitch or a band, they permanently attach the bottom of your uterus to your cervix. That way there is essentially no way for the cervix to dilate. For those of you wanting more medical explanation here is a copy of some of my research.

All procedures are performed with the type of abdominal incision decided based upon the size of the uterus and maternal body habitus. The uterus is usually pulled out of the mother's body and maintained moist with warmed saline. The procedure requires removing the bladder from the cervical area while tunnels are created near the uterine artery on each side. A mersilene band (a polyester suture) is placed around the upper portion of the cervix and tied in a square knot tightly enclosing the cervix which is not removed after the pregnancy. Because many fragile uterine veins are in this area, the most common complication is bleeding. Methods of stabilizing this bleeding depend on the situation and anatomy, while avoiding compromise of the supply of blood to the uterus. In recent years, perioperative treatment with indomethacin has been used for a total of 48 hours, as a uterine relaxant. Indomethacin is a drug that belongs to the family of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Indomethacin reduces pain, fever, swelling, and redness.

Prenatal care following the procedure would also include cervical exams every two weeks, careful attention to signs and symptoms of preterm labor (with aggressive use of tocolysis if labor persists) and planned delivery by cesarean as soon after 37 weeks as fetal lung maturity can be documented. Because of the latter intervention tactic, 37 week delivery is considered “term” for the purpose of our follow-up information.

As you can see the TAC means an automatic c-section as the stitch is intended to permanently stay in place. It is usually done before pregnancy, but can be done early in the pregnancy as well. Doctors only like to do it as a last resort because it is such major surgery. It is very frustrating to the women involved because often times the woman has to have multiple losses before a doctor will go to this length.

I did go on to have a twin pregnancy with a TVC and I made it to 35 weeks. They are healthy now, but I also did full bedrest from 11 weeks on and I still was dilated to the stitch at 22 weeks. It almost went south and it has done so for many of my IC sisters.

If you want more information on the TAC here is a link to a yahoo group devoted to it. It is called Abby Loopers and it is a great place for information and support.

http://health.groups.yahoo.com/group/Abbyloopers/

Noah and Mina's Story-3rd Trimester

Finally I reached the third trimester. Everything was still going great and there was an end in sight to the bedrest. I was released from the bedrest at 34 weeks...kind of. I was only allowed one outing a day, and it had to be mostly sitting down. For instance I could go to Wal-Mart, but I had to ride in the little carts. My friends made sure I had a fun. We all went to lunch, to Target, and had a blast. It was also the same week as Thanksgiving so I got to be released in time to cook my very first Thanksgiving meal.

At 35 weeks and 3 days I started feeling a little trickle everytime I would stand up. I called my doctor who advised me to go to the hospital and get checked. I still had the cerclage in. The game plan was that I would have an amniocentisis at 36 weeks to check the babies lung maturity. Then the cerclage would be removed. If the lungs were mature, I would have a c-section that day, if not we would see how far I could go without the stitch. The reason they remove the stitch is because if you go into labor with it in, you can rip through it permantly damaging your cervix.

So I went to the hospital and they did not think my water had broken, but they noted contractions every 2-7 minutes. Since they were not regular though they sent me home to rest. The next day Jake's coworkers threw me a baby shower. I was feeling funky all day long. Really strong contractions and just a feeling of pressure between my hips. The babies had dropped. I came home and took a Benadryl and laid down.

Later that night some men from our church came over to help Jake finish the remodel on our new master bedroom. They completed it and we ordered pizza as a thank you. I was hurting so bad from the contractions that I could not eat. After they left I went and laid back down. My sister-in-law called to check on me and I was hurting too bad to talk. Jake told her I was having really strong Braxton Hicks. She said we should time them because they may not be Braxton Hicks. We timed them with her on the phone and holy cow they were coming every two minutes on the dot. she and Jake convinced me to go to the hospital to get checked out.

So at about 10 o'clock that night we went to the hospital. We were checked in and a monitor was put on. Sure enough it was labor, and pretty advanced labor. Now they were worried because I still had my cerclage, and it was still early to deliver if I didn't have to. They made the decision to try and stop the contractions for the night and let my doctor take out the stitch in the morning.

The next morning they come to take my stitch out. They tell me not to get too excited because a lot of times there will be scar tissue and the women will take days or weeks to dilate. However, since I was already in labor, this might not happen. They thought I would deliver in the next day or two. They use the speculem and cut the stitch. I have put a picture of it above. Then they check to see if I am dilated at all. Holy cupcake I instantly dialted to 4 and was fully effaced. There was no way I was leaving the hospital. They told my husband he could go shower at home since it was likely to be hours before anything happened.

A few minutes later I got real bad contractions so I called the nurse. She checked me again and I am dilated to 7 withing 10 minutes of getting checked the first time. She says I need a c-section now and they start prepping me. I had to call my husband and say turn around, come back! He never did get his shower. Poor guy. Next time..delivery.