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Wednesday, July 28, 2010

Week 13: Cerclage: A Love Story

So yesterday, July 27, was my cervical cerclage. In this procedure, my OB places a purse-string type stitch around the opening of my cervix, to keep the baby from falling out, like my first child did 10 years ago. I'd done too much reading on the subject and of all the Internet articles and posts about this baby-saving procedure, I happened to find the two articles that mention its "effectiveness has recently been called strongly into question," and that it can stimulate miscarriage. So Colby and I have been tense for the past few days.

Colby took me in at 6:15, and I got prepped for my 7:30 surgery. The nurse, who turned out to be my favorite, put in my IV and told me they'd be back to bring the medicine. I asked what medicine, and she said, "The stuff to put you to sleep." Oh dear. I told her I was just getting an epidural, and that I shouldn't be getting any medicine or going to sleep. However, part of me was really excited with the prospect of being asleep for this. Unfortunately, she was mistaken, and I didn't get anything, not even to take the edge off.

She and another nurse tried to Doppler my baby's heartbeat but couldn't quite find it. I told them the doctor had told me it would be hard to find, and because they don't do them every day, they told me they have a hard time with it, anyway.

The anesthesiologist, who will be played by Lucy Liu, came in to explain the epidural to me, and the 1-2% chance I could have of getting a "very severe headache" from it. She was very serious and straightforward and when she said, Colby said, "Comforting."

Because this procedure is done with an epidural and totally awake on my part, I was actually walked into the operating room. The only time you should have to see all that equipment is if you are visiting the set of a hospital drama. Very disconcerting.

Dr. Ong (?) the anesthiologist whose name I think I heard somewhat correctly, had me sit on the edge of the table and hug a pillow with Nurse Cara standing in front of me for support. I was asked to curve my back into a C-shape or like a cat's back, so the vertebrae would separate for the needle to get in there.


Even in physical warmups onstage, I can't do that curve the back thing where the vertebrae unstack. So despite all my very best and most strenuous efforts, I couldn't do it. My neck and shoulders became extraordinarily tense and sore, I broke into a sweat, and I think I might have cried a little. The doctor would stick me and I'd feel weird sensations of achiness down the left side of my back and thigh. I'd gasp or moan and she'd say, sharply, "What is it? Talk to me. What are you feeling?" Freaked me the freak out.

Dr. Dominicis, my OB, was in the room watching this for a while, and I felt bad because my stupid vertebrae were holding things up.

I sang "Solla Sollew" from "Seussical the Musical" in my head all the while, trying to find my Happy Place. Nurse Cara rubbed my shoulders and whispered encouraging things to me. Finally I felt a very bizarre fireburst of white tingly elecricity spread across my left kneecap, and I gasped loudly. She asked me what it was, and I said, "My left knee just exploded!" Then I said, "Oh, my feet are going numb. Both of them. That's a good thing, right?"

She sat me there for a while so the anesthesia would gravitate downward to just my waist down. She said that with Cesarians, they lay you down immediately so your chest is numb, too.

I was so relieved, and the rest of the procedure was smooth. They strapped me into some weird stirrups, strapped my hands down outstretched (a little uncomfortable with an IV in one) and went to work cleaning me off. I could see my own legs splayed out above me in the reflection of the white lighting fixture on the ceiling, but once they covered me up, I couldn't see it anymore.

I closed my eyes and continued to sing "Solla Sollew" in my head. Occasionally I'd feel a weird tug or vibration as the stitch went in and out and I'd make a face, anticipating pain. Dr. Ong asked if I was OK, and I explained I just make faces. She chuckled and said, "Just let me know if you feel pain." I said, "Oh, trust me, I will."

The procedure was over before I knew it, with no miscarriage. Dr. Dominicis asked if there was a Doppler in the OR, because the nurses have a hard time finding the heartbeat in Recovery. The nurse said she could go get it, but I think he said not to worry about it. He had places to go, I'm sure, but I was a litle disappointed.

The nurses stuck a pad between my legs for any residual blood.The doctor asked if I had any questions and I asked how many days is normal for bleeding. He said, "At least 3 days is normal." I had a couple similar questions and after he left, Dr. Ong said, "I think you were asking, 'at what point should I become scared?' I don't think he got that." I loved that she showed such understanding.

The nurses had to lift me onto the gurnee to take me to Recovery because I had zero feeling or mobility in my lower half. I hope I will one day get to play a paralysis victim, because I know how it feels now. I have new understanding and sympathy.

I spent about an hour or more in Phase 1 Recovery, listening to a variety of people wake up in confused disorientation from their surgeries (lucky bitches). One girl, Jenna, was saying she had a Spanish final the next day, and didn't understand why she was so weepy. The nurses said, "The medication does that," but i wanted to lean over past the curtain, take her hand and say, "Sweetie, you're feeling disoriented, small, vulnerable, scared, relieved, and you want your mommy. And so am I."

Eventually I was able to move my knees a bit and lift my hips off the table, so they moved me to Phase 2 Recovery, where I got ginger ale (but no snack) and they brought Colby in.

Colby read me the letters he's written to Baby, and he made me cry. He's going to be a wonderful daddy.

Eventually I had to pee, but didn't think I'd be able to due to the numbness down below. But the nurses said we could try. They wheeled my recliner to the restroom and helped me stand and use a walker. I was very shaky and said, "I'm getting a taste of what 85 will feel like."

They sat me down but I wasn't even aware if I was sitting on the toilet. They assured me I was, and they waited. I asked if they could please step outside and I'd call them when I was finished. Unfortunately, it was a no-go, which didn't surprise me so they took me back to try again later.

After about 45 minutes the numbness was wearing off slowly but the pain around my cervix and pelvis was increasing. Like, really bad. I asked the nurse if this was from the surgery or the having to pee, and she said it could be both. We tried again, but I could barely stand or sit upright, I was in so much agony.

I got back to the room and the nurse said she'd see if the doctor would allow a catheter. I was writhing and sweating on the recliner and poor Colby was trying to be encouraging and asking if he could do anything .I told him he needed to just sit there and not talk. Then I apologized for being so snippy and mean. He just laughed and said, "if you think that was mean, then no wonder you sometimes think I'm yelling at you."

The order was approved and I was taken back to Recovery 1, where my favorite nurse greeted me with a hug and an "Awww!" The cath was a little big and so they had to get a smaller one, and after a lot of effort, it went in. And the relief was instantaneous.

I filled up the whole container, 700 mL worth. "No wonder you were in such pain!" they said.

When I was wheeled back, the nurses didn't exactly applaud me, but it was kind of the same thing.

After that I was a smiling, giggling little girl again. Dr. Ong had been the doctor to approve the catheter, and she actually took the time to come see me and ask if I was doing OK. She asked Colby if he'd gotten anything to eat (he had) and if I had (I had not). She asked if I wanted cookies, crackers, or graham crackers ("daycare snacks," she called them) and I said, "Whatever is handiest." She came back with an armload of snacks for me, which she placed on my lap, as well as a fresh ginger ale.

Even Colby was impressed, especially that she'd asked if he'd had anything to eat. "Now that's caring," he said. The fact that she was so serious and no-nonsense made it all the more touching.

Anyway, an hour later I was ready to pee again, and was very scared, but a quick feel down below revealed some feeling, so I had higher hopes. And this time there was success! I was even able to walk almost unassisted. The nurses teased me about not liking an audience, and gave me my privacy. I peed like Seabiscuit ("Juno") and they brought me a fresh pad, and my pants, so I wouldn't have to continue holding it between my thighs.

I was wheeled back for the rest of my clothes, Colby signed some papers, and was sent out for his car at 2:30. And they gave me some chicken noodle soup on the way out, which I thought was a cute touch.

Anyway, now I have to call the doctor to find out how much bed rest i should be involved in. Lying down is making my back hurt. My epidural spot is really hurting, and my thighs are also sore. Bed rest for half a day was really awful, and I was sitting up for much of it. I can't imagine full bed rest for months and months.

This kid better freakin' appreciate this! :)

Thursday, July 22, 2010

Week 12: Limebaby!

So after nearly 20 years of being a potentially child-bearing grown-up, and 10 years after my only other pregnancy, I discovered, on June 22, that I was With Child. Not having been blessed with a clockwork-like reproductive system, it might have taken me a while to make this discovery, were it not for the Prometrium I'd been taking every month. In May I had a very light, short feminine experience (I thought I might be going through The Change) that I kind of enjoyed. In June, I started spotting but even the Prometrium didn't kick my uterus into gear.

The OB nurse suggested I get my TSH tested again because I admitted I hadn't been taking my thryoid meds. This also explained the fatigue and weight gain, I thought. As an after thought she suggested taking a pregnancy test, just to rule that out.

Now, I've taken more pregnancy tests in my life than I can count, and I always keep a stock of several on hand. I've seen so many single lines on pee sticks, I don't even watch the line progression excitedly anymore.

But this time, something told me to keep an eye on this one. I'd been commenting to my boyfriend that he needed to "mind the baby" and "be careful not to punch me in the unborn child." And I kept feeling my fat stomach to see if it was hardening or not. That was the first sign I'd noticed when I was pregnant 10 years ago, although I didn't realize it was a symptom (and I didn't realize I was pregnant until my cervix proved itself incompetent. Stupid, murderous cervix).

As of today, I am 12 weeks along. My baby, according to the baby sites, is the size of a lime, and will squirm if I poke myself in the uterus.

I have been in a theatre production that opened last week, and my costume only barely fit by last Sunday's performance. It sort of fit during dress rehearsals. I have serious doubts my jacket will meet in the middle tomorrow through Sunday. So that would be interesting.

I haven't announced my new mommy-to-be status to the world yet, because I am having a cerclage next week, so I want to wait and see how that goes.

I'm a little scared of the risks and what the next few months hold. Will it hurt? How long until I can return to work? Will the doctor recommend bed rest? What if the stitch doesn't hold? What if I'm meant to miscarry but the cerclage prevents that from happening?

Plus, I'm 40, so, all the potential babyhealth problems are top of mind. Do I get amniocentesis? Will that hurt? Will it harm the baby? What if we get a false negative (or positive) result?

And then there are the money/care/work issues.... and my family is so far away....

My plan for now is to use The Secret and just think positively. And to pray, pray, pray. And eat more vegetables.