My Cerclage

In September 2005, I was pregnant with twin girls. I lost my pregnancy at 19 weeks apparently due to my "incompetent cervix." I became pregnant again and wrote all about it on this blog. I now have a wonderful son. Since bed rest, anxiety and cerclage were so much fun, I've decided to do it all again.....

Friday, April 28, 2006

Other Material I Shouldn't Read

I was basking on the back porch reading this week's New Yorker--don’t you love how I throw out this highbrow publication as if I am reading this stuff all the time? I manage to forget to mention the cheesy mystery with large gold letters and red cover that I really can't put down. But that's not the point. The point is, I was reading The New Yorker!

In this week’s New Yorker, I was grabbed by a title in the Personal History section which included a birth and death date 4 days apart. Looking closer, I saw that the death date preceded the birth date. Oh, no. My stomach physically sort of tightened, but of course, I read. This is a story by Daniel Raeburn (a writer who I've never heard of) about the stillbirth of his daughter. It was heartbreaking and achingly familiar, and yet, it didn't reach me totally. But maybe that is because I am not trying to read about baby tragedy right now.

In the past this is the kind of thing I would eat up. I mean that in a good way--in the past it would inspire me to feel less alone, that there are others like me struggling with the same thing. But now, pregnant again, I ended up feeling more afraid than anything else. His wife was 8 months pregnant when their daughter died in utero for apparently no reason. In reading that, the creeping sensation of fear that we are never out of the woods for this pregnancy became a bit overwhelming. And yet, getting to 36 weeks is a time I tell myself that we should, theoretically, be home free.

Maybe I should not have read it, but my heart breaks for this author and his wife, and maybe because he needed to write it, I am glad I read it. That said, in general, I think it's a good rule that during my high-risk pregnancy after a loss like we experienced, reading about losses is not so good for my general Zen (don’t laugh, can't you tell I am Zen?) pregnancy state.

The Outside World

This week I have had the pleasure of three outings! Well, the last one is still to come, but you get the idea. And they are all sanctioned because they are all trips to the hospital. On Monday we had the cervix check, a regular OB appointment on Thursday (all appears well if measuring your belly and listening to a heartbeat is the criteria for "good job") and today, this afternoon, I get to go to put myself on a monitor and check if I am having any contractions.

This last one is a little different. But, I told my doctor that there are times I have pulls, stretches and weird feelings in the abdomen and as far as I know they're not contractions, but how do I recognize them again? I think she is simply sick of me asking that question every time I see her. So she decided to just have me come in and find out if I am having any contractions without my knowing. Usually this is the kind of thing that would make me go batty with worry and wonder, but I am too excited about the open window on the drive over to care.

The nice part about these outings, aside from seeing my stranger friends in the outside world, is that I can usually get my fretting husband to add a little something to the excursion. Like a trip to a cafe or mellow restaurant. I mean, the stairs to the car were already walked, so....might as well take advantage, yes?

Tuesday, April 25, 2006

6 Things You Don't Know About Me

I’ve been tagged by Becci from Bedrest and Beyond. I am supposed to write 6 things about myself that you don’t know. This is a hard task because there are a few people who read this thing who know an awful lot about me. I guess I’ll just do the best I can assuming that most people who read this don’t know much.

1. I hate toothpaste.

That sounds gross, right? Because it suggests that I don’t brush my teeth? I do brush my teeth, and I like how it feels afterwards. I brush at least twice, sometimes 3 times a day.

There are two levels to my toothpaste hatred.

Level 1 is unused toothpaste issues. I will gag upon viewing a tube of toothpaste that has any toothpaste crud on the sides or around the opening. It is so nasty and disgusting, especially if it is not mine. And I really don’t like using other people’s toothpaste if I can avoid it. I am a slob in other areas of my life. In fact, my old roommate (who I know reads this) is probably nodding vehemently about my slobbiness. Oddly, I am rather OCD about the cleanliness and neatness of my toothpaste.

Level 2 is the actual foam. There is nothing grosser than watching people brush their teeth in movies and on TV. Sometimes they have the gall to add a love scene to toothpaste brushing where people actually make out with the nasty foam in both mouths!! Ew! Seeing this makes me hide my eyes while screeching as others do in horror movies. My husband can get me scurrying out of a room by leaving toothpaste on his face. Toothpaste is a necessary evil, but that is all it is. I hate it. It is totally disgusting.

2. I ran the NYC Marathon 2 months after September 11th and it was really inspiring.

Wow. Was that 5 years ago? Damn, it’s been a while. You have to understand that living in NYC during September 11th and the months after was extremely intense. I mean people breaking down regularly on the street intense, missing person posters in the subway intense, makeshift shrines all over town and at all the fire houses intense and smelling the rubble in my Brooklyn apartment when the wind was blowing East intense. So, you can imagine the endurance test of training for a marathon, plus New York at that time making the marathon quite an experience.

3 important memories: 1) A fireman who was running in honor of his fallen colleagues. He wore a t-shirt listing their many names and some sort of “We will never forget” logo. In fact, he was one of many runners I saw that day running in memory of one or many that made my heart ache. 2) Running by a firehouse where the guys were cheering me (and the other runners, I guess) on. I just wanted to hug every big burly handsome one of them and thank them thank them thank them for all they sacrificed. 3) Crossing the finish line to experience some wonderful New Yorky New Yorker medal me while yelling “you just ran the New York City Marathon! You ran a marathon in the greatest city in the world!” At which point, with the preparation finally realized and the September 11 emotion, I LOST it. I mean big sobby sobs as I limped away from the dude, who I think was still yelling at me.

It is my goal after this pregnancy is over to run another marathon.

3. I worked at Planned Parenthood while my husband was in law school and when his law school friends talked about abortion policy, I got really annoyed.

It’s not that I disagreed with them, and they talked about it thoughtfully. It’s just that they were so emphatic about their intellectual opinions, and their right to them without ever having set foot in an abortion clinic. Actually, not entirely true; at least one of them had been to an abortion clinic:)

4. I have 4 brothers and one of them is moving to Switzerland.

It’s true. I grew up in a big old Irish-Catholic family the only girl in a Catholic/Protestant suburb of NY. It’s sort of funny I ended up marrying a NYC Jew who is an only child. Needless to say, my home town doesn’t always feel super welcoming to him. ANYWAY, right now I am quite sad that my big brother who lives down the road in Santa Cruz is moving to Switzerland and leaving me the only pioneering West coaster in my family!

5. I think Tom Cruise is a good actor.

Hold your horses! Stop moaning! I know! I know! Believe me; I feel the same way about TomKat as you. Probably even more so because I am social worker and have seen what happens to my clients without their medication. It is more than irresponsible to suggest that psychotropic medicine is unnecessary (and with my own diagnostic skills, I admit to thinking Tom has a touch of Mania). I know we all want to hate him, but I don’t care. I think he is a good actor, and further more, Jerry Maguire is a better movie than you think! There. I said it.

Five Tom Cruise movies with good performances: Collateral, Born on the 4th of July, Rain Man, Magnolia and yes, Jerry Maguire.

6. My due date is also my 33rd Birthday.

Monday, April 24, 2006

The Power of the Ultrasound Tech

I was feeling extremely nervous about cervix check today because although the numbers were very close, it seemed my cervix was getting shorter in our last few ultrasounds. When my freakish anxiety gets going I play all sorts of games in my head about the pattern and the direction of things and ohmygosh I am only 22 weeks and all can go down hill really fast and was that a contraction?

So when I walked in today, I was more afraid of the funnel than ever. To make matters worse, the sonographer was HER! It was the same one I will never, ever forget. The one who performed the 19 week ultrasound last pregnancy that sent us straight to L&D for the emergency cerclage that never happened. It was her. And today I was in no mood for anything that could be perceived as a bad sign. Have I mentioned I already was in a near tizzy over...nothing?

The best case scenario in this pregnancy is that all this worry is without any need. I hope I put myself through all of this anguish when everything is just fine and dandy the whole time. I really hope I am overreacting at every worried turn. Yes, I will feel a little hard on myself for not being more relaxed, or having better faith in the cervix, my body and the little guy, but whatever. A few nights of worry are no match for a healthy baby boy.

I am happy to say that she redeemed herself today, she surely did. She measured the loved cervix at 3.8cm long and fully closed. I guess she doesn’t have the power to ruin my life like I thought!

Friday, April 21, 2006

I Still Love my Cervix...

I still go to the message board every day. I go multiple times a day. I even posted a reply to someone as if I am suddenly the know-it-all in the incompetent cervix world (but really? Are you really wondering whether you should call your doctor if you are spotting?!) It still makes me anxious, but what can I say, misery loves company and these are the people who whose boat I am sitting in.

The baby is still inside, becoming very active and everyday gets us one day closer to that 28 week mark where, maybe I can exhale (babies born at 28 weeks, while still considered very pre-mature, have a high likely of survival with minimal complications. We don't want a 28 weeker, but what we really don't want is a 24 weeker).

Still, it's amazing how you can always find something to be terrified about (if you're me). The Peri originally told us that 16-22 weeks is the risk period in that most people with incompetent cervix tend to have symptoms during that time. So, here we are at 22 weeks, long and closed, and I wonder, can I relax at all? Apparently not. Once I (hopefully) hit 24 weeks, it is all about pre-term labor and avoiding that. There are so many reasons it's a risk factor, it's boring.

Suffice to say, positive thoughts and bedrest is my game plan for the next 6 long weeks. It's what I got and I’m sticking with it, sore butt and all.

I love you cervix! I love you! That's right, YOU!

Wednesday, April 19, 2006

I Love my Cervix and I am Keeping It

What is an incompetent cervix to do in this situation but chose to change its mind and act competently? When I spoke to the doctor, she made it clear that there is nothing to do but what I am already doing. We will have no new cerclage because the process alone can start another process, which I am desperately trying to avoid--pre-term labor (isn't everything in this horribly complicated pregnancy about avoiding PTL?). Has the stitch actually torn, lowered, "walked down the cervix"? It’s hard to tell from ultrasound, but my doctor doesn't really care because, as she put it, "the stitches could be hanging off the end of your cervix and I still would not recommend another cerclage." No, ladies and gentleman, bedrest, my old friend, is my only hope. Actually, bedrest and that my cervix continues to behave itself. And, it turns out that we have a fairly good prognosis for a behaving cervix. I will not have another surgery.

What I will do is vent about some of my well-meaning friends in the on-line world. I made the mistake of posting a question about my diagnosis on an on-line forum about incompetent cervix.

I know that if you are diagnosed with this it is scary and upsetting and that pregnancy is an endurance test of anxiety, close calls, bedrest and all the other emotional and physical ups and downs. Believe me I know. I acknowledge even reading my question back I could see how people have that sense of "this one doesn't sound too good" and maybe a guilty "glad it isn't me" response. A lot of women on these sites have lost pregnancies around this time (22 weeks), and I am sure the idea that their stitch wouldn’t hold is a terrible notion to even consider. For many of us, the stitch feels like your only hope you won't have another loss. That said, this is the situation I am in and I need to figure out how to be okay with it.

After hearing all the risks of another cerclage placement, when the cervix is doing great on its own, I wouldn't want to try going through the process of a new cerclage. Not to mention that I have now spoken to 3 perinatologists who agree that it is a mistake at this late stage. I feel good about these professionals, it’s not like I am living in the middle of nowhere. This is San Francisco for godsake (forgive snobby tone; I am in the middle of a vent).

The point is, I made the mistake of posting this question about stitch situation, and I got back a bunch of "I am very worried for you and your baby" type replies. ONE woman said something positive about how great it is that I am nearly 22 weeks without changes and nearly 4cm long. She also mentioned other women on the site whose stitches tore and who are doing well (one actually being induced today). I single out this one nice lady and sincerely say, thank you. Everyone else just made me feel alarmed and worse.

I posted for support, received all these negative responses, and then cried big tears all evening while I tried to figure out how I might handle another loss. Then, the next day, more research, which led to more reassurance and I was in a good space (did you know it is very rare for this to happen with a singleton after twins? Also, the danger period tends to be from 16-22 weeks. No funneling yet is a good, good sign).

I have decided to take a break from these forums while I am in the scary zone since, so far, they feeling they inspire is dread that I won’t make it another day. The problem is that they sort of call to me while I am online lying around all day. It's like a morbid curiosity. I don't want to look at a car accident when I drive by, but I just can't help myself. I know it will make me feel bad and scared to hear about losses and complications, but I can't help going to these message boards.

Ah yes. This is a day in the life of an incompetent cervix.

Monday, April 17, 2006

Sigh....

The good news, and this is very good news, is that the cervix remains in very good shape. The stitches do not need to be doing any work. I am measuring around the 4cm mark, and cervix is still closed. Not even a hint of a funnel.

This cervix news is a good thing, because, apparently, my stitches are useless. Yup, that's right. The good stitch is making its way into bad stitch territory—it’s slipping, or tearing, or whatever. So now I have two useless stitches. The ultrasound doctor was going over how great my cervix is behaving when he casually pointed out the stitches and noted, "yeah, that one looks pretty superficial too." Wait. What?

He didn't seem terribly concerned since I am doing so well, but, I remember being diagnosed with this horribly named thing called incompetent cervix. So, I don’t have so much faith in myself to do this on my own. You know, evidenced by when I lost my baby girls??? Even knowing the most important part, that my cervix is doing really well, I am totally, anxiously counting the days again. I mean, the whole point of this stupid cerclage is so I can have piece of mind that if things go bad, I have this nice little safety net. What now? No net? WTF??

Saturday, April 15, 2006

Fatso

It turns out I am a bit of a fatso. At my doctor's appointment on Friday, I found out I had gained nearly 10 lbs since my last appointment--two weeks earlier!! For those who don't know, you are supposed to gain a pound a week. Not 5! I had lost a lot of weight in my first trimester (apparently, my doctor told me it is not unusual to loose weight when first on bed rest) so, she pointed out that I am still "within normal range" for weight gain despite my rapid increase, but also observed it is "a big jump." She also decided to notice some, "guilty looks" as my husband and I exchanged knowing glances.

Okay, I admit I recently noted an older version of that face I had my freshman year of college. I know some of you know it! People talk about the freshman 15; I gained the freshman...25. So, I admit that I was looking in the mirror lately, thinking, oh shit, it's that fat girl I haven't seen in nearly 15 years.

But c’mon! I love to eat. This is why I am so active in my regular life. I am proudly a girl who eats, and I am healthy and active to boot. I like my pasta and damn if I am ever going to give it up. The reason I am not usually totally fat is because I exercise. And obviously, there are no calories being burned in this house now. I just can’t help feeling with all the other deprivation, puuulleeeassse do not pull the plug on the Oreos! And the ice cream! And the chocolate! I need my daily dose!

The truth is I did notice I was overdoing it with the sweets. I did notice that I wasn't being as great about my fruits and vegetables, and I have felt a little crappier as a result. In fact, the honest to goodness truth is that I was about to make some changes myself. Really! This is how I know I am somewhat healthy in my regular life; I like the fruit, especially when it hasn't made an appearance in a while. But now that it is coming from the doctor? Now that she is the one confirming that I need to gain a little less rapidly? Now it is just another part of my prison sentence, and my husband, formerly known as “loving supportive guy,” is now known as "my captor." He isn't down with the excuse that I need the Oreos! And, as my captor, if he doesn’t buy them, I don’t get them!

Wednesday, April 12, 2006

Rain is a Shame

The good news is that my weekly cervix check went well. The cervix still remains near 4 cm, with no funneling! I will hope and hope and hope it stays that way until after 36 weeks when we get to take the stitches out. Tomorrow I hit 21 weeks. I thought 19 would feel like the longest week, but so far it is 20. Maybe I thought that if I got through 19, things would just start to move faster. It was such a huge milestone in my mind. Turns out that gearing up for 19 must have left me without much emotional strength for uh...the other half of the pregnancy? So, I had a rude awakening during this last week. This just isn't close to being over. And you know what doesn’t help? The damn rain here in Northern California.

We are having this record breaking rainy season here. First of all, I acknowledge I am about to totally contradict a previous post where I relished in the fact that the rain was forcing the rest of the population indoors too. But, times change and pregnant lady’s feeling about the rain change too. I am so SICK of the F------- RAIN! I lived in Seattle for a while (4 years!), and I moved to California for a reason. The reason I moved is that Seattle is depressing. Seattle is depressing because it is rainy and gross too much.

I do this thing now (warning: This is somewhat pathetic) where when I drink my morning coffee as I take one of my "allowed to sit in a chair mealtimes." I sit on my front step to watch people walk by. This is a funny thing to do because we have a really nice back porch, with nice comfy chairs, but there are no people there. So, I sit on the step, hurting my butt so I can breathe in the outside, drink my coffee and literally get excited by all the action. This little saving grace during my day just cannot happen without the sun shining on my face. It is pathetic that this ritual is my version of taking a long walk or run, but it is what it is. But how, I ask, how can I have this needed reprise when it is pounding down rain all day every day? HOW?

Sunday, April 09, 2006

Bad! Online Shopping is Bad!

I never was really one to shop online. I am actually not much of a shopper at all. I hate trying on clothes, dealing with stores, sales associates and the time out it takes from doing other things. I inevitably feel badly about my body or that I don't have enough nice shoes/make-up/skin products to look my best, evidenced, of course by all the products out there begging me to buy them. That is not to say that I don't enjoy new clothes and like it when I feel put together. In fact, I often feel that I'd be better off if I made a bit more effort. I wouldn't have that feeling of my "cute" shirts being two years old, and somehow feeling slightly off in my outfits based in my limited home selection. I also hate spending the money. The point is, shopping is not really my thing.

However, while stuck here in bed I decided I needed a few new things because I was having weird feelings about my old maternity clothes from the previous pregnancy. Online shopping seemed the way to go to get a few basics. It started with a pair of Gap maternity jeans. No biggy, right? Then, some t-shirts I know I like from another store (extra long). Then I remembered a baby gift (actually I needed to get two baby gifts for recent parents) and I found that you can find baby gifts online really easily! Presto! While the computer was up, why not a few more books, I was almost out of what I had at home. A quick trip to Amazon and that was done. Okay, oh! Now that I don't go to prenatal yoga, I decided I really needed some props at home. Like my own bolster and yoga blanket. It was so easy to find yoga accessories online! I was in a daze, and seemed to have no plans to slow down as all sorts of things poped into my head that I suddenly needed.

My husband walked in. I was waving my credit card in the air with a wild look in my eye as I concentrated on typing my credit card number on some web site. He looked at me curiously, "what's going on?" I was uncertain. I was ashamed. I said in a small voice, "I did a little shopping today." I confessed to everything. He laughed at me, nice guy that he is. He took it in stride (truth is, he knows we are spending a lot less with me home in bed—even though my disability only pays me 60% of my salary—and he wants me to feel there are areas I am NOT deprived) I laughed, uncertainly, at myself. Who was that crazy shopper?

Here's the thing. I know that maybe I shouldn't have. But I have to say, since the shopping event? It's like, PRESENTS kept coming for me. They’re dropped off right at my front door. All I am saying is I see why people get addicted to this kind of thing. It is BAD. BAD! Luckily, once out of the trance, I have managed to stay away from those web sites and stuck, mostly, to my email when online.

Tomorrow is cervix check. Let’s hope that all continues to go well. I have a new fear. Since the twins were twins, there was a lot more weight than a single baby at 19 weeks. Even now, at 20 weeks and 3 days, I look less pregnant than I did when I was 19 weeks and pregnant with twins. In fact, I was measuring a month ahead in terms of size (something common with multiples). Therefore, when I lost my pregnancy at 19 weeks, I was actually the size of someone 24 weeks. So now, I think that I need to get to 24 weeks before I can at all feel like maybe we are through some of the danger zone. It’s just like me to find a way to worry! I’ll have to ask my doctor about this issue….

Thursday, April 06, 2006

More Pregnant than Ever

I made it! I am 20 weeks today. This means that I can...well, I can know I am 20 weeks and that I still have a little guy (yes, we know a little man is coming) inside. Nothing else has changed, but I may take my one day a week outing today and go to a restaurant to eat lunch to celebrate! I am feeling lighter. This is represented by my new template, which is obvioulsy, literally, lighter. But I am not counting my chickens. I am just observing that last time I was pregnant it lasted until 19 weeks, and clearly, this time, it is lasting...longer.

Tuesday, April 04, 2006

Poor Husband

My husband is so nice. He works from home, thank god, so he can be my little manservant around the house. He gets me my meals, my coffee (yes, by god, I am still drinking caffeinated coffee--one cup a day--while pregnant and I am fine with it!) and generally takes care of me. The problem is when I know that I want some extra things that are not necessarily needed. For example, I forget my book upstairs. Okay, well, right. A girl needs an activity so he goes and gets it for me . But then, a little while later, I want a cup of tea. It's raining in my city (one of the few times I miss the East coast is when I hear from every family member about how spring is bursting, and yet, my city in California it's just raining) and tea sounds sooo cozy, doesn't it? But do I need it? Do I need to get the nice man up away from his computer again because I have a little craving? One of the most challenging aspects of bedrest is those little comforts that you just can't do for yourself. I only notice what a pain in the ass they are when I see how many times I interrupt my husband to do them for me. And, I have to be honest, more often then not, I decide that I really just CAN'T do without because...I can't! So, I've decided I do have the nicest, patient and most caring husband on the planet whose life is practically as derailed as mine. Poor guy.

Saturday, April 01, 2006

I am a Failure at Bedrest

I am squarely on bedrest doldrums..again. I realize that part of my issue is that I have a conservative doc who appears to believe in bedrest very much. The problem is that I find myself feeling rebellious and second guessing her, because I know not all docs would have me lying about so strictly. I find myself emphatically pronouncing to whoever will listen that there is no real research about bedrest, and really, do people really take in the other costs? At my worst I can even be heard spouting things along the lines of how "these doctors" don't really know what they're talking about--they just have nothing else to offer. Am I really sitting here in the very week I lost my previous pregnancy trying to think of logic to ignore my doctor’s advice, just to be able to enter Starbucks to...what? Interact with strangers?? Yes!! Yes I am! Sigh. I guess I will still wait for the back end to make true my secret fantasy of gorging on sushi while drinking a vat of wine. This fantasy takes place in various settings, none of them home.