I started a reply to Monica in the comments of my last post, but then it got so long that I decided that I better just post it here.
I didn't have a TAC (transabdominal cerclage), I had a vaginal (McDonald) cerclage. This is my first pregnancy after my IC loss, and all of the high-risk specialists that have reviewed my charts have agreed that I am a good candidate for this type of cerclage.
In my links list I have a link to a new IC forum (under IC Support) and there is a spot on there all about TACs, so that may be a good place to go for information/personal experiences with them. I have found this to be a pretty good forum. It is active and it represents a wide variety of IC experiences.
Physically I'm feeling pretty good. I tried to pay attention to all of the different twinges, aches, etc. before my cerclage was placed, so I could have a bit of a clue what might be "normal" for me and what might be due to the cerclage. I still find myself obsessing over anything that doesn't feel quite right, though. I find that I tend to have good days and bad days. Some days I feel more confident, like everything is going well. On the bad days I feel like everything is on the verge of falling apart. It can be set off by something physical--like a back ache that really is muscle soreness, cramps that turn out to be gastrointestinal, or a bit of extra discharge--or it can be set off by something psychological or emotional. Hopefully as the days go by I will have more good days than bad days. This was true as I got through the first trimester--then the surgery kind of threw me into a new kind of turmoil. I went from fearing miscarriage to fearing PTL.
I feel so fortunate to have the information that I've learned through the two and a half years prior to getting pregnant again. Without it I know that I wouldn't have been the advocate for myself and this baby that I have been able to be. A lot of what I have learned has been from women I *met* through the Stillbirth board on iVillage and through the world of deadbaby momma bloggers. My doctors know that I am well informed, too. I've come at them with so many questions that I don't think they get very often.
Here are some things that I might not be doing/wouldn't know about/might not be taking as seriously if I had only relied on the advice of my doctors:
*I might not have pushed to have the surgery earlier. Yes, my loss was "later" at 22 weeks, but it is still better to get the cerclage in as early as possible to allow for healing and to avoid possible complications due to contractions. I would advise anyone who had an earlier loss than I did to push for as early as 11 weeks.
*My doctors have been agreeable to my suggestions and have altered my care accordingly. If they hadn't, I wouldn't have hesitated to find a doctor that would listen to me and take me seriously.
*Even though my OB really downplayed the impact the cerclage placement would have on me (he said I'd be up and about in just a couple of days and that I would probably only feel some cramping) I knew to expect a wide range of possibilities of how my recovery might go. One woman on a message board who has had 4 (successful) cerclages told me that each time her experience was different and that with two of the surgeries she needed up to a week to feel like she could be up and about.
*I am avoiding some things that both of my doctors have said are "probably fine," like baths and sex; my OB said that I don't really need to alter my activity level, aside from not lifting anything heavy, while my Peri said he'd like me to take it easy and put my feet up as much as possible--I'm following what the Peri says.
*I have made it clear that I think it is important to monitor for infections. My OB has already taken cultures once and I do believe that it is because of my encouragement. The research may not (currently) be able to prove a causal link to infections and cervical changes, but my feeling is that it is easy to test for and easy to treat--so why not do it?
*We don't currently have plans to do the P17 shots, but both doctors have told me that if it is something that I decide that I want to do then we will do them. If anyone out there has strong feelings on this, I'd love to hear what you have to say.
That is just a start to a list of what I would hope every woman would know prior to a sub-pregnancy after an IC or PTL loss. If anyone has anything to add or alter about what I've written, I'd appreciate the feedback.
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7 comments:
Well I thought you got a vaginal cerclage, but then I was confused by some of the remarks that you made. Then you said you were going back to work and I was confused all over again :-)
Thanks for clarifying. I'm glad you are doing so well.
Sorry for the confusion!
It sounds like you've found (and are providing others with) a wonderful resource. Obviously, a sub pregnancy is going to be impossibly difficult in so many ways. This kind of knowledge and shared experience is one of the few things that can make it a little easier.
Thank you for posting this. I'm going to email you, I think. Monica and I are working on something and I think you might be interested in helping us. So I'll email you.
In the meantime, thank you for posting this! Wow, 16 weeks. Now I can worry for you : )
About the P17 shots...I honestly think that the benefits far outweighs anything else. Personally, and I know this varies, I didn't even have as much as braxton hicks. Ever. Whatever your body doesn't use comes out, and it's just a shot every week. I really, really feel that it got me as far as it did.
On that same note, did you happen to see the study that increases in folic acid has been shown to signifigantly reduce the risk of PTL? If I can find it here, I'll email that to you as well. My Peri suggested that I take 1000mg a day in addition to my prenatal to help keep away PTL. Of course, monitor infections which you are doing so well! I'm so proud of you!
I totally did the same thing...I went with the attitude that I knew what I needed for my body because I've done all the research and if you couldn't help me, I would find someone that would. Luckily my first choice was the right one.
Cerclage pregnancies are more painful than normal pregnancies. My OB gave me extra refills on my pain meds to take if the pain got unbearable. Sometimes I could feel it and it was uncomfortalbe but not painful. Don't be afraid to take something.
Let's see...what other advice do I have...
Take it easy. Everything will get done when it gets done. If your house is a mess, it's a mess and guess what...when the baby gets here it's still going to be a mess! The sooner you embrace those things, the better off you are. Don't be afraid to ask for help. People want to help. You having a healthy baby is important to them too. Even though it's hard sometimes, try to think of one thing you are grateful for in regards to the pregnancy every day. Write them down, if possible. You'll miss them later.
Ok...if I can think of anything else, I'll pass it along...
You're doing wonderfully! I'm so happy for you, and I'm going to email you now!
I have 2 preemies and did P17 injections with #3 (from 16-34 wks). I made it to term, with no complications from the shot other than a sore backside. Honestly, while every situation is different, I agree with Becky that the potential benefits outweigh the risk.
Thanks Becky and anonymous for your input on the P17 shots. So far I have only heard good things (except one woman who felt they made her depressed) about the shots.
Beruriah also had both the cerclage and the P17 shots, and she thought for her the shots were more helpful (she felt different the day after the shot and the day before the next one, in favor of the shot...).
Also, when I was doing research on infection and stillbirth, I found a bunch about infection and PPROM. And this is all clinically detectable infection.
There's also what's called subclinical infection, and many MFMs believe that to be the cause of many PTL cases.
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