Monday, February 26, 2007

My 2-Year-Old Daughter is Wearing a Panty Shield: Moments of Levity in a High-Risk Pregnancy

There haven’t been very many fun moments in this pregnancy but there have been a few. Who says it’s all bad news (and too much information) coming from Little Miss Sunshine? So how did my daughter end up proudly sporting a Carefree Lite Day Pantyshield? Well, those of you with kids who are mobile know you can never go to the bathroom without an audience. If you’re not quite there yet, trust me, you will be.

Bear with me here for a little background information. In order to help prevent another disastrous infection like the one that ended my pregnancy with LC, I have been using an acid gel nightly. Since what goes up must come down, I use pantyshields to absorb the run-off.

Now I rarely have any privacy in the bathroom because Troll Girl (TG) either hears me go in there or her sixth sense that detects when she might me missing something kicks in and she drops her baby like a bad habit and bolts to my side. Yes, I’ve tried locking the door.

She immediately muscles her way to a full view of the situation. Then comes the commentary: “Mama, you go peepee in your underpants? Mama, you NOT get a treat. Or my personal favorite, “Mama, your underpants a little bit broken.” Then she proceeds to demand a pantyshield for herself despite my efforts to dissuade her; I draw the line when she wants them solely for the purpose of sticking them to her arms and legs. She’s allowed one, which she deftly opens, peels back the paper, and expertly places in the crotch of her beloved brother’s hand-me-down, Bob the Builder briefs. Then off she goes, a big-wheel driving, pantyshield-wearing force to be reckoned with. I stand in awe of this child every single day.

The other funny thing that is happening involves Troll Girl’s use of the Doppler, a hand-held gadget used to hear the baby’s heartbeat. I rented one to combat the force of my catastrophic imagination; that is, I use it to confirm that our baby is in fact alive.

TG loves this gadget and almost every day, sometimes more than once a day, she subjects me to this treatment. It goes like this: she comes marching over to my spot in the couch and says, “Mama, I do your heartbeat?” It’s not really a question even though it is posed as such. Then she grabs the tube of goo from my tray o’ crap, unscrews the cap, and squirts some around the base of the wand. She turns on the device, yanks up my shirt, and positions the wand on my belly. She listens ever-so-briefly, not attempting to actually find the heartbeat, then cocks her head and inquires, “All done?” Then, swear to God, she wipes my belly up and with a little prompting trots off to dispose of the gooey tissue.

The thing that amazes me is how she goes, unhesitatingly, through this routine with the practiced hand of a seasoned obstetrician. I started to think this was fairly normal until Rocket Man’s godmother saw her do it and set me straight with, “_____, I’ve never seen a 2-year-old work a Doppler before.” Once again. Awe.

Thursday, February 22, 2007

Off the Ledge

Fancy doc and Rocket Man talked me down and I feel like I am back to my normal? state of being. My cervix looks good on u/s. It’s 3 cm, down from 3.4, which is virtually nothing, taking the margin of error into consideration. The stitch looks fine. The placenta looks great although a problem isn’t necessarily visible; there is nothing whatsoever to suggest a placental problem. Plenty of amniotic fluid. Blood pressure is normal. Urine culture results coming soon. The baby looks great. The 3-D picture are so cute; I need to find a neighbor with a scanner so I can share them.

My cervix feels good to fancy doc. He spent a lot of time with us as he always does even though he’s got 10 patients waiting. He listened to all my questions and concerns and we joked, not condescendingly, about my reading of medical research and abstracts and basically the 10 hours I spent researching fFN. He really has been great with us.

Basically he said he is not super-concerned about the fFN because the protein could be showing up because it hasn’t completely gone away from when it was supposed to be there. In other words, the presence of fFN is normal early in pregnancy and it is supposed to go away by about 22-24 weeks. It could be that it just hasn’t completely gone away yet. It could be there because fFN is leaking from the placenta. In either case, no signs of pre-term labor is a good thing. Apparently my contractions aren’t a sign of PTL nor is the pressure or the discharge. He views PTL as actual labor that occurs pre-term.

We’ll test again on Wednesday, next week, and then it should be gone. Actually he said there is a 66% chance of a negative result after a positive. Yeah right. That should be interesting. Who knows, maybe it will be negative.

Anyway, he said he is concerned enough about the current result to see me every week and check the cervix and re-do the test. He also thinks it’s a good idea to start with modified bed rest, not because he thinks it will prevent pre-term labor but because it will help me feel better. He was all for us getting a second opinion and he gave us a recommendation of his peer at a local university hospital.

I felt much better after talking to him. He assured me that he thinks my cervix is holding up great, the contractions haven’t taken a toll, we’re watching very carefully for changes, I have no history of PTL (pre-term labor), and the stitch is very strong.

We’ll re-do the test in a week, check the cervix again, rest a lot and in the meantime the baby’s chances of survival increases 3% each day after today. If the contractions increase we will consider home monitoring. If I show signs of PTL, we’ll do a steroid injection to help mature the baby’s lungs. If the next fFN is positive, I will be resting more.

So the panic is over. Emotionally I feel much better. I still feel a lot of discomfort and pressure around where I imagine the cervix to be. I get pretty sore after only a little bit of standing. Sitting up at a table is particularly uncomfortable. I’ve gone from sitting in a reclining position on the couch to a more horizontal position because it’s more comfortable. Fancy doc says that the discomfort probably is the stitch and the pressure on it. I am taking it super easy, partly because I am uncomfortable.

I am feeling more connected to the baby. Seeing an actual picture of her face was very cool. She looks so little and sweet. She kicks A LOT; feels like I’ve got a constant companion living in my belly. I’m really rooting for her to grow and develop. My other babies were so little at birth, 6 lbs, 2 ozs and 5 lbs, 14 ozs AT TERM. Doris Foodle needs to grow!!

That’s all I’ve got for now. Yesterday my son said, “Mama you need to rest so the baby doesn’t die.” This needs to happen. There is no alternative.

Tuesday, February 20, 2007

Time to get off the internet

UPDATE: I don't have any new information to report. I'm updating to say how frustrated I am with this situation. I've been considering getting on the message boards but I can't bring myself to go there. Maybe it's the atrocious spelling or maybe it's display names like "sweetluvinmama." I'm looking for advice or guidance or help or somebody to tell me that my doctor sounds a little crazy. Message boards and chat rooms are probably not going to help. I probably should be talking to medical professionals, but I don't have very many of them at my disposal. I left a message for my dear friend who is an ob/gyn so I will get another opinion from her. She tends to be very calm and generally advises that I have nothing to worry about.

Trouble is, I'M WORRIED, PEOPLE. I'M REALLY FUCKING WORRIED. I'VE BEEN THROUGH HELL ALREADY AND I DON'T WANT TO GO BACK. IF THIS BABY DIES I AM GOING TO LOSE MY FRIGGIN' MIND.

I'm not sure what I want. I don't know what I want from fancy doc. I think I want him to worry a little, mostly because if he isn't worried a little then what the hell is wrong with him? This guy does more cerclages than anybody else in the world. He is Mr. Cerclage. Is that somehow skewing his frame-of-reference in a way that I don't understand?

Trusting doctors is what got me into this mess to begin with. Maybe I will mention to fancy doc that I am considering getting a second opinion because I am concerned that he isn't being conservative enough. I think that I NEED to do that. Maybe he can consult with one of his more conservative partners. For chrissake, I've got a bootlace holding my cervix together, I've been having contractions for weeks, I've got pressure and discharge and now this positive fFN. When will this man worry? I KNOW he was wigging when my organs were failing in intensive care but for fuck's sake, is it going to take a disaster to get him concerned?

The thing is, fancy doc is a perinatologist. He is the high-risk guy who gets called in AFTER trouble starts. He does not do routine OB or GYN care. He is my OB ONLY because I left my doctor after the LC disaster and I didn't want to find somebody completely new so he took me on. I think I've hit upon the issue with him. He really is a problem-solver. He doesn't do problem-prevention, routinely. I had to remind them that I need to pee in a cup every visit. I need to find out when the glucose loading deal is so I can get that done. Oy.

If I had an OB/GYN, I would have that second opinion. Maybe it was an error in judgment to go just with fancy doc. I thought it would be better to have only one doctor handling my situation instead of two, one of whom would be a complete stranger to me. Where to go from here?

Bottom line: I am really worried. 24 weeks is the mere cusp of viability, a veritable NICU nightmare, if we're lucky. Good lord. This has been the longest 24 weeks of my life. I guess that could've gone without saying.

Baby Drama Tuesday, Back on Schedule

Goddammit. When trusty assistant called first thing this morning, I asked, “Are we gonna do this the easy way or the hard way?” Naturally, we’re going the hard way.

The Fetal Fibronectin Test (fFN) results came back positive. What does that mean, you ask? Good question. Here is what I have learned. Don’t quote me on any of this.

A negative result means a 1% chance of going into labor in the next two weeks. Negative would’ve been good.

Positive is much less clear. There is a 40-60% chance that I’ll go into labor in the next two weeks. There are lots of false positives. False positives come from having sex, a vaginal u/s, or a manual exam prior to doing the fFn swab. I did none of those things. False positives are also sometimes inexplicable.

The fFN test measures a protein that is present in the cervicovaginal secretions when labor is imminent. The protein “reflects mechanical or inflammatory damage to the membranes or the placenta.”

There are four situations that can cause the damage:

-activation of labor through the hypothalamus-pituitary-adrenal axis, which is brought on by stress; good thing I’m not stressed out by this whole situation
-a problem with the uterus
-a problem with the placenta such as abruption
-my least favorite, infection.

I was not happy to see infection on that list because as you well know, infection is what ended LC’s life at 23 weeks. The cerclage is a breeding ground for infection, being a foreign body and all. My understanding of an infection is that by the time I would have symptoms, it’ll be too late to save the baby.

I wish I’d been having regular urine and even blood cultures done to monitor any signs of an infection brewing. I have an appt. tomorrow and will certainly be asking for cultures to be done. Maybe we can discover an infection before it gets into the placenta where it is untreatable.

The other problem with the cerclage is that it puts me at risk for pre-term labor, as does incompetent cervix and a prior LEEP procedure. The fFN test is more predictive of labor with women who are high-risk and are symptomatic.

Am I symptomatic? The contractions are certainly a concern. I don’t know why I am having them although I know I had them, albeit less frequently and later on, in prior pregnancies. They could be doing damage to the placenta that is causing the protein to show up.

Another reason that fFN shows up is a problem with the placenta. This reminds me that about my elevated hCG level that was 3x normal. Elevated hCG is associated with placental problems. Fancy doc wasn’t concerned about that, naturally, but it makes sense to me that a placental problem could be showing up now via detection of fFN.

The placental problem disaster scenario reminds me that I haven’t had an u/s since early January for the amnio. Things could be happening in there. I have an u/s scheduled for tomorrow. I am most eager to see what’s going on in there. I love the idea that I can actually have a look in there instead of just wondering.

So far the list of things that’ll keep me up tonight:

-positive fFn, as high as 60% chance of labor in the next two weeks
-cerclage breeding infection, infection causing fFn to show up, infection kills baby
-damage to the cerclage from contractions, causing fFn to show up
-elevated hCG coming back to haunt me in the form of a placental problem
-I haven’t had an u/s since early January
-I haven’t had a urine or blood culture since I can’t remember when
-the pinchy, ouchy pressure that I’ve been feeling could be… something, I don’t know what

So fancy doc, once again, is not concerned. Sometimes I wonder what it will take to raise an eyebrow on this guy. Is he just trying to keep me calm? As if. Tomorrow I want to ask him, “If this thing goes south, will there be anything that you regret not doing?” In other words, “Are we doing everything we can to make this happen?”

During the course of my morning’s research, I came across the ACOG practice bulletin’s flowchart for pre-term labor issues. Basically, regarding bedrest, it says something like don’t prescribe it routinely because it doesn’t work. That really discouraged me because resting feels like the only thing that I can do. I feel safer when I am resting. I imagine that I can keep my baby safer if I rest. Bottom line I think is that I can’t. I can’t keep my baby safe. If this is going to happen soon there is nothing that I can do about it. That, my friends, is depressing.

Saturday, February 17, 2007

Stream of consciousness

I'm not quite ready to delve into the details of LC's birth. Sorry to leave anybody hanging. Clearly it ends badly. The motivation to write this shit down comes when I am at my most anxious and out of sorts. Fortunately, recounting the details has been somewhat of an outlet for me. Seems like I have a little less of the burden to carry around with me.

It’s a shame that now all of you have a little burden in the form of your memories of my horror story. I guess we all take that on when we choose to support each other through this journey; it’s not always pretty that’s for sure. I read your stories so that I know where you are coming from. Man, we are coming from some dark and shitty places.

I’ve stopped commenting on newly-pregnant people’s blogs for fear that they will naively stumble into my chamber of deadbabyhorrors.

Many of you have said how you are impressed (that’s not quite the right word) that I have found the strength and courage to get pregnant again. Depressing as it is to say it but this is not my first post-Big Fucking Nightmare pregnancy. I got pregnant again in April 2006. That pregnancy ended very, very badly at 11 weeks. It wasn’t nearly on the epoch-disaster-scale of the BFN but it was really fucking awful and shocking and horrifying in its own way.

Yes, there is another nightmarish tale of pregnancy loss to come. I barely believe it myself sometimes. The next one REALLY got me down. The aftermath was plain ugly.

The really incredible (hopefully not incredibly stupid) thing here is that after the second disaster, I tried again. For months now I have been saying that this is it for me. God forbid this thing goes south, I am done.

On a lighter note, I saw fancy doc on Thursday and he said my cervix feels good. He checks the cervix by sticking his hand up me basically. He says that he thinks his exam is more accurate than an u/s exam.

Still I’d like to have an u/s (it’s been six or seven weeks since my cervix has been measured by u/s) so my cervical length can be measured; his exam assesses pressure on the cervix but not length. Sounds like shortening of the cervix would cause pressure and he would feel that, but still. I have an u/s on Wednesday. I like the idea of actually seeing what the hell is going on in there.

Typical that I would hear perfectly good news and still walk out of his office thinking about how I’d like to see an u/s measurement before I’ll relax a little. As if anything but a lobotomy could lead me to relax.

I also had the Fetal Fibronectin Test (fFN) done. I should’ve expected stirrups and speculum for that to be done. If I never hear, “Could you move a little further down please?” again, it’ll be too soon. Isn’t that just the fucking worst? Could you hang your naked ass and crotch a little further off the edge of the table and then spread your legs way the hell apart while I turn on my spotlight and prepare to jam a speculum up you? UGH. That’s the worst. Holy self-consciousness. To make matters worse I was in need of a trim. Zero bush-confidence happening. Hellooo, trimming makes me scratch like a flea-infested hound dog. Seriously.

So on Tuesday I’ll get the fFn (I’ve no clue why they abbreviate it that way) results. Basically fFN tests for the presence of a protein that is indicative of impending pre-term labor.

A negative result is highly accurate. If it’s negative then there is a 1% chance of delivering in the next two weeks. If it’s positive then there’s a 50% chance or less of delivering in the next two weeks. So negative is great. Positive scares the shit of you, possibly for no good reason.

Usually those results take a day but since it’s a holiday weekend, it’ll take until Tuesday. I’m not really worried about it. I’m taking it super-easy and will continue to do so despite the results.

Naturally a positive result will concern me especially since my dad is gone for 9 days. We are piecing together coverage for the week. This would be bad timing for a scare.

It’s nice to have my dad gone, especially since my mother came to town on Wednesday. They went off for a vacation. As usual I reverted to my surly sixteen-year-old self as soon as she walked in the door. I didn’t have far to regress since I seem to be locked into my sullen eighteen-year-old when my dad is around. There have got to be some of you out there who know what I mean. All good intentions go to shit when one of my parents walks in the door and my psyche seizes up and clamps down on itself. I can’t bring myself to even have a conversation with my mother. It’s quite awkward actually. Then I feel awful afterwards. Argh. More on that later.

I’ll be 24 weeks on Thursday. My tickers always put me a day ahead so maybe Wednesday.

We’re starting to call the baby Doris Foodle. Sounds crazy I’m sure. Doris Foodle is a character in RM’s favorite children’s book, The Teacher from the Black Lagoon.

I’ve often found that the best nicknames are not the ones that we choose but the ones that choose us. We’ll see if it sticks. For now it’s fun to put a name to this busy little girl living in my belly.

It’s actually time to start knitting something. For Doris Foodle. Don't freak, I would never dream of calling her that after she is born. This is strictly an in-utero nickname.

I think I’ll do a pale pink blanket with cables. Never done cables but I hear it’s easy once you get the hang of it. Question is what type of yarn? It has to be soft but wash-and-dryable. It’ll also need to be soft but not fuzzy so she doesn’t get little hairs on her tongue should she be inclined towards sucking on it. Cashmerino? Suggestions?

Monday, February 12, 2007

Day 2 of the BFN, Thursday cont.

Before I continue with the BFN, I've been thinking about how, during the first night and next morning in the hospital, I had NO CLUE that the pregnancy was in danger. I knew I didn’t have the flu and I reckon we were thinking about an infection but not in my wildest catastrophizing did I imagine how bad it was. I was thinking maybe the cerclage might need to come out and maybe I’d end up on bedrest but these were my worst case scenarios. When fancy doc first told us about the possibility of an infection in the amniotic fluid, I was COMPLETELY SHOCKED.

Back to the BFN, I was on my way to the OR to have the cerclage taken out. When I got in there, I saw what I thought was a carrier for a tiny baby. It turned out not to be. We pretty much were expecting the baby to come flying out once the cerclage was removed. I had the epidural and then got spread-eagled further than I ever thought possible. I distinctly remember the awfulness of having my knees practically at my ears under the bright lights with a bunch of people with their faces in my crotch. I asked for a sedative but whatever they gave me was very mild. Too bad I didn’t have the same anesthesiologist I had this go-round; I would’ve been unconscious. The horror of being in such a vulnerable position knowing that this procedure was the beginning of delivering my daughter is indescribable.

I recall also that I didn’t want to be too heavily sedated because I wanted to be awake and present during the delivery. Even if my baby was going to die, I wanted to remember the delivery. It was all I was going to have left of the pregnancy and I thought it would be my only vaginal delivery.

At some point during the procedure, a nurse came in to tell me that my mother was in the hallway outside the OR and was making a pretty big scene. You can only imagine how this compounded the awfulness of the situation. Frankly I have a hard time even being around my mother and I did not want her at the hospital at all. I had been very clear about that when I told her not to come. She completely ignored me.

The nurse said that she was pretty upset and was waiting to see me when I came out of the OR. She had staked out the door. The nurse took me out a different door so I wouldn’t have to deal with her immediately. Rocket Man had to go talk to her. It makes me angry just thinking about how astonishingly inconsiderate she was being.

When I got back to my room, my dear friend (DF) had arrived. DF had the pleasure of witnessing my mother’s scene outside the OR. Basically my mom had pulled the old “my baby” routine and was going off about how her baby (me) was in there (the OR). DF had to deal with her and explain that I had asked her to be present for the delivery. My mom went off about how my friends had always been more important to me than her. Duh, none of my friends ever slapped me in the face repeatedly when I was a little girl or beat on me when I was running out the door to kindergarten. I could go on here but I won’t.

Basically my mom threw a gigantic “poor me, my daughter doesn’t want me here" scene as she staked out the door to the OR. Then when DF tried to talk to her, she got mad. Then she did the arms folded, puss on her face routine while she tapped her foot and verbally abused the nurses. Unfuckingbelievable.

Rocket Man spent an hour talking to her while I heard about her horrifying scene from DF. Suffice it to say that DF had heard about my mother for five years and she heard many gory details as we went through some very deep personal work in our graduate program. You know when you tell a friend how awful somebody is and then they’re all, “Oh your mom’s not that bad.” Well that didn’t happen. My mother had WILDLY exceeded her expectations and I KNOW that she was expecting a really crazy person. We actually laughed about it. But then I had to talk to her.

She came into the room doing the “I’m sorry, I’m a bad mother, I shouldn’t have come here, I’ll just leave without talking to you, nobody would care if I die, poor me routine.” I asked why she didn’t listen to me when I said, “Do not get into that car (and come here).” She said, I shit you not, “I didn’t get into the car. I took a taxi.” That was her answer. Never mind that she completely disrespected my needs and wishes on the single-worst day of my 35 years, she was pulling some infantile, semantic bullshit in a mind-boggingly, pathetic attempt to justify her behavior. I couldn’t believe it then and I can hardly believe it now. Mercifully, she didn’t stay long and then it was back to the business of delivering the baby so the infection didn’t kill me.

The next thing that I remember was the worst round of shaking and fever. As it did each time, every three or four hours, it came on suddenly. I got really cold and despite the pile of heated blankets, I shivered violently for 20, maybe 30 minutes. I had to keep something in my mouth so my teeth didn’t clank together; it was way too hard to fight the shaking the keep my jaw still. I tried sometimes to stop the shaking by bracing my whole body and resisting with all of my might but it didn’t even work and it was incredibly exhausting. I tried having Rocket Man lay next to me, or was it on me, to keep me from being so cold and to stop the shaking; that didn’t work.

After I stopped shaking, the nurse took my temperature. It was 106.1. The blankets came off and a frantic effort began to bring the fever down. I was at a maternity hospital so they didn’t have a giant ice-pack type thing to put me in. Somebody was dispatched to try to find one. Rocket Man, DF and our current amazing nurse went to work on me.

They stripped me naked and bathed me with cool washcloths. There was some kind of device blowing cool air on me. I think I started to check out a little here but I do remember it. I actually felt very peaceful and much better now that the shaking had stopped. I was staring at the lights on the ceiling and talking about how I saw a Charlie Brown-looking figure in them. I know they probably started to worry about me even more after I said that but I insisted on it and showed RM what I was talking about. He did see it so maybe I wasn’t losing brain cells by the trillions.

The fever scared the shit out of everybody. After it came down, I checked out. RM and DF later said that I was talking complete nonsense alternating with talking to my living daughter who of course wasn’t there. I lost my sense of time and where I was in the room. I recalled things that hadn’t happened. It was the middle of the night when the fever happened but I don’t think any of us slept much after that. Once again they gave me an ativan that didn’t help me sleep at all and the blood-pressure thing checked my bp automatically every 15 minutes. It was another hideously long night. All hell was breaking loose outside. The flood waters were rising on the worst flood our county had seen in 25 years.

The next day was all about waiting for the baby to come out. I was getting all kinds of meds to induce labor but it wasn’t happening. My cervix wasn’t dilating. They didn’t want to do a C-section because of the danger of spilling all of the infected fluid into my intestines, etc. Also, I was in no condition to undergo a major surgery.

Fancy doc was getting extremely nervous and it started to show, not that I noticed. He came back frequently to check my cervix. I was terrified of the prospect of the C-section and I was also afraid that the delivery would coincide with a fit of fever. I kept trying to talk the nurses and doctors into giving me more drugs to keep the fever down. The drugs didn’t help prevent the fever but I thought that they could if we timed them to head off the fever.

A nurse, one of the ones that I didn’t care for, came back on shift and needed to do something with my IV. Maybe she needed to move it, maybe she was actually drawing blood, but she did it as badly as she had when she first put my IV in. That was another time that I cried out in pain. I’d already been through botched catheters, IV insertions, countless needles and blood draws, a thousand blood pressure band tourniquets, an epidural, a surgery to remove the cerclage. I about lost it when she botched whatever she was trying to do with that needle. I started crying. I hadn’t been crying much. I had been in survival-coping mode.

Shortly after the bad needle, I started having trouble breathing but was afraid to tell the nurse because I thought they might do an emergency C. I told her anyway. Shortly after they moved me to intensive care, which was convenient because my organs had started to fail. I didn’t know until later why the nurse kept frowning at the bag of pee coming out of the catheter. There apparently wasn’t much coming out because my kidneys were shutting down. They also kept checking my blood pressure and asking ME if I knew if I had low blood pressure. I thought this was odd since it had been taken a thousand times in the last two days. The alarm kept going off because my blood pressure was so low.

My veins and arteries were constricting. The bacteria had gotten a foothold in my bloodstream and I had gone into septic shock. I didn’t know at the time how serious this was and how easily I could’ve gone into a coma. On the bright side, the intensive care nurse was incredible.

There was a very creepy moment where the intensive care doctor came in and examined my neck. I didn’t know it at the time but he was checking my veins to prepare for putting in a central line. Since my blood pressure was falling, they wouldn’t be able to use my collapsing arm veins if they needed quick access to my heart and lungs. They needed to put a central line in my jugular vein. That was freaky. I didn’t know why creepy doc was there but I remember him looking at my neck. It freaked me out at the time and it freaks me out retroactively.

Fortunately that morning an infectious disease specialist had been consulted and my antibiotics were redone, maybe just in time to save my life. After they checked my neck, I started to turn the corner. I don’t think I had any fever fits after that.

Fancy doc had been coming in all day to check my cervix. At some point after midday, I started having labor contractions. Having had two scheduled C-sections, I had not had the pleasure of having real contractions. They hurt. A lot.

I was in labor. I was in quite a bit of pain despite the epidural that had been in since the cerclage removal. The anesthesiologist came to check the epidural and added some more meds. It didn’t help. I was in real labor and was having painful contractions. The epidural wasn’t taking the edge off even. It got worse. The anesthesiologist said to call him in 15 minutes if it didn’t get better. It got worse. I called him in 5.

Looking back I wonder (duh) why it hurt so bad. Maybe it was because of the hell that my body had been through and that I hadn’t slept for two nights and I was fresh out of septic shock. Maybe it was because labor contractions are apparently (I’ve heard) as painful at 23 weeks as they are at full-term.

At some point, fancy doc came in to check my cervix and I swear he jammed his hand up me so ruthlessly that I burst into tears from the pain. He expected that my epidural would be numbing the pain so he didn’t think twice about ravaging me. That fucking hurt. I was nearing the end of my tolerating-all-of-this-painful-invasive-shit rope. He bellowed about why the hell my epidural wasn’t working. I had been wondering the same thing.

Oh yeah… for a long while during the labor contractions I wasn’t complaining because even though they hurt, they were bearable and… this part is really sad… I could still feel the baby kicking. I felt her thumping around regularly throughout the two-day ordeal and I wasn’t ready to part with her. I hadn't complained for a long time because I wanted to feel her before she got forced out of her toxic home.

Looking back it's amazing that she was still alive. The infection had brought me close to the brink of survival but she was still hanging in there even in a placenta full of deadly bacteria.

She was 22 weeks, 5 days old. Before the delivery I had fleeting thoughts of maybe, just maybe she could make it. Maybe she could be one of the youngest babies ever to survive. I knew better but there were brief moments of irrational hopes.

Backing up a little, once the contractions got really painful, I was ready for the meds to kick in. DF talked me through them and let me squeeze the life out of her hand. I switched to the bedrails.

RM was in the hallway talking to bad-timing-brother-in-law (BTBIL). I considered leaving this part out but it was part of my experience. I adore my BIL but he has notoriously bad timing. Immediately following my first D&C, back in 2003, we were scheduled to go away for the weekend with RM’s 3 brothers, one of the girlfriends, and his dad. NEVER EVER in a million friggin’ years would I have considered going but for the fact that we were going to have my son’s 2nd birthday party. We planned to have his party on Sunday, after his nap and before our three-hour drive back home. I only went on the trip because I wanted my son to have a nice party.

It was the most miserable weekend of my life. Nobody spoke of my situation ALL WEEKEND. It got worse when BTBIL left us stranded at a lake, unable to go back for a nap when the little birthday boy got tired. When BTBIL and his girlfriend finally came back and we took our son back for his nap, he was so overtired that he threw up in his crib and wouldn’t sleep. By the time we gave up on the nap, we had time for a super-quick cake and presents. Then we had to drive all the way home with BTBIL while I seethed.

I SPENT THE POST-D&C WEEKEND WITHH FIVE DUDES TALKING SPORTS WHEN I WANTED TO BE HOME IN THE FETAL POSITION ALL FOR A BIRTHDAY PARTY THAT WAS FUCKED BECAUSE MY BROTHER-IN-LAW IS AN IDIOT.

Bad timing indeed. To his credit, he really is a good guy and he came to the hospital to bring us some stuff we needed like a clean shirt for RM who naturally hadn’t planned on a four-day ordeal in the hospital.

It just figured that he showed up while I was in full-blown labor with zero painkiller about to deliver a baby that was going to die. After 45 minutes, DF went to retrieve RM. I wanted him there with me and not in the hallway with his brother.

I kept calling for the anesthesiologist and he finally returned and was once again completely mystified. Eventually he thought to check the place where the epidural was inserted in my back. It wasn’t connected. Mystery solved. I had probably sweated out the epidural during the big fever. We got it hooked back up and that was the end of the pain and the end of feeling my daughter alive.

At some point after waiting all day, it was determined that my cervix was ready. It was time to deliver the baby.

My ob/gyn was going to do the delivery. She was the doctor who never told me that a LEEP procedure could cause incompetent cervix and despite the fact that I got pregnant two short months after the LEEP, she never checked my cervix to see how it was holding up. I no longer have a relationship with her but at the time I was thrilled to have her at the delivery. Her father-in-law was dying so we thought she would have to leave but she ended up staying and I was very grateful. We’d been through a lot together during the nine years she was my doctor.

Enough for now. Not looking forward to the next part. I hope you'll keep commenting if you can and reacting if you want. Ask questions if you have them. It was much better to have readers engage after the last BFN post than not say much after the first.

I hope I'm not scaring the shit out of you all. It was really an extremely rare series of events that caused this to happen.

I realized that on the day that I was writing this I was 22 weeks and 3 days pregnant. That’s exactly how far along I was when I went to the hospital with the fever.

Wednesday, February 07, 2007

Second-guessing fancy doc

After reading lagiulia’s comments and question, I really got to thinking (as if I haven’t been overthinking this whole thing from the get-go). Basically she asked if I’ve considered putting myself on bedrest at least until 28 weeks or so. I’ve been so worried about my doctor’s seemingly cavalier approach to my situation. I know that he is the best around with cerclages and he probably knows exactly what he is doing but I haven’t been able to stop worrying. Looking back, I wish I had done a little more second-guessing of doctors so I am inclined to keep on questioning him.

I put myself on light duty and decided to have my dad come out to help with the kids because I couldn’t stand the idea of carrying on with a normal activity level. I was way to stressed out about having a normal activity level caring for two kids while having a cerclage and contractions. He agreed that light duty is a good idea but I don’t think he would have suggested it himself.

He said the other day that my history and the B-H contractions that I’ve been having put me at increased risk for pre-term labor. The contractions could start to put too much pressure on the cervix and cause it to shorten or dilate. He said that checking my cervix every two weeks is sufficient to monitor any changes. He said that the cervix changes very slowly, but two weeks sounds like a long time to me. Does anybody know anything about this?

This part bugs me: it seems that fancy doc isn’t completely convinced that I am having contractions. He asked where I felt the tightening and said that the whole uterus should feel tight and that he wanted to be “sure that we are communicating clearly” regarding the contractions.

The crazy thing is that I actually started to doubt myself after he said that. But then when I got home and was on the couch having several contractions, I felt my uterus like he showed me and the whole thing felt hard. It’s easy to feel the bottom half but harder to feel the top because I have more abdomen and intestines and fat in the way. I know what contractions feel like, both B-H and labor ones. I don’t like that I doubted myself and I don’t like that he seems to be doubting me. I hope that he isn’t making decisions based on a belief that I’m not really having contractions.

So the answer to lagiulia’s question is yes, I have been considering putting myself on not bedrest but extra-light duty. My dad is here to help us and he can do everything if need be so he can certainly do more. I think I will take it especially easy for the next two weeks and then I’ll be 24 weeks and we’ll do the fetal fibronectin test.

Does anybody have any experience with these things, i.e. incompetent cervix, cerclage, bedrest vs. no bedrest, fetal fibronectin? I looked at the babycenter message board but it seems to be all questions and no answers. Are message boards a bad idea? Are some better than others? Will I just freak myself out even more by going there?

By the way lagiulia, did the magnesium burn like a mo’fo? I think that’s the “big gun” they used to stop my contractions before we knew I had the infection. I SO do not want to end up in a bad situation like you did where the cervix becomes dangerously short. That’s why I wish fancy doc would be a little more proactive and conservative and prevention-minded. At least I can reduce my activity level myself so I know that I am following my gut and doing some of what I can do to keep this baby in there.

I continue to be awed by your responses to the BFN. I really enjoy (is enjoy the right word?) hearing your personal experiences and reactions to my story. I really encourage the questions. I’m glad lagiulia asked hers because it helped me to clarify some thoughts that I had percolating. The interaction really provides a rich experience that leads to reflection and questioning and ultimately growth. I appreciate the de-lurking and the people who may feel like they are sticking their necks out with their responses. Thanks for engaging, all of you.

By the way, those were real questions about the message boards. I’d really like to hear if anybody thinks they are worthwhile. I’m especially curious about experiences with medical issues similar to mine.

Tuesday, February 06, 2007

Wow. Now that’s more like it.

I so appreciate all of your comments and your willingness to engage with me. It feels so much better to share and then receive a response like that. Thanks for taking the time and for reaching back to me.

Catherine- I was thinking of you when I wrote please don’t feel pressure to comment. I know it must be hard, impossible even, to go there. Thank you for going there by reading and your comment about not commenting really was a very touching comment. I often read your blog and don’t comment because I just want to say something good but can’t find the words.

Kari- Thank you for your honesty and for having the balls to say that you secretly thought that losing your baby at 38 weeks was worse than my disaster. I love that you had the guts to say that. Even though you said you changed your mind, I think I’d lose LC twice before I’d lose a baby at term. I can’t imagine anything worse. And I was lucky enough to have two kids at home. I came home from the hospital with a copy of Empty Cradle, Broken Hear yet every night I went in to see my daughter sleeping, I counted my blessings that my cradle was full of a footie-pajama-clad little girl. If LC had been my first I don’t know what I would’ve done.

Ladybug- Having the nurse cry with us like that really did help us deal. The doctors and nurses were so incredibly empathic that we actually sent a thank-you letter and homemade cookies a few weeks later. Their compassion was so appreciated that we actually felt grateful even while the nightmare was unfolding. When times are so shitty like that, it is a real gift, a lifeline even, to feel some gratitude.

To all of you who are reading as you are pregnant and fearful or wanting to be pregnant (and not fearful): This can’t happen to you. This is one disaster that you are safe from unless you’ve had a recent LEEP procedure, ZERO follow-up care, then an incompetent cervix, then a late cerclage. Then a whole bunch of other things had to go wrong for the bacteria to travel up the vagina that far and thru the cervix and then INTO the placenta. It truly was a series of unfortunate events. Fancy doc has seen two infections like this in 20 years. We can all take a little comfort from that, cold though it is. The chance of it happening to me again is infinitesimal. The reason that I say all this is that deadbabyland is a frightening place indeed and we are all brave for being here and supporting each other through the nightmares and their aftermaths.

I really felt so much better about sharing after I read your comments. After the first round I was less than inspired to continue but now I feel better about pressing on. I loved that you shared your thoughts, reactions, and experiences. That’s what I’m here for and I hope that I can provide the same for you.

You really are an extraordinary group of people. Thank you.

By the way, I saw fancy doc today and my cervix is holding up great. I still worry that he is not very conservative and that other doctors would’ve put me on bedrest especially with all of the contractions that I’ve been having. He is taking a wait-and-see approach and says that although the contractions put me at increased risk for pre-term labor, we’ll just check the cervix every two weeks and if it looks good then we’ll carry on with business as usual. It helps my anxiety level to have my dad here and for me to be on light duty. Otherwise I’d be half-expecting my water to break every time I bend over. As it is, I feel like disaster is lurking around every corner. But my cervix feels good and that’s good news now matter how my twisted psyche tries to spin it.

In two weeks I will go back for an u/s and the fetal fibronectin (FFN) test. The FFN measures a protein in the cervical mucus and then predicts whether or not pre-term labor will occur in the next two weeks. It is very reliable when the result is negative but it is prone to false-positives. I’ll spare myself and you all that drama for now.

Thanks again for your responses. My faith in the power and richness of blogland has been restored.

Day 2 of the BFN (Big Fucking Nightmare), Thursday

This is the second part of my recounting of how we lost our baby at 23 weeks. This took place last December, 2006.

I remembered that during the first night in the hospital and the next morning, my contractions were constantly being monitored. At first I thought they didn’t really think my contractions were real. The nurse would come in every now and then and glance through the pile of paper that the machine spit out. Nobody seemed to care about the contractions. I didn’t think much of them either.

At some point during the first night in the hospital, they started noticing them. They gave me medicine to slow or stop the contractions. I had an IV in me from the get-go so all the drugs went in through there, although I swallowed plenty of pills as well.

At one point they gave me a serious drug to stop the contractions. I don’t know what it was but they said it might burn my arm a little. A little?? There were only a few times during the four days in the hospital that I actually burst into tears from the pain. That was one of them. It burned like the inside of my arm was on fire. An icepack helped a little but man I remember how much that hurt. Looking back I guess my uterus was trying to save itself by forcing the baby out.

During the interminable wait to find out if I had an infection in my uterus, I don’t really know what we did. We called a few friends. Mostly I laid in bed. I don’t think I got out of that bed once from when they admitted me until after LC had been delivered. I had a catheter put in at some point and I had an IV the whole time so I didn’t eat anything.

While I waited, I was lying down watching the door open to see whose shoes would appear under the curtain. I was anxiously and dreadfully awaiting one of my doctors to show up. I didn’t watch TV. I certainly couldn’t read. I cried. We speculated. We waited.

After what seemed like forever and what was actually probably six or seven hours, my ob/gyn came in. She had that look on our face and I knew right away. I don’t remember what she said.
The look on her face spoke volumes and I knew it was bad news.

Fancy doc was also there. I remember what he said. After they broke the news and told me what would happen, he leaned over and put his hand on me and said, “I’m sorry for your loss.”

I’m sorry for your loss.

My loss wasn’t even dead yet. She was still kicking and thumping around in there.

I HATE “I’m sorry for your loss.” Since then I really, really hate it. I know that people meanwell but to me it feels so sterile and impersonal and devoid of feeling.

My loss? My baby girl that wasn’t even dead yet?

While the doctors were horrifying me with the bad news, there was a baby being born across the hallway. I was on the maternity ward so life was going on around me.

The baby was literally crying its first cries while I was hearing that mine was going to die. This definitely added to the horror of the experience but I do recall that when I heard that baby cry, I felt that I knew with utter and absolute certainty that I would one day hear my newborn baby cry. I don’t really believe in God the bearded man in the white robe but if I did, I would believe that it was the grace of god that brought me that certainty.

I kept hearing the Live song, Lightning Crashes.

Lightning crashes,
a new mother cries,
her placenta falls to the floor
the angel opens her eyes
the confusion sets in
before the doctor can even close the door
lightning crashes, an old mother dies
her intentions fall to the floor
the angel closes her eyes
the confusion that was hers
belongs now, to the baby down the hall
oh now feel it comin' back again
like a rollin' thunder chasing the wind
forces pullin' from the center of the earth again
I can feel it.
lightning crashes, a new mother cries
this moment she's been waiting for
the angel opens her eyes
pale blue colored iris,
presents the circle
and puts the glory out to hide, hide.

The certainty that my moment would come, again, has abandoned me at times but I remember that feeling. It was also strange that in the outside world it had been pouring rain for days and that waters were rising for the worst flood in 25 years. Landslides, thousands of lost homes and businesses, downtowns under 4 ½ feet of water, $110 million dollars of damage in our county; it was an epoch disaster in the outside world as well.

The horrid reality of the situation was overwhelming. Oh yeah and I was going to deliver her vaginally. Both my living children were delivered by scheduled C-sections. I had a large fibroid removed from the wall of my uterus, back in ’99, so after that my ob recommended scheduled c-sections to eliminate the 10% chance of uterine rupture. So I was never supposed to have a vaginal delivery at all. I wanted to and I wished that I could. I used to care about that a lot more than I do now.

When they told me that I would have to deliver LC and that it would be vaginally it was like salt in a gaping wound.

I would have to deliver my baby at 23 weeks, knowing that she would have no chance of survival. And I would be having the vaginal delivery that I always longed for. I was going to go into labor and push out a baby and my doctor would hand her right to me.

But then I would have to watch her die.

Isn’t it ironic?

Isn’t it so much more ironic than “10,000 spoons when all you need is a knife?” That’s not fucking ironic. That’s inconvenient.

“No smoking sign on your cigarette break?” Ironic? No. Bummer? Yes.

I do love Alannis but I have always thought she could have dug a little deeper for those lyrics. I digress.

During this nightmare that I wasn’t waking up from, I was having godawful convulsive fits and then spiking fevers that went higher and higher. 103, 104. They always told us the temperature in centigrade so we didn’t always do the math. The fevers were high and my doctors were freaked out.

They originally thought that the infection in my amniotic fluid was e.coli.

Oh yeah and how could I forget this? How did I get e. friggin’ coli in my placenta, you ask? More irony. From my own goddamn ass.

E. coli is present in the colon, rectum, stool, etc. and is also a major cause of your garden variety bladder infection. It is often found in the vagina which I learned is actually a pretty filthy place on a microbial level. The bacteria that I had turned out not to be e.coli but rather proteus mirabilus which was even nastier than e.coli.

The bacteria found its way from my colon or whatever into the vagina and then through the comprised and stitched up cervix and across the friggin’ placenta where it could no longer be treated with antibiotics. I had been taking all kinds of antibiotics since I walked in the door of the hospital the night before but none of it could help save the baby. Apparently, an infection in the amniotic fluid is untreatable when the placenta is intact. By the time you know you have one it is too late.

The baby needed to come out as soon as possible because the infection was a deadly one. It could easily get a foothold in my bloodstream and cause septic shock, coma, and death.

Now on Thursday afternoon the tide had turned and instead of trying to stop the contractions, gears were shifted and labor was going to be induced. But first the cerclage had to come out.

During the day we had called my parents and told them what was going to happen. My mother, whose emotional dysfunction is legendary, was in hysterics. She wanted to come for the delivery. Now this is a woman that I had a hard time seeing on my wedding day. Not in a million fucking years would I want her present at the birth of a viable baby even. For her to be there when I delivered LC was NEVER EVER an option that’s for damn sure and I told her in very clear terms, “Do not come to the hospital.” When she said she just had to jump in the car, I said, “DO NOT GET IN THAT CAR.” She’s so wacked out on xanax that I didn’t want her driving our car anyway and endangering her life or the lives of innocent motorists. Nice that I had to deal with her self-centered infantile bullshit at such a horrible time.

I also called my dear friend and she was going to jump into her car, at my request, and drive two hours to help me through the delivery. I think we all expected that the baby would be delivered shortly after the cerclage came out.

The next thing that I remember was being wheeled out of my room towards the OR so the cerclage could be taken out. As the nurse wheeled me out the door, she paused in the hallway and started crying. She said that she had a baby at home and was just so sad for us. We all cried in the hallway. We were really touched by this nurse.

I didn’t look up on the way to the OR for fear of passing brand-new families.

That’s it for today. Writing this has been harder than I thought.

I appreciate the comments. I know that it is hard to think of something to say. I have trouble thinking of what to say when I read the horror stories.

I do encourage anybody reading this to say something especially lurkers. I kind of feel that if I can say all of this and you are reading it, you can say something. Just please don’t say “I’m sorry for your loss.” Curse words are encouraged. Questions are welcome and encouraged. Interaction is good. Just say what you think or feel.

Please don’t feel like you have to comment now that I’ve said this. I don’t want to shame you into it. I just encourage readers to speak freely and react and respond.

Sitemeter shows that over 400 people have checked my site since I posted the first part of the story and 10 of you left a comment. It feels like my divulgence and sharing has fallen into a vacuum of sorts. You know like when you share something really personal and awful and nobody says anything. That is not to say that I don’t appreciate the thoughtful and heartfelt comments. I really really do.

Okay. Think I beat that dead horse long enough. I'm off to see fancy doc today to see how my cervix is holding up. As usual I have a feeling that the other shoe is going to drop. But it hasn't yet.

22 weeks on Thursday.

Friday, February 02, 2007

How did i get there from here? Long story. Day 1 of the BFN

My big belly post isn’t sitting very well with me. I didn’t mean for it to come out like, “Oh wah wah wah look at my big, beautiful belly. I look pregnant at six weeks, cry me a river.”

What did I mean? I’m not sure. I did mean to communicate something to the effect of, “Sweet jesus, look at the size of my belly. This is what happens when you are pregnant six times. More specifically, this is what happens when you have three deadbabydisasters.”

I think the heart of the matter for me is this: I’ve been thinking a lot about losing LC and what an epoch disaster that whole thing was. I think the physical experience of having the belly back and feeling a baby kick again has brought me back to the time just before my pregnancy ended so disastrously.

I thought that Christmas was the time for the really awful memories to surface because that’s when it happened last year. But as I approach 22 ½ weeks, which is when the disaster began to unfold, I am finding myself thinking a lot about what happened.

The belly is a reminder. I love the belly but I know all too well that it could be gone tomorrow, leaving me another white plastic box of ashes in its place.

I think this is why I have mixed feelings about the belly. It reminds of how I felt my baby kicking when they told me she was going to have to die. I felt her kicking while I was being induced so I could deliver her. So she could die.

Having the belly is bittersweet. Feeling her kick sometimes brings me to the verge of tears. I can’t lie in bed feeling her kick without wondering if I will end up there again sobbing uncontrollably because she’s gone. Going to bed without her was the worst. I cried myself to sleep for weeks and weeks. Being pregnant with a girl again is a trip down memory lane that I’d rather not take. I think the baby being a girl extra-reminds me of the BFN (big fucking nightmare).

Rocket Man can’t touch the belly without me feeling the uncertainty of the whole situation. Nobody can comment on the belly without me thinking, at least fleetingly, about how the whole thing could end in complete and utter devastation for all of us. I can’t fathom surviving another loss.

My kids are so into this baby. The moments of joy that I’ve experienced in this pregnancy have been watching them talk and sing to the baby. My daughter gives the baby her biggest and cheesiest, chipped tooth grins as she coos to the baby and tries to “pick her up.” They’ve each birthed many many babies out of their own bellies, often at the dinner table.

This has to happen.

I think it’s also time to start writing down the miserable story of what happened. Hopefully it will be cathartic and then I can put some of the fear behind me.

It all started way, way back.
Way back in the days when the grass was still green and….
Oops. Wrong story. Neither one ends well.

Basically when I was pregnant with LC (pregnancy #4), everything went pretty well until my 19 week ultrasound. The first trimester was a little rough. I was miserably nauseous all the time and I couldn’t eat anything that didn’t pass the “burping test,” that is, I considered how it would be to burp potential food source up for hours after consumption. Bowl of cereal? Pass. Just about everything else? No way. I have long described myself as savory-toothed, as opposed to sweet, so this was hard for me. So was all that burping.

But anyway, I made it through the first trimester. I worried about the baby dying and me not even knowing about it for three weeks as in my first deadbabysurprise two years earlier. That baby, pregnancy #2, died at 7 ½ weeks but didn’t bother to notify me until 10 ½ weeks when I started spotting. Deadbabyultrasound #1. I had an unconscious D&C the next day. Looking back, I really had it pretty good. Except the 3-week-dead baby. That really undermined my confidence in future pregnancies. So much for no news is good news.

I was also pretty worried about having a blood clot like with my daughter. The blood clot was my third pregnancy, right after the missed miscarriage. I started spotting and went for an u/s and the doctor diagnosed a large blood clot in the placenta. She said it was probably going to end the pregnancy. The bleeding went on for 10 weeks, on and off, sometimes bright red and terrifying, sometimes brown and old-looking. I was freaked out most of the time. I saw a psychic during the bleeding and she said if the baby did survive, she would have physical problems. After hearing that, I was terrified until my daughter was delivered, 5lbs, 14 ozs of the smallest and fiercest creature I had ever laid my eyes upon. I digress.

So with LC, I made it through the first trimester and to 19 weeks with minimal spotting, no crumpled up babies on the u/s screen. So I basically went skipping into my 19-week Level II u/s, thinking “this has been remarkably smooth sailing.” We knew there was trouble when the technician started frowning at the screen and seemed to be fretting over something. “Interesting,” she said. Interesting is not a word that you ever want to hear during an u/s nor do you want the technician to go get the doctor.

Turns out my cervix had pulled a disappearing act. Four centimeters is generally considered an acceptable length for a pregnant cervix. Mine was 1.7 centimeters. I had no clue what the hell was going, having had no cervical problems whatsoever during either of my full-term pregnancies (son-pregnancy #1 or daughter-pregnancy #2). The doctor that came in said my cervix was dangerously shortened and that we should see a specialist ASAP to talk about having my cervix stitched closed aka cerclage.

Enter fancy doc. I spoke to his trusty medical assistant that night on the phone. She asked me lots of questions, trying to get to the bottom of the case of the missing cervix inches. I had no clue what the problem could be. She asked me if I had had an abnormal pap smear. Oh yeahhh. I had had an abnormal pap smear. Two of them in fact and both fairly recently. I told her about the first funky pap and then the second, follow-up pap that also came back funky with high-grade funkiness. The second pap involved a bigger scraping that was meant to remove the bad cells. The results showed bad cells on the margin so my doctor recommended that I have a LEEP procedure done. “Ohh the LEEP procedure,” says trusty assistant. She had identified the culprit.

The LEEP procedure had been done in late April of 2006. The procedure basically uses an electrical loop to lop off part of the cervix, ideally the part with the bad cells. It was quite unpleasant but it turned out the margins were clear and I promptly forgot all about it and about cervical cancer. Trusty said that the LEEP procedure can cause incompetent cervix. Since the LEEP took place long after my daughter was born and a mere two months before I got pregnant with LC, the mystery was solved. But we had a problem.

We met fancy doc the day after the u/s. He said he thought I would’ve lasted another week or two before I would have gone into pre-term labor and lost the baby. We decided pretty much on the spot that I would have a cerclage put in the next day. He mentioned a miniscule, 1% or so, risk of infection from the procedure and that cerclage didn’t always prevent pre-term labor. Bed rest was discussed.

I had the cerclage put in the next day. I think it was December 7, 2006. The procedure went okay. I was in a lot of pain afterwards and asked for more painkiller. Still a lot of pain, then more painkillers. Unbeknownst to me, the painkillers basically disabled my bladder and so I couldn’t pee when I tried to. After several hours, like 4 or 5, I was in so much pain (from a hugely full bladder which I couldn’t empty because of the pain meds), that I had to have a catheter put in. A liter of pee was drained from my bladder. I left the hospital shortly after and went on my merry, well not really way.

I saw fancy doc a week later and he didn’t love the look of the stitch and so he put me on “do as little as possible, rest as much as you can,” modified bed-rest, house arrest, whatever you want to call it. My dad came out to stay and help us for the duration of the pregnancy. I was about 20 weeks at that point. It was mid-December.

We cancelled our trip to Mexico and went on a little getaway at a fancy hotel in the city instead. I had a great big belly. I got all dressed up and reveled in the fun of being pregnant. I laid around a lot, feeling the baby kick. We knew that we were having a girl (I had a CVS back in the first trimester). Upon hearing that the baby was a girl, I had been just as shocked and admittedly disappointed as I was this current go-round. By 20 weeks, I was well over it and was looking forward to meeting our younger daughter.

I was worried about pre-term labor and I was paranoid about possible symptoms. All of the normal stretchy and pully feelings were magnified. I had a burning feeling that seems like it might be a bladder infection. I made extra efforts to drink a lot of water and cranberry juice. The feeling came and went. Christmas came and went. I specifically remember having the burning feeling three days after Christmas. I thought about calling my ob/gyn but I had an appointment to see her the next morning so I decided against calling.

That afternoon, it was December 28th, 2006, three weeks after my cerclage was put in, I was 22 ½ weeks pregnant. I made goulash and was grumpy. I went upstairs to lie down and came back a few hours later. I was irritated that nobody had started getting dinner on the table. We ate the goulash; it was pretty good, lots of sour cream, minimal peppercorns. Our seven-year-old neighbor ate with us. Rocket Man was planning to meet some friends in the city to watch a basketball game.

After I finished my goulash, I got cold. I put on a sweater or something and layed down on the couch (our brand-new couch that we had just gotten a few days before0. I was still cold. My mom got me a blanket and I started shivering. I sent her to inform Rocket Man that I was cold. I imagine he was like, “yeah, okayyy” but he came and sat with me. I started shivering a lot. Soon I was shaking pretty violently. I had a pile of comforters and blankets on me.

I remember saying goodnight to my son while struggling to keep my teeth from clanking together. I imagine that he was pretty freaked out. After he went to sleep, RM got me something to put in my mouth to keep my teeth from clanking. It was too hard to hold my jaw clenched, resisting the clattering.

Rocket Man called the after-hours clinic. The doctor on-call seemed like she was going to dismiss it as the flu going around but I was yelling, “Tell her about the cerclage.” By then I had stopped convulsing and my temperature was pretty high. The thermometer was so slow, we just gave up on it at 102.7. She told him to bring me in. I saw this doctor five months later and she told me that she didn’t think I would have survived if she hadn’t told him to bring me to the hospital.

We left for the hospital, in the dark, Christmas lights blazing on the cul-de-sac, me with a comforter wrapped around me. I distinctly remember saying to RM, “We better not be coming home without her.” He attempted to assure me that there was no way that would happen. I might have even been reassured. I couldn’t have had any idea of the nightmare that was coming our way.

We got to the after-hours clinic at the hospital and the nurses started checking me out. They monitored the contractions that were occurring I can’t remember how frequently. My temperature was up still. They did a vaginal swab to culture. After a while decided to use a catheter to get a clean urine sample. That was the beginning of days of invasive horribleness. The nurse wasn’t very good at catheters and it hurt like a mo’fo. She didn’t get it right the first time and had to torture me again, spread-eagled. It was quite painful, two nurses working on me. They finally got it right.

We waited. I was reading a book. I was reading The Adventures of Auggie March; literature, for chrissake. I really felt pretty okay. The fever was down, the shaking had stopped long ago, the contractions were mild and infrequent (I thought they were Braxton-Hicks). I was pretty sure I didn’t have the flu because I felt fairly normal.

After a few hours of being there, the urine sample came back clean but with an elevated white cell count. We met the doctor who told me to come in and she said, “I don’t know what’s wrong with you but if you were my sister, I’d keep you here.” That was the second part of her decision that I guess saved my life.

I was very grateful to this doctor afterwards and tried to switch to her when I got pregnant again. Long story short, six months later, she was responsible for my horrifying bathroom delivery of my 11-week-old baby boy into my hand and then the fully conscious, completely unsedated D&C to complete the job.

But, at the time, we liked her. I was checked into the hospital and we debated about whether RM should spend the night or go home so the kids would see him in the morning. We decided that he would spend the night even though he had to sleep on sack-of-springs excuse for a cot. We called my parents and told them to just tell the kids that we left to see the doctor really early in the morning, before they woke up. My son was nearly 4 ½ and very perceptive and sensitive. My daughter was only 18 months and completely clueless.

I don’t remember when the next round of fever and shaking hit. Probably sometime that night. Each time it came on quickly and I shook VIOLENTLY for 30 minutes or so. It felt like forever. I tried sometimes to brace myself and slow the shaking but that was SO exhausting. The nurses covered me with heated blankets and I convulsed like crazy until I stopped. Then the blankets came off and the fever was way up. It happened this way each time, every four hours or so.

They gave me ativan to help me sleep. It didn’t help. Ativan isn’t a sleep aid. I don’t think I slept at all that might. Maybe I dozed off every now and then. I think that was the night they began checking my blood pressure automatically every 15 minutes. How the hell would I have slept anyway? I’ll never see one of those blood pressure things again without being reminded of the whole deal.

I’ll have to ask RM if anything noteworthy happened that night. The next morning my doctor showed up bright and early. I wondered if I would be charged the $35 no-show fee. I hadn’t spoken to her since the cerclage and since we realized that the LEEP was probably the cause of my disappearing cervix. I inquired about why I didn’t know that that could happen. She said it was very rare.

She said they didn’t know what was wrong with me but they were waiting for results of the vaginal swab or the blood culture or something. We waited.

Later on that morning, I think around 9 or so, fancy doc came in. He said that they suspected there may be an infection.

in my amniotic fluid.

They would be doing an amnio to draw some fluid for testing.

This is the part where my world stopped turning.

If there was indeed an infection.

in my amniotic fluid.

there was no way to treat it.

without the baby coming out.

asap.

but she was too little to be born.

22 weeks, 5 days.

she would die.

she had no chance of surviving.


Fancy doc left. I wailed. WAILED. NOOOO, NOOOOOO, NOOOOOO. I freaked. I wigged. I sobbed hysterically. I kicked, I rocked, I held onto my belly for dear life. That was the worst thing I have ever heard in my life. Shocking. Horrifying. Impossible.

A team came in to do the amnio shortly after. I saw my baby girl alive for the last time on the u/s. She looked perfectly healthy. She was kicking and wiggling and looking heartbreakingly sweet and adorable. They gave me a picture.

Fancy doc drew the fluid and said that it smelled good, which was a good sign. He left us with the tiniest shred of hope. He said we could expect to hear the results in the afternoon. Five, six hours maybe.

We waited.