Friday, September 16, 2005
Happiness and Joy, but also some trepidation
My appointment this morning looked good. The little lowercase appears healthy, active and strong. He wouldn't stay still in positions that would allow them to get good measurements. For instance, when measuring his thigh bone, you could not see the full bone -- what measurements she got were showing only about 21 weeks. When he was measured at 21 weeks, he measured larger than that, so I know it was positional. She couldn't get an accurate head measurement because he was at such an awkward angle that she would have had to remove part of my hip bone to get a straight shot (he was sort of sideways, but diagonal).
The cervical measurements ranged from 2.3 cm to over 2.5 cm. Of course, these aren't as accurate as normal because my boy was literally bouncing his butt off the top of the cervix the entire three minutes of the vaginal ultrasound. Even with that kind of bouncing, the cervix didn't appear to be opening up, the amniotic sac was staying firmly in the uterus and not sliding down into the cervix.
I was on edge going in this morning, had little sleep the night before, and was just generally highly anxious. (I was convinced they were going to require me to have a cerclage today) My blood pressure was the highest I think it has ever been in my life: 128/90. High enough that the woman who takes weight and blood pressure commented that she's never seen me with blood pressure that wasn't 'low' let alone something that high.
When I went in for my appointment with the perinatologist, she told me that she felt the baby looked good and that in the 6 weeks in bed, she had seen no real change. She told me that as a former patient at the fertility clinic out of the university hospital that the perinatologist is out of, she understands what I'm going through (LOVE HER -- interestingly? Her husband is an RE at that fertility clinic -- what a couple! An RE and a peri. I want them to be my new best friends!) As a result, she said I can come in whenever I want to, but she doesn't think it's necessary to be every week anymore. She also said that I can do a bit more, like go out to dinner or to a movie. I can even make a short trip to one of the baby stores to pick out bedding for this boy.
As for the cerclage? I won't be getting one. I don't need one this week, and this is the last week they would be willing to do it. Because babies can live if born at 24 weeks (she did say that only about a quarter of them survive long term and only a quarter of those are normal), it is the opinion of most of the obstetrical community that the risks of a cerclage there are more damaging to the baby. She said that the potential for infection and bringing on pre-term labor could be dangerous in that it could cause my son to be born at less than his best chance at a time when he needs to be as healthy as possible for survival. If I were to get one, it had to be today. And I'm not. She went on to tell me that by 28 weeks 90-95% of babies born in their hospital from their practice survive and that 70% of those are completely normal. Further, they have the same results at 34 weeks as they do at full term.
She just really feels like things are heading in that way for me and that with the care that I am getting and the fact that I am not afraid to call them for anything, that my son and I are going to be OK. So, we scheduled an appointment for Sept. 30 when I am 25 weeks. I will have an ultrasound and doctor's appointment.
I'm happy that things look so good, but I am fearful. It's that feeling of having had so much attention and then suddenly, it feels like there is none. And I realize that two weeks is not a long time between appointments, but I have become accustomed to the weekly visits. My peri likened it to infertility treatments -- you go in daily for monitoring, ultrasounds and blood work all the time, and then if the treatment works and you don't have any reason to be considered a high-risk pregnancy, you have to be ready to be seen a month later. For me, I had a year of pregnancies, miscarriages, testing, monitoring, appointments, then came the clomid, the first trimester intense monitoring because of my previous losses, the bed rest, the weekly visits...and now...nothing for two weeks. I feel as though I have been pregnant since this whole roller coaster started when we began trying (or not trying to prevent) to get pregnant in September 2003. This has been one constant struggle with almost non-stop visits to or calls from the office of one doctor or another. I have had very little break time and when I did, I was crying and waiting the time out before I got to get back in the game such that it wasn't a 'break' from any of that.
The fear of being treated more like I'm normal when for so long I have been abnormal is great. Yet it also feels good to know that the perinatologists all feel that we are doing the right thing. They meet mid-week every week to discuss all of their patients; they go through the files and determine together the best course of action. They all decided together (about 10 of them) that if I were at the same place this week, I didn't need the constant monitoring. In part because what we're doing is working and there's no need to think it isn't, but also because even if it's not we're no longer at a point where it is beneficial to do anything.
I'm rambling. I can't quite make my words convey how I feel. I'm choosing to focus on the joyful portion of all of this. I am healthy. My son is healthy. And we're getting so close. So close to a time when he can and will be alright.
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