I've been looking forward to this appointment and dreading it the same time. On one hand I wanted to see the doctor, receive the go ahead to TTC again when we were read and be re-assured by a "Professional" that there was nothing I could have done to change things. Whether that would have been being more vocal when I was spotting, going into the ER when I started bleeding instead of waiting or prevented things by not going to France and doing 6+hrs of walking each day and lifting Natasha.
Dr. Igras is amazing. I know I just met her, but she has a great sense of humour, is friendly, listened to all my concerns and was very re-assuring about the whole thing. She is the first doctor I've ever felt so laid back with. She did not mock me when I said I'd "googled" things and nicely corrected some mis-information that I'd read. She said that IC is actually a lot less common then the 25% of all women statistic I read.
When she came in the exam room, she said asked me why I was there to see her. When I said she'd performed a D&C on me on the 30th of October she actually remembered me. She said "Oh you were the poor woman who had to wait so long for a D&C! I'm so sorry, that must have been so hard for you". And while it sounds 'lame' in type, she was so sincere when she said and honestly meant it. I did not get any vibe at all from her that she was saying because she felt she had to. I was also surprised she remembered this, as it's been over a month.
We joked about my stubborn placenta(s) (I told her I also had retained tissue my first pregnancy) before she asked me about my pregnancy & delivery was with Natasha. As I've mentioned before, everything was normal. We then 'eased' into the events leading up to my miscarriage - the brown spotting (which thinking back was also muscus-y so makes me think it could have been my mucus plug), Dr. Paniche booking the u/s to re-assure me/her and then the fateful Tuesday when I started to bleed red, got a strong heartbeat at 7pm, having contractions (which I thought were BH) and then my waters breaking.
She re-assured me by saying that even if I had gone to the ER sooner, she would not have done a clerage on me. At the point I realized something was wrong (7pm-ish) I was already in labour and she would not have done it as under "normal" circumstances it's a risk, but an emergency one poses an even higher risk. Then of course once my waters broke the pregnancy became non-viable. :0( So that lifted some of the guilt I felt about the situation. It does not matter when I would have went in, I would have still miscarried.
She said she does not recommend a woman having a cerclage often or encourage it(which makes me feel good knowing she does not push them or put women at risk having one 'just because'), but after hearing the details of my miscarriage, she would strongly recommend it for me. She said that my waters breaking in T2 is an indicator that it was IC. As I learned later on, I was not having BH that night, it was real contractions, even though they did not hurt at all. I would not have even noticed them but I had my hand on my tummy and felt it harden and soften. My waters breaking is what caused the baby to die and made the pregnancy non-viable. :0(
She told me that if she had been in the hospital that night and I had come in earlier, she would not have done a clerage, even though my water had not broke yet. She said it would have been an 'emergency' clerage and it would have been too risky. So then eased my quilt that waiting "because hey i found a strong heartbeat!" would not have made a diff. if I'd went in sooner baby would not have been saved. I think at midnight I was 2cm and by 2am when they did a quick check I was 5cm? Things were just progressing too quickly. To be able to do it she would have had to try to stop the contractions/labour which she can't say at this point if she could have or not. Plus my waters probably would have still broke, at which point you can't do a clerage.
The best news of all is that she said she would love to have me as a patient. :D She told me to wait for my period before TTC again, but once I was pregnant again, to call her office. Tell them I needed to be seen right away, that she'd make a note in my chart for me to be bumped in as things get busy there, that she wanted me to see me by 8w. I also have to get their office to book me an u/s before she sees me. I imagine just to confirm pregnancy. I asked if she could tell that early if my cervix was stretching and she said no. I think, and I did not ask, but by the time the Dr. can tell that my cervix is stretching it could be too late, most cases I've read women miscarry between 14-23w, so I guess the earliest it starts to stretch is 14 ish weeks and by then it could be too late to get the surgery booked. Based on the details I've provided her with, she is being pro-active about doing a clerage. Scares the heck out of me, but if it saves my baby next time, I'll deal.
I asked about what happens after the stitches are done, bed rest? dr visits? etc and she said we'd take it one step at a time and get me pregnant first. A decision has also been made for us because of my "condition". Owen and I have continued to toss around the idea of 3 kids. We are quite happy to have just 2, but we've always been open to 3. Dr. Igras asked how many children we planned for and I said that we were happy with 2, but have always considered a 3rd, we were going to make a final choice after we had a 2nd. She then told me she would recommend us stopping at 2 if we were happy with 2 and not 'set' on 3 because of my weakened cervix. She did not say it out loud, but I imagine that continued pregnancies would further weaken it and from what I read, could cause it to further weaken to a point that I'd need permanent stitches.
She told me to relax, enjoy the holiday season and in January if we were ready emotionally to TTC again to do so. Overall it was a fantastic appointment and I feel like a weight has been lifted. There was absolutely nothing I could have changed in how I lived my life those 16w or changed by going to ER sooner that would have saved my baby, unfortunately.
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