I haven’t written in awhile, not because I’ve been too busy – necessarily – but more because I haven’t been ready to re-visit the horrors I began to live starting next, that fateful Monday in November, 2009. I haven’t wanted to feel this sad; I haven’t been prepared to write and therefore re-live what it was like to change forever, really three times, within that eleven night period. But since we’re super immersed in our next current fertility steps, and I’m all shot up with extra estrogen, taking two tablets a day and even having an extra patch on my right ovary that is literally feeding estrogen into my blood stream, I am extra emotional right now, and awoke with a little insomnia at 3 AM and decided it was time to rip off the band-aid. Here I go…..
MONDAY, NOVEMBER 23, 2009
I spent the morning laying out items that we’d be packing for our trip the next day to visit Craig’s dad and stepmother in the Florida Keys on our bed. I checked in online and printed out our American Airlines tickets. Then, in accordance with the bus schedule, since we were still a one-car household, I headed out to take the 2-bus ride to my doctor’s office. While I waited at the transfer bus stop at Venice and Windward Circle, I got a phone call from a sales rep. He wanted to know what I was up to in work and life. I told him I didn’t have any current projects, other than the fact that I was pregnant. He said whatever niceties people say when they learn someone is pregnant, at the level at which we knew each other, and we chatted a bit more, before the call ended, and I resumed reading whatever book I was reading. (I wish I remembered what book it was!) I boarded the second bus and walked the 1.5 or so blocks to my doctor’s office, checked in, and waited. I don’t remember my blood pressure being taken and being weighed, but I’m sure I was before I was sent to room number-whatever, where I removed my pants without being reminded, and placed the paper, large-napkin-sized blanket that doctors use – over my privates.
Dr. B entered the room and as I sat there with my legs spread out in their respective holsters, he started the ultra sound. When he asked how I was, I told him of the pains I’d been feeling, which I was sure were Braxton Hicks. He looked up at me, him with his white hair and glasses, when I described the amount of pain, where it had been, and when it occurred. He resumed prodding inside me, and I nervously began my small talk, telling him how we were going to go to Florida the next day to see Craig’s family for Thanksgiving. And then I heard my doctor, the fantastic doctor with the very thick usually un-discernable Israeli accent, utter the terrifying sentence with absolute clarity, “You’re not going anywhere.”
The next hour was startling, shocking, and beyond scary. I couldn’t understand exactly what he was saying as he was saying it, but I soon became to gather that the baby was poking through my amniotic sac, and that I needed to be hospitalized immediately. The pretty nurse, the one who typically really annoyed me, kindly helped me into a wheelchair, and carted me through my doctor’s office, and as she awaited the written instructions from the doctor to accompany me to the hospital, I started crying. There was a waiting room full of women, some with their men, some visibly pregnant, others not, who I could almost see through my hysteria. I was crying so hard that snot poured out of my nose, I was hiccupping, and I couldn’t actually breathe.
The pretty nurse wheeled me out of the office, to the elevator, downstairs, across the street, and up a ramp to the UCLA Hospital in Santa Monica. Somebody had obviously called just moments ahead and so after she maneuvered me through the maze of hallways that I will never forget but don’t really remember, we arrived at the ward where nurses were there to greet me and to transfer me from the wheelchair to the bed.
I had called Craig in hysterics before they’d even put me in the wheelchair to repeat what my doctor had said, and I called him again as I was being hooked up to all sorts of machinery, telling him where to go once he’d arrived. By this time, he had already left his office in Hollywood and was on his way to me.
INCOMPETENT CERVIX:
My pulse was taken, the baby’s heart rate was checked; the tubes were connected to the monitors that allowed the staff to monitor both from their station and by my bedside. Dr. B came in the room, and asked the staff if the Trendelenburg bed could be tilted any further.
In the Trendelenburg position the body is laid flat on the back (supine position) with the feet higher than the head by 15-30 degrees. This is a standard position used in abdominal and gynecological surgery. It allows better access to the pelvic organs as gravity pulls the intestines away from the pelvis. It was named after the German surgeon Friedrich Trendelenburg. (Wikipedia)
He explained to me that we needed gravity to force the baby back into my uterus, that I had what’s called an Incompetent Cervix.
Incompetent Cervix is a medical condition in which a pregnant woman’s cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term. Internal opening more than 1 cm is abnormal and cervical length less than 2 cm is considered diagnostic. Cervical incompetence may cause miscarriage or preterm birth during the second and third trimesters. In a woman with cervical incompetence, dilation and effacement of the cervix may occur without pain or uterine contractions. In a normal pregnancy, dilation and effacement occurs in response to uterine contractions. Cervical incompetence occurs because of weakness of the cervix, which is made to open by the growing pressure in the uterus as pregnancy progresses. If the responses are not halted, rupture of the membranes and birth of a premature baby can result. According to statistics provided by the Mayo Clinic, cervical incompetence is relatively rare in the United States, occurring in only 1—2% of all pregnancies, but it is thought to cause as many as 20—25% of miscarriages in the second trimester. (Wikipedia)
He went on to say that we could sew my weakened cervix up, in a procedure called a Cervical cerclage. The treatment consists of a strong suture being inserted into and around the cervix. (Wikipedia)
By the time my doctor had verbalized this plan, Craig had arrived, and we were now under the informed assumption that the cerclage would be performed the next day, with a couple of days to follow in the hospital.
Craig held my hand and looked me firmly in the eyes and told me it would be OK. Then we got into business mode. He had a flight to cancel, to inform his father that we weren’t flying to Florida, and to retrieve some key things for me at home.
I reluctantly let go of my firm grip of Craig’s hand to allow him to leave and do these things, and got into my survival mode, this space where I just keep doing stuff so that I don’t have to think too hard about the circumstances. I called my parents and told them what was happening. I called my eldest sister and explained things to her. She happened to have been with her mother-in-law ~ a nurse, on speaker phone from her car, and it was comforting and calming to get such an informed reaction from her, as to the commonality of a cerclage. I called or left messages for other close friends Dee and Jodi.
Craig came back that evening with some things for me, like my reading glasses, phone charger, and some basic toiletries – even though I was confined to the bed and wasn’t allowed to shower. Actually, I wasn’t even allowed to get up and walk the 10 feet to my hospital room bathroom. They brought in a mobile toilet and placed it only inches away from the bottom of the bed, with a roll of toilet paper nearby, and I was instructed to go there and then return immediately to bed – and call on the nurse to empty the toilet for me. It was pretty severe a sentence, I thought, but I did as instructed.
I was paralyzed by shock and fear to question that directive, or any of the others.
Dr. B returned and spouted orders to the staff about the angle of the bed. “Can it be more of an angle? I want her head 45 degrees from her feet.” “This is as far as the bed will go back,” the nurse responded. “Can we get bricks or something to put her feet up higher?” he asked. I think the nurse thought he was kidding, but I don’t believe he was. No bricks arrived, but his reactions made it very clear to me how much I needed to rely on gravity to keep my son safe.
I can’t remember if Craig stayed there that night, but the next day, since he had previously gotten Tuesday off as we had been scheduled to fly that day to Florida, he opted to consider it a work day, and so sat next to me while I watched TV from my angled bed, with his computer in his lap. I distinctly remember that was the day that he got a Request For Proposal from a major ad agency for the one of the biggest accounts there is. We took it as a lucky omen that he was on the ground – meaning not flying, as otherwise there would have been an automated response re-directing that request to another co-worker, and with so much potential for commission on such a size-able account, we took it as the cup being half full that he’d gotten the email.
My sister and her mother-in-law visited me that day. I don’t remember where Craig had gone, but they sat in my room and Lynne supported what the doctor had told me, that the cerclage scheduled now for Wednesday was a great idea, that it was a simple procedure, and would alleviate the problem of my incompetent / weakened / shortened cervix.
Over the next hours, I wracked my brain with wondering who else I knew that had experienced this.
I remembered that Robin – who I had seen only 2 days before at her son’s first birthday party, had been hospitalized late in her first pregnancy with her daughter for a similar thing. I spoke to her and it turns out it was the exact same thing. She asked me for some vitals, like where I was and who my doctor was. She was happy that I was at that UCLA SM hospital, as she claimed it had the best N.I.C.U. unit in the state. She gave me the name of her high-risk doctor, who performed her surgery. I held tightly to her strong recommendation in the hospital, and sort of shelved the information she gave me about the N.I.C.U. – which stands for Neonatal Intensive Care Unit, as I had confidence in the cerclage that would be done thereby allowing me to leave this hospital in a few days, eventually delivering at St. John’s, as we had planned.
I emailed my friend Kathy and asked her for her older sister’s phone number, recalling that she was on bed-rest for most of her pregnancy. I spoke to her, who explained that she had been on bed-rest from around week 8 all the way through week 29, only in the actual (and same) hospital around week 23 until she delivered early. She hadn’t had the same diagnosis or circumstance, and had given birth to a very premature son, but she also reported great things about the hospital, their N.I.C.U. unit, and the same high-risk specialist that Robin had mentioned.
I had been taught by my father that intelligence is strength, and felt comfortable being in full producer mode, doing my research, gathering information, and arming myself with intelligence so that when the doctor spouted next steps at us, Craig and I would be informed and thus prepared.
If only….