Wednesday, February 18, 2015

A Whole New Ballgame

Because I know that some folks come to my blog who are moms or dads of preemies, I thought it might make some sense to chronicle a little bit of my experience as a preemie mom blessed with a subsequent pregnancy. Note that this particular entry will be all about being preggers, and the only Calder-reference will be photos, so if you are here for the latter, you might do best to skim. J

We love bath time!
Yes, I am *almost* always this happy.
This week I switched to a practice with a doctor who specializes in high risk (an MFM, they say, Maternal Fetal Medicine physician). I felt it essential. Plus, when it became apparent I’d be coming in at a minimum of every two weeks to have my cervical length measured, a practice and hospital (should there be bed rest… or a NICU in our future) in Fairfax looked increasingly unrealistic. Long story short, it took me some time to identify someone and get in to see him, so my first visit with Dr. M was yesterday, at a bit over 17 weeks. Part of me feels very reassured and gratified that I made this switch while the other part of me is, let’s say, totally bugging out.

A little art with breakfast, thank you very much.
Those who’d talked to me about Dr. M had told me he too is laid back and “won’t make you unnecessarily nervous about your pregnancy.” Well then. I suppose it is a fundamental difference between how a high-risk specialist and an OB with other specialties approach pregnancy (another NICU mom today verified my experience in this department, telling me to “buckle up”), because his strong recommendations were certainly more conservative than I was prepared to hear. For starters, and the biggie we’re dealing with now, is cervical cerclage. If you don’t know what cerclage is, be glad. In short, you get your cervix stitched up. Super! You can get a preventative cerclage, which is essentially what Dr M is recommending for me; however, those are typically done between 12-14 weeks, and I’m closing in on 18, which is more typically when you would call it an emergent (emergency) cerclage. 
I brush my own hair...
flush toilets...
And bang on things.
I’ll spare you the details, except in the case that you are interested (this article really spells it out nicely, and there are a host of studies, none of which I know more about than their abstracts, which is a total bummer). Long story short, the procedure is riskier now than it would have been at 12 weeks (mainly of infection or causing your water to break early, either of which can cause the worst of the worst), and we have a very big decision ahead of us. Of course, there are benefits to cerclage or we wouldn’t even be discussing it, mainly that studies show it can extend your gestation period by nearly 14 weeks. Pretty magnificent! I am getting my cervix measured tomorrow morning and am scheduled to talk with the doctor around noon, and we’ll have to make our decision by the end of the day.

Found the dry spot.

I LOVE to be outside!
The rest of his advice isn’t nearly as grim but surprising just the same, given where I’d left it with the last practice. Of course, this man sees only high-risk pregnancies and has a very clear picture of where they can lead. All travel more than 30 minutes from the hospital is out. Exercise is out starting yesterday. Slightly more surprising is general restricted movement; Dr M doesn’t even want me going to work anymore. At all. I cringe whenever I think about it (I’m already feeling cooped up since we keep Calder isolated and I knew I wouldn’t be traveling until after the pregnancy), but you can believe I’m 110% willing to help stave off the alternative!

Right before I went into my appointment I ran into a mom I’d met through a preemie listserv who just happens to work at the State Department with me, a mom who knows exactly what I’ve been through, plus some, I’d say, and when I told her I was pregnant, followed by, “I’m a little nervous,” I could see it immediately in her eyes: she got it. She said to me, “Of course you are.” And I was grateful. Of course I do not want to be stressed out, I know that’s the best route, but it’s also much easier said than done.

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