Category Archives: TAC

Change

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As I had written several months ago it seems that bankruptcy is inevitable.  I have come to accept that and I am now in a better place about this.

Work improved much, in fact I was excelling at it.  My opinions were appreciated and sought after.  Things were going so well…

I had an unexpected pregnancy that I found out about in early June.  I miscarried on July 2nd; the day after we celebrated Savannah’s.  I’m so glad that it did not rob her of her day.  I have my moments.  Surprisingly, I did not fall to pieces this time.  I was caught off guard when I found out I was pregnant.  I was advised to wait 18 months to 2 years after my surgery before becoming pregnant….at the time I was hardly 6 months out….I was juggling too many hours at work…with too long of a commute.  There was never enough time to blink, breathe….and then I miscarried.

With that loss I gained perspective.  What had I been doing this whole time?  Commuting and working long hours so that my pay can go to daycare and pay off debt?  I was not spending the time I wanted with Savannah.  I was not spending the time I wanted with my husband.  I was not dancing, excercising, baking, reading…I was just on the wheel and going in circles.  The miscarraige brought it all to a halt.

It look about 5 days for the miscarraige to be completed.  My current gynecologist did not want to perform a D&C that was needed because of the TAC.  I reached out to Dr. Davis…he offered to walk my doctor through the process.  They did not want to touch me…the TAC intimidated them. Ultimately I went to see Dr. Davis again.  It was a bittersweet reunion.  He was so kind and he got to meet the baby that his expert hands helped provide.  By the time I got to him…he felt confident that I would be able to naturally miscarry what remained…he did not have to touch me.  Still, it was worth seeing him and hugging the man that played a part in the gift of my daughter (my husband does deserve an honorable mention, don’t you think?).

We in the process of moving back to NJ and resetting the clock.  For all the reasons mentioend above I resigned my position and am not looking back.  It was a very hard and painful decision.  Yet, it makes sense for my family and where I want us to be to move back.

It would not be the first time I pick up pieces and start again.  Strangely, I am excited about the changes that await.

While I’ve been home, i’ve been savoring these precious moments with Savannah, reading, working out and baking, baking, baking!  I’m rediscovering passions that have not been visited in too long. I’m awakening the person I thought I was losing within.

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Everywhere

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Currently I am experiencing a whole smorgasbord of emotions.

I am so thrilled with my little girl…she brings me so much joy. Each. Day.  Sometimes I feel like my heart could absolutely burst with love.

 

I worry about my grandmother who has been in and out of hospitals and doctor appointments with a heart valve issue.  I am not prepared to lose her or say good bye to her.  Yet, if her time on this earth is drawing to a close there is peace in my heart because God has allowed her to live to see her great-granddaughter and because she has lived a very full life.  I have to give thanks for those things.  

 

I was talking to my mother today about Ziggy.  I was telling her about her sweet smiles that light up a room.  She told me that she was meant to be.  She will never understand why Daniella wasn’t; but Ziggy was.  There has always been a sense of peace in my heart about Emi…I don’t know why.  But Daniella?  No…I wasn’t prepared to give her up.  I don’t know if there will ever be peace, but acceptance? Yes, and I am working on that. 

 

I miss my girls…Emi…Daniella….  God, I love them…  Will I forever wonder why and what if?

 

Work is going well…very well in fact.  My boss is suddenly my new BFF.  I just don’t get it, but I finally feel like I am part of something.  On that front, I have been getting a lot of calls about other opportunities…due diligence would be that I purse each and see, but I am so happy with the way things are going at work.

 

I have been working out and eating so much better.  I am still eating my weight in ice-cream each week.  (I just LOVE ice-cream).  Somehow the weight is coming off.  I am below my pre-pregnancy weight and really feeling beautiful and attractive.

 

My mother-in-law fell down the steps and broke her hip.  We have really been there for them and all the monkeys are appreciative of our efforts.  The mother-in-law and I have had some thinly veiled (and no-so thinly veiled) discussions on past hurt feelings and I feel like we are inching closer towards closure… (Perhaps because now she is the one in need???)

 

An assistant to Dr. Davis called me up recently to follow-up on my TAC surgery.  I told her that it all went very well and that I had actually sent a thank you to him. She said that she was certain it was somewhere in the stack (STACK!) of thank-yous he receives.  She said that he reads each one and then has them placed in the patients file.  I love that man.  LOVE HIM!!! I am a Cowb.oy’s fan for life, I hope they win the Supe.rbowl each year!

 

And finally…for the first time in eons I am looking forward to the holidays.  I just thought they were a good reason to drink…they now mean so much more to us. 

Moving forward with Dad

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Since my last post I have seen my father twice; we slept over one night at his home and he spent last weekend at our home.  On his second night here he met some of my closest friends and prepared a DELICIOUS meal for them.   The first time he saw me  he burst into tears and he is absolutely in love with Ziggy.  He stumbles all over himself while trying to do and say all the ‘right’ things.  While making dinner in my kitchen he was trying to teach me how to cut garlic up.  I feel for the man when he isn’t driving me crazy teaching me things I already know.  I am no longer a little girl and i’ve already learned many lessons that he missed making an impression on.  He laments the past deeply and I tell him that all we have is the present and the future.

Ziggy is doing beautifully; she is all smiles now and she coos to her (and our) delight.  She has had isseues with hearing out of her right ear and I have taken her in for tests and the specialist feel that the results are consistent with her having fluid in her ear as a result of the c-section.  She is reacting to sounds and responds to voices so we are not terribly concerned.  Tomorrow I am taking her in for another follow-up.  I can’t beleive she is already 2 months old and almost 13lbs.  I just fall in love with her more and more everyday and I thank whatever higher power and Dr. Davis for her.

Speaking of Dr. Davis, I need to let him know the outcome.  But how do you thank someone for such a gift?  Simply, I guess and from the heart.

37 Weeks – WE ARE FULL TERM!

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Can you beleive it? We are full term baby!  It’s all gravy from here… I never thought I’d get this far.  Even with the TAC I worried – heck, i’m still worried because she’s not quite *here* yet.  The doctors have been monitoring the fluid levels around baby and they have dipped again but are still within normal limits.  I’ve accepted that nothing is under my control and it has helped me get this far and I know it will take me all the way.  I am 37 weeks today and officially Ziggy has the ALL CLEAR to come along  whenever she’s ready.  I know I am – I can’t put into the words how badly I want to hold her and see her wiggle in my arms; I’ve been waiting over 3 years for a moment like that.  Should she need a little coaxing, we’ve got a scheduled c-section pending at 39 weeks.

Milestone – The (ELUSIVE) Third Trimester!

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Today is a good day…Ziggy and I hit the 28 week mark.  We are finally in the 3rd trimester and  viability is at 90-95% – this an amazing milestone.  After my losses I was asked when I would feel safe in a subsequent pregnancy.  I would always say when the baby is safely in my arms; they thought I was being cute and prodded for a ‘real’ answer.  Needless to say these were not deadbaby folk.  Due to my lack of success with a vaginal cerclage, I would offer 28 weeks as the earliest in-pregnancy date that would help me breathe easier (and the baby too…).  28 weeeks was a fucking awesome perspective pre-TAC.  But who the hell embarks on a TAC looking only for 28 weeks?  I’m in it for the long haul.

On another note – anxiety is rearing her very ugly fucked up head.  I was visiting with BigSexy and Mr. Diplomat today and told them about how i’ve been feeling.  Worried, anxious, fearful…and hopeful.  I’ve been so ‘viability-focused’ and now that it’s been attained, my focus has now shifted to getting her here safely.  Truth be told, I want her out the moment she can be out safely.   This is not for my sake in ANY way…it’s for hers…I just want her safe and sound.  The last thing I want to hear a doctor begin to say is “If only…”

In a very assertive, yet understanding way Mr. Diplomat told me I had to fight my anxiety for Ziggy.  I have to remember that stress, tension and fear based hormones can affect her.  I have to choose to be calm.  His words had a very positive effect on me.  BigSexy reminded me about the bio-physical profiles and non-stress tests that I have booked.  She assured me that if anything looks off my doctors will be proactive.

I am so fortunate to have fabulous friends like them.  I am going to give it my all to be calm in this final trimester.   I just can’t beleive that the finish line is actually within sight.

Transabdominal Cerclage Surgery

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Of all the posts i’ve written, this is one of the most vital ones.   It is very lenghthy and chockful of detail on purpose.  There are increasingly a lot of people finding me due to goo.gle searches for information on on the TAC, and I want to offer all the information I can.  This does not take the place of medical advice, but it is my experience and I want it to help you.  If you have lost your baby(s) due to cervical incompetence I am so deeply sorry.  I hope you continue to pursue your dream and to gain knowledge.  Additionaly,  I am more than happy to answer any questions you may have,  just email me as follows: jaded_me0223(at)yahoo(dot)(com)!
 
The Background

Following the loss of Daniella, I left the hospital empty-handed, but also with the knowledge that I would need a Transabdominal Cerclage or TAC to bring a future baby home.   Dr. Goo.gle dissapointed me; the internet offered very little info on the TAC.  Thankfully, I found a group called AbbyLoopers on yah.oo and through this group several doctors that were well recommended by members including Dr. George Davis.  Beefcake and I met Dr. Davis and came up with a plan that I would have a post-pregnancy cerclage placed at 14 weeks (pre-pregnancy is another option).  I continued to read the experiences of AbbyLoopers members and after a self-imposed break from TTC we were ready to try last fall.  We conceived shortly after and when my first trimester screen revealed a healthy pregnancy I got in contact with Dr.  Davis.  He and his staff had great follow up in scheduling and getting paperwork in order.  I knew I was dealing with a special doctor when he called me one night just after 10pm.  He apologized profusely for calling so late but he wanted me to know that he finally had my operating room booked and that surgery was all set for December 28th, 2009.

Surgery Prep

As planned my husband and I arrived at the hospital where I was registered and prepped for surgery.  Beefcake and I chatted and watched t.v. while we waited for Dr. Davis.  He came by rolling over the sonogram machine, which caused his diet co.ke to fall on the floor andd spill, and then he could not find towels and then he couldn’t get the machine to work.  He wasn’t smiling and it was all Beefcake and I could do not to laugh out loud.  Finally, he did a quick sonogram to check on baby and all was well.

Dr. Davis:  How old are you, again?

Jaded: 27

Dr. Davis: A teenager…Do you have any questions before surgery?

Due to nerves, I completely missed the question.

Beefcake:  Babe, do you have any questions?

Jaded:  Huh?  Oh!  Sorry Dr. Davis, I’m just so suddenly nervous. 

Dr. Davis: I’m not.

Jaded: If anyone should be nervous, I’d rather it be me.

Dr. Davis left to prep while the anestesiologist and his assistant came by to talk to us.  The plan was to give me a spinal, so that I would be conscious and just slightly whoozy.  I asked if I could bring my ip.od into surgery and they were fine with that.  I set up a playlist of Mich.ael Jack.son’s greatest hits, kissed and hugged my husband goodbye and was wheeled into surgery.

The Surgery

Upon entering the operating room the flood gates gave way.  I mean I was BAWLING – the bright lights and the cold sterility of the room with the surgical tools out brought back memories of my daughters.  Tears just kept coming without ceasing.  I reasoned with myself: I was now in a position of knowledge, power and preparation.   This was not a reactive attempt to save this baby, but a proactive one – BIG difference.  Compassionate hands cradled mine as compassionate words soothed my spirit.   I was then given more paperwork stipulating that I understood that I was about to undergo abdominal cerclage sugery and that I was agreeing to in-surgery ultrasounds to monitor the baby’s heartbeat.   I signed the paperwork and thought to myself: Wow, after all the research, blood, sweat and tears I am here and this is really about to happen.  The spinal was administered, and we waited for its effect as more lights were switcched on,  doctors strolled in including Dr. Davis and nurses and the anestisiologist monitored my vitals.  So i’m there, spread-eagle, legs strapped, arms strapped and naked from the waist down.  At this point I hear the familiar sound of an electrical razor as Dr. Davis shaves off about an inch of my pubic hair just below my abdomen,  I cringe as he places this sticky material over the shaved area and prepares to pull it off (i’m thinking a salon wax here) –  luckily I did not feel a thing.  Whew. Vulnerable does not capture how i’m feeling.  By now, the spinal should have taken effect, so they decided to put me to sleep.  A mask is placed over my mouth and nose as i’m instructed to breathe in deeply.  I remember my first breath…my second…and my third when I suddenly get this funny taste in my mouth. 

Hospital Recovery

The next thing I remember was waking up in the operating room and being told the surgery was over and that I was headed to a recovery area.  I’m very whoozy and so I’m ‘in’ and ‘out’ and don’t remember being wheeled over.  Once in recovery, I ask how my surgery went and the nurse smiles and says very well.  Dr.  Davis strolls over and I ask if surgery went well.  (I think I asked anything that blinked how it went).  He patted my leg and said very well.   My husband is soon by my side and he gave me this loving gaze and told me he almost cried when he saw the doctor heading his way immediately after surgery.   “Dr. Davis said you and the baby did very well and that he’s happy with surgery – there were no complications and everything went as planned, the surgery was over  in under an hour.  Thank God for that, because I could hardly stand waiting to know if my baby and wife were ok.”   Some time later I was wheeled to a private ‘mother-baby’ room.  My vitals continued to be monitored the rest of that day and through the next day.  On day 2 the strong meds were discontinued and I was told that I needed to start walking later that day.  Say what?  The meds had already started to wear off and the pain was creeping in.  The nurse laughed when she saw my face and said it helps with gas.  Huh?  What’s wrong with some gas?, I thought.  Ha!  Who knew gas could be so evil and so painful?  So I took my first step with her assistance and let me tell you  warn you – the pain WILL take your breath away.  I’ll fast-forward through the rest of my time there: I was there 3 nights in total, my husband helped give me a sponge bath and I progressed to taking showers on my own with him standing by.  The nurses were wonderful and I walked every day, despite the pain to encourage healing and help with gas as recommended.  On my last day there, the doctor performed one last sonogram to look over the baby, the TAC and to take my now-improved cervical length measurement.  The doctor was happy with how my incision healed and so he removed the bandage and staples and placed steri-st.rips over the incision.  As he filled out paperwork, I realized he was wearing a Cowbo.ys football team tie.  My husband and I are all about the NY Gi.ants, but I smiled and said that it seemed we were all Cowbo.ys fans that day.  Before leaving, I gave Dr. Davis another of many hugs during my stay and a very teary-eyed, heartfelt thank you.

At-home Recovery

We left the hospital on strict orders to drink water as if it were ‘going out of style’, move a little every day, take it easy, and to have s.ex when ready but on the condition of using condoms until after delivery.  Beefcake tried to drive home slowly, but every bump in the road was agony for me.  Once home, he took care of all meals, assisted with bathing and drying me when neeeded, he took care of Peaches, ran my errands, faxed paperwork to my job, helped with my grandmother who is still with us and at the time was still healing a broken ankle and much more.  We ran him ragged.  I returned to work 3 weeks post surgery.  I was still slightly sore for about a week after.  Now at 20+ weeks I feel fine, although the baby is now kicking me and occasionally making me feel soar above the incision.  However, every kick is like a breath of fresh air.

What is the TAC?

Again, it is always best to talk with a doctor, preferably a perinatologist but… There are 2 approaches to dealing with cervical incompetence.  A vaginal cerclage entails a stitching of the cervix at the site of the external os (the lower part of the cervix that a gynecologist views/’handles’ during a pelvic exam).  It is removed shortly before delivery and is therefore not permanent.  It has a good success rate, but does not compare with that of the TAC.  The vagina naturally has more bacteria than the abdomen, therefore the risk of infection is much higher when done vaginally.  For most women a vaginal cerclage will do the trick – but it can fail and some women are just not good candidates due to factors such as cervical trauma due to a previous birth, cervical surgeries, a congenitaly short cervix and i’m sure a host of other issues.   Ideally you want to get the stitch as high up on the cervix as possible to prevent funneling and the progress of pre-term labor.  This is where the transabdominal cerclage comes in.  To get it higher you have to go through the abdomen and the ideal placement is where the lower uterine segment and the internal os meet.  In other words, you want to get the cerclage at the exact juncture of where the uterus ends and the cervix begins.  Additionally, to my knowledge, abdominal cerclages are not stitched into the cervix, but rather very strong thread is wrapped around said juncture.   Make no mistake about it – this is major surgery and is a painful recovery especially when done post pregnancy, as I did.  In addition, due to the nature and placement you are FULLY committed to cesarean sections for all future deliveries.

However, the physical pain pales in comparison to the agony of losing a very beloved and desired child.

Unfortunately, some O/B’s are ignorant of this procedure or not even aware of it, and they do discourage many patiens from pursuing TAC’s when they are clearly indicated.  This is why I always suggest that you also consult with a perinatologist as difficult and complicated pregnancies are an everyday occurence for them and they are usualy up to date on new procedures and technologies.  I was lucky, in the sense that the peri that placed my ill-fated vaginal cerclage was the first one to tell me about the abdominal approach and give me hope.

Sometimes the situation is not black and white and you might be a good candidate for either approach.  What do you do?  In your shoes, I would take the more agressive approach – but that’s easy for me to conclude.  I don’t know your circumstances and i’m certain that there are many variables that you will thoughtfully consider.

Good luck to you if you are considering the TAC or another approach, I hope more than anything that you get your baby.  Remember knowledge is power, please make a well-informed decision.

A smile before surgery

With Dr. Davis before surgery - I look like a dork b/c my eyes are closed.

After surgery & whoozy

Last day in hospital - we are all Cowboys fans!

Ready to go home!

Some Hope

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I found this article while surfing the net on cerclages.  I think this is the exact procedure the maternal fetal specialist, let’s call him Dr. Stiffneck (he’s always rubbing his neck) had mentioned.  This article and outcome makes me feel better, like there might be some fucking hope left.  It shows that others who have lost two separate pregnancies so far along, have the courage to move on.  So why not us?

My husband, Mr. Positive is all set to try again.  He says we should not lament and linger, but move forward.  He is taking our losses very hard, especially that of Daniella, as she was born alive and was not plagued with Meckel-Gruber syndrome.  Sometimes I wonder if he has taken stock of all i’ve been through.  But in anycase, we will move forward and can’t wait until our consultation.