This afternoon I had my follow up with the high risk doctor. I had several questions for him and some clarifications from my appointment with my regular OBGYN. I was also hoping he might have the results from the genetic testing. It was too late in the afternoon for Adam to go with me, so my mom came to be another set of ears and support.
Since I had only been to the office as an inpatient in the hospital, I had to fill out all the regular paperwork you fill out at a first appointment. It was easier than when I had the ultrasound on my gallbladder. That had been the first time I had to answer questions about pregnancy on medical forms. How many pregnancies? 2 How many miscarriages? 1 How many births? 1 How many children? 0
This time it was a bit easier. It still stung, but I didn't tear up like I did the first time.
When I was called back they took my weight and then led me to an ultrasound room. I didn't say anything because I thought maybe they just took everyone here to finish the check in process. Nope. She just hadn't read far enough down my chart. Luckily we left that room and went to a consult room. She went over the medical history I provided and took my blood pressure. Then we waited for the doctor. I was hoping I was going to see the one I'd had while in the hospital, but I wasn't sure.
Thankfully he walked into the room a few minutes later. I'm just more comfortable with him. He sat down and asked how I was doing. I told him OK. I have more good days than bad now. Some good days have some bad spots, but the good outweighs the bad most of the time. The first thing we talked about was the genetic testing. He'd gotten it. Everything was normal. Thank goodness. One less thing to worry about and a weight had been lifted off my mind. Then we talked about my list.
I asked him about the infection again because in all honesty when I talked about it with my regular OBGYN I was still in a fog and was so surprised, it went in one ear and out the other. He said there was acute coria immunititis. Basically there were white blood cells along the placenta. They wouldn't be there unless there was an infection. He said he wasn't surprised since the amniotic sac had been hanging down into the vagina basically since that first night I came to the hospital. He didn't think an infection is what caused my cervix to open because I would have been showing signs before they gave me the antibiotics and even with the antibiotics I would have shown signs. The good news, however, was that everything else about the placenta looked good.
Next we talked about trying to get pregnant again. He had told us to wait at least 3 months before trying to get pregnant again but I had never asked for the reasons. Emotionally I know we won't be ready for a while, but I figured there were physical reasons too. He said it was to ensure the membranes that help close the cervix have time to reform and my cervix needs to heal in general. Also, the longer we wait the more time my uterus has to get back to normal and form a thick lining to provide the best environment for implantation and a viable pregnancy.
I told him about the test my OBGYN wanted to perform on my uterus and he agreed it was a good idea to check. There are several tests they can do. One is the hysterosalpingogram (HSG) which involves injecting dye into the uterus and then having an xray to see the shape and if either of the fallopian tubes has a blockage. This isn't the one she was recommending. Another is the sonohysterosalpingogram. Instead of dye and an xray, this test uses saline and ultrasound. I don't think this is the one she suggested either because she never mentioned my fallopian tubes. The last is a sonohysterogram or saline sonogram. It's similar to the previous one except it only focuses on the uterus. I think this is the one she suggested, but I need to ask her specifically which one she is going to do and why.
We also talked about a future pregnancy. He said basically what we had talked about before. I would see both him and my regular OBGYN the entire time. He would want to see me right away (as would my OBGYN) to get gestational age, an estimated due date and blood work (especially my progesterone levels since they were an issue this time). If we got through the first trimester and everything looked good he would recommend a cerclage at around week 14. This is a little different than what my OBGYN said (she said 12-13 weeks), so when we get there I'll ask more questions about the specific timing. Either way I'll have the surgery. He said we could do nothing because it's not a guarantee that because it happened this time it will for sure happen next time, but he wouldn't recommend it. Me either! Better to be safe than sorry in my opinion. I'll be nervous anyway, not having the surgery just seems crazy. Other than that we'd just see how things go. I may not need to be on bed rest, but we won't know until we get there. In his opinion there was no reason to think that I couldn't carry a baby to term (or pretty close) with an early cerclage. This was nice to hear.
He also reiterated what he had said in the hospital about doing everything we could, despite the risks to my health. He said we'd followed everything to a T (limited activity, cleanliness, taking my medications, keeping an eye on my temperature, etc.) and unfortunately we just didn't get the outcome we'd wanted. He also said he's had women who have not followed all instructions to a T and ended up loosing their uterus because an infection had gotten so bad. At least that didn't happen. It was nice to hear him say again though. I do take comfort in knowing we did everything we could to give our daughter a chance. I wish it had turned out differently of course, but at least that's one thing I don't have to have any regrets or guilt about.
Overall it was a good appointment and I felt good having a plan for the future when we left. He also said the surgeons I'm seeing this week about my gallbladder are excellent, so another positive.
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