A new day, although it felt like one long day because of the stress and not much sleep. The high risk doctor and an ultrasound tech came in around 8:30 or 9am that morning. Our daughter looked great. Her heartbeat was strong, she moved around and the fluid in the amniotic sac was on the low end of normal, but still normal. The only problem was that she was breech and one of her little feet kept trying to push down out of my cervix. Just 12 days ago she was head down. During that big ultrasound we almost didn't find out she was a girl because she was hiding under my belly button (being modest as girls should). But now she was feet down and because she was so active, they were putting more pressure on my weak cervix. I wasn't bleeding anymore and there was no sign of infection, so that was good. After the ultrasound they moved me to another room while the doctor double checked all of my stats, blood work and reviewed the ultrasound data. He came in a little later and told us we had 2 options at this point.
The first option was to take me off all the medications, do nothing and let nature take over. I was about 3cm dilated from what they could tell, which is a lot when it comes to doing the cerclage. In fact if I was 4cm he wouldn't do the surgery because there wouldn't be enough tissue to work with. If we did nothing or daughter had no chance. The second option was to do the surgery with the understanding that if I was more dilated once he got in there, he would stop because he wouldn't have enough make a closure he could be confident in. The other risk was that he could rupture the amniotic sac, in which case she would be delivered. Another risk was damage to my cervix, especially since the tissue had thinned so much already. And of course there were the general risks of surgery and anesthesia. I was going to have a spinal block because he wanted me to still be awake to know what was going on. The surgery wouldn't be a guarantee, but it would at least give her a chance. If we could get to 23 weeks she had a 20-30% chance of survival and at 28 weeks it went up to 80-90% with fewer complications and long term affects. At this point I was 21 weeks 1 day. He left the room and Adam and I talked.
It was a lot to take in. Adam sat next to me on the bed, held my hand and I sobbed. I couldn't keep it in anymore. I pulled myself together and we talked. We decided to try the surgery. To us the biggest risk was that he could rupture the sac and that would have the same outcome as doing nothing. We had to at least try. I wanted to give her every chance I could. I even contemplated asking if they could just put me in a coma and let me be an incubator until she was ready to be born healthy. I knew that really wasn't feasible, but it sounded great to me. I could go to sleep when things were scary and wake up to something happy.
We called the doctor back in and said we wanted to try the surgery. He had the OR reserved, but they needed to do an emergency C-section first. So we waited in the room. I asked my Mom to call Adam's family and ask them to come just in case. We had high hopes, but one of the risks was that she would be born that day anyway and I wanted them to be there if that happened. The anesthesiologist came in to introduce himself and tell us about what he was going to do. He went over the risks and I just nodded. We waited, trying not to get more nervous and then the nurses came in to take me to the OR. I kissed Adam, squeezed my Mom's hand and they wheeled me out. It's a surreal feeling to be rolled flat on your back in a bed.
We got to the OR and I scooted over onto the operating table while still staying on my back. My doctor didn't want me to sit up, so I curled into a ball on my side for the anesthesiologist to give me the spinal block. The numbing shot was the worst part, who would have thought? My doctor held my hand for this part. It meant a lot to me. We'd only met the day before and I knew he wasn't hopeful about the outcome of this surgery (he was always straight forward with us, which I appreciated), but he was still supportive and knew I was scared.
The surgery is kind of a blur. They strapped my legs up into these straps on poles, gave me oxygen and pulled my arms out to my sides. I heard lots of talking, but not much specific. My anesthesiologist kept rubbing my shoulder and telling me to take a deep breath in and out because I kept almost falling asleep. He said at one point that they hadn't needed to give me so much of one of the medications. I guess I'm just extra sensitive to it. They kept tilting my head down further and further and at one point I heard my doctor tell me they were going to basically stand me on my head. Again, using gravity to help push the sac back up into the uterus. I could feel my arms slip and the nurse gently put them back. Before long it was over. I honestly have no idea how long I was in there. Adam and my Mom both tell me it wasn't long, under an hour maybe even under 30 minutes. They warned me when they were going to move me back to the hospital bed and assured me they wouldn't drop me. They then wheeled me to recovery and someone went to get Adam. I was still pretty out of it but I was so glad to see him. They cocooned me in warm blankets and waited for me to wake up a bit so the doctor could talk to us about the surgery.
My Mom came back to see me too and then the doctor came in. He said the surgery went fairly well (better than he had expected). I had dilated a bit more and at first he wasn't sure he was going to go through with the surgery. But they tilted me and when he pushed on the sac it was very strong so he went ahead. He described the cervix like a clock. He used 4 stitches at 12, 3, 6, and 9. He felt confident in all of them except the one at 6. My cervix was much thinner there and he couldn't go very far back without risk of puncturing the amniotic sac. But overall things seemed good. The big risk now was infection. The next 48 hours were critical. If I got an infection it was over. So we were back in wait and see mode.
I went back to my room and saw my in-laws. I was glad they were there too. I was pretty exhausted so I told them to take Adam to get something to eat and I was going to try and sleep. The rest of the day was pretty uneventful. Just waiting and hoping I didn't show any signs of infection. My regular OBGYN came in at one point to check on me and it was such a comfort to see her. I really did like the high risk doctor, but he didn't know me and wasn't there for everything else we'd been through. She was very reassuring and gave us more hope. All we could do now was wait and see what happened.
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