Tuesday, January 5, 2010

23 weeks 5 days...."routine" doctor's appt

Dec 17th - Eric and I went to our regularly scheduled 4-week doctor's appointment at Kamm-KcKenzie. We were scheduled to see the last of 7 doctors in the practice, Dr. Hardin. As usual they did the normal checks - blood pressure, urine check, etc, and then we went back t othe exam room. I had my usual list of questions that I bring to each appt and ran down those wtih Dr. Hardin - I was getting over a yeast infection and wanted to make sure that was all cleared up, and also had started over the last couple days feeling pressure in the bladder area. Thosetwo things caused Dr. Hardin to check my cervix, and that's when the world changed.

Dr. Hardin started talking about my "incompetent cervix" and said I was going to have to be admitted to the hospital. Our heads were sort of swimming at this point - this was completely unexpected! He talked about laying me flat to pull pressure of my cervix since I was dialated. Finally when I got my head around what he was saying I asked, do you mean run home and get a bag packed and then go to the hospital? He said, no, go there now. 9:45 am, freak out moment #1.

So, we got in the car and headed to WakeMed. I called work to let them know I wouldn't be in, probably for a long while.

When we got to Patient Registration, we gave them my name, and next thing I know there is a wheelchair behind me. I get rolled to Labor & Delivery (L&D) triage, where I get my hospital gown. IV, and get hooked up to all kinds of monitors. We had to sign papers relatd to me, and to the baby. Freak out moment #2.

At some point they moved me to an L&D room, which became our home for Thursday and Friday. Dr. Rush was on call at the hospital, and she was the first of many doctors to come and see us. Initially she mentioned getting me stable enough to do a cerclage (cervical stitch to keep it shut), so I was told I could not eat anything in case we went that route.

The the parade of doctors started. Dr. Wells, the perinatologist, sent an ultrasound technician over with a portable ultrasound machine over to do a growth scan which would tell us the baby's size, which is important at this stage. The benchmark was if he was over 500 grams, and in addition to more ultrasound pictures, we heard his estimated weight was 533 grams, good news.

Dr. Wells came by himself later after seeing the scan and was reassuring. However, he did not recommend the cerclage due to how far along I was, so I was finally cleared to eat something around 9pm.

The most knowledgeable but scariest doctor (not that he was scary, but the topic discussed was) was the neonatologist - the doctor expert in caring for preemies. He came by and discussed what we were facing, odds-wise, in terms of survivability, potential birth defects, and we had to decide what our plan of action would be if we delivered that day. Freak out moment #3.

At 23 w 5d, the odds of survival were not good. 50% of babies born at 24 weeks survive, and of those 50% are deaf, blind, have mental retardation, or cerebal palsy. The odds get slightly better at 26 weeks, and at 28 weeks there is a 95% survival rate. Also, at 25 weeks there is no question of what they will do - they will do everything the can for the baby's survival. This was a sobering and scary talk. What they needed to know from us is if the baby came before that point, what we wanted to do. Dr. P gave us some time to discuss this and came by later to see what our decision would be. We knew that the goal was to hold on as long as possible, but that was, to a degree, out ofour control. So, we decided we would move forward and if I delivered, assess the situation at that point and, with the advice of doctors and our hearts, make the call.

Then Dr. Rush came in to discuss my health in connection with delivering now. If I went into labor, and they had to do a C-section, it would be a long cut on my uterus that would make any future deliveries be C-section without a doubt. This was a no-brainer decision at this point.

Eric stayed in the hospital with me that night, and I think it's safe to say our sleep was neither comfortable nor restful. What a day.

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