It may be Thanksgiving, but as a gluten-intolerant pescatarian, I've never been much for celebrating. Instead, I'm going to celebrate Thanksgoodness!
Why, you ask?
Billed to insurance for my TAC surgery:
$4,000 for Dr. $47,664.33 for University of Chicago med center and all associated care.
Paid by my insurance for TAC surgery:
$2,600 for Dr. $26,310.72 for University of Chicago med center and all associated care.
Paid by me:
$0 - In-network Out of Pocket Max reached.
To be fair, I've spent well into the five figures this year due to having no fertility coverage and hitting my out of pocket max, but it is such a relief that this surgery isn't going to cost any more. I know a lot of insurers refuse to pay for it, so I'm super, super grateful for mine. The fact that I have STD coverage so I can afford to be out and recover is even more amazing. I am so grateful, I just have to say Thanksgoodness for my insurance!
Showing posts with label transabdominal cerclage. Show all posts
Showing posts with label transabdominal cerclage. Show all posts
Saturday, November 25, 2017
Monday, November 20, 2017
Not-so Micro Blog Monday
Note: I am trying to participate in Microblog Mondays. On reflection, I don't do great with the Micro part. Does it count if this is shorter than my last few posts?
Today was my original return to work day. Hah! I guess I still have some optimism in me.
As for the rest of me - there are some "Yays!" and some "Boos!".
Yays: The incision is starting to tug/pull more, which I suspect is healing. I can roll my hips over in bed using my ab muscles. Swelling is down on the right side of my abdomen and I can even take a full breath or yawn! I am off all medications.
Boos: I have one section of colon that’s still stabby. I can breathe when on my back or on my left side, but the pain gets so severe when I'm on my right side I can’t breathe at all. The hemorrhoids are resolving but the skin around my bum is in horrible shape. Sitting, standing, moving - I am constantly aware of the pain!
Please tell me this will all be worth it some day?
Want more Microblog Mondays? Head over to Stirrup Queens to read more!
Today was my original return to work day. Hah! I guess I still have some optimism in me.
As for the rest of me - there are some "Yays!" and some "Boos!".
Yays: The incision is starting to tug/pull more, which I suspect is healing. I can roll my hips over in bed using my ab muscles. Swelling is down on the right side of my abdomen and I can even take a full breath or yawn! I am off all medications.
Boos: I have one section of colon that’s still stabby. I can breathe when on my back or on my left side, but the pain gets so severe when I'm on my right side I can’t breathe at all. The hemorrhoids are resolving but the skin around my bum is in horrible shape. Sitting, standing, moving - I am constantly aware of the pain!
Please tell me this will all be worth it some day?
Want more Microblog Mondays? Head over to Stirrup Queens to read more!
Friday, November 17, 2017
TAC - Part II
Saturday
Somewhere in the early hours of the morning, after the reglan kicked in, the pain got so bad I gave up and used the pump. I knew it would prolong the pain, but I literally couldn't draw a full breath and was too exhausted to care. It took the edge off, nothing more. That said, I got more pain relief this time than I did when I lost the twins and was on narcotics and NSAIDs, so that was beneficial. Sometime in the morning, the nurse came. I still had a catheter, but really felt like I needed to urinate, so I asked her to remove it so I could go. Initially she just asked me if I'd tried to push to pee with the catheter in - rather than helping to remove. Eventually she took it out, and DH helped me stumble to the bathroom. I peed, which caused burning in my incision, but otherwise was fine. The next time I peed, about an hour later, I got the explanation for why the catheter hadn't worked: a decent amount of air came out along with urine. That would have impacted the catheter, and wasn't good for me. Once again, the UC nursing staff missed something.
Eventually Dr. Haney came in. He said the cerclage itself had gone well - 3 bands placed, but then commented that I had serious digestive system issues. Apparently he thought my colon was the worst he'd seen in 20+ years - it was so bad that he called the intern to scrub in so she could feel it. I'm not going to lie, hearing that some random intern had her hand in me and squeezed my now utterly agonizing colon really irritated me. First, it's rather rapey to do that to an unconscious patient, and second, the last damn thing my poor colon needed was someone else messing with it. Haney commented that his wife has similar issues, and her GI encouraged her to do a colon resection to address it. This is not the first time major GI surgery has been suggested to me. Haney said the same thing my past doctor did - wait until it's a lifestyle issue, then address.
I asked Haney for an ongoing rx for Reglan for the next few days, and he agreed because it would help restart my digestive system. I also asked for ambien, as I find my sleep schedule gets really messed up from anesthesia. He wrote both prescriptions, told me that he'd write me out of work on STD for a month, although I could return earlier, and said I was good to discharge. I badly wish I had felt better so I could have celebrated how well the TAC went, but I was in such bad shape I didn't care.
Originally I had booked a room at the LaQuinta because the Hyatt was much more expensive. At this point, with the agony I was in, I had DH change reservations. The Hyatt was great, got a room with early check in for us. I was discharged around 1. I had been worried that with my "23 hour hold" at the hospital, they might discharge me before I had anywhere to go, but the day nurse said she'd be happy to hold me as long as needed - it meant she probably wouldn't have to admit another patient before her shift ended! My discharge instructions were a hot mess. Despite my chart saying everywhere that I'm allergic to NSAIDs, discharge instructions said to use percocet and aspirin every 4 to 6 hours. There were other errors in the instructions but that one was the truly dangerous one. One more example of how bad the University of Chicago hospital was.
DH had to help me get dressed, between the surgical and intestinal pain, I couldn't even raise my feet up to put my own socks on. A hospital "patient transport" person was assigned and was going to take us directly to the car in the parking structure. Since I get cold extremely easy, and I was terrified of shivering with the abdominal incision, going out into the 30 degree structure seemed a poor choice. DH asked the transporter to please leave me somewhere warm while he brought the car around. That concept took a long time to convey, but the lady was super nice.
The Hyatt had a wheelchair, so DH checked in, got the wheelchair, and then got us and our stuff up to our room. We were in a block with a whole foods and a nearby CVS, so DH left to get some food for me and to get my prescriptions. At this point I was still having to use the percocet every 4 hours, and the tylenol every 6. DH brought back great food options, but all I could get down were a few bites and then the pain was too much and I stopped. I think I watched some Law and Order, and went to sleep. DH went back out and got himself some deep dish Chicago pizza.
During all of this time, the surgical incision was sore, and it burned like mad when I had to pee, but wasn't horrid. The entire length of my sigmoid colon felt like it was being stabbed repeatedly, and my whole abdomen was painful to the touch. I couldn't pass gas in either direction, or get anything moving in my GI system, and it was awful.
Sunday
We had planned to drive home Sunday. Although I still couldn't take a full breath, and didn't want to contemplate 8 hours in the car, I was terrified that eventually my digestive system was going to let loose, and I didn't want a blow out in the car. DH loaded me up on meds, went and bought Depends and wet wipes as an emergency measure, and we set off around 10-11. Talk about reaching a new low.
The drive was miserable. One side effect of all the swelling was that I couldn't feel the need to urinate. I was also not sure I could make it from the car to a restroom, so I was really worried. About 5.5-6 hours in, the pain got worse despite the meds and worst of all, I started to have muscle spams down the left side of my abdominal muscles, where the pain was already the worst. When it was happening, I couldn't breathe at all. Eventually it got so bad I told DH he needed to pull over. I knew if I couldn't stop the spams, I would need to find a hospital because I wasn't making it home. I legit thought I was at risk of lung collapse or just hypoxia from being unable to draw a breath. I also thought I might need to pee, but there seemed to be absolutely no way I could get from the car to a potty. DH stopped at a random diner somewhere in the middle of nowhere in Wisconsin. I asked him to figure out where the restrooms were, and he did, then moved the car as close as possible and helped escort me in. Standing up and moving, as hard as it was, helped, and peeing helped even more. I still couldn't breathe deeply, but the spasms stopped. Random Wisconsin diner, thank you - I owe you more than you know! We decided I would take an ambien to see if I could sleep, since part of the problem was muscle tension (confession: DH drives a bit aggressively, and when I know that's happening, I freak out and tense up - that was part of the issue).
I texted my family waiting at home to ask for specific food and to ask them to put a sheet on the sofa so I could sleep on the main floor if I couldn't walk down stairs, and to make up our other guest bed in case I could walk downstairs. Our waterbed, in the master bedroom upstairs, was a clear impossibility because it's low to the floor and hard to get out of normally!
We arrived, I had a bit of food, crashed on the sofa, then shuffled downstairs to the guest bedroom and crashed there. DH made himself a bed on the floor next to me, and set alarms to make sure I woke up to take pain meds at all the right times.
Monday
Monday was more of the same. Some pain control with the meds, but still tough to take a full breath. I got my first shower. DH had to help me with my socks again, but I dressed myself otherwise. At this point I'd been on Reglan since Saturday morning, AND been taking peri-colace, miralax, and cirtucel. Still, no movemenet until just before bedtime. I can still no longer tell when I need to pee, and there's still intense burning and bruising along my incision line.
Tuesday
GI swelling is finally starting to reduce on the right side of my abdomen, and the pain is dropping a bit. Surgical site pain is getting better. DH gets busy with work, so I get a shower on my own with no issue. GI floodgates open and I'm constantly using the toilet, which in turn triggers other problems. Stop taking percocet mid-day. Remain on Tylenol 325 every 4 hours. Make sure to get up and walk laps around the house every hour, and it's going ok.
Wednesday
DH leaves for a work trip. GI pain continues to reduce, surgical pain is clearly getting better. Swelling down - can see my hip bones again! Able to move my hips using my ab muscles for the first time when rolling over in bed! Very excited. Constant bathroom trips after severe lack of bathroom trips has resulted in a thrombosed hemorrhoid. Also, the constant wiping gets the skin very irritated. I find myself wondering how in the hell people have/enjoy anal sex. Pain from an entirely new part of my GI system is not wanted! Push Tylenol out to once every 6 hours. Am finally able to take full breaths with only mild pain! No longer burning around incision site and incision bruising is gone, although what appears to be a thumb-sized blood blister remains on the left.
Thursday
Thursday AM goes well. Similar to Wednesday. Hemorrhoid pain getting worse, GI pain getting better. About 5 pm, all that changes, and I'm back to knives stabbing my colon and an inability to take a full breath. At this point I'm only on Tylenol and I don't want to change that and add percocet back, so I try to solider through. I have to cough, and despite holding a pillow to my stomach, I start my incision bleeding. Can't stand to be touched on the left side of my abs. I am unable to sleep because the pain is so bad when lying down that I can't breathe at all. Drowse after midnight while propped up in bed with pillows.
Friday - well, I guess I'll split this into 3 posts! So far I've gotten a shower and been off all pain meds, but still have a stabby colon. I will not be returning to work Monday like I'd planned, nor will I get to cycle again in November. I'm sad, but my body is really jacked up and needs time to heal. Hopefully part three of this note will be better.
Oh - and as a side note, remember the mice? E-gads, they've taken over. :( Dad has trapped 10 since he arrived on Saturday. Bless my amazing family for dealing with me and all of this.
Somewhere in the early hours of the morning, after the reglan kicked in, the pain got so bad I gave up and used the pump. I knew it would prolong the pain, but I literally couldn't draw a full breath and was too exhausted to care. It took the edge off, nothing more. That said, I got more pain relief this time than I did when I lost the twins and was on narcotics and NSAIDs, so that was beneficial. Sometime in the morning, the nurse came. I still had a catheter, but really felt like I needed to urinate, so I asked her to remove it so I could go. Initially she just asked me if I'd tried to push to pee with the catheter in - rather than helping to remove. Eventually she took it out, and DH helped me stumble to the bathroom. I peed, which caused burning in my incision, but otherwise was fine. The next time I peed, about an hour later, I got the explanation for why the catheter hadn't worked: a decent amount of air came out along with urine. That would have impacted the catheter, and wasn't good for me. Once again, the UC nursing staff missed something.
Eventually Dr. Haney came in. He said the cerclage itself had gone well - 3 bands placed, but then commented that I had serious digestive system issues. Apparently he thought my colon was the worst he'd seen in 20+ years - it was so bad that he called the intern to scrub in so she could feel it. I'm not going to lie, hearing that some random intern had her hand in me and squeezed my now utterly agonizing colon really irritated me. First, it's rather rapey to do that to an unconscious patient, and second, the last damn thing my poor colon needed was someone else messing with it. Haney commented that his wife has similar issues, and her GI encouraged her to do a colon resection to address it. This is not the first time major GI surgery has been suggested to me. Haney said the same thing my past doctor did - wait until it's a lifestyle issue, then address.
I asked Haney for an ongoing rx for Reglan for the next few days, and he agreed because it would help restart my digestive system. I also asked for ambien, as I find my sleep schedule gets really messed up from anesthesia. He wrote both prescriptions, told me that he'd write me out of work on STD for a month, although I could return earlier, and said I was good to discharge. I badly wish I had felt better so I could have celebrated how well the TAC went, but I was in such bad shape I didn't care.
Originally I had booked a room at the LaQuinta because the Hyatt was much more expensive. At this point, with the agony I was in, I had DH change reservations. The Hyatt was great, got a room with early check in for us. I was discharged around 1. I had been worried that with my "23 hour hold" at the hospital, they might discharge me before I had anywhere to go, but the day nurse said she'd be happy to hold me as long as needed - it meant she probably wouldn't have to admit another patient before her shift ended! My discharge instructions were a hot mess. Despite my chart saying everywhere that I'm allergic to NSAIDs, discharge instructions said to use percocet and aspirin every 4 to 6 hours. There were other errors in the instructions but that one was the truly dangerous one. One more example of how bad the University of Chicago hospital was.
DH had to help me get dressed, between the surgical and intestinal pain, I couldn't even raise my feet up to put my own socks on. A hospital "patient transport" person was assigned and was going to take us directly to the car in the parking structure. Since I get cold extremely easy, and I was terrified of shivering with the abdominal incision, going out into the 30 degree structure seemed a poor choice. DH asked the transporter to please leave me somewhere warm while he brought the car around. That concept took a long time to convey, but the lady was super nice.
The Hyatt had a wheelchair, so DH checked in, got the wheelchair, and then got us and our stuff up to our room. We were in a block with a whole foods and a nearby CVS, so DH left to get some food for me and to get my prescriptions. At this point I was still having to use the percocet every 4 hours, and the tylenol every 6. DH brought back great food options, but all I could get down were a few bites and then the pain was too much and I stopped. I think I watched some Law and Order, and went to sleep. DH went back out and got himself some deep dish Chicago pizza.
During all of this time, the surgical incision was sore, and it burned like mad when I had to pee, but wasn't horrid. The entire length of my sigmoid colon felt like it was being stabbed repeatedly, and my whole abdomen was painful to the touch. I couldn't pass gas in either direction, or get anything moving in my GI system, and it was awful.
Sunday
We had planned to drive home Sunday. Although I still couldn't take a full breath, and didn't want to contemplate 8 hours in the car, I was terrified that eventually my digestive system was going to let loose, and I didn't want a blow out in the car. DH loaded me up on meds, went and bought Depends and wet wipes as an emergency measure, and we set off around 10-11. Talk about reaching a new low.
The drive was miserable. One side effect of all the swelling was that I couldn't feel the need to urinate. I was also not sure I could make it from the car to a restroom, so I was really worried. About 5.5-6 hours in, the pain got worse despite the meds and worst of all, I started to have muscle spams down the left side of my abdominal muscles, where the pain was already the worst. When it was happening, I couldn't breathe at all. Eventually it got so bad I told DH he needed to pull over. I knew if I couldn't stop the spams, I would need to find a hospital because I wasn't making it home. I legit thought I was at risk of lung collapse or just hypoxia from being unable to draw a breath. I also thought I might need to pee, but there seemed to be absolutely no way I could get from the car to a potty. DH stopped at a random diner somewhere in the middle of nowhere in Wisconsin. I asked him to figure out where the restrooms were, and he did, then moved the car as close as possible and helped escort me in. Standing up and moving, as hard as it was, helped, and peeing helped even more. I still couldn't breathe deeply, but the spasms stopped. Random Wisconsin diner, thank you - I owe you more than you know! We decided I would take an ambien to see if I could sleep, since part of the problem was muscle tension (confession: DH drives a bit aggressively, and when I know that's happening, I freak out and tense up - that was part of the issue).
I texted my family waiting at home to ask for specific food and to ask them to put a sheet on the sofa so I could sleep on the main floor if I couldn't walk down stairs, and to make up our other guest bed in case I could walk downstairs. Our waterbed, in the master bedroom upstairs, was a clear impossibility because it's low to the floor and hard to get out of normally!
We arrived, I had a bit of food, crashed on the sofa, then shuffled downstairs to the guest bedroom and crashed there. DH made himself a bed on the floor next to me, and set alarms to make sure I woke up to take pain meds at all the right times.
Monday
Monday was more of the same. Some pain control with the meds, but still tough to take a full breath. I got my first shower. DH had to help me with my socks again, but I dressed myself otherwise. At this point I'd been on Reglan since Saturday morning, AND been taking peri-colace, miralax, and cirtucel. Still, no movemenet until just before bedtime. I can still no longer tell when I need to pee, and there's still intense burning and bruising along my incision line.
Tuesday
GI swelling is finally starting to reduce on the right side of my abdomen, and the pain is dropping a bit. Surgical site pain is getting better. DH gets busy with work, so I get a shower on my own with no issue. GI floodgates open and I'm constantly using the toilet, which in turn triggers other problems. Stop taking percocet mid-day. Remain on Tylenol 325 every 4 hours. Make sure to get up and walk laps around the house every hour, and it's going ok.
Wednesday
DH leaves for a work trip. GI pain continues to reduce, surgical pain is clearly getting better. Swelling down - can see my hip bones again! Able to move my hips using my ab muscles for the first time when rolling over in bed! Very excited. Constant bathroom trips after severe lack of bathroom trips has resulted in a thrombosed hemorrhoid. Also, the constant wiping gets the skin very irritated. I find myself wondering how in the hell people have/enjoy anal sex. Pain from an entirely new part of my GI system is not wanted! Push Tylenol out to once every 6 hours. Am finally able to take full breaths with only mild pain! No longer burning around incision site and incision bruising is gone, although what appears to be a thumb-sized blood blister remains on the left.
Thursday
Thursday AM goes well. Similar to Wednesday. Hemorrhoid pain getting worse, GI pain getting better. About 5 pm, all that changes, and I'm back to knives stabbing my colon and an inability to take a full breath. At this point I'm only on Tylenol and I don't want to change that and add percocet back, so I try to solider through. I have to cough, and despite holding a pillow to my stomach, I start my incision bleeding. Can't stand to be touched on the left side of my abs. I am unable to sleep because the pain is so bad when lying down that I can't breathe at all. Drowse after midnight while propped up in bed with pillows.
Friday - well, I guess I'll split this into 3 posts! So far I've gotten a shower and been off all pain meds, but still have a stabby colon. I will not be returning to work Monday like I'd planned, nor will I get to cycle again in November. I'm sad, but my body is really jacked up and needs time to heal. Hopefully part three of this note will be better.
Oh - and as a side note, remember the mice? E-gads, they've taken over. :( Dad has trapped 10 since he arrived on Saturday. Bless my amazing family for dealing with me and all of this.
TAC Experience - Part I
This will probably be long, so I'l split into two posts, but I wanted to capture what I remember from my TAC experience. Please be warned, I had some unusual complications, so this isn’t an easy/happy or normal story. Unless you have digestive issues like me, don't assume this will happen to you!
Tuesday
This was our twins’ first birthday. I had wanted to recognize the day by writing a letter to them and burning it in our wood stove after having dinner out with DH. Instead, DH decided over the weekend that we need to recaulk/re grout our huge master shower. We limited it to caulking, but it was still a four day project. I spent most of my day getting the house ready for my dad and step mom, stripping caulk from the shower, and then trying to clean some of the innumerable bits of stripped caulk from the bathroom floor. I didn’t have time to get ready for dinner and never vaguely had a chance to think about my letter or the fire. The priority was having a shower when I got home from the hospital and wouldn’t be able to move. As it was the bathroom was a complete mess when we left, with tools, chemicals, and bags of supplies everywhere, plus caulk scrapings everywhere but the floor. Not a good day.
Wednesday
I got one last good workout in, and we headed out to Chicago. Just to add to the fun, as I went to throw out all the trash in the house before leaving, I discovered that we had mice who and apparently arrived en-masse and chewed through our trash bags. Sent an apology note to dad and SM and left anyway, as there wasn’t much we could do.
I drove for the first 4-5 hours while DH worked, then he took over. Chicago traffic was awful. We got to our hotel around 6, and got upgraded. Highly recommend the place: The Guesthouse, in Uptown. We walked to dinner. I got a rice, kale, and sweet potato bowl with Thai peanut sauce and it was terrible - inedibly salty. I was too hungry/hangry at that point to find a new place to eat (it was also below freezing, windy, and a 3/4 mile walk to our hotel), but the manager refunded my meal. DH took me to Baskin Robbins, and then we returned to the hotel for the best night of hotel sleep I’ve ever had.
Thursday
I had grand plans to do something fun in Chicago this day. Instead I had a two hour work meeting, we got breakfast at this amazing cafe, then spent way too long driving to find the hospital complex and the hotel for afterward. We got Thai for dinner and it was good. Side note: it’s really hard to find gluten free vegetarian food in Uptown. I was really disappointed. I was NPO after midnight.
Friday
I had to check in at 7:30, and we were worried about traffic, so I was up early and got a shower. Didn’t hit any traffic. Parked in structure A ($18/day with validation) and went in to the DCAM same day/ambulatory surgery for check in. They gave me a number so DH could track my status on the monitors, and then I waited.
Just after 7:30, a pre-op nurse came and got me. She confirmed my name, dob, allergies, and had me give a urine sample for a pregnancy test. I got three bracelets - one for allergies (it just said “multiple” since she didn’t write them all down), two identifying me. Then I changed and put all of my clothes and belongings into a plastic garment bag. Next up was an IV. I’m allergic to adhesives and they had very few choices for me, far less than my local hospitals. That was suboptimal. I was told my temperature was 99, which is very high for me, but not high enough to postpone surgery. I suppose that might have been a harbinger.
Once I was set with a warm blanket, DH came back and kept me company. First a resident came in, confirmed the surgery I’d be having, and then had me pull up my hospital gown so she could write her initials on my abdomen. Apparently they do this to make sure they’re operating on the right part of the right patient? Either way, I’m not thrilled still having her initials on me as I don’t really want to scrub hard that close to the incision site and the ink is. . . Tenacious!
A research assistant came in and asked if they could take a tissue sample during surgery for research on ovarian cancer. I asked what the risks were and she couldn’t answer. That lack of professionalism plagued my stay. I felt oddly pressured, but as the daughter of a breast cancer survivor, agreed.
The anesthesiologist came in and told me that since I’m not pregnant, I had the choice of general or spinal. He also said that if I was pregnant, Haney would require general, to make sure I didn’t move at all. Most importantly, he told me that if I did the spinal, he could still use enough profofol that I wouldn’t know what’s going on, but he wouldn’t have to intubate me. That sounded good to me.
Haney came in, and reiterated a lot of what he’d told us during our consult. Then it was go time. I got one last hug from DH, and was wheeled into the OR. Everyone kept talking about what an ideal patient I am - I guess I have a nice spine for a spinal! :) I met all the OR nurses, got moved onto the operating table, got the ekg leads placed. A nurse set up a surgical instrument tray/stand with pillows, and the anesthesiologist had me sit up and lean over it. I remember him asking about glove sizing and that’s it.
Dr. Haney tells me that at one point during the surgery when they were tugging very hard, they heard my voice from over the drape asking to be knocked out further. I’m thrilled to report I don’t recall.
To be honest, I don’t recall waking in recovery, either. The first thing I remember is the feeling of being wheeled somewhere. Someone told DH or I that I had a pain pump to use, and then I was left in my “observation” room.
When I was lucid, I was in an insane amount of pain. Not from the surgical site, although I could sure feel that, but from my digestive system. It felt like someone was stabbing knives through my colon, constantly. I know my body well enough to be aware that’s what happens when my colon shuts down and gas starts to build. It was so bad I couldn’t draw a full breath. I knew that narcotics would make it worse, so I didn’t want to use the pain pump. DH and I asked, over and over again, for hours, for an alternative, and were just repeatedly told to push the button on the pump. It was an awful frustrating experience, to be in absolute agony, unable to breathe, and we couldn’t even get a doctor to come tell us there were no other options than narcotics.
Somewhere in there, I started throwing up. Puking with an abdominal incision is a special kind of hell. They wanted me on zofran, but that causes the same digestive problems, so that was a no-go. There are three things I know I can't have if I want my digestive system to work: sudafed, zofran, and narcotics. The hospital had me on two of the three.
After hours, the resident on call came in and told me to take the pain pump and the zofran, in a pissed off tone. I told her the problem wasn’t surgical pain, it was digestive, that zofran and narcotics would worsen it. She didn’t say anything useful. I asked for reglan instead of zofran, because reglan will cause the digestive system to speed up, doing exactly what I needed, and will reduce nausea. She agreed to that and left.
That was my night.
Tuesday
This was our twins’ first birthday. I had wanted to recognize the day by writing a letter to them and burning it in our wood stove after having dinner out with DH. Instead, DH decided over the weekend that we need to recaulk/re grout our huge master shower. We limited it to caulking, but it was still a four day project. I spent most of my day getting the house ready for my dad and step mom, stripping caulk from the shower, and then trying to clean some of the innumerable bits of stripped caulk from the bathroom floor. I didn’t have time to get ready for dinner and never vaguely had a chance to think about my letter or the fire. The priority was having a shower when I got home from the hospital and wouldn’t be able to move. As it was the bathroom was a complete mess when we left, with tools, chemicals, and bags of supplies everywhere, plus caulk scrapings everywhere but the floor. Not a good day.
Wednesday
I got one last good workout in, and we headed out to Chicago. Just to add to the fun, as I went to throw out all the trash in the house before leaving, I discovered that we had mice who and apparently arrived en-masse and chewed through our trash bags. Sent an apology note to dad and SM and left anyway, as there wasn’t much we could do.
I drove for the first 4-5 hours while DH worked, then he took over. Chicago traffic was awful. We got to our hotel around 6, and got upgraded. Highly recommend the place: The Guesthouse, in Uptown. We walked to dinner. I got a rice, kale, and sweet potato bowl with Thai peanut sauce and it was terrible - inedibly salty. I was too hungry/hangry at that point to find a new place to eat (it was also below freezing, windy, and a 3/4 mile walk to our hotel), but the manager refunded my meal. DH took me to Baskin Robbins, and then we returned to the hotel for the best night of hotel sleep I’ve ever had.
Thursday
I had grand plans to do something fun in Chicago this day. Instead I had a two hour work meeting, we got breakfast at this amazing cafe, then spent way too long driving to find the hospital complex and the hotel for afterward. We got Thai for dinner and it was good. Side note: it’s really hard to find gluten free vegetarian food in Uptown. I was really disappointed. I was NPO after midnight.
Friday
I had to check in at 7:30, and we were worried about traffic, so I was up early and got a shower. Didn’t hit any traffic. Parked in structure A ($18/day with validation) and went in to the DCAM same day/ambulatory surgery for check in. They gave me a number so DH could track my status on the monitors, and then I waited.
Just after 7:30, a pre-op nurse came and got me. She confirmed my name, dob, allergies, and had me give a urine sample for a pregnancy test. I got three bracelets - one for allergies (it just said “multiple” since she didn’t write them all down), two identifying me. Then I changed and put all of my clothes and belongings into a plastic garment bag. Next up was an IV. I’m allergic to adhesives and they had very few choices for me, far less than my local hospitals. That was suboptimal. I was told my temperature was 99, which is very high for me, but not high enough to postpone surgery. I suppose that might have been a harbinger.
Once I was set with a warm blanket, DH came back and kept me company. First a resident came in, confirmed the surgery I’d be having, and then had me pull up my hospital gown so she could write her initials on my abdomen. Apparently they do this to make sure they’re operating on the right part of the right patient? Either way, I’m not thrilled still having her initials on me as I don’t really want to scrub hard that close to the incision site and the ink is. . . Tenacious!
A research assistant came in and asked if they could take a tissue sample during surgery for research on ovarian cancer. I asked what the risks were and she couldn’t answer. That lack of professionalism plagued my stay. I felt oddly pressured, but as the daughter of a breast cancer survivor, agreed.
The anesthesiologist came in and told me that since I’m not pregnant, I had the choice of general or spinal. He also said that if I was pregnant, Haney would require general, to make sure I didn’t move at all. Most importantly, he told me that if I did the spinal, he could still use enough profofol that I wouldn’t know what’s going on, but he wouldn’t have to intubate me. That sounded good to me.
Haney came in, and reiterated a lot of what he’d told us during our consult. Then it was go time. I got one last hug from DH, and was wheeled into the OR. Everyone kept talking about what an ideal patient I am - I guess I have a nice spine for a spinal! :) I met all the OR nurses, got moved onto the operating table, got the ekg leads placed. A nurse set up a surgical instrument tray/stand with pillows, and the anesthesiologist had me sit up and lean over it. I remember him asking about glove sizing and that’s it.
Dr. Haney tells me that at one point during the surgery when they were tugging very hard, they heard my voice from over the drape asking to be knocked out further. I’m thrilled to report I don’t recall.
To be honest, I don’t recall waking in recovery, either. The first thing I remember is the feeling of being wheeled somewhere. Someone told DH or I that I had a pain pump to use, and then I was left in my “observation” room.
When I was lucid, I was in an insane amount of pain. Not from the surgical site, although I could sure feel that, but from my digestive system. It felt like someone was stabbing knives through my colon, constantly. I know my body well enough to be aware that’s what happens when my colon shuts down and gas starts to build. It was so bad I couldn’t draw a full breath. I knew that narcotics would make it worse, so I didn’t want to use the pain pump. DH and I asked, over and over again, for hours, for an alternative, and were just repeatedly told to push the button on the pump. It was an awful frustrating experience, to be in absolute agony, unable to breathe, and we couldn’t even get a doctor to come tell us there were no other options than narcotics.
Somewhere in there, I started throwing up. Puking with an abdominal incision is a special kind of hell. They wanted me on zofran, but that causes the same digestive problems, so that was a no-go. There are three things I know I can't have if I want my digestive system to work: sudafed, zofran, and narcotics. The hospital had me on two of the three.
After hours, the resident on call came in and told me to take the pain pump and the zofran, in a pissed off tone. I told her the problem wasn’t surgical pain, it was digestive, that zofran and narcotics would worsen it. She didn’t say anything useful. I asked for reglan instead of zofran, because reglan will cause the digestive system to speed up, doing exactly what I needed, and will reduce nausea. She agreed to that and left.
That was my night.
Tuesday, October 17, 2017
Preventing Fetal Membrane Rupture
Given my history, I'm quite interested in pPROM, and what might be done to reduce the risk of pPROM. The obvious answer is to prevent bacteria from ascending into the uterus, which we're hoping to accomplish via the TAC and clearing out my chronic endometritis. Beyond that, though, I wanted to learn more about fetal membranes.
Below are a selection of research articles I found. I've mostly included those that found consistent results. This is why you won't see any studies on Vitamin C below, as C has mixed results with respect to FM rupture. The caveat: read these and make your own decision, and note that the researchers are often the same across these studies. I will say that if I"m ever pregnant again, I intend to stay on progesterone (P4) and take Alpha-lipoic acid.
Fetal Membrane structure (FMs):
Fetal membranes are composed of two layers, the chorion and the amnion. During pregnancy, a weak zone in the fetal membranes typically develops over the cervix. This is the spot that typically ruptures during a normal labor.
In various modeling and testing, the amnion is the most important component of FM with respect to strength. Thinner amnion and chorion are correlated to lower strength and greater risk of rupture.
See: Function and Failure of the Fetal Membranes, (2017) Verbruggen, et. al.
Etiology of FM rupture:
When looking at the weak zone that appears over the cervix in a healthy term pregnancy, researchers find remodeling of the collagen that makes up the FM. Inflammation/infection and bleeding/abruption both produce the same collagen remodeling effect, when modeled using TNF (for infection) and Thrombin (for abruption).
See: The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited. (2016) Kumar, et. al.
Correlates with FM strength:
"The dietary supplement α-lipoic acid and progestogens (P4, MPA and 17α-hydroxyprogesterone) have been shown to inhibit both TNF and Thrombin induced FM weakening. The progestogens act at multiple points by inhibiting both GM-CSF production and GM-CSF action."
See: The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited. (2016) Kumar, et. al.
Alpha-lipoic acid moderates the impact of both TNF and thrombin on FM. "Treatment of FM with 0.25 mM LA completely inhibited thrombin-induced FM weakening and MMP expression (all p < 0.001). Thrombin treatment of cultured FM induces mechanical weakening and increased MMP3 and 9. Treatment of FM with LA inhibits these thrombin-induced effects. We speculate LA may prove clinically useful in prevention of PPROM associated with abruption."
See: Alpha-lipoic acid inhibits thrombin-induced fetal membrane weakening in vitro. (2010), Moore, et. al.
"TNF and thrombin both weakened fetal membranes and elevated media GM-CSF levels on the choriodecidua side of the fetal membrane. Pretreatment with progesterone, MPA (medroxyprogesterone acetate), or HP (17α-hydroxyprogesterone) inhibited both TNF- and thrombin-induced fetal membrane weakening and also inhibited the induced increase in GM-CSF. GM-CSF decreased fetal membrane rupture strength by 68%, which was inhibited by progestogen pretreatment with a potency order: progesterone <MPA <HP"
See: Progesterone inhibits in vitro fetal membrane weakening. (2015). Kumar, et. al.
Below are a selection of research articles I found. I've mostly included those that found consistent results. This is why you won't see any studies on Vitamin C below, as C has mixed results with respect to FM rupture. The caveat: read these and make your own decision, and note that the researchers are often the same across these studies. I will say that if I"m ever pregnant again, I intend to stay on progesterone (P4) and take Alpha-lipoic acid.
Fetal Membrane structure (FMs):
Fetal membranes are composed of two layers, the chorion and the amnion. During pregnancy, a weak zone in the fetal membranes typically develops over the cervix. This is the spot that typically ruptures during a normal labor.
In various modeling and testing, the amnion is the most important component of FM with respect to strength. Thinner amnion and chorion are correlated to lower strength and greater risk of rupture.
See: Function and Failure of the Fetal Membranes, (2017) Verbruggen, et. al.
Etiology of FM rupture:
When looking at the weak zone that appears over the cervix in a healthy term pregnancy, researchers find remodeling of the collagen that makes up the FM. Inflammation/infection and bleeding/abruption both produce the same collagen remodeling effect, when modeled using TNF (for infection) and Thrombin (for abruption).
See: The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited. (2016) Kumar, et. al.
Correlates with FM strength:
"The dietary supplement α-lipoic acid and progestogens (P4, MPA and 17α-hydroxyprogesterone) have been shown to inhibit both TNF and Thrombin induced FM weakening. The progestogens act at multiple points by inhibiting both GM-CSF production and GM-CSF action."
See: The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited. (2016) Kumar, et. al.
Alpha-lipoic acid moderates the impact of both TNF and thrombin on FM. "Treatment of FM with 0.25 mM LA completely inhibited thrombin-induced FM weakening and MMP expression (all p < 0.001). Thrombin treatment of cultured FM induces mechanical weakening and increased MMP3 and 9. Treatment of FM with LA inhibits these thrombin-induced effects. We speculate LA may prove clinically useful in prevention of PPROM associated with abruption."
See: Alpha-lipoic acid inhibits thrombin-induced fetal membrane weakening in vitro. (2010), Moore, et. al.
"TNF and thrombin both weakened fetal membranes and elevated media GM-CSF levels on the choriodecidua side of the fetal membrane. Pretreatment with progesterone, MPA (medroxyprogesterone acetate), or HP (17α-hydroxyprogesterone) inhibited both TNF- and thrombin-induced fetal membrane weakening and also inhibited the induced increase in GM-CSF. GM-CSF decreased fetal membrane rupture strength by 68%, which was inhibited by progestogen pretreatment with a potency order: progesterone <MPA <HP"
See: Progesterone inhibits in vitro fetal membrane weakening. (2015). Kumar, et. al.
Friday, September 1, 2017
CCRM, Again
My other appointment for the week was back with CCRM. None of the other issues matter if we can’t get pregnant again. With my one follicle response to 2400+ iU of FSH in February, I wasn’t sure what our odds of another pregnancy are. That’s especially true as I turn 38 in October. I wanted to get Dr. B’s take, find out how she’d treat us, get her input regarding chronic endometritis, and make sure she didn’t see a concern about the TAC. Thus, off to another appointment. Here are notes on what we heard.
If she thinks we can get pregnant again, and Dr. Haney did too, then I think proceeding with the TAC is the right call. I can’t speak to our embryo quality, having never seen one, but our three daughters were beautiful, and that I can speak to!
As for the gestational carrier, my logical side knows that would be our best chance at a living child. They’re all right about that. However, between the cost of IVF and surrogacy, we’re talking around $100k. That same logical side, the one that created a 20 page Excel workbook to track all our finances each year, that side can’t get on board with that much money, after the tens of thousands we’ve already spent, for a chance at bringing a baby home. Because nothing is guaranteed, even a gestational carrier. So, my ute it is.
My SIS and endometrial biopsy are next Wednesday. Wish me luck? Also, I have to get meds ordered from CVS Caremark. I'm certain that will be more painful than the biopsy. Sigh.
- We make good embryos. We have success during cycles that seem improbable. We should be able to get pregnant again. (Hah, famous last words!)
- Consider a gestational carrier. (Dr. N suggested this as well, but thinks with the TAC we don’t need one.) The challenge would be getting enough euploid embryos, but Dr. B thinks we could accomplish that. No matter what, she’ll up my dosages aggressively for my next cycle.
- Check out the ute more thoroughly. Instead of the saline sono we have scheduled, do a diagnostic hysteroscopy. Do this before the TAC so there aren’t issues.
- Be really aware of what a TAC means if you have a second tri loss. She’s treated patients with TACs who have been successful in subsequent pregnancies and those who haven’t. Hysterotomy to end the pregnancy is substantial surgery.
- Related to #4, be aware that at 38, the risk of genetic abnormalities goes up. Be prepared for that.
- Up my meds. Start with 150 menopur, 300 FSH, and use cetrotide if lead follicle(s) grow too fast. Target 3-4 follicles. Consider priming in advance of the cycle.
- She supports doing a longer course of doxy, starting prior to the cycle, if we push for that.
If she thinks we can get pregnant again, and Dr. Haney did too, then I think proceeding with the TAC is the right call. I can’t speak to our embryo quality, having never seen one, but our three daughters were beautiful, and that I can speak to!
As for the gestational carrier, my logical side knows that would be our best chance at a living child. They’re all right about that. However, between the cost of IVF and surrogacy, we’re talking around $100k. That same logical side, the one that created a 20 page Excel workbook to track all our finances each year, that side can’t get on board with that much money, after the tens of thousands we’ve already spent, for a chance at bringing a baby home. Because nothing is guaranteed, even a gestational carrier. So, my ute it is.
My SIS and endometrial biopsy are next Wednesday. Wish me luck? Also, I have to get meds ordered from CVS Caremark. I'm certain that will be more painful than the biopsy. Sigh.
Thursday, August 31, 2017
One Surprising Step Ahead
Today was my MFM consult. Some of it went as I’d have expected, other things were very different. Starting off, the first and biggest recommendation the perinatologist had was to get a pre-pregnancy transabdominal cerclage. With Dr. Haney. I wasn’t expecting that at all, but it turns out she had a patient with an identical history to mine. Lost twins due to pprom. Lost a singleton to IC. Did a TVC and kept culturing and treating the bacteria they found during pregnancy. . . . and still lost that pregnancy. So they sent her for a TAC, and she recently delivered a 39 week baby.
To say that recommendation was a pleasant shock is an understatement. While I was hospitalized and talking to another MFM in the group, he told me we’d place a TVC at 12 weeks during future pregnancies. I had pushed back, hard, on why you’d do a TVC, especially in someone with infection issues, and not TAC. He was adamant about the TVC being the right choice. So to hear the number one recommendation being a TAC, and to be told to go to Haney, that made me feel much, much better about my decision. It also means I'm one step ahead of the game, having already consulted with him and booked surgery.
On the subject of infection, this perinatologist, Dr. N, agreed with Dr. Haney that the underlying cause of both losses was cervical issues. Even though my cervix was long and closed after Zoe’s water broke. Even though Zoe was the higher baby, and bacteria should rupture the lower baby’s membranes first. She truly believes that there’s no scientific benefit or merit in looking for chronic endometritis, and that treating any bacteria found in my uterus that don’t belong there would cause other problems, as she saw in the patient previously mentioned. Having said all that, we pressed really hard and she agreed to request an endometrial biopsy and a consult with the true Infectious Diseases department. So, on 9/6, I go in for my SIS and a biopsy. Based on what those show, we’ll figure out what comes next.
Dr. N mentioned that infectious diseases would probably screen me for various autoimmune issues that interact with infections. With my history, that seemed wise.
On the topic of progesterone, she noted that it’s shown to help in cases of cervical shortening before 24 weeks, but with the TAC I will not have cervical shortening. Thus, she can not see any clinical benefit. At the same time, she’s willing to discuss further/prescribe it, if I get there, because there’s no harm either. The same goes for additional cervical monitoring during pregnancy. No need, but no harm, and there’s something to be said about the positive impact on my anxiety levels.
With respect to my Asherman’s, and my history of autoimmune disorders, that’s unlikely to be related to pPROM. I will have my placenta monitored more closely during future pregnancy to make sure there are no IUGR or placental insufficiency issues caused by the Asherman’s.
So, the plan:
1. During next cycle (which started when I walked out to the parking garage after the appointment) get endometrial biopsy and confirm uterine cavity is clear of scarring. At the moment I’m scheduled for a biopsy and SIS, but that may be replaced by a biopsy and hysteroscopy.
2. Consult with Infectious Diseases. Determine treatment based on biopsy and results.
3. Have TAC placed.
4. Return to CCRM for COH.
DH and I need to talk a bit more, but it’s a plan I feel pretty good about. It may not get us a THB, but I will feel confident that we’ve tried EVERYTHING we could in getting there.
To say that recommendation was a pleasant shock is an understatement. While I was hospitalized and talking to another MFM in the group, he told me we’d place a TVC at 12 weeks during future pregnancies. I had pushed back, hard, on why you’d do a TVC, especially in someone with infection issues, and not TAC. He was adamant about the TVC being the right choice. So to hear the number one recommendation being a TAC, and to be told to go to Haney, that made me feel much, much better about my decision. It also means I'm one step ahead of the game, having already consulted with him and booked surgery.
On the subject of infection, this perinatologist, Dr. N, agreed with Dr. Haney that the underlying cause of both losses was cervical issues. Even though my cervix was long and closed after Zoe’s water broke. Even though Zoe was the higher baby, and bacteria should rupture the lower baby’s membranes first. She truly believes that there’s no scientific benefit or merit in looking for chronic endometritis, and that treating any bacteria found in my uterus that don’t belong there would cause other problems, as she saw in the patient previously mentioned. Having said all that, we pressed really hard and she agreed to request an endometrial biopsy and a consult with the true Infectious Diseases department. So, on 9/6, I go in for my SIS and a biopsy. Based on what those show, we’ll figure out what comes next.
Dr. N mentioned that infectious diseases would probably screen me for various autoimmune issues that interact with infections. With my history, that seemed wise.
On the topic of progesterone, she noted that it’s shown to help in cases of cervical shortening before 24 weeks, but with the TAC I will not have cervical shortening. Thus, she can not see any clinical benefit. At the same time, she’s willing to discuss further/prescribe it, if I get there, because there’s no harm either. The same goes for additional cervical monitoring during pregnancy. No need, but no harm, and there’s something to be said about the positive impact on my anxiety levels.
With respect to my Asherman’s, and my history of autoimmune disorders, that’s unlikely to be related to pPROM. I will have my placenta monitored more closely during future pregnancy to make sure there are no IUGR or placental insufficiency issues caused by the Asherman’s.
So, the plan:
1. During next cycle (which started when I walked out to the parking garage after the appointment) get endometrial biopsy and confirm uterine cavity is clear of scarring. At the moment I’m scheduled for a biopsy and SIS, but that may be replaced by a biopsy and hysteroscopy.
2. Consult with Infectious Diseases. Determine treatment based on biopsy and results.
3. Have TAC placed.
4. Return to CCRM for COH.
DH and I need to talk a bit more, but it’s a plan I feel pretty good about. It may not get us a THB, but I will feel confident that we’ve tried EVERYTHING we could in getting there.
Wednesday, August 30, 2017
Blocking the Exit
Earlier this month, we had a telephone meeting with a doctor who could probably be described as the expert in transabdominal cerclage. His name is Dr. Haney. Due to my cervical issues this pregnancy, we’re unwilling to consider trying again without a better option than a(nother) transvaginal cerclage. Dr. Haney, who is located in Chicago, appeared to be that better option. For the sake of my record keeping, I’m going to use this post as a place to track what we learned during our two hours on the phone with him.
The Consult
Here’s my best translation of what Dr. Haney told us. I’m not agreeing/disagreeing with anything, just trying to reproduce in my own words what I heard from him. Since this was filtered through my memory/lens, take it for what it’s worth!
The cervix is like a tube or a spindle: there’s tissue around an open canal. Of that tube, 2/3rds of it is up in the abdominal cavity, attached to the uterus, and the last third is down in the vagina. There is a band of tissue at the top of the cervix, the part in the abdomen, that remains tightly closed. During labor, the pressure of the baby’s head, plus contractions, is what forces that band to dilate. But outside of labor, it stays tight. That’s in a woman without cervical insufficiency (CI).
In a woman with CI, the entire column of the cervix dilates from the internal opening downward as the relatively small pressure from the growing baby presses down due to gravity’s impact. As the cervix dilates, bacteria can get into the uterus, and the membranes of the amniotic sac can tear free from the uterus and prolapse out into the cervical canal and vagina.
With a transvaginal cerclage (TVC), a stitch is placed in the lower third of the cervix. Women who have true CI and a TVC will funnel down to the stitch, because nothing has been done to prevent the upper 2/3rds of the cervix from dilating. This means membranes will pull away from the wall of the uterus, and bacteria from the vagina will be able to ascend to the uterus. If I understood Dr. Haney correctly, his position is that women with CI and a TVC will always wind up with chorioamnioitis because of this ascending bacteria. The chorio in turn worsens the chances of survival for their infants. Having had chorio with all three girls, and knowing that Alexis and Zoe passed before birth due to severe chorio, this was a painful reminder of everything that we’ve been through.
With a transabdominal cerclage (TAC), a 2-3 inch incision is opened at the bikini line. A woven fiber band is tied around the cervix at some point in the upper 2/3rds. In my case, Dr. Haney would place two bands. Each band has the strength to support 100-120 pounds, so they could easily support the weight of a fetus, placenta, amniotic fluid, etc. With the bands in place, dilation is impossible. They’re not tied so tight that the cervix is occluded, but they are tied tight enough that the membranes can’t ever prolapse and the cervix can’t funnel. The result of this is that the mucus plug stays in place, the cervix stays long (~4cm) and bacteria can’t ascend from the vagina. The other results: while one can have periods, first trimester miscarriages, and get pregnant “the old fashioned way,” one will have to have a c-section for any 2nd trimester delivery. There is also a risk of uterine rupture as the cervix can’t dilate if contractions occur, and something’s got to give.
Dr. Haney reported a 99% success rate, where success is defined as a live birth, and even mentioned that 92 of 92 sets of twins whose mothers he performed TACs on were born live. He noted that when babies are born before term with TAC in place, it’s due to other issues.
What are my feelings on all of this?
I agree with the belief that TAC has much higher success rates than TVC, when you define success as live birth. There are numerous studies, most from outside the US, to support this. If we try again, I will have a pre-pregnancy TAC placed with Dr. Haney. There is no question in my mind about that. Having said that, the “other issues” that cause pre-term deliveries are also very relevant to me, and I’m concerned they were minimized during our conversation. That’s probably because I was talking to someone who specializes in TACs and not the other issues, but I know exactly how this works: any complications I have during pregnancy post TAC my local MFM team will blame on the TAC. The TAC expert will simultaneously assure me it’s not due to the TAC and that I should work with my MFM team. The end result will be suboptimal because everyone will be busy pointing fingers at everyone else. Cynical much? Why yes, I am.
Next steps
From my point of view, there are two issues that must be addressed before we decide to try for another pregnancy. First, infection. There’s a growing body of literature correlating first trimester miscarriages and failure of genetically normal embryos to “take” after IVF transfer with asymptomatic, chronic endometrial infection. Correlation isn’t causation, and there are plenty of women with term deliveries who also show these markers of infection (related note, I found a study showing a decent percentage of healthy pregnancies in the 36-38 week range have chorio, but no one ever looks for it because there’s no reason to).
Looking at my personal history, I had more than 15 years of recurrent UTIs. They started when I was a kid, a few times a year, and by early 2010, I got them every month or two. I would take my antibiotics each time, the symptoms would vanish, until the next trigger caused the infection to flare up again. In 2010 I was finally referred to urology. The urologist confirmed that there were no structural abnormalities, and then told me that in some people, the bacteria just hang around. The antibiotics knock them back enough to reduce symptoms, but as soon as conditions are right again, they go out of control. I was placed on 6 months of low dose macrobid, and had my last UTI in 2010. At least, my last until 2017. Long way of saying that I have a history of bacteria hanging on through antibiotics that should have cleared them. And bacteria that were asymptomatic until something triggered their uprising. Now I can’t help wondering if ‘pregnancy’ is what’s triggered uterine bacteria.
So, we must clear up the infection issue before we can make a decision to try again.
My cervix is the second issue. I think the TAC with Dr. Haney will address that. It comes at a high risk and a high physical cost, but it’s as good of an option as exists. Honestly, I’m grateful that there IS an option that works so well to solve one of my issues, even if the associated risks are great.
Overall, more answers, one potential solution, more risk and fear.
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