16 Weeks - A Long Update

Figured I should post an update. We have so many followers now.. Hate to leave them in the dark.

As far as the pregnancy is concerned, we've had a whole lot of worry, but very little activity. At about 12 weeks, I went for a visit with my OB, on a Friday morning, because I was feeling some "heaviness" after moving items around the home. So, to be on the safe side, just wanted to get checked out.

She felt my cervix and said, "It feels like 2 cm. I think you'll need a cerclage. I think you'll be fine over the weekend, if you want to wait, or I can send you to Indy right now for a consult."

Knowing that if I waited the weekend I would completely panic myself about every little thing, I opted to go to Indy that day to meet with the high risk doctors. Before I left the office, my OB said, "Next time I see you, you'll probably have a cerclage."

At that moment, I truly was overwhelmed with emotion. And I was trying to get ahold of Brad, who was at work, to tell him we needed to leave NOW in order to make it to Indy on time -- and to tell him I was about to have surgery.

I went to pick him up in his work parking lot, and I had already moved to the passenger seat by the time he emerged from his building. By the time he reached the car, tears were streaming down my face. I just muttered, "I don't want to go through this again." He just responded, "I know," and took my hand. Off to Indy we went.

I had calmed down by the time we arrived, but I was still going over all the possible complications. A cerclage is not without risk, and can cause infection, miscarriage, etc. It was hard not to worry about doing a 'preventative' procedure that could actually cause the thing you're trying to prevent.

But they called me back to the exam room to do an ultrasound. Doctor says the results aloud, "You're about 2.8 to 2.9 cm. You can either do a cerclage now, or wait til Tuesday to see if there are any changes. I'm comfortable with doing either."

When given the option for surgery or not, when the "not" is a viable option, I'm always choosing not. So, I told him I'd like to wait and see. That was the weekend I was on strict bedrest. The specialist actually told me it wasn't necessary medically, but it would keep me from blaming myself if something went wrong. I truly appreciated that a doctor would recognize the possible guilt involved in such decisions.

We went back on Tuesday, and lo and behold, I was measuring a 3.2 cm. Strong improvement. Whether it was the strict bedrest, or it would have happened anyway, I didn't much care. But given the improvement, doctor no longer deemed a cerclage necessary, and instead recommended weekly monitoring.

I saw the same doctor for several weeks in a row, so the visits got more humorous and relaxed, occasionally joking about his long fingers or how he has the biggest hands in the office (not sure how Brad felt about that conversation.. lol). Each week, I measured around 3.1 to 3.3. So everything was holding steady...

Until..

One week I laid down, and I hear the ultrasound tech whisper to the doctor, "She's contracting. Do you want me to wait a minute?"

My heart rate probably tripled that very second. Contracting?! I was actually too scared to even ask if I was in labor, and instead watched the doctor's face for a clue as to whether this was the end. He seemed completely unphased, so I was relieved, but still anxious for an explanation.

Finally, after much squinting at the screen, he turned to me, "Well, part of your uterus is contracting.. which is completely normal.. but it makes it really hard to get a measurement. Still looks okay though."

Whew!

I went a couple more weeks with different doctors seeing me. Last week, I got, "Everything looks about the same, but there is some slight funneling."

Ugh. For those that don't know, it's exactly what it sounds like. It means the cervix is opening up from the inside out, and it looks like a funnel on the ultrasound. It's not good. But this doctor, again, didn't seem concerned. I truly didn't understand why this wasn't concerning, as funneling -- to me, indicates labor is about to start. But I tried to let it go. If the high risk folks aren't worried, I probably shouldn't be.

Bean, sleeping on their stomach, during the "funneling" ultrasound.

Luckily, today, I saw my original long-fingered doctor. Still measured a 3.2 cm. And I asked about the funneling.

His response: "Yeah... I don't think that's actually funneling. In early ultrasounds, the uterus and cervix are sometimes hard to tell apart. And the softening of your uterus can look like funneling. But given your measurements, I think everything is completely fine."

:) Why couldn't the other guy have just said that?

And this week, per usual protocol, they've started me on progesterone injections. Theoretically, it makes your body feel "super" pregnant, and will hopefully prevent any preterm contractions and can help the cervix stay longer.

We're 3 weeks away from when we lost the twins (19 weeks, 2 days), so I feel myself getting more nervous by the day. But, I'm trying desperately to stay optimistic.

What Lies Ahead

Right after losing Jasper and Bodhi, the high risk doctor came in to speak to me. Along with all the information about the birth, and how none of it was my fault (medically speaking), he went on to briefly explain that we should ideally wait 6 months or longer to try to conceive again.

"Some women are just so eager to get pregnant again very quickly. I have to advise against that."

He didn't really explain further, perhaps because I was just shaking my head "no," implying that it was the last thought on my mind. Truth was, I was just terrified that we wouldn't even be able to try again. After the hyper stimulation and hospitalization at the beginning of this pregnancy, I wasn't sure there were any options for us other than IVF -- which was a financial non-starter.

After all, the last time we saw our fertility specialist, leaving from an ultrasound, he shook our hands and said, "I'm so glad you ended up with twins because I didn't know what we would have done next."

That was a very honest thing to say. The injections nearly killed me, after all. Even if similar medications were an option, was I up for that? And I knew my husband was terrified that I'd go through that again.. or that the complications could be even worse.

But over the next few days, I was aching to speak with the specialist. On the other hand, I was terrified to even bring it up to Brad. We were both still having breakdowns on a regular basis. I didn't want him, or anyone else, to think I was just trying to move on. Still, I was overwhelmed thinking about it and questioning our future. I couldn't keep this to myself.

So, the day after the memorial service, I did as I usually do and just blurted out, "I need you to promise me.. that you'll do whatever it takes to try again, if we can. I know you're scared, and I know we may not even have any options left.. but if we do, I need you on board."

He was confused, and taken aback by the abruptness. He definitely wasn't 100 percent on board yet.

"I don't want you to go through that again. It scares me."

I went on with a speech about how I could die from anything at any time. But going my entire life and never again feeling the way I felt when I first held my son and daughter.. or when I saw my husband become a father -- that's what scares me.

"Brad, I need you to know this isn't about replacing them.. or pretending it didn't happen. I love them so much, and I miss them more than I thought possible. But I need a plan... All of our plans were about them or for them. Buying a house, picking colors for a nursery, birthing classes, quitting my job... I have nothing to plan. Everything is up in the air, and I need something.. anything.. to feel grounded right now. I need to know if we can try again, or if I need to accept that it's over."

That, he got. "Then let's meet with the doctor to see if we have any options left."

Monday, one week after delivery, I called the specialist. As the nurse answered, I started to explain who I was.. "This is Carol Shilor.. I had gotten pregnant back in September.. with twins.." I felt my voice start to shake.

Oh man, I was about to fall apart on the phone. Deep breath. "But I went into preterm labor and.. and we lost them both."

She simply responds, "Oh hon. I'm so sorry."

I continue, "I know we can't try anything for awhile, but I wanted to meet with the doctor to see what our options are."

To my amazement, she responded that he could see us Wednesday. I paused for a moment. No. Two days from now? I barely made it through this phone call. So I scheduled it for two weeks out instead.

Of course, a few days later I was kicking myself, as I was growing so impatient.. wanting to know one way or the other.

Finally, the day had arrived. Our appointment wasn't until 3 pm, and I felt uneasy as each hour slowly ticked by.

Brad and I both left work early, and rode together from our home. As soon as we pulled out of the driveway, I felt my eyes conjuring up tears. I was simply thinking to myself, "I cannot believe we're going back there. That we might be going through this all again; or that we might be told we're done, and that it's time to give up."

I took a deep breath and pulled it together before Brad could notice I was unraveling.

As we arrived to the office, every step down the long hallway to his door filled me with anxiety. This waiting room was filled with pictures of babies, and memories of my pregnancy. This was going to hurt.

We walked in and the nurse immediately asked, "How are you?"

I sighed, "Well, not good.."

She popped up, arms outstretched, "You need a hug."

So there I was, hugging a nurse as she leaned over the reception desk. So not my style. But she was probably right. I needed it more than I hated it.

As we sit in the waiting room, I turn to Brad, "I guarantee he forgot we said no IVF before. He's going to recommend it."

Moments later, we get called back. We're left to wait for 5-10 minutes, but it felt like 30. The doctor finally emerges as the office door opens slowly. He walks in looking almost as depressed as I felt. He looks up at me and outstretches his hand for a handshake.

"What else can happen to you?" he mutters as he sits across from us. "I'm very sorry."

He proceeds to ask me what exactly happened; as in, how labor progressed. Without looking up from his file he responds, "Classic incompetent cervix. You've earned yourself a cerclage."

I remember thinking how much I hate that they call it "incompetent." It just makes it sound as if I could possess an amateur cervix. My cervix is playing T-ball while I'm trying to get into the Majors.

I also began to question this diagnosis after the appointment, since I had contractions for nearly 24 hours before giving birth, and an incompetent cervix is usually symptom free. I also don't have any of the 'risk factors' for the condition. It's really a chicken or the egg scenario. Did an incompetent cervix induce preterm labor, or did I have preterm labor (simply due to twins) that caused my cervix to dilate and shorten as it would in any labor? But I'll get into that at a later date when I speak with the actual OB/doctor that deals with such issues.

He then added, "You'd probably be fine with a single child pregnancy, but they'll likely put one in anyway, just as a precaution."

Now, the idea of a cerclage doesn't appeal to me at all. In the most general of terms, a cerclage is when they put stitches in your cervix to, in theory, hold it closed for the duration of the pregnancy. However, it has a lot of possible complications, such as bleeding, infection, ruptured bladder, ruptured uterus, etc. All of which could end up terminating the pregnancy you're trying to save. So, there's a lot to weigh out there. And to get the procedure, you have to be put under general anesthesia or get an epidural/spinal. You probably recall that I fought against getting the epidural for the placenta removal procedure after delivery. So... eh. But until I talk to my OB or the high risk doctor, who would actually do the procedure, I'm not going to dwell on that part.

What I was focused on, instead, was that he was talking about any form of a pregnancy as possible. But I glanced down at his file that he was scribbling notes in.. and what jumped out at me immediately was "IVF." My heart sank a little. Here it comes...

He looked up, "Okay, the plan would be IVF."

I expected this, and I understood why. With IVF, they could choose to only implant one fertilized egg (basically no risk of multiples), and they could drain the fluid after egg retrieval, which would remove the risk of hyper stimulation. But still, not feasible financially, and so invasive.

I looked at Brad briefly, then turned back to the doctor. "The problem is.. IVF just isn't in our budget," I sighed. "If IVF is the only option.. then unfortunately.." My voice began to quiver as I tried to swallow my pain back down. "We're done trying."

The doctor stared at me for a moment. "Hmmm. Well then.." He began to fidget with his file, flipping back and forth between pages. Then he started to scribble down a new 'plan.'

"Okay. You want to be difficult," he joked. "Then the new plan is to do what we did last time. We'll just lower the dosage, watch you more carefully, and hope we can avoid the hospital."

I could finally breathe again. At least I know I respond to the medication. It's just going to be a balancing act..

But then I wanted details. "Given what happened, I know we'll have to wait awhile."

"Oh no. You can try again whenever you want. Some people come to me the next month and want to start right away. Others need a mental and emotional break. It's up to you," he replied.

"The doctor at the hospital had told us to wait at least 6 months."

The specialist was unfazed, "The uterus heals very quickly. There's really no need to wait." He paused, then added, "On the other hand, I don't want you to worry about getting older. Your ovaries respond like you're 18 years old. You have plenty of ammunition."

I admit, I chuckled at that. Obviously, I had been worried as 35 is quickly approaching. In reality, even with enough "ammo," I'm still hoping sooner rather than later. After 35, risks for a lot of things go up, and obviously.. the odds are never in my favor to begin with.

"Now, will there be a lot of a cancelled cycles? Like, if I have too many follicles?"

He calmly answers, "I don't think so. I'm not worried about you having multiples. They'll be watching and monitoring you a lot closer now. So I won't freak out if you have three mature eggs release. Odds are, they won't all fertilize, and you'd probably be fine, even if they did."

I glance at Brad who now has a shocked look on his face just from the mention of possible triplets. Still, it's reassuring that the specialist isn't going to try to be so conservative that it impedes a positive result.

As we left the office, Brad turned to me, "You feel better?"

"Yeah. I feel like it's at least possible. How about you? Are you up for this?"

"Yes. I'm on board. I want to try again," he responded -- my partner, through and through.

So, that's the plan. Problem now, yet again, is finances.

Last time, we did an online fundraiser, and our family and friends helped us raise nearly a thousand dollars. It covered most of the medication for that cycle, and gave us the chance to conceive and hold our twins. We are forever grateful for that irreplaceable moment in our lives.

But now, we're still paying for my hospitalization last October and we're about to be billed for the delivery of the twins. I thought it felt bleak before, but I'm definitely anxious about money right now.. And while we could do another fundraiser, we both don't want to come across as taking advantage or trying to 'double dip.' It's something we'll have to think a little more about, but we truly appreciate those who have already told us they'd like to donate if we do. It means the world that so many people care about us, our story, and want us to have another chance. <3