QuestionKristi,
I hate to bother you again, but my husband insisted that I e-mail you "Thank You" from him. He is over sea's right now but I was able to read him your reply today and he was speechless. He said "I cant believe there are still people like her in the world". You are sincerely special to us and have some way of truly put the spark back into the wonderful process called "pregnancy". We have been and are so scared, and your words were so comforting, I cant even express how thankful we are for you. I am now elevating my feet but they are just on a stool in front of me, should they be higher than my abdomen or just about even? I know this is so petty, but if I'm doing it, I want to make sure I'm doing it properly. And is it true about "every pregnant women should lay on their LEFT side?". What is your suggestion on proper calorie intake, obviously I know I cant exercise, but I don't want to be gigantic from laying around, although if thats what it takes I would do it. Also, how much water should I be drinking everyday? Thanks again, your probably going to be our life savor, as I'm sure you are many others. God Bless you and your family.
Robert and Kyle James
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The text above is a follow-up to ...
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Hey Kristy, How are you?
I have lost two babies due to incompetent/short cervix and infection in the past two years, so I really need some encouraging words now that I'm pregnant again. We lost our first at 21 weeks, I started having labor at home and water broke, went to hospital, developed an infection and baby had to be born, which lived for almost 3 hours and I feel very blesses for the. They did genetic testing and everything came back fine, just said I had an infection. I lost my second one at 18 1/2 weeks, started having back labor, went to hospital, had vaginal ultrasound to find I had a "bulging bag" (I had a cerclage put in at 15 weeks). I was admitted, on mag for days, unfortunately my water broke about 4 days later and I began to develop an infection, which we knew the drill - baby had to come out. I am now 6 weeks pregnant and was lucky enough to quit my job as a restaurant manager. I did that because of the stress, being on my feet for atleast 11 hours, 5 days a week, and at a restaurant you are really "on your feet". I will be seeing a perinatologists throughout this pregnancy, he will be my delivering doctor and I will not see my regular OB-GYN. Well, I haven't seen him yet and thats why I've come to you. I have bedrested myself, but is bedresting sitting Indian style on the couch or do I need to be laying on my left side? How much of me NOT being on my feet and me doing this do you think will help? My perinatologists said he was going to put the cerclage in earlier this time because last time we put it in it was after they found my cervix thinning, so will it make a difference putting it in earlier? What is your thought on the abdominal cercalge, looks risky to me, I really don't want to loose my uterus. Also with my second lose my peri was going to put in an emergent cerclage but after doing a vaginal ultrasound it put me in full labor, so he felt it was best to leave things alone. What was the emergent cerclage all about, I already had a cerclage, so please let me know what the difference is. Have you heard/had any successes with women like me? Is it possible that one day I may really have a baby that lives? I need all the advice you can give me, if I were your patient what would you say to me? Thank you so much for your time. - Kyle James
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Hi Kyle, I am so terribly sorry to hear about your losses. Sent goosebumps right through me, reading your story :(
First off, let me tell you, that no 2-3-4 pregnancies are the same. I know its difficult after your experience to beleive that, but it is a fact. I will tell you a personal story, about me when I am done, in hopes that it gives you faith.
Given your history, definate precautions must be taken. Perhaps discussing with your doctors about taking progesterone suppliments could be of some help. Progesterone, is what keeps you pregnant, and it also prevents pre-term labour. Again, its definately worth discussing with your doctor. I would think, that given your history, you have been given suppliments. I would be very surprised, if you haven't.
Also, if you were my patient, you would be on complete bed rest. Absolutely, you shouldnt be working. I would only be allowing you to get up to shower, and use the bathroom. I definately, would not allow travel, or daily outtings. No housework, and no lifting anothing. Sounds extreme I know, but this has been prescribed to some women, and has made a significant difference, and many have had success and were able to remain pregnant much longer. And lets fact it, every single day, you can hold that baby inside, makes a huge difference to the babies survival. It would make for a long 8-9 months, but its totally worth it. Also, keep in mind that your feet MUST be elevated. So no sitting indian style, sit on the couch, but keep your feet elevated. So this is an absolute must. As much pressure must be kept off your abdomen, elevating your feet, elimates the pressure.
I dont know what kind of infections your suffered. However, if these infections are not resistant to antibiotics, I would most definately consider administering antibiotics probably around the 16 week mark as a preventative measure that in the event you do have the baby extremely early, you are atleast have these antibiotics in your system early enough that it will fend off any pending infection. Again, this suggestion is usless, if your past infections were indeed antibiotic resistant.
Ah, I have heard so many success stories with the aid of curclage :)
I agree with you doctor. I also think it should definately be used again, and this time is should be done earlier. I think it will make a huge difference, to do this while your cervix is competant, and not showing signs of labour. This will completely lower your chances of dialation, even before a slight thinning. With your cervix being competant, the procedure can be done securely, and properly again increasing your chances of continuing with your pregnancy longer then perviously.
There is absolutely not difference between the emergant cerclage, and cerclage. Emergant cerclage is the term used, when the procedure is done, when signs labour are showing, such as thinning cervix, and perhaps slight dialation. There is absolutely no difference in the procedures at all, but they are given different names, which is based on your condition.
So as I said, I definately, without a doubt have the cerclage. However this time, it definately had to be done nice and early. If it were up to me, I would definately have it done around the 3 month mark, way before any possible problems can occur. So kyle, without a doubt you have to have this done. You have an incompetant cervix, and given your history, without a doubt ..you have absolutely no choice. Remember, its all preventative, because we want you to have a baby, and not another loss.
Now, lets say that you do all the above, and your water breaks, and you are forced to once again have this baby early. Speak to your doctor about having onhand the injections neccessary to speed of the development of the baby's lungs. It is available, and can make the difference between life and death. The moment, you feel contractions, or spot, again, I would demand it. All preventative again :) But it would definately increase the chances of the baby's survival.
I hope my idea's have given you some insite. If you were my patient, you would be on progesterone, complete 100% bedrest, with your feet elevated. Cerclage would be inserted at 12 weeks. Sounds so tramatic, but definatly worth it, if it ends in a living, healthy, baby.
As for my personal story :)
My first pregnancy was a complete nightmare. I had severe gestational diabetis, and high blood pressure. I had to give myself 3 shots a day, of insulin for 4 months. My blood pressure was so high, that I was on medication for that, so I didnt keel over from a heart attack or stroke. I was only 29 when I was pregnant with my first one.
Everything was controled, and I made it to the 40 week mark, even though I was at risk for preterm labour. I went into the hospital, and had a long, labour ..almost 38 hours.
I stopped dialating at 7 cms. They gave me pitocin (a synthetic drug to induce labour) and I had the pains, but didnt dialate. They broke my water ..but my body just quit.
So they decided to give me an emergancy c-section. By this time I was releived, because I was exhausted.
They topped up my epidural, and took me to the OR. They started to make the insicion, and I felt it. So they stopped, and topped me up again. They started again, and I could still feel it.
They then said "Good Night Kristy" and gave me a general aneasthesia to put me to sleep. MY daugher was born, healthy, and normal.
While they were working on me, my heart stopped. I went into complete full cardiac arrest on the table. Ofcourse, they never intubated me ( put a tube down my throat), because at the time when they knocked me out, my daughters heart rate was falling. So when my body seized, my jaw locked like a vice.
3 male doctors, pryed my jaw open. and they were able to get the tube in, and hook me onto life support. I was in ICU for 1 week.
When asking for an explantion, they didnt have one. They said that my system could have just crashed because It was tired, due to the mediations I was on, with labour. Also, they said it could have been the general aneasthesia, combined with the epidrual, could have been too much. They said when they topped up my epideral, it could have went up my back, instead of down my back, therefore paralyzing my breathing, and heart. I still, to this day dont know what really happened.
I was strongly advised, never to have another baby again, due to my complications.
Well, almost 4 years later, I got unexpectedly pregnant again. I am 33 now. I am scared to death. My OBGYN knows my history, and just shakes her head because she cannot guarentee me that I will make it this time. I wrote a will,to make sure all my affairs regarding my kids, were in order.
I was at extremely high risk for diabetis again, and high blood pressure.
I decided to have a c-section, with no general, and opted a spinal.
From start, to finish, my pregnancy was a complete, peice of cake. I didnt have gestational diabetis with my son, even though my risk was 90%. My blood pressure, remained perfect, without the use of medicine. And my risks were high for hypertension.
My delivery, was beautiful, I was awake, was able to see him, and enjoyed every moment of it. ( Even though,there were 12 emergancy personel waiting outside the operating room, in the event I had a cardiac arrest, which was still a real serious risk)
They couldnt even guarentee that I would live to see my son, given my history. Well, History doesnt always mean its going to happen again ..it just means, preventative measures, and good care is needed, to avoid sad endings.
So ..you get the moral of the story right?
This baby your carrying, could be in your arms fast asleep, at home in the near future.
Preventive measures, as gruelling as they can be, are a must. Excellent care, and monitoring, are an must ...
Hope this is of some help, and please keep me posted, on your condition, okay?
Sorry this was so long of a responce, but I really felt it was neccessary to discuss this indepth ..
Thanks for writing, and Good Luck.
-Kristy
AnswerHi Kyle,
Aww thanks for such a sweet letter! That was very touching. Tell your hubby I said Hello, and thanks :) You both sound like very sweet people :)
Soooo, back to business eh!
I really dont think you should lay on your side Kyle. We dont want any unnessary pressure within your pelvic region.
So, If you are sitting in a chair, kicking your feet up on a stool is fine :) In bed, I would put 2 pillows under your legs. The pressure, and weight will actually fall on the pillows, and not your pelvis :) You'll see what I mean when you do it :)
Anyways Kyle, I hate to tell you darlin, I really think its so important for you to be "lying around" for the next little while. Sure, you might get a little plump ..But really, who cares? They weight can come off after the baby is born. So don't worry about it! If getting fat, is all its going to take, for you to bring a healthy baby into the world, then so be it. Its not that bad, because as I said ..It can come off, and is certainly not forever. The main thing right now, is for you to be off your feet as much as possible :)
Remember, food intake can help out here. Drink as much water as you want. Its reccomended, bare mininum that pregnant women should drink 6 8oz glasses of water a day.(Remember, I am Canadian, so I dont know alot about American, or other foriegn reccomendations with water intake.) If you want to drink more, its not going to hurt. Infact, it will keep flushing your system, and decreases your chance of a weight gain. In addition, you can eat veggies, and fruits till your blue in the face. Protein is essential, so chicken and fish are great for that. You must have milk intake as well. Keep your fats, and spices to a mininum if you can. Watch your sugars ..Gestational diabetis usually shows itself around the 25 week mark, and beleive me, its not fun!
And Kyle, one last thing, never assume that you are bothering me ..I was pleasantly suprised to see you write back, and you are definately not a bother! We're just 2 gals putting our heads together to ensure you a full term, or close to full term baby! So we will just keep working together till that little bambino makes it way, and I am feeling pretty confident, that with major prevention measures, your chances will greatly increase :)
You write back anytime you want :) I have your email, and I will be contacting you soon..its just tough for me because I have 2 small children of my own, so you can imagine, getting online is tough sometimes!
But I will be in touch soon ..:)
Take care, and GodBless!
-Kristy
