I didn't think I'd have much to write about before Wednesday's appointments but I was wrong. As I've mentioned before, I participate in a couple different message boards (one for women who have had a tubal reversal done and one for IVF.) These message boards have brought a ton of support, cheers, and shoulders to lean on during the hard times over the last couple of years and yesterday, one of these message boards brought me a great deal of hope about my questionable cervix situation.
To recap my concern about my cervix, after having my first two children (so many years ago with no cervical issues) I had a number of procedures done to my cervix. I had chronic dysplasia for a number of years. Cervical dysplasia is an abnormal growth of cells and is considered to be a pre-cancerous condition. In 1991 I had laser surgery on my cervix and that worked for awhile. In 1997 I had a LEEP procedure. LEEP is loop electrosurgical excision procedure. With this procedure, an electrical current runs through a wire loop and a layer of the cervix is removed in the affected area. Sounds great, doesn't it? Oh just wait...it gets better! In 1998 I had a cone biopsy. This is a surgical procedure where a cone shaped wedge of tissue is cut out of the cervix and removed to check for dysplasia below the surface of the cervix. The thought of that makes my legs cross...tightly! Then later in 1998, I had a 2nd LEEP procedure done. WOW, right??? Now to put this in perspective, women who have had a single LEEP procedure are often warned they may experience incompetent cervix. I've had 2 of those procedures, plus laser surgery, plus a good cone-shaped chunk removed from my cervix. It's no wonder doctors like to say "you barely have any cervix in there" and "it's just a nub of scar tissue".
So back to the message board...last night someone mentioned incompetent cervix in response to a post I made and I said that was exactly what I've been worried about. I told her my history and within minutes she sent me a private message. She urged me to be careful and proactive as she had lost twins to incompetent cervix and suggested that I contact this doctor that specializes in cerclages. In fact he helped to pioneer the TAC (transabdominal cerclage) which is actually a loop placed around the top of the cervix through an abdominal incision. This has a high success rate, but there is risk associated since it is invasive surgery. A vaginal cerclage, where a pursestring stitch is put towards the bottom of the cervix, is more commonly used but has a greater chance of tearing and infection and a lower success rate. I had heard of TACs before but I was unaware that they could be done while one was pregnant so this was exciting news.
Anyhow, this expert in the world of cerclages actually practices just a couple towns away from me. (The other doctor she mentioned practices in Chicago.) She gave me the doctor's email address and said he'll normally do a phone consultation with you within a day. So I sent my email last night and tonight, just before dinner, the doctor called me at home. We talked for a bit about my history and he gave his thoughts on options that may be available. Of course, he cannot give actual recommendations without a thorough examination (I'd be a bit weary if he did) so he asked if I wanted to come into the office this week for an exam. You bet I do!! So I'll be calling his office in the morning and will go for an appointment this Thursday in Camden. At the appointment, he'll be able to measure my current cervical length via ultrasound and have a much better idea of how much cervix I lost from all of the procedures, how much I have left, and the condition of what is left. With that information he'll be able to give a real recommendation on whether a cerclage should be placed and if so, what method we should use. Added bonus - the guy participates in my insurance, thank god!
Can I just say, WOW? This doctor who I have never met, responded to an email in less than 24 hours, calling me at home to talk to me about my history and sharing his thoughts on my possible options. WOW again! This floored me (seriously, how many doctors do this) and filled me with a renewed sense of optimism. In addition to the 2 types of cerclages I mentioned above, he mentioned a 3rd type that may be a good option. It's a different kind of transvaginal cerclage that is done higher up on the cervix so it has the benefit of not requiring invasive surgery like a TAC would, but has more of the "staying" power of a TAC. Of course, we'll know more after he can see what's going on at Thursday's appointment but already I feel like I can sleep a little easier tonight knowing I'm going to see one of the experts in the country that deal with the more complex cerclage procedures. I'm extremely thankful for K on the message board for passing along the information!
So OB/GYN Wednesday morning, RE Wednesday night, MFM (Maternal Fetal Medicine) Thursday...will have much to post as the week goes by!
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