In good hands

OMG, I could scream - I just wrote a big long post and something happened with blogger - I lost it all. It didn't even auto-save like it normally does every couple of minutes....UGH!!!! Ok, so now that I'm so super tired and just lost about 45 minutes of writing, I'm starting over...sorry if I seem to rush through portions.

Today was my appointment with the MFM who is an expert in cervix issues and the appointment was GREAT!! I spent 2 hours with the doctor, talking, having the exam, talking some more, asking questions, etc. A 3rd year med student accompanied us during the entire appointment (granted I'm generally not thrilled with the idea of an audience staring at my cervix, but hey, they've gotta learn somewhere.) The exam itself consisted of a visual examination of the cervix, a pap smear, u/s, and manual exam to feel the portion of the cervix at the top of the vagina. Oh, and during the u/s we got to hear the little baby's heartbeat again (today it was 156 and still sounding beautiful.)

So after the exam we went back to the office to discuss the results. Now, a typical cervix is 3-4 cm in functional length. Mine is 2-2.5 cm so I've lost about 1/3 from all of the surgeries I've had. I also pretty much have no cervix at the top of my vagina. That's obviously where all of the procedures were focused so there's really nothing left and what is there is just scar tissue. But given those grim sounding findings, it's actually not terrible. In fact Dr D said we have a few options.

1. We could take a conservative approach and not do anything. The doctor said there's about a 90% chance that if we do nothing the cervix will hold up just fine. He would feel comfortable if we decided to take this approach. The part that scares me about this option is that if it does start to cause problems, there will probably be no stopping it. There's not enough cervix in there to do a rescue cerclage (not that those are great anyways, but it wouldn't even be an option for us.)
2. There is a type of vaginal cerclage that is done higher up on the cervix. It's almost as high as a TAC (transabdominal cerclage) but is placed through the vagina. What scares me about this is that vaginal cerclages can lead to infection which can lead to pre-term labor.
3. The last option we discussed was the TAC. Some women like to call their cervix post-TAC a "bionic cervix" because it can hold in anything. This would give us the most piece of mind, but it is scary. It is a surgery, done while pregnant, via an incision similar to a c-section. It does require 1-2 nights overnight stay in the hospital so they can make sure you do not go into premature labor. And it will require a c-section delivery, because once the TAC is in, it's in there for good.

The doctor gave us these options but the decision was up to us. Part of us would love to go the conservative route and not do anything. But in the end, I'm afraid of doing nothing, having something happen to the cervix and losing everything, when we could have tried to prevent it with the TAC. So after some discussion between DH & me, we're going to go with the TAC. We just want to do everything possible to keep this baby in until it's full-term. We still have a few weeks if we do want to change our mind (the surgery would not be until January 3rd after the first trimester screening is done) but we're both in agreement that we feel this is the best option for us. (I know some of you may not agree, but hey, we all have different opinions so we can agree to disagree.)

Also in good news, this MFM is going to take me on for my OB care, woo-hoo!! This was great to hear - as a MFM he generally just treats the high risk situations, but he does keep a small patient load for those that may want or need the extra attention for their OB care. I told him about yesterday's dingbat doc and the crappy docs that were awful in February and he offered for me to stay on with him. I can stay on until I find a new OB or I can stay on him for the whole pregnancy, whichever is going to put my mind more at ease about receiving the quality care I've been looking for. (Can I just say I was thrilled with this and I was sooo happy to call that dingbat OB's office from yesterday to cancel my future appointments and say I'm going to a different practice! YES!!)

So I left feeling like I was in good hands. The u/s tech told me the farthest they've had a patient travel to come see Dr D for care was from Australia. People from all over have come to see him for his expertise and I feel lucky that he's so close to where I live. He gave me a hug before I left and said everything is going to be ok. And I'm really starting to believe that now!