Showing posts with label incompetent cervix. Show all posts
Showing posts with label incompetent cervix. Show all posts

Thursday, May 31, 2012

Miracle Workers Save Babies' Lives

Today marks the 3rd anniversary of the day I held my little girl for the first time.  A little girl that I dreamt of having since I can remember my dreams.  A little girl, who funny enough, is a better-looking version of me.  She shares a birthday with two of her three brothers.  I adore them as much as I adore her.  However, I know with certainty that my triplets should not be here.  They were destined for heaven before they had a chance to live.

My cervix was only five millimeters thick.  It was supposed to be 450 millimeters (or 4.5 cm).  I researched incompetent cervix on the Internet and found the Incompetent Cervix Support Forum.  Post after post contained stories of other mother's who lost babies with cervixes thicker than mine.  Mothers who lost one, two and even more babies to this dreadful condition.  My cervix, as thick as five strands of hair, and I had something these other women didn't have, The Miracle Workers at Maternal-Fetal Medicine in New York City, specifically Dr. Nathan Fox and Dr. Andrei Rebarber.



If you visit their website, it boldly states that they blend Hi-Tech & Compassion.  I'd challenge that.  Yes, they are hi-tech and yes, they are compassionate, but I'm not so sure that hi-tech comes first.  The compassion I saw in Dr. Rebarber and Dr. Fox's eyes, their relaxed manner and wiliness to sit and comfort me, reassure me was more than anyone would ever expect from such highly sought after doctors.

Not a day goes by that I don't think of these men and their medical practice.  I can imagine the pain I would feel at having lost my babies and it terrifies me when I  think about what should have been.  However, I am lucky.  I am lucky that Dr. Ketly Michel referred to Maternal-Fetal Medicine Associates.  I am lucky that Dr. Rebarber took me on as his patient and I'm lucky that he works with Dr. Fox.  I am lucky that they just happen to be compassionate doctors who are among the best in the world (my opinion, but probably could be backed up by fact).

Thank you Dr. Nathan Fox and Dr. Andrei Rebarber.

I will always think of you with love,
Laura



Here are links to chapter one of my book:




Tuesday, May 22, 2012

Help for Incompetent Cervix: A New Procedure


Novel laparoscopic procedure gives hope to multiple miscarriage cases
By PMA RasheedMay 21, 2012
DUBAI: Multiple abortions, a major infertility problem faced by an increasing number of women in the UAE, can now be prevented by a new laparoscopic procedure developed by a Dubai-based expert, who has reportedly performed the highest number of laparoscopic surgeries in the world.

Dr Hafeez Rahman, specialist laparoscopic and gynaecology surgeon and chairman of International Modern Hospital in Dubai, has introduced laparoscopic cerclage for prevention of recurrent pregnancy loss due to cervical incompetence.

This innovative mode of infertility treatment, which has gained wide popularity the world over, has been introduced for the first time in the region.

“The number of miscarriage cases with second trimester abortions is on the rise in the UAE, especially after one or two deliveries,” he said.

“More than 90 per cent of women, who underwent the laparoscopic cerclage procedure, have become successful in carrying a healthy baby. This treatment has now become a breakthrough for childless couples,” noted the Indian laparoscopic surgeon.

“I performed the procedure on two women, one of whom had 19 abortions and the other 13. However, both successfully delivered healthy babies, through Caesarian sections, which is the only drawback of this procedure. The patients receiving this treatment cannot have a normal delivery, but that is not a serious issue, if compared to the severe ordeal suffered by the women from continuous miscarriages,” Dr Hafeez pointed out.

Dr Fatin Khidr, obstetrics and gynaecology specialist at the hospital, said, “This is a useful procedure in such cases and a big breakthrough. Laparoscopic cervical cerclage can be performed during pregnancy or in non-pregnant women.”

“More patients now prefer laparoscopic cerclage procedure rather than open surgeries to prevent abortions to avoid the complexities and risks associated with open surgeries. But, there’s a shortage of highly-skilled surgeons to perform the laparoscopic procedure,” she added.

Dr Hafeez Rahman is among the only 10 surgeons in the world conducting this interventional procedure, which was pioneered four years ago. He has successfully performed about 80 laparoscopic cerclage procedures in five countries, including five in the UAE.

“Recurrent pregnancy loss is generally caused by birth defects such as a weak or incompetent cervix that shortens or opens too early in pregnancy. The cervical cerclage procedure involves placing a stitch around the upper part of the cervix to keep it closed to prevent abortion,” he explained.
Dr Hafeez was listed in the Guinness World Records for conducting 50,000 laparoscopic surgeries around the world. He regularly conducts laparoscopic surgeries in a number of hospitals in the UAE, India, the UK, Australia and other Middle Eastern and Asian countries.


***From The Gulf Today

If you'd like to read some of my book, see below:

Here are some chapters of my book:


Or you can purchase it on Amazon for $3.99 by clicking the link above.

Monday, May 21, 2012

Chapter 23: That Discussion


Chapter Twenty-three:  That Discussion

I didn’t want to bring it up.  Talking about it made it real.
“What if?” I hesitantly voiced.
“I don’t think the Eagles will score.  The Giants are fine,” Jack unflinchingly replied.
Seriously, men suck sometimes.  Jack sucks sometimes.  How could he not tell that I wasn’t talking about the football game?  Didn’t he notice the tone in my voice?  Ugh.  I was an idiot.  Of course, Jack didn’t notice.  He, like most men, had the ability to escape into sports or other activities.  He was able to compartmentalize our triplets and put them into a closet in the back of his brain, whereas, the triplets and Brian were in every millimeter of my being.
“No, honey, what if I go into labor.”
“Please, let’s not talk about it. If you do go into active labor, then we’ll talk about it,” Jack pleaded.
“I need to know what we’ll do.  I need to know,” I started whimpering.
“What can we do?  I didn’t think we had any options left if you went into labor,” Jack said as kindly as possible.
“So, they’ll die,” I sobbed.
“Yes,” Jack said with a tear trickling down his cheek. 
We stopped using the names we chose for Baby A, B and C,  Elizabeth, Garret and Hunter.  It wasn’t something we talked about.  We both apparently felt the same way and sometime during the morning, we both changed.  It was too hard to think of them as the perfect, little babies that they were.  If they did die, we thought it would be easier to bury A, B and C and not Elizabeth Ann, Garret Jack and Hunter Frank.
We were silent for a while.  Jack was back to watching the Giants and I was trying to drift off to sleep.  I couldn’t sleep.
“What if my cervix gets worse, but it is only twenty-three weeks?” I interrupted his peaceful football watching. “Or twenty-two weeks?”
“Laura, please don’t play the what-if game.  Let’s go to the doctor tomorrow and see what he has to say,” Jack stated, hoping that I wouldn’t go there.
“But I need to know what you are thinking.”
With a big sigh, Jack said, “Can we saddle Brian with three special needs children?”
He said it.  It needed to be said.  He would want to abort, terminate, kill my babies.  It is what I was thinking too and I hated myself for it.
Dr. Nasty predicted that I would go into labor within the next two weeks, which would only get me to twenty-three weeks.  He was a senior doctor at the practice.  I’m guessing in his sixties, but I’m not so good with age.  He had many, many years of dealing with high-risk pregnancies.  As much as I hated him, I thought that he knew what he was talking about.  After all, my cervix only got worse after taking the progesterone.
Of course, I hoped the new medicine would work, but for how long would it work.  I needed it to get me to twenty-eight weeks when my babies would have an 80% chance of being fine.  However, sadly, I was currently aiming for twenty-five weeks when they have a 50% chance of being fine.  At twenty-one weeks and 2 days, twenty-five weeks felt like a lifetime away.  It seemed almost inevitable that I was going to go into labor soon.
Jack and I waited to fall in love, commit to marriage and start a family.  I was thirty-eight years old; Jack was 39.  We were worried about dying on the young-side of average and leaving Brian to take care of his siblings.
“So you would want to abort?” I asked.  I wanted to hear him say it.  Make him say it.  Could he say it?
“Yes, sweetie, if things look really bad and the doctor recommends it, I think we should abort and try again.” The power of Jack’s words was unknown to him.
Abort and try again, rang through my head.  It sounded so simple.  Abort and try again.  Abort and try again, repeated in my head, I felt my heart expand and envelope my babies.  We, my babies and I, were not going to abort and try again.  There was no trying again.  This was it.  These were my babies and they were perfect.  They were going to live.  Abort and try again.  Over my dead body.  Never. 
I felt alone.  Alone with my babies. 
“You want to abort,” I accused Jack.
“No. No, I don’t.” He slid over to my side of the couch and encircled me in a bear hug, burying his face in my belly.  He cried.  Thankfully, not the gut-wrenching crying that I was doing, but silently crying that I didn’t even notice until he got up and I felt that my shirt was soaked with his tears.
“What about Brian?  Even if we make enough money to make sure the triplets’ needs are met after we die, how much attention can we give Brian on a daily basis if we have three special needs children?”
“I don’t know,” I said.
“Laura, in a best-case scenario, if the triplets are born at twenty-five weeks, we are looking at three children with cerebral palsy and even that diagnosis has a wide range of capabilities.”
“Ok,” I said ending the conversation.  I realized that we just didn’t know.  I couldn’t have a plan.  There was no plan.  Nobody plans for this, not even me.  I tried planning for the impending stillbirth of my babies, getting an outlook so bleak that aborting look possible, making it far enough along that the babies were on the edge of survival.  However, my heart wouldn’t let me plan.  My babies were going to make it.  My heart was firmly cemented around each of my babies and it was going to make sure that they stayed safe.
I went to bed Sunday night and quietly sang to my babies.  Brian was my sunshine, so my little girl, Baby A would be my flower.  Baby B was my star and Baby C was my moon.
“You are my flower
My pretty little flower
I will love you
Every single hour
You are my flower
My one only and only flower
I will always love you.

You are my star
My shiny bright star
I will love you
Even from afar
You are my star
My lovely star
I will always love you

You are my moon
My big full moon
I will love you
And sing you a tune
You are my moon
My one and only moon
I will always love you”

My eyes were tearing up.  I wanted a girl so badly.  She wasn’t just my flower.  She was my desire, a life-long dream since the beginning of my memory.
I had been surrounded by boys when I was growing up.  I do have an older sister, but she is eight years older than me.  We had never been on the same page when I was young.  When she became boy-crazy in high school, I was in second grade, digging for gold with Bobby and David on the playground of Lincoln Elementary School.
I even had a boy baby doll, Robert.  It was actually a girl baby doll, but the baby had brown hair and brown eye lashes.  My brother, Frank, convinced me that the baby wasn’t mine, because I would only have a baby with platinum, blond hair like mine. I pulled out all of the baby doll’s eyelashes and painted its hair with our house paint, English Ivory, so that it looked blond.
I was proud of my accomplishment and showed Frank how great my baby, Mary, looked.  He told me that girls have eyelashes and boys don’t, so my Mary was no longer a Mary.  Hence, I was one of the few little girls who had a boy, baby doll.  
I never asked my mom or Santa for a new girl baby doll.  I probably could have gotten one.  However, I had fallen in love with Mary and it really didn’t matter that much to me that she was now Robert.  I loved him just the same.
After I finished my breathing exercises, I remembered when Dr. Nasty initially suggested selective reduction.  He told me that we would have to reduce Baby A, because A was in the best position.  I put my hands on my belly and whispered to her, “I will not let you go without the fight of my life.  I am your mommy and my heart is inside of your heart.  I will love you for always and ever.  You are my little girl.”  I sang to my little girl and tried to calm my emotions. “You are my little girl.  My only little girl.  I will love you for now and always.  You are my little girl.  My sweet, little girl.  I will keep you safe,” and I lost it.  “Please, someone please, help me keep my girl and boys safe?”  I begged to everyone and anything that I thought could possibly help.
I lay there and thought, I am Dr. Jekyll and Mrs. Hyde.  One minute I knew with certainty that my babies would be fine and the next I planned their funeral.   I felt the protective bubble of love around them.  Then my visions changed and I was crumpled in a ball as if my bones disintegrated next to a grave marker.  I never could picture my life the day after the babies’ funeral.  I knew my life would continue, but my brain and heart didn’t think the other could recover from their loss.  

Here are some chapters of my book:

Friday, May 18, 2012

5 Strands of Hope: Chapter 22



Chapter Twenty-two
The Longest Saturday

As Jack drove our only son to my sister’s house, I spent the entire day frozen on the couch.  I curled up in a ball and sobbed my eyes out. I was scared to move in case that one particular movement would cause me to go into active labor. 
I watched football to pass the time.  I barely made it through the first quarter before anguish like I had never felt before tour through my body.  I let out an animal-like scream, body-convulsing tears followed.
My perfect babies are going to die, I thought.
I suck.  I suck.  I suck. I suck, I cried with such force that my brain was left void of thought. I curled up tighter and cried.
I hate this, I screamed in my head.  I knew that crying wasn’t going to do anything.  It offered some relief to the anger and sadness in my heart, but I knew that it wasn’t going to fix anything.  I picked up my cell and called my parents.
“Hi, is Dad there?” I muffled through held-back tears.
“Is everything all right?” my mom questioned.
I love my mother.  Don’t get me wrong.  I know with 100% certainty that she would do anything for me, but sometimes my father was whom I needed.  My mother felt my pain as if she herself was living through the exact same experience.  In the last two days whenever I called her, we just ended up crying.  We were two grown women sharing sobs across the eastern seaboard.
I needed a plan.  I wanted to figure out how to make it to twenty-five weeks pregnant and give my babies a 50/50 chance of making it.  I was twenty-one weeks and a day, so I had six days and three weeks to go.  Shit, that was a long time, I thought with uneasiness.
“No, can I talk to Dad?” I softly said.
“What happened? Are you in the hospital?” my mom said, trying to hide her tears.
“I want Dad.”
“Laura, are you ok?” my dad asked.
“Dad, how do I do this? My babies are perfect, but my body isn’t.  I’m going to kill my babies,” I sobbed with snot running down my face.  I felt like I was being overly dramatic, but sadly I also knew this to be the truth.  “Daddy, tell me what to do to save my babies,” I unfairly asked.
One of my favorite images from my childhood is my dad holding me high on his shoulders as he walked into the ocean.  I was a short and a super-skinny little girl.  I loved the water, but I was scared of the ocean.  The waves could knock me around like a rag doll. 
We spent the summers at our house in Mantoloking at the Jersey Shore.  My father only came down for the weekends.  The only time I went in the water was either when my father was holding my hand or carrying me.  On that particular day, he had me on his shoulders.  I felt invincible.  There wasn’t a wave that could get me.
As I talked to my father, I needed him to be that little girl’s daddy who could lift her up in his arms and save her from the scary waves below.
“Laura,” he paused.  It sounded like he sniffled.
I knew why he paused.  I asked the impossible.  I finally asked him something for which he didn’t have an answer.
“Don’t think about it.”  Silence again.  I think he knew he just said the impossible.
“Dad, they’re kicking,” I sobbed. I figured they knew that we were talking about them.  I wondered if they knew the peril that they were in. I tried catching my breath and controlling the sobs and finally did after a moment or two.
“Watch one of those girly movies you and your mother like. Just don’t think about it.   Try to escape into the movies,” he suggested.
That’s it? I wanted to say.  I wanted a solution, a plan of action.  I wanted a miracle.  Where was my superman?
He didn’t have anything else to say and became uncomfortable.  I have always known that my dad, similar to my mother, will do anything for me.  However, there are differences.  For example, my mother probably would have loved to beat to a pulp my ex-boyfriend who broke my heart.  She would defend me in any battle.  My father would listen to me and then explain why he thought the relationship failed.  My father would arm me better for the next battle.
Nothing prepared him for this, though, his littlest girl, heart-breaking, pleading for him to figure out a way to save his grandchildren. He had nothing concrete to give me. 
“When’s your next doctor’s appointment?” my mom said softly, having been handed the phone from my father.
“Tuesday morning.  It’s early, so Jack is going to go with me,” I responded equally soft.  I noticed during the past few days that when I am on the verge of tears, the softer I spoke the less someone could tell I was about to cry. However, in this case, I could care less if my mom knew I was crying.  I was tired of crying.
“Call me after the appointment,” she said gently, knowing that she was always the first person I spoke to after Jack.
“Ok,” and I unwillingly hung up.  I didn’t have anything more to talk to my parents about.  However, I felt that nothing could go wrong when I was around them.  I fretted that once we hung up the phone, I was going to go into active labor.
I lay on our brown, leather couch with my hands on my belly, feeling contractions that I had been having since thirteen weeks.  Thankfully, there was no regularity to them, but some would last a minute and I wondered what it was doing to my cervix.
Three hours must have transpired and I probably fell asleep, because my cell rang and it was Jack.  He had made it to my sister’s house and Brian was doing great.  He had one little mishap, Brian fell down the second floor staircase, but other than that everything was fine.
I wanted to shout at Jack, What do you mean he fell down the stairs? but I didn’t have the energy.  Jack looked horrible when he left that morning. I knew he felt as badly as I did about shipping our baby off to my sister’s house.  I tried to focus on the fact that Brian was fine.
Brian was almost 17 months old. He was at an incredibly cute age and was a wonderful little guy.  We were lucky that he was extremely adaptable.  We were even luckier that my sister and her family unwaveringly welcomed Brian into their home.
My sister has three kids.  Alex, her oldest and only son, was a senior in high school.  Hannah was a sophomore and Rachel was in seventh grade.  I loved her kids and all of them were terrific people.  I knew that each of them would be a lot of fun for Brian.
Alex is a handsome combination of his father and my father. He has beautiful, hazel eyes and a manly, chiseled jaw.  However, as attractive as he is on the exterior, it is his patience and heart that make him a beautiful person.
Hannah is my Goddaughter, so I am completely and utterly biased.  She has won a lot of awards for her athletic, academic and leadership abilities, so I am not alone in my approbation.  Hannah is also blessed with beauty.  She shares her mother’s gorgeous, blue eyes and long, shiny blond hair.  She has a softness to her personality that makes her inviting to everyone.
My little Rachel is just as accomplished as her older siblings.  She also has the bluest of eyes.  However, her thick, long hair is very blond and wavy.  She is stunning.  What sets her apart, though, is her quick smile.  When I think about her, I picture her with laughter in her eyes and happiness in her smile.
Lucky for Brian those were not the only kids in the house.  My sister, Crist, and brother-in-law, Leo, were as youthful as teenagers.  Maybe more so, as Leo ran two marathons the previous year and my sister ran one.  I was sure that with three teenagers in their house that they had some stress in their lives, but you’d never know it.
One image I have of Leo beautifully captures his quirkiness.  It was Christmas and Brian was three months old.  Leo took the frog hat that his parents gave to Brian and put it on.  Then he took a toy tambourine and started dancing around the music-less kitchen, making Brian and everyone laugh.  He had absolutely no problem making a fool of himself just for a baby’s giggle.
Brian was going to have fun with everyone in my sister’s family.  It comforted me to know that they were looking forward to Brian’s stay as much as I dreaded his absence.
Now I knew that I had another five plus hours to wait until Jack got home.  I called Ruth to ask if I could come downstairs.  We got in a little argument, because she didn’t think I should get out of bed.  I explained with a bunch of profanity that my apartment was depressing without Brian in it.  It was the first time since Brian was born that I was there without him.
“Hi,” I said as Ruth opened her apartment door.  Ruth’s bottom lip began to quiver and we both started crying as she embraced me in a tight hug.
“How are you feeling?” Ruth hesitantly asked.  “I mean, ah, come in.  Let’s go lay down.” 
On Friday, we spent an hour on the phone.  She knew everything that was going wrong with my pregnancy.  She had been one of the few people outside of my family with whom I talked.  There wasn’t anything Ruth could say that would’ve been wrong, because I knew that she had my best interests at heart.
Ruth was gracious enough to know that I couldn’t or shouldn’t sit up, so she guided me past their family room and right into her bedroom.  She instructed me to lie on the bed.  She even threw some extra pillows my way so I could get comfortable.
“Wow, you really seem ok,” Ruth exclaimed.
“I’m not.  Trust me.  I’m just really tired of crying.” I responded.
“What do you think you’ll do…never mind…have you heard from Jack?” Ruth stumbled.
“Yeah, Jack called.  Brian fell down the stairs at my sister’s house, but he’s fine.  What were you going to ask?”
“Don’t worry about it,” Ruth said.
“Were you going to ask me what we’d do if I lost these babies?” I questioned.
“Yes, but, ah, not because I think you’ll lose them.  I really think you’ll hold out for a while longer,” she quickly got out.
“It’s ok. I have thought about that too,” I confessed.  “Unfortunately, I’d probably need to wait a year or so for my body to calm down before doing IVF again.”
“Have you thought about the entire IVF process?”
“Yeah, I don’t mind IVF.  I just don’t know what I’d do about how many embryos to transfer.  It all just sucks.” I concluded.
“Well, at least you’re lucky enough to have a bunch of embryos to choose from,” Ruth said.
“Yes, but you are proof that it doesn’t really matter how many eggs or embryos you start off with.  Remember, I had seventeen eggs, but only had four embryos – not a good hit ratio.  You got perfection,” I said joyfully.
Ruth smiled, painfully, “It didn’t seem like perfection, at the time.”  Ruth had a horrible IVF experience.  Ruth only produced two eggs on a very aggressive protocol.  Before seeing if her eggs fertilized, her doctor told her to look into donor eggs.  He thought her eggs wouldn’t fertilize.  However, he was wrong.  She lounged across from me with two healthy babies in her belly.
“It’s really hard to say what we’d do.  I’d be terrified of an IVF cycle not working, but equally terrified of having twins,” I spoke as I was thinking.
“Would you reduce if you got pregnant with triplets again?” she questioned.
“There’s no way I’ll transfer three embryos again.  I’m not sure we’d even do two.”

“Really?” Ruth said as she absent-mindedly rubbed her belly.
“Oh…please,” I said.  “I’m sorry.”
“No, no,” Ruth interrupted.
I interrupted her right back, “I would love twins.  I really would.  I’d love to have triplets. I would just be too scared that my body couldn’t handle twins.  I’d hate to be in this position a second time.”
“You know I go to this message board.  I read that some woman was reducing down to one baby.  I was so judgmental about it.  I guess she could have had a reason for it,” Ruth confessed.
“I would have damned her for sure, prior to this,” I said.  “I really have learned that it is hard to judge a situation unless you’ve been in it.”
“Oh, now I remember correctly the woman wanted to reduce down to one, because she didn’t want to ruin her body,” Ruth recollected.
“Oh, well, she can be damned then,” I exclaimed.
We both heard Greg enter the apartment and make his way back to his bedroom.  Earlier he had a long meeting and he looked exhausted.  He was very gracious and said that I didn’t need to leave, but I knew it was time to go back to my empty apartment.  
Jack would be home in two hours, so I turned the TV back on to a meaningless football game.
“Hi, can I leave a message for Dr. Kelly,” I said to the answering service.  I left a message and within thirty minutes my phone rang. 
“Hi, Dr. Kelly?”
“How are you doing Laura?”  I explained to her what was going on with my pregnancy in more detail than she probably needed.
“Even though your doctors don’t believe in bed rest, I think it is good that you are resting.”
“Really, you think so?”

“Yes, this way you’ll have no regrets,” Dr. Kelly said.
“Thanks, thank you so much.  I meant to tell you at the beginning of the conversation that I really appreciate you calling me back, especially on a Sunday,” I said.
“I’m just happy I can help.  Please keep me updated and don’t hesitate to call,” she said and hung up.  I sat on the couch and realize that my heart was lighter.  My mouth formed a smile.  There were no tears.  Dr. Kelly gave me hope, but better than that she gave me happiness during a day that overflowed with anguish and for that I would forever be grateful.




Incompetent Cervix: The Silent Baby Killer

My triplets and I suffered from incompetent cervix during the pregnancy.  It nearly cost them their lives.  Incompetent cervix or cervical insufficiency, as the March of Dimes calls it, is a cervix that starts to open before the baby is ready to be born.  Medically speaking, it SUCKS!  


Sadly, most women do not know that they have an incompetent cervix until it is too late.  A second trimester miscarriage or a stillbirth are the unfortunately ways a women usually finds out.


My incompetent cervix started because one of the triplets had too much amniotic fluid, polyhydramnios.  The extra amniotic fluid increased pressure on my cervix.  As each baby became polyhydramnios, the pressure on my cervix increased and my cervix shortened...ultimately to 5mm (should have been 4.5cm or longer).  However, in most cases, there is no known cause for the cervix shortening and opening.


The March of Dimes states that "Providers have not found a reliable way to routinely check all women for cervical insufficiency."  I find this hard to believe, because the March of Dimes then goes on to say that "if a woman has previously lost a pregnancy in the second or third trimester, vaginal ultrasound during the next pregnancy may help predict preterm birth."  If I read this correctly, then doctors, oh, I mean providers, know exactly what to do - give every pregnant woman a vaginal ultrasound around twenty weeks to check the cervix.  This is what saved my triplets.  Well, not the ultrasound itself, but having the knowledge that my cervix was in trouble, so the doctors and I could do something about it.




You can find more information at the March of Dimes website HERE and at the American Pregnancy website HERE.  There is also a great forum Incompetent Cervix Support Forum HERE.  I found great information at the former two websites and lots of support and hope at the later.



Here are some chapters of my book, Five Strands of Hope:

Thursday, May 17, 2012

Chapter 21

Good morning!
I'm jumping chapters again.  I hope you don't mind.  Please say so, if you do.  I won't have enough time, before my self-imposed publishing deadline (May 30th) to "blog" all the chapters.  Additionally, I'd think I'd like to add more "meat" to my blog by including more information about infertility, preterm labor, incompetent cervix, gestational diabetes and pre-eclampia, all of which I experienced during my triplet pregnancy.


Chapter Twenty-one

Friday – Not Technically, the Thirteenth

So there I sitting in Dr. Nasty’s office howling like a dying hyena, right after he told me to abort my healhty babies, when Dr. Andrei entered Dr. Nasty’s office.
He popped his head in the doorway and asked, “Is everything all right?”
Dr. Nasty started to explain to him my dire situation and the three options that I had.
He told Dr. Andrei that my cervix had measured one point six centimeters three days prior, when I was twenty weeks and four days pregnant.  However, during my ultrasound examination, not only did my cervix shrink down to one point one centimeters, which meant that the progesterone was doing absolutely nothing, but Baby C, Hunter, was polyhydramnios, too much amniotic fluid.  It was a sign of preterm labor.  Now I had two signs of preterm labor, a short and getting shorter cervix and too much amniotic fluid.
Dr. Andrei asked if my cervix was open and thankfully Dr. Nasty responded that it appeared to still be closed.   Dr. Nasty continued and told Dr. Andrei my options.
Abort
Selectively Reduce
Indomethacin

I tried to get it together since Dr. Andrei entered the room, but hearing the three options again, a fresh wave of tears flooded my face. 
My babies are perfect, little human beings, two boys and one girl.  How could I ever choose which one to lose?  I wouldn’t, never, ever.  I will never choose to spare one to save the other.  I will save them all, I resolved.
“Wait, wait a minute,” Dr. Andrei said, “First, you are too far along to terminate one fetus without losing the other two.”
Fetus, what a horrible word, I thought.  I didn’t have fetuses in my belly.  I had moving, breathing (kind of), heart-beating babies, who only needed a little more time.
“Second, you have three more weeks to decide if you want to terminate.  You have until twenty-four weeks to abort.  Let’s try the indomethacin first,” he said it so matter of factly that he made me feel comfortable. 
We have a plan, I thought, as Dr. Andrei started heading back down the hall.
I wanted to scream, Don’t leave me with him.  Don’t leave me.  Not because my George Clooney was leaving, but because Dr. Andrei had become more.  He was my only hope.  He had a plan.  He took termination off the table.  It might have only been for a few weeks, but he took it off.  I no longer had to think about killing my babies.
I was never going to abort my babies.  Abort is what the military does, Abort, Abort, the Colonel yells, informing his men to stop the offensive.  Terminate used for firing an employee.  “Sorry, your position at the company has been terminated.”  Kill.  That was what Dr. Nasty suggested I do to my perfectly healthy babies and here I was still sitting across the desk from him.  Weirdly, I sat there and listened to him.  He was a doctor, right?  He told me to continue with the progesterone suppositories and add 25mg of indomethacin three times a day.
I didn’t ask any questions.  Mummy-like I got up from the chair; grabbed my prescription and walked to the receptionists’ desk.  She asked if I was ok.  I guess everyone heard me crying and if not, then my swollen eyes, red face and inability to talk, gave me away.  I told her that Dr. Nasty told me to abort my babies.  She gasped; I cried.
I made an appointment for the following Tuesday and went outside and slid into a cab on 90th and Madison.  I promptly called Jack.
“Hi Sweetie,” he joyfully sang, “Sweetie.  Sweetie, are you there?”
“Yup,” I whispered with my heart in my throat.
“Is everything ok?” His worried voice only made things worse.  I needed him to be cold and calculating.
“Come home,” I near-silently begged.  This must have stunned Jack, because I was usually in control.  I liked being independent.  I was not the wife who neither needed nor wanted my husband to go to doctor’s appointments with me.  I was perfectly capable of listening to the doctor and then discussing it with my husband later.  In fact, during the entire IVF procedure, he only showed up the day he needed to make a deposit and when the embryos were transferred.  We both were perfectly happy.
He paused.  There was silence on the line.  I knew he needed more information, but I wasn’t sure I was going to be able to say it.  “They think I should abort,” I got out moments before a gut-wrenching sob over took me. 
I know that wasn’t what the doctors decided to do in the end, but it was the only thing that was ringing in my ear, screaming in my head, bashing my heart.  At the time, it was the only word that I could remember from the appointment.
ABORT, ABORT, ABORT
If you listen close enough NYC taxi’s horn sounds like the word “abort.”  The clicking of heals on the sidewalk are saying, “abort, abort.”  It’s everywhere.
I don’t remember how Jack responded.  I knew he would come home.  I knew he would offer me the protection of his love and the warmth of his body and most importantly, a distraction.
It took him an hour to get home.  He worked on Water Street on the corner of the South Street Seaport; we lived on 88th and 2nd.  He either had to take a local subway, two subways, or a taxi through midtown during the lunch hour.  He chose wrong.  Not only was a taxi through midtown a bad choice, but it also cost him $30.
He entered the apartment with one of those fake smiles, I hate.  His eyes didn’t lie and never did.  He had been crying.  I realized that is why he chose the taxi; he could be alone (more or less) with his feelings. I probably would have teased him about crying, as I did when he teared up at chick-flicks, but I couldn’t pretend not to be devastated.
I don’t know what we said at first, although I ended up in a bear hug with my face plastered against his chest.  I soaked his shirt and tried to wriggle free.  I needed a dry spot and a tissue. 
“What are we going to do with Gavin?” I said.
“What do you mean?”
“I don’t know if I want him here if I go into labor and our babies don’t live,” I said and tears slowly flowed.
“You probably should be on bed rest even though your doctors don’t believe in it,” Jack said.
“That’s what I was thinking, but I cannot imagine not taking care of Gavin. What are we going to do?”
“Do you think your parents can watch him?”
“My parents would love to have him.  How are we going to get him down to Florida?” I said.
“I guess I could fly him down.  What about getting a nanny?”
“I don’t know.  I don’t know what to do.  I just can’t believe this.” I crumbled down onto Jack’s lap and let misery take over.  My brain was going haywire. I couldn’t believe that I was in this position.  Abort.  Abort my babies?  Send Gavin away.  Keep Gavin here and try to remain calm around him.  Go into labor and effectively kill my babies.  My babies.  My babies.  All four were my babies.  Mine.
Eventually, we came up with a plan.  Gavin would go to my sister’s house for two weeks and we would take each day as it came.  It wasn’t much of a plan, but we both were in agreement that we were not going to talk about abortion.
“Crist, it’s Laura,” I muttered.
“Oh, Laura, mom told me.  I’m so sorry,” her voice started wavering and I started crying.  I really didn’t know if I could cry anymore.  I spent thirty minutes on the phone with my mother before Jack got home and we both cried the entire time. I had managed to be free of tears for a few hours.
“I need to ask you for a big favor,” I whispered.  “Can you take care of Br…” I couldn’t finish.  I cried.  I cried loud and hard.  I cried, because my heart was breaking.  I was sending my son away.  I wondered if Gavin was going to think that I was choosing the triplets over him?  Was I choosing the triplets over him?  I was.  I was choosing the triplets over him.  I was a horrible mother.  The worst mother ever.  I was the kind of mother that I never wanted to be.  I don’t deserve these babies, I wailed inside my head.
Jack had long since grabbed the phone from me.  He knew I lost my composure and it was going to be awhile before I could gain it back.
“Crist, I am going to drive Gavin up in the morning, after I get breakfast for Laura.  I plan on leaving around 9am, which will get me to your house between 1 and 2pm,” Jack told my sister.
“No, no, I don’t need lunch.  I’ll head back home once Gavin is settled,” I heard him tell her.  Then he hung up the phone.
“Laura, are you ok?” Jack stupidly asked. I didn’t respond.  I just looked at him with my broken heart in my eyes.  He sat down and snuggled me.
I don’t know if Jack ever knew what I was really thinking.  How much I felt like a failure to both Gavin and the triplets.  I had no idea how Jack could even like me.  I was shipping our son off when we both probably needed his innocence and quick smile the most.
I am killing your babies, my eyes screamed at Jack.  I wanted to yell, go away, run.  I am no good for you.  I am killing your family.
If there is one thing I have known with certainty about Jack is that he wanted a family, a traditional family.  He did not have that as a child and I think he still carries the pain of his parents’ divorce with him.  We had a perfect little boy and three perfect babies incubating; we were going to have a perfect, traditional family.
I am ruining your life.  Take Gavin and run, I pathetically thought as I spiraled as deep as possible into self-pity.
“What should I pack for Gavin?” Jack asked, interrupting my self-loathing.
“I don’t know,” I responded.  Fresh with the realization that I was the world’s worst mother, I couldn’t think of anything else. I couldn’t look at Jack or Gavin.  They deserved better.
I wanted these triplets.  I wanted these triplets before I even conceived them.  I wanted these triplets before the embryos were placed in my belly.
I never knew that my desire for them was going to wreak havoc on my family.  By my family, I don’t mean just Gavin and Jack.  I was causing emotional pain throughout my family.  My brother, Frank, who was a lifelong bachelor, even called me offering his love and support.  Crist had to adjust her life to take in a seventeen month old when her youngest was twelve.
I hated myself.  I did this.  In my selfishness to have a big family, I did this. I was the one on bed-rest during the IVF cycle who imagined three embryos implanting.  I did it and now there was nothing to do, but hand my darling, little Gavin off and pray for the impossible.
We ordered in our last super as a family.  Pizza, it was something that we could eat together.  I managed to hold it all together during dinner and continued to until it was time to put Gavin to bed.
Jack bathed Gavin as he often did.  They both climbed into the bath together and had a good time.  Jack seemed to be doing rather well, splashing in the tub with Gavin.  It pissed me off.  I wanted to have fun with Gavin too.  I wanted Gavin to remember me as a happy mom before he was carted away.
Jack usually put Gavin to bed, but I decided to take over after the bath.  I changed Gavin into his pajamas.  I lay down in bed and snuggled him on my chest.
“You are my sunshine, my only sunshine.
You make me happy when the skies are grey.
You’ll never know, dear. How much I love you.
Please don’t take my sunshine away.
And in the morning, when you wake up,
I’ll kiss and hug you, cause I love you.
You are my sunshine, my only sunshine
I will always love you.”
I sang softly to Gavin as tears trickled down my face.  My voice cracked, but that probably made it sound better.  I wouldn’t be there when he woke up on Sunday.  Would he still know that I loved him?  Would he feel abandoned?  Would he be happy?
People always say that they want their kids to be happy and healthy and I don’t doubt that is true.  However, sometimes I think parents let other goals trump happiness, such as getting into a good college or joining an “honorable” profession.  While I want my kids to do well in school, I want this, because I don’t want any professional goals of theirs to be limited due to their lack of education, which I would view as faulty parenting, on my part.
I had years to worry about Gavin’s education.  Now, I needed to figure out how to make sure Gavin felt safe and secure when he was being shipped off to my sister’s home.
I sang him one more round of my version of “You are My Sunshine,” and drifted off to sleep shortly after him.  I had a restless night, which included three trips to the bathroom and one horrible nightmare.  I dreamt that Gavin was a four or five year old boy.  His white, blond hair was bouncing as he ran around the soccer field.  He looked a bit aimless, but sometimes he managed to actually be near the soccer ball.  I cheered him on from the sidelines.  Gavin never acknowledged that I made a sound.  I heard a woman farther down the sideline’s yelling, “Go Gavin, Go.”  At the sound of her voice, Gavin turned and with a big smile on his face, he waved to her.  It was my sister.  I lost my son to my sister.  I woke up crying.
Did I really want Gavin to be happy at my sister’s house? Yes, but then didn’t it mean that he didn’t really miss me.  At best, I was conflicted.  There wasn’t one moment that I wanted Gavin to be sad or not enjoy his time at my sister’s home.  At worst, I was pathetically depressed. I saw everything turning out the worst possible way. 
Gavin woke up earlier than usual.  I scooped him up from his crib and sang him his morning song, “Good morning, good morning.  It’s time to say good morning.”  My throat tightened, my eyes filled with tears, “I’m losing my baby.”  I sat down on the couch and stared at Gavin.  I couldn’t take my eyes off of him.  He was beautiful, innocent.  He was mine, all mine (well, and Jack’s too) and I was shipping him off.   I turned on the TV and we watched “It’s a Big Big World.”  We waited for Jack to get up and go to the bagel shop for breakfast.
I ate my toasted bagel with butter in silence.  I was busy lashing myself with painful words that were emanating from my heart.  Jack broke the silence and said that it was time for them to leave.  I gave both a kiss and said good-bye.  I let him go.  I didn’t even put up a fight.  I was a failure.

Here are the other chapters: