Cerclage surgery day

Well, today was my cerclage surgery, it was scheduled for 12 noon. About 10AM we arrived up in L & D and went back to the little holding area near the C-section operating rooms. I got dressed, got my IV, actually got taken back to the OR on time (wow - crazy thought), and got my spinal without incident. After giving numerous spinals, it was so odd to feel the numbing sensations that I describe for my patients. I think I'll be even better at explaining things now, hopefully more patient, and more understanding after being on both sides of the needle. (I've been told I'm patient to a fault, and wear my feelings on my sleeves...but it's still humbling each time you're the one on the OR table.)

Once the procedure was underway, my OB informed me of the condition of my cervix when he had a close up look at things. Things were definitely short, very short for 13 weeks. My OB said we are darn lucky we are doing this now. Whew. But as he said in his ever calm voice, things could always be worse. We definitely still had some cervix to work with, and hopfully this will give us a little more protection room. For those of you who are familiar with an incompetent cervix or cerclage, you know that the success rates of the procedure depend on the reason for which it is done. Best outcomes are for preventative cerclages (when the cervix is still nice and long) done for women who have had previous second trimester losses due to incompetent cervix. Behind that are therapeutic cerclage done when the cervix has started to shorten a bit, but is not in danger range and still very early in pregnancy. The women with the worst outcomes are emergent or rescue cerclages where the cervix has shortened to dangerously short levels. Without prompt intervention, the cervix will be dilated and premature labor will shortly follow in either days or weeks - before the baby is viable. Usually emergent cerclages are done past 18-20 weeks gestation and are not necessary early at 13 weeks. According to my OB, our cerclage was "definitely needed urgently", and I am so grateful we did this today. But we all realize we're walking a very thin line right now.

After the procedure, they monitored me until the spinal wore off. They were also checking to make sure that my water had not broken from the procedure and wasn't slowly leaking out. They also checked to make sure that I was not having too much increased uterine activity or irritability which they would have treated with medication. I spent the following hours there, but thankfully didn't have to spend the night. I will spend the next week on the couch, as I've been told not to move very much, and to lay on my left side as much as possible. Next week I'll be able to see how the cerclage is holding up (they can tell my an exam followed by a transvag ultrasound). I'm hoping to get some good news at that appointment.

The severity of this is slowly setting in. I think I have realized how serious things were for the last few days, but was trying to shrug things off. At lunch on the weekend with some friends, I tried to put a smile on my face. But I now realize that was a bit forced. I've been afraid to take everything in, but now I have no choice. The look on my OB's face proved that to me today. I know him, and know him well both through work, as a patient for several years, and through through other areas of my life. He tried to sound hopeful, but I can tell he is still concerned. On one hand I know we can get through this. We've made it through the three years of infertility, the diagnosis of the unicornuate uterus, the journey ending in IVF, OHSS after the IVF, the placenta previa and all of the bleeding and couch arrest. Now at 13 weeks we are here. We've gotten through things like this before, I know. But this time, I'm not sure what's different. But I know that my heart is slowly breaking. I am just trying to stop it before there are too many little pieces - because I know I must move forward.