I recently had a procedure done to fix my incompetent cervix. The one most commonly used is the Transvaginal Cerclage (TVC). It's placed around 13 weeks and is done through the vagina .The cervix is stitched shut near the bottom. You are usually on full bedrest afterwards for the entirety of your pregnancy, and it is about 75-85% effective. When they say effective, the medical world means live birth. They consider live births that are severely preterm with lifelong medical complications success stories. Full term, healthy birth success rate is probably less than the 75%. Since the cerclage is placed low on the cervix, the pressure of the baby will still push down, causing you to dilate and funnel up to the stitch. There's a lot of pressure being placed on the cervix itself. Your water can break at any time and can even tear the cervix where the stitch is placed. To me, this is very risky. But I was willing to lay in bed for months on end if need be. I consulted last month with the high risk doctors at U of M and they wanted to do the "wait and watch" approach, measure my cervix to see if there were any changes and then possibly perform a TVC if they felt it needed. In my heart I knew there had to be other options. So we did more research and found the answer we were looking for.
The other kind of cerclage is called a Transabdominal Cerclage (TAC). It's placed through your abdominal cavity and is so much more effective. A c-section incision is made and a band (made of merselene) is placed tight and high on the cervix. It can support up to 100 lbs! The procedure can be placed pre-pregnancy or during pregnancy (but only up to 10 weeks or so) . The band is permanent and can be used for future pregnancies. You can only deliver via C-section after it's placed. It totally solves your incompetent cervix, no bed rest is needed and you can resume a normal pregnancy and have the chance to deliver a full term baby! There are only a few doctors in the United States that do this procedure. They are highly skilled and saved thousands of babies lives! This was the route I decided to go. We were lucky enough to live close enough to one of the most recommended ones in the world, Dr. Arthur Haney, at the University of Chicago Medicine. Women from all over the world come to have their TAC placed by him. We consulted with him on the phone for well over an hour, he explained any little detail we could have ever thought of, and a week later we traveled to Chicago. I had my procedure on 4/11/14.
I was not nervous the night before my surgery, I don't over think things. I couldn't eat 10 hours before hand (surgery was scheduled for 1:30 pm the next day) but I made sure to order room service for 2:30 am so I could get one last meal in. The University of Chicago Medicine Center for Care and Discovery is an amazing building. It feels like you are going into an airport or some kind of space ship, it's really state of the art and just over a year old. I felt I was in the best care possible when I was there. The entire staff that would be in the OR with me came in and introduced themselves, what their role would be and made sure I was comfortable.I was wheeled back into the OR with no nerves whatsoever. They started to give me general anesthesia and the next thing I remember I was waking up and heading to recovery. The procedure took about 2 hours. They were rather surprised that I was coherent so fast. They asked how my pain level was, and it was ok for the moment, they said it was just the anesthesia that hadn't wore off yet because I would soon feel pain and to not be tough, just use the medicine. I was given a pain pump and I could push the button every 8 minutes and have Dilaudid injected straight in my blood stream. I was in the recovery room for a long time, as it was a shift change and they had to get my room ready. I did not have any nausea, vomiting, or any other adverse reactions. I just wanted to get to my room and sleep and get something in my stomach.
I had one of the best rooms you can get there. It has a city view as well as a view of Lake Michigan, pictures don't do it justice and the windows are tinted. It was nice for my hubby. He was able to stay in the room with me the two nights I stayed which was wonderful.
That night I did get a bite to eat. I did not get into my room until 8:00 p.m. I had a catheter also which are always uncomfortable to me. I lived off the pain pump and was in and out of states of rest. I actually didn't get a wink of real sleep that night, as the catheter was not draining correctly and was causing me pain and I kept waking up trying to roll to my side to see if i could get it to drain better. My throat hurt so BAD! When you have general anesthesia, they intubate you (put a tube down your trachea to maintain an open airway) and that really messed with my throat. It felt as if someone had shoved something down there (which they had!) and irritated everything.
The next morning was rough. They came in, took the catheter out, stopped the pain pump and you are encouraged to try to get up and walk. Since this is not a normal Csection. They actually go into your abdominal cavity, move your muscles, bowels, bladder and uterus around, you basically feel like you've been cut in half! They give you Percocet as needed, but the next day was rough. Dr. Haney said I should recover well and quickly since I am fit, and have no fat. But, the next day I just felt like a big old baby! My hubby brought me flowers when he went out searching for breakfast and that brightened my spirits for a second.
I eagerly waited for my ultrasound. They finally came for me, and Dr. Haney met up with us when we went in. The ultrasound tech showed him the TAC and he was pleased with what he saw. He talked to me with how the procedure had went and that he had never had someone with such tight abdominal muscles! (I could tell, because they feel pretty bruised!!) He explained that my cervix would stay long and I could have it looked at every two weeks with my OB/GYN so I could have reassurance things were staying put. He's an amazing man. Truely, I've never met a doctor like him before and I'm so glad that this was all possible. We were all laughing because Dr. Haney personally escorted us to Pre-Op and after the ultrasound, he personally escorted me back up to my room (and this hospital is huge). He said that was the most expensive escorts I'll ever have in my life. I mean, really, he felt like a father I've always wanted!
And at the end of the measuring of the TAC and cervix, I finally got to see the entire reason for this, the reason why I'm willing to go through so much suffering, pain, and any obstacle I need to....
Introducing the incredible little life that is growing inside of me. John and I have conceived all on our own. I know that my baby has a fighting chance of entering this world healthy, because I have done all that I physically can to protect Baby Pak, and that is all any parent can do for their child.
I'm at home, recovering, and it's hard. Every day gets a tiny bit better. The worst pain I have had was the first 3 days after surgery. My body was so pumped full of air, I thought my stomach was going to explode and I've never been in that much pain in my entire life. Another thing, I would advise getting a TAC pre-pregnancy if possible. The incision is a bit smaller as well. I am at the end of my 1st trimester, but still not feeling so hot and it's complicated recovering from major surgery and being sick from pregnancy. Also, I would advise against the narcotics unless you're GI track can handle it. It makes things a lot worse for me with an already slow digestion because of pregnancy. I stopped taking them the day I got home. I rather suffer with pain from surgery, then the pain of bloating and not being able to eat when you are starving!
If you have any other questions regarding Transabdominal Cerclage (TAC) please feel free to comment below. I am so thankful for Dr. Haney, what a blessing he is!
How much did it cost? My insurance doesn't cover it.
ReplyDeleteIt was around $50,000 total. But I think he gives a discounted rate for those whose insurance doesn't cover
DeleteThank you!!!.
ReplyDelete