Update on bleeding at 16 wks (possible m/c ment.)August 7 2012 at 3:54 AM
|Marti (Login longing4baby)|
First of all, thank you to everyone for your support. On Sunday night, my DH went out to get dinner and I had a horrible incident of hemorrhaging at home. I will never forget his face when he walked in the bathroom that looked like a crime scene. Instead of going to my OB's hospital, i went to the closest hospital emergency room. The tests revealed I had a short cervix (1.06 cm) and Baby A had lost amniotic fluid and for the first time was measuring smaller than Baby B in measurements and weight; heartbeats were 160 and 153. On Monday, I called my OB who immediately referred me to my maternal fetal medicine doctor and they asked me to go in immediately since she was leaving on vacation. The MFM doctor confirmed the shortened cervix measurement, heartbeats were 143 and 128, still had no explanation for the bleeding episodes and said there was nothing else that could be done except "wait and see." When I asked her to explain her approach, it basically meant to wait and see when I miscarried because the cervix was too short to sustain a pregnancy. I asked about progesterone supplements and was told it would not work. I asked about a cerclage and was told it was too dangerous because of all the bleeding. I asked what would happen if Baby A didn't make it and she said Baby B would quickly follow and the shortened cervix may mean I was having contractions with the heavy cramping I had been having with the bleeding. For all my questions, this doctor kept staring at me to make a decision to agree with her opinion. No other options seemed to be open for dicussion and I was sent home with an appointment in 8 days to "see" the condition of my shrinking cervix. Now, I am irrationally angry...I am looking for a second opinion, reading everything I can get my hands on about cervical conditions and making my own plan of action. I do not understand why I sometimes feel I have to give deferrence and authority to someone in a white coat when I am part of the team. It's not like I can just run and get pregnant again in a few months....which is what I was made to feel with the "wait and see" approach, this is not just information we can use in the next pregnancy....I am still pregnant now!!! My babies have been hanging in for 21 days besides the heavy bleeding for 15 of those days!!! I thank you for listening and appreciate any insight you have.
I'm so sorry
|August 7 2012, 9:29 AM |
I will pray for you and your babies.
|August 7 2012, 10:16 AM |
I am very appreciative of your prayers. My best wishes for your continued health.
This is terrible, I am so sorry.
|August 7 2012, 9:47 AM |
I hope you do find a second option. I know they say bed rest will not help but will it help you feel better that you are doing what you can?
Amy has the most experience with this, if she does not see your post maybe try searching for her e-mail (I feel like she posted it once?) I can't speak for her but I think she would give you any advice she could.
With great love and gentle hugs,
Prayers and good thoughts,
|August 7 2012, 10:18 AM |
Hi Sara H,
Yes, I am on full bed rest now and am so grateful for your advice. Thanks! I hope you are doing well.
Oh no I'm so sorry
|August 7 2012, 9:53 AM |
I'm so sorry to hear this latest update. You must be beside yourself.
Did your dr. explain WHY s/he thought progesterone would not help? From the March of Dimes website: "Recent studies show that for some women, especially if they have a short cervix or if they already had a preterm birth, being given progesterone during pregnancy may help reduce the risk of having a premature baby"
I would think they should at least give it a try.
Here is the link, which suggests some other options as well:
Hopefully others can add some insight for you. Again I'm so sorry for what you're going thru and I am keeping my fingers crossed for a good outcome.
No explanation offered
|August 7 2012, 10:27 AM |
No explanation was offered other than the "wait and see" approach. I honestly was so tired and emotionally stunned I felt helpless. I know it's not good but I just needed time to absorb, read and research. Interestingly enough, I ran across that site and have it listed in my notes for my next dr. appointment. Thank you for your well wishes.
Wow that's sort of ridiculous....
|August 7 2012, 5:47 PM |
...that they didn't even offer an explanation and further, that's a pretty pathetic attitude for so called specialists. I know what it's like to be so stunned by bad news you cant process it and respond appropriately in the moment. Echoing what others have since said, you really need to call MFM and your OB and INSIST on P4 NOW. Cite the March of Dimes research if you have to. Ask them what could be the harm if you try. Go get 'em!
I am so sorry Marti
|August 7 2012, 10:07 AM |
I'm so sorry that you're dealing with this, and sorry that you don't have doctors that are helping you right now. Echoing the PPs, I don't see how P4 could hurt (and I would want to start right away). Do you have any lying around? Is there any doctor you could convince to prescribe some for you (even if you have to frame it as "just to make you feel better" so they don't feel like you're questioning their authority? Ridiculous to have to do this, but works sometimes- while you're finding a second opinion). As Sara H said, Amy would know the most of anyone on this board I think, and she did post her email address not too far down in a response to me on a post I started. I will be sending you and your babies lots of positive thoughts.
Thank you for the P4 suggestion
|August 7 2012, 10:31 AM |
I have never taken progesterone and wish I had some laying around
I put in one last call to my current OB to beg for the 17p injections or progesterone suppositories. I am researching new OB's and finding it difficult to switch at this point. I am kinda feel like the kid at the dance with no partner. It will all work out, it has to...thanks for the positive thoughts.
Re: Update on bleeding at 16 wks (possible m/c ment.)
|August 7 2012, 11:40 AM |
My heart goes out to you, I feel so bad for what you're going through right now. My greatest hope for you right now is that you can get a second opinion and a dr who will help you. I completely understand your anger and frustration with these doctors. I do agree that getting on some progesterone would be a very good idea and also strongly agree, don't "ask" you make sure you tell them you want it, it would make you feel better. I pray you can get some right away. Yes, definitely stay off your feet and in bed, don't do anything, just rest and drink alot of water. Before I posted this I prayed for you and I will continue to do so. I am so, so, SO sorry you are going through this. You're in my thoughts. May God Bless and watch over you and your babies.
Thanks for the continued prayers
|August 7 2012, 12:28 PM |
Thank you for the continued prayers. I am praying for peace and clarity on what to do next. My OB just called right now after reviewing the ER report and also was called by my MFM doctor. They both feel that I am a medical enigma right now. The reason for no progesterone support is the shortened cervix, contractions and bleeding makes them both feel that my body knows something the tests are not revealing. He wants to see me later this week to discuss how I am feeling and next steps before the weekend to give me more hope. I felt better that my concerns were being heard and dfinitely felt more validated than yesterday. He wants to do more research on the p17 injections and may move towards next week. He also said a cerclage was not completely out of the picture if we could get the bleeding to stop, their fear was stitching me up and I hemorrhage internally and put my safety at risk. He also stated hospitalized bed rest may be in the future to monitor the progesterone and/or cerclage.
Good news: have not bled in 7 hours. This is the longest stretch since July 22nd
I do not want to jinx but I know it's the prayer network and not standing for more than 10 minutes to get to the bathroom or get water/food
I know you have faced many challenges and I pray for your continued health and your baby's continued health. Take care!
Starting P4 and advice on dealing w/ doctors...
|August 7 2012, 1:38 PM |
I'm really glad you felt more heard talking to your OB again. That is really important. I don't want to sound alarmist but I would not wait until next week to start the progesterone. I would tell him/her that you feel strongly about starting it now and s/he can research it in the meantime since a very quick review of the literature I believe would show that it shouldn't hurt and why not start now if it won't hurt? If you've stopped bleeding (which is great!) how quickly can they get you in for the cerclage? Again, I wouldn't wait an extra day even if it's safe to do it sooner.
As for feeling deference to MDs, I totally understand b/c I've felt that way too many times. But, as someone who has been a patient of and worked alongside many, as well as been friends with and even dated some back in the day, I can tell you that they're just people. They are people that don't always have the answers, sometimes have bad days, sometimes feel overwhelmed with all they have to do in a day, sometimes have lost their empathy. Many times they will see 20-40 patients in a day but you need to advocate for you since at the end of the day, all that matters is you and your family's health. I know it's hard, especially when you're getting a lot of push back, but they are just people and you are a woman fighting for your family. Try not to worry about upsetting them, b/c at the end of the day, it just doesn't matter nearly as much as protecting yourself and your family.
In trying to get an appt with a new MFM, my recommendation is to always start the conversation with "I'm dealing with a very difficult situation and I'm wondering if there's anything you can do to help me" and then explain what's going on and be effusively polite. The medical secretary can be your friend and if you find someone with some empathy, they will often bend the rules and move things around to help you out.
Hope some of this helps- it's mostly tips gained from many years fighting against the medical system with a chronic illness- a lot easier after learning some of the "tricks of the trade". Again, thinking of you and sending lots of good thoughts.
|August 7 2012, 3:42 PM |
Thanks for the great advice. I just saw this post about 30 minutes ago and it inspired me to try one last MFM office using your conversation starter. This office's scheduling secretary not only listened but took copious notes and was going to get the MFM doctor to consider giving me another opinion. Even if it does not work, I feel like I am trying everything. Thank you so much for the encouragement!
|August 7 2012, 5:33 PM |
Your suggestion to appeal to the secretary's empathy worked. I even used your line of "I'm dealing with a very difficult situation...". She not only listened but took copious notes and said she would personally take my case to the MFM doctor. I told her I would accept whatver he had to say, respected the opinion of the other MFM but I had to be able to live with a cler conscious that I had exhausted every possible avenue. She called back within 30 minutes and said he would provide a second opinion with a consultation and I only needed to bring in the cervical measurements and ER reports. She also said he was very upset about the lack of concern for my case and instructed all of his office staff to review this week's appointments to see if they could squeeze me in earlier.
A million thank you for your strong words of encouragement and advice!
That is AWESOME
|August 7 2012, 5:44 PM |
I'm so glad you had a good conversation with the secretary and great advice from Erin!!!! I Love that and I'm going to pocket that phrase for future reference. Very good that someone is HEARING you!!!! Don't give up! Rub your belly and keep the faith!
I'm SO glad!!!
|August 7 2012, 5:50 PM |
I'm so so glad for you that they listened to you and made that appt. As you said, it's no guarantee that they will be able to do anything, but it's so important to have everything done that possibly can be. It's amazing how often using that line works- I think people really want to help but they get lost in their work and a million demands and it just becomes easy to automatically say "no" when they don't hear what is actually going on. When you start by giving them your story you become a real person with a real situation they may be able to help with. In any case, I'm really really glad it worked out and will hope that this MFM is able to do something to help. Continuing to send lots of positive vibes your way!
|August 8 2012, 2:27 PM |
Re: Thanks for the continued prayers
|August 7 2012, 2:05 PM |
I don't know too much, I'm just an average person here and most of the time I don't have much advice to give based on experience, just tons of support...but I wish they would start you on progesterone sooner rather than later. Maybe I shouldn't say that because I'm not a doctor but since it can't hurt, I just wish they would start you right away. Is there a reason why they can't get you started now?
I am so glad though, that you're resting in bed and not bleeding. Keep drinking lots of water. Have your food brought to you and just get up to go to the bathroom, keep doing exactly what you're doing..but I do hope you can start on that progesterone soon. I've been praying for you all afternoon. Today is also my birthday...the big fat 4-0 and since I get to make birthday wishes one of them is for your babies to be okay. Hang in there.
Not in my opinion
|August 7 2012, 3:48 PM |
I disagree with the first part of your post, I know you are very knowledgable and have admired your posts and grace for quite some time. I just read yours and Erin's post about 30 minutes ago and they both fueled me into calling the last MFM in my area that I would consider. I am waiting for their call back. I have nothing to lose in that phone call and I have made my peace before making the phone call. Thanks for the strong encouragement, I am so grateful for your support. I cried when I read your post about your birthday wishes and I send you the best wishes for a beautiful and peaceful birthday! Thanks for making me feel so supported
|August 7 2012, 5:32 PM |
I could give you a hug. Please post if you are up to it, after speaking with this dr. I am pulling for you and praying for you often. Thank you for the kind words you wrote also. Keep resting, keep your feet up and don't lose faith. Everyone is here for you, with you. Keep me in your pocket! Hugs, T
|August 7 2012, 5:41 PM |
I just posted all the details above to Erin's post, but in short, it worked
I got an appointment for next Monday with an opportunity to be called in a short notice for any cancellation.
Very happy to hear
|August 7 2012, 5:46 PM |
You made progress! Now take it easy Marti, PLEASE...stay in bed, don't do anything, let your hubby bring you meals and just relax...I'm praying you will wind up in there even sooner but until then, take it easy and of course godforbid if it gets worse call them back. Know that you're in my prayers. Thinking of you and your babies!!! Xoxo
I'd try another MFM stat
|August 7 2012, 11:57 AM |
Hopefully Amy will chime in too. I do agree 1 cm is very serious. Is there any way you can get into another MFM asap?? I know that here, MFMs vary a great deal on how they treat patients. Those associated with Hospital A always have poorer results. Hospital B group gets multiples further along on a consistent basis.
Do you want me to ask my triplet groups for a rec based on where you live?
Seems to take an act of congress
|August 7 2012, 12:35 PM |
It is seeming to take an act of congress to change MFM's. I called two and they refused to even talk scheduling until I get a letter from my current one releasing me from care. I tried changing OB's and similar situation or the doctor I wanted was no longer accepting new patients for my delivery month. It makes me think of that saying "sometimes the devil you know is better than the one you don't"
I live in San Antonio, TX and did not see rave patient reviews in my area about MFM's. I would appreciate any names you could pass my way. On the plus side, as I posted to Teresa, I have not had bleeding for the last seven hours. At this point, I am grasping at any hope that I can and will keep researching. Thanks for caring and take care!
|August 7 2012, 2:09 PM |
I live in San Antonio (past success ment and m/c ment)
|August 7 2012, 11:14 PM |
I go to Dr. H i g s b y and he is very very personable and dedicated to his profession. I would call tomorrow to see if he will fit you it. He has worked well w/ me in the past when I was pg w/ twins before I suffered my losses. He even allowed his nurses to draw my blood to test for NK cells and DQ Alpha and we sent the blood to labs out of town. He does not specialize in all the immune testing but he still listened to me and helped me out.
I also went to Dr. M c F a r l a n d for DS yrs ago and she was good but very curt and dry and not very personable.
I spaced out the names for the privacy of the doctors.
I wish you the best of luck. I so hope that some one can perform the cerclage.
|August 8 2012, 6:31 AM |
O-M-goodness...the first one you mentioned is my pending appointment!!! You have brought me such peace because I was not able to find anyone who had experiences with him. A million thank-you's!!! The second is my current and reportedly best in the city
I am certain she is excellent in her own right but my case is a bit of a medical enigma (dr. words, not mine).
|August 8 2012, 11:58 AM |
so glad you were able to get a connection from another board lady! It DOES help to know of another's experience!
I am glad you are consulting w/ him
|August 8 2012, 6:58 PM |
I know that he will give you his opinion and be straight forward but he has heart and compassion. I went to him last Feb for my NT scan of my remaining twin and it was discovered that the child died one or two days prior from unknown causes as the genetics were normal.
Anyways, it was a horrible situation as I have not gotten that far in a pregnancy since DS who is now 4 1/2. He and his staff were very compassionate. I don't know his partner at all as I requested to be seen by him only at each visit since my OB works closely w/ him and I did not want to be shuffled around from doc to doc.
I think you may need a higher specialist than him but I really don't know his expertise. The post below from Whitney looked interesting.
Please keep us posted.
Hoping so much for you,
I'm so sorry
|August 7 2012, 12:28 PM |
My heart goes out to you and I am so sorry that you are going through this right now. I do hope you are able to get a second opinion and find a doctor who will take a more proactive approach. Sending good thoughts and hugs your way.
Thanks for the good thoughts
|August 7 2012, 12:36 PM |
Thanks for the good thoughts. I wish your a great day!
i am so sorry
|August 7 2012, 12:51 PM |
oh, marti! i am just so terribly sorry for what you are going through. it is just awful and you must be so scared. you've gotten a lot of good advice, but i just want to reiterate getting a second opinion! you never know what approach another doc will take and what will help.... you deserve to be listened to. please rest and take care of yourself and think positive thoughts. i'm so glad the bleeding has stopped, let this be the beginning of things turning around. i am thinking of you and wishing and hoping for your good news soon.
Thanks for thinking of me
|August 7 2012, 3:00 PM |
Thank you for your kind thoughts. I know I cannot control what is happening but I can control how I feel about it. Stress is never good in pregnancy and I am forcing myself to not make rash decisions, think positively and get rest.
so sad and bewildering!
|August 7 2012, 4:21 PM |
I'm so sorry that you're dealing with this. I mean that sincerely. I can only imagine the fear you must have. I truly hope your babies make it.
I don't know your full history so forgive me on that. But I don't understand why you weren't on any progesterone support at all to begin with? Although granted even if you were on P4 you may have been weaned off it by now by the average doctor.
Do you have a history of m/c? Are you AMA? Is this your first ever pregnancy?
Something in your post struck me and that was your comemnt "It's not like I can just run and get pregnant again in a few months....which is what I was made to feel with the "wait and see" approach, this is not just information we can use in the next pregnancy".
I don't know if you know my history and about my P4 saga but short of it is that I am a success of Dr. Che.ck and was on P4 support until week 25. Dr. Che.ck was specifically trying to prevent miscarriage/pre-term labor. My first OB thought I was nuts for being on P4. I had many conversations with Dr. Ch.eck and during one of them he said to me (about my OB), "He doesn't care if you miscarry! He thinks so what, he'll treat you for the miscarriage and then he'll see you when you're pregnant again!" Sounds harsh and sick, right? (Note that at the time Dr. Chec.k and I had very frequent - and frank - contact about my situation so his comments were delivered harshly but were directed at my OB). And when I saw your comment, it made me think back on that. It made me angry about my first OB all over again! because like you said, you're pregnant NOW and this is the pregnancy that matters. And God knows if you'll ever have this chance again!
All that said, I do not believe that you can use Makena/17p shots to stop active labor/miscarriage. FYI - Makena shots are not progesterone like Crinone or Prometrium and the like. It's hydroxyprogesterone.
I don't have time for more, so sorry. I hope those babies hang on very tightly and that you have a big turnaround of events. But God forbid that this doesn't work out, please do find a doctor that will acknowledge (because there are studies!) that P4 could very well be the key here for you. And I would consider a cerclage as well given how thin your cervix has become.
|August 7 2012, 6:44 PM |
Hi Mrs. A,
Thank you for your empathy. My history is a bit like a patchwork quilt
I tried for 5 years to get pregnant but had the wrong husband who never really wanted children in the first place and finally admitted he even went so far to sabotage IUI efforts. That was my breaking point so I divorced him. Throughout that process of healing my broken heart, I never lost faith that there was someone out there who would want a family with me and would work with me to overcome challenges. I had my left ovary removed due to a previous surgery but had no idea what all the IF issues I would have to face. After meeting my beloved, we both knew we wanted a family together. We married in February but had been trying to get pregnant for some time before that. I set an appointment in March of this year to get a comprehensive view of IF issues. I finally got a lot of answers in a short amount of time. Apparently, my RE had never tested my blood as comprehensively as this time. My highest FSH was 31, lowest was 23, AMH .16, AFC 4 and TSH 4.4. I was told I was not even a candidate for the most aggressive IVF because I had DOR and the only way he would treat me was with a DE. I sought a second opinion and found an RE who agreed to treat me only once before trying a DE. However, her tests revealed my remaining ovary would have to be surgically removed due to a blockage meaning no chance of natural conception. I had been lurking on this board and the new to high FSH board and knew sometimes natural conceptions occurred. I could not go through with losing my remaining tube/functioning ovary and made appointments with 2 Houston doctors thanks to the fine women behind this board. The week my beloved and I were to travel to Houston, I found out I was pregnant with a natural conception. We found out in week 5 that the pregnancy was twins. I was monitored very closely by the RE because she wanted to make sure everything was ok before turning me over to an OB. My progesterone levels were never below 28 and she would not prescribe progesterone support. My current OB last tested my blood in week 11 and never saw problems. This is my first pregnancy and I do not have a baseline to know where normal ends and abnormal begins. I have also found my experience is different than my sister's pregnancy experiences. I have lived in a heightened state of concern since discovering I was pregnant because I know pregnancy does not come easy to most of us with IF challenges. That is where that comment came from with my statement of "I am pregnant now!". I am sorry to bring up those feelings of your first OB and I wish I could remove that memory but sometimes those are defining moments that make us fight harder. I feared that about the 17p shots but I just feel I would try anyways. I am so sorry this has been so long but it is my patchwork quilt
thank you for your advice, concern and empathy...I have long been a fan of your posts and responses and appreciate what you have done for this community
I am so looking praying for a good outcome for you!
|August 8 2012, 1:03 PM |
What a story you have! I'm so happy that you found the perfect love with the new DH! Those babies have to hang on for you!!!
I went to bed last night thinking about you. Laying in bed imagining the feelings of worry you must have. I remember those days. While my pregnancy was uneventful there were still those moments of gripping fear. So I can only imagine what you're dealing with. I haven't read everyone's comments (other than the one cluster with futurebeauty but I'm sure you've gotten all the basic advice of push push push until you get the care and info you feel is right. It may not be the answers you want to hear but you should feel confident about your care; that everything is being done. It was through this journey of IF and then pregnancy that I came to realize that the right doctor for me is the one who doesn't tell me to "take an aspirin and call me in the morning." That's not for me. I'm not down with outsourcing my care for something of this magnitude to someone else without having a solid understanding of what's going on. Don't feel bad for speaking up for yourself. This is literally a life matter; not a time for leaving unturned stones.
And don't worry about bringing up the bad memories! It fuels me in a good way. It reminds to not feel bad about standing up for my care. No one should. Doctors aren't perfect, they don't all have the answers and even if they do, they have off days. So sometimes we need to challenge/help them.
I just posted to Erin above on her current situation with selecting OBs. I'll pass on same tidbit to you...you need to be with a doctor that is going to recognize that this is a PREMIUM pregnancy and as such will put forth the highest care available. Good for you that it sounds like this new MFM could be the right match. Now fingers crossed that you can get in there IMMEDIATELY.
Marti, I am so sorry!
|August 7 2012, 7:55 PM |
What a nightmare. It seems you have gotten some really good advice and I'm glad to hear your bleeding has taken a break. Hopefully this new MFM will be a great fit. Please rest. Elevate your knees in bed (while lying on your left side as much as possible) with some pillows and ask about taking an iron supplement for all of the blood you've lost. Take care!
Knees :) Thanks
|August 7 2012, 9:28 PM |
Elevated knees in bed, had not thought of that. Thanks for telling me that. It is amazing how the simplest thing can evade us when we are just trying to exist
believe it or not, I had to fight to get the additional prescribed iron supplement last week because I was dragging my arse to work and back. I got it
hope all is well with you!
T&P (mc mentioned)
|August 7 2012, 9:04 PM |
Please know you have so many people giving you thoughts and prayers and pulling for those babies. The only experience I can offer is definitely stay strong and keep with the road of telling anyone who will listen, you are pregnant now and tell them you are fighting tooth and nail to keep those precious babies. Some of these obs have no idea what it takes for some of us to get pregnant. It gets lost in translation. I had to do it last year going thru something similar but not to your extreme. I did have experience with a later m/c years earlier. Stay strong
Appreciative of your sentiment
|August 7 2012, 9:34 PM |
I feel so blessed to have so much support. It was really hard to initially share this journey but it has also been a great sounding board to receive the messages I needed to not only hear, but see and believe. I have been sharing these posts with my husband at night and he is touched by the outpouring of support. I am sorry that you went through loss and something similar, it is experiences that shape you and make you focus on what matter most in life. Thanks for your thoughts and prayers.
Dr. Davis will do a rescue TVCIC.
|August 8 2012, 12:20 AM |
There are few ladies on Abbyloopers that he has preformed them on and has gone on to deliver healthy baby/babies. He is located in New Jersey and is one of the best. Here is his info: AskDrDavis@aol.com or you can call him and he has 3 different contact numbers 856-566-7098, 856-346-6200, 856-582-2789. You need to get on either Crinone or 17P injections stat! Both are equally good and do the same thing and next in order, strict bed rest. That means you don't get up unless you have to us the rest room. My heart goes out to you and I will pray for you and the babies.
|August 8 2012, 6:34 AM |
Thank you for the detailed advice. I will look into
have an awesome Wednesday!
|Current Topic - Update on bleeding at 16 wks (possible m/c ment.)|