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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.

 
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Antonialisa
(no login)

I'm so sorry

August 7 2012, 9:29 AM 

I will pray for you and your babies.

 
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Marti
(Login longing4baby)

Appreciative

August 7 2012, 10:16 AM 

Hi Antonialisa,
I am very appreciative of your prayers. My best wishes for your continued health.

 
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Sara H
(no login)

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,

Sara H

 
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Marti
(Login longing4baby)

Thank you!

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.

 
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gone_fshn
(no login)

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:
http://www.marchofdimes.com/pregnancy/pretermlabor_progesterone.html

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.


 
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Marti
(Login longing4baby)

No explanation offered

August 7 2012, 10:27 AM 

Hi Gone_fshn,
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.

 
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gone_fshn
(no login)

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!

 
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Erin
(no login)

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.

 
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Marti
(Login longing4baby)

Thank you for the P4 suggestion

August 7 2012, 10:31 AM 

Hi Erin,
I have never taken progesterone and wish I had some laying around happy.gif 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.

 
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teresa
(no login)

Re: Update on bleeding at 16 wks (possible m/c ment.)

August 7 2012, 11:40 AM 

Marti,

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.

Teresa

 
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Marti
(Login longing4baby)

Thanks for the continued prayers

August 7 2012, 12:28 PM 

Hi Teresa,
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 happy.gif 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 happy.gif I know you have faced many challenges and I pray for your continued health and your baby's continued health. Take care!

 
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Erin
(no login)

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.

 
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Marti
(Login longing4baby)

Great advice

August 7 2012, 3:42 PM 

Hi Erin,
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!

 
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Marti
(Login longing4baby)

It worked!

August 7 2012, 5:33 PM 

Hi Erin,
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!

 
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Teresa
(no login)

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!
Xoxoxo

 
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Erin
(no login)

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!

 
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Alli
(Login AC2009)

Awesome!!! nt

August 8 2012, 2:27 PM 


 
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Teresa
(no login)

Re: Thanks for the continued prayers

August 7 2012, 2:05 PM 

Marti,
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.
xoxoxo









 
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Marti
(Login longing4baby)

Not in my opinion

August 7 2012, 3:48 PM 

Hi Teresa,
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 happy.gif

 
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