Diagnosis: Incompetent Cervix...

           Why, why, WHY!? How could this happen to me again? My body lay uncomfortably confined in a head-down, foot-elevated position on a rock-hard hospital bed, while my mind reeling from the reality it was forced to rapidly process. Nurses bustled too quietly around the room while my obstetrician, Dr. Landry, attempted to articulate a medical discourse about my “condition.” Chilled by the news he communicated, I tried to mentally shroud his gently spoken, but decisive words.

           

            Roused from a Sunday evening with his family, he had shuffled slowly into my room five minutes earlier, hands buried in his bomber jacket pockets, his face a picture of concern and caution. Before he spoke, I instinctively dreaded his forthcoming appraisal. With a sober voice and matching demeanor, he bluntly pronounced his diagnosis: incompetent cervix: The medical community’s nomenclature for a cervix that opens prematurely during pregnancy.

           

            “Surprise, surprise!” I uttered inaudibly through clenched teeth. Hadn’t I questioned him repeatedly about this possibility occurring? Although he had offered repeated assurances, doubt, anxiety and unusual symptoms had plagued every stage of this pregnancy. I sensed that he initially found my concerns amusing, then—as I persisted in nagging him with them—a bit irritating. An ever-present cloud of dread had stubbornly suspended itself over my head. Having previously paid a catastrophic price for self-imposed silencing of my concerns, I wasn’t about to pay that price again. Was it simply a mother’s intuition haunting me, or something more?

           

            “Your cervix is dilated to three centimeters, and you are seventy-five percent effaced. If we can save this pregnancy at all…,” his voice trailed off as he carefully considered the predicament.  

           

            I inwardly recoiled from his choice of words. Several days ago in his office, he had spoken gently about “the baby.” Now he referred to my condition as ”this pregnancy.” I wanted to bark out a correction: “You mean this life I am struggling to carry to term!” Perhaps he was giving me the blunt, academia-style, medical-terminology version to make it more impersonal for him, attempting to dilute the tension cloaking the room. Quickly assessing my silent response, he continued his discourse by apprising us of possible treatments and procedures, and the prognosis for each.

           

            The blood test showed my white blood cell count to be slightly elevated, so performing a cerclage—surgically drawing my cervix closed like the opening of a marble bag—would have to wait until morning. They wouldn’t prematurely attempt the procedure if my uterus harbored an infection since that might be the underlying cause for labor. A closed infection could mean both fetal and maternal deaths. In the case of an infection, he wanted to perform a D and E.  I just stared at him and dumbly bobbled my head up and down.

           

            At the time, I didn’t fully comprehend what that D and E entailed, or know the barbarity of performing one when the end goal was an abortion. It certainly wouldn’t have been an option for us if we had fully understood the process, even with an infection. With rapidly waning energy, Chris and I dismissed the opportunity to question him, and he proceeded through his option list without hesitation or explanations of the gruesome details.

           

            If labor progressed, the result would be a severely premature baby delivered at twenty weeks—too early to consider supporting on lifesaving apparatus in 1994. Our only hope would be to survive the night, perform a cerclage the following day, and pray like mad that the amniotic sac wouldn’t rupture, either during or following surgery. Surgery alone could irritate the uterus enough to incite labor, taking us to the point of no return.

           

            Dr. Landry wanted to get a visual picture of what was transpiring, so he ordered an ultrasound machine delivered pronto to my room. He and Chris chatted while a glaze crept over my eyes. Within minutes, he was pointing out numerous problems, all visible on the monitor: the open cervix, the baby’s engaged position, the bulging of the amniotic sac into the canal. Everyone else in the room concentrated on the picture emitted from the screen, while I glared at the cold, ugly ceiling tiles. I was angry, disoriented, terrified. And despite the other three humans in the room with me, I felt so lonely.

           

            Yes, yes, I can see the baby! I wanted to sit up and scream at the two of them. I can see the precious baby I most likely will not be carrying tomorrow night! Instead, I managed a silent, terse nod before once again reverting my partitioned gaze to the unresponsive ceiling tiles.

           

            The jarring vision on the screen left me shaking, and doubtful we could really “save this pregnancy.” It felt so painfully hopeless. Five months of dreams evaporating before my eyes on an ultrasound monitor. Wasted dreams. The God I thought I trusted so deeply suddenly seemed cold and silent, miles from my heart and this hospital room. Maybe God doesn’t care as much as I thought He did.

            

             Disgust and self-protective ambivalence latched onto my heart, and both my heart and soul quickly hardened in response to the cold vacuum of truth sucking the warmth out of them. The pit closed its mouth over me, and I couldn’t locate a dribble of a tear to shed. Maybe my prayers will remain unanswered. Indefinitely. God’s saying, “No.”

           

            Chris and I had given ourselves this one, last chance to have another child. Now the odds indicated we would leave the hospital with empty arms and an empty womb.

           

            Again.

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NEXT WEEK: My night, and God gives me his first sign that He’s still watching over me…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

             

When an Incompetent Cervix Strikes: The Warning Signs (Part 2)

            It was one of those horrendous days that causes your heart to pound so hard in your chest that you're sure your ribcage will rupture, and then sink so low in your gut that you know you’ll die from the ache. A day where you’re clawing for an invisible life line you know in your heart isn’t there.

           

            With lingering discomfort and fatigue plaguing my body—yet, unfortunately, overpowering fear of disappointing anyone (especially my mother) winning the battle—I agreed to lunch and the movie…and rushed out the door to attempt both.

           

            In order to keep my promise. In order to be normal. In order to keep the peace.

            So, with these burdens weighing on my heart, mind and body, my mother, my four-year-old son, Parker and I zipped off to a restaurant to eat before the movie. We were in the middle of enjoying lunch when I excused myself to use the restroom. Seconds later, I gaped in horror at blood and mucous soaking into the toilet issue in my hand. Terror ripped through me. Please, God! No! Why would you allow me to conceive and carry to five months if I’m not going to be able to carry the baby to term? You’re not going to abandon me, now, are You?

           

            My own voice in my head screamed a response, I can’t panic. I’ve got to act. Now! Practically sprinting from the bathroom, I grabbed Parker’s hand, pulled him from his seat and bluntly informed my mother that I was bleeding. A look of nervous shock drained the color from her face as we hurried from the restaurant.

           

            “What about the movie?” she pressed as we navigated through the hungry crowd. I snapped my head around long enough to blink at her. “You’ve got to be kidding!” I wanted to shriek aloud at her. But I knew better. That comeback would only trigger an all-out riotous response and I’d be harangued about it for days.

           

            “I will drop you and Parker off at the theater and drive home,” I countered without breaking my stride across the parking lot, fighting an intense desire to break into a desperate sprint. “I need to call the doctor. Someone will pick you up in two hours.”

           

            I wanted to be alone. I needed to be alone. My body shuddered as the first cramping spasms gripped my pelvis. Will I make it home, or will I lose this baby in my car? “No,” I kept repeating, as if commanding my body to stop releasing blood. I have to hang on! I brusquely deposited them at the theater and then reinitiated the frantic fifteen-minute-drive home. Delirious panic hovered just below my self-controlled surface.

           

            “Almighty God,” I cried aloud in the car, “please don’t allow this child to be taken form me, too! I know I prayed that whatever Your will was in this pregnancy, I would be able to handle it—with Your strength and love. But I don’t think I can. I don’t want to have to try! Please, God,” my pleading evolved into a anguished moan. “Don’t subject me to another loss!”

           

            My thoughts raced wildly. Do I pull over, stop and call 911 from a roadside call box or give up and let it end right here? O, Lord, what’s the best thing for me to do? I decided to try to make it to the house. My hands rhythmically clenched, opened, and re-clenched the steering wheel, making the blood drain from my fingers. Prayer and incessant self-talk consumed my drive home.

           

            Methodically parking the car in its ordained spot, I gingerly applied the parking break, opened the door, carefully slid from my seat, and headed to the open backyard garage door. Chris must be working back there. He stepped into the garage before I made it to the door, and I didn’t wait for him to get out his characteristic, cheerful, “Hi!”

           

            “I’m bleeding and cramping. I need to lie down. You call the doctor.” Why do I sound so flat, so emotionless?

           

            I hurried upstairs to lie down and elevate my backside with pillows to reduce cervical pressure. Chris followed hastily with the cordless phone. Dr. Landry was off, but the answering service promised that his partner would return the call. My fingers drummed beside me on the mattress as we waited. When it came, his barrage of questions began.

           

            “What does it feel like?...Like labor?...How much blood?...Only some  spotting?...Probably nothing. Some women have bleeding off-and-on through their pregnancy…I find it hard to believe that you would have an incompetent cervix since your first child went full term without any problems. That’s just not what happens with women who have an incompetent cervix…If it was my wife, I’d tell her to lie down and relax a couple of hours to see if the bleeding and cramping stopped. Ninety-nine percent of the time, there’s nothing wrong. It’s the one percent that comes back to bite us in the fanny when we don’t do something about it…If you would feel better, come into the hospital and we’ll do an exam. When you get to the emergency room, tell them I sent you, and then go straight to OB. Tim will be on call in thirty minutes.”

            

           “Okay,” I mumbled a lifeless “thank you” then broke the connection. My body still felt peculiar, but emotionally, I was beginning to feel like a Grade A fool. Wanting to wish away the horrible possibilities, I dutifully followed his advice. And for good measure, I begged God to work a miracle. Even as I asked, I doubted one would be forthcoming.

           

            When my mother arrived home, she endeavored to offer emotional support by reminiscing about her bleeding bouts while carrying me, appearing skeptical about whether my episode should be a significant concern. Is she trying to wish away the possibilities, too?

           

            “This far into the pregnancy?” I questioned.

           

            “Well,…no,” she admitted after recalling the past. “Just the first three months.” Bleeding and mucous loss in the twentieth week of pregnancy seemed unusual to me. Recognizing my distress and need to remain calm—and to sleep—she hastily retreated to wrestle with her own feelings of helpless, and, I suspect, fear.

           

            The spotting eventually stopped, the cramping subsided, and I wondered again if this was simply an overreaction based on my previous, ghastly medical history.  The signature gripping low back pain and abdominal cramping had assailed me upon my arrival home, but I hadn’t told the doctor about the back pain. I deliberately omitted that information. Desperately wanting everything to be okay—normal—I tried to pretend it was, even with the doctor. And he thought my theory about cramping being nerves sounded plausible, so with one final assault against self-doubt, I managed to rest comfortably in my relatively pacific bedroom.

           

            Several hours later, after winter darkness settled in, I migrated downstairs to the living room couch and gratefully accepted a slice of dry toast from Chris. A fire warmed the room, and the expansive picture windows reflected the beautiful, brightly clad ensemble of dancing flame spicules. Mom played the grand piano and sang, while Parker tried—without restraint or humility—to outclass her in the solo department. Things were definitely not low key in the living room, and I considered returning to bed before an argument erupted between the two prideful performers.

           

            Time didn’t allow me to make that decision, though. Midway through my dry toast, something again felt terribly wrong, and a reluctant but hasty trip to the downstairs powder room confirmed my worst fears. More mucous and blood. With despairing resignation, I walked briskly into the bustling kitchen, stared at Chris and blurted, “We have to go to the hospital, right now!”

           

            My face must have communicated everything since Chris responded without flinching. “Okay!”

           

            Yet doubts and second-guessing waffled through my head while Chris yanked on a sweater, laced his shoes and plucked my winter coast from the upstairs closet. Meanwhile, I paced around our expansive entryway, feeling foolish, wondering if my instincts were playing tricks on me. Hoping they were playing tricks.

           

            “Do you really think you need to go?” my mother questioned with a doubtful gaze from her kitchen vantage point. Doesn’t she trust my judgment on this? Wasn’t it safer to be certain? Why does she have to contribute to my doubts, or does she just want to avoid hearing bad news?

           

            Chris vaulted down the stairs, offering a firm reply before I could respond. “I don’t care if they turn us around and send us home. I do not want to take any chances. I want to find out what’s going on!” His authoritative affirmation and resolve made me feel calm, secure and protected. Thankful for his firm decision—a reminder that I had a strong, loving ally—Chris and I climbed into the car and drove the twenty-five miles to the hospital.

           

            An hour later, after bypassing a standing-room-only emergency room crowd (thank God for the conversation with Dr. Landry’s partner!) and undergoing an examination by a nurse, Dr. Landry stood in my hospital room, presenting options.

           

            For the time being, he wasn’t letting me go anywhere…

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NEXT WEEK: The diagnosis made: Mentally processing your options with an incompetent cervix…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

When an Incompetent Cervix Strikes: The Warning Signs

           

            Thanksgiving.

           

            It would be The One I’d never forget.

           

            My parents arrived at the beginning of the week, after Chris, Parker and I bustled around prepping the house for their visit. Everybody, especially Parker, was excited about their upcoming stay.

           

            On Thanksgiving Day, all of us drove to my cousin’s in Escondido and enjoyed a fabulous epicurean meal prepared by his wife, and then capped off the meal with an afternoon of humorous reminiscings and the ritual football game spectating. (It became especially humorous, and—admittedly—somewhat stressful, when my mother and her sister—my cousin’s mom—entered into their typical sibling rivalry antics.)

           

            It was all good, until the end of the evening when I began experiencing such extreme pelvic discomfort that I had to deposit myself on their living room floor—in a desperate attempt to relieve the unrelenting, vice-like pressure. It must be my hips spreading! I quipped to myself. My own inside joke. (Unfortunately, I was right, but it wasn’t the “normal” spread a woman encounters at five months of pregnancy.) Still, as I rolled my girth around the floor like a barrel, trying to find that just-right, Goldilocks position. Relief remained elusive. Neither side-lying nor foot-elevation worked.

           

            If I could just go home and get some sleep.

           

            Thankfully, our stay didn’t last much longer after that, and when I awoke the following morning, I felt fine. Actually, I was energetic and bouncy. But Chris remained leery.

           

            “Maybe we should just stay home and hang around the house,” he suggested. But my mother vociferously indicated she’d like to go someplace, so I suggested a trip to Palomar Mountain Observatory—a little more than an hour’s drive from our home. Everyone seemed up for a mountain drive, particularly with the possibility of seeing some snow, so we dressed for a big elevation and temperature change. Because I felt slightly agitated, I climbed into the driver’s seat. Something to do besides just sit and watch, I thought. Chris questioned that decision, too.

           

            Turns out I should have heeded Chris.

           

            Following a bountiful breakfast in the flower-laden courtyard of a favorite Fallbrook restaurant, I pointed the car towards Palomar Mountain and headed up the hill.

           

            The mountaintop weather was snow and brisk, motivating all of us to walk hurriedly from the parking lot through the meadow to the glistening white dome. Then we ascended the winding stairs to view the large observatory located in the magnificent structure.

           

            My husband—an astronomy nut, who relishes pouring over heavenly pictures and information—intellectually devours everything he can possibly digest about the cosmos. I am more of a “Wow, look what God did, and is still doing!” kind of person. He constantly seeks to discover the universe’s secrets and whatever God will reveal to him about them. I, on the other hand, am satisfied by just acknowledging the awesomeness of it all, humbled by the eternal power of the Almighty Creator.

           

            Repeated glimpses into His realm convict me to abandon my ego, to attest to His omnipotence and everlasting, all-encompassing presence, to subjugate myself to His everlasting power. I think I’m far happier being simple-minded and relatively naïve about space, while I allow Chris to thrive on intellectual treading into that vast realm beyond our limited little globe. I know some of you are mentally or verbally chastising me right now. Ah, but take heart! Present me with human anatomy and physiology, and I come alive with voracious ingesting and excited banter about the current research. It is then that I equal him in his engineering and space excitement.

             

            Sorry, I digressed…

           

            Anyway, while returning to the parking lot, shooting hip and groin pain made walking nearly impossible. “After three pregnancies, the old joints must be pretty loose,” I joked to Chris as I waddled to the car. Visibly concerned, he helped me to my final, driver’s seat destination. That actually entailed stopping at the car door and first propping my cumbersome body against it to rest. Then I gingerly climbed into the driver’s seat. He offered to drive, thinking I’d be better off reclining in the second-row captain’s chair, but I declined. He’d say I stubbornly refused. Again, he was right.

           

            I felt better when I sat down, although complete relief remained elusive. We drove around the area, pointing out our favorite campgrounds and fishing holes to my parents, and were then treated to a viewing of a family of mule deer grazing in the forest. Before descending the mountain, we stopped briefly to enjoy hot chocolate and snacks at the local café.

           

            Having chocolate. That was another bad move.

           

            But as I drove on, fatigue quickly encompassed me. We were all hungry, and my energy rapidly waned. But wait! There was a furniture sale nearby in San Marcos, and I wanted to take the opportunity to shop for a curio cabinet for my hibernating doll collection! It didn’t seem too far of a drive, but by the time we arrived at the furniture store I could barely stand upright. I was beyond exhausted and uncomfortable. To complicate matters, my husband spotted a bunk bed he thought Parker would like, which provided the eager saleswoman the opportunity to perform her best pitch in an attempt to persuade me to plunk down a hefty deposit on the bright red bed.

           

           Because my concentration abilities had long since taken leave of me, I said, “No, thanks,” and we ambled out of the store—minus bed or curio—and quickly sought an eating establishment. Maybe food will help. I must have looked ill, because my father suggested we go home; he didn’t think I should be out running around. We’d been gone since nine-thirty that morning, and it was now well past dinnertime. Finally agreeing on our choice of food (we had some particularly persnickety eaters in the group, and it wasn’t Parker!) we found a restaurant and settled down to a hot meal.

           

            Turns out, I should have also listened to my father.

           

            Now, let me stop this story right here. I’m sure some of you who have read my story from the beginning, are reading this and screaming, “What is the matter with you, Andrea! Why didn’t you listen to them? Why did you insist on continuing to keep going, keep entertaining, keep trying to make others happy? (Yes, that was also happening, although I won’t digress to explain the precarious family dynamic right now.) You were so foolish, forgetful, selfish iand arrogant!”

           

            Yes, I can look back in retrospect and agree with you, but that is ONLY because I now possess the wisdom of years and hard experience to realize what had formed my psyche and actions up to that point, and know that it was those things that drove so many of my hasty, thoughtless, insecure decisions. For those of you have been with me from the beginning, remember: I was a highly trained athlete, conditioned to push through, keep going, ignore pain, resist defeat, and banish excuses! That belief coursed through every fiber of my being. It possessed me.  

           

            And, on that day, that ingrained self-discipline and callous mental conditioning didn’t do me any favors.

           

            So, I’m hoping you’ll toss some empathy my way, and I’ll get back to my story…

           

            It required a monumental effort to eat dinner. I felt more like slumping on the table and taking a nap next to my plate rather than enjoy what lay on top of it. The pressure remained constant and the discomfort steady. I wanted to crawl into the car and go home, but since we just happened to be in the parking lot of a department store that had a nice glider and footstool on sale—just right for the nursery—we walked (I trudged) across the parking lot. And Chris kept expressing his concern that I should go home, while I kept reassuring him that I was all right and was suffering basic pregnancy fatigue and joint discomfort, and those annoying Braxton-Hicks contractions that constantly plagued me.

           

            At least that last stop proved fruitful. I found a glider in the infant furniture department and immediately took up residence in the wonderfully padded chair where I could have remained, indefinitely. Eventually, though, I had to reluctantly vacate it’s soothing comfort, but not before my generous father offered to buy it for me as a baby gift. He then directed my mother to the cashier to arrange the billing, charging and shipping. With gratitude, I happily anticipated its arrival and the supreme enjoyment of spending the remainder of my pregnancy buried in its comfort—reading a good book or napping—while Parker tore happily around his pre-K classroom.

           

            That night, however, I just wanted to make it back to the car, recline in the passenger seat (yes, I was finally ready to acquiesce) and let Chris drive home. He jogged to the parking lot, after giving me directions to stay put in front of the store’s front door while he went to get the car. Visibly relieved that the day was now coming to a close, so he could return his family to the safety of their home, he chauffeured us back to its confines.

           

            Although the day wasn’t about to end, because there was an ice-skating special (my parent’s current addiction) on television. We spread out to recline on the floor and sofa. No matter what position I tried, the discomfort worsened. Eventually, after struggling to my feet, I told Chris about the tremendous pain and my need to go to bed. He joined me, and together we slowly climbed the stairs to our bedroom.

           

            Then I chastised myself for being paranoid and hypochondriacal. Hadn’t Dr. Landry been firm in his belief that chances of an incompetent cervix were minimal? “You’re just fine!” I kept mumbling to myself. “Four more months and this pregnancy will be penned into the Owan Family history annals. You’ll have a beautiful, healthy baby.”

           

            My personal pep talk didn’t fly. Restlessness, fear and discomfort plagued my night.

           

            Parker, my mother and I planned to go to the movie theater the following day to see The Lion King. “But only if I feel better,” I’d cautioned her. As long as I don’t have to rush around, I should be okay. If I could just get enough rest, I should be ready for the day’s activities. Languishing in a movie theater shouldn’t provide undue stress.

           

            Another thing I should have listened to: The urgent appeal of my conscience, the Holy Spirit speaking concern and caution into my brain when I awakened the next morning. With lingering discomfort and fatigue plaguing my body—but, unfortunately, overpowering fear of disappointing anyone, especially my mother, winning the battle—I agreed to lunch and the movie…and rushed out the door to attempt both.

           

            In order to keep my promise. In order to be normal. 

            In order to keep the peace.

           

            Eight hours later, I was lying in a hospital bed, waiting for Dr. Landry to pronounce a sentence on my unborn baby’s life…

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NEXT WEEK: The day’s event that unraveled the pregnancy thread spool…

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Until next week,

Thanks for joining me!

Blessings,

Andrea