Monday, April 28, 2014

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…

__________________________________________________________

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

Until next week,

Thanks for joining me!

Blessings,


Andrea    

Monday, April 21, 2014

Abnormal Pregnancy Blood Tests and Nagging Fears...


           
            “The blood test results were not in the normal range,” Dr. Landry said. I stared out our expansive kitchen windows and let my eyes wander across the valley and rolling hillside to the towering, snow-covered peaks in the background. Then I closed my eyes to bring my dazed mind back into focus.
           
            “They were just outside of normal, in the direction indicating an increased risk for Down Syndrome,” he continued. “Keep in mind that this test is not highly accurate. But there is a more accurate test I can order, performed through the University of California at San Diego. I will have to obtain approval through your insurance company first, but I think you should have it done. I do not believe there is any problem, but it is an option for you. The obstetricians in California have been pushing the state to utilize this test for some time, and it will be available to all pregnant women in January. Since you can’t wait until then, we have to get authorization.”
           
            “Okay,” I agreed as I began raking my fingers through my hair and pacing the kitchen and thinking out loud to him. “I know there’s no neural tube problem. The ultrasound pictures ruled that out. And even if the tests indicate a likelihood of Down’s Syndrome, you know I won’t agree to an amniocentesis. If I did have an amnio, and the genetic tests indicate my baby has Down Syndrome, you still wouldn’t be able to tell me the severity of the condition, would you?”
           
            “No,” Dr. Landry sighed. “This is true. I wouldn’t be able to give you that information. But I think it would be best if we knew what the possibilities were. However, the blood test is entirely voluntary."
           
           I didn't think twice. “I’ll have it done.” The phone call ended after Dr. Landry promised to call the insurance company.
           
            We quickly received authorization, and I drove thirty miles to the lab. Upon checking in, I learned I’d be part of a test accuracy experiment, which required me to sign forms giving my permission for the test information to be compiled into research data, and the outcome of my pregnancy forwarded to the testing and research facility. They drew the necessary amounts of blood then rushed the specimen to the University of California at San Diego.

            Dr. Landry assured me he’d call when the results arrived.
           
            His phone call came on a Friday night, around 7:00, while I was lying on my bed, relaxing and chatting with Chris, who was puttering around the bedroom. Chris answered the phone, uttered a “Hi!” and an “Uh huh,” and then handed me the receiver.
           
            “It’s Dr. Landry,” he mouthed.
            
            I sucked in my breath as a short oath abruptly escaped my lips. “He’s calling me himself?” I squeaked. Chris nodded, and I sighed in resignation. If Dr. Landry were making a personal call to me on a Friday evening, at this hour, it couldn’t be good news.
           
            “Hi!” he greeted me from the other end of the line. “It’s Mike Landry.”
           
            I dispensed with the usual “Hello. How are you?” then waited, eyes pinched shut, fingers raking my hair.
           
            “I am very happy to let you know that the results are back and everything is just fine! They indicated you have only a 1 in 600 chance of having a baby with a genetic abnormality. I thought everything would be fine.” I could envision his satisfied smile, as he sat hunched over my file at his office desk.           
           
            “Oh, thank you so much for calling me personally, Dr. Landry! When Chris told me it was you on the phone, and not your nurse, I thought for sure you’d be giving me bad news!”
           
            “No, with this kind of thing I do the calling myself.” (Shock.) Not too many doctors like that around.
           
            “Well, I appreciate it very much, “ I countered, eyes widening as I locked them with Chris's. “I am very impressed. Not many doctors I’ve had experience with do the calling themselves. Thank you!” A smile broadened across Chris’s face as he interpreted the conversation for himself.
           
            “You are welcome. Now you can relax. I will see you at your next appointment!”

            "Goodbye."
           
            My next appointment. I absent-mindedly nibbled my lip. If I could just get beyond that critical twenty-week period, I knew I’d be able to relax. Until then, concern would plague me about something going wrong, something we missed. I mentally admonished myself for reading too many books about pregnancy problems, too many books about prenatal and neonatal loss.
           
            I needed to enjoy the good news I’d just received: the chances of my baby having a genetic abnormality were slim, and I did not have a placenta previa. The baby was strong and active. What more could I worry about? Why not settle back and enjoy this last pregnancy?
           
            With all of this wonderful news, why do I harbor some elusive dread that something was just not right?


                                                ***************************

           

            My twentieth week appointment arrived, and Dr. Landry triumphantly announced that everything looked normal. My weight gain was still rapid, but he’d allow me further extension of culinary indulgence for another couple of weeks before insisting I watch my diet more carefully. Everything was proceeding so well that I could discontinue my disability status.
           
            Before leaving his office, I nagged him again about the cervical pressure I’d felt, and the unusually high amount of discharge.
           
            His response remained the same: Both of those complaints were normal. Since I had delivered my first son at full term without any problems, he said there was no reason to expect I had an incompetent cervix. He reiterated, with emphasis, “I am not concerned about your symptoms.”
           
            “I’m reading too many books about pregnancy problems,” I muttered to myself while dressing.
           
            Happily, I left the office after making an appointment to return in another month, and my focus turned to the following week when my parents would join us for Thanksgiving. We planned to converge on my cousin’s house in Escondido for a family gathering and feast.
           
            As long as I can get some rest, everything should be okay. Didn’t Dr. Landry say I was doing fine? He would know, wouldn't he...?
           
________________________________________

NEXT WEEK: A not-so-stress-free Thanksgiving sends me over the edge, and my women’s intuition bears fruit…
__________________________________________

Until next week,

Thanks for joining me!

Blessings,


Andrea