My Pregnancy Timeline ... Does This Look Anything Like Yours?

Here's my (excruciatingly) detailed account:

6 Weeks Pregnant:  I started to spot.  Freaking out and frantic that I was having yet another early miscarriage (the last one happened at 7 weeks), I went to my doctor's office where he did a quick ultrasound.  Dr. G couldn't find a heartbeat but assured me that perhaps it was still too early to worry.  He scheduled me to come back in two weeks to re-evaluate.  Sure enough, at the next visit, there it was ... a throbbing little fleck of white and grey on the ultrasound screen.  Phew, I thought.  That was a close one. I'm given progesterone suppositories to keep my levels up since it appears that my numbers were really low with the miscarried baby ... a possible cause and effect.  

8 weeks pregnant -- and we see a heartbeat! Yay!

9-11 Weeks Pregnant:  I'm spotting again intermittently over these two weeks where every time I go to the bathroom I dread what I'm going to see there.  I go in two more times for my doctor to grab a quick screenshot of Little Baby's heartbeat to put everyone's mind to rest.  However, I find out I have a lesion on my cervix and have a colposcopy to confirm it.  Doctor G throws out that perhaps it's the lesion that's causing my spotting and to just refrain from any sexual activity for a couple of weeks if I see anything.  Because I've had three preemies already (29, 27, and 35-weekers to boot), and my uterus is classified as "irritable" (more like "bitchy" in my words), we make a plan that includes me seeing a maternal fetal medicine specialist at some point and starting progesterone injections at 16-weeks.  

13 Weeks Pregnant:  We go on our big family summer vacation to the Bahamas. (Try Atlantis Resort. I highly recommend it; it's fantastic for families and your kids will think you're a rock star for bringing them there. The only down side is the cost of food and water. Borders on extortion.)  Our rock-bottom air fare means that we have a six-hour layover in Fort Lauderdale.  I return a call to Dr. G who tells me that my MaterniT21 test has come back normal and surprise!  We're having ANOTHER BOY!  Yippee!  Everyone's ecstatic because what would we do with a girl in the family anyway?  We've still got all that time to kill so what is a family to do when they have that much free time in a different city with an awesome beach??  Of course we high tail it over to a diner, followed by a visit to Walmart, and then off  to see "Despicable Me 2" for the third time because it's the only movie in theaters appropriate for everyone.  While we're in Walmart, my pregnant bladder starts acting up and I've GOT TO GO.  

Well, you can guess the rest ... but instead of just a few drops (sorry to anyone who thinks this is too graphic, but hey, it's what happened), I'm shocked by the amount and the redness.  It's no longer a darker color which would signify some old blood, but instead bright cherry red.  I panic and call the G-man right away.  I do as I'm told and I go in as soon as I get back to New York.  After a few minutes of poking around with the sonogram and muttering a few things to himself that I can't catch, Dr. G says, "Well, the only thing I can see is that you've got a low-lying placenta and it's completely anterior.  It looks like it's a marginal placenta previa but that's not really anything to worry about.  Chances are that it'll move up away from your cervix to a normal place as your uterus expands. That's probably what's causing the bleeding."  It won't change the how the baby will be delivered as I've already had two C-sections and I'll have to have another one.  I'm listening but mostly I hear, "There's nothing wrong with the baby" and "Don't have sex."  (Poor, poor Wayne.)  That's all I needed.  I file the rest of the information away, not really thinking about it.

15 Weeks Pregnant:  I go in for my regular bi-weekly visit. Most women only get to see their doctor every four weeks but they like me so much, I get to come in every other week!  Aren't I special?  The guys at the parking garage know me well enough by now so that they routinely ask how how each visit went and what the doctor said this week.  I can make friends anywhere. This time, Dr. G sees that while my cervix is long at 4 cm, with both the internal and external os closed, at 2.6 cm it opens up and then closes again.  It looks like a broken zipper on the sonogram.  He'll send a copy over to the maternal fetal medicine (MFM) specialist to take a gander.

16 Weeks Pregnant:  I start those dreaded progesterone shots (called 17P to us in the preterm "know").  I've been on them twice before and they didn't exactly work.  I still had a 27-weeker (Spike) and a 35-weeker (The Weet). Okay, maybe it did help with The Weet but I had still gone into preterm labor with him at 31, 33, and 34 weeks, although they managed to stop the contractions at the hospital.  Man, I really hate those 17P injections. I call the woman from the medical service who's hired to give them to me Nurse Ratchett.  I tell her I've given them to myself in the past but it's against the rules for me to do so now. It must be an insurance thing. So I have to suffer through the burn of the medication because she's pushing the plunger too fast and hasn't bothered to roll the glass vial between her palms for a minute to warm up the suspension oil.  Plus, she doesn't believe me when I say that the shots are actually increasing my contractions.  No, I must be mistaken, she smiles in her smug way.  The shots don't do that ... perhaps I only think I'm having more contractions or maybe I'm giving them to myself.  Each time she leaves, I want to slam the door on her hiney and tell her not to come back because she's mean to me and she doesn't believe a word I say.  Plus, she hates my dog and makes me put her in the bedroom before she'll take a step through the front door.   I'm having some spotting this week but I'm told again to just take it easy. I'm blaming it on the 17P shots and the contractions. AAARRRRGGHHHH ... 

17 weeks pregnant:  Oh hello there Mr. Fibroid. Fancy meeting YOU in here!

17 Weeks Pregnant:  I go in for my amnio because even though I've already had a screener telling me that the baby's okay from a chromosomal standpoint, I still want the works because I'm one of those people who hate any kind of surprise.  Dr. G's partner, Dr. M is there to perform the procedure.  Dr. M's first words are, "Aha ... an anterior placenta."  He repeats what I heard at the last appointment, that it's now more like a partial previa but we still have hope since it's early days yet. He also sees a large fibroid inside my uterus that's right on top of the baby.  He's worried that it'll grow more and compete for space. From what he sees, the fibroid is right on top of the C-section scar, and the placenta is right on top of the fibroid. There are inherent issues with a fibroid but he reassures Wayne and I that they'll be keeping a close eye on the situation but leaves it at that. The delivery will be more complicated because now they have to figure out another way to get to the baby, but my main problem is still the preterm labor and contraction factors.  There is no mention of an accreta.

18 Weeks Pregnant:  I see the new MFM.  I like Dr. P.  She's young, she's empathetic, and most of all, she doesn't poo-poo the fact that the contractions are still coming on like a mofo.  She explains that the 17P shots aren't supposed to make the contractions disappear.  Instead, for some reason still unknown to the medical community, the progesterone relaxes the uterus and mitigates the effects of said contractions.  The success rate is high enough to prevent preterm delivery that it's become the standard of care in treating patients like me.  She wants to keep me on it but ixnays Dr. G's suggestion to put me on a routine calcium channel blocker to prevent contractions period.  It's approved label use is to treat hypertension but my blood pressure is so low that it would make me sick instead.  (Which, by the way, it has. I was on it the two previous pregnancies and I had never felt so bad.)  

We talk about the placenta previa.  She's the first one to mention a possible accreta.  She hasn't seen my scans, but wants me to know that based on my history, I have a greater chance than most of having a "morbidly adherent placenta," especially if the placenta is over the C-section scar.  It's something to keep an eye out for.  Again, the conversation goes back to preterm labor and the fact that I'll probably see her in L&D before I'm supposed to be there, and how I'll most likely give birth prematurely again.  I leave and call Wayne from the sidewalk across the street from the parking garage.  It's raining and I'm crying because I don't want the baby to come early. 

21 Weeks, 3 Days Pregnant:  Happy birthday to me! I'm 41 today and I'm supposed to be spending the morning in the city at a meeting with the Chair of the President's Advisory Council on Faith-based and Neighborhood Partnerships to discuss anti-human trafficking initiatives.  I can't wait!  But first, I have a new nurse giving me the injections this morning because Nurse Ratchett and I finally had a parting of ways.  This new one actually likes my puppy so I figure she can't be all that bad.  Not even a couple of minutes after she gives me the shot, my palms start to get really itchy and red. My fingers swell and I my feet feel like they're on pins and needles. I'm having problems getting words out and my stomach starts to hurt badly.  I start vomiting.  My uterus is now going haywire ... these painful contractions are pounding at me, first three minutes apart, then two.  She makes me take two Benadryls but I throw up one.  She follows protocol and calls an ambulance, her office, then my doctor, in that order.  The paramedics arrive and they rush me to the nearest local hospital saying I'll never make the 30 minutes down to NYU Medical Center where I'm supposed to give birth ... not if these contractions are coming on as fast and furious as they are.  

It's obvious when they get me to ER that this little hospital can't take care of me.  They don't even have a fetal monitor downstairs.  I'm hooked up to an IV saline bag while a nurse stands at the computer terminal pushing a stopwatch application on it every time I say I'm having a contraction.  Yep.  It's technology at its finest.  The obstetrical attending eventually arrives after about 45 minutes and manually checks my cervix. He says because it's still long and closed, he'll let me go home but I should check in with my doctor and take it easy today.  Wayne and I look at each other, aghast.  WTF?? The contractions still haven't stopped but they want me to go home?  We can't believe what we're hearing.  It finally dawns on Wayne that they don't want me there because they're not equipped to deal with preterm labor as early as mine.  They don't want the liability.  I get it but I still don't like it.  

However, before I can go, they just want to take me upstairs to take a quick peek at the baby to make sure everything's okay with him.  The sonographer enters the room with the perkiest smile that quickly get very serious as she starts moving the wand over my belly.  "Did anyone mention anything to you about an accreta," she asks.  I tell her I'd heard about it before and I knew that I had an anterior previa.  "That's not the half of it," she says. "Your placenta is attached directly to the C-section scar." She adds that it looks suspiciously like an accreta and points out the black and grey spots that speak to her, but to Wayne and I, look like, well ... black and grey spots.  She hurries out of the room and brings back immediately two other doctors who immediately start talking in loud voices.  

I hear a jumble of words ... accreta, increta, "possible percreta" ... all the Latin terminology start to swim around my head.  I had read enough about the conditions since meeting with Dr. P but now they were actually being applied to me.  I look over at Wayne and he's standing stock still, one hand holding his chin, the other arm wrapped around his waist.  I wish he was closer to hold my hand.  Instead, my I've formed a fist around the knit blanket they've used to cover my lower waist.  The doctors explain what's going on, that it looks like I have a placenta previa and accreta, possibly something else that's more invasive. They can't really tell themselves.  

They advise me to go home, spend the rest of the day in bed.  They'll talk to my doctor too.  They also stress to Wayne and I that if I should have any bleeding, to not come back to this hospital.  They can't help me there because they don't have the manpower or the blood supply needed.  If I came back, they said, it could be catastrophic.

I call Dr. G immediately upon returning home.  I'll see him in a few days.  He calms me down and tells me to take it easy. But I can hear it in his voice that he's worried ... after 15 years with this man, I can read him pretty well.

Okay ... seriously, isn't this beautiful baby boy worth all the muss and fuss I have to go through????
Here he's measuring 1 pound, 2 ounces at 21 weeks.

Hiya again Mr. Fibroid ... You're kinda cramping my style ... 

22 Weeks, 3 Days Pregnant:  I finally see Dr. G.  His ultrasound shows the black islands on the placenta ... these vascular spaces that make my placenta look like Swiss cheese and is usually indicative of an accreta.  He turns on the color showing the blood flow through the placenta.  The placental blood vessels are traveling past my cervix so the previa is more severe than they initially thought.  Also, he sees a suspicious area near the bladder.  It looks like there's blood flow into the bladder too, indicating a possible percreta with bladder invasion. The news couldn't be any worse.  I've read the literature by this point. I know what this means and I'm terrified that not only will I lose my uterus, my cervix, but now there might be substantial damage to my bladder.  Wayne, Dr. G, and I sit in his office for a good 20 minutes or so and discuss options and strategy.  We talk about definites and possibilities.  Mortality versus morbidity.  Wayne doesn't let go of my hand.  That gives me a little bit of relief.  

My cutie pie, measuring 1 pound 7 ounces a week later.  I've been given license to eat, eat, eat so he gains weight!
22 weeks, 6 days old.

22 Weeks, 6 Days Pregnant:  I get in to see the MFM who's a world-renowned expert in obstetrical sonography, Dr. T.  The first thing that strikes me about him are his bushy eyebrows.  I focus on them and think of how I'd love to trim them for him while he and the sonographer futz around with the machine.  I'm trying to take my mind off of my REALLY full bladder I'm required to have for this procedure.  Anyone who's never seen a doppler ultrasound is really missing out ... there is nothing cooler than seeing a bisection of your internal organs.  Wayne got a huge kick out of watching my uterer shoot urine into my bladder. He jokes that he knows me inside and out.  What a guy.

The color doppler showed the placenta has indeed grown outside of my uterus and is right up against my bladder wall.  While a cross section of the bladder shows the imprint of the placental blood vessels on the exterior wall, it doesn't look like it's breached the interior yet ... operative word being "yet".  The analogy is that someone's knocking on the other side of the door but no one's come to open it yet.  Dr. T is really interested in what my six-week ultrasound shows.  He's doing research on the link between cesarean scar pregnancies and placenta accreta.  He thinks there's a direct correlation.  He's also advised other patients who've been diagnosed with c-scar pregnancies to terminate them early on because of the severe complications (like mine).  That's another post entirely.  Dr. T says he wants to talk to Dr. G immediately and look at all my records.  He asks for Dr. G's office address because he wants to walk over there later.  Wayne and I joke that for sure, we're now a part of his study.  Before we leave, Dr. T reminds me that if I start bleeding to not wait for a call back from the doctor, that I should head immediately for the hospital.  Again with the bleeding talk. Sheesh. 

So now the condition has been confirmed.  We're constantly told that the doctors can't be absolutely sure of the extent of the damage until they actually open me up, but we'll get another close look during the MRI. Now I'm just playing the waiting game until then.  At this point I haven't bled since 16 weeks and I'm holding out hope that I won't.  I'm being a good patient now ... I actually sit or lie down when I'm having contractions or a stabbing pain.  That's progress for me.  

If there are only two things I want this post to convey ... the first is that Wayne is there for me every step of the way.  He's proven over and over again how much he loves me and that he's my soul mate.  The second is that I have the most incredible team of doctors and they are REALLY on top of my care.  I feel so blessed to have these wonderful people around, looking after my Little Boy Blue and I.  I have a feeling I'm going to be spending a fortune on high-end fruit baskets as thank you presents when this is all over.  

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Peace out. ;-)

xo, L