Wednesday 8 April 2015

A New Perspective

Husband and I soon learned that there is a difference between acknowledging the worse case scenario, and actually preparing for it. Although the perinatologist couldn't definitively determine if an acreta was present on the ultrasound and was recommending an MRI, we both knew it most likely was there, or if not present now, it would become an eventual acreta. Cue the launch into research mode. We kept reminded ourselves that everything would be planned with my delivery with all the necessary professional and equipment in place. Yet I read one chilling statistic in an ACOG bulletin; Be mindful that even with a planned delivery, the mortality rate with a placenta acreta is still 7%. Husband found the original research article that produced that statistic and discovered that it was published in 1996, which was offered us some comfort, but not quite enough. Husband recommended that I contact my parents to invite them out before the delivery date. 'If for some reason you didn't make it, they wouldn't get over it if they didn't see you beforehand." I spoke with my parents and filled them in on all the potential complications with a placenta acreta. My mother started crying. It was the lowest moment of my pregnancy, if not of my life. I couldn't help going back to some of the deepest and darkest places during my infertility days. Why did we not pay any attention to all the obstacles the Universe kept throwing at us? Maybe we really weren't supposed to procreate and now we're being punished for defying natural law.

I wasn't in a particular hurry to have the MRI performed. Yet, in one business day, my insurance issued authorisation for the procedure and I received a call from the imaging department with a next day appointment. It makes you wonder how serious a condition is when bureaucracy moves this quickly. The MRI itself wasn't too bad, although,  I admit I had an emergency dose of Ativan to use if needed. I also wasn't too anxious to receive the results. I figured the MRI would either confirm the presence of the acreta, but even if it didn't show anything now, it wouldn't mean that is still couldn't become an acreta.

We met with my OB on the day after my MRI. She viewed the films with a radiologist as did the perinatologist and they all compared notes. They all agreed that there is no evidence of an acreta. No abnormal lacunae were detected. The location of my placenta noted that the edge of the placenta is right at the internal os of the cervix, with a lip of placenta tissue overlying the os. Although it was described as a likely persistent previa, it seems to be much closer to resolving than previously noted on the ultrasound. Both my OB and the radiologist feel that an MRI is more precise for determining placenta location, as an  ultrasound is more operator dependent. The perinatologist doubts that the previa will resolve, but he admits he's been wrong before.

This was by far the most encouraging news we've heard. At this point in time, we're looking at a C/section at 36 weeks if the previa persists. If by some miracle it resolves, we can proceed with an induction between 37 and 38 weeks to try for a vaginal birth. Although I know that my cervix would probably be unfavourable at that gestational age and I could be tortured for a few days just to lead into a C/section for a failed induction, but for someone who was preparing for a hysterectomy, it was unbelievable just to have a conversation where a vaginal delivery was on the table. Of course, things could change by the time we have our next ultrasound and we could be revisiting the acreta scenario again, but for now and the next few weeks, we're going to celebrate this news as a victory!

So, remember how I feared my fertile friends would be too keen to share their know-it-all expert advice? Well, sometimes it turns out they can be pretty helpful. Myrtle sent me a text suggesting that we should start looking into day care centres as we would probably need to secure a place months in advance. We had discussed looking into doing a Nanny share with our friends Amy and Sheldon, as they had one with their first child. Every other week, the Nanny and the other child come to your house. While it would be incredibly convenient on the weeks where everyone descends upon our place, they live in the next town over. It's in the opposite direction from my work and the commute would involve some of the most mind-numbing, infuriating traffic ever. The transport could easily consume two hours each day. Location was upgraded to a priority feature for our day care search. Lo and behold, we found a reputable centre within three-quarters of a mile from our house. We could walk there if we felt so inclined. I made an inquiry and learned they had four spots available in the time we need. We attended an open house and were impressed with the cleanliness and organisation. I put my obstetrical skills to work and sized up the gestational ages of the other expecting couples and estimated that there were five couples including us looking at the same time frame. Husband slipped out to get our cheque book, as it is only a two minute drive to our house. We put down a deposit and our child, who is not even born yet, is enrolled in day care. Did I mention how convenient the location is?

We received some more good news, as the HOA finally approved our requests related to our garage project. After a month on hold, work can continue! Additionally, I passed my glucose test with flying colours and I'm trying to avoid needing a transfusion with a solid haemoglobin at 12.8. Wow. We're racking up almost as many wins as the UCONN Women's Basketball team.

19 comments:

  1. Yay for good news all around!!! So happy that you were even talking about possible vaginal birth! Lovely that things are changing in the right direction. Smooth move on putting down a deposit for daycare. Quick decision making means you now have the peace of mind in the future.

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  2. This is all great news! You deserve good news at this point :)

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  3. Woo hoo! This is good news all around! How exciting for you! We will continue to keep you in our prayers!

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  4. Hooray for some good news! Finding a daycare that you like and trust is a huge step as well.

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  5. A whole bunch of wins! You deserve it for a change. I put Q on a couple of day care waiting lists at 11 weeks but I didn't get far enough to visit and pay a deposit, I thought I'd do that once he arrived. Now I hope I haven't left it too late!!

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  6. Fantastic news on several fronts! It's crazy how early daycare needs to be considered, especially for those in the US who either don't have much mat. leave, or choose not to take much time off (I'm thankful for the full year that I get!). Welcome to the rest of your life I suppose, early bird gets the worm for school, swimming lessons, any and all extracurricular activities!

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  7. I'm so happy! I mean, I'm really relieved for you guys (for now, at least, with the understanding that it's not over until the fat lady sings. Except in this case, she's pregnant, not fat (especially in your case) and there's probably more yelling than singing. But whatever.

    Also, the daycare search can be a grueling one, so that's awesome that you guys have secured a place! My mom takes care of our kids but she's going on a trip-of-a-lifetime for two weeks and we had to do our own daycare search. This area isn't nearly as bad as, like, a New York, but we were lucky that a new daycare was being built nearby so that the spots hadn't all filled up yet.

    Little Jate's (physical and metaphorical) nest is coming together!

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  8. Congratulations on all the good news! I put our name on a wait list when I was 12 weeks pregnant and they won't have room for her until she's 14 months. Finding a convenient daycare that you trust is so huge. I'm so glad it worked out for you.

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  9. I'm so glad to see this good news! And yay for getting the daycare situation arranged! Our first (and second) nanny quit unexpectedly before even starting, and it was so stressful... Hoping the good news keep coming!

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  10. wow, some positive light!! So we didn't find out until AFTER my home birth that I had velamentous cord insertion. We discovered it when my midwives asked if I wanted to look at the placenta and they were shocked when they looked at it. Apparently only 1% of pregnancies get it. I had an US at 22 weeks and 30 weeks at the special maternal fetal clinic and they didn't catch it. If they had caught it then I would have been forced to have a c-section at 37 weeks. If my water had broken on the side that the cord was on then my baby would have been still born. Instead I had an amazing home birth experience that I will treasure forever. I am sooooo glad I didn't know about the VCI and I am sooooo grateful that my baby was healthy as can be. I guess my point is you just never know what will happen. You can prepare and be as informed as possible but sometimes there are missing pieces of information and chance outcomes. It's a crap shoot. Anyway, I'm so glad things are looking up for you. Sorry you had to make your mom cry but it's good to be open about these situations I think. Hang in there!

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  11. This is great news Jane! I'm so glad that things are going so well, placentally and otherwise. Our baby is also registered for daycare, and I can't imagine that we have the same demand that you do. We just had heard that it could be a problem and wanted it off our plate. I, sadly, failed my glucose test miserably, so you'll have to eat a celebratory cupcake for all your great news on my behalf. I'm thrilled that things are going so well for you after some tense weeks.

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  12. Such fabulous news all the way round!

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  13. Good news all around! You were due a reprieve for a change!

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  14. yay, sometimes it is good news! glad that hopefully a bit of weight is off your shoulders.

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  15. Woohoo! Love all of the good news!!!

    And woohoo for UConn! Another championship!

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  16. Yay for some good news! You deserve some of that.
    Good for you for finding a daycare. We have a serious lack of them in our area which is part of the reason SH is still being stay-at-home dad. The few we called didn't have any space available. I guess everyone in LA has a nanny.

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  17. Wow. Some stressful stuff, but great news afterall!

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  18. Ok, so good news all around! Jane, I am continuing to pray for a safe delivery for you and your precious baby. I think about you all the time. Sending big hugs!

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  19. It sounds like you are finally getting some much-deserved good things and things going your way. It is about time. Here's to a smooth road between now and June.

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