Guest guest Posted April 2, 2003 Report Share Posted April 2, 2003 Dear , I'm really pleased to hear you've been able to make an 'informed' decision. After all, that's all any of us really want to be able to do, isn't it - make informed choices for ourselves, and not get bullied into things.. wishing lots of luck for your next step! Helen K Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2003 Report Share Posted April 2, 2003 Hi , I wish you the best of luck in TTC & just wanted to say I've been so impressed with your strength and optimism especially after your loss at 23 weeks. Cheers, Deanna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2003 Report Share Posted April 2, 2003 Hi , You sound very refreshed and ready to go. It is nice to hear. If the scarring is less than 5%, it sounds like ttc would be just fine. You are now armed with loads of information. Of course feel free to email me, or even call for any questions or concerns. We are allpraying for you to have an uneventful pg! melanieselcho wrote: Hey everyone,I have been out of town for a while and just caught up on the posts.I may get some cyber tomatoes thrown my way for this update, but since I consider you ladies some of my truest confidants, here goes:For those who don't know me, quick background: I had mild AS after retained placenta for my second child. After hyst and one year I had severe AS (no cavity). My RE (different doctor) did lap/hyst and restored 75% of cavity. I became (unexpectedly) pregnant before he could do the second procedure, but lost baby at 23 weeks due to PPROM from IC. Again retained placenta, again D & C.This time a SHG shows three "dots" of scar tissue which comprise less than 1% of my uterus. My lining looks great on US and I'm having good periods, so my RE gave me green light to conceive last month (he did NOT do this for my last pregnancy). Because I'm in "better safe than sorry mode" I was going to have Dr. Isaacson give me a 2nd opinion, but have struggled to get an appointment that will work with my schedule (long story).So, I did some soul searching and prayer and talked to just about everyone who would listen. I had discussion with my RE who said the risk associated with removal of this was too great compared with the return. He said he consulted with his partners about my case and they agreed.I also consulted with my brother-in-law, who is only an OB, but is the one who suggested at the beginning of this saga that I had AS so I trust his knowledge, not necessarily his skill. He agreed with the RE.So, I have decided to TTC. I was hoping for a happier "green light moment" in which an A-list told me it was okay. But, I realize that my fear of IC is as great as my fear of AS and I have decided that I do not want another surgical dilation of my uterus unless absolutely necessary, and I'm just not convinced that it is necessary to do it now. Though I know some of you will disagree with my decision, I want you to know how blessed I have been from your wisdom and knowledge I have found (and will continue to find) here. It was not a decision I made quickly or easily, and I feel it was made knowing the facts about AS, not just randomly trusting a doctor's advice. You have truly helped me become my own advocate with Drs. and questioning their judgment.So, now I begin my next process of waiting and anguish . . . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2003 Report Share Posted April 2, 2003 , It is your path an you make your decisions, good luck and don't forget to have fun;) Lesia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2003 Report Share Posted April 2, 2003 , Best of luck TTC! I have a question for you and K and anyone else who could contribute: I guess I remember reading that you are more at risk for IC after AS - how common is this? I have a long way to go before getting the green light, but I was just wondering as I've already had three D & C's and haven't even begun tests or treatments(much to my frustration!) to deal with AS. At my consultation with Palter I asked him about Peris in the Philly area. He seemed surprised that I was thinking that far ahead. I told him I was also asking on behalf of my sister-in-law who delivered at 25 weeks due to IC. He said that for IC she wouldn't need to see a Peri - that her regular OB would be fine handling her next pregnancy. I was pretty surprised by that - especially after reading all of 's posts. My SIL's regular ob didn't even pick up on the fact that she was pregnant with twins until 20 weeks and still didn't even do a pelvic to see how things looked! Cz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 Cz, The risk of IC is not from AS, but from all the dilation surgeries associated with it. My peri (who I did not see until after my loss) said anyone with 3 procedures (including D & Cs) is at greater risk. I think an OB probably could handle IC, but I think their practice has for the most part turned away from high risk situations - rather they take a ton of patients and see them briefly and refer high risk to others. My peri will not physically do anything to me but consult. She will see me every other week and ultrasound, etc. but the OB must do the cerclage and delivery. My BIL (an OB in the Philly area) said more peris are turning to consultants because it takes so long to do deliveries and they are already spending more time with patients than an OB that they can't afford it. He also said an OB could handle everything (he may be a bit biased) but usually you need the peri's opinion to get insurance to pay for the extra monitoring and tests. The worst thing is to be stuck in a hospital with an OB practice you don't trust anymore because the bad thing they told you not to worry about just happened to you. I would at VERY least, go for a preconception consultation with a peri. I raised IC questions to my former OB and she told me not to worry. I " didn't worry " so much that even when I felt my bag of waters in my vagina, I didn't call. I have had enough of that attitude. I will worry until they can prove to me I don't need to. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 , I am sooooo curious about how a peri gets reimbursed. My last pg was with an OB. My pg only lasted 8 weeks, but it looked as if he would have been paid the same if he saw me 100 times or 20 times. How does it work for a peri? Do they get paid more? Is it a flat fee? If you could find out, I would be very interested to know! I live in my peris office, I am wondering if it is really hard for them to make money. Do they get paid for extra tests? Also, I know their malpractice insurance is crazy! All of the Connecticut doctors went on strike last week (mine did not). My doctor was on ABC news last week saying his insurance went up 350% from last year! I think this is insane! BTW, I was on TV with him (not sure I mentioned this). I was there for a culture, and he needed a patient to do an u/s on. So I volunteered. The irony! melanieselcho wrote: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 , Thanks for all the info. I guess the reason I was so surprised that Dr. Palter said that a regular ob could handle IC was because of reading 's experience with her Peri. I don't think my ob would monitor me the way has been by her Peri - and that is probably the reason she has been able to carry the pregnancy this far. Do most AS patients automatically have a cerclage or are they just monitored more closely for IC? You're so lucky to have a BIL in the biz to get all the answers and the low down. I just feel like most doctors are so reluctant to tell you everything - because we're not capable of understanding? not capable of dealing? or they just don't have time? I usually end up out of breath trying to fire as many questions as I can get out to my ob before my window of time is up with her! She did refer me to a consultation to a maternal-fetal specialist after my second miscarriage (before discovering a potential AS problem) but he seemed even more laid back than her about the whole multiple miscarriage thing. I was pretty disappointed by his attitude. I completely understand what you mean about the " don't worry about it " line. I dread hearing that now because everytime a doctor has said that to me - the thing they say not to worry about happens to me! I guess they say it to try keep us positive, but it's so infuriating to have your fears brushed off like that! I'm sorry that it ended up being such bad advice in your case!!! Cz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 Jen, I feel some OBs would be able to handle IC, but peris seem to have better luck with this, They do lots more cerclages. Just like AS, experience counts. I asked my doctor how many he has done (he is about 40 years old).....he said somewhere around 300. He also has not had any complications! Quite a record. In addition, a peris office is very well equipped for ALL tests. No need to go anywhere else. Some OBs offices are. In addition, they have more practice in spotting problems quickly and off the beaten path. Like I said, I think there are SOME OBs that could handle this, but many that could not. The question is, how does one figure out which OB is the right one? jennczap wrote: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 , From what I understand, usually they just monitor your cervical length and then cerclage if necessary. Because I already had a loss because of IC and have had yet another procedure since then, my peri said they could just monitor me, or what she would recommend is just doing the cerclage at 13 weeks. Not all of us will have IC, we just need the monitoring in case. I also know how you feel about waiting. After my D & C I was told to just wait, and couldn't get anyone to try to jump start a period for 7 weeks. Then I had to wait for the period to come (up to 14 days they said, thankfully only 2 for me) before getting SHG. Because I'd had AS before pregnancy, I was terrified the entire time. I don't understand why Dr. palter won't give you SHG results when he does it, especially since you have to travel Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2003 Report Share Posted April 3, 2003 , I am sorry I did not respond to the other half of your question. With no solid history of IC, they will not do a cerclage. They will monitor you closely, and hopefully catch it. (This was why my cerclage was at 22 wks) Hopefully I am able to have another pg. Providing I am, I will have a cercage around 12-14 weeks. This is pretty much the standard. Not all AS sufferers will then get IC. is a perfect example. My AS was a little bit more severe, but she was on the same surgical schedule as me. She had NO surgical changes or other issues! She even used the same peri as me. (She was nice enough to assure me regularly that I was in excellent hands!) Hope this helps, melanieselcho wrote: Quote Link to comment Share on other sites More sharing options...
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