Zhenia

November 18, 2003

Hey Zhenia -

I just got this post and wanted to call you but it is too late to

call. I understand what you mean when you say you did not get any

hope or inspiration out of your appt. I remember right after I lost

my son in 08/03, I went for a consult with my peri and he basically

told me he was not sure the ab. cerclage was for me. He said if I

got pg. he would watch and see.

I was not happy with that. So, I was determined to find a doctor

who would guarantee the ab. cerclage. That is when I found this

website and Dr. . I know what you mean about not wanting to

travel so far. I am thankful Dr. is moving here. But, I will

tell you, I was more than willing to travel to the best.

Maybe Dr. could refer you to someone closer. I would not

chance another vaginal cerclage. I would rather go straight to the

ab.

Mandy

> Hi Mandy,

> Yes, I did speak to his secretary, and I guess she is to call me

in early

> December. I also went to see my peri today, who had explained

that the abdominal

> carcelage is a very serious procedure and is an extensive

surgery. She did

> not think that I needed it yet, and that I should be trying again

with the

> Shirodhar's carcelage. (needles to say, I was not filled with

feelings of hope and

> inspiration). Of course she does not know why my uterus was

contracting past

> 18 weeks, and the reasons for why my cervix could be shortening.

I had than

> asked her about progesterone levels. It had been my suspicion

that my

> progesterone levels could be dropping earlier that they should,

and therefore I go

> into PTL. Unfortunately, the doctors don't have a clear cut

information as to

> what the actual pregnancy levels should be for each individual

pregnant woman,

> since the hormonal ranges for progesterone during pregnancy vary

from woman to

> woman and there are not yet enough studies out there to know for

sure. The

> medical community does give progesterone shots once a week to

women with a

> history of PTL (I think that Taryn is getting treatment like

that), although most

> docs don't check the levels in the blood routinely anyway. It

sounds like this

> is a hit or miss situation. I am feeling very discouraged since

the fine

> tuning of the hormones that may be needed for a lot of women (and

perhaps some

> women on this website) is not readily available. I am also very

concerned about

> finding a doctor with a lot of experience in transabd. carcelages,

and the

> fact that I may have to travel pretty far to see such a doctor.

In any event,

> this is where I am today. Hopefully things will look more

optimistic in the

> next few weeks.

> All the best,

> Will try calling you. My number is .

> Zhenia

November 21, 2003

Zhenia,

I understand not wanting

to see your friend. It will blow over. Talking on the phone will help you get

over her pg. (the big belly etc..) I have two other friends that are pg one is

due in January, the other is due in April. I am due in March. So it was hard for me to see them. We all

were pg but I knew what I had to go through and they did not even get close to

what I have been through. i had girls night at my

house and they showed up. One was 29 weeks, one was 15 weeks and I was 18

weeks. You can guess how I felt seeing the one at 29 weeks. she looked big and

great. I want to be big that is big belly b/c that means that I am far along.

I did the same thing with

the computer. It drove my hd crazy. i would ignore him but he was right. I got obsessed. I am

glad that you like your job. It does help to pass the time by. Before you know

it you will be pg and you will be telling me how your doc visits went. Keep smiling.

God bless,

Taryn

Re:Taryn

Taryn,

Thanks for writing. I think I would be feeling pretty much the same way

you did. I am a physical therapist and many of my patients would be

asking about the baby and etc. The staff in the office is aware of all

that has happened to me and I know they will try to keep the annoying questions

away from me as much as possible, although nothing is full proof. I like

the place that I work at and hope that after initial few weeks it will be

easier for me to deal with work. Staying home now is a bit more

difficult, since I have too much time to think and to sit in front of my

computer and keep researching things on preterm labor and abdominal cerlages,

and etc. A part of me gets sick after a while from doing all that.

I know that I have to stop and not spend all day doing it. But its very

hard, as you know. On top of it, a coworker of mine is pregnant.

She was exactly 10 weeks ahead of me. We were both pregnant and ve! ry

excited about it. Of course, I lost the baby and she is doing fine.

I can handle talking on the phone with her, for she is a good friend and is

being very supportive, but am afraid to see her in person (I hope that I get

over that fear soon). Of course this is a very tough time and I am

supposed to feel all that I am feeling. Yet, getting through the next few

months still requires a lot of energy, mental strength and faith that things

will get better.

It certainly helps to express all that I am feeling to this group of women,

since I know most of them, if not all have been there too.

Stay well Taryn,

Zhenia

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November 28, 2003

Zhenia,

Thanks for the advice. I have

an appt Monday. The baby hasn’t been kicking down their since the last

time. Think the spicy food was

making him mad. Have a nice weekend and I will talk to you soon.

God bless,

Taryn

Re: Re:

Baby on cervix

Hi Taryn,

I have not experienced anything like that myself. When I was pregnant

with the vaginal cerclage my baby was pretty active at times, but don't think

that it was ever for 3 hours. Babies can be active though just like

adults and 3 hours of activity does not have to mean that something is

wrong. I did read that spicy foods may not be very good for the

baby. I think that when in doubt, you should always call your

doctor. That's what they are there for.

I hope that you were able to sleep without worrying too much. Also hope

that you had a good Thanksgiving.

Zhenia

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December 7, 2003

Zhenia,

I'm so terribly sorry for your losses. I've never got to 23 weeks

myself, my most mature pregnancy being 20 weeks. It's such a

painful thing.

I hope you too, will find the answers you're looking for, and I wish

you all the very best. Thanks for your reply.

Laurie

December 17, 2003

Zhenia,

Thank you so much for your

information. I can’t possibly imagine what you’ve been

through. I can’t believe that the doctors didn’t suggest an

ab/cerc. prior to the 9 losses? I just don’t’ understand these

doctors. I want a doctor that cares about me and it is very good to know

how Dr. Saltzman treats people. That is not what I’m looking

for. I understand the ab/cerc. is a major surgery with no guarantees, but

it is at least a chance for another baby. I think that I will regret it

later in life if I don’t pursue having another baby. I want so much

for my daughter to have a sibling. I’m not missing just part of my

cervix. I am missing so much that it would be impossible to do any other

kind of cerclage, other than the ab/cerc. I was told I could get pregnant

and end up on bedrest right from the get go and then ultimately spend 20 weeks

in a hospital bed on bedrest. That is not something I can do. I

have a toddler to raise and I have no support mechanism where we live. I

could wait until is school aged, but then I’ll be nearly 35 and

that increases more risks. I just have to research things and see what I

can find out. Let me know what you think of the other dr. you are going to

see. I am so grateful to find this group of women to help me on this

journey.

Love,

Ida

Re: Ida

Ida,

the abd. cerclage is a pretty involved surgery. doctors prefer to do it

as the last resort only. many women who are missing part of their cervix

are the ones that get the abd. cerclage. having the abd. cerclage does

not guarantee a full term baby. there are many risks involved, as well as

the benefits. you have to have a cut placed through your abdomen to get

the abd cerclage in place. it is a permanent stitch at the base of your

uterus. if the stitch is placed prepregnancy and if you were to decide to

do any genetic testing on the child, in case the fetus has a chromosomal

abnormality (such as Down's syndrome for example, although there are many

others), to terminate such pregnancy you will have to be cut again...

Therefore, to me it makes more sense to have the cerclage placed after the

pregnancy has been established and after you have determined that the fetus is

healthy. of course, that is

a very personal decision based on your religious and personal views. you

can have genetic testing done at 12 weeks and at 14 weeks have the cerclage

placed. for many doctors abd. cerclage is the last resort. most

will do it only after other options, such as the vaginal carcelages have

failed. one benefit of the abd. is that it is placed much higher than the

vaginal cerclage can be placed. that, I believe, improves the chances of

success for 95% of women (which is a pretty high).

The reason that I did not care for Dr. Saltzman is because he did not seem to

care too much about me as a patient. I think I was just another woman who

had been failing getting through her pregnancies (I was pregnant 9

times). When I has asked him how long I should wait before I can get

pregnant again since my last loss (which occurred on Nov. 7th of this year) he

had told me that I did not have to wait at all. " can try right

away " , he said. Being in the medical field myself I know that a

woman's body has to take the time to recover, both physically and

mentally. Getting pregnant too soon can result in an early

miscarriage. Dr. Saltzman did not seem to be too concerned about that.

And of course I did not like the fact that he wanted to try another vaginal

cerclage, although a higher than a " usual vaginal stitch, " with me

first. If that failed, than he would do the abd. Needless to say, I

could not and would not go through another loss of a baby. If I was to

get pregnant at all in the future, it will definitely be my last

pregnancy. He did not seem to be very sensitive about the emotional aspect

of it all.

To answer your last question, most insurances should cover the abd. cerclage if

its medically necessary. If the doctor that is doing the surgery accepts

your insurance, there should be no problem with the reimbursement for the

procedure.

Hope that this helps you to make some future decisions.

Best wishes,

Zhenia

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December 17, 2003