I am overwhelmed by your support, Readers. I was moved to tears more than once, and laughed out loud often when I read your commands and musings to my cervix. Yes, I am referring to it as "my cervix" again since it is shaping up and doing a better job. Thank you, thank you, thank you for your support. How do I know this? Glad you asked...
Yesterday afternoon I had more contractions than normal and pretty soon also had tremendous rectal/vaginal pressure which reminded me of labor with my daughter and freaked me out. I called my MFM and they told me to go to Labor and Delivery since their office was closing. My mom, the saint she is, came right over and took care of our daughter while we raced out. Dr. G, a wonderful man who I've spoken with on the phone before would meet me there. The ride there was long due to rush hour, and I was shaking with anxiety. What would they find when I got there? Would my cervix be shorter with all of the contractions? I tried not to panic, but inside, I was terrified.
When we got there, I was met by Dr. G and he did a scan of my cervix, showing it at 3 cm +!! I was quite relieved, but it had still gone from 4 to 3 or lower in a week. I asked him about cerclage and he said, "I love cerclage. I use it ALL the time and think it is an amazing tool for some women. You, however, do not have an incompetent cervix, you have preterm labor contractions, and your cervix is trying to hold strong, but it cannot hold on if you continue having contractions that affect it. The bottom line: we need to treat your contractions and cramping, not your cervix."
What a relief to me! Pre-term labor is real and scary, but much easier to treat than a cervix that cannot hang on at all. When he explained it that way, I was still nervous about the contractions, but much less so than with a renegade cervix. It looks like my one day of resting had already improved its length. Which leads me to... my treatment plan.
1. More resting. He feels "half time" bed rest is not enough. I need to be resting almost all of the time with my feet up.
2. Antibiotics. Apparently, any time he sees preterm contractions, he prescribes two strong antibiotics to ensure there is no infection or bacteria in the vagina or cervix. Either of these issues could weaken the cervix and irritate the uterus, causing contractions.
3. Nifedipine. This is a blood pressure medicine that is commonly used to reduce contractions. It can cause dizziness, fainting and headache. I already feel the headache. Dr. G feels this will be the "mainstay of my therapy" and we can increase the dosage. If this isn't effective, we are on to Terbutaline with all its ugly side effects.
4. Continue Ibuprofen. Also relaxes smooth muscles (like the uterus) and can control contractions. I am supposed to stagger this with the Nifedipine for the best effect.
5. More Folic Acid. The March of Dimes did a huge study last year that shows 4 mg of Folic Acid (I was taking 3) reduce preterm labor by 70%. You cannot OD on it, so whatever your body doesn't need, it doesn't absorb.
6. Magical Pills. This is a sleeping pill that has the effect of, you guessed it, relaxing the smooth muscles while you sleep. It made me sleep like a DREAM last night, and before I passed out, I laughed hysterically about some not-that-funny game my mom and I were playing. My husband Googled it to see what its side effects were, and "reduces anxiety" was one. Perfect!
Overall, I felt great about my treatment. It really feels like we have a lot more options to treat the contractions than to treat the cervix. Of course, it could continue to shorten, but we hope it does not. It is awesome to not have to think about cerclage yet (and hopefully not at all) since my cervix does seem to be responding to a contracting uterus. If we can get that under control, we hope the cervix will hang in there, long and strong for at least 9 more weeks.
Again, thank you so much for all the words of support, encouragement and humor. I particularly like Miss MVK's Billy Joel song dedicated to my cervix! All of your experience and kind words are appreciated beyond measure.