Back on the 1st I had my phone consultation with Dr. Arthur Haney from the University of Chicago regarding a Transabdominal Cerclage (TAC). I was very nervous going into this as I wasn't sure if I was emotionally ready to have this conversation. The minute I started talking with Dr. Haney I could tell that him and I would "mesh" well and his tone and demeanor instantly put me at ease. Our conversation started with a review of my history followed by a complete anatomy lesson that covered the entire female reproductive system. Even though I am already somewhat of an expert in this area, I learned a few new things. He told me that based on my history, both the pregnancy complications and the cancer diagnosis, that I am a perfect candidate for a TAC and that my insurance would cover the costs (cue:: happy dance).
Before our conversation, I prepared a list of questions that I had for him so that I didn't forget anything. Here is what I learned about the TAC:
- It will in no way interfere with fertility treatments or testing (HSG, SHG, Hysteroscopy, D&C, etc.).
- It is permanent. Once it is placed, it can stay in forever and is good for multiple pregnancies.
- While the success rate for a vaginal cerclage is only 75% (and that includes all live births, even the 24 weekers that have countless complications and spend months in the ICU) the success rate for the TAC is 99%...and this is based on full term births only!
- Once the TAC is in place, if I become pregnant, it will be virtually impossible for my cervix to open prematurely therefore bed rest will not be needed.
- A c-section would be required...and if you remember what my natural birth entailed, this is a welcomed "complication".
- I would fly out on a Sunday, have the surgery on a Monday, stay in the hospital 1-2 nights, and then fly home the day after discharge. Since the incision is basically a c-section incision, I would be required to stay home and not drive for two weeks.
Giovanni also had his appointment with the Gastroenterologist at the medical center, and as a matter of fact, it was today. I am happy to report that he has finally broken the 14lb. mark! While he is still in the 3rd percentile, he is sticking to his growth curve and that is all that I can ask for. To make a long story short, the Gastroenterologist was quite pleased with Giovanni. While he said that we have had some complications, he said that he is pretty sure that it would be an easy fix. We know from the upper GI study that he has severely delayed esophageal emptying and there isn't much that can be done about this. For the reflux he will be staying on the Prevacid, but instead of breaking the dose up into two doses, he is having us give it to him all at once. The other thing that he said could be causing the slow weight gain and vomiting is an inability to digest milk protein. Since I refuse to stop breastfeeding, I need to go dairy free. I have also agreed to keep him on one bottle of formula a day as well. The doctor switched the formula to Alimentum. He gets one 5oz. bottle of this at night mixed with 1 and 1/4 tbsp. of rice cereal. Giovanni had his first bottle of this tonight and he took it like a champ. We go back for a follow up in one month so hopefully this new "diet" will help. Despite being such a small dude, he is becoming such a big boy!