Thursday, June 15, 2017

From Arabin to Elective Cerclage: The 2nd experience

A few things had transpired with a slight shift of plan recently.


Part 1: The Arabin
As the Arabin insertion is non-surgical, it's therefore done in a procedure room instead of OT.  A pre-insertion TVS was performed to check the cervical length and to make sure there isn't any opening. A post-insertion TVS was done to ensure that the Arabin is properly in place.

As initially feared, and despite a repeated attempt, the Arabin pessary did not fit despite using one size smaller (the smallest available in stock at PPUKM).  Hence, the only option left was to have an elective cervical cerclage.

As for the Arabin which I'd purchased, it's been donated to the hospital instead of being brought home as souvenir since the latter will not serve any purpose.  Hopefully it will benefit someone in need and save a baby from being delivered too soon.

While waiting for Arabin insertion by Dr Rahana outside one of the rooms of Ward 1C


The Arabin pessary

Part 2: Elective cerclage
A day before the cerclage procedure at about 15 weeks ++, for once again, I had to check into Ward 2B.  The usual pre-op procedures such as branula insertion (received a green one… argh, painful), blood count, and review by doctor from the anaesthesia and intensive care department were all completed by the noon.

For unknown reasons, the caterer had missed out my lunch.  It was oh so frustrating as hunger and mood swing simply don’t get along.  At the same time, I did not fancy troubling the husband who had gone to work after sending and accompanying me to the ward earlier.  Domino’s Pizza delivery hence came into picture.  As normal appetite had slowly resumed, a pizza for just once in a blue moon should be alright.

Pizza for the Birthday Girl

D-Day
As the cervical cerclage would be done under spinal anaesthesia (i.e. half-body anaesthesia), I was required to fast for a certain number of hours before the procedure.  No food from 2 am onwards on 23/5, and no drinks from 6 am onwards.

Morning fasting

There wasn’t emergency cases at the OT that morning, so my cerclage this time – by Prof Azurah was done at about 10 am as scheduled.  Doing it on an elective basis this time, it was fast compared to previously when it was done on an emergency basis when Aaron almost followed Alvin’s path in arriving much too soon.

I felt alright throughout the procedure, except for a moment when I felt nauseous and as if passing out as my pulse rate suddenly dropped.  Dr Nabilah who administered my anaesthesia gave me an injection via the IV line, and I gradually felt normal again.

At the observation bay, I felt extremely sleepy under the cold blast of air-conditioner and probably slept for half an hour before I was taken back to the ward on bed, where I continued to sleep for a few more hours, with thick blanket covering my legs well into the hot afternoon.  Spinal anaesthesia could make me fall asleep very easily, although I was alert when called and could respond when people talked to me.

As this is the first time I was allowed to do things on my own upon gaining my sensation after the spinal anaesthesia (compared to previously when I remained on bed for the next 24 hours and hence wasn't really aware of what's going on because everything's taken care by the nurses), it's thus a new knowledge to me that there would be some spotting immediately after a cerclage.  The doctor who came and saw me assured me it's normal and should disappear within a few days.  I was discharged on the next day, following a Proluton (hydroxyprogesterone caproate) injection.  I was advised to rest and be sedentary at home, and advised to have a medical leave of 10 days. 

What's next
According to the plan, a Proluton injection of 250 mg shall be taken on a weekly basis until 34 weeks, that's if my body permits Baby No. 3 to remain inside for long enough - fingers-crossed. 

A weekly kiss

Apart from a weekly sting on the butt - oh gosh the Proluton suspension is quite thick, my antenatal check-up is expected to be at least every fortnightly for monitoring of cervical length, on top of the normal routine.  More than halfway through the journey now, there shall be no looking back, but to embrace everything that will come along the path, which includes taking that least expected path.  

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