Finally Some Answers...

Once again more medical stuff for my record (I've included lots of links for your benefit if you're interested though)...

This past Wednesday I had my appointment with Dr. Foulk. He's a Reproductive Endocrinologist at Utah Fertility Center. The appointment went really well and I finally got some answers as to why I'm having such a hard time staying pregnant. I told him my entire fertility/pregnancy history and had him pretty curious at that point. I've had so many different complications over the years and I think his medical brain was trying to piece everything together-I'm quite the complicated puzzle :) As soon as we finished reviewing my history we went right over into the next room and he performed a "water ultrasound." Pretty much right away he determined that I have an incompetent cervix. None of the water he was injecting was staying in my uterus, it would just come right back out. Ttalk about feeling like you majorly peed your pants... he said something to the fact that I was getting a major douche and would have the cleanest vagina in town... LOL! Sorry if that's tmi, I couldn't help myself! He also said it's usually pretty hard to get the catheter through the cervix (because it's suppose to be really tight and closed) and it went in really quick and loosely, pretty far into my uterus way too easy. He tried three separate times to inject a huge syringe (and all those other fun tools) full of water with no luck of it even staying in long enough to capture pictures on the ultrasound screen. Usually a incompetent cervix can't be diagnosed until you are pregnant (and having complications and dilating prematurely) and so it's crazy that mine is already in that state while I'm not even pregnant. He finally had the nurse get a big cup of water and she kept injecting water as fast as she could so he could capture some images real quick. Talk about a workout for my cervix... I was cramping pretty bad the whole time and he felt really bad that my day was starting out this way. I was actually happy though and told him to do whatever he needed to do because I was finally getting answers, finally everything was starting to make sense. During the ultrasound he found that I have a Septate Uterus which is a wall that partially or completely divides the uterus longitudinally into two cavities on the inside making the capacity a lot less, less room for a baby to grow. Mine is 1.51 cm long (the average non-pregnant uterus is 4 cm long) so it is in between 1/3 to 1/2 divided which he said is pretty significant. Also the right side is a lot smaller then the left side, so if a pregnancy were to implant on the right side there is even less capacity than half of a normal uterus. I know for sure that this last pregnancy I lost at almost 16 weeks was on the smaller right side :( I specifically asked the ultrasound tech. during one of my ultrasounds and was told it was on the right side. I'm not sure on the two I lost before this last one, both at almost 11 weeks. He also saw some Uterine Adhesion's while performing the ultrasound. The combination of these issues makes for lots of complications during pregnancy :( Also he dispelled a couple former diagnosis's that I've had. He wasn't able to see the Fibroid that I was recently told I had and that we thought might be a big issue... still a bit confused about that one, I can't imagine it could go away that fast. Also for years I've thought and been told I have a Bicornuate Uterus and it turns out I don't, I have a Septate Uterus. I guess with regular ultrasounds they can't really tell the difference, and so they just always call it that because it looks kind of heart shaped but bicornuate uterus's are heart shaped on the outside and septate uterus's are normal on the outside (like an upside down triangle) but divided on the inside. He was able to get a clear picture and distinguish between the two during the procedure. Which is good news because a bicornuate uterus can't be fixed but a septate uterus can. So I'm scheduled to have surgery early next month and Dr. Foulk will remove the septate wall and open it all up so I have a normal full capacity uterus. He will also remove any adhesion's or anything else that isn't suppose to be there. Then if I become pregnant I will have a Cervical Cerclage placed (ouchie!) pretty early during the pregnancy to (hopefully) keep my cervix from dilating prematurely and miscarrying as a result. I know it sounds weird but I'm really happy and at peace with all of this. It's so exciting to have real answers and feel hopeful at this point... here's to a happy surgery day!

Wednesday 4/6/11

Cardiologists, Dentists & Family Dr.'s...

Last month Avery had her NICU follow up appointment. The Pediatrician recommended we have her see a Cardiologist to check her heart murmur. Her appointment was this past Thursday. I was expecting a quick appointment (maybe thirty minutes to an hour), but we ended up being there over three hours. Needless to say it was a long day! Being stuck with three and five year olds in a room for that long isn't fun at all. I had planned on having time to go back home and feed the kids lunch before taking them to school. The appointment went through lunch time, I had to reschedule my hair appointment and the kids were an hour late for school. OK, enough complaining-on to the appointment. After we got signed in and I filled out some paperwork Avery had an EKG...

After the EKG Dr. Judd's assistant of the day came in and did an exam and listened to her heart very thoroughly in several places. Then Dr. Judd came in and reevaluated her. They both heard a pretty significant heart murmur. Avery had a PDA shortly after she was born while she was in the NICU. It was successfully closed with Indometacin. According to Dr. Judd, PDA's reopen 30% of the time. They were pretty sure this was the case with Avery. The Dr. decided to have Avery get a Echocardiography to determine the size of the PDA and more importantly get a better picture of, and accurate measurements of her heart to make sure her heart hadn't enlarged as a result. If it had enlarged she would need surgery to close the PDA because overtime the heart would be working too hard and keep enlarging and eventually give out. The ultrasound was over an hour long but Avery was a trooper...

When all the testing was complete the Dr. informed us that the PDA was really small and her heart wasn't enlarged at all. Everything was functioning perfectly and that she wouldn't need surgery. It was a huge relief! She recommended we just follow up and have her checked every year... that I can handle!

You can read more about Avery's delivery and NICU stay here, here and here.

Note: Her PDA was originally found when she had her first Echocardiography in the NICU on 4/18/07 when she was 8 days old.

Thursday 3/24/11

On Friday (the following day) Maddy had a Dr.'s appointment. Tuesday evening he and Avery were playing in Avery's room and Maddy came out crying saying he swallowed a penny. We did our research online but called the Dr. the following morning to get his advice. We were told if it "hadn't passed in 48 hours to have him seen so they can make sure there wasn't any kind of blockage." We never "found" the penny so we were back at the Dr.'s office (we had been there a couple weeks earlier with him due to stomach problems)...

They did an exam and were pretty sure he is fine. We were told we could get an x-ray if we wanted to but we opted to just watch him and make sure everything stays normal in the up coming days.

Later that day Steve and I had Dentist appointments. The kids had Dentist appointments the week before. So in a 10 day period we all four had Dentist appointments and both Maddox and Avery had Dr. appointments. I think we've had our share for awhile (hopefully!)

Friday 3/25/11

NICU Follow Up Appointment...

This past Friday Avery had her NICU Follow up appointment. She sees several different specialists who assess how she is doing developmentally. There are usually lots of kids and it usually takes about four hours. This time however, it wasn't bad at all and we were only there about 1 1/2 hours.

First she saw a Pediatrician who did a full physical exam. She could hear a heart murmur and recommended we see a Cardiologist to make sure it's nothing serious. Most likely it is a Venous Hum that she will just grow out of, but we scheduled an appointment just to be sure. She was really pleased with her physical development and had no other concerns and was amazed that she's never had any ear infections, hospitalizations etc.

Next she saw a Developmental Psychologist. He just did a quick evaluation and will do a long complete evaluation before she starts Kindergarten. He went over colors with her (she knew them all) and also would draw different lines and such and see if she could do the same. She did a great job and is right where she should be.

Last she saw a nurse and had her measurements taken...

Weight = 29.5 lbs. (25%)
Height =  101 cm-just under 40 in. (75%)
Head = 48 cm (25%)

She is growing at a great pace (they were really happy with her numbers-especially considering how small she started out) and jumped in the weight category (previously 10%) and let me tell you, you would never know it but she eats all day long. It's looking like she is going to be tall and lean just like her Daddy.

Friday 2/11/11

Minor Surgery...

More medical stuff for my record...

Last Tuesday I had a hysteroscopy done. It is known that I have a bicornuate uterus, but my Dr. doesn't know how severe the inside lining of my uterus is. If it's severe enough or separated by a wall then there probably isn't room for a baby to grow to a full term size. So he recommended doing a hysteroscopy to find out and look for any other abnormalities that might be causing me to miscarry late in the first trimester/early in the second trimester. I've been pregnant 7 times, 3 of those in the last year and a half. I miscarried twice at almost 11 weeks and this last time at almost 16 weeks. It's so frustrating to get through all those weeks of being so sick and such and then have nothing to show for it :(

As far as the procedure goes... I was given some pain medication and "relaxers" to take beforehand and also received a nice shot in the rear right before. Once I was all prepped, I received 4 shots in my cervix (really big ouch) to numb it so they could then manually dilate it. Steve was able to be in the room with me and said that was pretty brutal (luckily I couldn't really see anything.) Once that was complete the Dr. injected a bunch of water (which usually makes the uterus expand so they can see better) and used a scope to go in and take a peek. Unfortunately there was a pretty good sized mass on the top wall of my uterus that was pushing down so far the Dr. couldn't get in far enough to see how severe my bicornuate uterus is. Also the water wasn't helping at all either, my uterus would not expand. He kept pushing up on the mass with the scope (which I could totally see and feel *ouch* poking up through my stomach-I was afraid he was going to poke a hole in it) to try and get in further but it just wasn't happening. He's pretty sure the mass is a fibroid and he didn't want to torture me anymore (while I was awake) so he recommended I have a "operative hysteroscopy" to "shave away" the fibroid and look for and hopefully fix any other abnormalities he may find at that time. It's a more invasive surgery so I'm not real excited about it but I'm glad that we are at least getting some answers and so far they are issues that can be fixed. I have my follow up appointment at the beginning of next month (on Steve's birthday-bummer) and a surgery date will probably be set at that time. They also had me get a pelvic ultrasound (not fun either) the same day (by that point I was so out of it due to the meds. I almost fell asleep) to see if anything else abnormal could be found. We will be discussing those results as well at my follow up appointment. Once I got home I was so tired and out of it that I slept most of the rest of the day. Steve was awesome and took care of the kids, made dinner and woke me up to eat. After eating I laid on the couch for a bit and then went back to bed and slept soundly until the next morning. Recovery wasn't too bad and I didn't end up taking any of the meds. I was sent home with.

Thanks Steve for taking care of everything and being there with me, you are the best!

Tuesday 2/8/11

Dentist...

Wednesday before heading to Seven Peaks both the kids had dentist appointments. They both did awesome and just held still while they got x-rays, cleanings, exams and fluoride. They were both so excited about their new toothbrushes and stickers. Maddy really liked the "squirt gun" that they used to wash his mouth out with. Neither of them had any issues or cavities and the Dentist said their teeth looked great.

I was especially surprised at how well Avery did (as you can see though she was in a pretty big hurry to get off the table.) Last year she freaked out and wouldn't even let them get her mouth open for long at all.

One Tough Girl!

Monday we were out working in the yard and getting ready to finish up and head to Seven Peaks. Avery fell on the cement in our backyard and split her chin open. Steve got to her first and told me she probably needed stitches. The cut was only about 1/3 inch long but Steve examined it and it looked pretty deep. It also wasn't a clean straight cut so we decided we better take her to the Dr. and get it checked. Luckily her Dr.'s office was able to get her right in and we didn't have to take her to Instacare or the ER. It was our first time ever taking one of the kids in for something like that. The Dr. told us that it was a "crush wound" and recommended definitely putting a few stitches in it... especially since she's a girl. It's cool for boys to have scars right!?!

She was totally one tough little girl! She didn't even shed one tear or move or flinch at all. Not even when they gave her the shot and put in the numbing liquid (which they said feels like a really bad bee sting.) She just laid there with her game face on and didn't move at all. They couldn't believe it at all. They said most adults have a had time with it and they have to put most kids out. They got her all numb and then a few minutes later the Dr. came back in and stitched her up while I held her hand. Again she put her game face on and laid there not moving or crying at all. Steve and I were so proud of her... I wish I was that tough!

She was so excited to get a sucker and was as crazy, playful and happy as ever for the rest of the day. As soon as we left she said she wanted to go to Seven Peaks. Maddy was begging to go as well. We were able to finally convince them to stop and get snow cones instead. Steve had to be back to work in a couple hours so by the time we got there we would've only been able to be there for an hour. Friday we go back to get the stitches out and hopefully it will heal well.

Post NICU Follow Up Appointment...

On Friday Avery had a post NICU follow up appointment. She saw six different Dr's/Specialists and the appointment ended up lasting five hours. Normally it doesn't take quite that long but the Speech Therapist was backed up so we ended up waiting for her. The staff felt bad for how long we were there and were nice enough to get us a bagel and some water. So that was nice. Overall she did very well and is pretty much on track in most areas based on her adjusted age of 19 1/2 months.

First she saw a Pediatrician. He check her overall wellness which included her lungs, heart, spleen, ears, etc. He was amazed that being a former 25 weeker she hasn't had any health issues.

Next she saw a Developmental Psychologist. She basically played with Avery and watched how she reacted to different objects. She would show her something and then cover it to see if she could find it. Of course she did. She is very territorial and would get upset when the object was taken from her. She also put out a little peg board to see if she would stick her fingers in the holes, put little cubes in a cup to see if she would take them out, put small puzzles together, etc. She did very well in most of these areas.

Next she had her eyes checked. She is slightly near sighted with an astigmatism(which we already knew from her last appointment) and her prescription changed just slightly. The Dr. was very optimistic that she will have very good vision, it is just slightly blurred.

Next she saw a nurse where she got all her regular measurements done. Of course Avery had to add a little drama and peed on the scale while being weighed. :( Here are her stats based on her adjusted age of 19 1/2 months(her actual age is almost 23 months.)

Weight=22 lbs.(10%)
Length=33 in.(75%)-this is a big jump-last visit she was about 40%-may be she will be tall like her Dad.
Head=44 1/2cm.(2%)

Next she saw a Dietitian. We are still working on her chewing and calorie packing her milk to put a little weight on her. She wasn't too concerned because she is growing and on the chart. She gave me some tips to work on her chewing. Hopefully we can get her to regular table food soon.

Last we saw the Speech Therapist. This was her first time seeing a speech therapist. She just mainly asked me questions about her vocabulary and communication skills. If she asks for things and if she can do simple things when asked, how many words she is saying, etc. Based on what I told her she determined she is at about an 18 month level(she is 19 1/2 months adjusted.) She wasn't concerned she just said to keep an eye on it and have her therapist that comes out monthly follow up. She babbles like crazy and has just recently started showing interest in talking so I think she is just getting started.

Other than it being so long and being starving by the time I left(thank goodness for that bagel) overall it was good. I also ran into a really old friend back from my Malt Shop days during high school. It was so neat. We totally caught up over the several hours in between seeing the doctors. She also had a preemie born at just 24 weeks and has had all sorts of problems. It made me so grateful for how well Avery has done!

On another subject we got Steve's MRI results and luckily he just has a torn meniscus and not ACL. He just has to get it scoped later this month and won't have much of a recovery time.

Dr.'s Appointments...

Today I took Maddy for his 3 year well-child check up. He actually turned three in December but with our whole medical insurance mess I had to reschedule it. We have finally been able to get insurance for everyone but me. No one wants me...I guess my medical history is less than desirable. :( Anyway, here are his stats:

Weight-32.6 lbs.-50%
Length-37.5 inches-30%
Head 49.5 cm-60%

There were no concerns on my end or with the doctor. Maddy was excited that it was his turn to see Dr. Berry. Usually it is Avery or I. However once the Dr. came into the room Maddy was pretty shy. He was excited though because the Dr. let him listen to his heart and he of course got a sucker before we left. Here is another picture of him falling asleep on our living room floor yesterday. He said he didn't need a nap and I left the room for about 10 minutes and came back and he was out. He didn't even bother getting on the couch where his pillow and blanket were. Sometimes I wish I could just lay down wherever I was and go to sleep!

Steve was finally also able to get in to see the Dr. last week. He injured his knee and the Dr. thinks he tore his ACL. We are hoping not because it is usually a 6 month recovery time after surgery as well as being on crutches for a while. He is SO not thrilled about the crutches! He got an MRI last week and we should find out the results on Thurs.

Avery has her post-NICU follow up (monster-4 hour) appointment on Friday so I will probably be posting about that later in the week.