HELP!! prolapse & second trimester termination due to severe fetal problems....

Thank you so much Christine!
I know I don't have much choice in the matter, the termination is a must, I just wanted to make sure I don't overlook something that would further complicate my prolapse in this situation. Having battled age related infertility for the past 4 years, and then having gone through pregnancy and birth, I've learned to do my own research and prepare and not just leave it up to the Dr.s who may have their own routinesor agenda I hate to say, or may not always understand what a patient's priorities are or their particular situation. It is really up to us as patients to be informed and stay on top of things and make sure nothing is overlooked as we enter the medical practice routines where things are often done for convenience or $ rather than the patient's best interest. And this is particularly important for surgical procedures that can potentially escalate and require additional interventions. I just wanted to know if there are any definite "DON'Ts" as with child birth.

I guess in this case I have no choice but to trust this surgeon, he is not my regular Ob/Gyn as she does not perform such procedures, but he was highly recommended by the amnio specialist as having a very good record with fewest complications. So even though he's not my kind of Dr., I guess mostly by nature of his training since he thinks surgery is the answer to everything, right now I do need a surgeon, and a good one who specializes in such matters so it's about the best I can do. Thank you for your reply and kind, encouraging words.
-Elaine

Hi Anne,
Thank you for your reply and encouragements. I just finished writing you a more detailed answer, but apparently the site thinks that if you write a message for a while and aren't clicking around your account is inactive and when I tried to post it, I lost it all without any chance of recovery with the back button or anything. In fact it just did it again for the second time, but this time I was wise enough to copy my message before hitting "post"

Anyway, I don't have time to rewrite all I wrote before, but appreciate your suggestions and advice. I guess that's about all I can do, trust this surgeon who is not my regular Dr., she does not perform these terminations so I had to go on the amnio specialist's recommendations. I'm sure he's a good surgeon, I have no doubts about that it's just that 4 years of battling infertility and then pregnancy and childbirth have taught me to be cautious and I've allways chosen my Dr.s very well seeking those with whom I could collaboratively decide on the treatments.

I was sure to meet with him for a consultation and to discuss the fact that I want to have another child and need my uterus as healthy as possible, I just hope when he enters the operating room next week and starts his scheduled surgeries one after the other at the hospital, he remembers my priorities and doesn't just go by the info on top of the chart which will state termination at 19 weeks gestation, age 45, and just make ad hoc decisions based on that in case any complications occur.

I am weary of surgeons who use euphemisms such as "tighten up" when they really mean a surgical procedure that will make it so. I guess they can't help it, they are trained to think the human body can always be surgically made as good as new or better and may even feel it's their duty to try to correct or prevent what they see as future problems while they are in there anyway. I have friends who have ended up without a uterus or have had procedures they did not knowingly consent to, just going by euphemisms like that mentioned by the Dr. which they just took for granted and asked no more questions about and the doctor took as consent. It may not necessarily apply now, but since I don't know the Dr. and am just going of his general statements which would normally make me question and contradict, but since they don't necessarily apply to my case now, I don't want to cause any tensions. Like I said, I can't really be too picky here.

So that's why I just wanted to be prepared and know if given my prolapse there are any definite DON'Ts for this kind of abortion as I know they are for regular hospital births. You know the type of things Dr.s routinely do to make it easier for themselves or just because that's the procedure, it's how they've learned etc., without paying attention to the patient's individual situation or priorities. For him my prolapse is a plus, easier to work with. Now my question to him was if there are any considerations to keep in mind given I don't want the prolapse to get worse and that's when he made it sound like a positive, but it could just be that there are things to consider and he doesn't know about them or ever given it a second thought. So anyway, that's why I was so worried, but your reassurances have made it a little easier to give up my need for control and have faith it will all work out. He will be using laminaria to slowly dilate the cervix over 2 days and yes, I am pretty healthy, no meds or anything. Thank you so much!
-Elaine

Hi Anne,
Yes, I can see how a little humor that between the lines says "don't mess this one up!" can go a long way, esspecially since I'll be his first case early in the morning. He squeezed me in he said. I hope he has his coffee on time and that it's good and strong! I actually have heard of the wrong breast being cut off and things like that and women writing on their breasts with thick marker which was the one to operate on. May be just anecdotes, but I bet you it may have happened sometimes. After all, surgeons are just human and it's just a job that can get pretty routine and automatic in many ways.

Yes well, laminaria will hopefully do the trick and my uterus will cooperate after that. I like to be informed as best as I can esspecially when it is something so important as my fertility or health. I've seen some sites on abortion that recommend premedication with ergometrine and a local anaesthetic with a vasoconstrictor (nor-adrenaline)for advanced pregnancies which tend to bleed more once the placenta is removed. I guess they'll know to do that I just keep thinking is there anything about me that they should know and I've forgotten to tell them that may have any bearing on the situation. Because that's how things can go wrong, when somebody--patient or medical staff overlooks something. I've had other early miscarriages that ended up having to be D&C and had some complications with retention of material that cost me a trip to the emergency room and several second opinions. My doctor at the time kept saying that if there is no severe bleeding or fever I am fine, but the pains I was having and the clots and real tissue pieces were telling a different story, and I know I tend to not bleed too much generally and also to not get a fever even when others around me with the same condition are burning. Anyway that time my body dealt with it on its own after a week or so and somehow I felt more in control. This time I know the potential for damage to the uterus during the actual procedure is much higher since it is so advanced but we really wanted to be sure and only the amnio could give us that with the least risk of miscarrying a healthy fetus. I was so hopeful up until 3 days ago I thought I had beaten the odds on my own. Hopefully I'll have another chance. Best wishes to you and thanks again.
-Elaine

Hi there, thank you both for your support and advice. As difficult as it was, my doomed pregnancy is over now and I am recovering. I did experience unexpected uterine pain after 5 days post D&E and was put on antibiotics, yesterday was checked out by my midwife and had a pelvic ultrasound to be told that nothing out of the ordinary is going on there given what my uterus has been through. Just some fluid and a fibroid they said and possibly a mild infection which the antibiotic would cure. I sure hope they are right, I think the antibiotics helpped because I started feeling better after taking them. I didn't want to take them at first and was relieved when the surgeon did not prescribe them, but 5 days later when the pain started I changed my mind quickly. I guess sometimes they are needed.

One question I had was after the termination, my cystocelle returned with a vengence and I was leaking pretty bad. It had been under control during the 19 weeks pregnancy as the growing uterus was pulling it all up. After the pain started 5 days later and I felt my uterus swell it stopped again and I've been in control ever since. I still don't know whether that's good or bad. Does that mean my uterus is still pretty swellen and can I expect the leaking to come back once the swelling goes away? I was hoping my posture exercises would have helpped control it, but it looks more like it's the uterus itself that can do that when it is enlarged. Does this assumption of mine make sense? Just trying to see if I can use that as a guide for my uterine health. Would the swelling of an infection tuck it back up or am I dreaming? Thanks again for all info and support.
-Elaine