Friday, December 29, 2017

T-minus 2 weeks! The countdown is on!!

I have spent the last couple of weeks since my previous post laying low. We had such a wonderful Hannukah and Christmas, I was focused on cherishing every little moment.  Now that the holiday's are coming to an end it is back to reality.

On Wednesday I had two doctor's appointments in Orlando, one with our Maternal Fetal Medicine Doctor and the other with the Gyno-Oncologist who will have a large part in the portion of the surgery after the delivery of the baby.  Thankfully, it appears my placenta is behaving, as in some patients, it starts to spread like wildfire and wreck havoc on the surrounding organs.  It still appears on the ultrasound to be localized and we are crossing our fingers that this is the case once they take me into surgery.  The placenta in a way is kinda of like a blood rich tumor and that is why the Gyno-Oncologist will be involved in my case.  During my appointment with him, we discussed the ideal scenario which would be delivery of the baby followed by the hysterectomy and a plan B in case the situation is a lot messier than what the images have shown.  Prior to delivery, they will insert balloon catheters into my uterine arteries that can be immediately deployed to slow blood loss if that becomes an issue.   Plan B consists of delivery of the baby, then deploying the catheters, closing me up and letting things settle for 2-3 weeks, to then go back and do the hysterectomy when the uterus and placenta have had time to shrink down.  Of course, in a perfect world, I am very hopeful that I can avoid having two surgeries.

Baby M is definitely unaware of everything going on as he is growing at warp speed...almost as if he knows he has to come early.  Ultrasound shows I am measuring about 3 weeks ahead of schedule and the latest weight estimate is 4lbs 10oz.  With that said the doctor's have collectively decided to move everything up a week as to prevent an emergency since it is optimal for me to be delivered in a controlled and planned environment.  My delivery is scheduled for January 12th at 1pm and the baby will be 34 weeks. With each passing day my risk of bleeding goes up and so we have decided to pack up and head to Orlando on Sunday!  Doctor's recommended being as close to the hospital as possible, as soon as possible.   Originally the plan was to hopefully make it down her until January 8th but things change quickly.  I have now put on my logistically coordinator hat as we pack up to move for what appears to be the next month.

Marc and the girl's will come up with me Sunday to help my Mom and I get settled, then will return for a week with the girl's.  On January 10th they will plan to come back up and we will just have to take it day by day until after the baby arrives.  I am finding it helpful to be able to focus my energy on the planning process, as I don't think the reality of everything that is about to happen over the next couple of weeks has really set in.  While I was hoping to keep our little guy cooking a bit longer, I will be so happy once this is over and we can move forward with our lives, as a family of 5!
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Placenta Accreta is definitely not to be taken lightly and I frequently think of how I got to this point.  What if I had not let the doctor convince me I needed an elective c-section when Madison was born? What if I had been more informed and demanded a trial at labor when I went into labor on my own with Madison at 37 weeks and the doctor ordered the nurse to give me magnesium and send me home since it was a Saturday night.  I hope when this is all over I can find a way to turn these damn lemons into lemonade, find a way to turn my situation into something productive. I don't know what that may be yet, but clearly things happen for a reason and I believe in some way I will be able to give something I have learned back to others.  For many Mom's their prognosis is much worse than mine...some are told to terminate pregnancy and some mother's don't survive the delivery.  What hit home really hard for me this week is that one of the woman in my support group did not survive her delivery.  When I learned this news, I broke down, I cried for her and the three children she has left behind, for myself and for all the other mother's who are fighting this battle of placenta accreta like I am.  The only way to push through is remind myself that I have my own story and I will fight with every ounce of my being to make it out as a survivor!

So, today, I dedicate this blog post to Maribel Sanchez. I never met her personally, but would frequently see her posts in my Facebook support group.  She has left behind 3 beautiful little girls and a loving husband.  Life is so unfair....

A member of our support group has started a go fund me page in her honor and I will leave the link here...https://www.gofundme.com/maribel-sanchez-memorial-fund

Sunday, December 10, 2017

The Plan (part 2)

  Last Sunday we headed up to Orlando for our meeting with a recommended Maternal Fetal Medicine doctor at Winnie Palmer Hospital on Tuesday.  We decided to bring the girl's with us and to try to make the best out of the trip!  While we couldn't get to Disney, the girl's had a blast at the ICE exhibit at Gaylord Palms, where we stayed for two nights.  The girl's don't know what is going on and I have just been trying to keep a sense of normalcy for them as much as possible.  Luckily, they are young enough still where they don't ask questions.

  Tuesday, our appointment was at 7:30am and I am pretty sure I slept for about 2 hours the whole night. Winnie Palmer is definitely an impressive facility and feels more like a hotel when you enter than a hospital.  I underwent an extensive ultrasound with Dr. Gregory Locksmith and it was very clear he was not going to rush and walked us through as he examined my placenta's attachment.  What he found was that the placenta has embedded and almost replaced the wall of my uterus over the previous c-section scars and in that area is considered to be placenta increta (which is more severe than accreta), however, he did note the majority of the area outside my previous scar shows the uterine attachment to be normal. He was also able to confirm that he did not see any bladder involvement during the ultrasound (which is great news).  The recommendation of delivery and immediate hysterectomy is the current plan to handle and reduce the risk of hemorrhage.

  We than discussed the protocol for patients with accreta at Winnie Palmer.  Dr. Locksmith, while he would not take part in the actual delivery is still part of the team of interdisciplinary doctors that manage my case and plan out the delivery.  There would be no required two week inpatient stay, as is protocol for Miami and they try to avoid delivery of the baby before 35 weeks, as most babies will then not require a long NICU stay, if any.  The negative is that anesthesia will still require the delivery and surgery to be done under general, which has been my biggest fear this entire time.  It is very hard to let go of not being present during the birth of my son and I am constantly battling with it.  I understand and agree that my safety is priority number one but it just sucks....really sucks!

  Based on our two options we have decided to deliver in Orlando at Winnie Palmer.  I felt as though because they are very Mommy/ Baby focused they really work to personalize the care of their patients, even in cases like mine, where the delivery is scary and could be life threatening.  While I will not be required to be admitted to the hospital for a period of time before delivery, the doctor recommends I relocate up to Orlando after the New Year.  Executing this plan, finding somewhere to stay and filling my schedule with doctors appointments has become a welcome distraction for my mind.

  The first week in January, my Mom and I will head up to Orlando and leave the girl's and Marc back home while I spend the next couple of weeks meeting with doctors and riding out the rest of my pregnancy.  At times I feel as though I am serving a bit of a prison sentence, but I am doing my best to and try to find ways to enjoy the next 6 weeks.  It will be hard being away from my family, even just the few hour distance, but should there be an emergency as my delivery date gets closer, I need to be within minutes of the hospital.  As the date (unknown, but expected to be the week of January 21st) approaches Marc and the girl's will join us, followed by my amazing Step-Sister, Dad and Step-Mom.  I look forward to us all being to together...it has been all their love and support that helps get me through each day.

To read my previous posts and learn more about Placenta Accreta, click the arrow button at the bottom of this page. 

Saturday, December 2, 2017

The Plan (part 1)

  After receiving confirmation of my diagnosis of placenta accreta and placenta previa at my 24 week appointment, we were told it was time to get a game plan together.  My current OB would be unable to deliver me as the two hospitals he is credentialed at will not accept my case or are equipped to handle it.  Our best option would be a large facility with a multidisciplinary team that could treat me in moments notice. I will need to be somewhere that has access to a 24hr blood bank as the need for a transfusion during or after the surgery is highly likely  I began pouring myself into researching the best hospitals, both locally and out of state.  The main issue with the out of state options, although there are some remarkable facilities, bringing a premature baby on an airplane isn't a smart option, nor is driving a super far distance.

  With the suggestion of our OB, we decided to look into UM-Jackson as the closest option, along Winnie Palmer Woman's and Baby Hospital in Orlando based on a recommendation from my sister's friend who is an OB there.  Both teams are equipped and experienced treating placenta accreta cases. We then spent the last couple of weeks scrambling to get all of my information to the facilities and were finally able to secure appointments.  Marc and I were both amazed and frustrated with how much you have to advocate for yourself as a patient and stay on top of the entire process.  

Winnie Palmer

Jackson UM
On December 1st was our appointment in Miami.  Our current OB has sent several patients to the head of OB-GYN, Maternal Fetal Medicine and everyone has done well.

I knew not to expect sunshine and rainbows, that the doctor and his staff wouldn't be welcoming me with open arms to console me and tell me everything would be okay.  The reality of placenta accreta is a harsh one.  Even when you think you have read everything and know what to expect, hearing it is a tough pill to swallow.  The doctor was very matter of fact, no bullshit, no sugar coating.  Told me things I knew needed to be said, but that no expecting Mom wants to hear.

The protocol for UM is very conservative and they do not tread lightly with patients in my situation.  At 32 weeks (4 weeks from now), I will be admitted to the maternity ward.  For the next two weeks, I will meet with a revolving door of specialists, from Gyno-Oncologists, Vascular Surgery, Anesthesia, Neonatal and Pediatric Specialists, NICU, Trauma and General Surgery, and Interventional Radiology...  I will be put on modified bed rest while I wait to reach 34 weeks.  Everyone will know I am there and the OR will be ready at the snap of a finger should there be an emergency.  To most people, who are not going to be living this, I would imagine having this type of plan in place would be reassuring.  For me it is definitely the scariest thing I have ever had to deal with.

The day of delivery, I will be brought into the OR, put under general anesthesia and endure what is expected to be a speedy delivery of the baby and a hysterectomy.  There will be 35-40 different people present in the operating room ready to take any action necessary. The doctor said the entire surgery should expect to take 5-6hrs.

As I am sitting in the chair listening to this, I am biting my tongue, trying to focus and hold back my tears, trying to be strong.  I will not hear by baby boy's first cry, or be able to see him right away. I will be laying on a table with my life in the hands of the doctor's who will do whatever they can to protect my life.  As I try to digest all of this information, I can feel the tears start to pour down my face.  Marc has been nothing but amazing and does a great job consoling me and keeping his composure.  I know how hard this is for him too.  While we will get the little boy we dreamed of, he will arrive in a very unconventional way.  He will be born into a room of strangers....

With all of that said, I do not want to spend the rest of my pregnancy moping around and feeling sorry for myself, I need to refocus, find strength and remember I am a fighter!  I have spoken with a few Mom's who have been through my situation and while they say it was the hardest time they ever faced, I feel comfort in knowing they made it through and now get to enjoy they families.  I know I will be hugging by girl's a little harder and making sure to appreciate every little moment a little more.  I feel so fortunate for all the love and support from my family and friends who are constantly checking in and offering help.  I know I could not get through this without them.

Tomorrow, we will head up to Orlando to meet the team of doctors up there as another option for delivery.  I will post an update after our appointment on Tuesday.

In the meantime, I am starting to file away quotes of inspiration and strength.  If you have one you want to share, please post it in the comment section below.  xo, Lisa

Wednesday, November 29, 2017

About Me, and the Purpose of this Blog

  Hi!  Let me take a moment to introduce myself, my name is Lisa Lefevre, I live in sunny South Florida, with my husband, Marc and adorable daughter's (yes, I am bias, lol), Madison who is 6 and Marlie who is 3.  Until about a year ago, I was pretty certain there wouldn't be any more little one's in our future, but as I inched closer to 35, I felt as though someone was missing from my life.  I envied all my friend's who had little boy's and had always wished one day to have a son, a real Mama's boy, with big blue eyes and dimples to match his sister's.  On the morning of my 35th birthday, I was shocked and surprised to see 2 lines appear on a pregnancy stick!  After suffering an early miscarriage in April, I knew deep down that this was the little boy I longed for!!

  I have a few purposes of this blog, the first is for friends and family to share along in the excitement as we eagerly await the arrival of little man "M."  The second and main reason is because at 20 weeks I was diagnosed with a condition called Placenta Accreta.  I want to share my story and journey, in hopes that one day, when another scared Mom-to-be receives the same diagnosis, she stumbles across my blog and is able to read my story and know things will all work out okay.  That the "survivor side" as it is referred to in my support group is where we get through this sucky situation and get to hold our beautiful babies and watch them grow up.  That they are not alone and don't have to go through this alone.  The last reason for creating this blog is to provide an outlet for myself and all the emotions; a place to be raw and unfiltered.

For my friends and family who have never heard of Placenta Accreta, I found the links below to be the most helpful in explaining.

https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Placenta-Accreta

http://americanpregnancy.org/pregnancy-complications/placenta-accreta/

Thank you for taking the time to read this and for all the love and support I have been receiving!
Xo,
Lisa


What the hell is Placenta Accreta?

  I was extremely fortunate to have two very uneventful pregnancies.  While both ended in c-sections and my stubborn second daughter decided she preferred to breech, my experience being pregnant with my daughter's were nothing but smooth.

  When we found out we were pregnant with baby number 3 in June 2017, I expected the pregnancy to be very similar to the other two.  I had the normal morning sickness in the first trimester (luckily a lot less than with my girl's).  When, 20 weeks rolled around and we went in to see our perinatologist for the babies anatomy scan.  The tech went through the normal protocol and made sure to call out all the babies different body parts, confirming that baby was a boy, which my hubby Marc and I were over the moon about!  After she finished, she said the doctor would be in to see us.  Thinking we would just be getting a normal report we sat and waited.  The doctor came in and gave us an A+ report on our little guy, but then paused...we could tell there was something wrong.  The doctor told us I had placenta previa and what appeared to be something called placenta accreta.  What the hell is placenta accreta?!  I had heard of previa and knew that the course of action if the placenta remained over my cervix meant an automatic c-section but the other diagnosis was completely foreign.  My mind kinda of fogged over, I tried to focus on what the doctor was saying, he began to give statistics and threw out lots of medical jargon.  The doctor ended our meeting by saying he would re-check me in 4 weeks to see if there was any change.  I remember being calm and just nodding my head, but when I walked out of the office and in the car, I felt a little like a deer in headlights.

  Then of course I did what no person should ever do!  Damn GOOGLE!  Of course, all the scary shit comes up on the first page, like the maternal death rate is between 7-14%! Followed by ton's of articles about Kim Kardashian having Placenta Accreta, which at that point wasn't making me feel better, clearly I was too late for a surrogate...

  The next 4 weeks between doctors visits, had me feeling a little bit like I was on an emotional rollercoaster in the twilight zone.  For the first few nights, I would wake up with extreme panic attacks, from horrible nightmares.  As the days went by my worry would turn to anger, to feeling sorry for myself, to trying to refocus and stay positive to fearing I would miss watching my children grow up.  Add in the pregnancy hormones and someday's felt never ending.

  I joined some support groups on Facebook, which have been both a blessing and a curse.  I have spent numerous hours researching the best facilities in America for treating my condition and getting the baby I safely through delivery.  I have become determined not be a statistic, I am gonna survive this!  I feel so thankful to have the most supportive and loving husband in the world, because I know he is the glue that will keep me together through this! I am lucky to be surrounded by family and friends who are willing to be a shoulder to cry on, an ear to vent to, a welcome distraction and for filling my life with lots of love.

Placenta Accreta, you ain't got nothing on me!!!