April 11, 2013

Week 25- Pregnant with a baby boy, Placenta Accreta/Percreta, Placenta Previa, Thalassemia

{background info- Hello! My name is Jenifer and this is the story of my high-risk pregnancy.  I am currently pregnant with my eighth child (A BOY!!) and was diagnosed with Placenta Previa and Placenta Percreta.  I also have Beta Thalassemia which contributes to severe anemia.  While this has been a difficult pregnancy and we anticipate a difficult delivery, IT IS WORTH IT!  

We NEVER regret our decision to get pregnant with this baby and are so grateful for this experience!!

 Accreta affects about 1 in 2500 pregnancies.  (It is pretty rare!)  If you have had previous uterine surgeries, your risk of Accreta increases to 1 in 500.  I have had two previous c-sections and one D&C, following a miscarriage.  Although I was at risk, prior to being diagnosed with this condition, I never knew Placenta Accreta existed.  Accreta is becoming more and more common as abortions and c-sections becoming more common.    

What is Accreta?  Accreta is where your placenta attaches to your uterine wall instead of to the lining of your uterus.  There are three different levels-- Accreta, Increta, and Percreta.  Accreta is where your placenta is attached to the first layer of uterine wall, deeper than the lining-- often Accreta's can still deliver and save the uterus.  Increta (17% of all Accreta cases) is where the placenta has grown into the muscle wall of the uterus-- this usually requires a c-section/hysterectomy.  The rarest form of Accreta is Percreta where the placenta actually grows through the wall of the uterus and attaches to other organs in the abdomen   Percreta is very dangerous and will require a c-section and repair of other internal organs that are affected.  Percreta affects only 5% of all who have Accreta.  (What is 5% of 1 in 2,500 births? Very rare.)  Most commonly, Percreta involves the bladder which is in front of the uterus (anterior placenta).  Sometimes Percreta involves the bowels with a posterior placenta.  Rarely it involves the uterus, bladder, cervix and bowels...  this is my condition.

I have been on complete pelvic rest and modified bed rest since 12 weeks of pregnancy.  My husband and other kind family members are taking care of my home and family while I spend most of my days sitting or laying.  This time of resting has been difficult, but it has also been a great gift.  I am thankful for every week that this baby is growing bigger and healthy inside of my womb.  I can't wait to meet this little guy-- our grand finale!!

This is a record of my pregnancy for my family and for those of you who may be experiencing something similar.  Yes, I share a lot, perhaps too much.  Thank you for being a part of this journey with me.  I am one who learns much from the experiences of others and I'm happy to share my experience with you, in the hopes that somehow it may help.}

Week 25--

Doctor Appointments.
I had NO doctor appointments this week or last week.
I did spend a day in the hospital for 2 units of blood transfusions on April 9th.

They are trying to keep my blood levels above a Hemoglobin of 8.
One unit of blood is supposed to raise your Hemoglobin levels one.
So, if I was 7.7 prior to transfusion, I should be 9.7 after two units.
I was 8.4 the morning of my transfusion-- and 8.8 the morning after two units of blood.  ??!!
It's weird.  They are not sure where the blood is going.  I'm having some minor reaction, but nothing too serious.
(I'm getting used to weird test results.)
I LOVE my hemotologist and perinatologist.  They both are great at answering any questions I have.  They keep in close contact with me throughout the week and they are very wise doctors that I completely trust.

Insurance and Scheduling.
Who knew how discouraging it can be to receive bills in the mail for thousands of dollars saying "Pay this Amount" or "Denied by Insurance"?  It's ridiculous!  After I saw that ONE doctor appointment was costing my insurance $1600, I don't feel bad at all asking so many questions!  Ha!

Besides the fact that we need to buy a house this summer, our car just broke down on the way home from Costco this afternoon, and we just found out Jakob needs surgery on his toe, (ha!) we are doing fine financially.  Even with good insurance, just the sheer TIME bills and insurance and paperwork is daunting.  (And, we are just at the beginning.)  I can see why medical bills are such a nightmare for so many people.

Every person you talk to tells you a different thing, you are always on hold, and there are so many different specialists and doctors that it really makes me wonder how people without a PhD figure things out.  Just trying to schedule all the appointments I need to have is sometimes crazy... lab work, follow-ups, special tests.  At the office doctors all want to "schedule the visits for the same day", but actually trying to coordinate between offices is a joke.  Doctors will say, "call if anything changes" or, "I want to know how you are feeling."  Then, when you do call, you have to leave a message that you hope actually gets to the doctor.  If I didn't already have a headache, all this would certainly give me one.  :)

I have learned a few things-- it is WHO you know.  Being on the phone with doctors, nurses, receptionists, insurance workers, etc... I will say- not every person is created equal!!  There are kind, smart receptionists who can have your questions resolved in minutes and there are call centers who take a message that may or may not every get returned.  There are billing clerks who resolve problems and billing clerks who never call back.  GET NAMES!!

My life has been made SO nice because of a few nurses or doctors who say, "Here is my direct line, call me anytime."  I thank heaven for a smart billing lady, Melissa, who worked out all my insurance junk and got pre-approval for the next few months of my care.  I have a long list of phone numbers under OHSU on my phone-- I like to learn the names of my favorite contacts and keep in touch with the same people.  It is SO nice not having to explain my situation over and over.  I'm grateful for the good people that have touched my life through this experience.

Test Results.
(Normal Range-- Hemoglobin 12.0-16.0, Hematocrit 36-46%)
March 25-- Hemoglobin 8.4 g/dl, Hematocrit 27%
April 2-- Hemoglobin 7.6, Hematocrit 25%
April 8-- Hemoglobin 7.7, Hematocrit 25%
April 9 (at OHSU prior to transfusion)-- Hemoglobin 8.4, Hematocrit 26.2%
April 10 (in Corvallis after 2 units of blood)-- Hemoglobin 8.8, Hematocrit 28%

Physically at 25 weeks.
I just don't even like thinking about how I feel.  My answer is-- I feel just fine.
I do have some pain in my lower belly and my blood/blood reactions make me feel like I've taken a Benadryl even when I haven't.
Honestly, I hardly do anything.  I'm on bed rest and have wonderful In-Laws who care for my home and children.  It makes me laugh that the most I ever walk is when I end up walking around the hospital going from lab to appointment.

Mentally at 25 weeks.
All is well!
Sometimes I feel so stir-crazy I could scream.
I'm sick of not accomplishing things-- I don't want to read a book or watch TV.
I started doing family history and trying to make some digital photo books- that should help.

That's all folks!
I'm so grateful to be home and that I'm not bleeding!!!!!!!!
Thank you for your kind thoughts and prayers.


Daniellelovesjewels said...

Are you at 25 weeks right now?

Daniellelovesjewels said...

Are you still at 25 weeks?

Missy Smalley said...

Hi Jennifer I dont know if you still check this or not, but I was reading your story as I was recently Dec 26th put in OHSU in Portland for Placenta Precreta, placenta previa and uterine synechiae (tear in the uterus) and from Eugene. I am glad everything worked out well for you. The doctor I seen had me very very freaked out and reading this has helped me cope a little more.


jenifer said...

Hi Missy! Good luck. I'm glad you are at OHSU- they are wonderful. I love the sweet workers on the mother/baby floor. God bless you and your little one. It's worth it!!

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