Saturday, August 15, 2009

Question and Answer with TAC doctor

Hello gang! It is a Saturday night and here I sit with nothing to do, so I figured I might as well blog :-).
I want to thank Alana for submitting my story to Lost and Found. Alana is a sweet lady with a beautiful daughter who is struggling with secondary infertility. Stop by her blog and send some support or offer up a prayer for her and dh. I look forward to reading her blog daily. Her posts range from book reviews to her daily experiences as a wife, mom, and teacher. Take a minute, I guarantee you will enjoy it.

So I have been corresponding with Dr. George Davis in Sewell, New Jersey for the past two weeks. Many friends reached out to me and encouraged me to contact him. One friend in particular helped me the most (thanks Kiki!) I first e-mailed him with a brief history and asked him to please contact me when he had a chance. He earned high marks with me when he e-mailed me back while he was on vacation! This move showed just how passionate he is about eliminating the Incompetent Cervix epidemic.

He called me one night and we talked for hours. I began by telling him what happened in both pregnancies and what the Dr. told me at each post partum appointment. Below are a few questions I asked and the responses I received.

1. What are the risks?
The risks are generally those of any major surgery in an otherwise healthy young woman. They include blood loss, infection, problems with wound healing, etc. None of these occur very often. In reality, as long as the procedure is done by someone who knows what they are doing, the risks are very minimal.

2. Long term effects?
Virtually none.

3. Will I have to be on bed rest?
No!

4. Can the TAC fail?
Yes, in theory,. in twenty some odd years of doing this procedure, I have had women who did not end up with a successful outcome. However, none of my patients have ever lost a pregnancy because of a failure of the TAC itself. All were for reasons unrelated to the TAC.

5. Is there a possibility I will go to term?
Yes!

6. How can a TAC help me if I have a dynamic cervix? Will it hold while my cervix opens and closes on its own?
The TAC eliminates 99% of problems that affects the cervix. The cervix will still be dynamic, but the TAC will prevent the membranes from funneling and prevent ascending infection. It will definitely hold the cervix closed.

7. How is the TAC placed and is it more reliable than the TVC?
The TAC is placed via an open method (it involves an incision through the lower abdomen - similar to a c-section). The Davinci Robot is now being used. This involves using robotics to get into tight places. The TAC is more reliable. Vaginal cerclages only work 70% of the time.

8. I had an infection in my uterus which caused my loss and I am fearful of it happening again. What are the chances of this happening with a TAC?
You probably had an ascending infection which occurred because the cervix opened up. With the TAC, the cervix will not open.

9. How soon can the TAC be placed?
As soon as possible.

10. How long do I have to wait to TTC after placement?
30 days

11. What is my physical recovery after placement?
You will spend about 2 days in the hospital and can go home to Fl. the 3rd day. Recovery can be anywhere from a few days to a few weeks.

12. Is a pre-pregnancy TAC better than one done during pregnancy?
No.

13. How long have you been performing TAC's?
20 some odd years.

14. General anesthesia or spinal?
Pre-pregnancy - general
During pregnancy - spinal

15. How am I monitored after placement?
By OB, but before you leave the hospital pictures will be taken via US to show placement of the cerclage.

16. What kind of contact will yoU have with me? With my OB?
The OB or you can call anytime, with any questions. Collaboration as needed.

17. I know the stitch is permanent. Are there any long term effects to my body by having it there as the years go by? Is there a time when I may need to have it removed?
There are no long term effects, no deterioration or risk of infection. The body actually builds a protective coat around it which makes it even stronger.
No, but if a hysterectomy is needed for any reason, the band will not pose any problems.

18. Do you take my insurance?
His secretary is currently working with my insurance company to get approval.

19. Why does the TVC work for some and not others? Especially since I have not had any thing done to my cervix?
The TVC is only 70% effective. The connective tissues in your cervix may not be as string as others. Some women have some strength and the TVC work, but for women like me, it is useless.

20. Any meds after?
Just antibiotics and pain killers

21. Is it possible to go back to work after the surgery and through the pregnancy?
Yes!

22. What are the failure rates of TAC?
Less that 1% and other factors are involved. The TAC will not fail.

23. When can the surgery be booked?
Usually 6-8 weeks before the surgery.

24. Which is better? Laproscopic or open method?
The Lap have failure rates. Even though I have never done one that failed, I prefer to not take that chance. The open method has a higher success rate.


After talking to the Dr. I feel hopeful and will definitely be doing this surgery. This Dr. was patient and was willing to answer all my questions even of many were repeated. I debated between him and another Dr., but after reading the experiences of both, I decided on Dr. D because his patients all have successful pregnancies.
I also let the Dr. know that I do not plan on spending another pregnancy on my my back. If there is even a remote possibility of this happening, then all bets are off. I asked if I needed to have any tests done and he said no.
I hope this post helped someone who may be contemplating taking this same route.

Where is my expected end?

16 comments:

  1. Just reading this has made my heart smile for you! I went full term with a TVC but was on bedrest for 5 months of my pregnancy. Good luck on your journey and God Bless!

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  2. That is so wonderful! So much hope...so much positive information!!!!!!!!!! I'm so glad this guy sounds wonderful!

    Keep us updated about your insurance and everything...and when you plan on doing this...you don't have to wait long to TTC after that!

    Still praying for you!!!

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  3. Thanks for sharing this info. I currently have a semi-successful Shirodkar in place. It is keeping me pregnant but my cervix is still opening and I have been on bedrest since 11w (and now a month in the hospital on bedrest). So, my hubby and I are planning a pre-pregnancy TAC after this.

    My only comment is that the top TAC doctor says he does not recommend them during PG because there is a m/c rate and he always recommends them pre-preg. My OB actually said that he would not even consider placing one during pregnancy, not even in an emergency. I would check into that a little more, but otherwise, your info checks out with everything else we have heard.

    Good luck, dear one. I really hope that this is the answer.

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  4. That is amazing news! Let us know how things go! Good Luck!!!

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  5. Wow. What a lot of good, encouraging info!!! I'm so glad that you feel comfortable with the doctor and the procedure.

    Praying for you!

    Keep the info coming! :)

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  6. Thank you for sharing all of that information. I'm very interested in the TAC too. I am interested in knowing if your insurance will cover you. Let us know. Also, if insurance does not cover, what is the cost? I'm pretty sure my insurance wouldn't cover me because I've only lost one baby (sad, but true). I'm thinking I would need to show proof that a TVC failed first. Which is horrid. But, you know how the insurance companies can be. I'm still gonna look into it.
    So glad you aren't giving up! You'll get there!

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  7. I'm so glad that you contacted Dr. D about at TAC. I can't tell you how much peace I have about a future pregnancy now that I have the TAC. It is SOOOO worth it! I know that TVCs help too, but like you, I didn't want to spend the majority of a pregnancy flat on my back and worried 24/7. I encourage you to do it. It was really an easy surgery, and the recovery wasn't that bad. It really took me about 2 weeks to feel back to normal, although I was up doing things around my house after a week. My insurance also covered it just about completely--all I had to pay was the $250 deductible--all else was covered! I'm praying for you, my friend, that God will give you your expected end--and soon!

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  8. What an incredible conversation. I am thrilled that you have received this encouragement, and very hopeful for you.

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  9. Thanks SO much for the wonderful "shout out," you truly didn't have to do that! :)

    Your conversation with the doctor sounds super. I am glad he seems supportive and caring. Praying for you and DH. Hugs!

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  10. Dear Marie, What a wonderful , useful post. I'm a victim of Incompetent cervix and had a loss last year. Luckily a TVC worked for me and have been blessed with a baby girl. I understand what it is to undergo all the pain. But I'll strongly say that you are going to have a beautiful baby in your arms with the help of TAC. One of my friends who had 3 losses inspite of a TVC is contemplating a TAC. I've pointed her to your blog.

    Please understand that your blog is helping so many women that are brutal victims of IC.

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  11. Trina J, Los AngelesOctober 12, 2009 at 4:51 PM

    Hi Marie,
    My husband and I lost our pregnancy this August due to an incompetent cervix. I was pregnant with triplets and all three are now with the Lord. I am in the pre-op stages of TAC through Dr. Haney and he was so patient and answered all of the questions my husband and I had of him during our conference call (we're in LA; Dr. Haney is in Chicago). I am very encouraged that this surgery will be successful for us. I will be praying for you and your husband and I hope you will do the same for us.

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  12. Your blog is truly inspiring and gives alot of positive hope. I have had a laporoscopic TAC which was fitted at 12 weeks during pregnancy. The recovery was quick for me and I am now 16+5 weeks and praying for a successful outcome. I have lost 2 sons, one at 19 and 24 weeks which due to IC.
    For anyone who doesn't know - Abbyloopers is a wonderful group that has all the answers regarding the TAC
    Wishing you all the best

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  13. I'd love to talk to u! Ur story is amazing!! Sac2310@gmail.com
    Any others that read this and had the surgery please contact me too! : )

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    1. Thank you hey, I feel so encouraged and uplifted to read about your dialogue with Dr Davis. I have IC and now seriously consider having a TAC, I can't wait.

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  14. Marie,
    Thanks so much for sharing your story. My husband and I just lost our son at 22 weeks two weeks ago due to IC. Prior I delivered my daughter at 29 weeks after rupturing membranes and funneling. I also spoke with Dr Davis and knew from our conversation he was the doctor I wanted to place my TAC. I am scheduled for a traditional TAC June 29th and we are flying from Boston to NJ. He has given me much hope and optimism about being able to have a "normal" full term pregnancy. It's nice to have people to talk to in the same position and who understand so again I thank you for posting this :)
    Have you all joined the site called abbyloopers ? It's a fantastic website Specifically about TAC, IC, preterm labor, you name it. There are links to all the surgeons who perform the TAC and different threads about all sorts of topics that relate. I have found it a tremendous help and support.
    Melissa
    Lexis0527@yahoo.com

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  15. Hi Melissa,
    didi the TAC work? did you delivery full term.
    I had 3 miscarriage at 9, 19 and 21 week.s and im considering the TAC. Please let me know if you got any comlication. If any one out there can tell me an history of a successful TAC, i would appreciate. Thanks
    Veka

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