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?