My Story - Surgery

I was lying in bed the night of January 14, 2015 when all of a sudden I felt what I describe as a small explosion in my right lower abdomen. I had felt this in a much smaller scale every time I had my heartburn episodes. I instantly ran to the bathroom and began getting sick. Once my stomach was empty, I got into the bathtub. I drank water and Pedialyte to try and rehydrate myself. Because I had been to the hospital twice in the last few weeks, I refused to go again. Both Chase and I thought I was just dehydrated again and continued to drink water. As the night progressed, I was getting short of breath and wanted to throw up but I couldn't. I tried so hard to sleep, but I literally couldn't even close my eyes I was in so much pain. After a few hours of this, I talked to my doctor who immediately told me to go to the hospital. I had never gotten a call back so quickly!

Again, my back was in excruciating pain and I couldn't walk. After a speedy admission, I was seen by the doctor on staff. She wanted to put me on morphine, which I bucked for about 30 minutes. Then she told me that if I continued to be in so much pain it wouldn't be good for me or the baby, and that the risks of pain medication were minor compared to what my body needed. I agreed reluctantly. I was scared, they barely suggest you take Tylenol while you're pregnant, and now I was on morphine! I was terrified I was hurting Baby C.

Ultrasounds showed the baby to be fine, but there was some concern that they found while examining my images. They couldn't exactly tell what was going on, but it looked like I had fluid in my lower right abdomen. At this point, it was business hours and all the day doctors were coming to check on me.  A wonderful doctor from Maternal-Fetal Medicine, Dr. Ramirez, came to talk to me. She wanted to bring over a surgeon/oncologist from Baylor College of Medicine to review my scans. I also had my OBGYN, Dr. Shultz, come talk to me to break the news. He told me he was almost certain I would need surgery.

Surgery? How was that possible? I hate to admit this, but I didn't believe him. I thought, “Well he isn't a surgeon so he's probably wrong” (sorry, Dr. Shultz!!). However, the next thing I knew I was being wheeled off to the OR.

I remember telling Chase to take care of our baby girl if anything happened to me. I have NEVER seen Chase cry. Not because he isn't sensitive, but he is just a manly guy! We both broke down after I said that dreaded sentence. But I had to say it. I told him that he was going to be an amazing father and that I would love him forever. We prayed, kissed and cried some more before I was taken away. Once in the OR, I told the nurses prepping me to take care of the baby. I made sure they knew that if there was a choice to be made, to save her. I think if you aren't prepared to say that for your children, you probably aren't ready to be a parent. Although, I have to admit I didn't think I would have to be ready to make that sacrifice before she even got here.

The nurses were prepping me, and then I woke up the next day in the ICU and so began my recovery/journey to delivery.

When I woke up I had a breathing tube down my throat, a central line through my neck and my husband asleep on the couch next to me. I was terrified because I didn't expect to be waking up during the day (I went into surgery at 5:30pm) and I didn't know if I was even still pregnant. I couldn't speak, so I made noise until he woke up. He ran over, kissed me and told me I was ok and so was the baby. I instantly relaxed, but I wanted the tube out of my throat right away and wanted to know what happened.

Once I was a little more coherent, the doctors came to talk to me. I started with Dr. Ramirez from MFM. She told me that they went into my abdomen to explore and found a bowel perforation. Now, I am no medical whiz and honestly, I had no clue what she meant. She explained that my small intestine had a hole in it and was leaking intestinal fluid into the rest of my body. I really didn't process this. I didn't understand how that was even possible. I was too tired though to try and figure it out.

I really don't remember the next three days. I was on lots of pain medication and very strong antibiotics. I do remember worrying about the baby with all the medication, but again they told me that the benefits outweighed the risks. I was watched over constantly. Chase was by my side the entire time, making sure the decisions being made were the right ones by the doctor. One advantage of Chase during this time besides just being an amazing husband is that he works in healthcare. He talks to doctors all day long and knows how to ask the right questions. This was a valuable asset, because again I had no clue, nor did I really have the energy to worry about anything but Baby C.

After a few days in ICU, I was transferred to antepartum. Let's just say, I was the talk of the floor. Frankly, I'm pretty sure I shocked the nurses there. They usually deal with bed rest patients, pre-eclampsia, weight restrictive patients, etc. As they told me, I was a new case that caused them to think back to nursing school! Luckily, they were some of the most talented, caring and efficient people I have ever met. I loved them all! I like to think I was given special treatment, but I'm sure they were that wonderful with all their patients. :)

I was checked on daily by several different groups of doctors. First, I was usually woken up by the surgery team. My surgeon, Dr. Van Buren, sent his residents to check on me first thing in the morning and then he would come by later in the day. One of the main things they checked each day was my wound. It ran vertically down my stomach about 10 inches long, and started completely stapled together. However, as time progressed they had to take a few of the staples out because I was still pregnant and my stomach was still expanding. That left a pretty nasty opening that had to be changed twice a day. Eventually, they put a wound vac on it to help speed up the healing. While it was pretty amazing how quickly it started to heal, I absolutely despised the wound vac. It is used to suck air out of the wound and help expedite circulation, thus needing a completely air tight seal. Effective, yes--but extremely painful when they changed the dressing. In fact, they loaded me up with pain medication beforehand because I was such a baby about it! They even brought in the baby version of the adhesive remover so it wouldn't hurt so badly. It sounds silly, but this was literally the worst part of the healing process. I was only a diva about three things after my surgery and the following weeks of recovery (a stat I'm pretty proud of!). This was diva moment #1.

***On a quick side note, Dr. Van Buren is forever our guardian angel. I can't imagine how he operated on me without disturbing the baby. There were several life-threatening issues that could arise during this surgery. If my uterus was in the way, they would have to move it and cause potential problems. After a week or so, I asked him exactly what went down in the OR. He was able to maneuver around the baby and didn't have to move my uterus at all. He operated on me until late into the night. Later, his nurse told me that he could see the baby's hands and feet while operating. I don't care how professional of a doctor you are, surely that had to be a shocking sight. He even called me from his cell phone while he was on vacation to check on me (the nurses told me that they had never seen a doctor do that). He is an amazing person!***

I was also checked daily by MFM (maternal fetal medicine). Same process, residents first and then doctors. The doctors with MFM work on a rotation schedule, so I got to meet and see several different ones throughout the process. Again, I'm not sure how I lucked out but they were all incredible. They were all impressed with how well baby was still doing and told me they were shocked that I didn't give birth within 48 hours of surgery. I know that many people believe medical intervention should be limited, but I truly believe that because I was given an appropriate amount of pain medication my body was able to relax and I could stay pregnant longer. This proved to be such a blessing since Baby C came out PERFECT a couple weeks later. Funny enough, the maternal fetal doctor that eventually delivered Baby C, Dr. Bermudez-Wagner, ran into Chase...in our apartment hallway. They both had to do a double-take, but we found out that she lived directly across the hall from us. Sometimes it seems like things are just fate!!!

Additionally, I started seeing infectious disease. Unfortunately, I developed an abscess after surgery (not uncommon) and had to have a drain put in (OK I lied, getting the drain put in with no anesthesia was worse than the wound vac). It drained out infectious liquid that had collected after surgery. My diva moment(s) #2, was taking care of that damn drain after I went home a few weeks later (can you sense my hatred?). Because of this, I was on lots of antibiotics to keep an infection from spreading. The doctors in surgery and MFM were very people-oriented and communicated easily. When infectious disease came to see me, it was like they were speaking another language. However, I ended up really loving my ID doctor, Dr. Koo. He really did try to explain his plan of action to me, but eventually I think we both gave up (ha).

If you have ever been admitted to the hospital for more than a few days, you will know the feeling of "what's going to happen today?". So, I'll quickly run down a list of procedures I had done while pregnant.

1. Initial surgery

2. JP drain placed during surgery, pulled out 5 days later

3. Central line placed during surgery, pulled out 3 days later

4. Wound vac usage

5. PICC line placed to help draw blood and admister IV antibiotics

6. Ultrasounds every other day

7. Fetal monitoring twice daily for 30 minutes

8. Blood transfusion (twice)

9. Massage and pedicure (not kidding--thank you Diane!)

10. Developed abscess, discovered via ultrasound confirmed by CT scan

11. JP drain placed in right side of my body with NO anesthesia

12. Tubing was not large enough to drain the fluid, so 2nd JP drain placed WITH anesthesia (learned from my first mistake)

A midst all these procedures, I received my report from pathology. A few biopsies were taken during my surgery to find out what exactly had caused the perforation. My diagnosis: Crohn's disease. I can't say I was shocked, in fact, I almost expected it. I have always had a sensitive stomach and had visited doctors several times about it, but I always chickened out when they said they wanted a colonoscopy. Now, looking back, I can't believe I was afraid of a colonoscopy! I haven't quite forgiven myself for that yet.

Finally, after my tubing was replaced the second time, I started having contractions. My water broke the next day at 31.5 weeks. I then started a week long journey to delivery, the best day of my life!