Jill - posted on 01/24/2009 ( 3 moms have responded )
Surprised by Joy - Surviving Placenta Accreta
I never imagined that motherhood was a dangerous endeavor. Yes, maybe back 100 years ago, but not today. Today pregnant women see their doctors regularly and are watched carefully for any possible complications --- or so I believed. If I was having babies 100 years ago I would not be alive today to tell you about it. I had a condition called Placenta Accreta during my last pregnancy, and thankfully through modern medicine, skilled surgeons and wonderful blood donors I'm alive here today. And today I have Joy. That is the name of my little baby girl. I can never have any more babies due to the emergency hysterectomy that saved my life, but I have two Limited Edition little girls who will bring me joy and love and happiness (not to mention their daddy who is my wonderful husband and friend). For the sake of perhaps helping someone else get through this I'd like to post my story here.
I have never had an easy time with pregnancy. I lost my first baby at 12 weeks due to a missed miscarriage. My second pregnancy resulted in my wonderful daughter Katie but was difficult due to 16 long weeks of severe morning sickness and then later terrible back pain. When I got pregnant for the third time I was hopeful that this time everything would go smoothly, but it didn't. I suffered from 22 weeks of morning sickness. I don't mean just being slightly nauseous, but really throwing up sometimes multiple times during the day. Thankfully to prevent me from completely withering away I was prescribed a drug called Zofran that can end the nausea within 5 minutes. I had to take it only when it was absolutely necessary though because insurance would only give me 8 pills a month and it just seems like a good idea not to take too much of anything while pregnant. Not only did I struggle with nausea but I also found that some foods would set me off the entire pregnancy. Basically my pregnant body hated sugar. Anything at all sweet and I would be sick. This really helped me not put on too much weight, but it seemed cruel that a pregnant woman wouldn't be able to eat sugary things.
By January the nausea was much better. I stayed away from foods that made me sick and things seemed to go well. Until one day when I was unable to keep even the 'okay' foods down. I had the stomach flu. I was thankful when that finally went away a few days later. I was glad it was just the flu and not some terrible new form of morning sickness that was there to stay.
In February I noticed that something strange was happening to my legs. One leg was becoming very swollen but the other leg was perfectly normal. I looked it up online and found out that it could be something serious. I called my OB and she sent me that day to have a leg ultrasound done. Baby ultrasounds are a lot more fun. They were concerned that maybe there was a blood clot, but there wasn't and all was okay. The swelling then went down. A few days later my husband and I went to a junior high camp where he was the speaker. While at the camp I noticed that my lungs felt strange. The heater wasn't working our first night in the cabin and by the day we left I had a terrible fever and felt awful. I came down with Bronchitis and an ear infection. Being that sick and pregnant at the same time is no fun at all. Somehow I was able to recover though - even though I was worried the entire time that I wouldn't be able to breathe well by the time I went into labor.
In March there were new challenges. This time my blood pressure started to rise and I started getting very swollen again. This was quite scary. I was very concerned about the baby. My feet and legs became swollen to capacity. They turned a bright purple and no shoes would fit. The doctor put me on bed rest and had me start coming in for NST to make sure the baby was doing okay twice a week. Our goal was to make it to 37 weeks so that the babies lungs could be well developed and ready for delivery. I made it, but not much further. On April 8th after being on bed rest for two weeks they decided that we needed to induce labor and get the baby safely out.
On Tuesday we went to the hospital for a NST and then to the OB for my regular appointment. My blood pressure was now very high and it seemed that the best thing to do might be to induce. The OB checked my cervix but it was still high and completely closed. She did not feel that it was good to give me pitocin until that changed. She then sent us back to the hospital to labor and delivery for another NST. At 2pm they came in and said they felt it was best to induce. They would begin by giving me Cervadyl to soften and help open the cervix. They said it would take at least 12 hours to do anything and they really expected it to take two doses so we probably couldn't’t start inducing with pitocin until the next day at 2pm. She told me to rest and lay there for 2 hours after which I could walk around a little if I wanted to. They would be back to check it at 2am.
Apparently things happened a little differently than they expected. The Cervadyl worked quite well on me. Within the hour they administered it (they stick it up there) I was having contractions every two minutes. Josh went home and put Katie to bed and then returned. I remember the contractions getting stronger and calling to see when Josh would be back. By the time he came back they were much stronger and familiar to me from my experience with Katie. I called in the nurse and she agreed to check me and my cervix was now dilated to somewhere between a 2 and 3. She called the OB and she said I couldn't have an epidural until I got to 4. The contractions continued to get more painful and to come every two minutes. I noticed that between contractions there was that sense of rest before the next bad one began. I felt a gush and my water broke on it’s own. I asked again for some pain relief. She checked again and I was at 4. They called the epidural man. He came and started to give it to me. I complained it wasn’t working. By the time he got it in I was at a 10. They didn’t have time to put the cath in or anything. I complained more about the pain and the fact that the epidural was doing absolutely nothing. There was nothing they could do.
I started to feel the strong desire to push. They had called the OB and she was on her way. They told me not to push until she got there. That is not an easy task. So for 15 minutes I tried not to push. The pain was pretty bad. I really wanted pain relief.
Finally the OB arrived. They said I could finally push. I did. It took a while but they said I was making progress. I was distraught because I knew I was going to tear and I knew that I had no pain relief or numbing down there. I requested something. They told me too late. Oh well. Josh was doing a great job standing by my side and encouraging me. I could also tell that he was quite scared. He told me not to stop pushing but to keep going. Later he told me that he could see the head and that she was blue and he was scared something was very wrong. They were giving me oxygen for the baby. I pushed more and got the head out and took a breath and Josh was telling me to keep going because I had to get the shoulders out. The order of things here is kinda a blur but I remember her hands being blue, her not crying at first but then she started crying, I remember Josh being quite distraught. I remember being told that I did tear. Also the placenta didn’t come out. There was a lot of concern about this. I tried to focus on my baby. They were pulling and doing stuff down there for an hour. I kept my mind on little Joy and kept telling them I could feel the sewing – not just pulling but sharp pain. It was very traumatic. After I couldn’t close my eyes without having weird kinds of flashbacks about the pain.
I again tried to focus on the baby. One of the nurses cleaned her up a bit. She was 7 lbs 1 oz and 20.5 inches long. The nurses again began to focus on me.
I was in a lot of pain and soon I noticed that I felt like I was going to pass out. I kept having contractions every 15 minutes or so. I remember wanting to faint to escape the pain. They didn’t tell me all that was going on at this point but apparently a lot of it had to do with the problems getting the placenta out. I kept asking for pain meds. They did finally give me something in my IV that helped a little with the mental part of it. They had to give me a catheter because my bladder was too full and everything was swollen and it was all causing great pain. They also starting pushing hard on my belly all the time. They said that there could be placenta still in there. They thought the OB might need to give me a D&C. I just remember it was all very scary and painful. There were two different nurses who would take turns pushing on me. They would ask me where it hurt the most and then push even harder there. I told them I felt like answering that question was helping the enemy.
Eventually the contractions became further apart. I started to feel less faint and they didn’t push on my belly as much. They started talking about moving me to the mother and baby floor. I felt terrible and had no idea how they were going to move me. I couldn’t stand. I couldn’t even sit. I tried to just focus on my baby. She was so sweet and nursed so well and was perfect and healthy.
A lot of it all is a blur but I was put on IV antibiotics because of the placenta thing and later I was told that I had lost a lot of blood and was anemic. They did a lot of blood tests checking my levels. When I left the hospital I was at a 8.3. I guess that is high enough that I didn’t need a blood transfusion. I was told to take prenatal vitamins plus 2 iron pills a day and bed rest for 2 weeks.
There is lots more to the story but the order and such are all a blur now. I did see the epidural guy in the elevator on my way to the mother and baby floor and complained to him that the epi didn’t work. He said he knew it didn’t but my labor was just going too fast and I should have requested it earlier. ARGH! I did request it earlier and the OB denied it to me. I had a hard time in the hospital. They apparently had a baby boom. The rooms were small and husbands couldn’t stay. I was unable to get up and hold my baby but nurses didn’t respond to my calls. They would say they would be in in 5 minutes but then I wouldn’t see anyone for 2 hours. Josh decided that at home he could take better care of me. The OB took two more blood tests and then agreed that I could go if I wanted to. I came home on Thursday night.
It wasn't over yet -- The ordeal
This is the hardest part of the story to tell. This is where I was supposed to come home and get better but that didn't happen. I'm not sure how much detail I can go into right now but here is the story the best I can tell it at the moment:
When I came home I was weak but happy to be home with my new baby and near my husband and toddler. I knew recovery would be difficult but I didn't expect anything really to go wrong. The first thing that went wrong was that Joy stopped having wet and poopy diapers. She was really good at nursing at first but suddenly she would get upset like she wasn't getting anything to eat. After many tears (mostly all mine) and calls to lactation specialists it became clear that we were going to have to supplement. My milk wasn't coming in and my baby wasn't getting anything to eat. I grieved the fact that I wasn't going to be able to nurse my baby but I had no idea this was only the beginning....
Within the next few days I starting passing very large clots. The bleeding seemed to be getting heavier instead of lighter. My blood pressure was not returning to normal as it should have. Finally, I noticed that the lochia had a very foul smell - I know it never smells good but this was particularly foul - like the smell of death. I was also having contraction type cramping regularly - almost every day. All of these things were warning signs in the pregnancy books. I called the doctor many times and was told everything was okay. Then on Tuesday, April 22nd things seemed to be better. My bleeding slowed down. On Wednesday morning it seemed to stop. I took Joy to the pediatrician for her two week checkup. Later I needed some formula so I drove to Wal-mart and ran that quick errand (now looking back I shouldn't have been driving due to my extreme anemia - oops). When I got home the cramping started. I laid down on the couch. Josh was getting ready to go to the radio station to record his weekly show. Suddenly I starting hemorrhaging. I knew this wasn't good. I went through a pad in less than 3 minutes. I called the doctor and she told me to go to the local hospital right away. I called my mom and then Josh and I and the two girls headed for the hospital.
This part of the story is difficult to tell. I was taken into the ER and they did pelvic exams and tried to remove the clots. I was very faint and panicked. There was a wonderful nurse who was with me the entire time, taking great care of me. They assigned me a doctor and he did an ultrasound right there and said that there was placenta still in and I would certainly need a D&C. I would also need blood as I had lost quite a bit. Soon I was waiting for surgery. I was panicked and alone. A nurse whose name was Joy came and sat with me. I was thrilled she had my baby's name. I was given a fast transfusion of blood while I waited for surgery. That helped the fainting feeling. If you are reading this and are a blood donor - thank you so much - you save lives!
After the D&C the bleeding did not stop. They tried giving me pitocin, they tried shots, they tried everything they could think of but it just didn't stop. My doctor slowly started hinting that I would need a hysterectomy. Finally the next morning it was clear that was what was needed to save my life.
I woke up from surgery in great pain. They couldn't give me more pain relief until my oxygen levels went up. The nurses were great and took wonderful care of me though. Soon I was able to have more pain relief and with the help of a drug similar to morphine I was able to handle the pain better. I had a long incision in my lower abdomen and 17 staples. I had two tubes draining fluids out of me and a catheter. I had an IV coming out of my neck! By the time I left I had received 10 different IV's in my arms and one in my neck. I had also had shots and blood taken more than I could recall. I was in the hospital for 6 days. I had to learn to walk and get to the bathroom. My anemia was terrible, I had lost a lot of blood and received at least 6 bags but it only left me at around a 7 hemoglobin. This recovery wasn't going to be easy.
People from my church came and visited me. I lived for those visits. My online friends sent me flowers and other friends and family called me on the phone. Every contact with each person meant the world to me. People were praying for me and for that I am forever grateful. God spared my life.
This post is just the details of what happened and not the emotional roller coaster that I was on. I was having to deal with a lot emotionally and together with the physical recovery I think that will continue for a while.
Finally I was sent home. The first few days at home were very hard. My wonderful mother-in-law was here taking care of my children (even caring for the baby at night). After she left people from church came each day to take care of us, then my parents came and then my inlaws came again and now my parents are back again. Basically I have had care every day since I've been home. I am so thankful for the love and care everyone has shown me. I couldn't have gotten through this without it. Last but not least my wonderful husband has taken such good care of me. He's been here for me the entire time and has dealt with my moods, emotions, crying etc... He is the best husband in the world.
A week after my surgery I went to the doctor for a post surgery checkup. I really wasn't ready to go out yet. My hemoglobin levels were at 8.4. I fainted once in the doctor's exam room and also on the sidewalk on the way to the car. That emotionally set me back. Then the iron pills started really hurting my stomach. The lack of sleep, the weakness, the stomach upset were all becoming more than I could take. I changed the type of iron supplement and slowly was able to start eating again and gaining more strength. This week I have been trying to go on small errands with my husband or parents to get used to getting out of the house. My goal is to be able to go to church on Sunday and baptize my beautiful baby girl.
There is more to this story, but that is all I can recount at this moment. I'm hoping my life may help someone else who is going through something similar.
With all that has gone wrong I must say how thankful I am. I have a wonderful husband. I have a loving and caring family. I have a church that has been such a huge blessing. And I have two little girls. I call them my limited editions - the mold has been broken and they are the last of their kind. I also have a body that is slowly healing and getting stronger. I have a strong desire to live and love and laugh again. Most importantly I have my faith in God. I know that I am still here on this earth for a reason, and that God has many good works for me to do. I know that God is good and even though I have suffered I shouldn't have expected any less. A servant cannot be greater than their master and my Lord and master Jesus Christ truly suffered. He suffered and died on a cross even though he was perfect so that my sins could be forgiven and He has risen from the dead so that I may be saved. I praise God for that wonderful gift of salvation He has given me and pray that he will use this life that he has saved from death to serve Him.