Friday, 16 May 2014

Melissa's Story of Placenta Accreta, Previa, and Hysterectomy

 I'm fixated. I'm holding my breath. I'm praying. I'm concentrating intently upon an empty incubator.  I have to keep focus upon this plexiglass box towards my right. If I look towards my left I can see a monitor displaying flesh, hands, blood and gore. Those gloved hands, I realise are inside of my body. Those are the hands of the doctors attempting to extract my baby form my uterus. I can't look at that. I focus upon the empty incubator. I continue to pray. I hear a voice ask me, "Melissa. How are you doing?" I look up. It's one of the dozen masked doctors whirling around the room. I look him in the eye and ask, "Is that the baby crying?" He says no. "That is the sound of suction. Your doing great! We're almost there." He walks away. I stare at the empty incubator.
I have been diagnose with placenta previa and placenta accreta. Placenta previa is when your placenta attaches low in your uterus, sometimes covering your cervix. This creates a high risk pregnancy. According to The U.S. National Library of Medicine; "During pregnancy, the placenta moves as the womb stretches and grows. It is very common for the placenta to be low in the womb in early pregnancy. But as the pregnancy continues, the placenta moves to the top of the womb. By the third trimester, the placenta should be near the top of the womb, so the cervix is open for delivery. Sometimes, the placenta partly or completely covers the cervix. This is called a previa. There are different forms of placenta previa. Marginal previa is when the placenta is next to cervix but does not cover the opening. Partial previa is when the placenta covers part of the cervical opening. Or complete previa is when the placenta covers all of the cervical opening."
 Having placenta accreta means that your placenta begins to act like an amoeba. It starts to morph and attach to everything around it. It can attach to your uterus, your cervix, and your bladder. When you give birth, it most likely will not detach. So therefore, the doctors have to cut around where the placenta has attached itself. If the placenta has attached to your womb, cervix, they will have to take those along with the placenta. This creates a life threatening situation where you can bleed out, get sepsis, and die if not properly diagnosed and treated.
 I remember when I got out of the hospital  due to high blood pressure. I was so grateful that I did not have pre-eclampsia. I had pre-eclampsia with my prior children. However; I did have gestational hypertension, gestational diabetes, and now placenta accreta. The doctor said that the best case senerio would be to have a planned cesarean hysterectomy at 36 weeks. The alternative was to risk getting sepsis and possibly dying. I thought, "Thanks Doc. I wonder which door I should to take? Loosing my sex drive and womanhood with a side of crazy or eternal sleep? Decisions. Decisions." I remember being so angry at the doctor. I wondered why the doctor acted like it wasn't a big deal to get a complete hysterectomy.  I said to him, "Doctor, sir, I have no desire to have a hysterectomy. I would like to avoid it, if possible." “Oh. You’re not finished having babies? ” “No. Doc. That is not the case. I am definitely finished having babies. But, how would you like to loose 3/4 of your balls? Sure it still works, partially. However; do you still feel like a FULL man?” Of course, I didn't ask that. But I wanted to. I was adamant.  I did not want to have a hysterectomy. It's my uterus and I wanted to keep it.
 Lying there upon the operating table, I ponder upon my situation. I have both complete placenta previa and placenta accreta. I am an extremely high risk pregnancy. I and my team of doctors had been planning on a C-section, possible hysterectomy on October 11th, 2013. I am 34 weeks pregnant. I am in a room full of doctors, only two of which I know. I am alone with these doctors. My husband was not allowed to be with me in the operating room. I'm in the middle of an emergency c-section. I'm scared. I concentrate upon the incubator.
 Looking back,  I can not tell this story without including the tale of my other son Sirius. The stress of Sirius' plight caused me to go into preterm labor.  Previous to my emergency c-section, it was discovered that our son Sirius was very sick. His illness had begun the week before.Sirius had been walking on his tippy toes and claiming that his ankle hurt. Yet, he still ran around being a his normal jovial toddler self. This was Monday.
  •  On Tuesday, I took Sirius to daycare, like normal. An hour later, the daycare called me and said that I needed to pick Sirius up. He had not stopped crying and claimed his ankle hurt. I brought him home. My husband and I decided that we would wait to see if his ankle would heal before taking him to the doctor the next day.

  •  Wednesday, I called his regular doctor. We were unable to make an appointment. So I took Sirius to Urgent care to get x-rays. While there, he started favoring his left ankle & limping on his right. The nurse said he could be faking. After the x-rays came back negative, I began to think the nurse might be right. His diagnosis was a bruised heel. The doctor told me to give him Tylenol and keep him off the ankle as much as possible. He could go back to daycare on Monday.

  • Friday night Sirius refused to put any weight on his left foot. He started crawling like a baby around the house. He came down with a fever. Now I want to note that there was so swelling of the ankle. And Sirius was still wanting to play and go outside. But I knew something was wrong. I just didn't know how serious I should take it.

  •  Saturday and Sunday I went back and forth between Tylenol and  Motrin to keep his fever down. It never went away, just went down a few degrees. He seemed to progressively get worse. I didn't want to take him back to Urgent Care. On Monday Sept. 23rd, I was able to get him into his regular doctor.

That morning, I had an OB appointment. My husband Scott took Sirius to the doctor. While there, they took x-rays again. They came back negative. The doctor ordered labs. That's when the roller coaster ride began. Sirius' white blood cell count was off the charts, the doctor explained.We needed to take our son  to the emergency room immediately. I had a morning appointment at OU Children's Hospital the next day. So, I figured that would be the best place to go in case he had to stay overnight.
My little family waited in the big waiting room. You normally have to wait awhile in the emergency room before being seen. Not this time. Not for us. In a short time we were called into a smaller waiting room. There we met an Orthopedic surgeon that told us that Sirius had what was known as septic joint. He had to be operated upon immediately. The surgeon was explaining Sirius' diagnosis and the eminent surgery. I saw the man's lips moving. I barely could comprehend what he was saying. How could this be happening? My poor baby! It's my fault. I heard the words blood infectionsepsis, and critical condition. All of the sudden, I felt a large gush. I looked down to realize that blood was all over the chair and the floor. 

Everything seemed to slow down in that moment. I evaluated my situation. Where am I? I'm in the hospital. Why am I here? Because my son is sick. What am I to do? Deal with it. I began to cry.  My daughter started crying. My husband was reserved. My son was sick and sucking his thumb, asleep in his stroller. They brought me a wheelchair and carted me off to maternity urgent care.
While there, my hemorrhaging became increasingly worse. They began to prep me for an emergency c-section. The panic that I felt accelerated to a screaming roar. I couldn't have my baby now, I pleaded. My husband could not be with me. My husband had to be with my son during his operation. He was being prepped at that moment! I want to be with my son! He needs me. How could this happen?! What bad timing! 
 I soon endured hours of torture that entailed, but was not limited to; magnesium sulfate drip, starvation and denial of water.  I was poked and prodded for IV lines. And the most fun of all, I was subjected to a catheter.The doctor came to tell me that they were going to move me out of Urgent Care. I was moved to a new room on the maternity floor. There, I waited for hours to find out if I was to have an emergency c-section. I hoped that they would put me on hospital bed rest. I prayed that they would let me wait to have the baby on my scheduled c-section, three weeks away. My hopes were dashed when the doctor came in to tell me that they had scheduled my c-section at 11:00 the next morning. No ands, ifs, or buts about it. And I needed to prepare myself for a possible hysterectomy.  Fabulous.
 I called my husband for an update on our son. It had been decided that the doctors would post pone his operation until 11:00 the next morning. The exact same time that I was to give birth. They had given Sirius morphine for the pain, and he was asleep for the time being. Morphine. My three year old son needed a full blown morphine drip for his pain. I had been giving him Tylenol & Motrin and thinking he might have been faking. I officially felt like an asshole. I couldn't even be there to comfort him.
It occurred to me that this situation was  way beyond my control. My only options were to leave the situation to God, pray, and focus upon the task at hand. 

On September 24th, 2013 at 1:13 PM, my son Corvus Asher Clark came into this world blue and not breathing. I remember, it took five minutes for my third child to take his first breath. I heard him cry like a kitten. He was quickly presented to me so I would be able to see his little face. I kissed him. I watched the doctors place my baby into the incubator. I finally could breathe. Corvus Asher was whisked away in the incubator and delivered to the neonatal intensive care unit. He was 34 weeks plus 3 days gestational age. He weighed 5lbs 3 ozs and was 17 inches long.

          Immediately, the doctors attempted to detach my placenta from my uterus and cervix. It seemed as if it was going to come off cleanly. Alas, it did not. My complete placenta previa / accreta would not allow it to happen. They told me that it was time now to go to sleep. And that's what I did. I slept for another 5 hours while they carved my placenta, uterus, and cervix from my body.

 My son Sirius had to have a total of three operations on his left tibia to flush out the infection. He had what is known as MRSA. MRSA is an antibiotic resistant staff infection. Very heinous stuff. He was in the hospital for a total of three and a half weeks. They released him with a PICC line. He sported that for and additional eight weeks. By the grace of the Lord, he's healthy now. You can't even tell he was ever sick.

 Corvus Asher had to wear a cpap to help him breathe for three days. He had jaundice. He had to stay in NICU for 13 days total. Even though he was preterm, and he did not breathe for the first five minutes of his life, there is absolutely nothing wrong with him. He is as perfect as any baby could be.
 I was released from the hospital first, out of the three of us, after six days. I did not have time to nurture myself and heal. I ran on overdrive. I had two boys in the hospital, at the same time. I had a daughter and husband to care for. I had to put all my focus upon their healing. And they did heal. I healed too. Other than a nasty vertical scar that goes from my belly button towards my nether region, and having to have two pints of blood transfusion, I feel absolutely no damage from the experience.
 Pertaining to my uterus, it's strange knowing that part of your body is dead. Never to be alive again. I thought that it might have been a decent gesture to give my dead uterus back to me. I could've built a little cedar coffin so that I may bury it in my back yard. Do a service over it. Plant a tree, possibly. Is that's too macabre? Maybe. But it's too late. My uterus is gone forever. I wonder what they did with it. Did they burn it? Did it go over to the college for the medical students to study? Did they trash it? My poor wrecked uterus sitting at the bottom of a trash can. I shudder to think of it.
I'm OK with not having a uterus. My son is alive. Both my sons are alive. For this, I am truly grateful.  Asher is quite the consolation prize. The whole experience feels strangely surreal. But I don't morn my uterus being gone as much as I thought I would. I was afraid that having a hysterectomy would kill my love life. Thank goodness, that did not come to fruition. I will never have a period again. Who wants a monthly bloody mess anyway? I will never be able to be fertile again. I have three children. When my youngest is 18, I will be 55. It's OK. I'm done having babies. I accept it.   

          So, what is to be learned from this experience? I guess the main thing that I learned was when everything is absolutely crazy, you have no control over the situation, it is the utmost importance to have faith. You must give your troubles to your higher power and pray, breathe, and keep focused upon the task at hand. If you do that, things should work out the way that they are meant to be. Even if that means you must loose an organ in the process. Life will carry on.

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