Memorial Day, Monday, May 25, we were having some friends over for a BBQ. Right before they came over, I had finished pumping milk for Paris (maybe I have not mentioned this here- I had been pumping breast milk for Paris. Josh, Janelle, and I agreed that this would be a good thing for her for the start of her life, so I agreed to pump for a month). I stood up and felt a huge blood clot coming. I ran to the bathroom in time, but saw that the clot was really big, as big as my fist. I called my cousin who is a midwife and asked her if I should be worried. I was 3 weeks postpartum and had not had any symptoms like this. I felt like my recovery was going really well and nothing was super out of the ordinary. My cousin said she was concerned about the sudden clot and recommended that I call my doctor the next day, as soon as I could.
Tuesday, I called the doctor's office and spoke with the nurse. I explained my symptoms and she told me not to worry unless I was bleeding through a pad every hour. I wasn't, but I reminded her that I had had a retained placenta at the birth, so she said she would talk to the doctor and call me back. She called back that afternoon and told me that they wanted me to go in for an ultrasound right away. I went in and the ultrasound lasted 45 minutes. The tech went out at one point to talk to the radiologist and came back in and told me they wanted to get more pictures through a vaginal ultrasound. At that point, I was pretty sure they were seeing retained products in my uterus, but of course they weren't telling me anything, so I didn't know for sure.
Because the ultrasound was late in the afternoon, I didn't hear from my doctor (who had to get the results dictated from the radiologist) before my symptoms picked up. That evening, I passed another huge clot and then started just bleeding out. I don't know how else to describe it, but I literally could not leave the toilet, I was bleeding so much. Of course this worried me a lot and we started to think about going to the ER (as it was after hours now). I called my doctor's office on the on call line to be sure and they told me to definitely hurry to the ER.
Devin and I packed up and got to the ER around 7 or 7:30 PM. The ER doctor told me that he would get a hold of the ultrasound pictures from that afternoon and see what he thought. The next thing I knew, he was back in telling me that he had seen them, there was definitely something retained in there, and he had called my doctor, who was on his way in. Let me just pause here and say that this is blessing number 1. The ER doctor did not have to call in my doctor, he could have called the laborist to come see me, who was on call and already at the hospital. My doctor also did not have to come in. He wasn't on call; he was home with his family in the evening time. However, he made the decision to come in and see me, and I'll be forever grateful. He arrived and let me know that the best course of action was to take me in for a D & C, just to clean out everything that was in there. I remember him telling me it would be an easy 30 minute procedure and I would go home that night. I asked about pumping before hand and we decided that I would just wait until after since it would be so quick. The sweet nurse tracked down a pump and supplies and told me she would have it waiting for me in the recovery room.
I was wheeled down to the OR at around 8 pm. It was a fun little tour of the OR, a place I never go in the hospital (I was at the hospital where I work). I was transferred to the operating table and the anesthesiologist met me, put a mask on my face, and that's the last thing I remember.
The rest of the story is obviously second-hand, since I was out. Here is what I know. My doctor started the D & C and quickly saw that a portion of my placenta had grown into my uterine wall. When we talked about it later, he said that he thought this was there the entire pregnancy and said it was called Placenta Accreta. He had been confident that he had gotten the retained placenta out after Paris's birth, but this piece remained undetected. He was also unsure why I hadn't had any symptoms until 3 weeks later.
My doctor started working to remove the piece of placenta from my uterine wall, which he said was made more difficult by the fact that a muscle had partially grown over it. He said he had to be really aggressive in his attempts to remove it, but nothing was working. He eventually called in the laborist to assist him, so I had two OB/GYNs at that point, one running a camera inserted through my belly button in order to see things better and the other working on the removal. He said that there was also someone running an ultrasound at times. My doctor also mentioned that my uterus was tipped in a weird angle, complicating their ability to see the area they needed to see.
Devin was getting fairly nervous by this point as he had been told I would be out in 30 minutes. Nearly an hour and a half had passed without word. I think he talked to my mom a time or two and from the sounds of it, both were getting concerned about what was going on. My doctor called Devin around 9:30 PM from the OR to tell him of the complications. He called back 30 minutes later to tell Devin that through his continued attempts to get the retained placenta, he had accidentally perforated my uterus. I had lost a liter and a half of blood and required a blood transfusion by this point. He gave Devin options of what he could do, including attempting to repair the hole, but the retained placenta embedded in my uterine wall would remain an issue. He also said that a hysterectomy would be the safest option as it would stop the hemorrhaging and remove the original problem. Devin said later that he felt a lot of pressure having to make this decision without my consent, but he felt it was definitely the safest option and we had had prior conversations about being done having children, so he at least had that knowledge before consenting to the hysterectomy.
My doctor then cut me open and performed the partial hysterectomy. Luckily, I was able to retain my ovaries, which means that I will not go into immediate menopause and will not need to take hormones. I later asked my doctor when we were processing through all that had happened why he made the decision to do an open hysterectomy, instead of a laparoscopic one. He told me that mine is the 4th open hysterectomy he has ever needed to do, but he made the decision to do it that way because the situation was emergent. It sounds like I was losing a lot of blood and that was the safest way to quickly remove my uterus and remedy the situation.
The first thing I remember when waking up is how much pain I was in. I don't remember opening my eyes, but I remember saying over and over, "I am in pain. I am in pain!" The recovery nurse said, "Yes, you had some complications with your procedure." I asked her, "What kind of complications?" She said, "I can't tell you." Then the next thing I knew, she was on the phone to give a report to the nurse who was going to take me on the surgical floor. I heard her review my symptoms, the intent for a D & C, and then she said "And she ended up having a hysterectomy!!!" So, that's how I found out that I had had a hysterectomy. Not the best.
It was after 1 in the morning when I made it to my room and Devin was there waiting for me. I think I made him repeat 10 times what had happened (I was still drugged up), but I do remember understanding what had gone on and feeling like this was the best course of action, even though it was hard. (Don't worry-- mega emotions came later. I am going to make a whole separate post on that).
The hysterectomy was Tuesday night and I had to stay in the hospital until Friday night, first because I had lost a lot of blood and they wanted to make sure I did not need another transfusion, and second because they wanted to make sure my incision was healing well. I also had to be able to get up and move around on my own, walk the halls, and poop before they let me go. I was so happy to have my coworkers be able to visit me, and visit they did. I have the best co-workers, truly. Otherwise it would have just been me and Devin that whole time (no other visitors allowed). Devin stayed right by my side and I am so grateful. My mom came and got the kids for the week, which was so, so helpful. I also had fantastic nurses, most of whom I knew from working at the hospital. It's a little hard being on the other end of things, but since they knew me, I feel like they gave me extra care and concern. I was also seen by the physical therapist for a few days and I loved her help too.
One other note here... I had quit pumping cold turkey and that was also hard on me. I could have still pumped and dumped the milk for a time, but this just seemed like too much work for me, so I never pumped again after the surgery. This obviously caused physical pain, but was also difficult to have that taken from me not on my own terms. I sent home the last batch of milk from my freezer to Paris on Saturday, the day after I got home.
The rest of the story is obviously second-hand, since I was out. Here is what I know. My doctor started the D & C and quickly saw that a portion of my placenta had grown into my uterine wall. When we talked about it later, he said that he thought this was there the entire pregnancy and said it was called Placenta Accreta. He had been confident that he had gotten the retained placenta out after Paris's birth, but this piece remained undetected. He was also unsure why I hadn't had any symptoms until 3 weeks later.
My doctor started working to remove the piece of placenta from my uterine wall, which he said was made more difficult by the fact that a muscle had partially grown over it. He said he had to be really aggressive in his attempts to remove it, but nothing was working. He eventually called in the laborist to assist him, so I had two OB/GYNs at that point, one running a camera inserted through my belly button in order to see things better and the other working on the removal. He said that there was also someone running an ultrasound at times. My doctor also mentioned that my uterus was tipped in a weird angle, complicating their ability to see the area they needed to see.
Devin was getting fairly nervous by this point as he had been told I would be out in 30 minutes. Nearly an hour and a half had passed without word. I think he talked to my mom a time or two and from the sounds of it, both were getting concerned about what was going on. My doctor called Devin around 9:30 PM from the OR to tell him of the complications. He called back 30 minutes later to tell Devin that through his continued attempts to get the retained placenta, he had accidentally perforated my uterus. I had lost a liter and a half of blood and required a blood transfusion by this point. He gave Devin options of what he could do, including attempting to repair the hole, but the retained placenta embedded in my uterine wall would remain an issue. He also said that a hysterectomy would be the safest option as it would stop the hemorrhaging and remove the original problem. Devin said later that he felt a lot of pressure having to make this decision without my consent, but he felt it was definitely the safest option and we had had prior conversations about being done having children, so he at least had that knowledge before consenting to the hysterectomy.
My doctor then cut me open and performed the partial hysterectomy. Luckily, I was able to retain my ovaries, which means that I will not go into immediate menopause and will not need to take hormones. I later asked my doctor when we were processing through all that had happened why he made the decision to do an open hysterectomy, instead of a laparoscopic one. He told me that mine is the 4th open hysterectomy he has ever needed to do, but he made the decision to do it that way because the situation was emergent. It sounds like I was losing a lot of blood and that was the safest way to quickly remove my uterus and remedy the situation.
The first thing I remember when waking up is how much pain I was in. I don't remember opening my eyes, but I remember saying over and over, "I am in pain. I am in pain!" The recovery nurse said, "Yes, you had some complications with your procedure." I asked her, "What kind of complications?" She said, "I can't tell you." Then the next thing I knew, she was on the phone to give a report to the nurse who was going to take me on the surgical floor. I heard her review my symptoms, the intent for a D & C, and then she said "And she ended up having a hysterectomy!!!" So, that's how I found out that I had had a hysterectomy. Not the best.
It was after 1 in the morning when I made it to my room and Devin was there waiting for me. I think I made him repeat 10 times what had happened (I was still drugged up), but I do remember understanding what had gone on and feeling like this was the best course of action, even though it was hard. (Don't worry-- mega emotions came later. I am going to make a whole separate post on that).
The hysterectomy was Tuesday night and I had to stay in the hospital until Friday night, first because I had lost a lot of blood and they wanted to make sure I did not need another transfusion, and second because they wanted to make sure my incision was healing well. I also had to be able to get up and move around on my own, walk the halls, and poop before they let me go. I was so happy to have my coworkers be able to visit me, and visit they did. I have the best co-workers, truly. Otherwise it would have just been me and Devin that whole time (no other visitors allowed). Devin stayed right by my side and I am so grateful. My mom came and got the kids for the week, which was so, so helpful. I also had fantastic nurses, most of whom I knew from working at the hospital. It's a little hard being on the other end of things, but since they knew me, I feel like they gave me extra care and concern. I was also seen by the physical therapist for a few days and I loved her help too.
One other note here... I had quit pumping cold turkey and that was also hard on me. I could have still pumped and dumped the milk for a time, but this just seemed like too much work for me, so I never pumped again after the surgery. This obviously caused physical pain, but was also difficult to have that taken from me not on my own terms. I sent home the last batch of milk from my freezer to Paris on Saturday, the day after I got home.
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| Last batch of milk going home with Paris. This was a labor of love! |
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| Little gross for some, but it's not close up :) An incision in my lower belly and a laparoscopic scar in my belly button. |
Update: When I later followed up with my doctor after the hysterectomy, pathology results showed that I had something called subinvolution of the placental site. He gave me a description of this and I have done some reading on it as well. It is a rare complication that causes secondary post partum hemorrhaging. Basically, part of my uterus did not "clamp down" as it normally would after delivery. It took some time to try to do this as it normally would, but took 3 weeks for me to then start hemorrhaging. My doctor did not know that this is what was going on with me when he took me in for the D & C. I had retained products in my uterus, which he struggled to get out. This caused him to perforate my uterus. Because this happened, I then ended up with a hysterectomy. He told me at my visit that he believes that everything happening the way it did was likely a blessing in my case. Even if he had remedied the retained products with a successful D & C, because we did not know I had the subinvolution going on, I would have gone home and continued to bleed. Secondary post partum hemorrhaging is the leading cause of maternal mortality. I may have thought the bleeding was normal or not worried as much after having just had a procedure. Honestly, the more I have read about this condition, the more I feel so grateful and blessed that things happened the way they did. They were horrible at the time, but with more knowledge, I feel confident that my life was spared that day because of the way things happened. The subinvolution of the placental site happens just randomly and we did not know about it. But because I had retained placenta, I went in for the D & C and because my doctor then perforated my uterus while trying to take out those embedded products, I needed a hysterectomy right then. I am so glad that I did not go home that night and continue to hemorrhage. At best, I would have ended up with a hysterectomy later anyway, and at worst, I could have hemorrhaged out and it could have cost me my life.
More than ever, I am so grateful for the divine intervention that occurred in my life that day. I wrote about the spiritual experience Devin had that day in the emergency room and the line of my patriarchal blessing, which literally goes right in line with what happened. My blessing promises me what came to pass in my behalf that day. Miracles are real. God is present in our lives. I have no doubt of this.
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