Friday, February 19, 2010

A life ends...one continues...

The ride on the gurney back to the ER seemed an endless maze of sterile corridors. My mind was in such a state of chaos as it handled both my body's growing malaise AND it's forced hand at conceding to what was becoming a more and more obvious rationale for my visit to the ER. My anxiety was bubbling now just beneath the surface. I did my best to remain upbeat as we approached my room. The nurses had brought Cole some books, toys and snacks and he was so excited to show me. It was such a surreal moment as I engaged in animated conversation with him all the while trying to ignore the growing pain and keep my cauldron of emotions from pouring out. As a mom, I simply was trying to put his needs first and bottom line I didn't want to scare him.

The ER had filled up quickly in the 30 minutes or so that I was off having the ultrasound. You could feel the increased energy and hurried pace of the staff. I was acutely aware of the difference and thought to myself, "great, we'll be waiting around now". I had very little time to ponder that as the ER doctor rushed in. He confirmed that I indeed had an ectopic, that I had blood in my abdominal cavity already and that I would need to be prepped for surgery immediately. He followed this with "there was cardiac activity so it has not ruptured yet but you are bleeding internally which is a major concern. The OB surgeon on call is on her way and should be here shortly". The sobs just came uncontrollably as his news sank in. With a grim face he apologized for the curt delivery of my diagnosis but he wanted us to know that things would be moving relatively quickly and that I should take something for the pain. He left and I just fell against Dave crying out "no, no, it can't be..." I felt an overwhelming and incredible sadness at the loss that was inevitable.

I was forced out of my fresh anguish temporarily as the realization of what was to happen next consciously put Dave and I into next steps mode. We had to figure out who to call, what to do with Cole... Dave was supposed to be on a plane to Las Vegas in the morning, who would walk Tucker...the balance of our lives became unbalanced in one fell swoop, changing on a dime everything that was routine.

Our cell phones didn't work deep in the recesses of the ER, so Dave had to step out to make the necessary calls. With tears bursting from my eyes, I told Cole that Mommy would be staying at the hospital, that the doctor's had to fix her tummy and that he had to be a good boy for his daddy. He seemed to sense my distress as my voice cracked with emotion. With his molten brown eyes, he hugged my arm and said "it is okay mommy". The tears coursed down my face as I smiled at him, told him how much I loved him and ruffled his hair. The nurse came in to begin the process of hooking up IVs and setting me up for a heart monitor. It had been some time since I had had another episode of pain, the adrenaline of the past 15 minutes having numbed me I suppose.

Dave returned having spoken to Heather, my best friend who was on her way to the hospital. The plan being she would return to our house with Cole and remain there until Dave could come home. He had also notified my parents. I was scared about what was going on and waiting on the surgeon to arrive to understand what the protocol was to be. I began to feel sweaty and faint again and knew another flood of pain was on its way. This time seemed different from all the others though. The OB surgeon popped in already dressed in scrubs. She quickly reiterated my diagnosis and the need to move me into the OR quickly. I was having trouble with this bout of pain and she noticed as she continued to speak with us. The nurse was still setting up IV lines and had yet to get the morphine drip going. I remember the OB surgeon saying I didn't look good. I remember saying how much it hurt and looking down willing myself to breathe through the pain. I remember looking at Dave and then finding myself unable to utter another word. Then according to Dave everything went downhill.

In the period of time from when I had my ultrasound to then, probably 40 minutes tops, the ectopic ruptured and I began to hemorrhage. My body went into hypovolemic shock. My heart rate plummeted, my blood pressure dropped dangerously low, I was in and out of consciousness...I vaguely recall the sudden activity in the room but I have no further recollection until I was being raced out of the ER. The drugs kicked in by the time we got to PRE-OP and I was panicking because I could not feel my extremities. "Why can't I feel my feet? I asked repeatedly. A nurse's face came into view and she calmly said, "listen, I need you to take deep breaths, you are in shock and I need you to work with me so we can stabilize you, we will take care of you but you are critical condition and we need to get you into the OR as soon as we can". The anesthesiologist arrived and I heard the nurses say "we need a few more minutes", not completing understanding at the time, that that was because they were concerned I was not stable enough for surgery. I was becoming more aware and lucid as the morphine coursed through my body allowing me to grasp the enormity of what had occurred in the past 1/2 hour. The ectopic had ruptured, the baby was no more. Now my life was at risk. However, my brain must have decided to over ride my emotional core as it switched to concentrating on the mundane instead of trying to digest the magnitude of the situation. I began saying "I'm wearing contacts, don't forget to take out my contacts" and "where will my jewelry go?" I remember being oddly calm, almost conversational. The surgeon came and walked me through what the surgery would entail. Based on what they saw on the ultrasound (and what was typical with ectopics) they would be doing a laprascopic procedure which would take about 30 minutes or so. I would be staying overnight.

They brought me into the OR. The last time I was in an OR was when Cole was delivered by emergency c-section. The bright round overhead lights, the "whiteness" of the walls, the sheets, the drapes...the soft voices of the nurses who offered their condolences...the awkwardness as they moved me off the gurney to the OR table...the smell of the plastic as the mask went over my face...it didn't feel like me this was happening too, it felt like I was a witness experiencing something for someone else...

I woke up dry-mouthed and groggy and wrapped up like a newborn. The same nurse hovered nearby and must have been watching for me to awake. She came over and began talking to me and initially it sounded all garbled. I couldn't shake the heaviness I felt. My memories here are foggy but I do remember being startled and beginning to cry when she told me that because of the amount of bleeding and the rare location of the ectopic, that the surgeon did need to open me up and go through my c-section scar. I had had unexpected major abdominal surgery along with a very high blood loss. They were still unsure whether I would require a blood transfusion but they would be monitoring me closely. I don't recall much else.

I was reunited with Dave and Heather somewhere, I think on my way out of recovery and came to find out that I had been in surgery for over two hours. Dave had taken Cole home, put him to bed because he refused to go with Heather. Our neighbor Jesse came over to stay with Cole and Dave returned to the hospital. Heather was frantic because no one had come out to tell her about the severity of my bleeding or that they had to open me up to save me. She finally found her way to a nurse's station and requested about my status. It was late on a Sunday evening and thus there were few people around. The person she found ended up being my surgeon. The doctor explained in detail about the ectopic being in a rare and dangerous location which when it ruptured had perforated my uterus, the fallopian tube was saved because the rupture occurred where the uterus/tube meet and the hole was created down in the uterus instead of up in the tube. They had to repair the hole and manage the hemorrhaging. I would be fine but I had lost a great deal of blood. They wanted to avoid a transfusion if possible because I was otherwise healthy and a transfusion could possibly become an issue should I ever get pregnant again. The consequences on the body of such trauma would take quite some time to mend. But I was alive...

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