Sunday, March 8, 2015

Gall Bladder Woes

Once again, I woke up at 3:30AM.  Instead of bleeding, this time I was in intense pain.  For the first few seconds, if felt like an awful back ache.  It didn't take long to escalate and become unbearable.  It felt like labor cramps, but it engulfed my rib cage.  I woke Nate and told him I was in pain, then went downstairs to try to walk it off.  I thought maybe the baby had cozied up in my rib cage, and I tried to push him out.  I thought maybe I had a spinal infection caused by my weekly progesterone shots.  I thought maybe it was appendicitis, but I couldn't tell where my appendix might be since my anatomy is all squished together because of my growing belly.  The thought that I could be in labor at 26 weeks 2 days put me over the edge.  That is just way too early to be having a baby!  And besides, my belly didn't feel tight.  I tried rocking on my hands and knees.  I tried massaging my back against the door jam.  I tried breathing through the pain.  After about an hour, I sent Nate a text saying that I needed him to come downstairs to give me a blessing.  I don't remember what was said, but I do remember thinking that this wasn't going to go away on its own.

So we left our sleeping boys in their beds, called a neighbor to come sleep on our couch, and left for the emergency room.

I was in so much pain!!!!  They had to put me in a wheelchair (they wanted to send me straight to labor and delivery, which freaked me out) and Nate had to answer all of the questions because I couldn't talk or think through the pain.  There was no question my pain level was at a 10!  I never thought I'd be able to say that, because I am no wimp, but this was a 10, no doubt!

They ended up taking a urine sample, getting some blood, doing a non-stress test (monitoring the baby's heartbeat and my contractions), and starting an IV with morphine.  After the morphine kicked in, I felt like I could function like a semi-sane human again.  There was still no way I was going to go anywhere without a wheelchair, and by the time the morphine started to wear off I started writhing around on the bed again, but I had a few hours where I could think through the pain, which was nice.

Anyway, long story short, they were going to assume that it was kidney stones and we'd just have to control the pain while waiting for them to pass.  My blood, urine, and kidney ultrasounds showed nothing to lead them to believe that it was kidney stones, but it was their best guess since they couldn't do an MRI on a pregnant patient.  They were discussing admitting me for pain management (ie, giving me a morphine pump), because a few hours of morphine and some oral pain meds were clearly not going to do the trick.  When those meds were wearing off and the pain was coming back, it was easier to tell that the pain was originating from just under my rib cage on my right side.  The wonderful L&D nurse (seriously, I hope she delivers this baby in 3 months) had a "light bulb" moment and said, "Let's do an ultrasound of your gall bladder!"

So they did it, and it took a while to get the results back, so they admitted me on the Mother/Baby floor, set me up with a morphine pump (literal life-saver, there) and let me order lunch.  I took a few bites of food and couldn't keep it down.  I didn't exactly feel sick, but my stomach was just rejecting anything, even juice and crackers.

Eventually, in comes the surgeon, Dr. Patterson, to explain to me that I do, indeed have gall stones.  Two large ones and many small ones.  The small ones could travel through the duct and into my liver or pancreas and cause all sorts of serious problems there, and one of the large ones is currently blocking the gall bladder duct, causing the spasms and pain.  He said that the best course of action for me would be surgery to remove my gall bladder, and if I hadn't had lunch (even though I threw it up...) he could have done it then and there.  He also said that it's common for pregnant women to develop gall stones, and that they only feel safe removing gall bladders during the second trimester, before the growing uterus makes it too difficult to do it laproscopically.  Since I'm less than 2 weeks away from my third trimester, time was of the essence.

So I immediately start "fasting" and we plan to do the surgery in about four hours.  It's usually an outpatient surgery, but since I'm pregnant they wanted to keep me at least overnight so they could do a continual non-stress test to make sure the baby was alright and that the surgery wouldn't cause me to go into labor.  Then, on second thought, the nurse comes back in and says that they want to transfer me to Utah Valley Regional Medical Center, where they have neonatologists and an awesome NICU (the very same one that Caleb stayed at for his first 100 days of life) that could take care of us in the rare chance that this surgery caused the baby to come early.  And since I was on morphine, the only way they could send me was via ambulance.

(*Side note:  When Nate told the boys that I was going to ride in an ambulance, Caleb said, "NO WAY!" like he was jealous because it was so cool.  Russ said, "Oh no!" like he was concerned because I must be really hurt.  Those boys are so different!  And so funny!*)

Anyway, I end up in L&D at UVRMC.  We waited all night to see the on-call surgeon, who wasn't exactly on-call...they tried for hours to reach him, and he just never answered his phone.  They would have gone with another surgeon, but Dr. Patterson had already talked to him and gone over my test results and medical history with him, so he "knew" me and my situation.  They eventually realized that the surgery wouldn't happen that night, and let me eat a little jello and drink some apple juice.  I promptly threw it all up.  Nice.  The surgeon, Dr. Rasmussen, ended up coming in late that night and talked to me about the risks and benefits of doing the surgery.  He basically put the choice in my hands.  I felt a little like I would be crazy to opt for the surgery, but crazy not to.  It was dangerous either way.  If we chose not to do the surgery, it could cause serious problems for my liver and pancreas, or cause me to be in extreme pain for the rest of my pregnancy, and once we got into the third trimester they wouldn't be able to do anything about it without delivering the baby first.  If we chose to go with the surgery, it needed to be done ASAP to minimize the chance that they'd have to do a big incision (instead of laproscopic) which would require a longer hospitalization and a much harder recovery.  It could also cause me to go into labor and deliver a baby at 26 weeks, which is kind of a big deal!  That's even earlier than Caleb, who was born at 27 weeks 1 day!  We were to let him know in the morning.  So Nate and I talked and prayed about it, and I just felt strongly that I trusted the first doctor's opinion more, and he suggested the surgery right then and there.  I felt that the off chance of going into labor, or needing an open incision and longer recovery time, were worth the risk.  After all, if I went into labor, they could probably stop it, or at least hold it off for a few weeks.  Not to mention, I couldn't spend the rest of my pregnancy dependent on morphine, and there was no way I could handle the pain without it.  And then there's the fact that I was completely unable to eat or drink....So surgery was our decision.

Yes, this is my post-surgical belly.  All incisions were glued shut.  The lower one is the biggest one, and it's about a finger-length above my belly button, and maybe 1.5 inches long.  Baby Boy likes to kick it.  I don't like that so much.  It was pretty badly bruised coming out of surgery.   The two on the side are super easy to ignore, and the one on the top gets easily irritated just because of its location, but it's not so bad otherwise.

So they did surgery the next morning!  It went well.  Four laproscopic incisions.  The doctor said my gall bladder was starting to look inflamed.  Baby was going nuts afterwards, tons of movement with a good, strong heartbeat.  It was all very comforting.  Before going into the OR I was feeling like another "gall bladder attack" was coming on, which just confirmed that this surgery was the right choice.  And when I came out of the OR, that pain was completely gone.  It was replaced by a new pain, the kind you feel after you've been cut open and an internal organ was removed, but that kind of pain is more tolerable because you know that it will improve with time.
Yes, this is my gall bladder and those are the stones.  I have no idea if they're as bad as normal, or worse, but you can see two bigger ones and many smaller ones.

They let me order a late lunch, and I didn't throw up!  And I haven't thrown up since (although I've been eating really small portions)!

They monitored my little guy all through that night and until they discharged me around noon the next day.  He has a really steady heartbeat.  I felt like I got to know him better through this.  After all, he went through everything right there with me!  He's been through a lot for an unborn baby!  The heart monitor picked up and magnified his hiccups, and he hiccuped a lot!  He also would kick all day long against the monitor, which makes a really loud sound.  This kid is gonna have personality, I tell ya.  But after all of this, I feel more bonded to him.
Have you ever wondered what the outside of a uterus looks like from inside the abdominal cavity?  Wonder no more!  That's where my little guy is housed.  I'd guess he's just over two pounds right now, and safe and sound inside of his little womb.  Awww!

I was discharged after 2 nights and 2.5 days total.  Recovering at home has been lungs hurt, which is a normal part of recovering from an abdominal surgery.  I need to cough and breathe deeply, but it just hurts so much!  I've got a slight fever, and that first night at home my oxygen levels had me worried.  But today I woke up feeling half-way like a functioning human, and tomorrow will be just a little better, so I think I'll be ok.  :)  We'll see how living a gall bladder-less life effects me...good thing I never really jumped on that bacon bandwagon!  It's safe to say I'll be sad if I can never comfortably eat a donut again.  So far I haven't had any morning sickness or heartburn.  I can't say it has anything to do with the surgery, but hey, I'll take it!  There's a good chance that I can go on living without ever thinking of my lack of a gall bladder ever again, and that's the goal.


Alice Anne said...

Holy crap!

Megan T said...

Wow this was completely interesting and slightly disgusting! I'm so glad you're feeling better and hope you completely heal quickly!