My stomach hurt. I first complained on a Tuesday evening after dinner. I blamed it on what I thought to be bad spinach. I had a bowel movement the next day. The pain was gone.
My stomach hurt again Thursday morning. I blamed it on the leftover piece of fried chicken from the grocery store that I hurriedly ate because Maria had her first pediatrician appointment during the lunch hour.
My stomach pain lingered into the next morning. Russ was supposed to leave for Charleston early Friday to accept his CPA Merit Award. He offered to stay behind to care for me and take me to an urgent care clinic, but I quickly told him no. I doubted their treatment plan, predicting that I just needed to have another bowel movement, which I had and was soon pain free.
On Monday, I complained of a sore throat before Russ left for work. My caring husband went to the grocery store and brought home orange juice, chicken broth, and throat lozenges before leaving me that morning. My stomach soon started to hurt yet again which trumped my complaint of a sore throat. I was praying to God to help me get through the pain and apologizing to Maria for not being myself as I breastfed her.
Unlike the previous week, I had a bowel movement that morning and the pain did not go away. I began to worry of the possible reasons for this pain. The pain was localized to my left lower abdominal quadrant. I ruled out constipation and a small bowel obstruction. Maybe a urinary tract infection? Weird spot to feel pain though. Could it be my ovary? No. I have never had any problems with my reproductive system. Perhaps colon or ovarian cancer? Scary thought.
Russ called during his lunch as he usually does. He asked me how I was doing. I told him I was feeling stomach pain again, but this time it was not going away. He asked if he should leave work. I finally said yes. I needed him to care for me and Maria. The pain was so great that I could no longer refuse professional medical help. After packing the diaper bag, we were on the road.
I was going back and forth between going to urgent care or the emergency department. I always question whether or not insurance will cover the complaint. On the way there, Russ asked me to rate my pain. I told him it was an 8. He made the executive decision to take me to the ER. He dropped me off at the door while he parked the car. I registered at the front desk and proceeded to wait in the waiting area. I rocked back and forth quietly praying, "Oh, God" repeatedly. I was seen in triage without too much of a wait. Waiting for a room is what took awhile. So I continued to rock and pray in the waiting area while Russ rocked and played with Maria.
We were finally called back once I was assigned a room. I slowly walked to meet the ER patient care assistant. She took one look at me and asked if I needed a wheelchair. I asked how far the room was. She said it was at the other side of the department. Russ spoke up for me and said that I needed the wheelchair. The PCA soon whisked me off to the long-awaited room. Shortly after we were in the room, I felt nauseated and Russ brought the trash can to my side. I blamed the nausea on the quick transport from the waiting area to my room.
While I was grateful for finally being in a room, the waiting process there continued along with my intense pain, my rocking for comfort, and my simple mantra. It was almost an hour before I hit the call light to ask for assistance. When a nurse finally responded, I asked for a warm blanket and if someone was going to check me in soon. While it took her a while to finally meet my requests, she soon redeemed herself by getting the ball rolling with the admission and kindly keeping us informed on what was going on.
When she asked me to rate my pain level, I told her it was still at an 8 but approaching a 9. The ED doctor came in shortly after to evaluate me. He ordered a CT of the abdomen and pain medicine. When I questioned whether or not it was okay to still breastfeed with narcotics, he advised that I "pump and dump" while I received the narcotics. When he left, I asked Russ to hand over Maria so I could nurse her one last time before we had to introduce formula to her and before I received the IV narcotic.
Before I was transported to CT, I was given 2 mg of Morphine. Prior to the scan, I could not help but notice that the Morphine still had not kicked in. The CT tech recognized me as a familiar face from 6 North. After the scan, she told me that it could possibly be kidney stones. She transported me back to my room in the ED. I shared with Russ and my nurse what the CT tech thought it could be. I guess that kidney stones are a common postpartum complaint?
But the kidney stone suspicion was a technician's take, not a radiologist. The ER physician returned to let me know that the CT scan revealed a 12 cm benign teratoma. I assumed that I would be admitted, but he said that if the pain was under control, I might be able to go home. As the 2 mg of Morphine did not work, I could not picture my pain being controlled on some pill form narcotic. He asked me if I had a gynecologist. I told him no and that I had a midwife deliver my baby 4 weeks ago.
The nurse came and asked to rate my pain after the Morphine. I told her it was maybe at a 7 or even still an 8. The doctor then ordered 1 mg of Dilaudid to be given prior to sending me for an abdominal ultrasound. And thank God for Dilaudid! After feeling dizzy for a few seconds after receiving this drug, my pain was next to nil. Once I was being scanned for the ultrasound, I asked the technician why this teratoma was not seen when I had my other ultrasound done at 20 weeks during my pregnancy. She said that it could have been disguised as the bladder, as it is the size of a grapefruit.
When I returned from ultrasound, my new nurse asked how the Dilaudid had worked. I told her that the pain decreased, but was back at a 5 to 6. While I was away at ultrasound, the ER doctor had contacted the gynecologist on call. It was thankfully a physician from the WVU group. She and I had already met briefly at my 25 week appointment. As the pain was still lingering, the gynecologist told the ER physician that because the pain was still present, she wanted to remove the teratoma that night. The ED doctor told us that she would be heading over from Morgantown shortly for this emergent surgery. Russ and I were happy that it was happening during my maternity leave and not later.
Once the gynecologist finally arrived, she explained her plans to remove
this benign teratoma that was 10-12 cm in diameter and an ovary that it
had somehow twisted around. "Pump and dump" had come up in conversation
as was advised by the ED doctor. She told me that his advice was
incorrect, as mothers who had cesarean sections were on narcotics and
still breastfed. How could I forget that? She told me that I could still
nurse Maria prior to surgery, but I needed to "pump and dump" for 24
hours from the start time of surgery due to the anesthesia. We were now awaiting the operating room staff to come in. When she
left, I asked Russ to hand over Maria yet again before I received the
anesthesia.
My husband and I had discussed the possibility of this surgery so matter-of-factly between ourselves should it happen. When we were told that it was actually going to occur that very evening, we started calling friends and family to inform them and request their prayers. We both had trouble making it through conversations without tears in our eyes and shaky voices. We had asked our dear friend Kate to be present as almost another parent for Maria while I was unable to be my full self. Without question, she was there for us. Actually the only relevant question she asked was if we would like to use the breastmilk that was left behind of a fellow mother whom she used to work with. As we knew that this mother followed a relatively good diet, we gratefully said of course we will feed Maria with her breastmilk! Since I had to dispose of my breastmilk, it certainly beats formula! I had also called a fellow nurse friend and asked if she could track down some formula samples from the OB floor just in case we ran out of the breastmilk.
At about 10 o'clock that night, I was taken to surgery. I told Russ to take Maria home that night as they could both be more comfortable there. I assured him that the nurses would take good care of me. The OR transport tech, who I usually interact with being charge nurse on the floor, meticulously transported me over bumps on the way to the OR. I was grateful for her kind consideration with my abdominal pain. My last memories prior to surgery were saying goodbye to my two loves and two supportive friends who were present, receiving an anesthetic through my IV from the nurse anesthetist, and being lifted from the stretcher to the surgery table.
As I awoke after surgery, I remember trying to talk to the nurses with a sort of oxygen tent on my face. At that point, the anesthesiologist and the gynecologist were the ones now saying their goodbyes to me, their patient. The details I recalled from what the gynecologist told me that night was that the surgery went well, I could breastfeed again by 10 that night, and she would see me in the morning.
When the majority of the OR team had left, there were only two nurses left behind. I thanked them for coming in on short notice. They told me they had to be there as they are PACU nurses. I looked around the room to become acquainted with my environment and realized I had been there many times as a nurse to pick up PCA pumps and/or to transport patients back up to 6 North. As I was the only patient left in the recovery room, these two nurses were most enjoyable to talk to. Because the anesthesia effects were wearing off, I suddenly remembered these two helping out on our floor to start the difficult IVs that no one else could place. When asked about my pain, I actually rated it as a zero, but it would probably increase with movement.
After I was given excellent care by these two nurses, they transported me up to the OB floor. I continued to be blessed by a very caring night nurse. Just as my manager tells our staff, it is truly the little things that matter to the patients. From a patient's outlook, I was so thankful that my small requests of ice water, warm blankets, and a pen were given as I asked. The OB nurse took the time to patiently show me how to "pump and dump" with their very classy hospital grade Medela pump. I was in awe of how this gadget works! Prior to this pumping experience, I was very antsy for when I would need to start pumping.
Later that morning, the gynecologist came in and reviewed what happened during surgery. She told me that once I urinated, walked, and passed gas, I could go home. I didn't even have to have a bowel movement? I was thrilled at the thought of going home that day if I could accomplish those 3 goals.
And I did.
(My recovery from surgery story may or may not make it as another post!)
