ER - The Final Episode

I bet you're thinking you stumbled across the wrong blog. I don't usually write about frivolous things like the latest TV show. However, it's pertinent in this case to my healing.

I remember watching the first episode of ER. I was hooked. I loved the interplay of Dr. Greene, Dr. Ross, Dr. Benton, and Dr. Carter. So many things in my life have changed since that day, but that has been one of the constants - Thursday night at 9 pm. I haven't watched consistently in a long time, but I decided to watch last night's episode.

It started off okay. They got to the twin labor and delivery, and I was okay. (I can finally watch re-enactments of the happy deliveries without freaking out.) I watched them deliver the second baby, and I was still okay. The first gush of blood came out of mom, and I started to get a little tense, but I was okay. The second gush came, and I'm starting to think maybe I should switch to something else, and then... gush number 3, uterine inversion, mom starts losing consciousness, call for blood, start IV's... I jump off the sofa, grab my daughter, and run for the stairs. I rush to get her put to bed, and run back downstairs to change channels before the commercial is over. I'm shaking, edgy, panicking, and trying desperately to calm myself. I was up half the night crying.

Right after Peanut was born, I kept asking my husband and best friend questions about my birth. I have no visual memories after the attempted manual removal of the placenta. I have some memories of sounds, but no pictures. My nightmares were terrifying to me because I didn't have the pictures, so I kept looking for them to give them to me. I'd ask, What did they do? What did it look like? Anything to get a description of what had gone on. I've accepted this lack of visual information. I've gotten used to the missing time frame. Having that visual experience last night totally has me freaked out.

I'm achy, hollow, anxious, edgy, and exhausted. I want to hide in a small dark place, and forget what I saw. I want to forget the fear, the anger, the panic. It was like they wrote MY story into the script. The baby was in the warmer, Dad standing to one side watching, and it all falls apart.

I haven't been this bad in a long time.

I HATE feeling like this. I HATE being this new person. What did I do to deserve this?

I wrote this on Friday morning. I'm glad to say that by noon, I was feeling better. Still edgy, but not jumping out of my own skin edgy. By the time I got home, the stranglehold was gone. I could think about other things, talk about other things, be myself.

I sometimes forget how far I've come. It came in such small, baby steps that you miss where things began to change. Despite my being triggered, I'm grateful to realize that this experience doesn't control me the way it did in the past. Within 36 hours most of the intrusive thoughts were gone. I didn't have another nightmare, and the flashback was only in the immediate time frame of being triggered.

My husband wants to delete the recording from the DVR, but I won't let him. I know I have to watch the entire thing. I won't watch it today, and probably not tomorrow, but in the future I need to see it. In order for me to be free, I have to face it.

This was my story. It may have a few tweaks, but it's the story I live with everyday.

Uterine Inversion

I haven’t advertised my blog. I don’t link to it on any bulletin boards. I don’t include it in my online signatures. I have only told a few people about it, my husband, counselor, and best friend; however, I did set up the tools to see how or if people are finding it. Some of the queries have been sort of interesting, and I thought I’d try to address one today.

I had a partial uterine inversion after my daughter’s birth. According to Baby Center’s website, since I don’t feel like delving into a journal article today, a uterine inversion is defined this way:

Uterine inversion is a potentially life-threatening complication of childbirth that occurs in as many as one in about 2,000 births.

Normally, within about 30 minutes of a vaginal birth, contractions cause the placenta to separate from the wall of the uterus. After it separates, it comes out through the vagina on its own or with the help of the doctor or midwife, who may pull gently on the umbilical cord. (With a c-section, she manually removes the placenta right after delivering the baby.)

Sometimes, a placenta doesn't separate normally. And, in rare cases, attempts to deliver it cause the uterus to literally turn inside out such that the top of the uterus (the funds) comes through the cervix or even completely outside the vagina. This is called a uterine inversion and it's a true obstetric emergency. It can cause serious bleeding and shock, and requires immediate treatment.

So, my uterus didn’t come all the way out through the cervix, it just collapsed on itself. I had a low-lying, anterior placenta. This means that the placenta was below my belly button in the front. Some studies have shown a correlation between cord traction being applied to the umbilical cord and the incidence of inversion. I’ve never really believed that to be true in my situation. The doctor did attempt cord traction, but the umbilical cord tore off the placenta. Given the location of the placenta, I’ve never been able to figure out the physics of how this would cause the uterus to collapse from the funds, top of the uterus. The doctor then tried to manually remove the placenta. At this point in time, he still hadn’t diagnosed the inversion. It wasn’t until much later after I’d gone into shock that they diagnosed the inversion as part of the problem.

I had so many complications, that things sometimes get tangled up in my brain. I’m never really sure which complication or procedure caused the results; however, I was in massive amounts of pain. I was hemorrhaging, and I went into shock. I know the blood loss caused me to become hypertensive, extremely low blood pressure, but I don’t know if that was from the inversion or retained placenta. It was probably a combination of both.

There are several ways they can attempt to correct an inversion. In my situation, the doctor used nitroglycerine to relax the uterine muscle, so that he could put it back in place. After that, they performed the D & C, and used cytotec and pitocin to get my uterus to contract back down to the normal size.

There are some advantages to having this happen. I really didn’t have any blood clots because the doctor had done such a good job scraping out my uterus. I only bled for about a week, and then had discolored discharge for an additional couple of weeks. I couldn’t go without using personal hygiene products, but it was much less than I’ve heard some women discuss.

Unfortunately, there are some disadvantages as well. Obviously, since I was in surgery I missed out on the first hours of my daughter’s life. I needed blood transfusions. I had a difficult recovery. I ended up with PTSD because of my feelings of helplessness. I was incredibly weak from the blood loss. Just carrying my daughter upstairs to her room exhausted me. I’m also at risk of this happening again in any future pregnancies. The odds of having another placenta accreta / retained placenta are very high due to the D & C they performed. Because I’ve already had one partial uterine inversion, the risks for that are increased as well.