12w6d - Recap of TAC surgery (long post)

The surgery is done and it was a success. Baby did great! I got home last night but didn't have the energy to write my post here as I knew it would be a long one. So here goes...

Monday
We arrived at the hospital in Camden at 5:20am and at 5:30am we were escorted up to the surgerical waiting area. The hospital common areas and waiting areas were very nice (and after our frequent hospital visits in 2010, we figured we're qualified to compare them.) After getting my ID bracelets and signing my life away, they took 8 or 9 of us patients with their family member from the waiting area and moved us all to the pre-op curtained areas. There we waited awhile but eventually met with nurses, anesthesiologists, the nurse anesthetist, our doctor and more I can't remember, where I repeated answers to the same questions asked many times over (ok with me though, I'm happy to make sure everyone is on the same page.) They put in my IV and put me in this purple paper-ish gown. In all of my surgeries I've never seen this type of gown but it has air vents in it (think vaccuum cleaner bag.) In the pre-op and operating room, they hook up a machine to the gown and it blows warm air into the gown to keep you toasty warm. Interesting idea and quite pleasant really as pre-op and the OR are always chilly. At around 7:45am I kissed and hugged DH goodbye and the nurse anesthetist walked me into the operating room.

Once in the OR, I listened to nurses and surg techs do their inventory of equipment for a couple of minutes and then it was time to get my spinal. Like I mentioned in a previous post, I'd never had one before so I was a little nervous about this. I sat on the table and leaned against the nurse anesthetist (CRNA), curving my back into a C while the anesthesiologist first numbed my back with a local anesthetic and then did the spinal. I was expecting it to hurt more than it actually did, but it was only slightly uncomfortable. As they were laying me back down on the table I could already feel my legs getting warm and heavy. Then came the prickly feeling and oh, I did not like that one bit! As they were putting inflatable booties on my legs to help prevent blood clots, I had that prickly sensation you get when your foot falls asleep - ouch! I asked the CRNA if this feeling would eventually go away and thankfully she was right - it did go away. They warned me that I may feel tugging or pulling during the surgery and if it got unbearable I should let them know and they would knock me out. Oh hell, that really got my nerves on edge. But in the end I couldn't feel a thing from the ribs down. I could see Dr D and the OB/GYN assisting him wiping my abdominal area clean and prepping the area but I couldn't feel it at all.

They put in a catheter (thank goodness they did this after the spinal - catheters freak me out) and hooked me up to a bunch of monitors. They put an oxygen mask on me and to help relax me they gave me some propofol. Not enough to knock me out because me being awake and conscious would be best for the baby, but just enough to relax me. It really did help because once I lost feeling of everything ribs down, I did feel quite anxious. I just kept breathing deeply to keep myself calm. Before surgery started they did a quick ultrasound to show me the baby - there he/she was kicking and stretching, moving all around. That glimpse of baby was all I needed to distract me for the remainder of the surgery. They put the curtain up over my chest so I couldn't see what was happening but I remained awake for the procedure.

That air-vented gown came in handy in more than one way in the OR. Not only did it keep the top third of my body toast warm, it blocked out sound. I was thankful for that because as much as I like to document things, I really didn't want to hear "scalpel" or other surgical terms when I know it's my body they're cutting open. I could hear the docs ask each other how their New Year's were before they started the surgery but after that I distracted myself pretty well. I did talk to the CRNA at times during the surgery - she was very comforting and encouraging - and she was located right next to my head so she was the only one I could see the whole time. Once they'd finished placing the TAC and before they closed me up, they said "there's your baby's heartbeat" and I looked over to the left. They'd rolled the u/s screen over and there was our baby, h/b flickering away beautifully. Now, I could really relax - the baby had made it through just fine even after they had to shift the uterus out of the way to place the TAC. Thank God!

They closed me up and wrapped my abdomen up tightly in a binder, calculated my blood loss (negligible), and unhooked me from all of the machines. When it came time to move me onto a stretcher, wow, my legs felt like tree trunks. What a weird sensation to not feel anything. They did some fancy rolling of my body and voila, I'm on the stretcher headed to the recovery room. I arrived there at 9:30am and about an hour later they brought DH into see me. I must say it was really nice to be in recovery and not be all groggy like you experience when coming out of general anesthesia. I was perfectly alert and aware and happy to see my hubby. DH was only allowed to stay for about 5 minutes but it was great to share in our excitement and relief. He'd spoken with Dr D shortly before coming in to see me so he knew things went well. Then I waited and waited and waited. I was not waiting for hospital staff mind you. I was waiting for my body to be able to wiggle a single toe. I'd be able to leave the recovery area and go to my room once I could wiggle a toe. Every 5-10 minutes I tried like hell, but damn it, nothing would move! Finally at 12:30pm, the big toe on my right foot wiggled and I was sent up to the mother/baby floor of the hospital.

Once in my room (thankfully a private one), they did vitals, put on the inflatable booties to help prevent blood clots in the legs, and I waited for DH to get there. I wanted to sleep but I still couldn't - all that adrenaline I guess. DH did visit for awhile and I made a couple phone calls. At 4:30 dinner arrived - I was suddenly starving - and my clear liquid dinner was delicious. I'm serious. I loved my chicken broth, apple juice, and orange water ice (I passed on the jello and tea.) That evening they also gave me a breathing thingamajig to use - I had to inhale deeply a few times every hour and make sure some plastic thing inside it rose appropriately. They also gave me a folded blanket to put on my abdomen while I coughed. I was supposed to do a few good deep coughs each hour and holy shit that really hurt! But both the breathing thing and the coughing are supposed to help with recovery. By 8:30pm the effects of the spinal had finally worn off, I could feel both legs and all toes without any tingles, and the pain meds they used with my spinal were just not cutting it so I got my first dose of painkillers, Dilaudid. Unfortunately that only gave about 1.5 hours of relief so that night I slept in 1.5 hour blocks and spent 2.5 hours trying to get comfortable before I requested more pain meds. The rest of the night went on with that same pattern. The nurse only came in for vitals every few hours to try to let me sleep but I really wasn't able to sleep much anyways...not surprised.

Tuesday
After sleeping very little I finally just turned on the TV at 5:30am and looked forward to breakfast. I really just wanted a cup of decaf coffee and maybe a little fruit or whole wheat toast. Imagine my disappointment when I saw my tray of clear liquid diet arrive. Ah well, at least it's something I thought, my poor stomach growling away. I had 1/2 a cup of tea, the apple juice, and the orange water ice (I tell you that orange water ice was delicious!) and skipped the chicken broth and jello. Then I waited to be given permission to get out of bed and start walking. All morning I waited and waited, shifting uncomfortably in my bed as I watched the clock tick, tick, tick. Lunch came around 11: 30 and yep, clear liquid diet again. UGH!! This time I partook in the chicken broth, grape juice (pleasant change from the apple juice), my delicious orange water ice, and some hot water with lemon. At this point too, I'd gone about 7 hours without painkillers (I was holding off as long as possible) but I needed some, so we switched to Percocet.

At 12:15 we got word from the doctor that my catheter could come out and I could get out of bed. WOO-HOO!! (We also got word that I could now have regular food, but I was full from my liquid lunch and decided I'd just have regular food for dinner.) The catheter came out (momentary ouch and then ahhhh, relief) and I sat up on the side of the bed (longer, more painful ouch.) As I put on some hospital issued panties, my doctor and a med student shadowing him came to my room. We walked to the u/s room together - me, my nurse carrying my IV, my doc, and my med student. I slowly and painfully got up on the table and they did a transvaginal u/s. They could see the abdominal cerclage (looks great) but they could not see cervix below it. Apparently I had a great deal of bowel gas and a surprisingly full bladder interfering with their view. At my next appointment the week of the 17th, things should be much calmer for my insides and we should be able to get a better view of the cervix. My concern though was the baby - did it have any stress after the surgery? Did the painkillers do anything harmful? And of course I could not see the u/s screen while they looked around. But then Dr D told the u/s tech "Turn on the sound so she can hear her baby's heartbeat." Ahhh...that sound that instantly put a smile on my face.

Doc said if I felt good when he stopped by at the end of the day, I could go home that night, YAY!! So I spent the afternoon sitting up in a chair in my room and walking around the floor of the hospital. I probably over-did my walking a little, because by 4:30pm I was ready for another painkiller. 4:30 was also dinner time. Dinner was not great by any means but I had a little turkey, mashed potatoes, applesauce, and finally had my cup of decaf coffee. Ahhhhh. No more liquid diet. By 5:50pm, the doctor had come to see me, signed my discharge papers, and gave me a big hug.

DH and our dog picked me up in front of the hospital at about 6:40pm and we drove to CVS to pick up my painkillers and some gas pills. I think a lot of yesterday's pain was from all that gas. We got home just before 8pm and I took a gas pill and a stool softener and ate some fruit salad I'd made Sunday night. Then around 9pm I took one painkiller and went to bed. I was out like a light. It was a pretty painful night though. I woke up often and every time I tried to get out of bed to go to the bathroom I yelled out in pain (poor DH cringed every time he heard me yell.) Long night, but happy to be home.

Wednesday
Today it's SLOW going. I'm in a LOT of pain today. Getting up from sitting or laying position is the worst followed closely by any movement whatsoever. But I know moving around is helpful so I'm walking around the house 2-3 times/hour. Coughing is terrible as is blowing my nose. I should be able to drive in 2 weeks or as the doctor said - I can drive once I can stand on the bottom stair and jump off of the step with both feet at the same time and land without pain. Lord knows I'm not going to be trying that anytime soon...the thought alone makes me shudder. I'll go back to see the doctor on Monday to remove my staples...all 22 of them, OUCH!! Normally he said he'd remove them after 3 days but my abdomen skin is a little "beat up" from having kids and my previous abdominal surgery. In other words, it's just a pile of mushy skin. :-) So we'll leave my staples in a bit longer.

So here are a couple of pictures.

Here's the little one on Tuesday. What a relief to see he/she was ok after the surgery and night of pain I'd had.



And here's my incision with it's 22 staples. The "waffly" pattern above the incision is from the binder they had on me. To the side & above are scars from puncture marks from previous laparoscopic surgeries. And below are just a boatload of old stretch marks. I like to call my stomach Rand McNally after the road atlas.



So that's how my TAC surgery went. Overall, it was excellent. The pain sucks, but it's expected. The staff at Our Lady of Lourdes Medical Center in Camden was excellent. And Dr George Davis is amazing. We're so thankful for him and for our family & friends who have been cheering and praying for us. I'll check back in during the week to let you know how the recovery is going but now it's time to yell as I get up and walk around the house a little. :-)