The Day It All Changed

I'm making the story of the actual hysterectomy on this separate page. The main blog will be a post (a letter to my uterus) for every day of the year following my hysterectomy.  It's important for me to share this story for several reasons, the two main ones being:

• I need somewhere to let it out, to put everything down that I might not necessarily want to say aloud. 
• A warning. This does happen. This could happen to you. It wasn't going to happen to me. People praised my uterus. Doctors, fertility specialists, everyone said I was made to have babies. My uterus was "perfect"... "beautiful"..."ideal". It was all of those things-- until it wasn't.

*Warning*Graphic Content/Visualization*Warning*

(seriously.... it's pretty intense at one point)

I delivered my 3rd surrogate baby on May 29th of 2015. It was my 3rd delivery, 2nd c-section. I was 40 weeks and 1 day; officially "over-due". 

Other than the normal pain of a c-section, all seemed to have went well. My OB at the time (I have since switched) commented that my uterus appeared a little thinner than he expected but nothing alarming. The baby came out, he was perfect, and I was sewn back up.  I went home the morning of the 31st, two days later. My pain was manageable with ibuprofen, I was walking (albeit somewhat slowly), and ready to start the next part of my journey: pumping milk for a milk bank. 

Sunday, Monday and Tuesday (the 31st through the 2nd) were just like any other postpartum recovery day.  I was pleased that I had minimal bleeding. My pain was starting to become non-existent, and I'd even made a few very small excursions. 

On Wednesday-- some point mid-morning. I don't remember exactly because I didn't really document it.. I felt a larger than normal gush as I was up and moving around. I hurried to the bathroom to find that I had filled a pad, passed a clot into it, and soaked my pants. I sat on the toilet and continued to drip blood for several minutes. It was a constant drip. Eventually it stopped, I hopped in the shower to clean myself up and went on my day. I sat down at my desk to pump breastmilk at some point around noon. I completed my session, and felt a little cramping. If you've breast fed or pumped after a delivery before, this shouldn't shock you. The action of that causes contractions, it helps your uterus get back down to the little teeny size it normally is when there isn't an 8 lb baby in it, placenta, and tons of fluid. I went to stand up and immediately *gush*. After the first time which ended in me throwing away some underwear because I didn't even want to bother with them anymore, and a blood-smudged bathroom floor, I'd thought ahead. I'd absconded from the hospital with some extra chuck pads (those big blue pads they lay on the bed under you) and I had one on my desk chair-- just in case. My pad was insta-soaked again, along with the butt of my pants and the pad I sat on. Another clot had splashed out and down my leg onto my carpet.  This time was worse than the first. I sat on the toilet for an hour, with a constant drip. At one point I had my husband bring me a mug to try to get an idea of how much I was losing. After the initial gush was I "filling a pad in an hour"?

If you don't get the reference, you may not have delivered a baby recently. When you leave the hospital they always say to come back if you develop a fever or are filling a pad in less then an hour.

Inside the toilet looked like a warzone--- It seemed like a lot of blood, but I couldn't really tell. Maybe just a few drops made the water that red? I'd dumped another clot off of my pad and into the toilet... that could make it seem worse than it was... I decided I should probably go in. I was cramping fairly bad, but I felt fine otherwise. I put on a clean pad, found new pants (again) and was ready to tell my husband to take me in. And then it stopped.  Not just slowed down, but stopped. 

I waited around, afraid to sit on furniture or stand on carpet for another hour. Nothing. We got a phone call that our truck (which was at the mechanics) was ready to be picked up, I decided to go with my husband to pick it up because I was a little leery of being alone, just in case. We went and picked it up without incident, had it inspected (for our yearly registration) and I realized I'd left my phone at the mechanic shop. We went back and since I was still slow moving, my husband hopped out to get it. As soon as he left the truck. I felt it. Another gush. At least I have leather interior and not cloth..... I didn't even bother moving. I felt it gush once more and then stop. When my husband got back in the truck I told him I thought we should probably head in to the Emergency Room. He started driving that way and asked if there was any way my doctor could get me in to check it out. I still felt fine. It didn't seem like an emergency.  My words. Not his. 

I called the doctors office and relayed what I was experiencing to the medical assistant. At first she told me "You will still have some vaginal bleeding even after a c-section". I was aware of that. I'd done this before. I told her I how I was insta-soaking pads and I filled a mug half way just sitting there. She put me on hold and spoke with the doctor. When she got back on she informed me that according to the doctor it was "highly unlikely" he'd left any tissue in there because it was a c-section. He said that he could prescribe me Cytotec if it got heavier and/or I wanted to ensure everything was out of there. She warned that it could make me bleed heavier. They advised if I started feeling light-headed or began fainting I should go to the ER. She also said to start taking my Ibuprofen again as sometimes that can help stop the bleeding.

By this time we were parked in the Hospital parking lot. I had them call in the prescription. The medical assistant said this is what she would have done. My husband drove me home and then headed back out to get the prescription. In the meantime I reached out to some fellow surros with what they would do/considered normal. Several of them had experienced clots heavy bleeding in their later pregnancies (3+), and others had really bad experiences with cytotec. 

By the time my husband got back with the prescription, I decided I would wait and take it if I had another gush. Some of my reasoning:

• I hadn't been allowed to try cytotec to acheive my vbac because the contractions would be too intense for my uterus to handle and may rupture (according to this doctor). So, it flat out petrified me to take it now that my uterus had JUST been cut open and was still being held together. 
• I was already bleeding so much and they assistant said I would bleed more. The whole reason I called was because I didn't want to be bleeding that much.
• The doctor said it was unlikely there was any retained tissue/placenta-- so why torture myself trying to force something out that was not there/
• And finally... my bleeding had completely stopped. Again. 

For the rest of that night and the next day (Thursday) I pumped while sitting on the toilet because I didn't want another gush. I put a pad down wherever I sat /laid.  All day I felt great. I had maybe a quarter sized amount of blood on my pad after wearing it for most of the day. Perhaps it was just getting out the last little bit of blood or maybe there had been something in there and it was expelled? Either way, I was happy. It didn't seem that weird to me either, I remember with my last two pregnancies thinking my bleeding had stopped and then it would pick up for a few days before actually stopping. This had been more intense, but it had followed the same pattern. 

Friday morning was fine as well. I stopped pumping on the toilet, walked around without fear and was feeling great. I was still taking my Ibuprofen, a little afraid to stop again in case it made the bleeding pick back up. I laid down for a nap around 2pm and when I woke up and sat a few hours later.. gush. This one was a bit smaller, and more easily contained. It also didn't last very long. So I wasn't worried. A few hours later we went to the grocery store to pick up some dinner and the walking made me bleed a bit, but it was more on par with regular postpartum bleeding. 

I went to bed around 11 that night after my night time pump. When my husband got to bed finally it was 3am on Saturday and it woke me up. I sat up and you guessed it... gush. Another trip to the bathroom. I was getting good at this without making messes any longer. This time was immediately different. As soon as I sat down I felt a few clots pass, and then the cramping started. It was fairly intense. I risked a look and saw that I was again losing a good amount of blood.

I tried to stand in a hot shower and got light headed. Sat back down and passed more clots. I fought through it for an hour and it started to slow down, but by this point I was pretty light headed and just wanted to lay on the floor. I woke my husband up and told him we needed to go in.

We woke our three year old piled in the truck and went to the ER. I walked myself in, because I realized I didn't have my wallet or glasses. These were important things to have.. so I instructed hubby to go home and get them. I walked in and told the desk clerk what was happening and they sat me in a wheelchair. A few minutes later I was being wheeled back to a room. I remember noticing that I wasn't feeling any more blood and thought to myself they were going to think I was lying/exaggerating. 

The man handed me a gown to get into and left me to change. As soon as I bent to pull down my pants I started bleeding again. Even worse now. It poured out onto the floor. I managed to get into the gown and I was standing there, legs spread looking down when he came back in. I think I shocked him. His eyes widened and he helped me on to the bed while calling for the ER doctor. The ER doctor came in "Hi,Michelle I hear you've had some bleeding..." he trailed off. "Well, not some bleeding... a lot of bleeding." He corrected himself when he saw the floor and the bed under me. While some nameless guys hooked IVs into me, I asked for pain meds, and the ER doctor lifted up the gown. 

He had someone handing him these long..... sticks. I really don't know what they were. They were thin and long with big balls of hard-ish cotton on the end. I don't remember much of this but I remember he kept asking for more. He has my legs in stirrups and was pulling out clot after clot with these sticks. I think finally he gave up. I heard him yell at somene asking where my blood results were (blood count?) he said "Tell them stat, and I mean stat not ten minutes from now damnit."

He left the room. The room was cleaned(ish) and my husband and son were allowed in who had just got back). They'd covered me and the bed so no one could see the catastrophe underneath. My son was so tired. I felt so bad for him. I updated my husband with what had happened and I told him they were probably just going to give me the cytotec now and possibly some blood. No one had told me this, but it made sense in my head that was how they were going to treat me. I told him to take the 'baby' home and let him sleep. I'd message him when I was being released. He fought me, but I said there was no point in him and our son just standing outside waiting. 

A few minutes after they left, I was being wheeled down the hall, to another ER room. If I wagered a guess, it looked like a trauma room. It was huge. I asked why they were moving me and the techs told me it was just going to be less cramped since there were a couple people helping me. I'm sure they were trying not to worry me. It succeeded. I wouldn't want to be working shoulder to shoulder by people. 

Everything they were saying was pretty low or outside of the room altogether. By this point I was fairly certain they were going to give me blood. I tried to message my husband but I had IVs in both arms and couldn't bend them. They gave me a shot in my butt. metho--something. It was supposed to stop the bleeding, and then they put in EIGHT suppositories (also anal) that was supposed to stop the bleeding. 

Things became a little more serious to me when I saw my previous OB (the one who did my c-section), walk in in scrubs. He asked me if my husband was here, and I explained we didn't have a baby sitter and he was home with our son. He told me, we should get him back there. Then he said they were going to take me back and do a D&C and just get rid of anything that was left. I asked if they were "going to give me something for that... it sounds painful". He told me they would be putting me out. 

STILL I didn't realize the severity. I asked a tech to get my husband on the phone and update him. I asked if when I came out if I could have my phone waiting for me so I could update him. He took my phone and started trying to reach my husband as they wheeled me down the hall. The doctor handed me a form mid-walk. It was a consent for the procedure. With the knowledge that there was a 1% chance of hysterectomy from the procedure. Scary, but not horrible odds. Besides, people had D&Cs all the time. We got to the OR and the moved me onto the bed. 

Now things got real. The computer systems were down and they weren't supposed to start the surgery until they were up. I heard a nurse say something a long the lines of "I don't care what we're supposed to do, we need to get her under now! We can't wait."

I started crying. I told the nurse not to let me die. I had a three year old, a son. Don't let me die. She asked how old the baby was.. I said I was a surrogate. She said "Oh bless your heart". She patted my head and covered my face with the oxygen breath. She kept telling me to breathe. The tech with my phone rushed in. "I have her husband on the line." They'd already started the gas.. I could taste it. It tasted horrible. They pulled it away for a second and they held the phone to my face. "I love you" I said. "Goodbye." Mask back on. They told me to breathe in deeply, but my lungs felt paralyzed for just a few seconds. I was awake but couldn't breathe. Then blackness. 

I need to stop here for a minute and say the next little bit is all pieced together from what my husband and the doctors told me later.

My body made it exactly a half an hour before it needed assistance to keep going. I was transferred to life support as they continued to work on me. Another doctor (my now current OB) was called in. He arrived about the same time. He told me later than when he walked in and saw me, he didn't think I was going to make it. They tried everything, even things that had a low success rate, but they thought maybe combined with other things would stop. In no particular order: They clamped off the main blood flow to my uterus, the tried medicines, the D&C, they inserted a catheter into my uterus and blew it up, trying to make it clamp down and contract. They said a uterus is usually like a flexed muscle, mine was like a lump of fatty tissue. It didn't try to do anything. Finally.... the hysterectomy. An hour in another doctor was called, and to her I owe my life. She diagnosed the issue. I was suffering from DIC. I'll post a fuller article on here later about it, but you can Google it. Here's the short-form:

Disseminated Intravascular Coagulation is a disorder where proteins that control blood clotting become over active.Copy/Paste from here : When you are injured, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If you have DIC, these proteins become abnormally active throughout the body. This may be due to inflammation, infection, or cancer.
Small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage the organ and it may stop working properly.
Over time, the clotting proteins in your blood are consumed or "used up." When this happens, you have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause healthy red blood cells to break up when they travel through the small vessels that are filled with clots. 

So basically I clotted. A lot. Then I stopped being able to clot. And bled out. DIC has anywhere from a 50% to 75% death rate. We have a few family friends that are nurses, and I'm glad I didn't speak to them until after I was released. A few of them said DIC is also known as "Death is Coming" and another said that out of a handful of people she's known to have it, I'm the only one that survived. THAT is moment stopping, heart pounding when you are told something.

My husband arrived about an hour into the surgery and was updated only after it was completed in another hour. When the third doctor had arrived the second OB said I had finally stopped bleeding, but only because I had no blood left in me. They were pumping in a bag every three minutes and it was still not fast enough. A bag of blood. Every three minutes. Take a moment to let that sink in. They worked on me for 2 hours, finally slowing the bleeding enough to close me up, but they had to leave a drain in because I was still in DIC, and still not clotting. My husband wasn't allowed to see me for 45 minutes while I was moved to a completely sterile room. He had a few choices and papers to sign in the meantime.

He signed for a Central line to be placed in my neck, as well as another one in the artery in my wrist.  I also had the two 'normal' IVs in each arm. The abdominal drain as I mentioned. The picture below shows most of these, I also had a NG tube, which fed through my nose and down into my stomach. I was also intubated, so I had a tube down my throat and a machine breathing for me. The picture was taken a day after these were removed.

With the two lines (neck and wrist) they were able to get plasma, platelets and blood cells into me faster.

I can say now that at this point I had the easy job. I wasn't 'there' for all of this. For almost 12 hours I was out (counting the first bit when I was just under anesthesia). For Glen though, my husband. He spent the next 8 hours in a room with me, with machines breathing for me. With doctors telling him they really didn't know what would happen. I'd depleted the blood supply at the hospital and they'd had to call in the red-cross for back up. They'd considered life-flighting (air transport) me to another hospital that was better equipped, but there was wonder if I would survive the trip.

He updated my family and friends as best as he was able. Updated the internet. Most of you who are reading this. He cried. My parents were on their way making a 15 hour drive. His mom arrived about 4 hours into his 8. He finally had someone there with him. See what I mean when I say I had the easy part? I don't know how anyone watches that? I can't even imagine.

I started coming around towards the end, but they sedated me a few times, my body wasn't ready to sustain consciousness.

Back to me memories.... I remember hearing people speaking (I'm guessing in between sedations). I remember waking up once and seeing my mother in law. Everyone says my eyes went wide. I can imagine they did. I remember wondering how she was there. She lived 4 hours away. They just took me back. Back to sleep. Awake again. They told me I had a breathing tube, not to talk, not to fight it. Back to sleep. When I next woke up (or at least thte next time I remember) I felt them pull the tube out of my throat. I looked around. So many nurses. And a doctor. A lady doctor. I'd never seen her before. Glen was standing by his bed, and my mother in law too. The doctor told me I was in ICU. That was the moment. Somehow I knew. Something told me to ask. "Uterus?"

"I'm sorry" she said, "We had to take it to save you."

Tears. Glen came to my side and leaned down. He said "We can adopt how ever many babies you want." <3 <3 <3

I drifted in an out and honestly the first day or so is a bit foggy.

I was in DIC until late Monday night, when finally by body started making all those good clotting properties on it's own. I was awake and talking and slowly feeling better. The doctors told me I wasn't quite out of danger yet, but that didn't make sense to me. I HAD been on life support, and now I wasn't. How could I still be close to death. Evil thing, DIC.

They removed the NG tube on Sunday. Quite possibly even worse than getting the vent tube removed. I didn't realize it was super long I felt it moving out of my stomach and up slowly through my chest and out finally through my nose. Monday I lost the two lines (neck/wrist). Tuesday I finally lost the abdomen drain. Another weird, and slightly painful experience. The drain tube was line up against my incision to suck away any fluid/blood from around there. So I felt it rub all the way along it as they pulled it out, another thing that was longer than I imagined. Not horribly painful, but not comfortable, and I don't want a repeat. Ever. They glued the little hole in my side shut. And Wednesday I had the staples removed a few hours before I was finally released.

Wednesday a few more puzzle pieces came together- and my thoughts and future actions will be chatted about at a later date.  They sent my uterus for a Pathology report. I guess that's pretty normal, but I didn't know that so I assumed we would never really know what happened. The pathology report came back and my new ob explained the findings as he pulled 30 some odd staples from my abdomen.

I'd apparently had Placenta Accreta (when blood vessels and other parts of the placenta grow too deeply into the uterine wall.) and I was starting to develop Placenta Percreta (The placenta attaches itself and grows through the uterus, sometimes extending to nearby organs, such as the bladder) He said it hadn't attached to any organs but had grown completely through the wall. SOMEHOW this was missed during the c-section I'd had. This in part made my uterus lose it's "tonality" and not be able to contract down. Which started me o a long slippery slope to DIC.

I'll talk a little about the first few days (emotions/reactions/etc.) In the first few posts on this blog. My goal is to write a post a day for the year following this all, and obviously I have a few to catch up on, but those will be back dated and centric to things I remember feeling and experiencing on those days.

Before I end, I want to add a little note to the surrogates who are reading this that don't know me.
In the past day or so I became more aware of how wide my story had traveled. I 'know' a lot of surrogates personally from state-based groups and agency based groups. A lot of them shared my story or at least that I was in ICU from complications and asked for prayers and well wishes. (My husband heard a nurse say I was a 1 in 100,000 case in that I LIVED after how extensive everything was-- so all those positive vibes must have done something). Large groups picked up my story and people started asking questions. My friends and family felt it was really my story to share and while I had given a short version of what happened no one knew the story I have just shared. I was/am in several pregnancy groups, due date groups, and smaller surrogacy groups. I have a personal group that followed this second surrogacy and I have people that are in that group as well as these other groups with me. I was exhausted and barely could update one page so I gave permission for people to share my updates in groups we were mutually in. A lot of people didn't feel comfortable sharing in the larger groups because while I might be emotionally okay to share to people I KNOW, they didn't know if I was ready to be 'out' to the whole world. 

Since then I've had several group admins message me and ask if they could give some sort of an update or if I could share the update. I gave them permission to screenshot any updates that came from me directly and pass them on. There were lots of posts and comments happening, some I think not understanding why admins were not posting updates or sharing stories. I didn't want people speculating or accidentally passing false information. So today I sat down and undertook this, for myself, for my friends, and for all of you. 

As a surrogate we are all told that this could happen, or something that would cause infertility. I've heard of surros that have fertility issues after surrogacy for no known reason. I understood it. I knew our family wasn't complete but I was okay with expanding it in other ways. We wanted to adopt a child anyways, so why not adopt two? Still, you never think this will happen to you. I had no complications... I had idea pregnancies... no sign that in a few hours everything would turn out like this. 

So when your RE or your agency asks you if you're done your family. They are asking you for a reason. It's not a choice to be taken lightly. 

Even knowing that we can adopt later down the line, even after considering that maybe we'll become IPs.... there is still a LOT for me to process. I wasn't ready to never experience pregnancy again. I'll never buy another pregnancy test. I'll never wait those 3 long minutes. I won't feel a baby move and kick inside me. I won't get to take fun maternity pictures. I didn't get to decide that I was done. I didn't get to "retire" from surrogacy. 

I wasn't ready.