Thursday, December 6, 2012

Why I Had Surgery While 17 Weeks Pregnant

After I finished my post about my gallbladder surgery, I realized that I keep talking about the risks, but I hadn't painted a clear picture from diagnosis to the decision to have surgery. So here it is:

Jan / Feb 2012: I had some occasional pain right under my ribcage on my right side. It felt like baby toes hooking up under my ribs, but I was not pregnant. My mother (who had her gallbladder out when I was a pre-teen - and almost DIED because she let it get out of hand before seeking treatment) told me that it was my gallbladder, and told me to get it looked at - immediately. I didn't blow her off... exactly... I knew that she was probably right. I just didn't want to go to the doctor.

March 2012: During my annual exam, I mentioned my occasional pain to the midwife. She told me that it was probably my gallbladder. She told me to have it looked at immediately. I didn't ignore her... it just stopped hurting... and I forgot :-/

09/04/12: Knowing that I was 7 weeks pregnant (and I had already felt a bit of ligament loosening), I chose to pick up my cranky daughter and carry her on my back as we were leaving the Botanical Gardens. I was hoping to ward off the impending temper tantrum. It worked, but I felt an ominous twinge or two in my back.

09/05 and 09/06: I thought that I was having a really bad muscle spasm in my back, but everything that I tried to relieve it either had no effect, or made it worse (!?!?!?). I went to bed Thursday night in a lot of pain. I knew that I would most likely spend a good chunk of Friday at the minor emergency clinic.

09/07/12: By the time that I got Miss Lily Ruth dressed in the car for school, I was almost in a panic. I couldn't take a deep breath in, and I became convinced that I had herniated or otherwise compromised my diaphragm. My intercostal muscles were in constant spasm.

Somewhere between our house and the church, the pain began to ball up under my ribcage on the right side, and I remembered the gallbladder warnings.

Immediately after dropping her off, I signed myself in at the clinic.

By the time the doctor came in, what I called my 'All Day Nausea' had kicked in, and I was taking weird, shallow breaths because of the pain. He very sweetly told me that I looked awful. I laughingly acknowledged my misery and gave him a rundown: possible back spasm, diaphragm weirdness, gallbaldder? oh, and the nausea - but I had that almost all day pretty much every day.

He decided to address the nausea first. One Zofran and 10 minutes later, and I felt like a new person. A person who was in a lot of pain, but who could function.

I was sent off with A) prescriptions for 1) Zofran for nausea 2) Hydrocodone for pain 3) An antibiotic in case I had a bladder / kidney infection (only a minor possibility) and 4) Flexoril (a skeletal muscle relaxer) in case it was just a muscle spasm AND B) an appointment for an ultrasound of my gallbladder in a few hours. I had to wait a few hours without eating so that my gallbladder wouldn't be 'active' during the scan.

The ultrasound revealed a 3 cm stone and sludge in my gallbladder, but no current inflammation or thickening of the gallbladder walls. A mixed bag. The doctor put me on a clear liquid diet through the weekend, and recommended that I contact my midwife group for a surgical referral immediately. I thanked him politely for the advice, and hung up thinking - 'Not on your life, buddy. I worked hard for this baby! No way I'm gonna risk losing it during surgery.'

I eventually called the midwives. They recommended a surgeon, and told me to set an appointment. Not because they wanted me to have surgery, but they pointed out that if surgery became unavoidable, it would be better to have a consult in place, and to know what my options were.

I became aware of having a small to moderate amount of pain after almost every meal.

10/08/12: 12 weeks pregnant. I had my surgical consult. I went in with a list of questions and a mental list of reasons why I was NOT going to have surgery. The surgeon put me at ease immediately. I felt confident in him right off the bat. He told me that he was willing to give me a few weeks to let it ride and let the baby grow stronger, but given my current level of pain, and the images of my gallbladder, he did not believe that I would make it to the end of my pregnancy without surgery. He very gently explained that this probably meant surgery before the end of the year because this procedure is least dangerous to the fetus during the second trimester. It is also less dangerous to both mother and fetus before the uterus reaches the height of the navel (20 weeks). After that, it can no longer be performed laparoscopically, and a full incision is inherently more dangerous.

We talked about how I would know if I needed to call him. He said that if my pain level did not decrease or if it got ANY worse, I would need the surgery. I asked if I could try yoga, exercise, acupuncture .. he said that I was welcome to try any or all of it - he hoped that it would bring me some relief.

He told me to stay on a no fat / low fat diet (less than 5g of fat per day :-O). He also told me to stop taking the Flexoril (I had only taken one or two total) since my condition was not skeletal. Instead, he prescribed Bentyl - a smooth muscle relaxer - to help keep the gallbladder from contracting so forcefully.

10/29/12: 15 weeks pregnant. We head out on vacation. By now, I was taking at least 1 Zofran per day, 2-3 Bentyl per day, and a Hydrocodone every 3 days or so. While I was still well below the prescribed limits for each medication, I was not comfortable  Over our vacation, it became apparent that I was getting worse. Despite the awesome vacation, I was in daily, almost constant pain. I scheduled a pre-operative consultation for 2 days after we returned.

By the time I went in for my second consult, I had an almost Pavlovian, negative reaction to eating. Knowing that pain would follow any meal (no matter how fat free) caused a physical wave of dread to wash over me. I found myself avoiding meals for as long as I could - not good. I also knew that I could not healthily support a pregnancy with the stress of this much pain.

The rest is history, or rather, has already been talked about in other posts.

So there you have it. Not in a nutshell, but in a loooong, drawn out manner: Why I Had My Gallbladder Removed When I was 17 Weeks Pregnant by Rachel. I hope that this helps someone who is struggling with either gallbladder pain, or the decision to have surgery.

Wednesday, December 5, 2012

It's a BOY!

Last week was very eventful :-)

On Wednesday, I had my anatomy scan. For those not up on their pregnancy-speak, somewhere around 18 - 22 weeks of gestation, most mothers-to-be undergo an anatomy ultrasound. The technician takes a lot of skeletal measurements, checks the function and size of all of the major organ systems, and checks things like amniotic fluid level, placenta placement, umbilical cord function and cervical position. After all of that is done, they will also attempt to tell you the gender of the baby. I say attempt, because if the baby is not positioned favorably for a gender picture, or if they are feeling active and won't hold still, then you get a maybe guess or a 'come back another time'.

Our baby was feeling mellow and cooperative, so in addition to seeing a beautiful array of skeletal poetry and healthy organ function, we found out that our baby on the way is a boy.

Isn't he just precious ;-) If ultrasound photos are not your 'thing', this is a profile shot. Baby's head is on the left. The 'curlicue' on his forehead is actually the fingers of his right hand. Just above his tummy on the right side, you can see his knee and leg bones. He seemed pretty cramped in there, and I resolved to drink more water, but then I read that babies spend their time curled up like that until around 20 weeks. After that, they start to really stretch (as much as possible). I'm assuming that this has to do with skeletal and muscular development, but assuming is usually unwise... so I have some research to do... but I will also up my water intake!

I am not posting the gender shot. You'll just have to take my word for it.

Lily Ruth is thrilled. She is already referring to him as 'little brother' or 'baby brother' instead of just Baby Bean.

Don and I would have both been genuinely happy with either a boy or a girl, so instead of the gender reveal being emotionally charged either way, it was just something that was nice to know after they told us that he was healthy and developing right on schedule.

After the fun of watching the baby move in real time, Don and Lily Ruth headed out for school and work. I stayed for my post-surgical visit with the surgeon. Leading up to the appointment, I had a lot of anxiety about how slowly I felt the healing process was progressing, and how much scar tissue was massing. Even just two days before, I was really frustrated and quite worried. I STILL didn't feel like myself, and I could feel a 'ball' of swelling / scar tissue / muscle weirdness right above my poor, sore belly button. Honestly, it freaked me out.

My doctor heard me out, then palpated my navel and the surgical path. Then he adopted a fairly insulted tone and asked me exactly what I was worried about since that was obviously a beautiful incision that was healing remarkably well.

I had been in a bit of a rush that morning. I bathed, slapped some Neosporin in there and took off. At his request, I looked at it and did my own poking around. Much to my surprise, it was fine! No redness. No swelling. No lump under the skin. So I apologized, thanked him for the incredible non-scar, and promised to bring the baby in for a visit after he arrives.

You guys, I cannot tell you what an incredible feeling it was to see our beautiful, healthy baby and then be released by the surgeon with a clean bill of health. I felt like I was taking a deep breath for the first time in AGES. I felt like a boulder had been removed from my shoulders, and blinders had been taken from my eyes. I felt happy and peaceful for pretty much the first time during this pregnancy.

I finally feel like a can acknowledge this baby and work toward his healthy birth.

I even bought him something to sleep in once he gets here...

2-Pack Sleeper Gowns
I LOVE sleep sacks!!!!!! I couldn't help myself. It's time to celebrate this baby, ya'll!