Monday, August 13, 2012

Placenta - part 2

Heidi, the NILMDTS photographer, left around 12:20.  The doctor was just coming into the room then.  Delivering the placenta was the new focus.  This is where we go from good/bad to bad/ugly.  Although the doctor and the nurses all had a nice, pleasant demeanor about them, gentle did not seem to be something they were familiar with... the doctor was most foreign to the concept.  He checked to see if the placenta was detached from the uterus at all.  At this point, nothing had been so painful that I grunted, groaned, complained, or what-have-you.  There were labor pains, but everything had been manageable.  That went out the window as soon as the doctor went to check on things.  As doctors usually do, he did more than he told me he would, and it hurt so badly that I was squeezing the bars on the hospital bed as tightly as I could (I was afraid of hurting a nurse if I held onto one of them as was offered, plus it gave stability) and tears were pouring down the sides of my face.  That was more pain than I've ever experienced even in full-term child birth.  He said that my cervix was closing but he could reach a tiny bit of placenta.  He told the nurse to go get some ring forceps to give it a tug.  (I should mention here:  she brought something, he scolded her saying they weren't ring forceps, she tried to say she was hurrying and grabbed what was labeled as ring forceps, he used them anyway and found that they had been on the table prepared for him right behind him the whole time.)  He spent some time coaxing the placenta out.  He mentioned watching for any retained bits and pieces among blood clots, but everyone seemed comfortable that all was now well.

After a while, once the doctor had left, Denise gloved up and started to inspect the placenta.  I asked to see it, she brought me a glove and the bowl containing the placenta and we looked.  I commented quickly that it was not large enough.  My placenta with Taylor was much larger and she was three weeks younger.  Nurses tried to explain that all placentas were different sizes and that this one was also already deteriorating, so I shouldn't expect it to be like any other I'd ever seen.  The nurses were not at all concerned.  Denise was trying hard to see things as the nurses did, though she had her doubts too.  We searched for the spot where the umbilical cord attached but couldn't find it.  Nurses tried to point out a thick spot but Denise and I were unconvinced.  We were trying so hard to be as unconcerned as everyone else, trying to see the holes in the placenta and cover them with flaps that might have fit, or excusing irregularities due to the deterioration, but it just wasn't right.

Finally, around 2am, everything calmed down enough that we turned off lights to try to sleep.  Of course, the doctor came back in at 2:30 to say that he was ordering an ultrasound to be done in the next hour, just to be sure all the pieces were out, and then I'd be sent home two hours later.  I went back to sleep, though the ultrasound cart came in around 3:15am.  I noticed color on the screen and she spent a LONG time doing it, measuring things, though she didn't speak at all during or after so I had no confirmation for what I was now fearing.  The doctor came back around 5:30am to say that the ultrasound showed that a large chunk of placenta was still attached to the uterine wall and was still circulating blood through it.  -  Even reflecting back, all I can do is release a sigh, close my eyes, and slump into my chair.  I felt defeated.  I should have been up walking around.  More would have come out if I had walked more.  But I was already so physically and emotionally exhausted.  Now I felt mentally exhausted, too.

In the next little while, nurses came in and out, the anesthesiologist came in and out, I signed consent forms, I removed all jewelry and anything that had metal (even my hair clip had a metal spring inside) just in case they had to cauterize the inside of my uterus.  I reminded nurses, Ben, and Denise that my grandma did not do well with general anesthesia and my mom was always slow to wake up from it.  Denise found a couple guys to give me a blessing.  We meant to have them give Ben a blessing too, but things were so hurried that we forgot.  I'm so sorry, Ben.  He really could have used one right then.  The doctor came in and scolded Denise in front of me.  She had been talking to someone who seemed to want the information, so she told them about some things they could do at home to keep from going into preterm labor, since the hospital had just sent them away refusing to stop or help labor at that point.  The doctor gave her quite the verbal lashing right in front of me, saying it was unprofessional to be soliciting his patients from him in a hospital.  He went on and on about how she was not to do it again, how unprofessional it was, how it was the wrong setting, etc.  She tried to apologize and explain that she was not trying to solicit, just be friendly, and how sorry she was.  He would have none of it.  Then he turned to me and said it was time for surgery and left the room.  Ben and I quickly commented on how unprofessional that was and I apologized to Denise.  How dare he treat my support person so UNPROFESSIONALLY right in front of me like that?  If he had a problem, he should have asked to speak to her outside my room, not in front of me.  Now, as they strolled me down the hall, I was fearful of how they'd treat Ben and Denise while I was unconscious and was fearful of how he would treat me and my body while he was angry with my friend and I was not awake to do or say anything about it.

I guess I kind of left something out.  With the placenta still attached, they said I needed to do a D&C.  Since I had not had an epidural, they had to put me under general anesthesia, completely knocking me out, in order to do the procedure.  With this, they would vacuum suck the placenta out, then use a sharp something to scrape the inside of my uterus until it was empty and the lining was gone.  I should also let you know that this is the absolute last thing I wanted done (yes, I expressed that to them several times).  But, since there were no other medical solutions to hurrying up to get the placenta out, this was where I was faced.  I know it is something that lots of women have had done, and many women are as unconcerned about it as the hospital staff was.  I, however, am NOT a fan of scraping out my uterus.  I didn't want to be in the hospital at all, but I was already informed that it was really my only option unless my body decided to kick into gear and delivery Seth on its own.  I feared that this would cause cervical scaring and interfere with delivery later on if we choose to have more children.  D&C's usually leave only minimal scaring, but now with an angry doctor holding a knife, who knows what could happen.

They wheeled me down to the operating room (7:45am as I left the room) and put the mask on my face.  They said it was oxygen but it made me feel like I was getting less oxygen.  The nurse wiped tears from my left eye (nurse on the right didn't seem to notice) several times before I was no longer awake.  Next thing I knew, someone told me where I was.  I couldn't remember what they said when I opened my eyes again.  I had to ask.  A woman told me I was in recovery.  Once I seemed a bit more awake, they found someone to help stroll me down to my new room.  I looked at the clock.  9:45am.  I had looked just before going into surgery so I wanted to know the time now, to see how long it took.  2 hours.  They said the procedure would only be about 30 minutes (which Ben and Denise confirmed it was), so it took me 1 1/2 hours to wake up.  Oh, and I really needed to use the bathroom, they gave me a bedpan (ew) but I could NOT go!  It took probably a good half 20 minutes to finally go... which was apparently a BIG step in my recovery as they won't let you go home until you pee after being put under.  Who knew?

Of course, then there is the perspective from Ben & Denise.  Someone came to tell them that surgery was over and they were waking me up about 30 minutes after it started.  So they assumed I'd be strolled back down soon.  So they waited and waited, asked someone what was going on, were told that they were bringing me down, so they thought another couple minutes but kept waiting and waiting.  An hour after surgery had begun, they moved Ben & Denise from the delivery room to the recovery room.  Of course they thought this was good news and I'd be there, but no.  Our bishop arrived (THANK YOU!!  I think Ben was really in need of a blessing about then) and sat to wait with them in the new room.  Apparently he made a comment that encouraged Ben to get up and go hunt for me since no one seemed to be able to properly communicate where I was and when I was coming back.  Of course, that's when I finally arrived.  2 hours after a 30 minute surgery.

After this, things calmed down.  The bishop gave me a blessing.  My blood pressure was low (it's normally textbook perfect), my heart rate was high, but these are apparently common after surgery.  I was dizzy for a while but finally felt well enough to stand unassisted to shower.  The new nurse, Renee, was the most gentle of all of them.  I'm not allowed to lift anything over 15 lbs for two weeks (and I've seen the ramifications if I do, and this includes lifting Kiersten, which she is NOT enjoying), not even supposed to be up doing household chores for two weeks (this is killing me, but again, I've seen how easily I aggravate the healing process)... and I'm SO SORE.  I didn't expect to be this sore afterward, but I suppose I did have a knife scraping the sides of my uterus, which is bound to cause lingering pain that's just enough to grit your teeth about.

Through it all, we were reminded why we hate hospitals so much.  Communication is extremely poor.  No one seems to understand how to be gentle.  Pain seems to mean "I'll do it harder and faster to get it over with more quickly."  Doctors are awful creatures with no compassion or understanding, who expect to be treated like the knights in shining armor they believe themselves to be due to years of "superior" education.  I hate it there.  Ben hates it there.  Would it have really been so difficult to be a little more kind, compassionate, and gentle with a woman who just gave birth to her tiny dead baby and those there to support her?  Is it too difficult to spend 5 minutes explaining that they can't bring me back to a postpartum room until after I have become coherent so that a man who just held his dead baby could at least be comforted that his wife was okay?  Is it necessary to scold a nurse or a patient's friend in front of the patient who is about to go into surgery, making her fearful that the anger will lead to even less gentleness during said surgery?  I'm not impressed.  I don't expect you to stand there crying with me, but I do expect more than what we received.  I will obviously NOT be going back to his horrid doctor for my follow-up, nor will I ever willingly go to that hospital again.  This was an opportunity to calm and comfort, but instead they made a bad experience even worse.  Just not pleased at all.


Anonymous said...

Ginger, I just finished reading all that you went through. I am truly sorry for your loss. Some people are just so ignorant to people, to their feelings. I spent many years in the medical field and I have seen how after being around it for so long some people become numb to what is going on around them. There is no excuse for them to treat you, your family or your support person in anyway but with kit gloves given the circumstances. I am a doula and have seen the very gentle compassionate side of the medical field. I have always been treated very well. When you feel up to it maybe you could write a letter or just copy your blog. The hospital and Doctor should read your experience. Sending hugs your way.

Anonymous said...

that was like pouring salt into a wound. I don't get people and their super ego, doctors especially. It makes it hard to remember anything 'good' about your experience, if that makes sense. I would recommend writing a letter to the hospital as well as the doctor. ugh...I wish I could have been there to defend you.

Anonymous said...

that last comment was from me, Arah.

Anonymous said...

I don't know about the hospital you were at, but the one in Chillicothe had review cards that you could fill out and send to St. Luke's Health Systems, which owns Hedrick Medical Center. I'm sure that if the people who own/run the hospital you went to heard about the treatment and lack of senstivity you reveived that there would be some sort of action taking place.