Saturday, June 30, 2012

The Detour...

... so, as I said in our birth story post, all was going well. Babies were born very healthy and ready for this world. We spent our 3 nights in the hospital from our c-section and decided to take the extra 4th that they offered, just for one more night of sleep. On the 3rd night however, I spiked a fever. They took a look at my incision and noticed there was more redness and swelling there than there should be at this point. I also had a ton of rash like areas on my back and abdomen and everywhere else they had put adhesive tape during the surgery. I was a mess.

After an evaluation by the attending OB, they decided to start me on a triple cocktail of IV antibiotics to help the infection. I would be monitored for the next 24 hours and hope that this helped decrease my temperature and redness. The babies and Tidy were still in my room and would stay there until we decided differently.

Unfortunately, after 2 days of monitoring, my fever wasn't staying down, as I would spike a little one somewhere around 101 degrees ever 24 hours or so. Additionally, the wound wasn't getting better. The OB resident decided to bring the attending back in for a consult and also involve the Infections Disease (ID) attending at that time. They came up with a plan: Switch up the IV antibiotics and open up the wound to let it drain and hopefully heal better.

The next day, a team of 3 doctors came in to assess the wound and my situation. They took some blood and asked me if I wanted some pain meds for the procedure. I opted for just gritting my teeth as I had had way too many pain meds the first few days of my C-section recovery and they make me feel like ass. I was dry-heaving and drowsy when on them. I wanted so baldy to be free of those meds... so acetaminophen and ibuprofen were all that I took. They proceeded with the wound opening by taking out the first two layers of stitches in my incision and letting all of the infection drain. The pain of the procedure was not too bad, just like bee-stings. Luckily the other deeper layers of the incision looked clean and were healing well. So no need to do anything further. They packed the wound with gauze and put a light air-flowing dressing on the top.

It's amazing to me how they let these wounds heal. It's not how you would think... They don't re-stitch it back up. They leave those layers open, and have it be packed and unpacked with gauze to help stimulate better blood flow and healing to the area.  It's called "open wound care". I won't go into too many more details here, but I never thought I would be doing something like this to my body. Very strange.

We were on the path to healing. The opening of the wound helped a lot, my fevers had subsided a bit and they switched me to 1 IV antibiotic instead of the 3. The babies had also been discharged at this point from the hospital since they were healthy and they really didn't need the nursing care anymore. But we decided to keep them in the room with us because we wanted to continue the family bonding and breast feeding. This discharge was good news, but also bad because it meant that we couldn't use the nursery at night anymore to help us get a bit of sleep.  On top of that, I was having my vitals checked 4x a day. Rest was very hard to come by.

The next day, after my blood test results came back, ended up being one of the worst days of my stay there. Apparently, my white blood cell count levels were way too high, that they were on par with that of a leukemia patient... higher than expected given the infection. So the team of OBs, ID and now a general surgeon attending, had me going from one test to another. I had 2 cat scans, a chest x-ray, a pelvic and leg ultrasound and numerous swabs and cultures taken. The goal of all of these was to rule out any sort of other deeper infection that they couldn't see just on the surface with the wound infection. The day was pure hell. I woke up at 6:30am and didn't have more than 15 minutes alone with my babies and my husband until about 3pm. During that time were all the tests and the consults with the doctors. There was talk of possible uterine infections from left over placenta, a gall bladder infection that might need to be operated on, other abscess of infection deeper in my peritoneal cavity... Thankfully all of these tests came back negative and there was nothing else causing such a high wbc other than the wound infection.

This confused the team however, and with 5 different doctors (between the various areas and residents and attendings) they couldn't come up with a good plan to get me out of the hospital, especially because I was till running a little temperature every 36 hours or so. And, once that happened, the protocol of the hospital was that I couldn't leave until I was 48 hours with out a fever. As you can imagine, taking my temperature was a very nerve wrecking thing, especially when a temp meant at least another few days before we could go home.

This was all occurring during the week of June 17th. Also a point to note, my OB, the one who saw me through my blissfully easy pregnancy, was out of town and unaware of all of this.

On Thursday, June 22nd, he was in the hospital for a c-section and stopped by my room. I looked at him and began to cry immediately. I could tell he felt badly for me and was frustrated that I was still there. He was not the attending on call that day, and he was still learning more about my case, so he couldn't take much action that day, but I could tell he wanted to take matters into his own hands. The hospital machine is a funny thing... after having so many different doctors opine on my infection and care, it was very hard to really understand who was responsible for what. What were we really waiting on to determine if I could go home? The wbc count to come down? The fevers to stop? The infection to look better? It's so hard to say, especially when you can't get one straight answer out of anyone.

Additionally, at this point, they decided it was best for me to be moved to a surgical wing instead of the post-natal suites we were in since the nursing staff was better equipped to handle my case in that unit. The new rooms were a MAJOR downgrade from the hotel like suites we had been for over a week. Adding this into the extended stay along with  little to no sleep proved to be a very depressing few days for me.

While I was showing sings of improvement over the next few days, not all of the measures were going together. So no one was saying when I could go home. I began to get very very sad and wanted so badly just to be in my own bed with my own food, nurturing my babies in a proper environment, unhooked from IVs and such.

Finally, on Sunday, June 24th, my OB was back on call as the attending that day and he stopped in. In my mind, I was hoping for a Monday or Tuesday release, but when he came in, he said, "Let's get you outta here today" we all brightened up! My mom & dad were in the room as well and they were very impressed with his thought process. Basically he said, although things weren't prefect, there is no reason that I couldn't be doing this healing at home. None of the interventions that they had me hooked up to right now couldn't be adapted to be done at home. I could do the wound care on my own with an out-patient clinic and I could move over to oral antibiotics.  Tidy and I looked at him and said,"Um!! These are the things we've been trying tell the other docs all along! AND I can guarantee that I will heal faster at my home rather than in this depressing place".

So, within about 2 hour, we had our discharge papers signed and a prescription for an oral antibiotic. We had our bags packed and our babies loaded up into the double stroller. And even though I still had a fever, I could already feel a healing wave wash over me. There is something truly to be said for the environment in which you are healing.

Since my release, you will be happy to know that the infection is clearing up, the wound is healing, I have not spiked any fevers, I am breathing beautiful fresh air, I am sleeping (as much as one can with twins) in my own bed, I am nursing my babies and I am resting whenever I can so that my body heals quickly.  We are on the mend and making up for the lost time in the hospital.

One thing I do know, is that I will never ever take for granted the road that we took to get these babies home. They are what kept me going trough the seemingly endless day/nights at the hospital that blurred into one long hellish event.

I know my story could be worse. I know that I am blessed to have two beautiful healthy babies. I know that we have a lot to be grateful for and not everyone gets their take home babies. So I will focus on that... on these two little lives that struggled so hard to get here, to our home... and take all of the strength that I can from this experience and turn it into strength to parent these two amazing babies.


Eb said...

Wow. That was quite the ordeal. I am totally with you with the environment healing thing.
Best of luck with the little ones. Hope you have some serious help.

LeslieGail said...

Holy COW, you went through a lot. I agree, healing at home is a much better option! So glad your OB got your there. Hugs and healing!

KC said...

Those two cuties make me smile!!! They have the sweetest faces and look like they already have little personalities.
I can't believe how much you had to gothrough,gosh haven't you been through enough. They say good pregnancy equal hard deliveries and recovery but seriously that is a bit much! Glad you are healing and that the babies are thriving.

DR said...

that sounds like an awful experience. good for you for being so positive. and your little bubbies are so cute!

Anonymous said...

You always have such an awesome outlook on things! I'm sorry you had to go through so much. Yikes!! They are absolutely BEAUTIFUL!! Congrats :-D

St Elsewhere said...

Oh Em Gee....that's quite a horror-ish experience.

I am glad you and babies are home. Being home is such a delight. Hospitals are hospitals...they can never get cozy. I hope the infection is 100 percent gone....


Ted and Maria said...

Oh my goodness....they take my breath away with how precious and beautiful they are. Any pain and suffering would surely melt away when looking at them. :) I celebrate your homecoming with babies in tow from afar, my friend. xo

Heather said...

Gosh how awful. Only reading this now. What a horrible long stay and I'm so sorry you had to go through all those invasive tests. ( hugs)