Saturday, October 2, 2010

Superhero: The TAC Details

I now have a bionic cervix. Does that make me a superhero? A super woman who is now able to carry a child to term! Oh, wait. That's most women.

Prior to heading out to Chicago, I'd read other stories of the surgery - particularly Trisha's and Jaded's - and had very specific ideas about what to expect. None of them truly prepared me for the excruciating pain. I don't think that it's possible to really wrap your head around it unless you're actually experiencing it. I was also expecting a ton of waiting and it to be loud and busy and crazy, but since I was the first surgery of the day, it was the opposite. Yes, we had to check in at 6am, which meant waking up at 5am, but it was well worth it. We didn't have to really wait at all, and everything proceeded on time. Highly recommended to get that slot if you can swing it.

We left Omaha Wednesday afternoon to drive out to Chicago, which took about an hour and a half longer due to tons of construction. On the way there, I got a call from the hospital asking if I'd consent to having my surgery photographed for some magazine. Of course I said yes - I'm all for educating anyone I can about the TAC. I told Trisha about it and she joked that my cervix would now be bionic AND famous. Autographs, anyone?

Once we arrived in Chicago, we got some deep dish pizza (can you go to Chicago without doing that?), checked into the hotel, and grabbed a few hours of sleep. I wasn't nervous at all, surprisingly. The next morning we woke up early, around 5:30, and headed to the hospital. We found the parking garage right away, and note: you do have to pay to park. Which...am I just small town spoiled? Paying to park at a hospital? Valet is actually cheaper, so I recommend that, and obviously that has the advantage of delivering you right to the door.

Once we checked in, Chris was given some paperwork to read over and a code that he could use to check my progress on a monitor. I was called to pre-op almost immediately with three other patients who were also having various surgeries. They set me up in a little curtained-off area with a recliner where I changed into the hospital gown, was given an IV, took a pregnancy test (which I knew would be negative, sob) and answered a bunch of questions about my medical history. When she was putting in the IV, she couldn't do it in the back of my hand like she prefers, because I have "tiny" veins. She has to do it in the crook of my elbow, which meant I had to keep my arm straight...a problem since they put it in my left arm and I'm left handed. So ouch. After about 45 minutes, they brought Chris back to wait with me. Dr. Haney, a few of his staff, the anesthesiologist, and a few residents talked to us, answering any questions we had and giving the details of how the next two days would progress. I was under the impression that I'd be given the choice between general anesthesia and a spinal, but I don't remember them actually asking. I told them about my bad epidural experience, so maybe they made the choice for me based on that. The nurse then walked me back to the OR room, and Chris went back to the waiting room.

The OR room was just like in the movies - bright white, big lights, bed in the middle of the room. It was a little surreal. They strapped me onto the bed with my arms out, crucifix style...and that's the last thing I remember.

The surgery took about two hours - longer than average thanks to my severely retroverted uterus. After it was over and I was in recovery, Dr. Haney talked to Chris for about 20 minutes and let him know that the surgery went well, and they talked about the loss that we experienced. Dr. Haney told Chris that while I was going under I was chanting to the staff, "Let's do this! Yeah! Bionic Cervix! Whoo!" and got them all excited. Don't ever give me drugs. When I woke up, I was in a recovery room and Chris was next to me. I remember very little about the next few hours. I felt really shitty. My stomach didn't hurt - but my head was groggy and I felt dizzy and nauseated, like a really bad hangover. I was in recovery for about three hours, and drifted in and out of consciousness for most of it. I vaguely remember Chris taking this picture of me and asking if I looked cute. Obviously the answer is a resounding NO, but he said yes like a good husband. That black cord I'm clutching for dear life is the pain pump. I could press a button every eight minutes to dispense pain meds.

After I was deemed sufficiently awake, the transporter (sadly, not Jason Statham) wheeled us across the hospital complex to my recovery room in maternity. It shows how far I've come in my grief that it only momentarily bothered me. The last time I was in a maternity room was after delivering Caleb.

Chris brought up a body pillow, another pillow, and a blanket that we'd brought from home. Best idea EVER. I would not have been even the slightest bit comfortable without those things. We spent the day watching TV, movies, and I slept on and off. Chris played Civilization 5, and I think he was glad to have an excuse to be off work and play a computer game all day. ;) In terms of pain, there was actually very little from the incision. However, I was extremely dizzy and felt sick whenever I moved my head. I attempted to have some water and a bit of a smoothie, and immediately threw it up. Hours later I tried to eat dinner, and threw that up too. The puking is what caused my incision to hurt - without that, I would have still been fine, pain-wise. Of course, that also could have been thanks to the pain pump. Since after dinner I was still feeling dizzy and nauseous, the anesthesia resident came to check on me. I had to get my blood pressure taken laying down, sitting up, and standing. Standing, it was 90/60, which I thought was low, but apparently it was okay. The resident said I was just taking a long time to recover from the anesthesia - that is, after grilling me to make sure I wasn't suffering from drug withdrawls. "Could you be suffering from withdrawl from anything? Do you take any illegal drugs? Be honest." Yes, ma'am. The lack of heroin at the hospital is positively disgraceful! Ok, I shouldn't laugh. I know people lie about drug use all the time at hospitals. But I'm me, and I'm so not a drug user...I don't even drink caffeine. (Not because I'm some crazy health nut, but because it upsets my stomach, so you can go back to not being impressed.) That was the first time I'd sat up or stood and it hurt like a mother effer.

Shortly thereafter, around 10:30, Chris headed over to the hotel to sleep for the night. I fell asleep right after he left, but woke up off and on until about 3am, when I woke up for good. I passed the time reading and watching TV, which was difficult since I had the IV in my left arm and had to keep it straight. Every time I bent it, an alarm would go off and I had to call the nurse to turn it off. A catheter had been placed during the surgery (while I was out of it), and I hadn't even realized it until a few hours into the day. At one point I felt like I had to pee really badly, which I knew wasn't right because of the catheter (which, by the way, I couldn't feel at all and didn't hurt a bit). I had to call the nurse yet again - I think I was a "problem" patient - and it turned out the tubing had gotten tangled so it wasn't draining correctly. The relief I felt after she untangled it was amazing. I wouldn't mind having one of those all the time, you know, minus the whole having to carry around a pee bag thing.

At 4am - almost a full day after the surgery and a little over twelve hours since I'd been in recovery - the nurse came to remove the IV and catheter. Neither hurt, but since I was still feeling dizzy from the drugs, the nurse decided to keep the IV cap in just in case I couldn't keep down the pain pills and they needed to do intravenous drugs again. Luckily, I was able to keep down two Percocet. Just after that, I had to get up to pee, which was again excruciating. It was actually kind of funny (the situation, not the pain), because I couldn't go. I could feel it right there, but nothing was happening...so the nurse ran some water and put my hand in warm water. Is that funny just to me? That nurses use frat party tricks to make you pee? Okay then.

After that she had me sit in the chair for a few hours. Apparently I was supposed to have done that the day before, but due to the dizzy spells didn't want to risk it. Around seven I got back in bed and tried to get some more sleep. Dr. Haney came and talked to me for almost an hour around 8am to make sure I didn't have any more questions. We talked a bit about the sad state of treatment for second trimester losses. Chris made it back to the hospital around 9:30 (after leaving an hour earlier... Chicago traffic!), just in time to miss both Dr. Haney and a crying jag, after I'd asked twice for more pain pills and over an hour later they still hadn't arrived. That was the only real failing of the hospital, and the nurse apologized profusely when she finally showed up. I had some breakfast - about one bite of sausage and one bite of French toast - I just wasn't hungry at all. I was able to keep that down, so they decided I was okay to be discharged. They removed the IV cap, I changed into my street clothes, got one last dose of Percocet, and waited for the transporter to arrive to wheel us out to the car. I was still feeling the incision from puking, and was still dizzy and feeling slightly nauseous. However, as you can tell from the picture, I felt a lot better.

The ride to the hotel sucked for obvious reasons, as did the walk from the parking garage to the hotel room. I'm sure I looked like total hell and like someone fresh of a bender or something. Chris made me get up and walk around the room every hour or so, and oh my god. I don't know exactly what caused it, but Trish said she had it too, so it must be normal, but there was this burning sensation that was beyond excruciating. It wasn't at the site of the incision, but off to the side. I have no idea what it was, but I still feel it occasionally, and it's the most painful part. I kept taking two Percocet every few hours until I passed out for the night.

The next morning (this morning) I woke up and could tell it felt a ton better already. I still have slight dizziness occasionally and the incision is still painful, but the terrible burning sensation is mostly gone. Don't get me wrong - walking around still sucks. And my back is killing me from walking around stooped over. But compared to yesterday I already feel better. I haven't had any discharge or bleeding, which I know some women experience. I bought an abdominal binder that is specifically for use after C-sections and abdominal surgery, which has helped quite a bit by supporting it and offering constant pressure. I also take a travel pillow with me to press against it when I am standing up or coughing or whatever. Each time I walk it's really painful for the first few steps, then gets progressively better. Right now, it's a toss up between what hurts worst - my back or my incision. I'm down to one Percocet every three hours. The bottle actually says one pill every four to six hours, but the hospital said one to two every three or four hours, and I called my best pharmacist friend and he told me that what the hospital said is fine, especially for just a few days. They gave me 50 pills, which means I'll have plenty left over to sell on the black market. Takers?

I keep half joking to Chris that I'd better get fucking pregnant now that I've gone through this. And I will say that I'm now scared of the C-sections that I'll be having in the future...this is painful shit! And to do this on top of having a newborn? Yikes. I don't know how people do it. Maybe the newborn cuteness acts as a numbing agent or something.

So now I just wait. Wait to feel back to normal, wait to get knocked up, wait to put this damn thing to use. Oh, and wait to shower. I am grosssssss right now.

9 comments:

  1. lol! instead of an S it can be changed to BC for your super woman logo.

    It sounds like there are a few similarities to a c-section. When you lift yourself up (from any position) try exhaling. I found that works for some of the tummy pain.

    Glad to hear all went well!

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  2. I'm glad it all went well...minus the uncomfortable pain afterwards. I hope your incision heals fast and the pain disappears. Sending you lots of hugs!

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  3. Hope you are feeling better soon! I saw a commercial tonight that the Bionic Woman season 1 was on DVD and I instantly thought of you.

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  4. Sounds like you got the RED CARPET treatment from Dr. H! We definitely didn't get that kind of time from him, so consider yourself special! I really think the burning is from where they pull your body apart to do their work. Eeek! I'm glad I was able to prepare you somewhat, but you're right, no one can really prepare you for that initial pain. I'm so glad you made it through well and hope the pain gets better FAST. At 3 weeks out, I was back to house cleaning and catering a dinner for 25 people, you'll feel like yourself very soon!!!! Love you!

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  5. Glad you made it through it! You look HOT for having just had surgery! ;)

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  6. Lara, thanks so much for posting so many details about TAC! I had pPROM with my twin boys and lost them at 16 weeks. The ONLY mention of my cervix was AFTER the waters broke, the perinatologist said it was incompetent. Nobody has mentioned it since then! My ob wants to do a TVC next time at 14 weeks. Ummm...funneling? I've read all about Dr. Haney.

    I have some questions for you, but I can't figure out how to email them to you. Would you mind emailing me so I can send them to you? kathryn_nguyen@tx.rr.com

    Or, here are the questions:

    A few questions:
    1. I saw the time frame of your surgery 9/30 to finding out you are pregnant in November - wow, one month! Were there no restrictions? I will be doing an embryo transfer and thinking about putting it off any further than is necessary is hard.

    2. Why did you choose to go all the way to Dr. Haney instead of to a specialist in your area?

    3. What was the time frame like? I noticed that you were in the hospital and then at a hotel. For how long? How long until you went back to work?

    4. Did insurance end up covering it (do you happen to have Blue Cross)? Do you mind sharing with me about how much it cost if insurance did not cover it? Did you have to pay up front or were there payment plans with Dr. Haney?

    5. How long did it take you to not hurt from the surgery?

    6. Are you nervous in this pregnancy or do you feel pretty confident? Like, would you go for a jog or vacuum furiously? Are you THAT confident with the TAC? (I'm not going to do either of those, but I'd like to cruise around the mall or Target)

    Thank you and congratulations!

    Kathryn Nguyen

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  7. BTW, Buddy is our dog - not me! :)

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  8. I responded to Kathryn's questions in a private email, but when re-reading this I thought it might be helpful to include the answers here, so I dug them out from my email history.

    1. I saw the time frame of your surgery 9/30 to finding out you are pregnant in November - wow, one month! Were there no restrictions? I will be doing an embryo transfer and thinking about putting it off any further than is necessary is hard.

    There were no restrictions. Dr. Haney makes jokes about trying in the hospital room. :) I think I read that the rules might be different if you're doing IVF or similar treatments, but Dr. Haney or whoever you used would be able to give you specific information about that. We did wait maybe two or three weeks to have sex - I pushed it because I knew I was ovulating. :)

    2. Why did you choose to go all the way to Dr. Haney instead of to a specialist in your area?

    There are several doctors in our area that perform the surgery, but they are all of the "only after a failed TVC" (vaginal cerclage) mindset. Dr. Haney in Chicago and Dr. Davis in New Jersey both have very proactive mindsets and both feel like the TAC should replace the TVC in most situations. Dr. Haney explained to me that he used to be an RE, so to him every single pregnancy is a huge freaking deal, whereas most OBs who perform the surgery routinely see perfectly healthy pregnancies ALL the time...they just come from two very different backgrounds. Dr. Haney ended up being only six hours from us, so it was really a no brainer - a few hours to get to one of the two premiere TAC doctos in the country? There's no way I'd turn that down.

    3. What was the time frame like? I noticed that you were in the hospital and then at a hotel. For how long? How long until you went back to work?

    I would have to look back at the exact post to see, but I believe my surgery was on Thursday morning. I was dismissed on Friday afternoon, and then we drove back home on Sunday. I was out of work for maybe two to three weeks? I remember thinking I could have gone back after a week because I felt pretty good. I'd take as much time as you can, though, just because you can.

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  9. 4. Did insurance end up covering it (do you happen to have Blue Cross)? Do you mind sharing with me about how much it cost if insurance did not cover it? Did you have to pay up front or were there payment plans with Dr. Haney?

    I do have insurance, and I do have Blue Cross! Dr. Haney worked it out with them to get it covered, they had absolutely NO issue with it at all. I was really worried because they often don't with just one loss, but Dr. Haney said he rarely has issues. He actually did a study with Blue Cross of Illinois and it showed them that by doing the TAC over the TVC they saved something like $5 million a year, so I'm not sure if that had something to do with the easy approval or what (I have Blue of California, btw).

    5. How long did it take you to not hurt from the surgery?

    Hmm. That's a good question. I had a big photo shoot (I do photography) two weeks afterward and I was fine for it. I know that 72 hours after the surgery the pain had already lessened a lot from the excruciating first day, and then it seemed to get 50% better every day after that. I stopped taking the vicodin pretty much the day we got home from Chicago and was on Tylenol only without any issues.

    6. Are you nervous in this pregnancy or do you feel pretty confident? Like, would you go for a jog or vacuum furiously? Are you THAT confident with the TAC? (I'm not going to do either of those, but I'd like to cruise around the mall or Target)

    Nope, I feel super confident! At 14.5 weeks, my cervix measured over 5cms with no funneling, which is longer than it ever was last time. I don't jog, but I try to walk for 2.5 to 3 miles every day and I vacuum no problem. I even flew to Australia at 10 weeks, put together some furniture...I haven't really done anything to coddle this pregnancy like I thought I would. I do feel it every once in a while - a twinge around the cervical area - but everyone I've talked to has said that's totally normal and just your uterus stretching above the TAC. [Note - she was born via c-section at 39.5 weeks and I never showed any signs of shortening in the cervix!]

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