Wednesday, October 21, 2009

Anna's surgery from my perspective

If you're here reading my post, then you've probably already read Anna's post about the ectopic pregnancy, her surgery, and recovery process. Anna told me that she found it very helpful to blog about what had happened, and she encouraged me to do the same. It's been a while since my last post, but I figure that this is an important enough event to start again. For not posting in a while, this is going to be long, so thanks for bearing with me.

To start, you may or may not know that Anna and I headed to the Pigeon Forge/Sevierville area of Tennessee this past weekend in order to celebrate our tenth wedding anniversary a little early--it's actually in July of next year. We knew there was a good chance (when we booked the cabin rental) that we would have a new baby (or two--apparently) next summer. So we packed up the car, headed to Pigeon Forge, and we made it to our cabin after dark (Anna never got to see the view from the deck).

We'd been at the cabin for less than two hours when Anna started feeling pains in her stomach. Given the morning sickness she'd had with the twins thus far, we were concerned but not worried, because the pains were worse--and in a different location--than usual. I asked Anna if she wanted to call our OB, but she said she was feeling better, and we went to sleep.

Anna woke up around midnight, darting to the bathroom, calling out to me to ask where the light switch was. She barely made it (after getting the light on) before she threw up. Again, Anna told me that she was feeling better, and that the throwing up helped, but she needed me to go get her some Gas-X. We had passed a Walgreens on our way to the cabin, so I headed back there. It took me about twenty minutes to get back down to the drugstore, and then about ten minutes inside, because, being that it was about 12:30 in the morning, there was only one employee working, and it took her a while to get to the front when I was ready to check out.

Up until this point, I was thinking that Anna either had bad nausea from the twins, or she had picked up a stomach bug. I called Anna when I left Walgreens, and she said that her OB had told her she should go to the ER to get some fluids. My worst thought at the moment, was that we might have to take our weekend a little easy to let her get better. I headed back, and a few minutes later, Anna called me and said--barely audible over the phone--that we needed to call an ambulance. I was still ten minutes away; I didn't know where to tell a 911 operator where we were; I didn't remember the keycode for the front door of our cabin. I started to get very nervous, and I started to drive faster than I should have on the winding mountain roads.

I made it back to the cabin, and as I alluded to above, I struggled with the keycode. I started to freak out, and I had to calm myself down so that I could get my fingers to obey the numbers in my head. It finally clicked and unlocked the door, and I ran downstairs to the master bathroom. Anna was sitting, back against the wall, on the bathroom floor. Her cellphone was in her hand, her eyes were closed, she mumbled to me, and--this I will never forget--she was white as a sheet. I got 911 on the phone, and they GPS'd our location and had an ambulance on the way in almost no time.

The paramedics arrived about ten minutes later, and they came down to the bathroom. I think, based on the description given to them by the 911 operator, that they were pretty sure Anna was dehydrated before they actually saw her. As soon as he saw Anna, Andrew (we learned the paramedics names later, as they came to see us in the hospital, and are absolutely great guys) told me to go upstairs with Aaron and get the step chair that allows them to carry a patient up stairs easily. I think he asked me to go with Aaron because he didn't want me to see how concerned he was--I appreciate that now.

Andrew and Aaron got Anna loaded into the ambulance, and Aaron told me to keep up, as I would be following him to the hospital. In a day full of disconcerting events, following the ambulance through strange, mountainous terrain was one of the worst. If you've ever had to follow an ambulance that has your loved one in it, you'll understand what I mean. I could see Andrew working on Anna--but I couldn't hear anything he or she said, so I could only guess as to what they were saying, either good or bad. I wished for nothing more than to know what was going on--it was an incredibly helpless feeling. And, just as an FYI--I couldn't ride in the ambulance, because it wasn't yet considered a life threatening emergency, and we didn't know anyone in town who could come and get me from the hospital after the fact.

After what felt like an hour in the car (it was actually twenty minutes, mostly because of the roads in our cabin's subdivision) we made it to the hospital. I checked Anna in, and I was immediately whisked to the ER, where they gave me a seat next to her. She was in a bed, and she didn't look good--but she looked much better than she had when I last saw her. She had had a liter of fluid started via IV, and it helped to increase her blood pressure. This would not be long lasting--and if you want to keep score, Anna ended up having eight liters of fluid pumped into her by the time of the surgery.

The next couple of hours were what you would expect for a patient with abdominal pain and dehydration. The ER nurses and doctor gave Anna fluids; they gave her protonics (proton pump inhibitors, like Prilosec); they gave her anti-nausea meds--but nothing really worked. Her pain started to spread. I still wasn't too worried. The ER staff were very reassuring. "It's probably just food poisoning," "It's probably just a bug," they said. Yet, out of everything they threw at this, nothing worked. Her blood pressure would go up, and then it would drop again. I could tell by their faces that they were getting concerned as to why she wasn't completely responding. And that made them start to worry about the twins.

So on we went to get an ultrasound to look at Anna's gall bladder--nothing. Urine samples--nothing. Stool samples--nothing. Thoracic cavity x-ray--nothing. Ultrasound to look at the twins--something. Wiggling babies with great heart rates. And some free fluid. Normal stuff, the imaging tech said. But when we got back to the ER--they were still unsure why was her blood pressure dropping despite the fluids they kept giving her.

The nightshift ER doctor (Dr. H.) consulted the dayshift ER doctor who had come in early for Anna. They were worried, but not too worried. They called the surgeon on-call. They wanted to do an abdominal CT with contrast in order to determine what was wrong. They called the OB on-call. They wanted to be sure that anyone who could provide input on the safety of an abdominal CT would be able to.

The surgeon and the OB arrived, and this is when I knew things had taken a turn for the worse. Anna was shivering (we found out later because she was going into shock due to blood loss), she was wracked with pain that shot up her right arm. Her abdomen could barely be touched by the doctors due to the intense pain. The surgeon clearly stated that there was no time for contrast (it would take thirty minutes), they would do an emergency CT scan--now. The emergency CT scan was discomforting enough by itself, but as we left the ER, I noticed how many people came with us. Anna was being wheeled by our ER nurse who was accompanied by our OB, our Surgeon, our two ER doctors, and two imaging techs. You don't draw that kind of attention if you're due for a routine exam. I knew something was seriously wrong.

Due to regulations--I couldn't go into the CT room with Anna. Dot--one of the imaging techs was my proxy--she held Anna's hand when I couldn't. I had to sit in the hall and wait for them to finish. And while I sat there, I heard Dr. P.--our surgeon--talking on his phone. This is not verbatim, but he said: "I don't care that [the surgical team] isn't on tonight. Tell them to get here now." This was said in a tone of voice that I can only describe as gravely serious. I started to cry, but I knew I had to hold it together for Anna. As we walked back to the ER (jogged is more like it), I asked Dr. B.--the dayshift ER doctor--if Anna was going to be okay. I'll never forget this. He couldn't say "Oh, sure. She'll be fine." He had to say "Sir, we're going to do everything we can." I'd never thought words could knock the wind out of me--I was wrong.

Within minutes, we were back in the ER, and after having a chance to review the CT scans, we were being told by Dr. A.--our wonderful OB doctor--that there was blood in Anna's abdomen, and a lot of it. And they didn't know where it was coming from. They knew that they had to operate in order to determine the source of the bleeding. They told me from the start that this would not be a laprascopic surgery--she would have a major scar. What they thought--however--was that the bleeding was related to Anna's reproductive system. The doctors suspected that there was an ectopic pregnancy that had burst.

Dr. A. explained to us that Anna could lose a fallopian tube, an ovary (or ovaries), or her entire uterus depending on the extent of the damage. Again, I tried to hold it together for Anna. But the dominant thought running through my mind was: "Are we going to lose both twins, and then any chance of having any more children of our own?" Anna took the news in stride (I continue to be amazed at the peace the Lord gave her), and she communicated with me in the way that husbands and wives do--with looks and touch. She never said a word, but the way she held my hand said "I'm going to be okay."

Dr. P. was making it abuntantly clear that we didn't have time to waste, and it was time to get Anna to the pre-op room. Almost like running into a brick wall, the concept that Anna was dying slammed into my mind. I wanted to see and hold Addie. I wanted to take the pain from Anna and make her better. I wanted to protect the twins. But I couldn't do anything. It was the most helpless I've ever felt in my life.

As the surgical team prepared Anna for surgery, I sat next to her, choking down sobs so that I could try to be strong for her. Dr. A. rubbed my back, and I knew she was praying for us. Will--our ER nurse--told me I had to drink something because I hadn't had anything in hours, and I had to get some energy be there for Anna. I've heard the expression that something can taste like ashes in your mouth. I experienced that first hand.

The last thing we did, before I was taken to the OR waiting room, was to remove Anna's jewelry. I wished more than anything that I could let her wear her wedding ring. Everything else, I was willing to hold, but I wanted her to know that I was with her in surgery. But I knew she couldn't keep any jewelry--and I know that our bond is much stronger than a ring--but it broke me to take the physical manifestation of our wedding vows from her finger and put it in a personal effects bag.

An OR nurse walked me to the waiting room, where I sat by myself, as the room was empty. I called Anna's mother and her two best friends to get them to pray and let them know that Anna was in surgery. When I hung up with Anna's mother, I looked to see if anyone had called or sent a text to Anna's phone, and I saw Addie's picture (as her wallpaper). I wanted my wife to see her little girl again, and I broke down. I sobbed--pretty much uncontrollably--for several minutes. I missed Addie so much--I would have given anything to hold her at that moment. I wish that I was as ready with scripture as Anna was, but since I wasn't, I simply prayed for strength for Anna, and strength for our twins. And I remembered the psalms. "Yea though I walk through the valley of the shadow of death, Thou art with me."

After about half an hour, an OR nurse came into the waiting room. I sprung up as if the waiting room door was attached to my chair. She told me that there had been a ruptured ectopic pregnancy, and that we had lost that baby in the course of the surgeons stopping the bleeding. She also told me Anna's vitals were holding steady. I was stunned. At the time, I thought we had lost one of our twins. I started to cry again--and I consoled myself with the fact that we still had one. I called Anna's mother and her two best friends. I asked them to continue to pray.

After about another half an hour, Dr. A. came into the waiting room with a smile of relief on her face. She sat next to me and told me that Anna was okay. A wave of exhaustion came over me as I released a huge amount of pent up stress. But there was still the matter of the ectopic pregnancy. Dr. A. started to explain that there was no damage to the uterus. There was no damage to the ovaries. She even drew me a picture to show me what had been done--I needed it because I was so tired, I didn't understand that Anna had only lost some of her left fallopian tube until Dr. A. drew it out for me. I was thankful that Anna was mostly intact. "But here's the thing," Dr. A. said. And, I don't know how, but I knew before she said it. The ectopic was our third baby. The twins could still be there.

My exhaustion turned into absolute, directed energy. I started making phone calls, and I started people praying for Anna and the twins--but now that they would still be healthy after the surgery, and that Anna would recover as fast as possible. That's about where my story ends and Anna's continues. She tells her part better than me. But I appreciate you reading this, because it was important for me to write it.

The emotions are still raw--I've had tears come to my eyes several times while writing. I've yet to really comprehend the fact that I found out about a baby and lost it at the same time. I've been in survival mode over the last five days, and I don't think it's set in how close I was to losing Anna and the twins. Forgive my rambling and my inclusion of too many details. But I want to keep this, for myself, for Anna, for Addie, and for the twins. I want it to be a testament to God's power and His ability to work through the most broken of vessels. I would have never made it through this with Him, working through the staff at the hospital, our tremendous family and friends, our church, and the countless others who have prayed for us based on blog viewings and Facebook statuses. Thanks to you all. You'll never know how instrumental you were to me and my family. God has worked through you in a powerful way, and I hope you never forget that. Thanks.