Friday, October 25, 2013

Dilation and Curettage or D&C

     I promised this post a long time ago. This is a difficult procedure to discuss as I had it only because my twins didn't survive. I want the information from a patient side to be out there however, so I am going to get through this. I will do the procedure and recovery in two separate posts as it would be quite lengthy otherwise.
     I had this procedure completed the day we found out our babies had no heart beats. We were given an option, I could do it then or I could wait until my assigned physician was on call. As I have mentioned in a previous post, I didn't like that physician so waiting all weekend for a procedure, while carrying babies I knew were gone just wasn't really an option for me. My husband and I chose to meet the doctor on call and ask him to perform the procedure that day. We loved him and haven't looked back since I switched to him.
    After it was decided that I would have the procedure that day, I had to have something inserted in my cervix called Laminaria. This is a sea weed based "stick" that is inserted into the cervix to ripen and dilate it. Then gauze moistened with sterile saline was packed into my vagina to allow the Laminaria to grow and do what it was designed to. This procedure was painful for me. To place it in the cervix a speculum is inserted. I was already tender from two transvaginal ultrasounds and Pap smear that day. Then a tool was used to "grab" my cervix and make it "pop" so that the physician had access. I do need to mention that the words in quotes come from the original physician whom I didn't like. She performed this to prepare me as the other physician had to see a patient. She let the tool attached to my cervix dangle while she turned around and walked to a counter to get something. Most physicians would not have done that, especially with an assisting nurse behind them. I don't feel the procedure needed to be that painful and had it been with a different physician I feel it would have been a better experience.
     After the Laminaria was inserted, I was told to not have anything to eat or drink and go home for a few hours while I waited on my 4:30 pm check in time to same day surgery. So I went home and layed on the couch. I was numb, I am not sure if I cried the whole time or even at all. My husband was just trying to be there for me and deal with the grief and realization that in a few short hours this pregnancy would be over and we would have nothing to show for it.The Laminaria felt like a two by four had been placed in my vagina. If I moved wrong it was painful. I had to sit at specific angles to keep the pain away. Finally, the time to go back to the hospital came.
     We checked in, I was weighed, asked a million questions that I somehow had the presence of mind to answer, and an IV was started. I had a horrible migraine by this point so the nurse called anesthesia and asked for something to help. I was given some IV morphine, which promptly caused the nausea to worsen and I began vomiting. I was given IV Zofran while my wonderful husband just rubbed my back and let me know he was there. I was miserable. I just wanted to close my eyes and know it was all a dream.
     When the time came to go to holding, a friend was there to greet me. I have known her for 17 years and she was to be my nurse in the OR. She prayed with us, and we went to the OR. The only problem I have with that process is that my husband didn't get to kiss me on my way back. I had a terrible fear at this time that I was going to die. I prayed, " God, please don't let my husband lose his wife and babies on the same day." I was given medication to help me relax, moved onto the OR table. The eyes of my friend and the anesthesiologist are all I remember before falling asleep.
     I awoke very restlessly while my gurney was being rolled into recovery. I was moving around a lot and hearing my friend tell me to be still, I had lost a lot of blood. The compassion and firmness in the familiar voice was a gift to me I can't describe. I am so thankful God allowed this friend to be the person on call for the after hours procedures on that day. I stayed in recovery for a while, I needed some pain control and there was concern about my blood loss.I also could not get warm. My core temperature had dropped and I had a Baer Hugger on. This is a device that fills a balloon like body blanket with warm air.  I had required two doses of a medication called Cytotec to help contract my uterus and make the bleeding slow to an appropriate flow. The nurses in recovery were very compassionate, quick to respond to my pain, and worked very hard to warm me up and stop the rigors from anesthesia. I did have some pain and nausea problems initially. I was also very cold for a long time.
      I was taken to the women and children's floor for a few hours. I had to have and H&H drawn. This was to confirm I hadn't lost so much blood as to be dangerous to go home. I had to get up a few times and urinate and be coherent. Once all of those things were accomplished, I was told I would have some bleeding, if soaking more than one pad an hour for two consecutive hours to call my doctor immediately or come back in. I was also told not to lift over 5 lbs for a week, to drink a lot of fluid, and to make position changes slowly as I would be prone to passing out for a few days. The doctor came in for one final check of me, determined I was safe to go home and my husband could take me.
     The day was one of the longest of my life, my husband can write from his side, because he was the one alone in a waiting room. I will write about the recovery period a bit later.



So, we have a little one coming.

  How long it has been since I posted!!!  My dear husband (DH) posted about having two positive home pregnancy tests, (hpt). I have avoided posts. Partly due to some superstitious fear that to post it here will end in some sort of tragedy. Unfounded? Yes. Ungodly? Yes. Easily shakeable? Nope. If everything keeps rocking on, we will have a beautiful little boy in about 12 weeks. I am doing better with the anxiety, at times even believing that this little guy will get to come home to our arms. There are still moments that I can't quite comprehend it. I feel him move and wonder, will I really get to meet you? Will I get to see your smile? Will I get to put your picture up next to your Dad's and see how much you look like him? Pregnancy after a loss has been trying at times, made me feel very lonely and frustrated at other times.

We are anxiously awaiting this little person, with hopes and prayers that he will be the healthy, happy little boy we have prayed for for so long!!

                                                                          - Her -