Sunday, November 2, 2008

Prologue to Kaden – Part 4 - Au Revoir Appendix

Just a few days after I fled the doctor’s office and decided not to move forward with an amnio, I woke up at 2:00 am with sharp abdominal pains. The pain was severe enough to keep me awake all night but not so bad that I couldn’t get dressed and go to work in the morning. My husband was leaving town for an overnight business trip to Boston and I reassured him that I would be okay, that it was probably just gas. I promised to call my OB as soon as I got to work to ask if there was anything I could take to relieve the pain.

By 9:00 am my doctor had given the green light to take Gas-X or Mylanta for what I assured him was probably just gas. He asked if I had any fever or vomiting. Nope, just the sharp pains. No bleeding. We agreed that I would call him at noon for a status report.

By noon the pain had increased. I was taking Mylanta as if it were candy but still no relief. Still no fever, vomiting or bleeding either so the doctor told me to go home and relax. If the pain persisted through the afternoon or I developed other symptoms I was to call him right away and go to the hospital for examination. My husband was nervous and decided it was best to make apologies to his boss and come back from Boston that evening in case I needed him. Thank God he did.

I threw up for the first time at about 5:00 pm but then, miraculously, I felt better. I called my OB and he was tentative. Maybe I had gotten out whatever was bothering my stomach. He told me to call him right away if I threw up again, the pain came back or I developed a fever.

Within an hour the pain returned tenfold. I was alone in my apartment and not sure that I had the strength to even call a cab to take me to the hospital. My mother in law, knowing I wasn’t feeling well, was on her way to the apartment to take care of me until my husband returned from Boston. She walked in the door at about 7:00 pm. Within minutes I was vomiting again. We called for a taxi to take us to the hospital. Because we live in the suburbs and my OB and hospital were in NYC, it took more than and hour to get there.

Here’s what I found out at the hospital: abdominal pain when you are 5 months pregnant is a complicated thing to assess. Since I had no fever, which is generally the first sign of an infected appendix, they performed other invasive manual testing to rule out pre-term labor and the like. The night was starting to get really scary.

My husband was by my side by 9:00 pm but we still had no idea what was wrong. Even worse, it was a busy night on the labor and delivery floor of our hospital and it seemed as though my belly ache was the lowest priority. We literally waited in the room for hours before an MRI machine was available for me at about 1:00 am. I will save for another time a diatribe against my original OB and the hospital care we received that night, but let it simply be said that I have never in my life felt pain as severe as my appendix rupturing and I hope that I never do again.

There was a point in the night when I didn’t need MRI results to tell me it was my appendix, the pain in that area became so penetrating and severe. My moaning turned into screaming and crying. Unfortunately the doctors did have to wait for MRI results so my husband, beside himself at that point, did his best to hold himself together and be there for me until they finally took me for surgery at about 5:00 am.

The hours right before the appendectomy are fuzzy to say the least. I was in a haze of pain, fear and morphine. I remember being met by a group of doctors right outside the operating room who asked rapid fire questions about my medical history and began explaining the risks associated with surgery, which I supposed was necessary for informed consent. Between grimaces and squirms I looked at the doctor and asked, “If I don’t have this surgery right away there’s a strong possibility that the baby and I will both die, right?” Yes. That was all I needed to know. I didn’t want to hear any more about risks or potential complications. I just wanted me and Kaden to survive and get to the other side of the whole horrific situation as quickly as possible.

I woke up from general anesthesia to the faces of my husband and mother in law telling me that everything was okay. The doctors had already performed an ultrasound and confirmed that Kaden made it through the surgery too. We were all so relieved.

I found out later that the doctors performed a laparoscopic appendectomy, which means they filled my abdomen with air, inserted cameras and thin instruments, removed my appendix and vacuumed my abdominal cavity to remove toxic matter that had leaked out. Fortunately, the perforation in my appendix was small and the leakage remained localized. How they were able to do all this without harming Kaden is beyond me, but I will always be extremely grateful.

My husband later told me how scared he’d been in the waiting room. How the surgeon told him before surgery that the whole procedure should only take 45 minutes unless the appendix ruptured, in which case things would be far more complicated and severe. After an hour and fifteen minutes passed with no word from the surgeon, he felt trapped inside the worst moment of his life. My appendix had indeed ruptured and he was faced with the unthinkable possibility of losing his wife and unborn son in an almost absurdly unexpected turn of events. I think it’s safe to say that was the longest hour and a half of his life. At least up to that point, anyway.

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