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Monday, December 22, 2014

Surviving holidays

This might be a bit surprising, but I've never spent a holiday family gathering with either a pregnant woman or a baby since we started TTC more than five years ago.  My parents are not grandparents, and my youngest cousin is in grade school.  Thanksgiving and Christmas have been essentially safe spaces for an IFer.  No family member has ever asked us about when we are going to have kids (and we have not shared with family that we are IF), so we haven't even had to attempt an awkward conversation about it.  Last year on Christmas, DH was reading in the living room, and nearby two of my aunts were saying that my grandma needed more babies around.  DH made a beeline to the kitchen to "get something to drink" to avoid getting pulled into the conversation.  I know we've had it easy compared to stories I've heard from other IFers.

All that will change this Christmas.  There will be two infants at our extended family celebration on Christmas Day.  Two of my cousins who married in the last few years recently had a baby.  One of my aunts will likely be sharing her excitement with everyone, as any new grandma would.  During the afternoon people gather in the kitchen or living room, and I really just want to hide in the room where the babies are not (the living room) and avoid them, but I kind of expect that aunt to personally introduce the baby to everyone.  (The other aunt has other grandchildren so maybe her excitement won't be as fresh?)  Is it bad to hope that both babies will be sleeping the whole afternoon?  It's only about five hours that the cousins with babies will be around on Christmas Day, based on previous years, so at least it's a limited time.  I can't spend much time in the bathroom as there are only two bathrooms for 40+ people.  ;)  I'll be in the middle of my post-peak phase, so all bets are off how my mood will be.  Just thinking about being around babies is making me cry right now, so I'm not super optimistic I'll be able to hold it together in three days.  There's nowhere to escape as we'll be in a rural area, and the nearest city is a half hour away.  I suppose I could go for a walk outside in my nice dress and big winter boots if it got too hard to handle...  I know I can't just avoid them forever though.

I'm also not looking forward to comments about having babies, especially if they're thrown in my direction.  I'm hoping it just doesn't come up.  :)  I had asked for advice on what to say to the question, "Where are you going to have kids?" in an older blog post.  The advice in the comments ranged from sharing about IF to saying "I don't know" and changing the topic or walking away.  I'm leaning toward saying: "I don't know.  I'm going to get some more water."

If you have any advice on how to get through Christmas gatherings with babies around or how you handle relatives' comments and questions related to having kids or IF, please share in the comments.  :)

I keep all you of in my prayers always, but most especially this week.  If I end up having a difficult day on Christmas, I will be offering it up for you.

Tuesday, December 2, 2014

Surgery recap and recovery

This is rather long.  Read what interests you, and skip the rest.  I mostly wrote it out as a record for myself.

Day of Surgery

hospital socks
Friday morning (Nov. 21) I was supposed to be at the hospital at 5:30 a.m.  I showered with a special soap that morning (and the night before).  After we filled in the paperwork at check-in, I headed over to the chapel to spend a few minutes with Jesus in the tabernacle.  I love Catholic hospitals.  :)

When the nurse took me back, before putting on the hospital gown, I had to use large wipes on my entire body.  The wipes were supposed to leave a film on my skin that would help prevent infection during and after surgery.  I think she said it was protective up to 24 hours after surgery?  It was new since my previous surgery at this same hospital.  I also put on the fashionable hospital socks that have no heel and are the same on both sides so you can't put them on upside down.

In the past, my biggest worry the morning of surgery was the IV, but this time I didn't even blink when the nurse inserted it.  I guess years of blood draws and some awesome prayer warriors can help a girl get over her fear of IVs (and needles in general).

my view in bed all prepped for surgery
This time they put what I call "water wings" on my calves while I was still conscious. They're supposed to help prevent blood clots by sporadically inflating to squeeze my legs.  After I was all tucked in bed, the nurse turned on the warm air to inflate my gown and keep me comfortable (and to keep my body temperature up which improves recovery after surgery).

When the anesthesiologist came in, I mentioned that I had nausea and vomiting after both previous surgeries.  He said he read that in my file and would be giving me a patch to prevent that.  I was definitely looking forward to no vomiting.  :)  Later the nurse anesthetist came to give me the patch. She stuck it behind my ear and said I could keep it on for up to three days.  She warned me not to touch it, but if I did, I would have to immediately wash my hands.  I guess if you touch it and then rub your eyes, it will dilate your eyes and give you a headache.  She gave me a rubber glove to use to remove it at home.

Around 7:20 a.m. Dr. E arrived with a third year med student who was accompanying her for the day. It was the student's first day on her ob/gyn rotation, so she was just going to be observing, not assisting.  I gathered that Dr. E hadn't had a chance to explain much about her training or NaPro, so I decided to fill the med student in a bit.  Just a bit.  :)  I told her that many of Dr. E's patients travel long distances because she has done a special fellowship in surgical techniques for endo and that she's 1 of only 14 in the country (not including Dr. Hilgers himself) to have that kind of training.  I think I might have slightly embarrassed Dr. E, but I wanted the med student to know ahead of time that she was going to be observing a highly-trained surgeon.  The med student seemed intrigued.

Dr. E then prayed over me which I loved.  I noticed at the end of the prayer the med student made the sign of the cross when Dr. E did, so maybe she'll be even more interested in NaPro because she's Catholic...  Hopefully Dr. E was able to plant more seeds as she spent time with her...  :)

Dr. E promised to tape a rosary to my hand before surgery started.  She said she had a bunch that were blessed by Pope Francis.  My last surgery I had one that was blessed by Pope Benedict.

rosary blessed by Pope Francis
Just after 7:30 a.m. the nurses came back to wheel my bed to the OR.  I was awake long enough to see the inside of the OR briefly before the anesthesia kicked in.

My surgery lasted about an hour.  I don't know what time I woke up from anesthesia, but when I did I was in a large room with curtains around each bed and a rosary wrapped around my hand.  I wasn't nauseous at all.  :)  I asked the nurse standing next to my bed for water, but she said that would make me nauseous so she brought me apple juice instead in a cup with a straw.

Dr. E stopped by to explain what she found during surgery.  I tried really hard to concentrate on what she was saying because it was unlikely I would remember anything based on previous post-surgery talks with the surgeon.  I remember her saying that I had stage I (nearly stage II) endo and that perhaps Dr. K (at PPVI) would want to do the next surgery.  Somehow I was coherent enough to reply that my insurance didn't cover the hospital in Omaha.  She said she would at least consult Dr. K before doing my next surgery.  What is not clear in my memory is if she said it would be robotic "with the possibility of opening you up." (meaning a full laparotomy)  I really hope I am remembering that part completely wrong.  A laparotomy would be a six-week recovery versus the robotic laparoscopy's two-week recovery.  She also said that she could tell I had ovulated prior to surgery by looking at my ovary.  Surgery was on P+1.  She did cultures of my endometrium and cervix, but I won't have those results for a while.

Dr. E spoke with DH separately and gave him pictures of my insides.  As she explained them to him, she labeled some of them.  I had endo near where my rectum meets the colon, and that would be the tricky spot to remove.  I had another spot of endo near my cervix.  There is some scarring on one ovary, but I don't know if that's endo.  There was another questionable spot that might be endo or could be something else.  All of the endo is in new spots.  Why, oh why does my body regrow new endo so easily?  :(  It's been 21 months since my last surgery.

The nurse anesthetist stopped by briefly to ask if I was nauseous.  I said no.  She smiled and said she has a 100% nausea-free streak with the patch on her patients.  I'm glad to have kept her streak alive.  I ended up keeping the anti-nausea patch on for a day and a half.  I'm definitely asking for it next time.  :)

So there I am lying in bed sipping my apple juice and feeling pretty good.  The next thing I know the nurse says it's time to get me dressed.  I was really surprised (since I hadn't urinated yet...that was the ticket out of there in my first surgery) but I didn't mind.  I got some granny-style hospital underwear (so comfortable!) and two large pads.  Why two?  I don't know.  I didn't discover the second one until later in the day when it fell out in a rest stop restroom...  At that point I was thankful the first one was still in place.  :)

Shortly after getting dressed, the nurse moved me to a chair next to the bed.  DH came into my curtained room and got some last minute directions from the nurse.  Another nurse brought a wheelchair and wheeled me to the hospital entrance.  It was about 10:30 a.m.

We drove to a pharmacy near the hospital to pick up my two prescriptions for pain meds.  I learned that Dr. E doesn't call in pain meds, so we had to walk in with the prescription in hand (well, DH walked in) and wait until it was filled.  Thankfully it only took about 10 minutes, unlike my previous two post-surgery experiences where it took an hour or more.

I had a small pillow in the car to put between me and the seat belt to cushion bumps in the road.  I reclined the seat a bit because that was more comfortable than sitting straight up.  I ate a few snacks, which tasted so good after the previous day's clear liquid diet of chicken broth and apple juice.  :)

At home, DH made me chicken noodle soup, my comfort food of choice.  I set alarms in my phone to take the pain pills on a schedule (hydrocodone/acetaminophen aka "the good stuff" and ibuprofen) and then napped until dinner.

Day after surgery

Early the next morning, I awoke after a poor night of sleep thinking I'd spend the day watching movies and napping.  As DH was helping me out of bed, he stopped and sat on the side of the bed.  He was having terrible abdominal pain on his right side.  He never has pain like that.  After a few minutes it subsided.  He took a quick shower in case in came back, and it did.  I was worried about appendicitis.  He normally avoids going to the doctor, but he said he needed to go to the ER. I knew that meant it was bad.  If he didn't volunteer to go, I would have forced him in my I-can't-get-out-of-bed-by-myself state.  Don't mess with a girl who just had surgery.  ;)

I did spend my day watching movies and napping at home as I had expected...but also e-mailing back and forth with DH who was lying in a bed in the ER.  It turned out to be a kidney stone. Thank God it wasn't more serious.  He came home in very little pain.  He had no pain when he passed the stone.  A little tiny thing sure caused a big problem...

Rest of recovery

The next morning I felt decent enough to make a public appearance, so I went to Sunday Mass with DH.  I took both pain meds beforehand so I was happily drugged up.  I couldn't genuflect, but everything else was fine.  Afterward I was exhausted.  You don't realize how much up and down there is (sit, stand, sit, stand, etc.) until it's hard to stand up on your own.  Mass on Thanksgiving was better (no pain meds), but I still felt like I had competed in the Olympics afterward (i.e., was wiped out).

I took my pain meds on the prescribed schedule for the first four days, and then I started to wait and see how I was feeling before taking something.  On Wednesday, I only took one pain pill.  I took my last one on Friday, a week after surgery.  Since then, I have been using the heating pad for random pain flares, and it works well.

I learned a new post-surgery trick the hard way.  After surgery, I had no other choice than to sleep on my back.  I normally sleep on my stomach or my side.  By the third night after surgery, I could lie on my side a little.  One night while sleeping I rolled onto my stomach and woke up in the morning in a lot of pain.  Not fun.  To prevent it from happening the following night, I slept on my side and hugged a large pillow.  It kept me from rolling onto my stomach.  I still sleep with the extra pillow because I don't think I'm ready to sleep on my stomach.

Something else new I realized this time around is that a straw is a really useful thing to have, especially during the part of recovery where it's difficult to sit up when you're lying down.  If you have a bendy straw in your cup or water bottle, you don't have to sit up to drink.  It will come in handy more when I have my next surgery.

I experienced a new and unpleasant symptom during this recovery that I didn't have after my previous surgeries.  Involuntary, quick deep breaths started about four days after my lap.  At that point, taking a deep breath was not really enjoyable because it increased the pressure on my incisions, but it was possible if I did it slowly.  I know most breathing is involuntary, but this was strange because they were little gasps for air when I thought I was breathing just fine.  They would happen quickly like hiccups and last a second or less, but they didn't happen as often as hiccups. Oh, did they hurt.  :(  Dr. Google told me it was common after abdominal surgeries.  They lasted 4 or 5 days, but became gradually less painful because my abdomen could tolerate the pressure better.

About the same time the weird hiccup breaths began, I started sneezing quite a bit, which hurt more than a deep breath.  I should have read the discharge directions that said I should hug a pillow tightly against my stomach whenever I had to cough or sneeze to minimize the pain.  Next time I'll have a pillow ready.  :)

Even though I had been told you can expect to go back to work within a few days of a lap, I was happy that I took the week off through Thanksgiving.  Being able to nap whenever I wanted was really nice.

I ended up spotting for eight days after surgery.  My urge to urinate disappeared for two or three days after surgery, so I had to remember to go to the bathroom those days.  I was very happy when it returned.  I guess you don't appreciate things so much until they're gone.  ;)

My incisions still ache a bit on and off.  Sneezing is still a bit painful.  I can bend forward most of the way without pain and pick up things from the floor.  I probably could drive (the prospect of slamming on the brake doesn't scare me like it did last week), but I've preferred not to drive since DH can.  I've been really grateful that this surgery's recovery is so much easier and quicker than the robotic lap.

I haven't heard back from Dr. E yet about scheduling my next surgery.  I assume she's going to consult with Dr. K first to better plan the surgery.  It will be January at the earliest.  I have a post-op appointment in two weeks.  I don't know if it will be in person or virtual (phone or Skype).

Here's a little summary of what I've learned:

What to bring to the hospital when you have surgery
  • yoga pants or any clothing that isn't snug at the waist
  • underwear that sits either really high (granny-style) or really low
  • pads
  • all prescription medications in their original containers
  • small pillow to put between you and the seatbelt
  • large pillow to make napping in the car more comfortable
  • plastic bags or bucket for car in case of vomiting (if you don't get the anti-nausea meds)
  • food for the ride home

Nice things to have at home during recovery
  • straw for drinking when lying down
  • large pillow to hug during sneezing/coughing and sleeping (to prevent rolling onto stomach)
  • heating pad