Infertility, Part 6, or, Fertility, Part 1

Other than the fact that I had a high risk pregnancy due to recurrent miscarriages, the first couple trimesters were pretty normal. I had nausea and very specific food cravings. I was tired and my breasts ached.

The only abnormality was my ever-present anxiety. I was constantly worried I’d lose the baby, though there was never an iota of evidence that I would. Every ultrasound was perfect, every check-up routine, every symptom normal.

Still, I must’ve asked Josh everyday whether he thought our baby was okay. He never once got frustrated with me and always assured me that the baby was fine. At some point, I began to laugh at myself when I asked him, fully aware of just how ridiculous I was being. But I still asked him.

Everything was mostly fine for a change.

—-

One April afternoon when I was 29 weeks pregnant, amidst a two-week period of even enjoying my pregnancy, I began to have what I thought was severe heartburn. It rapidly evolved into some kind of attack. I had pain radiating into my left shoulder and painful spasming in the right side of my belly. I knew it wasn’t the baby, though. At least, I was pretty sure. She’d been moving around normally all day. She even moved around normally during the attack.

I grabbed my phone and texted a friend who works in medicine. She said it sounded like a gas attack and to get gas medicine. Since this was my hunch as well, I calmed a little. At least, I felt calmer until the pain got worse.

I called Josh to the bedroom where I was lying on the bed, making futile attempts to get comfortable.

After assuring him that the baby was fine, I sent him to Walgreens for Gas-X.

When Josh got back a short eternity later, I was pacing the bedroom. I was crying, but not in a way that was familiar to me. Tears steadily streamed out of my eyes, but I wasn’t sobbing. My breathing get louder and more rhythmic. I sounded like a TV actress doing “lamaze.” I heard myself whimper. I felt like a wounded animal.

“Are you okay?” Josh asked, clearly shaken by my appearance.

“Open them,” I said, walking back and forth.

“The pharmacist said to get chewable so you wouldn’t have to mess with water. Plus he said they work faster.” He handed me a tablet.

Even in my state, something about what he said stood out to me.

Josh asked for help, I thought. With that mid-attack observation, nearly all of my doubts about how he’d be as a father were erased. If he doesn’t know the answer, he’ll ask for help.

Within a few minutes, I started to feel better. I even dozed off on the bed.

But when I woke up in worsening pain a few minutes later Josh asked if I wanted him to call the OB. I said yes.

When she called back, I was again feeling much better, though quite tired. I told her that at one point I was probably at an 8 on the pain scale. She said it didn’t quite sound like a gallbladder attack or appendicitis.

“I felt panicky.”

“You’re worried about the baby,” she said.

“Actually, I don’t think that’s it.”

“Just try to relax. It sounds like really bad gas. Take another Gas-X and see what happens.”

“And if the horrible panicky pain comes back?”

“I guess head to the hospital and call me on the way. Don’t go to the ER, though. Go to Labor and Delivery.”

—-

I was fine for a few more hours. I even went crib mattress shopping with my mom. But while we were at the store, the pain came on again. My vision started to quaver.

“We have to go. Now,” I said.

“Do you think I can I buy this first?” my mom asked, pointing to the mattress.

“What? No!”

“We don’t know what’s going on with you. What if you end up having the baby?” she asked.

She had a point.

I paced the store near the registers while she bought the crib mattress. Then we loaded up the car and I started to drive us back to my house.

“Are you sure you don’t want me to drive?” she asked.

“I’m sure,” I said.

“Okaaaay,” she said.

I made it about a mile before I realized how stupid I was being. I pulled into a gas station parking lot.

“Do you want me to drive now?” she asked.

“Yes,” I said. “But don’t drive like an old lady.”

She drove slowly, while I hounded her for it, all the way to my house.

Josh packed a bag for me and we headed to the hospital around 8 pm.

—-

The Labor and Delivery staff was expecting me. They told me my OB would be by later to check on me. I figured that meant she’d be there in a couple hours.

We were taken to a small room. I was told to put on a gown and get into bed. The nurse drew a couple vials of blood and hooked me up to a saline drip.

“Then you’ll be ready if you need surgery,” she said.

An automated blood pressure cuff was wrapped around my left bicep, a pulse monitor was clipped over my index finger. My pregnant belly was wrapped with an external fetal heart monitor.

Fetuses and babies in utero have very rapid heart beats. Through the monitor, it sounded like whoosh whoosh whoosh. The microphone is external, though, so every time I moved there was a much louder static sound as well. I tried to distract myself by watching TV, but I was having sensory overload from the beeping blood pressure machine, the wooshing baby and my amplified movements. Plus, Josh fell asleep almost immediately and he’s a world-class snorer. I yelled at him to change positions in his chair.

I was living the soundtrack to my personal hell.

For the next several hours, I suffered bouts of extreme pain. I couldn’t get comfortable, but I was supposed to be very still so the monitor could accurately record the baby’s heart rate. Every hour or so, the nurse would come and draw more blood. Because of the saline, I had to get up to go to the bathroom more than a couple times. I had to unhook the baby monitor and make sure that none of my cables or tubes were caught on anything. Then I had to wheel the IV stand to the bathroom.

Around midnight, the nurse told me that the doctor on the floor wasn’t sure whether it was my appendix or my gallbladder.

“Nothing in your bloodwork has changed,” she said.

“Really?” I asked. “How is that possible?”

“I don’t know, honey. Sometimes it takes awhile for things to become evident. Are you in a lot of pain?”

“Yes,” I whimpered. I was soaked with sweat.

“I’ll see what I can get you.”

She returned a little while later with Tylenol with codeine. I took it. What’s a little codeine when facing surgery? I thought.

She came back an hour later.

“Did that help?”

“Not at all,” I said.

She didn’t say anything.

I don’t know whether it was the teenage druggie in me, or what, but I felt like she thought I was drug-seeking.

She checked all my vital signs and the print out from the fetal heart monitor and told me to hang in there. Then she left again.

I started to cry.

At some point, even though I was in pain, I fell asleep.

—-

I woke up in sudden, excruciating pain. I sat upright and tried to shift my weight around.

I was in so much panic-inducing pain that I didn’t even notice I was peeing on the bed until it was too late.

I woke up Josh and had him find the nurse.

When the nurse came in she seemed mad. I sat quietly while she checked everything and fixed the bed. Then she left again.

“What’s her problem?” Josh asked.

“I don’t know. She’s been like that the last couple visits.”

She came back a few minutes later.

“Your doctor should be here soon, maybe an hour or two,” she said.

It was around 3 am.

My doctor showed up at 6 am. I was drowsy when she came in. Josh was asleep. She started to say “How are you feeling?” but took one look at me and rushed over to me.

“I am so sorry,” she said.

“For what?”

“I thought you were exaggerating because you were scared. You’re obviously sick.”

“It’s okay,” I laughed a little. Just a silly, possibly life-threatening misunderstanding!

“No. You obviously know your body very well. I won’t make this mistake again.”

“Thank you.”

“I’m going to have them take your blood again. Hopefully we see something. If not, you’re going for a scan. We can’t wait much longer.”

“We could’ve done a scan?”

“We don’t like to do them when the patient is pregnant.”

I thanked her and she left. The nurse came in a few minutes later.

“Your white blood cells finally rose. I told them 5 hours ago that it was your appendix,” she said.

That’s why she was pissed. They didn’t listen to her.

“What do you know?” I said. “You’re just a nurse.”

“Exactly,” she said, smiling.

My OB came back in.

“Are you okay with me giving you morphine?” she asked. “It’s a category-“

“I’m fine with it.”

She pushed the morphine through my IV line.

“They’re setting up a room for you now. Your surgery is scheduled for 8 am.”

“Okay.”

“I think you may have the worst luck in the world,” she laughed.

___

I felt much better on the morphine. I was able to get comfortable enough to fall asleep for about an hour. The surgeon woke me to talk to me. After pleasantries, he cut to the chase.

“I’m very good at what I do. Very. But I am also a human being. I will do my best to ensure that your surgery is my best work.”

“Thank you,” I said.

“I do about two appendectomies on pregnant women every year. So it’s not a rare surgery, but it’s still relatively unusual. You’ll have to have an open incision because, due to the baby, we don’t know where exactly your appendix is.”

I laughed.

“I hadn’t considered that.”

“If you’d been less than 20 weeks pregnant, we could have done this with a scope.”

“Of course,” I said.

“Now, if for some reason there are complications – which are very rare even in your situation – I would focus on saving your life first. You are the patient. But I would also try to save the baby,” he said.

I nodded.

“All of this is in God’s hands now. I am merely his instrument,” he said.

I’m not religious. I refer to myself as agnostic, if only because there’s maybe not a good word for what I believe. But he was so genuine in what he was saying, so gentle and kind and confident, that I trusted him completely.

“I understand. Thank you.”

He left.

I had to have this surgery. There was no point worrying about whether I’d die on the table because appendicitis would kill me and the baby eventually anyway.

—-

About an hour later my bed was wheeled to the elevator, down a series of halls connecting new buildings to old, and into a curtained room in the surgical waiting area. A series of nurses, aides, and doctors – all wearing scrubs and those papery hats they wear – came and spoke with me.

I cracked jokes while answering questions. They poked, prodded, and wrote on me with marker.

“You’re in good spirits!” said one nurse.

“You seem like you’re feeling better,” said another.

And I was feeling better, though I wasn’t sure why. Is it the morphine? Nah – it’s been several hours. Maybe it’s not my appendix.

But I shrugged that off because obviously it was my appendix. If it was my gallbladder, then the other thing they were testing for would’ve spiked instead.

Josh and my mom hugged and kissed me and then it was just me, the nurses and the anesthesiologist heading down the hallway. He’d administered the anesthesia in the waiting area, but I stayed awake and talkative for several minutes after we entered the operating room.

I told them to watch the old Levi’s ad set to Soft Cell’s “Tainted Love.”

“You’re still awake?” the anesthesiologist joked.

Then they all started talking to each other and I drifted off.

—-

“You’re okay, honey. Calm down,” said a voice.

I thrashed.

“How long has she been like this?” said another.

“Just a couple minutes.”

“[Spants], you are okay. You’re in surgical recovery.”

“Here,” said the second voice.

I felt something resting on my stomach. I opened my eyes. It was a small, paisley pillow. There was a written note attached to it. It took me a few minutes to be able to read the note, which said: “Get Well Soon! :)” It was from a hospital volunteer group.

“What is this?” I asked.

“You’ll need that later. To hold against the wound.”

I must still be out of it, I thought.

“I’m thirsty,” I said.

They gave me ice chips.

—-

I was in the hospital for two more days.

The nursing staff was nice, but one nurse in particular was outstanding. She was the only one who worked with me to learn how to stand up and get around again. It’s hard enough to sit and stand and get out of bed with a pregnant belly. It’s extremely difficult to do so when that pregnant belly has a 6-inch incision across it.

I was determined to do things on my own because I knew that I’d mostly be alone once home.

The paisley pillow came was more useful than I’d imagined.

—-

A few days after being at home, I noticed that my incision looked pink and puffy. It hurt about the same as always, but there seemed to be more pressure behind it. Of course, that might have been from Tiny kicking away at it from the inside.

Or maybe it was something else.

I woke up in the middle of the night with a cold and wet belly.

“The hell?” I said. I thought that I somehow got pee on my belly.

I reached over and turned on the lamp.

The wound had burst. There was blood-tinged liquid all over me, the paisley pillow, and my side of the bed.

Josh helped me clean up and change clothes. I called the OB’s exchange and waited.

The on-call doctor said that it sounded like a fistula which sometimes happens following surgery.

“It’s just a build-up of fluid, likely harmless. I think you could probably just talk to your regular OB tomorrow,” he said.

“Really? You don’t think I need to have this looked at now?”

“I think it’s probably fine, though I guess to be on the safe side…”

“I’ve got a history of miscarriage. I definitely want to be on the safe side.”

“How far along are you?” he asked.

“Thirty weeks.”

“You know, on second thought, maybe you should go to the ER.”

—-

We were at the ER for a few hours. I definitely had a wound infection.

The ER doctor told me to look away while he snipped and removed two stitches that were stretched so tightly they were cutting my skin.

Of course I watched anyway.

“I don’t know how your stomach is going to heal,” the doctor said.

“What do you mean?”

“Your stomach is going to keep growing and stitches don’t stretch,” he said. “The good news is that we caught it early. No signs of cellulitis.”

He swabbed the small opening so they could run a culture and find out which bug had gotten me. Eventually, he returned with the news that the infection was an extremely rare bug, so rare that he had to research it. He said it I most likely picked it up in the operating room.

He shuffled around in cabinets and drawers, collecting long tweezers, packing tape, wood-handled cotton swabs, and surgical tape.

“Will you be packing the wound yourself?” he asked.

“Uh…” I looked down. “I don’t know if I can see it well enough.”

“I’ll do it,” said Josh.

“Come watch,” said the doctor.

He showed Josh how to use the tweezers and cotton swab to shape and then guide the packing tape into the small opening.

“How tightly do I pack the tape?” Josh asked.

“She’ll let you know,” said the doctor. “Believe me.”

The procedure was mildly painful. More than anything it creeped me out to feel the dry tape and cotton swab rub over the inside of my partially open wound.

I was told to follow up with my surgeon in two days and to have Josh change the packing twice a day until then.

—-

Josh handled the wound packing for the next two days. My mom attempted to do it once. She took so long trying to handle the tape with the tweezers and cotton swab that I became nervous and requested Josh pack it instead.

For the next couple days, my wound continued to look puffy and red. More stitches began to tighten and cut grooves in my belly.

We went to the follow-up appointment with the surgeon and his nurse unpacked the tape. She told Josh he’d done a very good job.

The surgeon came in and apologized.

“I’m so sorry this happened. We do our very best to maintain a clean operating room. I can tell you that all the equipment we used during the surgery was sterile or new.”

“Oh, I understand these things happen,” I said.

He took one look at my belly and decided to remove the stitches.

“The infection clearly isn’t improving. I’m surprised they didn’t remove these at the ER,” he said, snipping the black stitches and tugging the threads with tweezers. My skin felt like a too-small shoelace eyelet with unwaxed leather laces being forced through. My stomach turned.

After he finished removing the stitches, he set his tools onto the table. He stuck a gloved pinky into the open section of the wound and poked a bit.

“Sorry to do this,” he said as he dragged the side of his little finger along the length of my not-healing, infected wound and unzipped me like a bowling bag.

“Oh my god,” I said. For once I couldn’t look anymore. I don’t know what I was expecting, but that wasn’t it. I thought about mealy, rotten peaches and wanted to puke.

“You okay?” Josh asked. Meanwhile the surgeon kept talking and poking about the wound.

“I’m really hot,” I said. “Really hot.” I knew my face was turning bright red.

“Do you need water?”

I shook my head. “I’m hot.” I was breathing heavily. I wanted to roll off the table and run, away from the fluorescent lighting and the sadistic surgeon and the recycled office air.

Josh opened the exam room door and started fanning me with his hands. The surgeon used gauze to soak up the fluid inside the wound.

“Nurse!” called the surgeon.

The nurse came in.

“Can you get her some damp paper towels?”

Josh looked scared.

I was gulping for air. The nurse began to dab at my temples and forehead. She told me to exhale slowly and completely between my inhales.

“I’m so sorry,” said the surgeon. “I thought warning you might make things worse.”

“I’m normally not very squeamish,” I said. I could feel my pulse slowing.

“It’s different when it’s your own body,” said the nurse.

“I guess,” I said.

Or maybe it’s because he just used his little finger to unzip my pregnant belly! I thought.

After making sure I was okay to proceed, the surgeon told me that the wound had to stay open indefinitely. This meant that I would need dressing changes twice a day until the wound closed.

“Which probably won’t happen before the baby comes out,” said the nurse.

We were given a list of instructions to follow regarding packing and cleaning the wound. The surgeon also gave us a large bag of supplies to use: gauze squares, paper tape, wood-handled cotton swab.

“And here’s some smelling salts. You might need to use these,” the surgeon said, handing the small white packets to Josh.

We went home.

—-

For ten weeks, with few exceptions, Josh dutifully and gently changed my wound dressing twice a day. After a few weeks, if he couldn’t be home, then I packed it. Once the wound was a little smaller, it was easier to use my fingers to pack the wound than to blindly jab a swab at it.

But that first week was rough. I was on the brink of tears with every dressing change, and exhausted after the few minutes I had to lie there and wait for it to end.

The procedure for cleaning the wound was horrific, and it was entirely up to me to do it. I had to take a cotton washcloth, lathered with Dial bar soap, and insert it into the wound. Then I had to gently scrub the wound.

Josh stayed with me the first time I did this, just in case I panicked. I didn’t. But I cried a little and shook. I could only manage to insert and remove the washcloth. There was brown and bright red blood on the washcloth.

“Oh, no,” I whimpered.

“It’s okay, baby,” he said.

I sobbed while letting water rinse the wound.

As most things eventually do, all of this got easier over time.

—-

There were lots of times in our relationship and marriage that I had leaned on Josh emotionally. I had even leaned on him financially. But I had never physically needed him like I did then.

Josh was awesome. He was never outwardly uncomfortable, and insisted that he didn’t look at me any different than he had before. He was always patient and gentle and kind. His horrible hand tremor was never an issue. I made sure I thanked him after every change because I wanted him to know how much what he was doing meant to me. I felt closer to him because I was so vulnerable and he handled it all so perfectly.

The more and more pregnant I got, the more I thought about the baby during dressing changes. She was usually active then. It was a little unnerving to watch my pregnant belly undulate and jerk around while my husband packed the open wound. I wondered what she thought about it and whether she was frightened.

Eventually we decided that maybe she could hear us better since there was a giant hole in the wall. She was just coming over to hang out with us by the temporary window.

—-

I gained way too much weight during the pregnancy, partially due to a much lower activity level in the third trimester. Unfortunately, my appetite didn’t diminish along with my activity level. Luckily, I never had gestational diabetes or any complications. The pregnancy itself continued to be normal.

Still, I continued to be a high risk case, so I had ultrasounds almost monthly. The ultrasound tech kept telling me that I was going to have an eight- or nine-pound baby. This sounded like a c-section in the making and I was hoping to put a few decades between the appendectomy and my next surgery.

As the month of June dragged on, and I continued to not be dilated at all, I entertained the idea of being induced. I had been resistant the whole time because I wanted to do everything as naturally as possible. There were so few things about my fertility and pregnancy that I could control, but this was one of them. I would think about induction and then rule it out. I did this several times. It’s so easy to be idealistic when you’re seven months pregnant.

Then, one day, my legs and feet were so swollen I could barely get around. My knees were in severe pain and I was worried I’d fall down the stairs if I kept trying to walk around like that. I’d had enough. My insurance required that I wait until about a week before my due date before I could be induced. We timed it with my OB’s schedule so that she’d be available to be there.

I’ll spare the labor and delivery details. Other than some horrible back labor the night the induction drugs finally worked, and a bad postpartum reaction to the induction drugs, everything was text book. The delivery itself was easier than I imagined.

And my 9-pound baby? She was actually six and a half pounds and quite long, with a full head of strawberry-blonde hair.

—-

Immediately after she was born, my OB placed my daughter on my chest. She was still attached to me by her umbilical cord.

“Hi, baby,” I said, patting her little bottom.

She turned her head and looked at me. I think she knew my voice.

“I’m your mommy.”

I kissed the top of her head.

Then I wept.

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