The rain is here.

So this isn't really something that I would normally blog about. I try to keep my blog a little more impersonal. But since this saga has taken up, and will continue to take up, a fair chunk of my life, so I guess sharing the details won't be so detrimental, most everyone I know, knows anyway.

After marriage, the next step is generally babies. So after 18 unsuccessful months, I visited my mother's employer who also happens to be a gynecologist. A hysteroscope and laproscope were decided upon and being a friend to the Dr and staff, my appointment was made for the operation in two weeks time. For those of you who don't know a hysteroscope is basically where there go through your cervix and do a bit of a 'dust and clean', as it were, of your uterus. Pretty straight forward. The laproscope is where they make several incisions (5mm-10mm) in your abdomen, at different places, then they fill your abdomen up with carbon dioxide and have a look around, essentially to see if there is anything wrong and flush some dye through the Fallopian tubes to ensure they are not blocked. Also pretty straight forward, minimal risk of complications and a month of recovery before you can return to normality. My Dr had asked me prior to the operation, what my plans were for the upcoming month, "I plan to make babies!" was my reply.

So the day of the op, I was starving and not nervous at all. This was to be my 7th anesthetic, 'accident prone', would be putting it gently, so was used to theatre (as much as you can be). I think the fact that I'm also a nurse, probably does more to hinder the situation, than to help it, ignorance is bliss sometimes, as the saying goes.

After the operation, I recall coming to in the recovery, I was getting a lot more attention than I was used to, something was wrong. I asked what was happening, my blood pressure was low. I said "it's normally a bit low", the reply was "not this low". I was surprisingly groggy after the anesthetic which is not normal for me. A nurse friend came and give me a big hug, with a very worried look and soon I was being sent in an ambulance from the private hospital I was in, to the base hospital. The only other thing I recall was that the procedure had gone off without any problems and that everything appeared well.

The base hospital, I was also receiving a great deal more attention than I would like. I work in Emergency Department, I know that a lot of attention is never a good thing. God knows how many doctors, nurses, students, cleaning staff (ha ha) has surrounded me, and were proceeding to try and get and arterial line in my arm. I'm pretty sure that it was 12 stabs in one arm and 8 in the other before they achieved success. They were very apologetic, but I was in a fair bit of pain by now and I wasn't overly concerned. I was then whisked off for a CT which in hindsight, I could have told them, was a waste of time. If we think about this logically; my blood pressure was dropping, I was white as the sheet, what could have caused it? The only logically response to that I can think of, is that I was bleeding, internally. So to theatre again I was sent, anesthetic number eight. Exploratory laprotomy, is a term that I am now fairly familiar with, it is basically where they cut you open and have a good look around.

Bruises are the laproscope site. You can't feintly see the old laporotomy scar above from 3yrs ago. 

As you can probably tell, from this blog, I'm not dead. Although, from what I'm told, it was only just. Apparently, when they made the incision, it released the pressure, that all my blood in my abdomen had been holding on the artery that was punctured. So I bled, and bled and then I think I bled a bit more. I was told that I lost 7L of blood; in my body, I probably only have 4.5L; so as you may guess, I even lost some that wasn't mine to lose. I had 22units of blood products transfused, my Hb (red blood cell count) which at its lowest is normally 115, dropped to 35, my blood pressure was 40/20. So for those of you familiar with these figures, I was hanging on by the skin of my teeth, for those of you who don't know..... I was hanging on by the skin of my teeth. 

Recovery from this was a bit steady. I remember waking up in ICU (intensive care unit) when I was still intubated, and I was trying to pull the tubes out of my throat. I think perhaps I got aggressive because when I woke, I was tied down. ha ha. Oh well that's what they get for not sedating me well enough. The nasogastric (tube down your nose into your stomach) was the first thing to come out, and I was so grateful. Those are the worst. I had a bit of trouble breathing, I was very overloaded with fluid, from all the transfusions. First day, wasn't so bad, I think I was glad to be alive.

I was told that I was lucky, a vascular surgeon happened to be doing a locum in the hospital and managed to suture my aorta (your main artery). He flew out the next morning. The next doctor who came to visit (you get a lot in public hospitals) asked me if I understood what had happened. I said "my artery was severed", "he replied, "yes, your aorta". I looked at him bewildered. "I don't think so," I said, "are you sure?" I think this doctor was a little taken aback that I would question his greatness. "Yes, yes, your, your aorta was severed during the laproscope," he stammered. 

"People don't normally live through that!"

"Ah, well no, not normally"

So turns out I've got a few more lives than I thought. 

Going into the exploratory laprotomy, myself and the surgeon, had thought my spleen, liver or bowel my have ruptured. I had a previous laprotomy 3 years earlier, when a cow split my pancreas in half, and we believed the adhesions resulting from that op had torn when I was blown up with carbon dioxide. 

So now was all about recovery, with the PCA (patient controlled analgesia) in my hand and probably just a fair dose of adrenalin, running through me, I was discharged from ICU and sent to the ward. A rough night a had, after the adrenalin wore off, the morphine didn't cut it. My breathing wasn't real good either, with still a lot of fluid on my lungs. The next morning, and I'm sorry if this is harsh, but the nurse, who obviously didn't realize exactly what I had been through, insisted I have a shower and then after wheeling me in there, left me, while my bed was made. I was flat out breathing, let alone shower myself. That afternoon, after my observations hadn't been done for over 5 hours, mum was not happy (she's also a nurse). The finally were done, and a MET call (medical emergency team) ensued. Despite the lack of the MET call team and alarm, but that's what the document said had happened. Turns out my breathing wasn't so flash after all. Back to ICU. 

Thank god mum brought her 'cow' bag of food every day to feed me or I may have starved on that crap hospital food. And to my beautiful husband for running around to get me some hospital clothes. 

I stayed here for a few more days and then I think after sending me off prematurely (mostly due to their need for my bed I think), they were reluctant to let me go. So I was an out-lie next door in CCU (coronary care unit). Slowly I improved and showering was far easier, with mum to help, rather than the stressed nurses. Although the ICU and CCU nurses were beautiful and patient. The physio people were the worst (I say in jest). Breath, they would say, (oh yeh, let me cut you open and then fill you up with fluid and see how well you breath, if I wasn't so unwell I would punch you!). I got weighed in CCU, 7kg, more than my usual weight, and I hadn't really eaten for 4 days. So it was fair to say that I had some extra fluid on board. 

Recovery went pretty good, my breathing improved and I was just about able to shower myself. Good to go home I thought, and so I told the doctor. I had been in hospital 9 days now and 2 days ago I had been sent to Surgical ward, not a lot of fun, I was ready for home. But my blood tests weren't satisfying and so I was sent for another CT. Two hours later I had a visit from two doctors. This was not a usual ward round. "How are you feeling?"

"Not so well having seen you pair here."

"Yes well, we just want to know how you were feeling, any changes?"

As it was, stupid me, told them, that mum and I had both thought, I had, had more swelling today. Great! The CT showed active bleeding from the repair site. Happy, I was not! Held it together pretty well, until mum returned to visit in the afternoon, I knew it was going to break her heart. I was never really that worried for myself, not that I wasn't scared. But I can understand that it's hard to be a bystander, especially when your so damb helpless. So, exploratory laporotomy, seems like there is an echo in my story. Anesthetic number 9, and yes I'm told that's very bad for your memory (truly), that's my excuse anyhow.  

I think I ended up back in ICU, just as a precaution but it was hard. The night after the op, I was in such unbearable pain, nothing they gave me would relieve it. Unlike in the first op where they had put a local anestheic drip going into my wound site, the anesthetist did not believe I would be in much pain, and so I did not have any this time. She was wrong! All I could do was moan and when they asked me what my pain score was I said "20/10", luckily they knew me or they may have thought I was full of it. Finally, out of exhaustion, not relief, I fell asleep. The next day, I was still in a fair bit of pain and it wasn't until a lovely female doctor came and dosed me up on ketamine, that I was actually pain free again.  This lovely lady, for the first time, since all of this occurred, said she was sorry for what I had gone through. She, had nothing to do with any of it, other than relieving my pain, but yet she was the only person to apologise, 10 days post the original surgery. It was seemed such a small thing, but it was just what we needed to bring down some of the walls we were building. 

Only good thing about Surgical, I could have flowers. 

  Being back in ICU was nice but I had made a point of getting to know these doctors and their names;  I was feeling so lousy and to have all 10 of them (sometimes there really were that many), looking down on me with such despair. I think they liked me because it's not normal to have a patient in ICU that actually speaks, most are too unwell even for that. I couldn't look any of them in the eye, this second round was a lot more emotional than the first, I didn't feel I had the strength to start all over again. Luckily, without the fluid overload, recovery this time was far easier. I didn't have the difficulty breathing, and once I was out of pain, I could get up far easier. My bowels were a bit of a drama, but I will spare you that story, just to say that they are finally good as gold now. 

My two mummies, real one on the right.

So the second laporotomy, found nothing. Just in case you were still wondering. So the second surgery, pain and emotional stress on everyone, had all been to no avail. I was discharged from ICU and spent another 3-4 days in surgical ward. I'm not blaming the nurses, but it's very difficult to do anything in surgical ward, other than to look after yourself. Getting pain relief is a drama in itself. As soon as I was up to it, home was where I was wanting to go (home to mum's in town anyway). I was now eating, drinking, bowels moving and my bloods were improving, so I put the pressure on, and home I was sent. 

My gorgeous niece and nephew. 

A week at home and I was due for a doctors appointment. I had been going ok, it was good to sleep. But I was still on a lot of pain relief and I was a bit despondent because, I guess I felt as though I should have been 9 days in front of where I was. The second op had been a fair set back to my recovery. I went to see my GP, concerned that I should still be in so much pain, I was sent for a CT. Another one! This was a big day out for me, as most days I had been sleeping all night and then another 3 hours or more during the day. I was stuffed. So in the afternoon, we were waiting for the results. When we rang the surgery to ask if they were in, we requested that he just tell us about them over the phone. He wouldn't, not a good sign, I knew it, mum knew it. But it was unspeakable. So I went back to see the GP. 

False aneurysm. My new word for the day. So now I'm told that essentially, I'm a ticking time bomb. One layer or maybe two if I'm lucky, of my normally three layered artery, has a nice little balloon coming out of it. It wasn't huge, but if it burst, I'm back to day one, and being out of hospital maybe just dead if we didn't catch it in time. YAY. So pretty hastily, we organised to see a specialist in Brisbane and the next day we flew down for a review. 

After a few dramas with our flight being cancelled and then on arrival, they didn't have a bed for me, I was finally in bed (exhausted). The doctor came, and didn't seem to know a great deal about what had actually happened to me, and after everything I had been through, wasn't very reassuring. The young registra had suggested that he may wish to do another laporotomy, either that or a stent. I would love to write to this girl and let her know that, this is valuable information that she probably needs to know before she spoke to us. The doctor reassured us that it would be a stent and it was to go in through my groin, very uncomplicated and straightforward (again an echo I think). We had heard it all before. 

By this stage we were very confused. We had read my discharge notes and just from talking to the doctors, the artery that had been severed, had been referred to as; the aorta, the illiac artery and the superior mesenteric artery. So we are thinking, there are two arteries. Especially when one lot of notes said that it was severed and the other says that it was torn (very different in medical terms).   

Oh well, off to theatre again, no general anesthetic this time just local in my groin. This is one of those instances where knowing too much is not a blessing. I knew what they were shoving in my groin/ artery and it wasn't painful, but it was sickening. The doctor however, was lovely, I had been pretty teary going into the op (my tolerance levels were not what they normally are). The doctor was very reassuring and during the op and there is a part when they inflate a balloon in my abdomen, it feels very uncomfortable/ a bit owy. He said "Can you feel that?"

"Yes, it's a bit owy."

"It's just the balloon inflating and we are backing up a bit of your blood."

"Great." (sarcasm)

"It's down now, is that feeling better?"

"A bit, but I think it's mostly in my head."

"No, no it's in your stomach, I can see it on the screen here."

I did not say this, but 'smartarse', was my next thought. The suturing of the artery in my groin and the subsequent pressure that must be applied to stop the bleeding was very painful, as I said, my threshold for pain of any kind was significantly lower than normal. 

The surgery was an uncomplicated success. Finally! The doctor showed me the images of my artery and the repair. After I was back in my room and the pain was now minimal he came for a visit. Turns out that it was only one artery and that the instrument that had punctured it, had actually gone straight through and damaged the opposite wall to where the suture is. Not only that, but this doctor seemed convinced that this aneurysm would have been there, or at least the puncture site would have been there at the time of my second laporotomy So now that the stent is in place, the doctor said that once my laporotomy site has healed, that I am good to go. This news was a relief, because on the topic of conception, we had been having some conflicting recommendations. The initial vascular surgeon said one year before conception, the gynaecologist had said three months, and this doctor said "knock yourself out". Yeeha! 

Even though it was a bit of mental trauma going to Brisbane, this was a very good thing, at least now we knew exactly what had happened, and now that the stent was in place, felt reassured that the puncture site was stable/ strong. So then back home to Rocky. Couple of weeks in town, getting better every day. After two days of being home, I went cold turkey on the pain meds and I didn't need them. Thank god!!! Handy to have for horse busters in the future though! 

I'm back home now on the property and mum has come out with me, just to give me a hand to get back into it, and to do all the jobs that she thinks I might attempt once she's gone. These include; weeding my severely neglected garden, vacuuming the excessive cobwebs and cooking for me and doing all my washing! God I'm going to miss her when she has to go back to work. I feel useless, still being pretty restricted, but it is nice to be home. Tomorrow will be one month since the second op. I guess I shouldn't be too hard on myself, I still have a fair bit of swelling to my abdomen, the CT said the haematoma remaining in 16cm x 8cm x 3cm, so I guess that will take a fair while to dissipate. I wish it would hurry up, cause I still can't wear my jeans! Oh well. I'm still alive and that's a bonus. I'm so lucky to have such great support networks around me with my friends and family, it's times like this that you realise where your allies are. 

As you may imagine, a lot of my friends and family want someone's head on a block for what has happened to me. But to be honest, I'm pretty glad just to be alive and at the moment, I don't have the energy to hold a grudge.

 I'm listening to the rain and hoping that the drought stricken areas are getting some of it. I feel for those people, I think I'd rather have gone through all of this, than to see my cattle and horses starving. Here's to the rest of the year, surely it can only get better. I have been to 3 funerals this year and I truly believe I had three little angels sitting on my shoulders. I must have something to contribute to the world yet hey?!?