I had planned to have a tubal immediately following delivery. (Delivered at 1:44 am) That didn't work out because my epidurals (yes, plural!) did not work. My OB told me that I'd have to wait until at least 6 weeks post partum and get it done under general anesthesia. I was freaking out because I knew if I waited that I wouldn't follow through. He said we could talk about other birth control options until I was ready to get the tubal done. That was a horrible feeling! There I was with little Norman on my chest and already wanted another...and I couldn't get a tubal to stop myself!
Then at 5:30 or 6:00 am, I was awakened by my nurse. The OB who was on for the weekend wanted to know whether I still planned to get my tubal done that day. I was SO CONFUSED! I told her about the problems with the epidurals not working, but that I still wanted to get it done before leaving the hospital if possible. But whatever anesthesia was used would have to be safe for breastfeeding. The nurse talked to the OB, who suggested that we do it that afternoon with a spinal. (Now why didn't my OB suggest that?!) So that's what we did.
I went in for surgery at 4:00 that afternoon. The spinal worked, but they started it a little too low. They had to tilt the table head down for a few minutes to get me numb high enough. They did the surgery laproscopically through one incision below the belly button. It didn't go as easily as expected. I was in the OR for 35 minutes instead of the 12 that I was told it usually takes for a post partum sterilization (PPS).
At some point the anesthesiologist put something into my IV to put me into a twilight, which was not part of the original plan. Despite that, I do remember bits and pieces of the procedure as the OB talked through what she was doing with the assistant. She explained that a PPS is not usually difficult. Part of my bowel was in the way so they had to tilt the head of the table way down to get it out of the way. That made the spinal medication go higher in my body. They were worried about my breathing so they had to put my head back up for a bit so that my lungs wouldn't be too affected. Then I went head down again while the OB finished up. I thought I was going to throw up on the table.
After the surgery, they wheeled me to recovery where I had to be reminded to breathe several times before I just started counting to myself so that I would remember to breathe without reminders from the nurses. My recovery nurses were really confused because no one told them that it was a PPS or that I was breastfeeding. Apparently, it's rare that they see tubals in the general OR, rarer that they are done with a spinal, and rarer still that the spinal is done with the medication that was used. That med was chosen because I refused to allow formula supplementation for Norman. The problem? That particular medication takes a loooooooong time to wear off.
Once they found out I'd delivered that morning they all wanted to hear about Norman. Then came the well-intentioned comments about my family being complete with 2 boys. So there I laid in recovery, bawling my eyes out. Of course they were all alarmed that I was regretting the surgery so soon after it's completion. So then came the obligatory explanation that my body is not good at being pregnancy...which, of course, leads to more questions...which leads to me saying that I was hyperemetic to the end. It sucked. Even being done, I couldn't be DONE!
So they finally sent me back up to the mother/baby unit with a strong caution to my m/b nurse not to rush me out of bed. Apparently it's not unusual for this particular medication up to 8 or 10 hours to wear off. My m/b nurse was paranoid about letting me up too soon, so she refused to let me/help me get up once the spinal wore off because it didn't last as long as expected.
I finally told her that if she wouldn't remove my catheter and help me up that I was doing it myself. So I got to get up over 3 hours after I was sure that the spinal had worn off.
The next day (Saturday) when the OB looked at my incision it was a bit red and swollen, so she put me on antibiotics. Not 5 minutes after the OB left my room I noticed a big puffy spot just off of the incision that went away when I was sitting or laying down. My nurse and OB said it could just be gas or it could be a hernia, but that there was nothing to do about it right then.
Early Sunday afternoon I was discharged to home. I took my second dose of the antibiotic that evening. Less than an hour later I was covered in hives from the chest up and my face had started to swell. Yet another antibiotic to add to my list of allergies.
The OB just laughed when I told her. It was the only thing to do. (I didn't mention earlier that I had also reacted to all of the adhesives that had been used since I'd gone into L&D so I welts all over my legs, chest, back, stomach, hands and arms by the time I left the hospital.) My incision was looking better so she just had me discontinue the antibiotic altogether
I had my first follow up a week ago today. My incision looked good, but the puffy spot was still there. The OB said that she wasn't convinced that it was a hernia, but she couldn't say for sure that it wasn't. So I've got a referral to a general surgeon for mid-February. And my pain medications were increased because my pain level was higher than what it should be.
As of today, I'm still having enough pain that I can't stand to wear clothes that sit on my incision, but I no longer need to set an alarm to take my pain medication the very minute that it's due. So it looks like my body is on the mend... Now I wonder how long it will take the emotional wounds to heal.[/i]
