Wednesday, 16 March 2016

Candace's Story: Part One

Back on January 8th, I alluded to Candace's story and the trials we went through during our son's arrival. Well, I'm happy to say Candace is ready to share her story today. But please note this disclaimer: the details were not spared! So with that said, it's over to Candace.

When we served with Mercy Ships, I met some ladies with VVF (also referred to as obstetric fistulas) for the first time – VVF stands for vesicovaginal fistula. A fistula is a passage or hole that has formed. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula. These fistulas can also open into the rectum, colon, or small bowel.

From WebMD: In developing countries where women have no health care nearby, vaginal fistulas are much more common. After days of pushing a baby that does not fit through the birth canal, very young mothers can have severe vaginal, bladder, or rectal damage, sometimes causing fistulas. 
 
In the countries where Mercy Ships serves, there are many, many women who are forced out of their homes due to fistulas. They leak urine and/or feces and, besides the smell, they are thought to have a curse or are being punished by the gods for unfaithfulness to their husbands. But it's not that at all! In December, after giving birth to our son, I realized how blessed I was to be in a developed country with a skilled, caring, competent Ob-Gyn caring for me in a hospital with a clean, functional, well-equipped operating room with a team of excellent nurses and anesthesia providers. So many women do not have ready, affordable access to a trained doctor. If I had been in one of those countries we served – Sierra Leone, Togo, Ghana, Guinea, etc. – I could be either a VVF patient waiting for corrective surgery, or I could be dead. Either way, my baby would not have survived. Here's my story.

Part One

When I went into labor with Riaan, I was waiting for a.) my water to break, or b.) my contractions to continue steadily at 3-5 minutes before I went to the hospital. Neither of those things happened, but I began bleeding. I had been texting a friend who has given birth 5 times herself and is also a trained doula. She and I both felt that I needed to go quickly to the hospital. Upon arrival, I was only 2 cm dilated. (I was really hoping for at least 3 or 4. I mean, come on! I had already been having contractions for 24 hours.) The only reason they kept me overnight was due to the bleeding, but there didn't seem to be a logical reasoning for it. Riaan was doing fantastic, and my lab work looked great. It didn't seem to be my placenta, but they wanted to observe me just in case.

Fast forward to the next morning, Monday, December 7... Dr Frances broke my water when I was at 8-9 cm and I began pushing when fully dilated. I pushed and pushed but didn't seem to be progressing well, so my nurse Marietta had me lay on one side, then the other, to continue pushing. Still not much progress. She could see Riaan's headful of hair, but that was it. After two hours of pushing, Dr Frances came and tried suction. No luck. He told me I could either push for a half hour longer to see if I could give birth naturally, (but he wasn't optimistic) and then go for a c-section, or just go straight for a c-section right then and there. Either way, Riaan was doing awesome in there, but he needed to be born. I cried from sheer exhaustion and a bit of frustration and disappointment that all that pain and pushing didn't work, but decided that if he wasn't optimistic, then there was no way I was putting myself through another half hour of pushing. The room was quickly filled with OR nurses and the nurse anesthesiologist to prep me for surgery.

The c-section went very well, and our healthy baby boy was born. I was so tired and also drowsy from the medication, that I could hardly keep my eyes open and was disappointed that I wasn't more awake and excited about Riaan's arrival. But Murray's excitement was enough for both of us. :) I slept during most of my time in the recovery room, and was only allowed to “hold” Riaan with very close supervision. He was laid next to me because I was too weak and sleepy to really hold him. Thankfully, he was very content. He had his eyes open and was taking everything in while sucking on his beautiful little hands. I heard my parents, sister, and nephew Lincoln in the background meeting Riaan, but didn't even roll over to look at them. 

Two hours after surgery, I was wheeled to my post-partum room. By then I was a bit more awake and could finally hold my precious baby boy! He nursed amazingly well for the first time. Then I suddenly felt very hot and nauseated. I passed Riaan to my mom as quickly as I could, then she handed me an emesis bag. I said, “Never mind, I'm gonna pass out.” The next thing I knew, I was waking up to at least four nurses surrounding my bed. I had puked on myself and had also bled a lot. They did some lab work and found that my hemoglobin had dropped significantly. I received 2 units of blood that evening.

The next day, things looked good. My bleeding appeared normal, and I was finally allowed out of bed. I was terribly sore and pretty weak. My catheter was removed, but I was unable to urinate for about 6 hours afterward. The nurse got permission to straight cath me because I was in so much pain from needing to pee and being unable to. Very early the next morning, maybe 2:00 am, I was able to pee on my own. What a relief! (It's amazing the things that I took for granted up to this point.)

When my day shift nurse came in, I told her there was a clot in the toilet that she needed to see. I recall thinking it was the size of a baseball. She came out and told me in no uncertain terms that I would not be going home that day, even though it would be 48 hours since giving birth. I asked her if it was normal to pass large clots like that. She laughed and joked with me that nothing about my delivery and recovery so far had been normal.

Thursday rolled around and I felt good and we were released to go home! Those were some very difficult days. The lack of sleep, the pain of my incision, the painful swelling in my feet and ankles (they were huge!), the newness of this sweet little baby who needed me 24/7... The crying that started anywhere from 10:00pm to midnight and lasted for 2-4 hours regardless of what we did or how we held him... Learning all about this new baby - his ways of telling me when he was tired or hungry, the way he preferred to be held, his sweet face with those big eyes... The incredible amount of food I ate around the clock to hush my growling stomach. (Breastfeeding definitely made me far hungrier than pregnancy ever had!) Murray was so helpful! But he couldn't nurse Riaan for me, and he couldn't sleep for me. I had a few meltdowns. My mom kept telling me that if we needed her to come over, even if it was in the wee hours of the morning, to call her and she would hold him while he cried and try giving him a bottle if needed so we could get some sleep. I was stubborn. I didn't want to bother her, and I also was uncertain why he was crying. Was I doing something wrong? What if he stopped crying as soon as I called her?

Tuesday, December 15, I called Mom at about 2:30am. Riaan had been screaming for hours and I was in tears. I hadn't been to bed at all that night. I had just laid down when Riaan started crying and he hadn't stopped. As soon as I hung up from calling Mom, Riaan pooped loudly and the crying stopped. It had been another belly ache and he finally had relief. I called Mom back, but she didn't answer. I sent her a text to let her know she didn't need to come. She returned my call a few minutes later and said she was already up and ready so she would come anyway in case his crying began again. I sit here now with tears in my eyes at what a blessing that was. None of us had any clue what was about to happen. Mom came over and settled in on the couch with Riaan in his rock-and-play next to her. We made sure a bottle of formula was handy – I really wanted to breastfeed exclusively, but at this point, sleep was more important, and I had already given him one bottle of formula on Sunday when he had been nursing basically non-stop for hours and hours and didn't seem to be getting anything. I grabbed a snack and headed upstairs to bed. 

Part two will continue shortly.

1 comment:

Casey said...

I love your bravery, Candace! Looking forward to part two. And I can totally tell you are a nurse by your writing style, very informative. ;)