Tuesday, 15 April 2014

Felicity's story - Placenta Previa and Accreta.

Harry and Felicity
A little bit about me first.
I live in Perth WA and have 4 children all c-sec, (15, 9 & 7) and the youngest Harry (2) is my Placenta Previa & Accreta  child. I have also had two early miscarriages before Harry.

I was 31 when at my 12 week scan I was diagnosed with a low lying anterior placenta and possible placenta Previa. My GP advised that until my next scan at 16 weeks I was to be placed on pelvic rest. This would not have been an issue except that after 10 years we were to get married smack bang in the middle when I was 13 weeks. So needless to say this did no go down well. Wedding went ahead and was perfect with a wonderful week down in Yallingup hiking along the coast to coast track (oops). At my 16 week scan nothing had changed and my doctor referred me to Kaleeya for my ante natal care. The midwife told me that she had never advised someone with a low lying placenta to avoid sex so away we went, happy with that outcome. 
Our Wedding

Time for the 20 week scan where we were advised that we were expecting a little boy – of course I thought, after 3 girls it was going to be the boy causing trouble. After my now husband left I had my first internal ultrasound. No surprises there it was definitely complete placenta Previa. Still no mention of accreta. I went home and googled trying to find out what this placenta Previa was that I was getting little information on. A lot of horror stories came up and I began to get worried. My following appointments and more ultrasounds kept confirming PP and I was still not getting many answers, It was either that no –one had minimal if any at all experience  or they just would not tell. All I got was a cheap drawing of the placenta covering the cervix. It was at my 32 week scan when I was actually told a few things by the radiologist because I asked. I know they should not tell but no-one else would. I asked about accreta and he advised that my uterus was so thin it was like a clear window and that I should make this my last pregnancy. He could not tell if my placenta invaded my uterus as it was to close to tell. Accreta was now a potential issue as well. After that scan I was transferred to King Edward Memorial Hospital for my prenatal care. It was here that the possibility of a hysterectomy was advised and everything become very real.

I was booked in for C-section 6th Feb 2012 at 37+4 and an appointment was made for me to see the anaesthetist 1st Feb.

On January 30th I was taken out for lunch by my friends and eldest daughter and had a great mini- baby shower. I came home and decided some last minute vacuuming was in order. The kids were starting the school term the next week and I would soon be in hospital. I needed to get things organised.
That night at 4am I woke up feeling wet. I turned on the light and noticed that I was bleeding. All I could think was what I have done... This is it. I have not been taking it easy and now this is pay back. I rang my husband who was at work to come home and KEMH who advised me to come it right away. The bleeding stopped on the way thank goodness and would have only have been 70ml or so but I was admitted and there I was to stay for the 7 days until my section. This was a horrible week. I missed my daughters first day at Pre- Primary and the whole first week of school. I was bored, put on bed rest for the first few days and had a bunt put in case emergency surgery was needed. I had no more bleeds whilst in hospital that week. The nurses were checking me every day to see if I had any contractions, I had ultrasounds every second day and I was allowed to leave the premises to go to the close park with my children and husband on the weekend. I was provided with an emergency beeper if I should bleed. My appointment with the anaesthetist was very overwhelming. I cried and was in shock.  It was comforting to know that they were all experienced with this kind of surgery and that they would try to save my uterus and a hysterectomy would be a last resort. He told me it was natural to be scared but things would be ok. I signed the hysterectomy consent

The night before my scheduled section I didn’t sleep. The next morning I was taken down to pre-op where I was given a spinal block ( my request) and so may bungs and drips placed in my arms. There was no central line but one in each wrist, the back of my hand and the inside of each elbow. This was the worst feeling, the anticipation of what could possibly come next. I was so scared.
In the operating theatre the first thing I noticed was how many people was there. There would have been at least 20 with all the nurses, specialists and residents, I felt like I was on display in a zoo. I looked to my right and there was the blood recycling unit. To my left was my new best friend the anesthetist. I had experienced a C-section 3 times before so I knew what to expect. After about 15 minutes I was asked if I wanted to see my son born. I regretfully declined but moments later I heard his cry and finally got to see my little trouble maker. He was taken away for cleaning and my surgery continued they were going to try to save my uterus. After another 20 minutes the surgeon learned over and said “I cannot remove the placenta I will have to do a hysterectomy” I was prepared for this and at this stage I didn’t care anymore. My son was born and appeared healthy. I accepted the anesthetist offer of a general anaethetic and that was it.

I woke up hours later in the high dependency unit. I was advised that along with the hysterectomy I had my cervix, both fallopian tubes and one ovary removed. I also had a 4cm hole in my bladder from surgery and lost 2000mls and was given 300mls back via a cell saver. My son was in NICU as he had some breathing issues (due to his small size 5.6lb) and as I was being prepared to go see him, he was brought down to me. Harry was fine and I was so relived. I finally got to hold him. With all the cords and bungs it was very difficult but I was so happy. In the HD unit I had some cold toast and jam (Yuck) and was given an iron drip due to blood loss. This can have some side effects but I did not notice any. My husband finally got to come in and by the look on his face you tell he was emotionally drained. He told me that the surgery went for four hours and that he was continuously updated on the progress. Poor love. I was transferred back to the ward that evening where I had the first chance for some sleep.

For the first few feeds my colostrum was obtained by syringe. I was then put on the pump to try to get the breast milk flowing. My son was doing well and I was trying the best I could. I was exhausted.  It was day three when I decided that I needed to get out of bed. OMG was that the worst thing I have ever tried to do, so I thought until I tried to go to the bathroom. After numerous attempts and laxatives we had success. I was now allowed real food. That week was terrible. I wanted to go home, but I had no idea how I would cope as I was so sore and my husband only had another week off work. Finally on the 13th I was allowed home. I had my staples removed however I needed to keep in my catheter for another 4 days so I would be back to have this removed later.

Things slowly improved at home. My son was thriving and I was getting physically better every day. There were days where I would over do it and pay for it in the following days however my body was healing and I was getting stronger. Emotionally I was a mess. I was fine for the first month but then I became numb to the world. My Husband didn’t matter to me anymore and my other children took a back seat. I didn’t realise at the time how low I was. I was crying all the time and didn’t want to be with anyone other than Harry. The child health nurse referred me to the Fremantle Hospital psychologist department but by the time they called and offered me an appointment we couldn’t afford it. It was about this time that I found the original Placenta Previa group on Facebook. I decided to join and suddenly there were people who had been through what I had. I befriended a few people in this group who even through they don’t realise it helped my get through that tough time. They had problems with there relationships too and I decided to bit the bullet as they say and make my self be present in my families life. I realised that everyone had issues being intimate with there partners. Part of this was unattachement and also the physical pain and subconscious memories of surgery. It took quite a long time for the healing to progress to a stage where I was comfortable to talk about what had happened and to accept things for how they are now.
Harry now 

My pregnancy was quite easy compared to some. I worked full time up until 36 weeks, and continued to marshal the children’s little athletics events. I don’t think I ever really thought that I would have a major bleed. Even though my surgery was straight forward, recovery was hard and it was a tough emotional journey for everyone involved. I decided that when Harry turned one I would book myself in for my first blood donation ever. I have since paid back my 4 units and now donate plasma every month. I also contacted the hospital and obtained my surgery records. I have only read them once but every now and them I am tempted to have another read. I never do but just knowing they're there and are based on fact not emotions is a good thing.

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