My surgery was last Thursday, and I think it went well.
I had a luminaria put in the day before the procedure (which, once again, really hurt going in), but it fell out that night. I called the doctor’s after hours number and was told not to worry about it.
Since I’ve had TWO other surgical procedures in the past year, I knew what to expect.
The first time (my anencephaly D&E), I was sobbing more or less uncontrollably most of the time during the pre-op. Unfortunately they did not let my husband back in the room with me, so I was crying all by myself. It was awful. For my second procedure (D&C to remove retained tissue after the first D&E), I was a woman on a mission because I did not want the retained tissue to slow down our next frozen cycle (which didn’t work anyway). The pre-op was the same, but the surgery was really quick. This time, the baby was measuring 12 weeks, but I was almost 14 weeks since my LMP, so my doctor said the procedure was a D&E (because she would be doing some cutting), but with the lower risks of a D&C.
I was far more calm this time (I did not cry once), but we learned our lesson the last two times. My husband and I insisted he be permitted to come back to pre-op with me, and they let him. I suspect that may have as much to do with which nurse is on duty, but it’s worth asking / demanding. I wish he’d been with me the first time.
As for the procedure, I knew what was coming. Get blood taken. Sign some forms. Talk about surgery with nurse. Talk about surgery with doctor. Meet with anesthesiologist. Meet with nurse anesthetist. Take antibiotics. Get fitted with leg cuffs (that keep blood circulating while you’re out?) and those little conductor things on your body. Get IV line. Versed. Get wheeled back to surgery. Propofol. Out for an hour during surgery. In recovery. Meet with doctor. (Sometimes remember, sometimes don’t.) Husband meets with doctor in waiting room. Once lucid, husband can come back into recovery room. Crackers. Juice. Home.
One pre-op difference was this time, when I met with the anesthesiologist, I asked about the drugs we were going to use. The last two times they used Versed when I was still in the prep room and I was out by the time we got into the surgery room. Then they used light Propofol in the surgery room to keep me out. I was actually looking forward to the Versed—it was like getting lightly drunk and calm—but then he said he thought he could do the whole surgery just with Propofol. I was clearly very disappointed, and asked repeatedly why this time was different. He suggested if I wanted to do Versed first with light Propofol that would work too. My husband was clearly very, very nervous that I was dictating how they were going to be drugging me. Literally the only good thing about the entire process the last time was the Versed, and they were trying to take it away from me. (Maybe it’s because I was not as hysterical this time, but the Versed did not seem to do anything. They gave it to me right before we left, so I was still wide awake when we first went into the surgery room. I remember them moving me to a new bed and getting things situated. Then I was out. I never got that peaceful calm, but maybe that’s because I was already pretty calm.)
The big post-op difference between this surgery and the last one was that I lost a lot of blood this time. They expect patients to lose 100-200ccs of blood after a D&E. I lost over 500ccs. The doctor told my husband (when I was still loopy) that the heavy bleeding could be related to my abnormal placenta. (Did he ask what was abnormal about it? Noooo.) From what I’ve read, it will take me about three months to replace all of the blood I lost.
I called the next day to ask—what was abnormal about my placenta? She said there was something abnormal about the attachment of the placenta to the uterus, as it was actively bleeding during the surgery, which is rare. When I suggested maybe it was because of the hematoma, she said she did not think so—hematomas are, apparently, not uncommon, and tend to produce just old clotty blood. The active bleeding was unusual.
(Here’s an article that describes >500cc as “hemorrhage” level bleeding. It also gives some thoughts on causes of post-abortion bleeding:
I bled a lot the day of the surgery (changing a large pad every 2 hours), but it slowed down the day after. For the first 24hrs I just laid in bed. Once it seemed like the bleeding had slowed, I started moving, and I have not had much bleeding since the second or third day. So that’s good. (I think I bled for a while after my first D&E.)
I have not had any pain at all. (I was uncomfortable after my first D&E, but I don’t recall taking any strong pain meds.) They sent me back with a few really good narcotics, just in case. Guess I’ll have to save those for a rainy day. Haha, just kidding.
Emotionally I’m in a MUCH better place than I was after my first D&E. (I knew the chances of this pregnancy continuing were small, and I was just removing an already passed away pregnancy.) Physically I’m also doing much better. I gained much more weight last time, and I started at a higher weight. This time I started at an adult all-time low weight, and “only” gained 9 lbs. (You’re not supposed to gain that much weight in the first trimester, but I was on total physical restriction for a large portion, felt awful, and stress ate.) I also have a much better idea of what I have to do to recover—physically and emotionally—and have already started working on it.
So I guess what I’m saying is, I’ll be okay.
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