I typically have crazy horrible anxiety.  I’m continuously fretting over the What If’s and my health anxiety tends to be especially bad.  Even so, I was not at all worried about having my cervical polyp removed.  It’s a very minor procedure and I have underwent far more invasive surgeries with no problems at all.  It never crossed my mind that I would come so close to death!  I must say that the whole experience left me quite shaken, though now, nearly three months later I’m able to reflect back on the experience without feeling my blood pressure rise.  It now just feels like a dream.  Here’s what happened:

 

After my failed polypectomy, I arrived to the hospital two days later to have the thing removed under general anesthesia.  The procedure was scheduled for 1:00 and after two hours of observation I would be free to go home. 

 

Everything started off relatively well.  I had my pre-op the day before and they collected blood for a CBC as I have been anemic in the past.  The phlebotomist who saw me was incredibly kind, but she left me with one hell of a bruise.  Ouch!  My hemoglobin was 124.  Lovely to see after having worked so hard to bring it up after enduring so many periods from hell this last year.  Upon arriving to the surgical floor I had to have blood withdrawn again to confirm I was not pregnant.  It would have been preferable had they done that testing along with my initial CBC, rather than having me undergo the torture of yet another blood draw.  Oh well!  While waiting, I read the book Nurture Shock.   The book had been sitting on my shelf for nearly a year.  It was a good read.  

 

Around quarter to one, I was taken to the operating room.  It felt really awkward to be pushed around the hospital in a hospital bed when I was fully capable of walking myself.  I would have much rather walked.  Once there, a nurse administered an IV.  I absolutely hate IV’s.  I fear them.  As a midwifery student, I was excellent at administering them, but I have to admit that it hurts a hell of a lot less giving them than it does getting them!  Since, I’m such a wimp when it comes to pain,  I had been mentally preparing myself for the horrificness of the IV insertion since I received news of my impending surgery.  I was prepared and coped admirably through it all!  The nurse was great, aside from the fact that she did not get the tubing on fast enough and I bled everywhere.  She joked that my little hemorrhage [referring to my IV bleed] was going to be the worst part of the whole procedure and I had nothing to worry about.  Ha ha?  

 

The medication used in the general anesthetic hurt like a son of a b*tch going in, but fortunately whatever drug they gave me was very quick acting and I was in the recovery room before I knew it.  The doctor came by and said everything went well.  The polyp was removed without any problems and a hysteroscopy revealed that everything else in my uterus looked perfectly normal .  Approximately 20 minutes later they moved me back to the day surgery ward where I would remain for two hours.  After that, I would be free to go home.  I was in no pain and I attempted to pass the time by finishing that book I had started previously.

 

About an hour following the surgery, I started to feel some bleeding and asked if I could go to the bathroom, clean up and get a new pad.  Some bleeding was expected so I wasn’t the least bit concerned nor were my nurses.  But when I stood up out came a HUGE grapefruit sized clot along with a large gush of blood.  I was still not concerned.  I tend to always bleed a tad more than expected.  That’s all.  My nurses on the other hand did not appear as calm as I.  I wasn’t even allowed to be in the bathroom alone.  Lovely.

 

I washed up, changed my gown and then returned to my bed where I continued to bleed and bleed and bleed.  Each clot seemingly larger than the previous.  The doctor came in, manually expelled some more clots whilst applying very firm (and uncomfortable) external uterine massage, much like one would do for a postpartum hemorrhage, and then ordered my blood to be drawn once again.  My hemoglobin came back at 98.  A decrease of 26.  I knew it would have been lower though I didn’t anticipate it would have plummeted that low so quickly.  The bleeding didn’t cease.  My hemoglobin continued to drop by the minute.  

 

The polypectomy was supposed to be an outpatient procedure.  However, at 5:00PM, the time at which I was supposed to be discharged, was the time they admitted me for the night.  My husband and kids came to pick me up, but I was in no shape to go home.  Hubby came into recovery briefly to speak to me, but he had to quickly leave as the kids were not allowed in and they had been left unattended in the hallway.

 

Soon after my husband left, I had to have yet another blood draw.  This time it was to verify my blood type just in case I would need a transfusion.  Four blood draws in less than 24 hours!  Yay me!  As the blood thief left, yet another new nurse came to take me to the post surgery ward.  She asked if I was able to walk down the hall to my new bed.  Every time I moved, I gushed blood.  I was soaked.  My bed was soaked.  The floor beside still wet from having been washed after my previous attempt to stand up.  I laughed and said housecleaning wouldn’t approve.  She didn’t get it. She hadn’t yet received report regarding my status from my original nurse.  I’m certain she must have thought I was just being lazy.  After all, it was just a cervical polyp removal and at that point I was still surprisingly calm and collected.  At the entrance to the new room, she asked if I would at least be able to walk the ten or so steps to my bed.  I agreed.  She brought me a regular sized maxi pad to place underneath me as I walked.  Again, I laughed at her and requested an adult sized diaper not that it would be any more effective.  Even with the diaper, I still managed to leave a trail of blood all the way to my new bed.  Had I used only the maxi pad I am sure I would have left a river!

 

Once settled in bed, the doctor quickly arrived and attempted to place a foley bulb catheter (ballooon tamponade) in my uterus which would work to decrease the bleeding by applying internal pressure to the bleeding site.  I had become familiar with this technique during my midwifery training as it is another method used in managing postpartum hemorrhages.  I had never seen it attempted, until now.  Unfortunately, it did not work.  He tried and tried and tried to get the thing into my uterus, but all of his efforts were in vain.  I must say that was one of the most awkward experiences of my life.  It wasn’t nearly as painful as I would have imagined such a procedure to be.  There was a lot of pressure and at some points it felt as though he had his whole arm inside me, but it wasn’t painful.  Just awkward.  Extremely extremely awkward.   I have a sensitive cervix.  Ordinarily, the pinch of a mere pap smear is enough to send me jumping off the bed.  This should have hurt.   Reflecting back, I’m certain the lack of pain was the result of my going into shock.  It was then that I became tachycardic and my blood pressure began to drop.  I remember the nurses watching in horror as the doctor pulled out clot after clot.  Later, one nurse described the clots being as big as newborn babies she’s seen delivered while working in labour and delivery.  That was the nurse who had wanted me to walk to my new room.  She later apologized for her initial poor judgement.  She was actually a really awesome and lovely nurse.  In fact, she was probably one of my favorites of all time.  She did a great job of calming me when my anxiety finally kicked in and I lost my cool.  And I did lose my cool.

 

The balloon tamponade failed.  My vitals started to deteriorate.  I became light headed and cold and shaky.  I rapidly spiked a fever.  I went from feeling okay to horrid almost instantaneously.  The doctor ordered a blood transfusion STAT and preparation was made for me to undergo yet another surgery where he would attempt the balloon tamponade once again under general anesthesia.  It wasn’t spoken, though I knew the next step if that didn’t work was a hysterectomy.  While waiting to go to the OR I was also given a medication called Cyklokapron.  I wasn’t at all familiar with this medication. It is most commonly used in individuals with bleeding disorders to aid the clotting process.  

 

As one nurse administered medication in my IV in one hand, another nurse began the process of inserting yet another intravenous line in the other.  As mentioned previously, I am a complete wimp when it comes to IV’s.  I had done very well with my first IV of the day, but I did not cope nearly as well the second time around.  With an IV in both hands I was a blubbering mess.  Then they started the blood transfusion.  How gross and disturbing is that?  Watching as someone else’s blood flowed right into my veins.  Disgust aside, I was and still am incredibly thankful! 

 

blood transfusion

 

And then it happened.  The bleeding stopped.  It reduced to nothing more than a slight trickle.  It seems as though the Cyklokapron was just what I needed.  I was no longer hemorrhaging!  Yet another thing to be thankful for!  My repeat trip to the operating room was canceled and as long as I didn’t continue to bleed, I would not have to return there.  I prayed.  

 

The positive effects of the blood transfusion occurred much quicker than I had anticipated.   Within an hour, my vitals stabilized to a somewhat normal level and my anxiety attack and shortness of breath dissipated.  It was then, when I was calm, that my husband had returned to see me.  He had fed the kids supper prior to dropping them off at my mother’s house and had subsequently missed all of the ‘action.’  I would have preferred had he been with me the entire time, but such is life.  When I initially sent him home with the kids, I did not convey the urgency of my situation, though admittedly at that time I hadn’t a clue as well.  It was just a little bleed, I thought.   No big deal, I thought.  It would just stop on it’s own, I had thought.  

 

The transfusion continued throughout the entire night.  With an IV in both hands and a urinary catheter that tugged at my poor bladder every time I moved, I could barely sleep at all.  When I would eventually doze off, a nurse would come to recheck my vitals.  It made for a long night and to worsen things further the night nurse was no where near as wonderful as the day time nurse though it was no fault of her own.  The poor dear was near nine months pregnant and was ALL belly.  Under normal circumstances  I adore pregnant bellies, however, in this case not so much.  Every time she would come in and check on me her belly would always snag either my IV or urinary catheter tubing.  Sometimes both.  OUCH!  

 

Eventually, morning came.  The bleeding had remained minimal throughout the night and other than one large softball sized clot that I passed when I initially stood up it appeared as though all was going to be okay.  My vitals were fine and although I was left somewhat weak, lightheaded and white as a ghost I was ready to go home.  My blood was taken yet again (sigh) and despite receiving two units of packed blood cells, my hemoglobin was shown to be at a mere 78.  God only knows what it was at prior to the transfusion.  The doctor advised me to increase my usual dose of iron supplements and he also prescribed me Cyklokapron to keep at home just in case I started to bleed excessively again.  

 

Because of the unusualness of my hemorrhage, my previous breast hematoma, my history of abnormally heavy and long periods and tendency to develop bruises for no apparent reason it is now thought that I may have Von Willebrand’s disease.  Thus far, I have undergone a screen for Von Willebrand’s which has turned up inconclusive.  Some of the values were normal, some low normal, some abnormal.  My doctor hasn’t a clue what to make of it, so I have been referred to a hematology clinic two hours away.  I have not yet received word as to when my appointment will be, but I was told it will be sometime in the next 6 months (that was in December).  

 

Note:  The polyp came back benign :)