Artery.

I should be dead, too.

I was groggy from the anestia and I saw my husbands bloodshot eyes, soaked in tears, sniffling and weeping again just like when Harvey died, when we were waiting for Harvey to die, when we had small hope that he might live.

“Did they have to take the uterus?”, I asked hurridly. Was he grieving the loss of our potential children? His heart was clearly set on another, on more, and all I could imagine his tears to be for another loss, the loss of the hope we’d gained.

“No, no”, he shook his head and between sobs said, “You almost died. But you are okay now, you are okay now. I asked him over and over again and you are going to be okay.”

______________

My uterus ruptured. My baby died. the rupture site didn’t heal correctly. It required a surgical repair.

“Dear Monica, There is a very small gap on the uterus, but everything else looks normal.” -OB

“I don’t know who looked at your initial CT, but he never should have told you, you couldn’t carry a pregnancy. No one can tell you that. Looks to me like once this is repaired and unless there is intergity issues with the tissue, your risks would be the same as normal pregnancy risks but you won’t be allowed to labor.” – Perinatologist

“Depending on what we see when we get in there and our access to the defect and surrounding tissue, we’ll be able to repair the uterus so that it will not only be closed up, but it will be stronger than it was before.” – Surgeon

Everyone is so confident. We stop looking into adoption. I notice a couple weeks before surgery, that the thought of being able to physically carry a pregnancy, if not emotionally, is really getting me through this time between finding out the uterus hasn’t healed correctly and the actual surgery. It is my silver lining, my beacon of hope. The numbers and statistics that my team of doctors and specialists throw out at me are starting to penetrate and make me feel like this is all a fluke. How likely is it to be struck by lightening twice, to win the lottery for a second time? Despite my fear that my body is actually not equipped to birth babies (emergency c-section, miscarriage, rupture/dead baby), their confidence has bolstered me. The light at the end of this tunnel is the physical possibility of pregnancy, the very low odds of anything bad happening again. We cease discussing with the doctors the possibility of no more babies.

_____________

The surgeon comes in and talks to me, tells me what happened, draws a diagram in pencil. It was not at all what we expected. I am too drugged to understand, to fully grasp my husbands overwhelm until days later when I am out of the hospital and he explains it again, in his shook up way and then promptly falls asleep.

They went in laprascopically as planned. Camera through the belly button, surgical instruments on both sides of the abdomen. Three surgeons, one an intern or at some level of training as an after thought, just for an extra pair of eyes. They cannot find the defect on the uterus so they expand the lower uterus by inserting a Foley balloon and inflating it, as was the plan in this instance. As the balloon expands only in the slightest, the abdomen begins to fill with blood. There is a rush to find the source. The small incision that might have had to been made if they couldn’t repair it laprascopically, turns into a full transverse c-section incision as they frantically try to find and stop the source of bleeding. The prepare for surgical assistants prepare for transfusion. The anestisologist assures them I am fully under. They find the source: the left, lateral uterine artery, the one that connects directly to the aorta, the heart. They stem the bleeding and save me from a.) a trasnfusion and b.) bleeding to death in a matter of minutes. They repair the artery. The seemingly unflappable surgeon we have met with four times, is shaken and close to tears as he goes out to talk to me husband and the others stabilize me and sew and staple my wounds.

There is no defect on the uterus. He had told us that he couldn’t see exactly from the MRI where the gap was, I had asked him specifically. The “very small gap” was on the main uterine artery. It had torn open at some point during Harvey’s birth, depriving him of life sustaining oxygen and creating the giant hematoma in my uterus they found a week after his birth. It had never healed. As the uterus clamped down after birth, with the added weight of the hematoma at first, it fell just right so as to put pressure on the artery and stop the bleeding, just like you do to the puncture site after you have a blood draw. How I did not die right along with Harvey cannot be explained, says this man of science. How I have been walking around, dancing, doing yoga, giving massage, picking up Vesta and spinning her around, and the uterus has not moved off this artery leading to a bleed out within minutes, is nothing short of a miracle. For the past almost 6 months, I have been a walking time bomb. That during surgery, they were able to find the source and stop the bleeding in time, well, I am just plain lucky.

Arteries are not made of the same tissues as a uterus. The straw-like tissue of an artery is not meant to give and stretch and be pulled on the way the musculature of the uterus is. If the uterus expands just a bit, like say the amount it does in the first couple months of pregnancy, my life is threatened. No more pregnancies, no more babies. We hung our hat on it and now there is nothing.

Except that I am alive. That I should have died in childbirth, that I could have died at any moment in these months leading to the surgery, that I almost died under the knife. The probability that I live on remains in these slim margins that I have grown accustomed too. It was incredibly unlikely that my baby would die and it is just as unlikely that I would  not. And so here we are, he and I: dead and alive.

 

 

 

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