You think my OP was TMI wait for this.
My wife and I had suffered five early pregnancy losses, anywhere from 10 weeks and 22 weeks. Genetically OK, physiologically fine. For some reason we were never able to figure out her cervix would just open. On two of the pregnancies the OB performed cervical cerclages but she would still funnel and the amniotic sac would start falling through until it pinched and popped. This was all on top of fertility problems that required hormone shots and IUIs.
In 2002 she got pregnant, for the first time in years without fertility assistance. We think it was because we had just finalized our daughter’s adoption. The OB and reproductive endocrinologist decided to pull out all the stops. The kept the supplemental hormones going longer, gave her a cervical cerclage at the earliest possible moment and put her on hospitalized bed rest.
In November her cervix started to funnel anyway. The OB recommended performing an abdominal cerclage where they would tilt the operating table so she was head down making the baby slosh to the top of the uterus. They would then cut her down the middle like a C-section and tie off the cervix from the inside. Normally this is done before the woman gets pregnant and had only been done on pregnant women 87 times worldwide with a 70% success rate. We decided to go for it and the operation was a success, the baby was safe.
Unfortunately 3 days, still on bed rest (she even used a bedpan), her water broke. The only way to get the baby out was with a C-section. They cut along the incision line and pulled him out. He was 22 weeks along, too early to even attempt to save. Tommy lived only a half hour and died in my hands.
One week later, on the day of Tommy’s funeral, my wife was feeling very weak and feverish. When we got back from the cemetery she went to lie down on the couch. As soon as she sat down she felt a pop and felt her stomach was wet. There was blood and fluid all over her front.
It turns out that she had an infection in the incision. Staph, strep and e coli had eaten down through the tissue and gone through the fascia layer creating a massive hernia. When they reopened the incision the doctors decided that it was better to leave the wound open so it would heal from the bottom up. She was left with a wound almost 7 inches across and 5 inches deep.
After 6 months of wound therapy and several wound debridements her stomach was healed but she still had the hernia. She was reopened to put in mesh to repair the hernia. She developed an abscess that made the wound dehisce. The dehiscence tunneled down to the mesh. The mesh got infected with MRSA.
The wound had to be reopened so the infection could be treated. Over the next six months she went to wound therapy to help it to heal and she had multiple wound debridement surgeries. Occasionally they would trim back the mesh in the hopes that she would heal but it would eventually get to a hole about the thickness of a pencil and 5 cm deep.
The doctor decided that she might be actually rejecting the mesh and decided that the best move would be to remove this mesh and attempt a tension closure by pulling her tissue in to cover the hernia. They closed her up again and sent her home with a drain. About a week after the drain was removed she developed a seroma (pocket of fluid) and the wound had to be reopened. It turns out the tension closure didn’t hold and the hernia was back. Back to wound therapy for more months.
She was reopened and a different mesh was put in to close the hernia. She was closed up and sent home. About one week after the drain was removed she developed another seroma and the wound popped open about 2 cm. She had to go back for more surgeries where they removed this mesh because it was detaching from the tissue. Over several more months of wound therapy they cleaned her and healed it up to the surface again.
The doctors decided now to avoid artificial meshes because her body seemed to reject them and to try biological tissue. They used denatured porcine material, basically cleaned up pig tissue that would be absorbed as her own body grew through it. She was opened again, the material attached and she was closed. Once more she developed a seroma and the wound was opened so it could drain and be cleaned. The pig tissue began to dissolve too soon and starteted coming out in chunks. Fortunately enough of it held that the hernia was officially healed.
But the wound didn’t heal. She was left with a hole about 1 cm diameter and 4 cm deep. Throughout all of this time we have become experts at home wound care. We can change wet-to-dry dressings, know what medications work best and are on first name basis with the surgical supply people.
It has now been over 4 years that she has basically been open. She lost her job when she was pregnant because they combined her short term disability and Family Emergency Leave time (legally they are allowed to do that) and she couldn’t come back to work. The good thing was she had invested in long term disability so we have been barely able to survive (she used to make over six figures but LTD only gives about a third of the pay). The original infection almost definitely was caused by poor sanitary practices in the hospital but my wife was reluctant to sue because it could have also involved her OB whom she respected. By the time I was able to convince her that maybe we should try to go forward with a suit, the statute of limitations had passed.
Now she is almost completely healed. Her abdomen has been opened and closed so often that the surface has depressed and she says it looks like she has a butt in the front. When she gets her (hopefully) last surgery she will be off disability so she has to find a job before she is healed. The doctor said that he will work with us on that.
Don’t think that we stayed blindly with one doctor. We got multiple opinions and saw some of the best general surgeons and plastic surgeons in Chicago.
OK, that’s our story. 4 years, over 30 abdominal surgeries of various complexities, all to save one baby. There are lots of other issues and problems mixed in there. If you have any questions, let me know.
