Monday, November 7, 2016

Recovering from a repeat c-section

Our Hospital Room

In many ways a c-section is simply a drawn out reverse of a natural birth, you have a quick and a somewhat "painless" birth and then you are in excruciating pain for weeks afterwards but the first 24 hours are the most challenging. As I mentioned in his birth story everything they told me about controlling the itching was all a big lie. The OB told me the anesthesiologist would handle it, the anesthesiologist assured me the nurses would take care of it by giving me something in my IV line. The nurse looked at me somewhat blankly when I mentioned it a few hours after the surgery when I was finally wheeled to my room. She came back and told me they only had benadryl  in the form of a pill. A pill!!!!  There was no magic itch relieving medicine that would go in my line and start working right away. no. There was a pathetic benadryl pill that would basically take 30 minutes to get into my blood stream and would still do nothing.
The itching gradually built up in intensity to the point where it was unbearable; I was itchy from head to toe and also in terrible pain. My face was the itchiest especially my nose and mouth. The nurses all seemed focused on controlling the pain and not really as concerned about the itching. However in my opinion the itching was far worse than pain. Pain is a constant that you can kind of get used to but itching crawls all over your skin and is impossible to ignore! They assured me the itching would start to go away in about 24 hours. The longest 24 hours of all time.

Aside from the itching and hunger, the main challenge in the first 24 hours is the intensity of the pain, combined with being bedridden, the discomfort of the compression boots and catheter. Caring for the baby that first night fell fully on my husband once again. After the first 24 hours I was able to get up, take a shower and start feeling like a human again. I started to walk around a bit and hold my precious baby more. 

Just like last time, basic activities such as standing up, sitting, walking and coughing are excruciating because they all rely on the abdominal muscles and tug at the incision. However based on my last experience this didn't come as a surprise at all. The hospital provided me with a belly support binder that really helped me get back on my feet.

On day 4 after the c-section we were ready to go home!  I was told once again that the average heal time is 6 weeks and I was restricted to very light activity to allow the incision to heal. I foolishly expected the recovery to be similar or better than the first time but I was in for an unpleasant surprise. With my first c-section I started to feel much better at about the 3 week mark. By 6 weeks I was fully feeling fine and was able to go out with my daughter to run errands. I had no issue carrying her in her car seat or in the baby bjorn carrier. At 2 months post partum my husband and I left our baby at home with my mother and visited a theme park, we walked a lot and went on rides and I was fine doing all that.  Fast forward to this repeat c-section and the experience was totally different with a much slower healing time.

I've heard from others that their c-section incisions were sometimes held closed with staples but in both my surgeries the incision was initially covered with steri strips instead. The photo below shows the difference between sutures, strips and staples.




The strips eventually peel off by themselves like a bandaid or you have to remove them when they are wet. By the 3 week mark some of the strips had started peeling off.  The incision looked mostly healed but I noticed that one section seemed to be open and every time it got wet in the shower it seemed to be oozing. I waited a  week and then went in to see the doctor to make sure it wasn't infected. The nurse removed all the strips and confirmed that one inch section of the incision was still open! At 4 weeks!! She pressed and poked all over the incision and it began to ooze and bleed.  She had a doctor come and look at it and they both agreed that it just needed additional time to heal so she placed fresh strips over the section that was open. She said she felt like a suture on the inner layer was poking at it and not allowing it to heal in a timely manner. At this point it really dawned on me the reason why a c-section leaves you in so much pain; because they cut through multiple layers of skin, fat and part through muscle to get to the baby. So you are actually dealing with multiple incisions in the same area, one on top of the other.

 A week later it was still looking awful or maybe worse. I went back in and again they removed the strips and that section was still open and oozing and bleeding! Why!?! The doctor calmly explained that the incision site was uneven and that was delaying the healing process. I was so annoyed because showering and other basic things were a nightmare with this section of my tummy open! I also couldn't help constantly worrying about it because I wasn't sure if it was maybe getting infected! They kept telling me to give it more time and keep it dry, I was literally spending 10 mins after each shower patting the strips dry. Meanwhile holding my baby was tricky because I had to hold him in way that wouldn't put any pressure on my still super sore belly, which was basically impossible. It was also impossible to use my boppy pillow while feeding him without being in a lot of pain.

At 6 weeks I had my postpartum check up and once again the strips were removed and that section of the incision just fell open!! I could have cried. The midwife then proceeded to poke inside the incision with a cotton swab to determine how deep the opening was. Not fun!! She determined that the inner layers had mostly healed up and it was just the top layer of skin that was open.  She consulted with the doctor and they both agreed that at this point it was best to discontinue using the strips and just leave the incision open.  To be clear this is a one inch opening on my belly thats constantly oozing, bleeding and icky and they were telling me to leave it uncovered for two weeks and then return for yet another incision check! To say that I was frustrated would be a major understatement, but I had no choice but to take their advice and hope for the best. Naturally I was also googling it like crazy and finding many stories that were similar or even worse.

The first few days were the trickiest because the inside of my clothing kept sticking to the open section of the incision, however after a week I realized it was definitely looking much better with the open section shrinking daily. Today is exactly 8 weeks since the surgery and the incision is 95% healed with a small section of it still healing. This time around the recovery process was definitely not easier or quicker than the first time. To be honest I'm not sure how people claim to have a faster recovery the second time around, It actually makes sense that it would be a tougher recovery because the old incision with scar tissue is reopened so it is logical that it would take longer to heal.  To all the c-sections mommas out there going through a tough recovery hang in there and remember this too shall pass.




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