|My IVC Filter... bigger than I had imagined.|
Before I finish telling about Natalie's birth, I should tell you about the procedure...
On Monday after getting my staples removed from my belly, we drove to South Sac for an ultrasound of my leg. The sonographer was a quiet lady who didn't easily engage in conversation, so I didn't even try to get information out of her like I can with some of the techs who scan me.
That afternoon Dr. F. texted and asked if I had been told the results. "No, they're funny that way." I wrote back. "Well I have a feeling a lot of people have been praying for you," he wrote back. We spoke on the phone and he told me that the scan of my leg looked clear, and that the blood flow out of my leg appeared normal. He said no clot could be seen in my pelvis and that though there was some residual clot in my groin, he didn't anticipate needing to place any stents at all, just remove my chest filter. I was glad for the good news.
Wednesday we went in for the procedure at two. Dr. F. was so kind, and happily let me have Natalie with me in pre-op to nurse before having to go in. Guy kissed me good luck and took Natalie out to wait for the half hour procedure. Once I had a chance to talk to Dr. F. I didn't feel too nervous anymore. I chatted with the prep team as they worked and was happy to see Velma, the nurse I had for my last two procedures, was there as well. Music from the 20's played, and my head and neck were draped, meds started, and finally, my neck was scrubbed.
"A little bee sting..." Dr. F. warned, and we began. A needle in your neck feels much less like a bee sting and more what I imagine an Amazonian blow dart might feel like. Dr. F. sent his tools into my neck, through my heart and down to where the filter lay waiting.
At one point, my heart suddenly began to race out of my chest, and I could not breathe. The pressure I felt in my chest, face and hands was so immense that I could barely utter a sound. My voice grew instantly hoarse, and I could only force out a word at a time, "something... wrong... pressure...can't... breath... lights..." My vision filled with bright little lights that swam in circles like tiny tadpoles. Velma held my face in her cool hands and stroked my hair, talking to me and encouraging me to breathe. The pressure built and I thought for a moment that I was going into anaphylactic shock, or that perhaps this was a heart attack. In several minutes things began to settle down, I could breathe again, and eventually all but a deep pressure in my face and chest lifted. "I think your heart responded to the tools touching it." Dr. F. said, I haven't given you any contrast yet". He seemed calm, but I can't imagine it hadn't frightened him. By the speed that Velma stroked my hair, I could tell she had been rattled.
Guided by fluoroscopy, he located the tiny loop at the top of the filter and secured it. An intense pulling sensation deep inside my chest finally gave way with a pop, to the sliding feeling of the catheter coming back through my chest and neck. "Here's your filter," Dr. F. told me as he held out the small metal umbrella form on the end of the catheter. It was actually bigger than I had imagined.
Dr. F. went back to work to scope out the leg vein from the same entry point in my jugular vein. The tools were placed and dye was released, but soon Dr. F. said, "Laine, looks like I am going to have to go up through your leg." For some reason, he was not being able to get the images he needed. My neck was patched up and now laying almost on my belly, the team prepped the back of my knee. A half and hour and a "bee sting" later, and tools were being inserted into my leg vein. Contrast dye was injected and this time a clear picture told a totally different story than any of us had anticipated.
The dye flowed up my thigh through the femoral vein, but suddenly took a detour, splitting off into about 5 collateral veins that crossed my pelvis and entered the femoral vein of my right leg. The entire vein in my pelvis, running from my groin to the Inferior Vena Cava up near my chest was 100% blocked, and to save my leg, my body had created bypasses that made my right side do all of the work for my entire lower body.
"I'm afraid we're going to have to place stents after all." Dr. F. said. "I'm sorry." I wondered why he was sorry, except that perhaps he felt like he had misled me. Honestly, though I am nervous about having metal parts in me for the rest of my life, and hopeful that they last, I was relieved that I hadn't been crazy. I had felt so many sensations in my leg these last few months and been so careful, that Monday's news there had been no clot had made me feel as though I was imagining things, and even as though I, in my unwarranted caution, had caused the baby to become poorly positioned resulting in the cesarean, all because I had been fearful. This new scan proved it had not all been in my head.
The process for placing the stents was long and painful. A wire was first forced through the blood clot and up the vein. It touched the bottom of my heart and my pulse shot up again to 140, but without the drama of the first event. Once it was pulled back, my pulse settled down. Next a series of balloons were guided by catheters through the clot, and then inflated. The inflation was intense and very painful. As Dr. F. worked I was given fentanyl a few times, and I will admit to yelling out when he inflated the balloon that lay between my spine and my artery. The searing pain and pressure was akin to the worst part of a labor contraction. Even now, as I write this, the majority of my pain now is right where those balloons were placed.
Finally, the area was ready for stenting, and one by one three long stents were placed to line the walls of the vein from my groin up to the IVC (Inferior Vena Cava). All in all, I was being worked on for over 3 hours placing 25 centimeters of vein length. I learned later that Guy was not told what was taking so long. After the first hour someone came out to tell him that it was taking a little longer than planned and would be another half hour, but no one went out again for another hour and a half. In that time my poor sweetheart had imagined a terrible accident having taken place with the filter removal, and, not knowing they were placing stents after all, thought that all that time they were working on keeping me alive.
I was finally wheeled into the recovery room, all patched up, sore and pretty tired. Seeing Guy again brought tears to my eyes. We were finally done with all that had begun back on February 20th. He kissed me and asked how it was. I tend to lose my fortitude when Guy is near, and suddenly the difficulty of the procedure surfaced in tears.
Dr. F. brought cake to us that his wife had made. I thought it was funny that after not eating for a whole day my doctor gave me cake, but there was the feeling in that moment that we had something to celebrate. I reserve cautious optimism as I move forward from here. I deeply hope I never need to revisit that room for another clot, though my risk of future clots is about 30% for the rest of my life. But you never know what life is going to bring.
And you know, even though Dr. F. might have felt that he had been wrong about all those people praying for us -since there was a clot after all- that is not how I feel. After the clot came, I asked our loved ones to pray for the health of my leg, and the health of my baby. The very first time we faced this crisis we were told that if my vein completely blocked up, I would have no choice but to undergo this stenting procedure in order to save my leg from amputation, exposing the baby to 3 hours of radiation. Instead, God provided answers to prayer in the form of all of those collateral veins that both saved my leg and protected the baby.
Perhaps some would say that in a real answer to prayer God could have kept all this from happening. Or that if he were going to heal me it would look different than it has. I have stopped trying to dictate to God what an answer to my prayers should look like. I still struggle with some aspects of all of this experience, because the part of me that wanted certain things to be within my control that ultimately were not. My postpartum brain is working hard to undermine my sanity and the many comforts that have been extended to me.
But as I sit here on the couch, a bandage on my neck and leg,
a scar on my belly, and a beautiful, healthy baby girl at my breast,
I look back and see the answers to so many prayers.