Those of you who follow me on Twitter (it’s quite simple, just click on the Twitter link on the right hand side of this page) will know why this blog has been SO quiet for the last couple of weeks.
As you know, after egg collection I was at risk of ovarian hyperstimulation syndrome and, in fact, was mildly affected by it in the days following. I’d been bloated and my stomach was sore, so I drank lots and lots of water – 3 litres a day is the medical recommendation – and gradually it improved.
By the Thursday and Friday after embryo transfer, I felt pretty much back to normal and all we had to do was wait for test day with bated breath.
However, Saturday morning I woke up feeling bloated again. We were going down to my nan’s for the night, so we headed off, but I was uncomfortable and achy. After a lovely evening with my nan, we left early Sunday morning because I really wasn’t feeling good and after managing to eat some lunch, I actually threw up. This continued when I tried to eat dinner and I was also struggling to drink anywhere near the recommended amount of water as I felt so full and bloated.
Monday morning my stomach hurt so much I couldn’t stand up straight and I was still being sick. I phoned in sick to work, text my mum to see if she could come over and check on me during the day as she works part time, and rang the ACU at Guy’s, leaving a message on their answer phone describing my symptoms and asking for some advice.
I got a call back around 9:30 Monday morning and the nurse I talked to asked me to come in to meet with a doctor. So my mum came and picked me up and we headed up to Guy’s.
The doctor examined me and confirmed that it was OHSS. He wanted to take some blood and then said I may as well go home and rest for the hours it would take for the blood test results to be processed, but that, depending on the blood test, they may want to admit me to the gynae ward at St Thomas’.
I had the blood taken, but then went rather pale and dizzy – as I had been at several points during the day – retching and heaving like anybody’s business. A nurse ushered me into a consultation room and gave me a sick bowl. They then got back to the doctor and after not much discussion decided that it was probably best to admit me straight away.
Of course, straight away in hospital terms means “several hours later” in human terms. In the meantime I had a cannula put in my hand, which I won’t go into the gory details, but the doctor really struggled to do, and was given some IV fluids and mostly laid around moaning in pain and dry heaving into a sick bowl. It really was quite unpleasant.
Eventually an ambulance arrived to take me the short drive from Guy’s to St Thomas’ and I was settled into the gynae ward just as the sun was setting over Big Ben. I amused myself by taking pictures of the view:
And my very sexy anti-embolism stockings:
And posting them on Twitter.
After a day or so, things didn’t seem quite so amusing, plus I was just feeling worse and worse. They gave me lots of anti-sickness medication and painkillers, plus the fluids I was getting through IV as I couldn’t keep anything down, but I was JUST. SO. UNCOMFORTABLE.
The doctors said that sometimes OHSS starts to resolve itself with enough rehydration, but that if my stomach became too bloated, they might have to insert a drain to remove the fluid that was building up in my abdominal cavity. I was really hoping it wouldn’t come to that. I was being seen by a consultant from the ACU at Guy’s as well as by ward doctors from St Thomas’ and I also have to say that the care I received there was excellent. I was really relieved to have that continuation of care from the IVF clinic across the gynae ward.
On Tuesday morning the ward doctor came to see me and examine me and she also told me that the blood test had showed positive for levels of HCG – the pregnancy hormone. Partly, I was too ill to care much at this point, but also, we were still two days from test day and I worried that the HCG levels were left over from the injection I’d given myself before egg collection.
I told L what the doctor had said, but flatly refused to get excited about it.
I had to have an ultrasound so they could look at the fluid in my stomach, which was excruciating as not only was my stomach so tight I was struggling to lay flat, but also – of course – they were pushing down on it with the ultrasound device. They discovered that, yes, I did have a stomach full of fluid.
By Thursday my stomach was ridiculously bloated and when the consultant from Guy’s came to examine me again and started talking about a drain I was practically chomping at the bit to get it done – anything to relieve the pressure in my stomach!
So I was wheeled down to the Interventional Ultrasound department by a team of junior doctors as a slot had suddenly become available and that didn’t allow for any time to get hold of a porter. So the consultant had sent three of her juniors to wheel me down. That was amusing – or would have been if I’d had much of a sense of humour about anything at the time – as they didn’t really seem to know where they were going.
We eventually found where we were supposed to be going and the doctor had a look at my stomach with the ultrasound, deciding where to insert the drain and then drawing a little cross on my stomach with a marker like you see them do on medical programmes. The procedure was done under local anaesthetic, which was really weird. The anaesthetic hurt quite a bit and then the sensation of the drain being inserted was so odd. It’s like I could feel it going in, but it didn’t hurt.
Once it was over, the doctor unclamped the drain and immediately the bag it was attached to started filling up with yellow liquid. I don’t know why it surprised me that the fluid was yellow, but it did. I’ll be honest, it looked like a catheter bag. You kind of assume that any OTHER liquid inside you is either red (i.e. blood) or just, kind of, clear. But I can now inform you that, in fact, there is a lot of urine-coloured fluid inside you.
What a lovely fact for a Thursday morning.
The plan was to try and drain 1 litre every twelve hours, but by the time I was wheeled back to the ward I had lost 1.7L of fluid. I couldn’t feel it leaving my body, but it didn’t take long for my stomach to feel SO MUCH better. However, losing that much fluid so quickly sent my body a little bit into shock and I came over really tired all of a sudden and my heart started pounding. The nurses did an ECG and my heart’s rhythm was fine – just very fast – so they then decided to try and just drain around 500ml every 12 hours.
I really perked up after that. The drain was uncomfortable, but my stomach felt so different. It was weird, because actually I still was – and still AM – very bloated, but nothing compared to how tight and swollen my stomach had felt before. The nurses had been weighing and measuring me every morning and at one point my belly was 96.5cm around. So, just under a metre! Also, once the drain had kicked in, I lost about 4 or 5 kilos in just a couple of days.
Finally, the drain stopped draining as much, which was what the doctors were waiting for. Sunday night it only drained about 60ml and the same Monday morning. This meant the drain could come out and I could go home.
One of the nurses came to remove the drain, but really struggled to get it out. They offered me some painkillers as there had been some resistance and they were worried that it might just be a bit stuck and therefore, require a bit more brute force to get it out. I know. If you want to skip to the end of this entry now, I don’t blame you at all.
Of course, my drug chart had been sent down to pharmacy to prepare for my drugs to take out with me, so they couldn’t give me anything until that came back.
Which took several hours.
Then they gave me some kind of codeine-based painkiller and told me they’d be back in half an hour, with a doctor, to try again. Of course, that half an hour became more like an hour and a half before they managed to finally pin the doctor down and get her to come and see me.
She tried to remove the drain, as the nurse had done, but also said that she felt resistance. She pulled on it. Hard. I actually cried.
They then decided a good tactic would be to call down to the Interventional Ultrasound department to see if they had any tips. Thankfully they did.
The drain had clearly formed some kind of vacuum type seal. I can’t even tell you how much it hurt. When the doctor returned, she snipped through the drain tube, which broke the seal and the tube came sliding straight out.
The doctor put a dressing on the wound, which was still leaking a bit of yellow fluid, and said that I couldn’t go until they’d checked that the wound was dry enough. By this time, it was already getting on for seven pm and my mum had been there with me since 2:30, ready to take me home. I’d packed up and just needed to change out of my pyjamas and into my street clothes.
I lay there for a while and watched the fluid soak through the dressing. They used this amazing stuff called Tegaderm, which is like a thin plastic skin with a gauze in the middle. It didn’t take long for the gauze to be soaked through, at which point the liquid started forming a yellow bubble under the plastic.
By the time the nurse came back to check the dressing, the pressure of the fluid under the dressing was so much that it had pushed against the adhesive on the plastic and burst out of the side.
So I still couldn’t go yet.
We went through about 3 or 4 dressings before they decided that they couldn’t let me go home while the wound was still leaking.
So I was there another night.
The night staff put another dressing on, this time layering up so much gauze I looked like I was growing another limb out of the side of my stomach. The soft, delicate skin on my belly was bright pink by this point, having had so many adhesive dressings applied and then ripped off again. By the morning, when the dressing was changed one last time, the wound had stopped leaking so I could finally go home.
My arms and hands were bruised from having blood taken every day and from the five different cannulas I’d had to have as my veins seemed to reject each one after only a day or so; my stomach, although greatly reduced in size, was still swollen and the wound was still sore; I struggled to walk all the way out of the hospital to get a cab to Charing Cross, having only walked at most the length of the corridor for the last 8 days, but I was going home.
I’m still not 100%, and not back at work yet, but very glad to be home, where I could finally do this: