I explained that I had c-section under general anesthesia. I have learned that anesthesia and anesthesiologist are two of my least favorite words. Because no matter how many times I type them out, I always forget how to spell them. Every. Damn. Time.
I needed a c-section because I was getting sick so quickly, we didn’t have time for me to go through labor. And I needed general anethfuckingsia because my platelets were too low. On the day of delivery, my platelets were 88, or 88,000 per micro liter. The normal range for adults is 150 to 400. As the day progressed, my doctor wanted to see if they were going up. They took a second sample closer to surgery time, and my count was down to 85, which was too low to do an epidural or a spinal block. There was too big a risk of uncontrolled bleeding into the spine. Which is bad, I guess.
So that’s why I had a c-section. But why were my platelets so low? I figured with all those other symptoms I had been having, I probably had pre-eclampsia. It’s more common for “elderly” moms. Yes, that’s what they called me. They also called me a geriatric mom. Isn’t that charming?
We were on the lookout for all the pre-eclampsia complications. But the blood thing was weird. It got super weird the day after I delivered the babies.
The nose bleed started sometime in the morning, I think sometime before 9 am. I didn’t bleed from my nose. It came from somewhere up in my sinuses. I got a heavy glob of something swelling in the back of my throat. Thinking it was post nasal drip, I spit it into a tissue. And it was a great big gross wad of dark red blood.
“Uh…” I said. My nurse looked at me, and I showed her the tissue.
“Uh, yeah.” I grabbed another tissue and pinched my nose closed. I was getting drips out of my right nostril, but it was not gushing. But I could feel my right sinus swelling up.
“Do you get nose bleeds?”
“No. Never. I got two little ones in the past week. But I don’t usually get them.” I needed to spit up again. I grabbed another tissue. Huge red bloody mess.
Another nurse walked in and she rummaged through a drawer nearby. She produced a plastic barf bag.
“This is pretty gross,” I said.
“Yup, it is pretty gross,” she agreed. I liked all the nurses who helped me, but I appreciated that this one didn’t mince words. Her name was Michol (like Michael). I already knew from meeting her previously, she seemed direct and to the point. I spit into the barf bag. It was a lot of blood.
I was told to hold my nose tight and tilt forward. Or tilt back. I don’t remember. I explained that the bleeding was not coming from my nose. It was coming from my sinuses, somewhere way in the back. No amount of pinching my face was going to help, other than to contain the drips coming from my nostrils.
I had spent the night breathing with an oxygen tube. It was incredibly dry. I figured my breathing passages got dried out and inflamed. But there was so much blood. I spit up into the barf bag. Michol held the bag up to my mouth.
“I’m sorry, this is so fucking gross.” I said. I was certainly on swearing terms with all my nurses.
“It’s okay,” she said.
I don’t know when, or how it happened, but it suddenly seemed like there were half a dozen nurses in my room with us. It sort of felt like a party. I was in good spirits, and I was pretty jovial as people came and went. All things considered, I wasn’t in pain. It was just weird. Nurses came in our room to witness the wack-ass nose bleed. They shook their heads and exchanged glances.
I looked at the clock, and an hour had passed. I was still bleeding hard as ever, after an hour. Michol wordlessly switched out the barf bags with fresh ones. They were nervous I was ingesting too much blood and it was going to make me nauseous. My day nurse came back and shared my lab results from that morning. She said my platelets were at 25.
Twenty five. Dave looked it up later, and when your platelets are that low, that’s when they start worrying about paradoxical bleeding, where you just spontaneously start bleeding, from like, your eyes.
So that was why this was such an epic nose bleed. I had no platelets. My blood had no way to clot. I looked at the clock again and another hour had passed. I had a lot of people bustling around in our room. Michol came and went, presumably to check on her own patients. When she came back, I said, “Hey, this sort of sucks.”
“Yeah, this isn’t funny anymore,” she said. She told me she had been a labor and delivery nurse for nine years, and had never seen anything like this.
“At least I got out of having to go through labor.” I said this truthfully. I was completely relieved that I had avoided labor. I’m a big baby. I felt lucky.
“Sweetie, going through labor is nothing compared to what you’ve been through,” my day nurse said.
At some point, I had to get another goddamned IV in my hand, which fricken sucked. IVs in the hand hurt like hell. But they needed it to give me a blood transfusion. And then another transfusion. And then, a round of platelets. I was bleeding out the nose as they were giving me new blood.
Another hour passed. I was still dripping blood out my nose. Three goddamned hours! What the fuck? Sometimes the blood came out in long ropey clots. In my mind, it sort of gave me hope, like, hey, I’m clotting over here! But most of the time, it just bled. It kept coming and coming. I could see nurses exchanging nervous glances.
They had put in a call to an ENT doctor. But the doctor on call was unavailable. So the next call was to the ER. They said they would probably have to pack my sinuses. Which didn’t sound like fun. And if that didn’t work, they’d have to cauterize, which sounded like even less fucking fun. I hated the sound of having my damn nose packed, but the idea of cauterizing my sinuses sounded a zillion time worse.
I sat and wished the bleeding would just stop. I wished I believed in some benevolent higher power, so I could put in a desperate request. Or I wished for the power of mind over body, where if I just believed hard enough, I could shut off my nose like a faucet. I wished for some woo woo bullshit, anything, ANYTHING, to make it stop before they had to pack my nose or burn my sinuses.
The ER doctor strolled in, looking like a character from Portlandia. He was gangly tall, with big plastic horn rimmed glasses and Chuck-Ts. He explained that he was going to administer a “rhino-rocket.” Sounded great. It was like a big fat tampon he was going to shove up my nose. Here’s a link to a video of how to administer this device, but I’m telling you right now, even with virtual sinuses, it’s sort of horrifying.
So let me set the stage for you: The room was full of people. Dave, the ER doctor, my actual day nurse, all kinds of other nurses. I had been in good spirits up to this point. But now, this was probably going to suck. I was not looking forward to whatever was about to happen. I was on the verge of panic. But I felt like I had to be brave, so as to not make an ass of myself. I didn’t want to show this room full of people that really, I know it seems like I was joking, but I really, really am a big baby.
The ER doctor dredged the rhino rocket in some water. He said it was going to create a slippery coagulant that was going to make it easy to shove up my nose. It looked like a slimy wet tampon. It was the size of my index finger, which I’ll have you know, is almost three inches long.
He was quick. He shoved the rhino rocket up my right nostril. It was two shoves. It hurt. Oh, it fucking hurt. Dave was holding my hand, and I’m sure I must have crushed his fingers. I felt intense pressure on the right side of my face, and the chambers of my sinuses creaked. Then he inflated the damn thing like a stent. The pain of the insertion faded, and I just felt pressure. The whole right side of my face sealed up. It felt solid, like the most hellish sinus cold you could ever imagine.
He checked the position and made sure it was in place. There was a long plastic piece sticking out of my nose. He taped it to the side of my face and said not to disturb it. I asked how long I’d need to keep the rhino rocket up my nose.
“Usually, three days,” he said casually.
I didn’t say anything, but I can tell you I was thinking, Jesus fucking Christ, THREE DAYS, are you fucking kidding me? Three days with this thing up my nose. Sleeping and eating with this thing up my nose. I didn’t even know if I’d be in the hospital for the next three days. Three days! Fuck!
Dave was beside me watching everything go down. He told me later, he observed how miserable I was after the rhino rocket. I was doing okay up to that point, even after everything else we had been through. My spirit just went out of me as that thing went up my nose.
We all sort of held our breath, though, waiting to see if it worked. If the bleeding didn’t stop, they’d have to cauterize. I waited to feel the blood drip down my throat.
But it seemed to stop. A few minutes went by with no blood. I began to relax. The Epic Fricken Post Partum Nose Bleed of 2012 was over. A total of three and a half hours had passed since it began.
What caused it? I had HELLP Syndrome. It’s a complication of pre-eclampsia. It only happens one or two times in 1000 pregnancies. It’s like winning the damn unlucky lottery. They don’t really know what causes it. But it’s life threatening. And the only way to cure it is to deliver the babies.
And you know what I totally forgot about though all of this? I totally forgot I had babies. I was so busy being sick, I forgot the reason why I was there.
Yes, that’s me, looking like total hell, but photographed from an angle where you almost can’t see that I have a tampon shoved up my nose.
Here’s the new family. Me, Dave, Cascadian, Loyal, and Rhino Rocket.
But wait, there’s more! I’m only on the second day of ten days in the hospital! Isn’t this fun?
I think I have two more chapters after this. Then really, I might write about something else. Maybe.