The Evolution of My Wound

Here's a recent picture of Ellie, looking super cute!

Yesterday I was (finally!) released from Wound Care.  My c-section incision is officially healed (enough), after 8 months, 3 weeks and roughly 8 hours. It is such a huge relief.  That incision has been a part of me, like another (unwelcome) family member for the past 9 months!

I cannot possibly thank everyone enough for the love, support, and prayers I've received over the past several months as I've struggled to heal and get through this difficult time.  I have really felt a tremendous amount of love and support from my family and friends, and am so lucky to have so many wonderful and caring people in my life. 

I thought I would share with you the evolution of my wound, but I must warn you that if you are squeamish, or don't like to look at gross things, you might want to think about skipping this post.  I won't be offended.  Some pictures are upside down because I was generally taking the pictures while laying down, and that's how my iPhone did it.  I tried flipping them around before posting, but some wouldn't save right side up. 

I didn't think to take pictures of the wound until September, so this is about 2 months after Ellie's birth (which was on July 14).



Middle of September -- The one on the left is 3cm X 1.5cm X 3.3 cm (length X width X depth); The one on the right is 3.5 X 1.8 X 2.8; A tunnel connects them under the section of healed skin on the top

Early October -- After we stopped using the Wound Vac -- both wounds are about 1 cm deep here, but there is still a tunnel connecting the two under the surface

Mid-October -- So you can see it with a ruler and get an idea of the surface size

Right around Halloween, progress stalled around this point and my measurements stayed pretty much the same for several weeks in a row

Around the end of November, it all the sudden got so much better, but I still had that tunnel connecting the two holes under the surface

 

December didn't bring about much change.  I was supposed to have the deep wound debridment surgery right before Christmas, but developed a mastitis in my right breast the day before.  I had a temperature of 102.2 in pre-op, so got IV antibiotics instead of surgery. 

 

January brought about some major changes -- the tunnel started to close up, and the wound on the right was healing (you can actually see the bottom of the wound in the picture on the right side)

 

 Early February -- Progress continued, and the tunnel completely closed up

 February 14 -- Happy Valentine's Day to me!  My measurements were deeper this week, and I was in a lot of pain.  My Wound Care doctor numbed the wounds (that's where the bruising came from) and got some really good tissue samples.  Those showed an anaerobic bacterial infection and an OSSA staph infection.  I went back on antibiotics and...

 

 The wounds started closing in March!!!

 By the end of March I was measuring a 0.1 cm depth on the right side, and 0.2 cm depth on the left. 

 

When I went to the doctor yesterday (April 5) this is what he saw -- 0.0 cm depth!  And, the surface is closed all the way too. 

 I've been released from Wound Care and can resume normal activity as long as it doesn't cause me pain.  The nerve endings will continue to come back, so the area will likely be tender and sore for several more months. 

 

So there it is, in all of it's glory.  My c-section wound from almost completely open at 2 months post-partum to healed at almost 9 months post-partum.  Now, I am in no way a typical case (I tend to be a medical mystery), but I urge women to avoid a c-section unless absolutely medically necessary.  The risks of the surgery are just so great. there is no way to predict what will happen.  (I'm not talking about women who HAVE to have a c/s, I'm talking about those that WANT one because they want to schedule their births, or are afraid of labor pain -- elective c/s).  This has effected me in ways I probably don't even know yet.  I've been in chronic pain, suffered from post-partum depression, put great strain on my marriage, made work difficult, and worst of all, not been able to care for my daughter as well as I should have been for almost her entire first year.  If this can happen to me, it can certainly happen to any other mother. 

 

 

 

 

 

 

 

 

Nursing Woes

It would be an understatement to say that I did not have the birthing experience that I planned.  I wanted an all natural birth with very little medical intervention.  What I got was an induction, and epidural, and finally a c-section.

I thought I would at least be able to nurse the way that I wanted since nothing else had gone my way (besides the actual birth of my beautiful daughter, of course!).  Unfortunately, that didn't happen either.

Ellie was born at 37 weeks gestation, and we were told nursing would probably be difficult because babies don't develop the rooting and sucking instinct until 38-39 weeks.  I was prepared for the challenge, but feel like we were never really given the chance.  When Ellie was less than twelve hours old we were told we had to supplement with formula.  The neonatologists were worried about weight loss and jaundice.  All babies get a little jaundice, but because she was born with several bruises on her head and face (she really tried to engage -- for days! -- but just wouldn't fit, and she had the battle wounds to prove it) the doctors were worried that her jaundice would be worse than normal. 

Reluctantly, I agreed to supplement with formula, as long as we didn't have to use a bottle.  So, we learned how to use a feeding tube, and we established a very regimented schedule.  Every 2 hours I would nurse on both sides, pump, and then feed up to 10 ml of formula with the feeding tube, but at the breast so Ellie would associate food with my breasts.  I was really OK with this, until we were told on day 2 that she should be eating 30-60 ml of formula at every feeding.  It was hard enough to get her to eat the 10 ml; She obviously was not hungry enough to eat 30 ml!  I got really frustrated with this turn of events, but we were being threatened with bottle feedings and a return to the NICU if she lost any more weight or her jaundice got worse.  I certainly didn't want that, so again, we agreed.  Only, we changed from every 2 hours for feedings to every 3 hours.  I figured if she had more time to get hungry, then maybe she would eat more.

On day 3 they changed our routine once again.  We had to supplement with formula at the breast (for at least 30 ml of formula) and then pump for 15 minutes.  Whatever was collected with pumping would start the next feeding.  This meant that I no longer was able to nurse without any supplements at all.  I was not particularly pleased with this turn of events, but again agreed in order to keep her out of the NICU. 

We were discharged on day 4, under direct orders not to miss our pediatrician appointment that afternoon because of her jaundice (still not bad enough to require light therapy -- just slightly in the danger zone, but already going in the right direction).  When we made it to the pediatrician she asked me how breastfeeding was going I just burst into tears.  I told her I felt like I was force-feeding her and she never had an opportunity to get hungry so it was just frustrating to her.  I didn't want to be on a schedule, I wanted to feed her when she was hungry.  The doctor gave me a hug, told me it would be OK, and we started a new plan.  We would stop the formula feedings (yea!), and we would start feeding on-demand.  This meant that I didn't have to watch the clock anymore, instead I could watch my daughter and let her tell me when she was hungry.

We started that day, and it was an immediate change.  I know babies get more active and alert as they get older, but it was uncanny how her level of alertness increased with the induction of this new plan.  That afternoon I saw her eyes open more than I ever had, she was much more aggressive with feedings, seeking out my breast, not just waiting for me to give it to her.  Maybe it was just me, but she also seemed happier and less stressed or frustrated with the entire act of eating. 

The one good thing about having to formula feed was that Jeffrey was able to be a part of the feedings in a way he otherwise would not have been.  Finger feeding allowed him an opportunity to feel her latch and that was really exciting for him.  He is eagerly anticipating the start of bottle feeding in a couple of weeks so he can be more involved again.