Severe OHSS Resulting in a Paracentesis

So on saturday, March 16th, all was well. Troy, Kristen (who was visiting), Avery, and I went to a family appreciation day at Creech with Troy. There was a tour of the new facility that his squadron is moving into and a BBQ, complete with bouncy castles and sunscreen (because is was 90 degrees that day).

Everything was peachy. In fact, here is a picture of us, all looking normal, and Avery looking adorable.



Kristen and I went and saw "Safe Haven" that night, because, hello?? Whenever we're together, we always go see a movie with man candy (in this case Josh Duhamel).

On sunday morning, I woke up around 430 in some pretty bad pain. I went downstairs and got comfy in one of the recliners and watched Pitch Perfect. When I got up to go take a shower and get ready for church, I looked like this...NO kidding:



We were all shocked. I looked about 5 months pregnant. I gained 11 pounds overnight. I wasn't in a super amount of pain, BUT I was more worried about what I looked like and answering questions about "when are you due?" and "wow, are you having a boy or a girl?" That seemed like the cruelest part of the whole deal. I looked pregnant and wasn't.

Kristen and I went and got pedicures after church, which turned out to be a great decision, because I ended up spending a HUGE amount of time in a hospital gown/with swollen feet/getting ultrasounds in the next week.

I started getting uncomfortable, having more pain, and having a hard time breathing with all the fluid build up in my abdomen. So, sunday night, Troy and I headed to the ER at Nellis. I got an abdominal ultrasound, a pelvic ultrasound, a heart ultrasound, and a chest xray. Part of the danger with OHSS is the dehydration of your body while it pumps fluid into your abdomen (trying to heal your ovaries) and then your blood thickens up and you can get a clot (in your heart, lungs, brain, etc). My blood levels weren't looking great. My ovaries were 10cm and 12 cm (almost 5-6 inches each) and I had a bit of fluid around my heart and lungs. Ughhhhhhh. They sent me home with pain meds and a follow up the next morning with my fertility specialist. They had given me morphine while I was there for pain. I threw up in the street for about 5 minutes when we got home. No more morphine for me. We are not friends.

I got up monday morning and got ready for work. I weighed myself. 6 more pounds... and went to my appointment. They gave me a note to be on "light duty" at work. I gave my note to my boss and she took one look at me and sent me home. I wasn't allowed to work until this was resolved. Awesome.

I kept getting bigger and bigger. I gained 8 more pounds by tuesday.



I kept eating my high sodium and drinking gatorade. It was awful. The electrolyte drinks were all so sweet and syrupy. I tried the Pedialyte. It was SO gross. All the pain medication, salty food, and high protein was making me so constipated. I seriously started to feel like I was dying. And I felt this feeling of SO much hopelessness. I felt like I was NEVER going to shrink back. My skin hurt SO bad.



I couldn't pick up Avery. I couldn't hardly eat because my body was so swollen that there was no room in my stomach for anything. And I wasn't peeing. AT ALL. Like downing fluid, and NOTHING. All fluids straight into my belly. I could feel like skin stretching every time I ate or drank anything. I couldn't sleep because my belly would flop over and pull all my organs over. It is SO different than pregnancy, where it's all hard and baby. The pressure was building and my kidneys were getting CRUSHED. My lower back was killer.



The swelling started to spread. I wasn't allowed to wear pants. Troy was rubbing my back and he said I looked like Quasimodo because the fluid was pushing my back out at the bottom. It was CRAAAZY. My hips, butt, thighs, and knees tripled in size and none of my maternity clothes fit.



Wednesday night was the worst. WORST. I woke up around 11pm DYING. Like pain worse than labor. Crying. Screaming. Writhing in bed. Troy holding me down. Me punching him. He loaded me in the car and we went to the ER. Again.

We walked in and they thought I was in labor...I was that big and uncomfortable. Until we told them what was going on. Some of the same nurses/doctors were there from sunday night and they remembered us. They immediately gave me an IV and loaded me up with dilaudid. Thank you Jesus for dilaudid. And Zofran. They redid the pelvic ultrasound to see if my ovaries had changed (same size) and look at my abdominal fluid (there was way more). They sent me home with percocet and zofran. And another follow up with my specialist. My lab work was worse. I was taking the max dosage for pain meds every 4 hours and it was not helping.

On thursday, my fertility doc told me to wait it out through the weekend and if I was not getting better by monday, he would recommend the paracentesis to drain the fluid.

Needless to say, it was not getting better.

Sunday night, Troy told me that I was bigger that night than I was the day I delivered Avery. He was helping me in and out of bed, on and off the toilet and with showers. It was awwwwwwwful.

This is Sunday night. I was SOOOOOOO swollen.



This is me, the morning I went to Nellis for the paracentesis. And up 31 pounds in a week.



We had to wait for a bit. The doctor who checked us in at Nellis was like, "I do this procedure all the time, hold up a second and we'll have this done in a few minutes." He was contracted and didn't realize Nellis procedure for performing a paracentesis and we had to wait on the interventionist radiologist to do the procedure.

I was feeling like SUPER poop and Troy was trying to make me laugh. They told me my liver enzymes were not so great from taking all the pain meds and I needed to stop taking anything with tylenol in it. So no more percocet.



We finally got everything in order (6 hours later) and were set up in a small procedure room in the ER for the paracentesis. The doctor was WONDERFUL. He ultrasounded my belly to looked for an area where he wouldn't poke bowel, ovary, stomach, or liver. He used lidocaine to numb my skin (OUCH) and then put in the catheter to start draining the fluid out of my belly. He guessed he would remove about 2-3 liters. In the picture below, you can see where the needle is in my skin, how he pumped out the fluid manually, and then the bag (which is a 2 liter bag). The bag was emptied twice and he had me roll onto my side to move more fluid towards the drain. He ended up removing 4.5 liters of fluid. SURPRISE!!!



The hole WOULD NOT plug. I had fluid in a constant drip coming out of my belly from about 3 pm until I went to bed at 10. SO MUCH gauze. They sent us home with gauze, tape and absorbent pads for leaking. Gross.



That night, we were worried about leaking all over the bed, so Troy fashioned me an absorbent diaper. Luckily, during the night, the leaking stopped and no damage was done to our mattress or sheets :)



Since the procedure, I have been feeling 100000000% better. With WAY less pain. My abdominal muscles are trashed. A human body shouldn't go from normal to 10+ mo preggo in a week. I'm lucky I made it out with no stretch marks. I'm so vain. I'm also lucky that my friend, Kristen was here and Troy's parents were here to help with Avery. Ughhhhhh. I have an appointment at Nellis next week for another draining. They are guessing the fluid will come back. I hope not. I started having increased kidney function. So hopefully I'll just pee the fluid out now.

What are the odds of this happening? It happens to a 10th of a percent. A TENTH OF A PERCENT. Very uncommon. Odds were not in my favor. Or were they? Should I buy a lottery ticket? Or avoid skydiving?

My mom is here now because I'm still supposed to be on bedrest and I can't pick up Avery. Poor baby doesn't understand :( Love her.