I was so excited to be contacted by U.S. News & World Report again this week. This was for an article about life after having a colectomy. I think they did a great job with this article, explaining more about the surgery and what to expect, but also showing that it’s not something that will inhibit the way you live you life. The subtext says it all: “What can people do once they have an ostomy? Anything they want.” Check out the full article.
I have known all along with this pregnancy that I could have some complications because of my ostomy. I even mentioned in my post on the second trimester that I was concerned about the possibility of blockages as things progressed. Turns out, it was a valid concern.
Sorry if this is a little long, but I’ll try to tell this story as succinctly as possible. It started last Monday evening. I started feeling a little funny at work and by the time I got home, I was having a decent amount of pain around my stoma. I also realized that I really hadn’t emptied my bag much at all that day. I tried to take it easy that evening, drinking a lot of fluids and staying away from solid food, putting a warm compress around the area, massaging it the best I could and eventually taking a warm bath, all of the old standbys for dealing with a blockage. But this all becomes a little more complicated when you’re pregnant, since you have to be careful about heating your body up too much, plus it’s just hard to submerge a big belly in a bathtub. But after the bath, I was feeling a lot better. I tried to sleep it off and told myself that if things weren’t better in the morning then I would go to the ER. Well, in the morning I was feeling better, but still was having very little output. I decided to go to the ER out of an abundance of caution since I’m also responsible for another life now.
At the ER, they checked everything out and decided it would be best to admit me in order to give me some IV fluids since I was dehydrated and to keep an eye on my output. Normally when someone has an intestinal blockage, the doctor can sort of thump on the belly to listen for certain sounds, and they will usually do an X-ray or a CT scan to find out if a blockage actually exists and where it is. But none these are options when you’re pregnant. The belly thumping is pointless and the X-ray and CT scan can be potentially harmful to the baby because of the radiation, so really all I could do was wait. Not eat anything and wait.
I ended up staying for 2 days, getting lots of fluids and keeping a close eye on the baby during that time. By then my output was getting back on track and I was able to eat solid foods again. So home I went on Thursday.
We had a family wedding going on that weekend, so it was very busy. I felt fine all day on Friday and even when I woke up Saturday morning, my output was completely normal. But about noon, I started feeling blocked up again. At the wedding, I was in a decent amount of pain, but this time it was not focused around the stoma, but rather right between my uterus and my ribs, which is where your small intestine gets smushed up when you’re pregnant. I was also very nauseous. I tried to stick it out as long as I could, but I couldn’t touch any of the food there and was honestly concerned I was going to vomit at any moment. I couldn’t even get water down at this point. I left the wedding early to go home and go to bed.
I felt better being in bed, but when I woke up Sunday morning, I was still in a lot of pain, I hadn’t had any output for close to 24 hours, and I was still nauseous. I knew I needed to go back to the hospital, no matter how much I didn’t want to. This time, as soon as I arrived they took me straight to Labor & Delivery. They checked for any signs of early labor, but the baby was perfectly content to stay put. While thankfully everything looked great with the little one, I was in pretty excruciating pain. I was literally scared that I could get a perforated bowel that could put both me and baby at a huge risk. I got some more IV fluids which really seemed to help at first, but then the pain and nausea came back just as strong. This time, I did actually throw up some horribly vile looking stuff, which is the first time I’ve actually thrown up from a blockage. I was again admitted to the hospital.
By now I hadn’t eaten anything in over 30 hours, yet I was burping repeatedly, but thankfully did not throw up again. Since I was still having at least a minimal amount of output and I wasn’t throwing up anymore, the doctors figured it wasn’t a complete obstruction, but likely a partial one due to a kink or something like that in my small intestine.
I was still in pain the next day, even after 2 days of not eating and lots of fluid, but it eventually started to subside. They put me on a clear liquid diet and by day 3 I was getting more output, and the cramping was down to a minimum. Still causing a little discomfort, but nothing as frequent or intense.
One upside was I went down for an ultrasound that morning to check on the little one, who seemed to be completely unfazed this entire time, which helped me to relax. It was difficult not knowing what was going on with the baby this whole time. I was on a prenatal floor the entire time, so I was glad knowing we were in good hands and that they were keeping an extra close eye on both of us.
I was able to go home by day 4, feeling a lot better, even though a little worn down. All of this to say that blockages are a real concern when you’re pregnant. And I assume even more so when you’re short like me and there’s just not a lot of room for all of the baby and uterus and bowel and everything else. I would think this would be true for anyone who has had bowel surgery, whether you have an ostomy or not. My surgeon told me that the baby itself is rarely the cause of a blockage and it’s usually due to scar tissue. So I take that to mean that it’s most likely an area of my intestine that has scar tissue that also got jammed up because of my growing belly and the lack of available space.
After spending 7 of the last 10 days in the hospital, I think I’ve decided that I need to stick to a low-residue, mostly liquid diet for the remainder of this pregnancy. (I do not recommend doing this unless you speak with your doctor or nutritionist first!) Both my OB doctor and the dietician said that it should be fine for me and for baby, especially since I’m as far along as I am, but I need to make sure that I am getting enough protein and enough good calories, not empty ones from sugar and such. I know it will be hard, but thankfully it’s only for a limited number of weeks. We will see how it actually goes in practice because I really love food! But I also really love not being in the hospital.
Have you dealt with intestinal blockages while pregnant? Are there any tips you have found for avoiding them? Or for helping them to pass once one starts?
I am spending this World IBD Day in the hospital. This was definitely not my plan for this day. But I suppose it’s kind of appropriate since those living with Crohn’s disease and ulcerative colitis never get a break and they can be fine one day and hooked up to a bunch of IVs at the hospital the next. And that’s pretty much what happened to me.
Let me say first of all, though, that I am not in the hospital for a Crohn’s flare. But I am in the hospital as a result of Crohn’s disease and the surgeries I’ve had because of it. I’ve been dealing with some bowel obstruction issues since Sunday and they got even worse last night. When I woke up this morning, I still was having very little output, so out of an abundance of caution, especially considering my pregnancy, I decided to go to the ER. It’s now 11 hours later and I’m still not having a lot of output, or at least not anything substantial.
On three separate occasions in the past few weeks, I’ve been confronted with the discussion of individuals who have been diagnosed with a chronic disease, specifically Crohn’s disease or ulcerative colitis, deciding to have children. I realize this can be a controversial topic and, as you probably know, I am currently 8 months pregnant with my first child, so I understand the process that you go through when making that sort of decision. I understand why there are those who might decide not to have children themselves, whether due to their personal desires or due to concerns about their own or their children’s health. And while all of this played a role in our process, I wanted to share some of the reasons why my husband and I made the decision we did. And that’s not to say that this process should look the same for everyone else. This is a deeply personal decision, one that no one else can make for you and one that no one should ever pass judgment on.
I have always wanted kids and have never really considered not having them. Since I was much younger than I am now, I have wanted to be a mother and to have a family. Both my husband and I come from family-centric homes and we’re still very close with all of our family members. I don’t think I have ever truly considered not being a mom at some point in my life, whether through natural means, medical assistance or adoption. I think it’s something that is built into who I am and what I desire out of life.