The Appendectomy: Part I

Last Wednesday night, I started feeling a little less than well. James, Shelby and I went grocery shopping, and the whole time we were out of the house, I was feeling more and more bloated and uncomfortable. On Thursday, that bloated feeling gradually changed into a stomach ache that just got worse and worse.

Late Thursday night, I was violently ill, vomiting about every twenty to thirty minutes. The vomiting eventually stopped, but the intense abdominal pain continued. I convinced myself that it was just a bad stomach bug. I stayed convinced all day Friday, even though the only way I could make the pain manageable was by laying in bed and not moving anything below the neck.

Friday night, I had a temperature of 101 degrees. Saturday morning, the fever was gone, but the pain was even more intense. Late Saturday afternoon, the pain migrated to my lower right abdomen. I remembered that the appendix lives in the lower right abdomen and headed to the emergency room that evening.

Going to the emergency room is a slightly more complicated endeavor than you might imagine. Right now, James is dealing with some health issues of his own. He can't drive because of the medications he's taking. To make matters worse, we'd never given Miss Shelby a bottle and we only had enough milk in the freezer for five smallish feedings, so if I went to the hospital alone, I'd be leaving James in a potentially volatile situation. My dad had to come get all of us.

Once we were at the hospital, I explained to the triage nurse that I didn't want any pain medication unless it was safe for breastfeeding. Then I explained to the regular nurse that my main concern was that any medication I take should be safe for breastfeeding. The doctor came in and examined me. When she pressed on my abdomen directly above my appendix, it hurt so bad I cried. She said it looked like appendicitis, but they would need a CT scan to be sure. She said I would have to drink some contrast fluid. I asked if it was safe for breastfeeding. She said, "The oral contrast? Yes, the oral contrast is safe for breastfeeding." She also said she would have the nurse give me pain medication, and she verified that the pain medication was safe as well. After talking with the nurse, I decided to start the pain medication at a lower dose than ordered. I wanted to stay coherent.

I had to wait quite a while to get the contrast, and after I drank it, I had to wait quite a while for it to make its way through my system. Finally, I was taken for the scan. The technician said he would need to give me IV contrast before he did the CT. I remembered the doctor stating so specifically that the oral contrast was safe. I asked if the IV contrast was safe for breastfeeding. He said it wasn't. I asked how much time it took to pass through. He said I would have to pump and dump for 24 hours. That wouldn't work for us; we didn't have enough milk stored to last 24 hours. His solution? Someone should go to the store and get some formula. I took a deep breath and, as calmly as I could, explained that my baby has never had a bottle ever, and it would be hard enough for James to get her to take one filled with familiar and loved milk. I also explained that James couldn't drive right now to go get formula. I laid out some of the reasons I prefer to continue exclusively breastfeeding rather than supplement with formula. I asked if it would be possible to do the CT with the oral contrast and wait for the results, then do another scan with the IV contrast only if necessary. At least by then I'd have some time to pump more milk.

Fortunately, this man was a father of two and appreciated that I was trying to look out for my baby and keep James from having to deal with extra issues. He called the doctor, and when my nurse came in to talk to me, he helped me make sure she understood I wasn't refusing the CT, just asking to take the IV contrast only if absolutely necessary. After my nurse left, he told me if the problem was appendicitis, it would show up without the IV contrast anyway. Sure enough, it was appendicitis, and they were able to confirm it without doing anything to render my milk unsafe for my baby.

I was admitted so they could operate the next morning. That entire night, I took half the pain medication the nurses offered, instead of full doses, in order to be able to advocate for myself as necessary.