The Crazy Things We Do

Kidney surgery. It was supposed to be the most bizarre, wild, certainly the most severe “side-effect” of pregnancy I would ever experience. Just three months ago I contributed my kidney story to a funny online thread about medical effects of pregnancy, postpartum, and mothering (with the wonderful cartoon above as inspiration). We were a bunch of moms-who-are-happy-being-moms, many of us with more than the average number of children, laughing good-naturedly at the things we’ve suffered for our little ones: black eyes, blown discs, bloody noses, hemorrhoids, thyroid problems, insomnia, constipation, restless legs, bruised and broken tailbones or ribs, weird rashes, pelvic separation, and so on. Three years after my surgery it was easy to join the fun; the severe pain I experienced because of fluid build-up in my left kidney the day after my third child was born was a far-distant memory. Easy to laugh about now.

The reality is that three years ago when I was in the hospital feeling that pain, not knowing what was causing it, I had turned to David in a moment of extreme vulnerability and asked him what cancer feels like. And I thought about my two beautiful girls at home, and my infant son, and for the first time my mind timidly probed the heart-sickening possibility that I might die young and leave them to grow up without a mommy.

But the CT scan came back without undue concern – I was suffering from a congenital mechanical blockage in my kidney, probably exacerbated as my husky in-utero boy shoved aside my internal organs. Easily fixed a few months later with surgery (“just move a blood vessel” they said – it’s amazing what the medical world can do these days). I have never had problems with my kidney since. The scars remind me of the crazy things mothers do to bring children into the world and when I remember them, I even smile.

I was thinking about my kidney when I almost impatiently strode into the emergency room three weeks ago. My newest son was not even three weeks old, and again I was experiencing unidentified, severe flank pain. This time on my right side, near ribs that felt like they’d been broken. The pain radiated up into my right shoulder and I thought maybe I’d pulled a muscle in my torso. But my concerned husband consulted my doctor brother-in-law, who heard my symptoms and firmly suggested that despite coronavirus fears, I go to the ER.

David was unable to come with me due to no visitor restrictions, and besides, everyone we knew was social distancing and would be unable to take our children. I was strangely grateful for previous ER experiences that allowed me to march bravely alone through the doors with the big red words over them, waving goodbye to my husband in the car. I knew what to expect at an ER and so going alone felt okay. Doable.

I hadn’t anticipated that I would be at the hospital alone for the next several days. I entered with only my phone, a small tube of chapstick, and my nursing pump. I knew that I would need to protect my milk supply, but I hadn’t thought to bring a toothbrush or dry shampoo or a change of underwear because this time I hadn’t been thinking about cancer or other life-taking things. I wanted to enter, get a diagnosis and some pain relief, and go home to my nursing baby.

It didn’t happen that way. After tapping around on my back and a preliminary ultrasound with a small, portable machine, the intern attending me thought maybe I had a blockage in my gallbladder. They asked me not to eat or drink in preparation for potential surgery. The news should have scared me perhaps, but I was enjoying the irony (blocked kidney last baby, blocked gallbladder this time) and my kidney surgery had been too good a fix. I expected a quick surgery to remove the gallbladder, and no more problems ever. No problem.

I was wheeled away to a dark imaging room where a technician took careful scans of my gallbladder and both kidneys. It wasn’t until I returned to my room and a new intern told me they needed to run more tests that I started to worry. The ultrasound of both my gallbladder and kidneys had come back clear. Then I was sitting in a hospital room alone, the easy answers gone, looking at a new bout of tests that would lead to who knows where. I started up my nursing pump, wondering for the first time how long I’d be away from my baby and family.

They ordered a CT scan. After I was wheeled back to imaging, I looked at the bench under the rainbow-shaped tube and told the tech, “I can’t lay down.” I’d spent the previous night sleeping hunched over in a chair because I had hurt too badly lying down. On my back, I hadn’t been able to breathe through the pain. But the CT tech affirmed that I would have to lie flat and promised he would help ease me down. He was gentle and moved slowly and I was grateful. I breathed shallowly as the machine started to move. There were times when the voice of the tech came over the intercom and asked me to hold my breath. Each time I was only to hold for perhaps five seconds but even that brief moment stretched the limits of my current lung capacity. As they backed me out of the machine, I felt myself panicking over the lack of breath. My eyes filled with tears but the sob couldn't come. I couldn't get enough air even to cry.

I think it was then that I started to realize something was horribly wrong. I'd thought walking into the ER that any breathing troubles stemmed from the pain. I thought I wasn't breathing deeply because it hurt too much. Lying down for the CT scan taught me that I couldn't breathe because I couldn't breathe. As I processed my panic I wondered, what was it that was taking my breath away? What was I dealing with?

I expected to have to wait a lot longer for the results of my scan. But it seemed like only a few minutes after returning to my room before the intern hesitantly slid around the privacy curtain, eyes looking nervous and pitying over his coronavirus mask. New enough in his profession to have not yet learned how to deliver bad news, his body language told me enough. They had done the CT to rule out pulmonary embolisms, but if he was coming to me now, so soon after my scan, looking nervous and sorry, it meant they’d found clots: “Lots,” he said. I asked him a few calm questions. So calm I think he must have thought I didn’t understand the news he was delivering. I remember realizing I was blinking rather slowly at him, my eyelashes scraping the top of the blue medical mask I was wearing. I assured him I understood.

It wasn’t until the intern left me alone in the room, after I’d taken off my mask and dialed Dave to give him the news, that emotion welled up. There was a sort of external awareness as I gave the diagnosis to my husband at home alone with three young children and a newborn baby not even three weeks old. I was away at the hospital, but how close had I come to just being "away"? To heart attack and leaving my husband permanently alone with three young children and a newborn? The tears came with my report and I couldn’t think of anything else to say but, “I’m sorry.” His tears came as he asked in bewilderment, “Are you sure? Are they sure?” We cried together for a brief moment and then we hung up, and I returned to sitting alone in my hospital room and he went back to caring alone for our four children, both of us reeling from the news that this time it hadn’t been a blocked kidney or a blocked gallbladder like I’d thought, but a blocked artery in my lung.

The scan showed clots in both my lungs, but the most worrying was a large clot in my right lung. It had already caused infarction; tissue in that lung had already died because the clot had cut off blood supply. It was the infarction and resulting inflammation causing my pain. And maybe I should be grateful for the pain. Had I not been in pain, would I have risked an ER visit during a pandemic? Had I not risked an ER visit, what would have happened in my blood vessels as the days wore on? It was almost impossible to send my mind down that road. The possibilities were too impossibly frightening.

I had to stay at the hospital. They were worried there might be strain on my heart - a heart working harder to squeeze blood past the clot. They were worried about oxygen levels while I was still grasping for breath every few words. They checked me in and talked about the ICU. They wanted me closely monitored.

I am humbled and inspired by the examples of compassion I experienced from the staff of the hospital during my stay. I seem to have been labeled "the new mom," and in their great concern over this patient with a newborn at home, so many women mothered me as they cared for me. Some I remember by name: Agnes, the nurse who was attending me when I received my diagnosis. She clucked around me while she took blood samples, shaking her head telling me how sorry she was that a nice mama like me had to go through such a thing. She testified in her Southern, straightforward way that God knew me and would provide. Later, when they were wheeling me away to a different floor, Agnes called my new nurse on the phone and told her she was praying for me.

Kendra was my night nurse two nights in a row. She was gentle and quiet. One of the doctors who poked his head in to check on me saw her attending me with approval. “Oh good,” he said. “We’ve got the mamas together.” As the door clicked behind him, Kendra explained that she, too, had four children and that a week after one of her deliveries, she’d ended up in the hospital. She looked at me directly and said, “I know what it’s like.” Kendra was diligent in reminding me to pump every three hours, even through the night. There was no lecture in her voice. We both knew I needed to keep pumping if I wanted to nurse my baby when I got home. Her gentle, persistent reminders came from a place of knowing, of aligned priorities and steadfast support.

Michele shuffled and outsourced her duties one frenzied half hour so she could take milk I had already pumped down to the parking lot where David waited for it. She also acted quickly and firmly later, when I was returning from an imaging appointment and was trying but failing to stifle another panic attack that was stealing what little breath I had.

There were others whose names I never knew, but whose ministering touched my soul. One nurse spent ages on the phone calling from one department to another to find me a mini fridge that could be installed in my room so that I could store my milk. Extra nurses cheerfully came to lend a hand every time I had to be moved, to follow behind us wheeling the hospital-grade pump they’d found for me. There was one phlebotomist who knocked on my door softly around 5 am. I was bleary with sleep but I remember she was a tiny woman, older, with a soft, gentle voice. I showed her the bruising inside my elbow where the many other phlebotomists had found blood and she nodded, finding another, unbruised place from which to draw. I can’t describe the tenderness with which she tucked the covers back around my arm before she gently withdrew from my room.  And there was a young cleaning lady who came as I was waiting to be discharged. She got to my doorway and blinked at me sitting up on my bed and said in the most unaffected, sincere way, “You are so beautiful.” Her sincerity pierced my soul as I thought about my four days in the hospital without a brush to smooth my hair, without makeup or lotion to cover dried and flaky facial skin, without tweezers to tame my thick, dark eyebrows. In the social silence of a hospital room without visitors, I was profoundly touched by every single act of kindness I experienced by staff who acted from a place of deep humanness, meeting the needs of my soul and not just the needs of my body.

Their kindness meant more because of how difficult this hospital stay was. I was in pain despite medication. The dry hospital air scratched my throat and made me cough, but even the tiniest cough made my lungs feel like knives. I still couldn't recline, so I got minimal sleep sitting up, curled over a tower of pillows. Breakfast one morning made me throw up. And through it all, I ached for my baby. I came to dread pumping, when I'd have to juggle cold, hard tubes and feel the pump's stinging, lifeless pull. Milk came reluctantly and only after pulling up photos of Reid on my phone and trying to remember what he smelled like and felt like, after trying to imagine kissing his soft hair and holding his warm body. I felt a deep, visceral need to be reunited with him, to be able to feed him again and care for him. It didn't feel like an emotional need. Still bleeding from his birth, pouring forth milk for his nourishment, it was a physical and fundamentally instinctual need. I was deeply grateful for all the staff - male and female - who showed me they understood that.



Slowly I showed progress. By my third day I could walk without doubling in pain and stopping for breath. I could even sleep with my hospital bed somewhat reclined. I felt more like myself and I was desperate to go home. My cardiologists had promised I was very close. The next morning, I woke up energized, hopeful there would be an imminent discharge. The doctors came early, starting with the internal medicine doc who had checked in daily but to whom, to be honest, I hadn't paid much attention. I'd been troubled when she'd suggested that I shouldn't nurse my baby for the next few months so I could choose stronger pain medications, and I'd dismissed her as someone who didn't understand what it meant to have a three-week-old baby at home. When she arrived that morning, she asked me a few questions then prepared to leave. Before she did she turned to me and asked, in an off-hand tone, "You don't need to rush home for any reason, do you?"

I think I might actually have gaped at her. The first thing I wanted to do was scream. Then I wanted to throw something - hard. Then I wanted to sob hard, ugly sobs. After she left I did sob and felt some relief that I could get enough air to cry some. But in that moment I somehow kept calm enough to say, probably rather strongly, that yes, I needed to get home to my baby. The doctor looked surprised, then displeased. She grumbled that the appointments I needed weren't set up and that she didn't know if my pharmacy could fill my essential blood thinner prescription. I vowed I'd drive to any pharmacy in town.

To her credit (and after the cardiologist firmly agreed it was time for me to leave), the internal medicine doctor quickly arranged for the needed appointments and medications. I was discharged by lunch.  Dave picked me up and we drove home to where my in-laws, who had flown in the day before to help, were waiting with the kids.  Anna had taped welcome-home hearts all over the garage door and Madelyn ran outside to greet me as we pulled up.

And then I sought my baby; I could hear his cries inside. Higher pitched than I remembered, and in Grandma's arms he looked smaller than I'd remembered too. He was fussy, hungry. I cried as I took him and hugged his little body, curled in the newborn way, and I like to think that his fussing stumbled as he heard my voice and turned toward me. For a second I held my breath to see if he would nurse after four days on a bottle. I needn't have worried; he ate easily, contentedly. Madelyn asked me later why I'd wanted to feed the baby so much. I don't know, child. I don't know which gene drives a woman's primal instinct to nourish and sustain her little ones, to find closeness through succor. But it's there. I've felt it.



With no family or personal history of clotting and no other risk factors, my doctors are ascribing my embolisms solely to pregnancy*. Pregnancy and postpartum changes in the body affect the blood in drastic ways. While clots aren't usual, they're also not wholly uncommon in pregnant women. Sadly, pulmonary embolism is a leading cause of maternal death in the United States. The good news is that once it is caught, the scariest part is already over. Blood thinners prevent the clots from growing or spreading and give the body a chance to break down existing clots, even one as big as mine.

It has been four weeks since I entered the hospital and I am recovering well. I can now walk out my front door and breathe in the scent of these gorgeous spring days slowly, fully, and without pain (though I can still feel the bottom of my right lung, a sort of heaviness as it expands deep inside my chest). Unfortunately for me, there is not enough data yet to know whether the newest blood thinner pills are safe for breastfed babies. So now across my abdomen, alongside my kidney scars and stretch marks, I bear a freckling of tiny bruises and pin pricks - remnants from the blood thinner shots I had to give myself twice a day, additional tokens of the physical price I've paid to bring children into the world.

Absurd as it undoubtedly seems, I am inspired by those marks my body bears, for the beauty and power of what they - and their associated struggles - represent. I am deeply grateful for the sweet soul who has joined our family, with eyes that gaze at me from a much older place and tiny fingers that twine through my hair. I am deeply awed by my role as mother, awed in a way I have never been for any other role I have ever played, for any other duty I have ever been given, for any other task I have ever thrown myself into. After my recent experience, I have a renewed gratitude for every day, for the chance to hug my little ones and be the one they call mama. What happened to me was scary, and huge, and will affect my life for a while. But the physical toll has also felt, somehow, appropriate - commensurate to the profound enormity of what mothering has meant and will continue to mean in my life.

*Note: Yes, they tested me for Covid-19 and my test came back negative. They are finding blood clotting in coronavirus patients, especially, apparently, in the younger adult age bracket I'm in. But between the negative test and the otherwise clear scans of my lungs, my doctors are sure it wasn't Covid that caused clots in my case.