Melissa Wade

Hello. My name is Mel and I am 23 years old. I found out when I was 32 weeks pregnant with my first child that I had necrotizing fasciitis in my perineum. It all began in the beginning of this year. For the first 28 weeks of my pregnancy, not even I could tell I was pregnant. The sonograms, fetal hiccups, and a slightly (very slight) protruding belly were really my only ways of truly believing I was as pregnant as I was. After 28 weeks of pregnancy, I began to notice that my daughter was growing towards my rectum and I was carrying her very low. I began to notice extreme pain in my lower back. After trying to get up from lying flat on my back, I noticed a "popping" sensation in my perineal area. Immediately following this sensation, severe pain and pressure began to develop in my perineum... As time went on, I could feel as though something was pushing from inside my perineum into my rectum. At 31 weeks, I noticed slight swelling, redness, and tenderness near my vulva and anus. I had also experienced severe constipation for 5 days (and I was taking twice the normal dosage of stool softeners and drank gallons of water a day!). I went to labor and delivery, underwent stress tests to monitor the baby, and was swiftly shooed away. I was told that the symptoms I was experiencing were common with pregnancy and that I should get used to it. The nurse monitoring me told me, "Welcome to motherhood. It's only going to hurt worse as your pregnancy progresses." Little did she know how prophetic her cynicism really was.... I went home distraught. The pain and pressure I felt was worsening by the hour. The swelling seemed to grow significantly each day. I went to my ob/gyn two days later to have a more thorough exam than I had in labor and delivery. The Dr. noted that I had what appeared to be a baseball sized hematoma in my recto/perineal region. She recommended that the hematoma be depreded within 2-3 days if it continued to grow. The Dr. prescribed me norco's to manage my pain. That day I noticed I could no longer urinate. The following day, I still could not urinate and the pain was so intense, normal conversation with my friends and family was next to impossible. On this day (four days after my first visit to labor and delivery), I was admitted into high risk maternity and debredement of the presumed hematoma was recommended within 48 hours. The admitting Dr could barely touch the swollen area because of the excruciating pain it caused me. They put in a foley catheter and bag to help with my inability to urinate. I was put on a delotted pump that could barely take the edge off of my pain. Two days into my stay, my vulva had swelled from the size of a golf ball to the size of a baseball. The physicians on call disagreed with the recommendation for debredement of the presume hematoma, despite its growing size. I fought with the ob/gyns to drain what they thought was hematoma and to stop the bleed. At certain points, I begged and pleaded hysterically. For two days, I was snubbed and kept on a pain pump. My white blood count had tripled in three days, I became hypertensive. My blood count had also dropped significantly. And I developed pneumonia because I could not move from the pain. For four days, I laid in a hospital bed as my left vulva grew from the size of a small golf ball to that of a melon. The swelling continued down my buttocks and along my anus. My right vulva, also, began to swell. In early hours of my fifth day in high risk maternity, I woke up screaming and writhing in pain. The small amount of delotted I was given was of no match for the pain and pressure I was feeling. The Dr on call, ordered an MRI to be performed that morning. The MRI technician was very kind. She tried to prop my feet for me so I could be comfortable enough to hold still for the MRI. She accidentally slipped and hit my expanded genitals with the hard foam prop. That was by far the worst pain I had ever felt. Every nerve in my body felt as though they had each been individually triggered. No one did a pelvic exam to make sure the genital area was ok. Upon returning to my room, I felt wet. With wet wipes, I lifted my largest vulva to clean myself. Upon doing this, blood and a grey & black fluid began to rapidly pour out of the large slice in my perineum. The skin was blackened near the cut. The smell was so foul that everyone immediately cleared the room gagging. The nurse on call said I wasn't bleeding too badly and that the grey and black fluid was stool from me being constipated. That the hit from the MRI tech sparked my incontinence. HA! I reached down into my oversized vulva and scooped out the blood and "dishwater pus" and said "This is not just a little blood". I must have been a horrifying sight because my bed sheets were soaked in blood and grey & black fluid and it really looked as though someone had been stabbed. Unfortunately, I became septic within a few hours and went into shock. My body began to shut down and I mentally checked out. The pain was so terrible, I could care less what happened to me. I was transferred to ICU and was put onto sepsis protocol and had a crash team on call just for me. I was given six pints of blood and was taken into surgery to debrede and confirm the necrotizing fasciitis. It was successful. I had a wound the size of a large melon. Half my left vulva was removed, I lost perineal and some rectal muscle during the surgery. But I was alive. The anesthesiologist put a central line in to directly pump anti-biotics into my jugular (hated having this done!). Then I was taken back to ICU to rest until the next morning's follow up exam and debredement. That night, I was having regular contractions but they were not measuring strong enough for concern. I felt differently. Instinctually, I knew something was up with my little girl. I didn't feel right and didn't feel safe. During my next surgery, I went into arrest because of a faulty spinal placement. The surgeons recessitated me but my daughter's heart rate dropped and would not go back up. She was born via emergency c-section. When I awoke to this news, I was angrier than I have ever been. Being misdiagnosed? That's nothing... A Dr making a mistake and almost losing my child? Way worse! Thankfully, my pretty girl was born thriving and at exactly 32 weeks gestation! She only spent five weeks in the NICU and had no signs of bacterial infection! I was hospitalized for 21 days and underwent 2 1/2 months of wound clinic (to pack and keep my wound healing properly), 3 months of ob/gyn follow up appointments (their way of apologizing for my misdiagnosis??), and a follow up exam with the colo-rectal surgeon who performed my surgeries. 4 months after the first day of my hospital care, the colo-recto surgeon found a recto-perineal fistula that had tunneled its way through during my recovery. Finally, I was given a proper theory for what had happened to me! The surgeon believes that I had had a fistula from my child growing into my rectum and applying so much localized weight and pressure... The popping sensation I had felt was likely a hemmorage at the sight of the fistula. I must say, this has been the most horrifying experience of my life. The severity of pain was indescribable... It really felt as though someone was pulling me apart from the inside. I am still undergoing procedures 7 months later... Although the wound had closed up after 3 months of care, the cause is still being treated... My (hopefully) final surgery will be to surgically close up the opening of the fistula with a muscle flap. I am glad to say that the scarring does not bother me too much... My perineal area is slightly deformed but its a small price to pay to still be alive. If I could offer any advice, it would be to fight for your right to be properly diagnosed. Dr's make mistakes everyday. If you feel something is not right, fight for a new Dr to examine you. I still have nightmares about what happened to me. My biggest fear is to experience that level of pain again. I know its unlikely but... It still bothers me. (Looking back, I am so glad they put a catheter in when they did... There is no way they could have put it in a day later!)