The next 5 days

The CTA was severely degraded by respiratory motion and inconclusive in its findings. At that point, based on equivocal report and in absence of any symptoms, heparin was started being fully aware that the patient has just had a recent abdominal surgery.. In the CCU, my HR stabilized during the night. Dr. Bajaj arrives next morning and instead of ordering definitive diagnostic tests, took the decision to start me on Coumadin and anticoagulation for a year and 5 days on heparin moving me to the heart hospital. Dr Bajaj also asks me not to breastfeed and says she will give me injections tomorrow to dry out my breast milk. This was after that fact that I denied all symptoms and insisted I was feeling fine. I was also not told that CTA was inconclusive and I was not allowed to see the report in the hospital and all requests for confirmation CTA were denied for 5 days. I was also not made aware of the possibility of bleeding on anticoagulants.

On Post Op Day 3, there was significant bleeding from the incision site and wound was opened with 4 staples. There was copious amount of serum and blood drainage (almost to soak fifteen to twenty ABD Pads and bed sheet completely) However still no definitive studies were carried and anticoagulation was continued. Also Dr Bajaj tells me that I should never have any more kids because of the severe PE I had. On Post-Op day 5 the entire wound opened up, again large amount of serum and bloody fluid was extracted from the abdomen. Again fifteen – twenty ABD pads and the entire bed sheets were soaked with blood. And anemia kept on getting worst in spite of oral Iron medication thrice a day. WBC count keeps on rising daily in spite of intravenous antibiotics for past 5 days. The wound which was superficial is now almost a centimeter deep. Still heparin and Coumadin are continued in spite of recurrent bleeding and repeated absence of any symptoms (chest pain, shortness of breath, leg pain, swelling etc ). I am also discontinued from telemetry saying that my tachycardia is due to anxiety and anemia. At that point I again requested them that since I am having no symptoms and I am bleeding and telemetry is being discontinued saying tachycardia is due to anemia and anxiety (And since tachycardia was only indication of cardiac consult) why don’t we order another CTA and see where we are at clots. But they dismiss me. On day 5 nights, I start running a fever due to loss of blood and weakness. However still heparin is continued. On Post op day 6 finally wound erupts and massive hemorrhage occurs. There was enormous oozing through gauze despite significant amount of pressure. I was on vitals every 4 hours and when nurse came to check vitals she saw me covered with clotted blood and gradually diminishing blood pressure. Since I was not on monitor even my falling vital signs were not detected. At that point five days late Doctor Bajaj finally orders a second CT scan, VQ Scan, and Venus Doppler study all of which rule out DVT and PE. At the end of 6 days finally she refers me to pulmonary doctor who rules out PE and DVT. On Day 6, Dr Bajaj tells me that we need to do a CTA to drain fluid from the abdomen and also because first was inconclusive so let’s now order a CT scan again and see if clots actually exist. It was determined that there was no PE or DVT and there was no evidence of PE or DVT ever, I was never required to be on anticoagulants.