Amanda K shares an amazing, detailed and emotional story about her journey with femoral nerve damage. A huge thank you to her for sharing her story with us.
I had my last prenatal appointment on a Monday. It was October 15, 2018 and I was told to come back at 6:00 p.m. that night to be induced. My daughter was due on October 9th and I was told that the benefits of inducing outweighed the risks. I remember leaving the hospital in tears. I desperately wanted to meet my baby, but I had this huge fear of being induced because I knew that there would be an increased risk for c-section. I wanted my baby to come in her own time.
The nurses started the Cervidil around 7:00 p.m. that night, which meant that I was stuck in bed and confined to monitors to ensure that my daughter remained stable. I was able to get up about an hour later to use the restroom, and then it was right back to bed. I got out of bed one more time that night before going to sleep. Around 1:00 a.m. the next morning I started experiencing this excruciating pain near my right hip flexor and decided to take some IV pain meds so that I could get some relief. I received the epidural about five hours later and started the Pitocin. I had originally wanted to wait as long as possible before getting the epidural, but between the normal contractions and the pain near my hip flexor I decided to receive it as soon as I could. Sometime after the anesthesiologist placed the epidural, the doctor came in to break my water, but it turned out that she did not need to because it broke without anybody noticing.
I felt pretty good throughout the day on Tuesday, with the epidural doing its job. I was moved from side to side quite a bit, mostly with the peanut ball, and we had various visitors come to see us while we waited. Sometime that evening a couple of the nurses tried to use an IUPC to determine the strength of my contractions. However, they gave up on finding that measurement after multiple failed attempts.
Around 6:00 p.m. there was another staff change, and I was introduced to an experienced nurse who had just started at this particular hospital. It was my understanding that I would have two nurses since one was new, but it became very clear that the new nurse would essentially be my only nurse. There were multiple times where the epidural medication would run out, or some machine would start beeping and she did not know how to work the system, so she would just tell us that it would have to wait until someone else could fix it.
Late Tuesday night the nurse told me to call for her when I started to feel a constant pressure. Shortly after 12:00 a.m. on Wednesday I thought that I might be ready to start pushing so my husband went to get the nurse. I remember being surprised that she did not ask me any questions about what I was feeling, just started prepping me for what came next.
It was not long before I started to experience that pain in my right hip flexor again. I had mentioned it to the nurse, and she stretched my leg out a few times, but basically chalked it up to a hot spot in the epidural and the baby’s positioning. She did move me so I could push on my side for a while, instead of just trying my back, but that did not seem to help. I asked a few times if my daughter was face up, making delivery a little more difficult, but none of the nurses could determine how she was positioned. I was two and a half hours into pushing when the doctor finally arrived and confirmed that she was face up, and that is when she also told me that I was all baby and my daughter was probably at least 9 pounds. My doctor mentioned a c-section and I immediately started crying. I wanted skin to skin, and I wanted my husband to have the opportunity to cut the cord. I knew that a c-section would change all my expectations and I was determined to stay away from the surgery. So, I finally decided to have the doctor turn my daughter to see if that would help the delivery process. I ended up pushing for about two and a half more hours, and during that time I also began experiencing this terrible pain near my ribs. It was not a consistent pain; it was connected more to the actual act of pushing and it hurt the worst when I extended my abdomen to rest after each push. I struggled to catch my breath with that pain, and after five full hours of pushing I decided to have a c-section.
Right before I decided to go with the c-section I had a different nurse come in to stay with me for a few minutes and she asked me if I needed a break. When I said yes, she told me to just rest through the next few contractions. Then she asked me if I felt better by not pushing, asked if the pain of pushing was worse than the pressure, and I was honestly a little shocked by her question. I was shocked because after five hours of pushing I did not feel any pressure, no desire to push. I felt like I was completely missing something, and in those five hours, this nurse was the first one to actually ask me about what I was feeling.
Looking back, I know that I began pushing way too soon. This was my first baby, and I started to feel that constant pressure so I thought that it may be time, but during that entire phase I never truly felt the need to push, and I was so confused on when to push. For guidance I was looking at the monitors and the nurses to tell me whether I was having a contraction. That should have immediately raised a red flag, but I figured it was normal with the epidural. I had no idea what I was doing, or how I was doing, and the nurse kept giving me mixed signals. There were some moments when my nurse would say things that made me believe I was close to delivery, and then she would make comments like I wasn’t progressing at all. I was confused and looking back I cannot believe that I did not express myself more during this phase. I cannot believe that I did not realize the signs and listen to my body earlier.
Back to the delivery room. The nurses had me sign another consent form for the c-section, and at about that time another lady walked in and said that my family was freaking out in the waiting room. They were worried and they were wanting to know what was happening. She basically pulled my husband out of the room so that he could give everyone an update, and while he was gone the nurses wheeled me back to the Operating Room. Since my epidural was at the 24-hour limit, they immediately prepped me for a spinal block. That was one of the scariest moments for me, being in the operating room without my husband while a nurse held me steady for the anesthesiologist.
The next thing I knew, my daughter was born. She arrived at 6:10 a.m. Wednesday morning, and I barely remember seeing her for the first time. I slept through almost the entire surgery, and only remember bits and pieces of conversations. However, I clearly remember them telling me that the spinal would begin to wear off in a few hours. In addition, I got extremely worried when they told me her weight was 10 lbs and 1 oz, and I asked the Doctor if I would even be able to carry her since the restriction after a c-section is 10 lbs. I was relieved when my Doctor said it would be okay to carry her, just not with a car seat or anything else that would add additional weight.
My husband and I were exhausted after 36 hours in the hospital but elated to finally have our little girl in our arms. We got some rest and had some visitors that day, and even though I was still stuck in bed, the day seemed to go by very quick. I did not notice that anything was wrong until Thursday morning when I still could not move my right leg. It had been over 24 hours since the spinal and my right shin was completely numb from my knee to my ankle. I could move my foot without any problems but trying to bend or extend my knee was impossible. The nurse thought that walking would help, but once I finally got out of the bed I could not move my right leg forward to take a step. I tried to take the step anyway and my knee immediately buckled. Thankfully, my husband and the nurse caught me and got me back in bed.
I had all these dreams of walking around with my little girl in my carrier wrap and experiencing all the things that come with having a newborn baby. Those dreams were shattered. Instead of enjoying my first few days of motherhood, I was too worried about what was wrong with me and I was too scared to get out of bed again. My husband changed all her diapers and experienced many of those first moments alone. I was flagged as a fall risk and my nurse was hesitant to allow me out of bed all day, which was almost fine with me because I was too afraid of falling again. Instead of getting up to take a shower, my nurse provided a washcloth and some water, and a commode was positioned right by my bed so that I could pivot to it with assistance. I was so worried about my weight restrictions when my daughter was born, but it turns out that it didn’t matter because I physically couldn’t stand or walk to pick her up anyway.
Thankfully my sister is a nurse, and that Thursday night she pushed me to get out of bed for an actual shower. She brought in a friend with a walker and a gait belt, and they helped me navigate to the bathroom. The trip to the shower was not graceful, it was very painful, and it seemed to take forever, but I made it and sat down on the commode where my sister and her friend helped me get cleaned up. That moment when I made it to the bathroom seemed to change everything, giving me a little confidence to get up and begin my recovery.
It breaks my heart to think that so many women go through this experience without having someone in the medical field to properly support their journey to recovery. To this day I do not understand why the birthing center would not have an actual seat in the shower, or even immediate access to a walker or gait belt. The postpartum nurse I had was very kind, but she didn’t know what to do for me because nobody had seen this before, and I was the difficult patient that needed a nurse who had plenty of extra time.
The next morning (Friday), I was scheduled for an MRI all the way across the hospital, and at that moment I had to begin giving my daughter formula because of the dyes used during the test. While I knew that there was a possibility that I would need to supplement with formula, I also felt that this was just another shattered dream. I completed the test, and the individual that wheeled me back from the MRI didn’t even know where he was going, he passed up my room and told me that he never had to travel to that end of the hospital.
I received the MRI results later that day and the anesthesiologist reported that the injury was not caused by the epidural or spinal block. A neurologist came in shortly after that and told me that I had femoral nerve damage. I had no reflex in my right knee. He explained that it impacted my quad muscle, and that the nerve was likely pinched during labor, due to being in the stirrups for so long. Luckily, I had an amazing neurologist who gave me a quick diagnosis, he reassured me that my reflexes should slowly return and scheduled an EMG for confirmation a week later.
Friday night a physical therapist came to see me, and she showed me how to use the walker properly, this was another game changer for me. That first trip on the walker was very painful on my incision since I was doing a little hop step maneuver, but her instructions reduced the pain and gave me even more confidence in my ability to move around. I still needed help any time I got up from bed and struggled even more with carefully sitting down, but I was making progress. Saturday morning, I had another physical therapist stop by to show me how to walk up and down steps. We also discussed the best way to get into the vehicle so I could go home.
I was set up with a referral so that I could continue physical therapy at home, and I was released at about 5:00 p.m. Saturday night. That is when the physical and emotional struggle really began. We were staying at my parents’ house for a few months while our new home was being finished, and I still remember that first trip up their steps. I was so afraid of those stairs, without being able to use the walker my husband and father did their best to hold me steady with the gait belt.
That Monday after arriving home I received a voicemail from a nurse to start the process of in-home physical therapy. I remember not wanting to call her back, I had been using my walker since my daughter was born, but I was starting to lift it up while walking to test myself. I had tried this a few times without any issues, I was so happy, and I did not want to worry about the physical therapy because at the time I did not think it was needed. However, shortly after that debate with my husband, I went to throw something in the trash, and I must not have been paying close enough attention to what I was doing because I fell to my knees. That is when I started to realize the magnitude of my situation, and my in-home physical therapy journey began.
I completed my EMG later that week. After being poked in the feet and legs with needles and being shocked with something that looked like a cattle prod, my neurologist confirmed that I had Femoral Nerve Damage. The test showed moderate to severe damage, likely severe since my leg movement already had some decent improvement since the day he saw me in the hospital.
I continued with my physical therapist, which required that I be home bound, except for doctor’s appointments. I could do very little for my daughter, I was not comfortable standing up with her, and I could not walk around or bounce her to calm her down. I did not feel like I was bonding with my baby. All I could do was breastfeed and even that was painful and difficult with my caesarean incision. I watched my husband and my mother care for my daughter. They basically raised her for me while I could barely care for myself. Showers were exhausting and I only took them when my husband was available to help me, I couldn’t even go to the restroom alone, and I slept in a recliner in my parents living room every night for at least a month. I basically lived in that recliner, and my lack of movement lead to muscle atrophy in my injured leg.
While this entire situation was very difficult for me physically and emotionally, I know that it must have been tough on my husband as well. However, he stepped up to the challenge to help me whenever I needed it and he never complained. He has been very kind and patient throughout this journey, and I could never thank him enough for how he cared for me and our daughter during those early months.
I have been very blessed to have this support system that I call family. I cannot say that I enjoyed the thought of living with my parents and having newborn baby, we had hoped to have our house finished before she arrived, but it turned out that it was the best place for my recovery. When my husband returned to work on nights, my mom was the one to help me every time my daughter woke up. She slept on the couch beside me, she was always with me when my husband was not, and someone had to be there because I couldn’t care for my baby by myself.
Three weeks after leaving the hospital with my daughter, I landed myself in the ER, and I ended up having my gallbladder removed. I became very discouraged at that moment. I may have been emotional before this hospital visit, but I felt like I was able to stay somewhat positive, until this happened. I was dealing with a recent caesarean incision and nerve damage, all while trying to recover from the gallbladder removal and related gas pains. I was still using the walker at the time, and every movement was incredibly painful. I had just stopped taking the regular dosage of pain medication too, and I ended up right back on it after this surgery.
After a couple more weeks of physical therapy, and a couple more falls, I finally moved to one crutch for walking assistance, and at about seven weeks post-partum I was walking on my own, but only with my right knee locked. At this point I was traveling to see a different physical therapist, which allowed me access to better equipment for balance and strength exercises. I was still too afraid to walk around with my daughter, but I gradually started to stand up and hold her, transferring her from her bouncer, to her swing, to her play mat, and back to her bassinet.
I had three more weeks left of maternity leave and I still felt like I hadn’t bonded with my baby, which made the thought of returning to work very difficult. I constantly felt like everyone else was raising her while I missed out on those precious moments. I will never be able to get those moments back, and when I do think of those early days all I can seem to remember are my struggles and the constant physical therapy sessions. This trauma makes it much harder to remember those wonderful moments when my daughter would coo or smile, or even when she learned to sit up and roll over.
Somewhere in those last three weeks of maternity leave I began walking short distances with my baby girl, making sure I was extremely careful by locking my knee for every step. I also took precautions to make sure I didn’t carry her around after any of my physical therapy sessions, or any other moments when my leg might be more weak than usual.
I probably began walking with her earlier than I should have, but toward the end of my maternity leave I noticed more significant improvements in my recovery. Every now and again my knee would still buckle on me, but I now had the strength and the ability to catch myself. It was around the middle of January, about three months post-partum that my knee stopped buckling all together, and I continued with physical therapy for another month after that. During my last physical therapy appointment my right leg was only at about 75 percent strength compared to my left leg, and I hadn’t improved much in the previous month, but I was considered functional and ready to be released.
My leg has slowly improved since that last physical therapy session, and as I finally finish writing this birth and postpartum story, we are one week past my daughters first birthday. I still have some lasting effects of the injury, but I have recovered enough to be released from my neurologist. My current symptoms include some slight numbness by my right knee, occasional pain around my hip flexor or femoral triangle, and a slight limp or lag in my right leg when I try to run. Plus, to this day I still hate walking down steps, no matter how many times I have successfully walked down them without assistance. Walking downstairs, or even taking one step off a curb, gives me this feeling of weakness and tightness in my quad. It gives me this fear of falling and is a constant reminder of my birth story. A constant reminder to lead with my bad leg when stepping down, and lead with the good leg when stepping up.
While I may be close to a full physical recovery, the emotional healing takes much more time. I often feel like I started motherhood as a failure. I didn’t take the initial IV pain medication because of my contractions; I took them because of the excruciatingly sharp pain in my hip flexor. I honestly don’t even remember what the contractions felt like, but I vividly remember that pain near my hip. I tend to believe that I just covered up the signs of my nerve damage, instead of trying to fix the problem. How could I have not known that something was wrong? How could I have not known that I started pushing too soon? So many questions and no real answers.
I received the biggest blessing from this experience, a healthy and happy baby girl, and I am very grateful for my daughter. However, I have struggled a lot this past year, with disappointment and anger toward myself and the hospital. I do believe that my nurses and doctors were only doing what they thought was best, and I never really blamed the hospital for my nerve damage, but it isn’t just disappointment from my actual injury. It is disappointment in all the small events that led to my c-section, in the staff for pulling my husband out to talk to my family, and in the postpartum nurse who left my room while my sister helped me make it to the restroom that first time.
I hope that sharing this story will encourage other mothers to speak up and be their own advocate. Many health professionals simply tell me that this sort of thing “just happens” while others tell me that they have never heard of this injury. Whether you have heard of it before or not, one thing is certain, this experience has changed my life. Almost every night when I pick up my daughter to put her in bed I am reminded of where our journey began, and I will always be grateful for my ability to stand up and walk. I am also thankful for the one nurse who asked me questions about how I was feeling, who showed me kindness prior to my c-section, her name is the only one that I remember today.