Yesterday,on what was to mark my 33 rd week of pregnancy, I went to see my doctor. It all started like it normally does--I went into the little vestibule where they check weight and blood pressure. I got on the scale, and the nurse got concerned, made me step off and back on again. I had lost 5 pounds since last week. Same scale, roughly the same clothing. And I know it wasn't all water weight because I was never really swollen to begin with. I told her it was probably right, that I haven't been able to eat all week. Which prompted the question: "What's wrong?" And so the floodgates opened. I told her a brief synopsis of everything, and as I was sitting there, the high-risk clinic nurse, who sees only us problem patients, came walking in, saw me crying, and got in on the conversation. Before I knew what was happening, they were crying too from my story.
So we go into the exam room, and she hands me the little disposable sheet, to which I just handed it back to her, telling her no, I'm sorry, I just cannot tolerate an exam right now, as I am in too much pain. She agrees and in less than 2 minutes, the doctor comes in. It's the one I like, and he comes through the door with a hearty "Duuuuuuude, what's UP????" This is why the L& D nurses refer to him as "Surfer Boy". He's young, and blond and tan, to go along with that personality. But he is also the one who listens to me, who promised me I would not suffer any longer than necessary, who finally offered me pain relief.
So we talk. I tell him I am miserable, as the tears start again. By the way, I think this is the first time he has seen me cry in all of this. We talked about the ridiculous number of trips to the hospital, the brethine pump's future with all of this tachycardia, and more. As soon as he said "36 weeks", I started crying yet again, and told him no, that I couldn't. Because then when I come back at 36 weeks, someone else would change it to 38 weeks, and so on.
Then he looked at me and said "No, I'll do it!" At which point the nurse handed him a calendar. I heard something about amnio, then something else about the next day. Huh? It has really been a long time. I remember the amnio with E taking almost a week to get back. I literally started laughing at this point. Amnio at 36 weeks, then c-section the same week? I could deal with that. 3 weeks.
Then he started explaining. We think of lung maturity, because that is the biggie at this stage in the game. But we want his brain to be developed, too. And his bowels. Nectrotizing enterocolitis is a big one in preemies. I agreed. "Plus," he said, "Little Dude wouldn't be able to eat yet!" At which point I laughed again. This is honestly the first time someone has referred to Zachary as "Little Dude" instead of the "baby" or "fetus".
He wanted the amnio on May 13th, but the perinatologist is unavailable on that day, so it was scheduled for the 12th instead. I was going to have my c-section, assuming amnio results are favorable, on the 14th, but now we aren't sure. I asked him after the date was changed, and he said they would call me, that he had to look at his schedule, that he should be able to find an hour in there somewhere. That was almost comical and completely strange to me: something this big and life-changing on my end is just a spare hour to him. Weird.
So the bottom line is that I am staying on all of this junk: the brethine pump, the monitor, etc., until then. He admitted that the pump isn't doing the trick, but that he is afraid it will be even worse for me without it. He refilled the pain meds and told me to continue taking them, that I was fine so long as I used discretion. I told him that was not a problem,that a few years ago, I had to have my knee reconstructed, and I am so leary of pain meds that I took about 10 total through that entire process, but that I was actually needing them now.
He ended the converstaion with this: "Please tell me you aren't having any more!" No, I'm not. But they all keep telling me this, and I wonder if it is a concern for my well-being or a concern for them, not wanting to deal with another of my pregnancies. They cannot say I didn't warn them--I had been telling them, as early as my first appointment, that it would get bad, long before it actually did. I consider that fair warning.
So in a little over 3 weeks, I will be holding my youngest son in my arms. Somehow, since finding this out, I have been able to relax a little. I'm still hurting and exhausted, but this knowledge has instantly made it more tolerable.
Showing posts with label brethine. Show all posts
Showing posts with label brethine. Show all posts
Tuesday, April 27, 2010
Sunday, April 25, 2010
32 Wks, 6 Days: Again
Back to the hospital. It went like this:
I got them to change my orders on my monitor. Instead of 6 or more contractions in an hour, they changed it to 6 or more painful or overly strong contractions in an hour. In other words, unless I hit the little marker on the monitor 6 times, I should not have to go to the hospital.
Or so I thought.
All day yesterday, I was hurting pretty badly. I took some pain medication and slept most of the day, then woke up to do my required monitoring. The nurse called me back, very concerned, saying that I had 36 true contractions, and that while she realized my orders had been changed and I didn't mark any of the contractions, she felt like she had to call my doctor. The same doctor who told me only painful contractions would count, that we would wait until 37 weeks, that they didn't care was the same doctor on call yesterday. So I thought I was safe. I understood her concern and told her to go ahead and call if she had to, but that I expected him to dismiss it.
He didn't.
They had me go in. Gave me a liter of fluid, but this time, the nurses felt so bad for me that instead of treating me like a pin cushion, they called IV Therapy. Iv Therapy makes up the Kings and Queens of Vascular Access in our hospital, and she got my IV on the first stick. I actually got my hopes up when the nurse told her to put an 18-gauge in me "in case we end up sectioning her". They also had me stop my pump while there for heartrate again.
Of course the contractions didn't stop. They called the doctor back, and he said it was okay for me to go home. Per the request of the home monitoring nurse, I called her to let her know I was home. She tried to remain professional, but could not even try to hide the exasperation in her voice. She told me her day job is still to be a L&D nurse at a large high-risk OB hospital, and that she has never seen them send someone home who was contracting over 30 times an hour. The poor woman was so flabbergasted that she was literally stammering on the phone. I found myself feeling sorry for her--she knew I didn't want to go to the hospital and was so apologetic about sending me, but was honestly concerned, only to have her worries and professional opinion completely disregarded.
And now? Now I am in complete pain. The weight of my ever-growing uterus has done things to my body that are too embarrassing to mention, and this was exacerbated by the pelvic exam and laying in a hard stretcher for hours last night. I didn't sleep last night. Finally, at about 4 AM,I took 2 pain pills and dozed for about 2 hours, only to be awakened by more pain. That's it.
I've been taking the pain meds religiously every 6 hours today, and have not even been able to move until now. Still, I cannot cough, sneeze, strain, laugh, or switch positions without this pitiful whimper that escapes my lips no matter how hard I try to control it. Each time, J and E come running to check on me. The nurse who is on today called to check on me, and told me she could hear the misery in my voice without even laying eyes on me. All I could hear was pity in hers, which I hate. I told her I would not be monitoring today. All that would do would be to put her in the professional dilemma of calling when I didn't want her to, or of being completely complacent like my doctors, against her better judgement. I don't think I could tolerate that bed again, or another pelvic exam with this pain, so I want to avoid another trip to the hospital at almost any cost. I think the only thing that could get me there now would be if I honestly thought Zachary was in some sort of danger.
I got them to change my orders on my monitor. Instead of 6 or more contractions in an hour, they changed it to 6 or more painful or overly strong contractions in an hour. In other words, unless I hit the little marker on the monitor 6 times, I should not have to go to the hospital.
Or so I thought.
All day yesterday, I was hurting pretty badly. I took some pain medication and slept most of the day, then woke up to do my required monitoring. The nurse called me back, very concerned, saying that I had 36 true contractions, and that while she realized my orders had been changed and I didn't mark any of the contractions, she felt like she had to call my doctor. The same doctor who told me only painful contractions would count, that we would wait until 37 weeks, that they didn't care was the same doctor on call yesterday. So I thought I was safe. I understood her concern and told her to go ahead and call if she had to, but that I expected him to dismiss it.
He didn't.
They had me go in. Gave me a liter of fluid, but this time, the nurses felt so bad for me that instead of treating me like a pin cushion, they called IV Therapy. Iv Therapy makes up the Kings and Queens of Vascular Access in our hospital, and she got my IV on the first stick. I actually got my hopes up when the nurse told her to put an 18-gauge in me "in case we end up sectioning her". They also had me stop my pump while there for heartrate again.
Of course the contractions didn't stop. They called the doctor back, and he said it was okay for me to go home. Per the request of the home monitoring nurse, I called her to let her know I was home. She tried to remain professional, but could not even try to hide the exasperation in her voice. She told me her day job is still to be a L&D nurse at a large high-risk OB hospital, and that she has never seen them send someone home who was contracting over 30 times an hour. The poor woman was so flabbergasted that she was literally stammering on the phone. I found myself feeling sorry for her--she knew I didn't want to go to the hospital and was so apologetic about sending me, but was honestly concerned, only to have her worries and professional opinion completely disregarded.
And now? Now I am in complete pain. The weight of my ever-growing uterus has done things to my body that are too embarrassing to mention, and this was exacerbated by the pelvic exam and laying in a hard stretcher for hours last night. I didn't sleep last night. Finally, at about 4 AM,I took 2 pain pills and dozed for about 2 hours, only to be awakened by more pain. That's it.
I've been taking the pain meds religiously every 6 hours today, and have not even been able to move until now. Still, I cannot cough, sneeze, strain, laugh, or switch positions without this pitiful whimper that escapes my lips no matter how hard I try to control it. Each time, J and E come running to check on me. The nurse who is on today called to check on me, and told me she could hear the misery in my voice without even laying eyes on me. All I could hear was pity in hers, which I hate. I told her I would not be monitoring today. All that would do would be to put her in the professional dilemma of calling when I didn't want her to, or of being completely complacent like my doctors, against her better judgement. I don't think I could tolerate that bed again, or another pelvic exam with this pain, so I want to avoid another trip to the hospital at almost any cost. I think the only thing that could get me there now would be if I honestly thought Zachary was in some sort of danger.
Wednesday, April 21, 2010
32 Wks, 2 Days: Can I Call It or What?
I hit the 32-week mark Monday, and I was excited. Until they sent me to the hospital again. That was the 4th time in roughly the past week. It seems my brethine pump is doing strange things to my heart, and the insane contractions of Saturday still have not stopped. Again, not dilating. So I follow-up in the office Tuesday as planned, and the doctor I saw pretty much told me that, while he did not want to sound heartless, it doesn't matter how miserable or uncomfortable I am, so long as baby is fine. So now they are saying 37 weeks. I knew it would happen. I've been to this show before and I know how it ends.
Tuesday afternoon, I did my required monitoring, and of course my uterus was doing insane tricks, so the nurse had to call my doctor, and of course my doctor had to tell me to go back to L&D. Trip number 5 in 8 days. I begged and pleaded, and tried to "respectfully decline" to go, at which point I was told I would be labeled a non-compliant patient, which would cause issues with my insurance company. I had no choice but to go. In the process, they had me stop my pump temporarily because my heartrate was 136, a contraindication of brethine. Nothing changed. Everything was the same, except the contractions were bigger and badder, but still not causing me to dilate. They tried giving me a one-time dose of Procardia (nifedipine) which did nothing other than cause my blood pressure to lower and gave me a raging headache that lasted into this morning. I was sent home with the same instructions I got Saturday, Monday, Sunday, and at the office on Tuesday morning.
So what are my instructions? I have been thoroughly educated on the symptoms of uterine rupture, as it seems I am a prime candidate right now with all of these contractions. I also found out by complete accident that, while my external incision from E's delivery was transverse, my actual uterine incision is classical. If you aren't well-versed in c-section lingo, this is bad. A classical incision is straight up and down and an even higher risk for rupture. I didn't know this until someone mentioned it in conversation. Apparently they got it from the OR report from E's delivery.
In a nutshell? I am still at home, having over 40 contractions per hour, on narcotic painkillers that are no longer working, and waiting for a crisis. A crisis that could kill me and the baby. My home nurse told me today to not even monitor, as the doctors don't seem to be doing anything about it and it is completely futile at this point. The only result will be that I will have to rush to the hospital again. They keep having me temporarily suspend my brethine infusion for heartrate, then start it back up when my pulse is again under 120. My nurse from the call center, my home health nurse who administers my progesterone injections, and even my case manager from Humana are all infuriated that this is being permitted to continue, that not only is it permitted, but they are actually prolonging the pregnancy. But they are not my doctors and can essentially do nothing. They will not even do the amnio at this point. When asked why, he said "Why risk infection?"
Why. Risk. Infection????
Because I do not want to die. Because I do not want lose my unborn son. Because I don't want to ruin my heart with the medications. Because I am tired of disrupting E's life. Because I cannot stand the pain anymore. Because after steroids and the best prenatal care money can buy, odds are that Zachary is okay now. I am not anymore, on the other hand.
A simple course of antibiotics can cure an infection. There is no simple cure for anything mentioned above.
Tuesday afternoon, I did my required monitoring, and of course my uterus was doing insane tricks, so the nurse had to call my doctor, and of course my doctor had to tell me to go back to L&D. Trip number 5 in 8 days. I begged and pleaded, and tried to "respectfully decline" to go, at which point I was told I would be labeled a non-compliant patient, which would cause issues with my insurance company. I had no choice but to go. In the process, they had me stop my pump temporarily because my heartrate was 136, a contraindication of brethine. Nothing changed. Everything was the same, except the contractions were bigger and badder, but still not causing me to dilate. They tried giving me a one-time dose of Procardia (nifedipine) which did nothing other than cause my blood pressure to lower and gave me a raging headache that lasted into this morning. I was sent home with the same instructions I got Saturday, Monday, Sunday, and at the office on Tuesday morning.
So what are my instructions? I have been thoroughly educated on the symptoms of uterine rupture, as it seems I am a prime candidate right now with all of these contractions. I also found out by complete accident that, while my external incision from E's delivery was transverse, my actual uterine incision is classical. If you aren't well-versed in c-section lingo, this is bad. A classical incision is straight up and down and an even higher risk for rupture. I didn't know this until someone mentioned it in conversation. Apparently they got it from the OR report from E's delivery.
In a nutshell? I am still at home, having over 40 contractions per hour, on narcotic painkillers that are no longer working, and waiting for a crisis. A crisis that could kill me and the baby. My home nurse told me today to not even monitor, as the doctors don't seem to be doing anything about it and it is completely futile at this point. The only result will be that I will have to rush to the hospital again. They keep having me temporarily suspend my brethine infusion for heartrate, then start it back up when my pulse is again under 120. My nurse from the call center, my home health nurse who administers my progesterone injections, and even my case manager from Humana are all infuriated that this is being permitted to continue, that not only is it permitted, but they are actually prolonging the pregnancy. But they are not my doctors and can essentially do nothing. They will not even do the amnio at this point. When asked why, he said "Why risk infection?"
Why. Risk. Infection????
Because I do not want to die. Because I do not want lose my unborn son. Because I don't want to ruin my heart with the medications. Because I am tired of disrupting E's life. Because I cannot stand the pain anymore. Because after steroids and the best prenatal care money can buy, odds are that Zachary is okay now. I am not anymore, on the other hand.
A simple course of antibiotics can cure an infection. There is no simple cure for anything mentioned above.
Sunday, April 18, 2010
31 Wks, 6 Days: Crunching Some Numbers
2: The number of times they made me monitor yesterday.
34: The number of contractions I had in the first hour of monitoring.
3: The number of brethine boluses I got between attempts at monitoring.
54: The number of contractions on the second strip. Yeah, that's right. Not a typo. The OB nurse at the call center said she has never seen anything like it in her 25 year as an OB nurse. And yes, I felt them all.
4: The number of nurses at the hospital that it took to get my IV.
13: The number of sticks it took the 4 nurses to get my IV.
2: The number of IV bags they gave me. Also the number of Percocet it took for them to get me to be able to sleep.
5: The number of hours I slept once I got home.
36: The number of hours this has been going on. They will not stop. And so long as I am not dilating, they do not care. I wonder if my uterus could spontaneously combust. If it could, at this point, I am sure it would. Today, I actually had 0 contractions. Great right? Nope. Because now they are so frequent, that they don't even last long enough to be considered contractions. Just very frequent waves on a monitor strip, which resembles an EKG more than it does uterine activity, according to my husband. Just wave after painful wave. As soon as one stops, another starts, to the point that I cannot even feel distinct contractions anymore, but rather this wrenching feeling like my guts are being ripped from my body.
They offered me morphine at the hospital yesterday. I should have taken it instead of the weaker Percocet. But there is honestly something wrong when the pain is so bad that they offer me morphine. Me, a pregnant woman. The offer makes me realize that they realize how miserable I am. If they know am that miserable, isn't it time to act?
But nobody cares. My home health company doesn't even care anymore. I ran the strip today like a good girl, and since I was seen yesterday and the doctor on call didn't care, they don't either.
I have no faith in the 34 week mark anymore. I have a feeling they will change it once I get there. As in, "Well, you made it this far. Let's see if you can make it to 36 or 37."
And I will lose my mind.
I am a prisoner in my own body, and I cannot endure another day of this.
34: The number of contractions I had in the first hour of monitoring.
3: The number of brethine boluses I got between attempts at monitoring.
54: The number of contractions on the second strip. Yeah, that's right. Not a typo. The OB nurse at the call center said she has never seen anything like it in her 25 year as an OB nurse. And yes, I felt them all.
4: The number of nurses at the hospital that it took to get my IV.
13: The number of sticks it took the 4 nurses to get my IV.
2: The number of IV bags they gave me. Also the number of Percocet it took for them to get me to be able to sleep.
5: The number of hours I slept once I got home.
36: The number of hours this has been going on. They will not stop. And so long as I am not dilating, they do not care. I wonder if my uterus could spontaneously combust. If it could, at this point, I am sure it would. Today, I actually had 0 contractions. Great right? Nope. Because now they are so frequent, that they don't even last long enough to be considered contractions. Just very frequent waves on a monitor strip, which resembles an EKG more than it does uterine activity, according to my husband. Just wave after painful wave. As soon as one stops, another starts, to the point that I cannot even feel distinct contractions anymore, but rather this wrenching feeling like my guts are being ripped from my body.
They offered me morphine at the hospital yesterday. I should have taken it instead of the weaker Percocet. But there is honestly something wrong when the pain is so bad that they offer me morphine. Me, a pregnant woman. The offer makes me realize that they realize how miserable I am. If they know am that miserable, isn't it time to act?
But nobody cares. My home health company doesn't even care anymore. I ran the strip today like a good girl, and since I was seen yesterday and the doctor on call didn't care, they don't either.
I have no faith in the 34 week mark anymore. I have a feeling they will change it once I get there. As in, "Well, you made it this far. Let's see if you can make it to 36 or 37."
And I will lose my mind.
I am a prisoner in my own body, and I cannot endure another day of this.
Tuesday, April 13, 2010
31 Weeks, 1 Day: I Take It All Back
I have been a whiny baby lately, complaining about this pregnancy and how I am "done".
I lied. I'm not done. I wish it were easier, but I want him to be healthy. And be in there as close to full-term as possible.
I'm nervous. Today, I have to go back to the doctor to "check everything out". They're worried about my BP and pregnancy-induced hypertension. Not pre-eclampsia yet, as none of my lab values mesh with that. Urine, blood..everything was normal but my blood pressure. My BP has always been perfect. As a matter of fact, when pregnant with E, I was on Procardia for preterm labor and they had to stop it because it would cause my normal BP to drop, then when I would do anything that would cause it to lower more, I would randomly pass out. I had to take cold showers bcause the heat would cause me to vasodilate and John would hear a big thunk! where I would hit the floor. So when oral brethine didn't work this time, that is how I ended up on the pump. They didn't want to add nifidepine to the mix.
So yesterday, when they sent me to the hospital for PIH, I was the talk of L&D. From my stretcher in triage, I could hear the doctors and nurses at the nurses' station talking about it. "She's here for PIH and on a brethine pump!" They kept implying that it would have to be stopped, and the doctor that sent me to the hospital in the first place even said so much--that if BP became a problem, they would have to stop it.
Hmmm. Stopping the brethine pump.....
I've been fantasizing about this for weeks. What it would be like to sleep without worrying about rolling over on the tubing and occluding it. Of worrying about the syringe emptying in the middle of the night, causing me to miss a scheduled bolus and wake up contracting. To be able to take a hot bath because there is no catheter on my thigh that cannot be submerged in water. To be able to go to a doctor's appointment or anywhere else and not have to worry if I have enough batteries or meds to survive the trip without going into labor. About not having something constantly attached to my body.
And if they stop the pump,they are going to stop everything. My progesterone shots. Most likely my home monitor that works in conjunction with the pump. I'm getting scared.
The truth is that, while I have been getting really sick of this stuff, I also realize that there have been countless times where I have avoided hospitalization because of it. And as much as I hate it, I hate being in the hospital even more. And I know that, while they have spent months trying to find the delicate balance of injection frequencies and infusion rates to keep me from having breakthrough episodes of contractions, those breakthroughs would occur more frequently without the stuff. Or my contractions just won't stop, period. And my beloved son will be born too early. Or if he isn't, I will lay in misery in a hospital bed, contracting away, in pain, with my needs not being taken into consideration as I incubate him longer. Neither one is an option I can live with right now.
I'm really scared for myself. And terrified for Zachary.
I lied. I'm not done. I wish it were easier, but I want him to be healthy. And be in there as close to full-term as possible.
I'm nervous. Today, I have to go back to the doctor to "check everything out". They're worried about my BP and pregnancy-induced hypertension. Not pre-eclampsia yet, as none of my lab values mesh with that. Urine, blood..everything was normal but my blood pressure. My BP has always been perfect. As a matter of fact, when pregnant with E, I was on Procardia for preterm labor and they had to stop it because it would cause my normal BP to drop, then when I would do anything that would cause it to lower more, I would randomly pass out. I had to take cold showers bcause the heat would cause me to vasodilate and John would hear a big thunk! where I would hit the floor. So when oral brethine didn't work this time, that is how I ended up on the pump. They didn't want to add nifidepine to the mix.
So yesterday, when they sent me to the hospital for PIH, I was the talk of L&D. From my stretcher in triage, I could hear the doctors and nurses at the nurses' station talking about it. "She's here for PIH and on a brethine pump!" They kept implying that it would have to be stopped, and the doctor that sent me to the hospital in the first place even said so much--that if BP became a problem, they would have to stop it.
Hmmm. Stopping the brethine pump.....
I've been fantasizing about this for weeks. What it would be like to sleep without worrying about rolling over on the tubing and occluding it. Of worrying about the syringe emptying in the middle of the night, causing me to miss a scheduled bolus and wake up contracting. To be able to take a hot bath because there is no catheter on my thigh that cannot be submerged in water. To be able to go to a doctor's appointment or anywhere else and not have to worry if I have enough batteries or meds to survive the trip without going into labor. About not having something constantly attached to my body.
And if they stop the pump,they are going to stop everything. My progesterone shots. Most likely my home monitor that works in conjunction with the pump. I'm getting scared.
The truth is that, while I have been getting really sick of this stuff, I also realize that there have been countless times where I have avoided hospitalization because of it. And as much as I hate it, I hate being in the hospital even more. And I know that, while they have spent months trying to find the delicate balance of injection frequencies and infusion rates to keep me from having breakthrough episodes of contractions, those breakthroughs would occur more frequently without the stuff. Or my contractions just won't stop, period. And my beloved son will be born too early. Or if he isn't, I will lay in misery in a hospital bed, contracting away, in pain, with my needs not being taken into consideration as I incubate him longer. Neither one is an option I can live with right now.
I'm really scared for myself. And terrified for Zachary.
Saturday, April 10, 2010
30 Wks, 5 Days: My Meltdown
I did my required monitoring strip in the early afternoon yesterday, and about 5 minutes after sending it, I got a call to tell me I had 26 contractions in one hour. I couldn't feel them, but just felt a constant tightness in my belly that was uncomfortable. The nurse had me give myself a bolus, then wait an hour and give myself another, then re-monitor. On the second strip, it actually worsened and I had 29 contractions. So they insist on calling my doctor.
Of course the nurse is still at the doctor's office, as it is during business hours, and she tells my home nurse to send me to the hospital....again. And that she will let the doctor on-call know I am going. I really don't want to go, and am concerned that the instruction to go is some knee-jerk reaction, that they aren't keeping in mind who this is, that I do this. So I call the doctor myself, and pretty much beg him to stay home. I'm worried that this is it--that I will get there and they will keep me until I deliver. He tells me this is not necessarily the case and says we will see if I am dilating any and go from there.
So I go, and of course I get a nurse who has never had me, but she is older and seasoned and has seen it all, so she doesn't panic. She is more worried that my blood pressure is up, as is my heart rate. I tell her the history of the pregnancy, how badly I wanted to stay home, and she understands.
They call my doctor, who gets one of his colleagues at the hospital to check me, and they want to do a fetal fibronectin. I'm not really happy about that. I know those can take forever to come back, and I also know that as I get further, with my history of preterm delivery, it is likely to be positive. So they check me afterwards, and of course am not dilated any but the doctor notes that my cervix is very soft. And after waiting, we find out the fetal fibronectin is negative. Good! They are calling my doctor at this point, and I am waiting for word that I can go home.
Wrong. He wants to keep me. "Just overnight, sweetie," the nurse says. He wants me to stay for observation overnight and IV fluids.
No. NoNoNoNoNo. NO! I start crying hysterically at this point. I know this song and dance. and I have a complete meltdown on my poor nurse. This is what I tell her:
They'll put me in with "just IV fluids". And the monitor. And I will have contractions all night, because it's me we're talking about. And in the morning, another doctor will be on for my practice and will see that I am contracting, so then it will be mag sulfate. Then someone else will be on Sunday, and they will say, "Gee, you aren't quite 32 weeks, so let's ship you to another hospital." And so it goes.
And I would be fine with all of it if I were feeling the contractions, or even if the mag sulfate worked for me, but I know it won't. It didn't with E at this stage of the game, and it didn't the last time with this pregnancy.
I want to go home. I am not dilating, the FFN was negative, I am not in pain (other than back and hip pain from the way they keep making me lay on the uncomfortable stretcher in order to keep Zachary on the monitor).
No. I'm going home.
The nurse asks me if I will sign treatment refusal forms, and I cry and tell her yes. I don't want to upset my doctor, as I respect him too much and understand why he wants me to stay, but I have to go. I just keep telling the nurse, "I'm DONE. I'm sorry, but I'm just DONE!"
I want to be home with my husband and son in these last days of the pregnancy. I want to sleep where I am comfortable and be able to eat. I want to be able to bathe. If I stay, I tell them, it is because they are going to deliver this baby. I've had enough.
This has been going on for 11 weeks. Painful injections, first every 7 days and then every 5. Having to stick myself with needles every 2 days for my pump. Heart palpitations from the medicine. Lowered blood pressure from the medicine. Hospitalizations, both inpatient and outpatient. Scars all over my arms and legs from needles. Probable nerve damage in my left hip from the time someone gave me my shot wrong. The times in the hospital where they wouldn't even let me bathe myself, one of the most basic of human needs. $2K worth of just insurance copays per month. Medical bills piling up- a $500 copay for every inpatient stay. My most-likely-lost job. My abandoned education. J's abandoned education. Being alienated from everyone I know.
But you want a healthy baby, don't you?
You're damned right I do! I have done all of this for no one but him. I have had no benefit. J has had no benefit. And E most certainly has not had any benefit from this horrendous pregnancy. And I will endure more. More contractions, more painful injections and needle sticks. More of everything as the pregnancy reaches it's end.
But I am finished. And I am going home.
I don't know what happened from there. I know she called my doctor again and told him what had to say about the probable chain of events. That I was willing to sign papers stating I was leaving against medical advice. She said his response was , "And she is probably right". So he agreed to let me go, without signing papers, so insurance would pay.
Now I'm worried. I'm afraid I have upset my doctor, whom I absolutely love. Or the L&D nurses I work with and rely on. I'm afraid that, since I couldn't feel these contractions, that when I do my required monitoring, the whole process will start over again later today. That I will have to do this over and over before I finally deliver.
Of course the nurse is still at the doctor's office, as it is during business hours, and she tells my home nurse to send me to the hospital....again. And that she will let the doctor on-call know I am going. I really don't want to go, and am concerned that the instruction to go is some knee-jerk reaction, that they aren't keeping in mind who this is, that I do this. So I call the doctor myself, and pretty much beg him to stay home. I'm worried that this is it--that I will get there and they will keep me until I deliver. He tells me this is not necessarily the case and says we will see if I am dilating any and go from there.
So I go, and of course I get a nurse who has never had me, but she is older and seasoned and has seen it all, so she doesn't panic. She is more worried that my blood pressure is up, as is my heart rate. I tell her the history of the pregnancy, how badly I wanted to stay home, and she understands.
They call my doctor, who gets one of his colleagues at the hospital to check me, and they want to do a fetal fibronectin. I'm not really happy about that. I know those can take forever to come back, and I also know that as I get further, with my history of preterm delivery, it is likely to be positive. So they check me afterwards, and of course am not dilated any but the doctor notes that my cervix is very soft. And after waiting, we find out the fetal fibronectin is negative. Good! They are calling my doctor at this point, and I am waiting for word that I can go home.
Wrong. He wants to keep me. "Just overnight, sweetie," the nurse says. He wants me to stay for observation overnight and IV fluids.
No. NoNoNoNoNo. NO! I start crying hysterically at this point. I know this song and dance. and I have a complete meltdown on my poor nurse. This is what I tell her:
They'll put me in with "just IV fluids". And the monitor. And I will have contractions all night, because it's me we're talking about. And in the morning, another doctor will be on for my practice and will see that I am contracting, so then it will be mag sulfate. Then someone else will be on Sunday, and they will say, "Gee, you aren't quite 32 weeks, so let's ship you to another hospital." And so it goes.
And I would be fine with all of it if I were feeling the contractions, or even if the mag sulfate worked for me, but I know it won't. It didn't with E at this stage of the game, and it didn't the last time with this pregnancy.
I want to go home. I am not dilating, the FFN was negative, I am not in pain (other than back and hip pain from the way they keep making me lay on the uncomfortable stretcher in order to keep Zachary on the monitor).
No. I'm going home.
The nurse asks me if I will sign treatment refusal forms, and I cry and tell her yes. I don't want to upset my doctor, as I respect him too much and understand why he wants me to stay, but I have to go. I just keep telling the nurse, "I'm DONE. I'm sorry, but I'm just DONE!"
I want to be home with my husband and son in these last days of the pregnancy. I want to sleep where I am comfortable and be able to eat. I want to be able to bathe. If I stay, I tell them, it is because they are going to deliver this baby. I've had enough.
This has been going on for 11 weeks. Painful injections, first every 7 days and then every 5. Having to stick myself with needles every 2 days for my pump. Heart palpitations from the medicine. Lowered blood pressure from the medicine. Hospitalizations, both inpatient and outpatient. Scars all over my arms and legs from needles. Probable nerve damage in my left hip from the time someone gave me my shot wrong. The times in the hospital where they wouldn't even let me bathe myself, one of the most basic of human needs. $2K worth of just insurance copays per month. Medical bills piling up- a $500 copay for every inpatient stay. My most-likely-lost job. My abandoned education. J's abandoned education. Being alienated from everyone I know.
But you want a healthy baby, don't you?
You're damned right I do! I have done all of this for no one but him. I have had no benefit. J has had no benefit. And E most certainly has not had any benefit from this horrendous pregnancy. And I will endure more. More contractions, more painful injections and needle sticks. More of everything as the pregnancy reaches it's end.
But I am finished. And I am going home.
I don't know what happened from there. I know she called my doctor again and told him what had to say about the probable chain of events. That I was willing to sign papers stating I was leaving against medical advice. She said his response was , "And she is probably right". So he agreed to let me go, without signing papers, so insurance would pay.
Now I'm worried. I'm afraid I have upset my doctor, whom I absolutely love. Or the L&D nurses I work with and rely on. I'm afraid that, since I couldn't feel these contractions, that when I do my required monitoring, the whole process will start over again later today. That I will have to do this over and over before I finally deliver.
Monday, April 5, 2010
30 Weeks: The End-of-the-Road Blues
I just got back from my 30 Week check at the doctor's office. Good Lord!
I'm trying to stay positive, so first of all, Yay!. Hooray for 30 weeks. Another milestone reached and another week closer to a healthy baby. But...
I didn't blog about this over the weekend because, well, I just didn't feel like dwellng on it. The progesterone shots every 5 days were seeming to work. I have not had to go back to the hospital in 2 weeks, which is a small victory. But Friday, I started to have breakthrough contractions--every 3 minutes, to be exact. We got them stopped with the monitor-bolus-monitor routine, without me having to report to L&D. Then nothing but mild crampiness on Saturday. But Sunday? Phew! Every 2-3 minutes again, for literally hours. They increased my brethine infusion rate and my doctor allowed me to stay home when, after 4 hours, we got them slowed to 6 contractions per hour. Then I went for my appointment this morning...
First, the doctor walks in the room and says "So! How is your uterus doing?", which I find absolutely hilarious. We talked a bit because I am starting to worry about reaching the same point I did in E's pregnancy where the meds just stopped working and I never stopped contracting. He asked how many boluses it took to get them stopped yesterday, and said that if it gets any worse, they are just going to put me in the hospital until I deliver. His exact words? "If the boluses stop working, pack your bags!" I reminded him that mag sulfate didn't even stop them last time, and he agreed, but pointed out that I am nearing the time where I was when I ended up finally delivering E. So instead of my being further along serving to reassure, it is just causing me to be labeled as a giant time bomb. As in we're getting to that point, where no one knows if the contractions will be able to be stopped, and the only way to ensure that I don't have a baby in my house is to keep me in the hospital under close watch. It's like my uterus is the Boy Who Cried Wolf. So many trips into the hospital, contracting worse than a woman in the final stages of labor, with no cervical changes. So many days at home doing the same thing, and we all assume it is all okay because,well, it's me! There really is no way of knowing when it all stops being okay, so I understand the rationale behind his statement, but would pretty much rather have a lobotomy than spend weeks in the hospital.
So I'm trying to hang on. I'm getting really exhausted from all of this, and have that Woe-Is-Me attitude. I'm so tired of needles and painful contractions, of financial difficulties and mounting medical bills. I want to have the I-just-want-a-healthy-baby outlook on all of this. I do, because I really do want a healthy baby. But this is where the rubber meets the road in one of my pregnancies--it gets harder and harder to hang on, harder and harder to endure. This is the stage where I want to scream from the rooftops, "But what about me? Doesn't my well-being matter, too?" I don't, because I am a mother. It is my job to be completely selfless for my children. There have been countless times where their needs come before mine and I do not whine because that is the job for which I signed up from the minute I decided to have children.
But here? On this blog? I feel like I can whine all I want. Because this is really, really difficult, both emotionally and physically. And because this is the main reason I started this blog in the first place- a documentation of what happens, of how I feel, of the process I endure to bring a child into the world.
I'm ready. I'm ready to give this baby the food off my plate, the clothes off of my back. I'm ready to work endless hours to pay for his education or go without something I truly need to give him something he truly wants. I'm ready to be that crazy woman you see lined up in the cold at Christmas to get The Toy of the Year, freezing just to see a my child smile. I don't care about sleepless nights in steamy bathrooms to relieve croup or stopping what I am doing to mend skinned knees. It doesn't bother me to balance a textbook on one knee while rocking a colicky baby to sleep. I've done all of that and more. It's my job.
But I'm also ready to have my body back, and to be free from pain.
Just a few more weeks.
I'm trying to stay positive, so first of all, Yay!. Hooray for 30 weeks. Another milestone reached and another week closer to a healthy baby. But...
I didn't blog about this over the weekend because, well, I just didn't feel like dwellng on it. The progesterone shots every 5 days were seeming to work. I have not had to go back to the hospital in 2 weeks, which is a small victory. But Friday, I started to have breakthrough contractions--every 3 minutes, to be exact. We got them stopped with the monitor-bolus-monitor routine, without me having to report to L&D. Then nothing but mild crampiness on Saturday. But Sunday? Phew! Every 2-3 minutes again, for literally hours. They increased my brethine infusion rate and my doctor allowed me to stay home when, after 4 hours, we got them slowed to 6 contractions per hour. Then I went for my appointment this morning...
First, the doctor walks in the room and says "So! How is your uterus doing?", which I find absolutely hilarious. We talked a bit because I am starting to worry about reaching the same point I did in E's pregnancy where the meds just stopped working and I never stopped contracting. He asked how many boluses it took to get them stopped yesterday, and said that if it gets any worse, they are just going to put me in the hospital until I deliver. His exact words? "If the boluses stop working, pack your bags!" I reminded him that mag sulfate didn't even stop them last time, and he agreed, but pointed out that I am nearing the time where I was when I ended up finally delivering E. So instead of my being further along serving to reassure, it is just causing me to be labeled as a giant time bomb. As in we're getting to that point, where no one knows if the contractions will be able to be stopped, and the only way to ensure that I don't have a baby in my house is to keep me in the hospital under close watch. It's like my uterus is the Boy Who Cried Wolf. So many trips into the hospital, contracting worse than a woman in the final stages of labor, with no cervical changes. So many days at home doing the same thing, and we all assume it is all okay because,well, it's me! There really is no way of knowing when it all stops being okay, so I understand the rationale behind his statement, but would pretty much rather have a lobotomy than spend weeks in the hospital.
So I'm trying to hang on. I'm getting really exhausted from all of this, and have that Woe-Is-Me attitude. I'm so tired of needles and painful contractions, of financial difficulties and mounting medical bills. I want to have the I-just-want-a-healthy-baby outlook on all of this. I do, because I really do want a healthy baby. But this is where the rubber meets the road in one of my pregnancies--it gets harder and harder to hang on, harder and harder to endure. This is the stage where I want to scream from the rooftops, "But what about me? Doesn't my well-being matter, too?" I don't, because I am a mother. It is my job to be completely selfless for my children. There have been countless times where their needs come before mine and I do not whine because that is the job for which I signed up from the minute I decided to have children.
But here? On this blog? I feel like I can whine all I want. Because this is really, really difficult, both emotionally and physically. And because this is the main reason I started this blog in the first place- a documentation of what happens, of how I feel, of the process I endure to bring a child into the world.
I'm ready. I'm ready to give this baby the food off my plate, the clothes off of my back. I'm ready to work endless hours to pay for his education or go without something I truly need to give him something he truly wants. I'm ready to be that crazy woman you see lined up in the cold at Christmas to get The Toy of the Year, freezing just to see a my child smile. I don't care about sleepless nights in steamy bathrooms to relieve croup or stopping what I am doing to mend skinned knees. It doesn't bother me to balance a textbook on one knee while rocking a colicky baby to sleep. I've done all of that and more. It's my job.
But I'm also ready to have my body back, and to be free from pain.
Just a few more weeks.
Saturday, March 20, 2010
27 wks, 6 days:Can a Girl Just Sleep, Already?
Yesterday, I felt horrible. I had a stressful day worrying about bills, my job, my insurance. I cried a lot and got one of those raging headaches I get after hours of crying. I felt dizzy and nauseous, and after having J check my blood pressure, laid down to rest. I slept off the nausea and dizziness, but then the contractions started.
I put myself on my monitor at about 11 PM. I was feeling crampy on top of it. I wanted to see what I was doing. I know what the process is like, so I should've known better.
I had 14 contraction from 11 PM to 12 AM. The nurse calls and tells me to give myself a bolus and re-monitor for an hour, starting at about 12:30 to allow the bolus to work. I do, and monitor from 12:30 to 1:30. This time I had 10 contractions. Better, but not good enough. Another bolus, wait 15 minutes and re-monitor from 12:45 AM to 1:45 AM. 7 contractions. Another bolus, then re-monitor from 2 AM to 3 AM. Wait for the nurse to call, which happens at about 3:20. 4 contractions. I am finally allowed to sleep.
Of course by this point, J has been awake a long time, since he had clinicals yesterday and had to leave earlier in the morning than usual. He and are both exhausted. I cannot sleep from the contractions and the monitoring, along with the jitteriness that goes along with 3 brethine boluses. I am laying on the sofa, and he is in the recliner. And he keeps snoring so loudly. This gets to me more than anything.
I know this pregnancy hasn't been easy on anyone in the family. Of course it hasn't. But I feel that for someone who shared an equal part in the creation of this baby, he has had to make minimal sacrifices. He's only missed 2 days of school, while I had to drop out completely. I had to surrender my career temporarily, which meant the world to me. I am the one who has to endure the pain. I worry about the bills and other financial aspects. Other than driving me to appointments and to and from the hospital, when needed, his life has remained largely intact. The fact that he could not just suck it up and be there for me was too much to handle, and I went off on him. It may have been unfair--he did get substantially less sleep than me yesterday--but now I am awake, contracting again, and he is snoring away the bad night we had last night. I can only wish for sleep. Then he is going to wake up and study all weekend for exams, while I just watch. This makes me jealous, as I want more than anything to go back to my life.
I put myself on my monitor at about 11 PM. I was feeling crampy on top of it. I wanted to see what I was doing. I know what the process is like, so I should've known better.
I had 14 contraction from 11 PM to 12 AM. The nurse calls and tells me to give myself a bolus and re-monitor for an hour, starting at about 12:30 to allow the bolus to work. I do, and monitor from 12:30 to 1:30. This time I had 10 contractions. Better, but not good enough. Another bolus, wait 15 minutes and re-monitor from 12:45 AM to 1:45 AM. 7 contractions. Another bolus, then re-monitor from 2 AM to 3 AM. Wait for the nurse to call, which happens at about 3:20. 4 contractions. I am finally allowed to sleep.
Of course by this point, J has been awake a long time, since he had clinicals yesterday and had to leave earlier in the morning than usual. He and are both exhausted. I cannot sleep from the contractions and the monitoring, along with the jitteriness that goes along with 3 brethine boluses. I am laying on the sofa, and he is in the recliner. And he keeps snoring so loudly. This gets to me more than anything.
I know this pregnancy hasn't been easy on anyone in the family. Of course it hasn't. But I feel that for someone who shared an equal part in the creation of this baby, he has had to make minimal sacrifices. He's only missed 2 days of school, while I had to drop out completely. I had to surrender my career temporarily, which meant the world to me. I am the one who has to endure the pain. I worry about the bills and other financial aspects. Other than driving me to appointments and to and from the hospital, when needed, his life has remained largely intact. The fact that he could not just suck it up and be there for me was too much to handle, and I went off on him. It may have been unfair--he did get substantially less sleep than me yesterday--but now I am awake, contracting again, and he is snoring away the bad night we had last night. I can only wish for sleep. Then he is going to wake up and study all weekend for exams, while I just watch. This makes me jealous, as I want more than anything to go back to my life.
Tuesday, March 16, 2010
27 wks: Back I Go
Gah!
Today is the 27 week mark. So now, regardless of what pregnancy book you are reading, I am going to be officially in the last trimester.
But yesterday...Good GOD!
I woke up as J was leaving for school. About 30 minutes after he left with my car, the contractions started, but these were different. They started up under my rib cage and would spread down the lower half of my body, and almost felt like they were going all the way down to my knees. And they hurt. And started out as really frequent. No building up and getting closer together, but about 3 minutes apart from the start. So I pick up the phone and try to call my home health nurse, like always. No phone. My landline was out. It was so bizarre because I had internet, which is from the same company. I couldn't call my nurse, my doctor, J, or even 911! What to do???
Well, thank you, Facebook and Yahoo! A friend of mine from Michigan was online, and I IM'd her to see if she could call J for me to get him home. She did, and 15 minutes later, he came through the door. He had to call the phone company, and scared the living daylights out of some poor rep who answered the phone, when he told her what was going on, and why we needed our sevice restored immediately. Thank God, she had it fixed within 15 minutes!
So the first call was to my doctor's office, who advised me to go ahead and do what I normally would. I ran a strip on myself and sent it in to the home health company. I don't know how bad the contractions were, but the nurse who called back is usually pretty liberal with me because she knows my story, that I do this. But even she seemed kind of concerned. We did the whole monitor-bolus-monitor-bolus thing all day. At some point, in the afternoon, she icreased my dosage of the brethine again, and as she was leaving for the day, she had me run another strip. She said she was going to let the after-hours nurse know what was going on, and that she would be the one calling me back after the strip was sent.
In the meantime, my other nurse showed up to give me my progesterone injection. I knew I was still contracting, but I also knew they no longer hurt and were further apart. So while she did her home visit, I continued to monitor. The monitor beeped to let me know the one-hour mark was up about 15 minutes after she left, and I sent the data. It wasn't long bfore the after-hourse nurse called to tell me I had 9 contractions in the hour. But it was still over the 5-an-hour threshold my doctor gave them, for the fourth time that day, so she insisted she call and talk to him. Of course, it had to be one of the doctors in the practice who doesn't know me well. And he is known for being on the cautious side, so that is how I ended up in labor and delivery again last night.
It was probably a good thing. There were no cervical changes, but I was dehydrated. So after 7 attempts, they got an IV in and gave me fluids. I woke up this morning feeling much better, aside from the big purple splotches up and down my arms from blown veins after IV sticks.
Today is the 27 week mark. So now, regardless of what pregnancy book you are reading, I am going to be officially in the last trimester.
But yesterday...Good GOD!
I woke up as J was leaving for school. About 30 minutes after he left with my car, the contractions started, but these were different. They started up under my rib cage and would spread down the lower half of my body, and almost felt like they were going all the way down to my knees. And they hurt. And started out as really frequent. No building up and getting closer together, but about 3 minutes apart from the start. So I pick up the phone and try to call my home health nurse, like always. No phone. My landline was out. It was so bizarre because I had internet, which is from the same company. I couldn't call my nurse, my doctor, J, or even 911! What to do???
Well, thank you, Facebook and Yahoo! A friend of mine from Michigan was online, and I IM'd her to see if she could call J for me to get him home. She did, and 15 minutes later, he came through the door. He had to call the phone company, and scared the living daylights out of some poor rep who answered the phone, when he told her what was going on, and why we needed our sevice restored immediately. Thank God, she had it fixed within 15 minutes!
So the first call was to my doctor's office, who advised me to go ahead and do what I normally would. I ran a strip on myself and sent it in to the home health company. I don't know how bad the contractions were, but the nurse who called back is usually pretty liberal with me because she knows my story, that I do this. But even she seemed kind of concerned. We did the whole monitor-bolus-monitor-bolus thing all day. At some point, in the afternoon, she icreased my dosage of the brethine again, and as she was leaving for the day, she had me run another strip. She said she was going to let the after-hours nurse know what was going on, and that she would be the one calling me back after the strip was sent.
In the meantime, my other nurse showed up to give me my progesterone injection. I knew I was still contracting, but I also knew they no longer hurt and were further apart. So while she did her home visit, I continued to monitor. The monitor beeped to let me know the one-hour mark was up about 15 minutes after she left, and I sent the data. It wasn't long bfore the after-hourse nurse called to tell me I had 9 contractions in the hour. But it was still over the 5-an-hour threshold my doctor gave them, for the fourth time that day, so she insisted she call and talk to him. Of course, it had to be one of the doctors in the practice who doesn't know me well. And he is known for being on the cautious side, so that is how I ended up in labor and delivery again last night.
It was probably a good thing. There were no cervical changes, but I was dehydrated. So after 7 attempts, they got an IV in and gave me fluids. I woke up this morning feeling much better, aside from the big purple splotches up and down my arms from blown veins after IV sticks.
Wednesday, March 3, 2010
24 wks,4 days : In the Hospital
So there I am, in the hospital. I can no longer feel the contractions, so I think the mag sulfate is working. I know from my nurse that this is not the case. Mag relaxes the smooth muscle of the uterus, and this is how it stops contractions. But it hasn't stopped mine. I just cannot feel them anymore. She holds up my strip to show me, and there is literally not a flat area on it, as my uterus goes through waves of contractions, a new one starting every 2 minutes. "Andrea, this is an active labor pattern!", she tells me. Gradually, my dose of mag increases until I am on 3 grams. At this point I am maxed out on it. They start adding brethine boluses, and these seem to work.
I ask about my KB test, and discover that it was positive. I don't know what this means, so I call J, who is home with E, and ask him to google it for me. He cannot figure it out for me, and noone there knows how to interpret my weird result. And somehow, over the course of the night, I go from not being able to feel the contractions, to feeling them but not being in pain, to actually having discomfort. When I get to the point where I find myself having to stop and focus on my breathing through them, I let my nurse know. Something is different. Something has changed.
Somewhere around 5 AM, my doctor comes in. I feel terrible, as I know he isn't even on call for my practice anymore, as it has switched to the next day. But he has been awake on the phone with my nurse all night, and makes the special trip in to see me. But he explains the KB test, finally. It means that there has been a breach in my body, and that there are fetal blood cells in my blood sample. In other words, a hemorrhage has occured. It isn't bad, and I am not in excrutiating pain or gushing blood, so it is probably just mild trauma from the fall. What he is concerned about is the change in my contractions. And he seems apologetic as he tells me he is sending me over the river from Northern Kentucky into Cincinnati to what I mentioned in an earlier post as our OB mecca. He knows I don't want to go. I have terrible memories of that place from E's pregnancy, but he pats my leg and tells me that if I were his wife, and this were his son, that is where he would want me to be at that point. I am 23 weeks pregnant,and this hospital is known for their NICU, even keeping micropreemies alive at points when noone thought they were even viable. For Zachary, I have to go.
On a side note, I was started on my Celestone course for Zachary's lungs. Should be finished with that soon.
I ask about my KB test, and discover that it was positive. I don't know what this means, so I call J, who is home with E, and ask him to google it for me. He cannot figure it out for me, and noone there knows how to interpret my weird result. And somehow, over the course of the night, I go from not being able to feel the contractions, to feeling them but not being in pain, to actually having discomfort. When I get to the point where I find myself having to stop and focus on my breathing through them, I let my nurse know. Something is different. Something has changed.
Somewhere around 5 AM, my doctor comes in. I feel terrible, as I know he isn't even on call for my practice anymore, as it has switched to the next day. But he has been awake on the phone with my nurse all night, and makes the special trip in to see me. But he explains the KB test, finally. It means that there has been a breach in my body, and that there are fetal blood cells in my blood sample. In other words, a hemorrhage has occured. It isn't bad, and I am not in excrutiating pain or gushing blood, so it is probably just mild trauma from the fall. What he is concerned about is the change in my contractions. And he seems apologetic as he tells me he is sending me over the river from Northern Kentucky into Cincinnati to what I mentioned in an earlier post as our OB mecca. He knows I don't want to go. I have terrible memories of that place from E's pregnancy, but he pats my leg and tells me that if I were his wife, and this were his son, that is where he would want me to be at that point. I am 23 weeks pregnant,and this hospital is known for their NICU, even keeping micropreemies alive at points when noone thought they were even viable. For Zachary, I have to go.
On a side note, I was started on my Celestone course for Zachary's lungs. Should be finished with that soon.
Saturday, February 27, 2010
23 wks, 5 days: The Brethine Pump and Star Trek Crap
So I see my doctor on the Monday morning that is to mark the 23rd week of pregnancy. And he is starting me on the brethine pump. I am a little nervous about this. The brethine I have been taking by mouth has at times had me having such bad palpitations that I have to focus on my breathing, feeling short of breath from the tachycardia. He, on the other hand, doesn't seem nervous at all, but rather excited by the idea. He is sure this is going to solve my problem. Whether or not he is truly happy about it, or whether this is his way of keeping me upbeat remains to be seen. Whatever. I will try anything that has the slimmest chance of giving me a healthy, closer-to-term baby while leaving my life intact.
After a brief visit, I leave the office expecting a call from the home health company that is handling my P17 injections. And it comes about 2 hours later.
They tell me a courier will be bringing the medicine, and the nurse plans to be there by about 3:30 that afternoon. Sure enough, by about 3:00, these boxes start arriving at my home, via a courier who looks like a disgruntled grandpa, angry at having to trudge through the snow to deliver the packages. I am wondering how in blue hell my doctor pulled this off so quickly until I see the garish fluorescent-orange "STAT" labels on each box. A-ha! I know exactly how he did it now, and am picturing his nurse on the phone with the company, making it sound like delivery of this baby is imminent if they don't get the supplies here yesterday!
Shortly thereafter, my nurse is here, looking kind of frazzled too, and I start thinking I may be the rudest person of all: the massive snow we got last week is still accumulated on the front sidewalk, as we use the back door to come and go from the house. In my fight to keep working, I have to get J to do everything, and it is all I can do to get him to do the laundry and keep the three of us in clean undies and socks. The front sidewalk was not at the top of my list. I mentally take note to get him to handle it, while apologizing to the nurse, who is bringing even more boxes into the house. It really does stink not being able to do anything by myself, and having to rely on others, when I am truly used to handling everything.
So we get started. First is the home uterine monitoring. What? The huh???? I had no idea this was even coming, but apparently my doctor wanted it. So she shows me how to strap myself up to a monitor like they use in the hospital to track contractions. And explains that I am to do these recordings for one hour, twice a day. She plugs this huge contraption to the outlet by my kitchen table, extends this antenna, and plugs the monitor box into it. After a series of beeps and flashing lights, it says that data has been sent, and ten minutes later, someone from Columbus, Ohio calls my home to let me know they got it, and it looks great. I am utterly amazed. My amazement turns to the thought, "Wow, I am old!". While pregnant with E and having contractions, the only way to tell the doctor that they were truly contractions was to schlep to the hospital. It was such a pain. Now I can do this from home, and a team of OB nurses will interpret what is going on and call my doctor for me. Fancy Star Trek crap!
Next comes the dreaded brethine pump. I am really nervous now. I guess I had pictured trudging around my house with an IV pole. My doctor had tried to explain it to me, and said it would be more like a fanny pack attached to a little catheter. I remember him laughing when I sarcastically commented on how hot that would look with scrubs. But this is even better than what he explained. It's smaller than a cell phone, and goes in this pouch the size of a large wallet, which can either clip to my waist or fit in a largish pocket. Cool. And the needle is tiny, and not an IV or even intramuscular catheter, but rather a small subcutaneous one. It actually looks like a large thumbtack.
So the nurse is ready to show me how to insert the catheter to start delivery of the medicine, and this is when I start to kind of freak out. My profession has me driving needles into peoples' arteries (which I am quite good at, by the way) without the teensiest bit of squeamishness. But this? This little needle the size of a large thumbtack??? Going into me??? I can't do it. My heart is pounding and my respiratory rate goes through the roof as my hand hovers, frozen in space, above the prepped area of my upper thigh. I cannot do it, until she places her hand on mine and does it for me. And it doesn't hurt, and I feel reallyreallyreally silly. But there it is, attached to this thin blue tubing that snakes its way to the tiny pump. Viola! Continuous brethine infusion, with a bolus every four hours.
I cannot wait to see if it works. I will find out the next night when I return to work.
(Image Credit: Smiths Medical, not mine. )
Saturday, February 20, 2010
22 wks 5 days: Put Yourself in My Shoes
So I report for my weekly cervical length,and I am having contractions about every 6 minutes or so. They have my cervix on the screen and know I am not dilated. Yet the ultrasound tech still insists that she tell the doctor, who makes me go to labor and delivery at the hospital. I go, but I don't like it one bit.
Once at labor and delivery, they hook me up to the monitor, and I am indeed contracting. and the nurse I have is one I don't know. By this time, I am frustrated and am scheduled for my big return to work in a mere 5 hours. I want out of there!
I tell the nurse that I don't want to go on the brethine pump, and I know that is what they are going to do next. She starts her "what is best for the baby" spiel. "You want a healthy baby, don't you?", she asks. Grrrrrr! Seriously? I give J a look at this point, and he knows I am about to lose it. Yes! Yes, I want a healthy baby. Yes, I know what I am up against. But I want to have a healthy baby with my job and finances intact, without having E and J fall through the cracks in my life. So I cannot help it: I get downright snippy with her, and look at J and say "Well, I can just refuse it, I guess!" Meaning the brethine pump, not the subcutaneous brethine injection they give at the hospital to stop the labor. What I want is for the nurse to try to understand. My frustration at my situation should in no way reflect on whether or not I want a healthy baby. I should be allowed to vent and cry a little without feeling less than adequate as a mother. I want her to put herself in my shoes: to be proud and independent and tough, to have worked to overcome multiple obstacles in life successfully, only later to be victim to random circumstance. Yes, I want a healthy baby. But I also want to be like all of the pregnant women I have known: working, smiling, glowing, and free of bruises and needle marks and pain that seem to mark my pregnancies.
One of the doctors from my OB practice whom I like is already at the hospital for a delivery, and he makes an appearance at my bedside. The nurse must have told him I had an attitude, because he looks at me and tells me I am contracting, yet again, and asks me if I want the sub q injection. I tell him yes, I want it, that I want the labor to stop, but don't want the pump. He asks me why, and I explain that another doctor in the practice told me I would be on strict bedrest until delivery if they had to go that route. Instead, I like it the way it is: playing it by ear and only being off of work when needed, instead of having to be off all of the time. He tells me he is going to call her and see what the thought process was behind that statement, and disappears, dialing her on his iPhone as he walks away.
Minutes later, he is back and tells me he wants me in the office on Monday, and that they are going to put me on the pump then. I can continue the way things are now with work, and I am allowed to leave, but no work tonight.
Once at labor and delivery, they hook me up to the monitor, and I am indeed contracting. and the nurse I have is one I don't know. By this time, I am frustrated and am scheduled for my big return to work in a mere 5 hours. I want out of there!
I tell the nurse that I don't want to go on the brethine pump, and I know that is what they are going to do next. She starts her "what is best for the baby" spiel. "You want a healthy baby, don't you?", she asks. Grrrrrr! Seriously? I give J a look at this point, and he knows I am about to lose it. Yes! Yes, I want a healthy baby. Yes, I know what I am up against. But I want to have a healthy baby with my job and finances intact, without having E and J fall through the cracks in my life. So I cannot help it: I get downright snippy with her, and look at J and say "Well, I can just refuse it, I guess!" Meaning the brethine pump, not the subcutaneous brethine injection they give at the hospital to stop the labor. What I want is for the nurse to try to understand. My frustration at my situation should in no way reflect on whether or not I want a healthy baby. I should be allowed to vent and cry a little without feeling less than adequate as a mother. I want her to put herself in my shoes: to be proud and independent and tough, to have worked to overcome multiple obstacles in life successfully, only later to be victim to random circumstance. Yes, I want a healthy baby. But I also want to be like all of the pregnant women I have known: working, smiling, glowing, and free of bruises and needle marks and pain that seem to mark my pregnancies.
One of the doctors from my OB practice whom I like is already at the hospital for a delivery, and he makes an appearance at my bedside. The nurse must have told him I had an attitude, because he looks at me and tells me I am contracting, yet again, and asks me if I want the sub q injection. I tell him yes, I want it, that I want the labor to stop, but don't want the pump. He asks me why, and I explain that another doctor in the practice told me I would be on strict bedrest until delivery if they had to go that route. Instead, I like it the way it is: playing it by ear and only being off of work when needed, instead of having to be off all of the time. He tells me he is going to call her and see what the thought process was behind that statement, and disappears, dialing her on his iPhone as he walks away.
Minutes later, he is back and tells me he wants me in the office on Monday, and that they are going to put me on the pump then. I can continue the way things are now with work, and I am allowed to leave, but no work tonight.
Monday, February 8, 2010
21 wks, 3 days: Labor and Delivery is a Cruel Place
21 weeks, 3 days pregnant. The contractions start at 5 AM. I don't wake J. I take my brethine. I wait a couple of hours and take more, even though I probably shouldn't. I am supposed to go back to work today. Please, God, make them stop!
After 3 hours, I call the doctor. Take a hot bath, he recommends. I do. The water turns cold, and I shiver as I empty the tub and let it fill again with hot water. It turns cold again, and I empty it to fill it again. No more hot water. I wait for the water heater to do its job, and fill it yet again. Please, just stop. The contractions don't, but now I am having palpitations from all of the brethine. They do go from every five minutes to every seven minutes, to every ten minutes. I dry off and curl up in a warm bed, and sleep.
I wake up. It is 11 AM. I am still having contractions. Every seven minutes again. More brethine, and now my heartrate is in the 130's. I call the doctor's office, just to hear them tell me what I already know: go to labor and delivery. I do.
No they don't hurt. They don't physically hurt. The contractions are uncomfortable, andI know they are there. But my heart hurts. I was foolishly holding onto the idea that this time would be different, that the episode at 20 weeks would be the last. The doctor comes in, and we devise a plan. Meds. More brethine, this time intramuscular injections. An ultrasound to check baby. A cervical length. What's that? I didn't have that with E. Must be new. Turns out they jam this rod that looks like a torture device into places you don't want anything jammed when you are contracting. But the cervix looks good.
I get 3 doses of brethine before all is said and done. The doctor is threatening to send me to Good Sam, the OB mecca I stayed in for a month when pregnant with E. Not that place. I don't want to go. J calls my boss while I cry. And listen to the sounds of an OB unit of a hospital, which is where the title of this post comes into play.
I listen. I listen to the woman in the bed next to me as she is sent to her room to deliver her healthy full-term baby. I watch smiling loved ones as they stroll down the hall, clutching pink and baby blue teddy bears, holding aloft the "It's a BOY!" or "It's A GIRL!" balloons. I am wheeled to a hallway where I am to wait for my ultrasound, wearing a thin, flimsy hospital gown. Pregnant women come and go for outpatient stress tests and ultrasounds. They glow as they stroke their bellies. And me? I'm just tying to hold on. And I sit in my gown, in a wheelchair. Contractions five minutes apart. A woman in the room across the hall asks if I am okay. No, I tell her. I work here. This is my place of business, and I am only 21 weeks. I am heartbroken,embarrassed, ashamed. She puts me in a bed, puts me on a monitor and alarm paralyzes her face as she sees the waves of contractions on the monitor. She calls my nurse, who brings more brethine.
Somewhere in all of this, the contractions stop. I ask about work, and my doctor asks me if I'm crazy. I feel weak and can barely hold the pen as I sign the discharge papers. We leave, and by now J has picked up E from school. E is upset with me because there is a book fair at school. He wants to go, but there is no way to explain why mommy can't. He doesn't understand, and I don't want to force the issue for fear of raising resentment toward the new brother who has already rocked his little world. I have failed him, too.
After 3 hours, I call the doctor. Take a hot bath, he recommends. I do. The water turns cold, and I shiver as I empty the tub and let it fill again with hot water. It turns cold again, and I empty it to fill it again. No more hot water. I wait for the water heater to do its job, and fill it yet again. Please, just stop. The contractions don't, but now I am having palpitations from all of the brethine. They do go from every five minutes to every seven minutes, to every ten minutes. I dry off and curl up in a warm bed, and sleep.
I wake up. It is 11 AM. I am still having contractions. Every seven minutes again. More brethine, and now my heartrate is in the 130's. I call the doctor's office, just to hear them tell me what I already know: go to labor and delivery. I do.
No they don't hurt. They don't physically hurt. The contractions are uncomfortable, andI know they are there. But my heart hurts. I was foolishly holding onto the idea that this time would be different, that the episode at 20 weeks would be the last. The doctor comes in, and we devise a plan. Meds. More brethine, this time intramuscular injections. An ultrasound to check baby. A cervical length. What's that? I didn't have that with E. Must be new. Turns out they jam this rod that looks like a torture device into places you don't want anything jammed when you are contracting. But the cervix looks good.
I get 3 doses of brethine before all is said and done. The doctor is threatening to send me to Good Sam, the OB mecca I stayed in for a month when pregnant with E. Not that place. I don't want to go. J calls my boss while I cry. And listen to the sounds of an OB unit of a hospital, which is where the title of this post comes into play.
I listen. I listen to the woman in the bed next to me as she is sent to her room to deliver her healthy full-term baby. I watch smiling loved ones as they stroll down the hall, clutching pink and baby blue teddy bears, holding aloft the "It's a BOY!" or "It's A GIRL!" balloons. I am wheeled to a hallway where I am to wait for my ultrasound, wearing a thin, flimsy hospital gown. Pregnant women come and go for outpatient stress tests and ultrasounds. They glow as they stroke their bellies. And me? I'm just tying to hold on. And I sit in my gown, in a wheelchair. Contractions five minutes apart. A woman in the room across the hall asks if I am okay. No, I tell her. I work here. This is my place of business, and I am only 21 weeks. I am heartbroken,embarrassed, ashamed. She puts me in a bed, puts me on a monitor and alarm paralyzes her face as she sees the waves of contractions on the monitor. She calls my nurse, who brings more brethine.
Somewhere in all of this, the contractions stop. I ask about work, and my doctor asks me if I'm crazy. I feel weak and can barely hold the pen as I sign the discharge papers. We leave, and by now J has picked up E from school. E is upset with me because there is a book fair at school. He wants to go, but there is no way to explain why mommy can't. He doesn't understand, and I don't want to force the issue for fear of raising resentment toward the new brother who has already rocked his little world. I have failed him, too.
Subscribe to:
Posts (Atom)
