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 preterm labor. Show all posts
Showing posts with label preterm labor. 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.
Wednesday, March 24, 2010
27 Wks, 6 Days: Again. Seriously?
Okay, so I wake up Saturday morning, the morning after I was up until 3:30 AM doing the monitor-bolus thing. I actually wake up about 4 hours later, at 7:30. I'm still contracting. Not bad, but I am not eager to repeat the experience of the night before all day so I keep my mouth shut. And I wait. In fact, I wait too long, and the contractions get closer and closer together. Finally, at about 11 AM, I put myself on the monitor for an hour. And then I send it. And then the nurse calls back. 27 contractions that hour, between 11 and noon. She asks me how I feel, and I am brutally honest:
"I feel like, if I could dilate, I would've already had this baby. I feel like my body is trying to deliver him, and I am fed up."
I tell her that I'm not sure that the contractions ever really stopped. I know I slept for about 4 hours, and have no idea if they continued then or not. I just know they were there when I went to bed, and they were there when I woke up. That's all. So she decides to skip the monitor-bolus routine and just calls my doctor. And they want to send me to the hospital. I tell her I am going to shower and eat first, and then I will go, and I do. Within 30 minutes, we are on our way.
The doctor has decided before I even get there that I am most likely going to stay. I do. They start the mag sulfate drip at 3.0 grams, and off I go to my room. But the contractions don't stop. I get Indocin for the first time ever, and that slows them to a stop. Over the course of the first night, they wean the mag to 2.0 grams. Then the contractions start back up again somewhere in the middle of the night. And continue. More Indocin the next day. They stop again. Another doctor is on call for the practice and he comes in and tells me to just hang on until "the completion of 31 weeks" and that the "mortality rate decreases to zero at that point". Uh. Okay.
But this time, the nurses have me worried. And J. They are talking about risk of uterine rupture. They tell me that they have seen where a woman contracts and contracts against a closed cervix and finally, her uterus ruptures. This scares me to death, and is something I had not considered up until that point. Something new to worry about.
Over the course of 3 days, the contractions come and go. They make changes to my medications. And they keep me there. I'm not even allowed to bathe. I am so dirty I can smell myself and feel like the right to have my most basic needs met has been stripped away from me. Finally, J arrives with an arsenal of bath products, and I perch on a stool while he gives me a sponge bath. This, of course, is against doctor's orders, but I don't care at this point. I am in tears and miserable, so my nurse doesn't even try to force the issue, but instead tells me to let her know when I am finished and quietly closes the door. I am so grateful at that point to have a husband who loves me unconditionally, because I am nasty. And he doesn't say a word, but instead, helps me clean myslef up.
Finally, on Monday night, I get my progesterone injection. From that point on, I have 3 contractions. Total. The doctor comes in Tuesday and I immediately ask him if I can go home. He looks at my strip on the uterine monitor and says he sees no reason to keep me. I am free. And happy.
I leave that place hoping that the next time I am there, I will leave with a baby. I have about four and a half weeks left before I will be okay to deliver. Before I will reach the point I did in E's pregnancy. And I know now that, with the way Zachary looks in utero, he will most likely be fine from this point on. Every week from here on out is just icing on the cake for me. No one wants a preemie, but I am to the point where I am finished. And I'm just tryingto hang on. The point of viability has come and gone.
"I feel like, if I could dilate, I would've already had this baby. I feel like my body is trying to deliver him, and I am fed up."
I tell her that I'm not sure that the contractions ever really stopped. I know I slept for about 4 hours, and have no idea if they continued then or not. I just know they were there when I went to bed, and they were there when I woke up. That's all. So she decides to skip the monitor-bolus routine and just calls my doctor. And they want to send me to the hospital. I tell her I am going to shower and eat first, and then I will go, and I do. Within 30 minutes, we are on our way.
The doctor has decided before I even get there that I am most likely going to stay. I do. They start the mag sulfate drip at 3.0 grams, and off I go to my room. But the contractions don't stop. I get Indocin for the first time ever, and that slows them to a stop. Over the course of the first night, they wean the mag to 2.0 grams. Then the contractions start back up again somewhere in the middle of the night. And continue. More Indocin the next day. They stop again. Another doctor is on call for the practice and he comes in and tells me to just hang on until "the completion of 31 weeks" and that the "mortality rate decreases to zero at that point". Uh. Okay.
But this time, the nurses have me worried. And J. They are talking about risk of uterine rupture. They tell me that they have seen where a woman contracts and contracts against a closed cervix and finally, her uterus ruptures. This scares me to death, and is something I had not considered up until that point. Something new to worry about.
Over the course of 3 days, the contractions come and go. They make changes to my medications. And they keep me there. I'm not even allowed to bathe. I am so dirty I can smell myself and feel like the right to have my most basic needs met has been stripped away from me. Finally, J arrives with an arsenal of bath products, and I perch on a stool while he gives me a sponge bath. This, of course, is against doctor's orders, but I don't care at this point. I am in tears and miserable, so my nurse doesn't even try to force the issue, but instead tells me to let her know when I am finished and quietly closes the door. I am so grateful at that point to have a husband who loves me unconditionally, because I am nasty. And he doesn't say a word, but instead, helps me clean myslef up.
Finally, on Monday night, I get my progesterone injection. From that point on, I have 3 contractions. Total. The doctor comes in Tuesday and I immediately ask him if I can go home. He looks at my strip on the uterine monitor and says he sees no reason to keep me. I am free. And happy.
I leave that place hoping that the next time I am there, I will leave with a baby. I have about four and a half weeks left before I will be okay to deliver. Before I will reach the point I did in E's pregnancy. And I know now that, with the way Zachary looks in utero, he will most likely be fine from this point on. Every week from here on out is just icing on the cake for me. No one wants a preemie, but I am to the point where I am finished. And I'm just tryingto hang on. The point of viability has come and gone.
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.
Sunday, March 14, 2010
26 Wks, 5 Days: So Relieved
I had a crazy day yesterday.
It started when I called the home health company nurse. J had me freaked out. I just had the lower abdominal and lower back crampiness, which he said is a sign of preterm labor. That is when they had me put myself on the monitor, and I posted the results of that yesterday. They had me bolus myself with brethine, then I got a normal scheduled bolus an hour later. Then it was back on the monitor for another hour.
Instead of the nurse calling me to say she got the strip, she called to say that they were experiencing heavy storms in Georgia, where she is located, and that she didn't get it. So she made me call my doctor, and it just happened to be the only doctor in the practice I have not met yet. I was sure he was going to tell me to go straight to OB Mecca, but he didn't. I told him I would rather have an aneurysm than go back to the hospital...any hospital. So he allowed me to stay home with the agreement that if anything changed or just felt different, I would go or at least call him back.
I settled in for the night, but somewhere along the way, I noticed that Zachary hadn't moved in quite some time. My very active baby was very still. So I got worried, and I called my friends at L&D, who told me to drink something sugary and/or caffeinated. I sent J up the road to get me 2 bottles of frappucino, since everything I had in the house was sugar-free. And I chugged them, laid down, and tried to count kicks. The home health nurse finally called back to tell me they were up and running, and that my last strip had 17 contractions on it...better, but still too much activity. I told her what was going on with the baby, and she gave me some more pointers, and said she would call back to check.
By the time she did, I had felt him move. Twice. In 3 hours. So she tells me I need to go on in to have it checked out, and she calls my doctor and L&D for me. Off I went.
I get there, and they have me pee in the cup an gown up, like always, and put him on the monitor. There it was...the little heartbeat that can make everything better. And then he started moving. Then and there. Thanks, Zachary! I mean, I was so relieved he was okay. I had been so scared that I had even called my RT colleagues to tell them that if they got a call for a 26 weeker, it was my baby. That is how scared I was. But why couldn't he do that at home? Little stinker!
So they watch me and the baby both for a while. And,well, it's me. I was having contractions every 3 minutes. Some resident buddies of mine were down there, and came into my room to chit-chat and keep me company. They stared at the strip of contractions like I was some sort of medical puzzle to solve, even though they weren't my doctors. Not that I don't think very highly of them, but I have a tough time working with anyone who has seen all of my business. That, and I am high risk and need very qualified OB's and not family practice residents. Everyone laughs at my issues with them seeing me naked, but have you ever worked a code at 3 AM with someone who has had their hand in your hoo-ha???
So I laid there. For 2 hours. Amusing myself by listening to the sounds from the next bed over in triage. The OB nurses had told me there are women out there who fake labor/ contractions. The idea was so bizarre to me. Who would do that, and how??? My friend C said they bare down like having a bowel movement, and it makes the toco jump, but you can tell between it and a real contraction, that real contractions are like rounded waves (she showed me mine on my strip as evidence) and that the fake kind were spiky and went straight up and down. As someone who has contracted uncontrollably through 2 pregnancies, this seems so bizarre to me, but apparently women get sick of being preggers and do this to try to get admitted. After hours, the doctor declares failure to progress, and they either get pitocin or a c-section. Well...The woman in the next bed over was a faker. 37 weeks pregnant and wanting to have her baby. She was asleep, and I could hear her snoring the entire time, until her nurse went behind the curtain to tell her that she was not in true labor and would be going home. Then the tears started, and the fake grunting and heavy breathing. I saw her husband leave the room, and when she was in there by herself, the noises stopped and I heard snoring again. As soon as the husband was back, she started up the act again. Unreal!
So my nurse comes in after she has talked to my doctor, and since it is me, they gave me the choice: stay and have them try to stop the contractions or, so long as I hadn't dilated, go home and call/ come back if anything changed. I knew if I stayed and the contractions stopped, they would just start up again sooner or later. Only a handful of them actually hurt, so I said I wanted to go home. The faker heard. And wanted to know why she didn't have the same choice, because she wanted to stay.
And that is how I was able to sleep in my own bed last night. But I left the hospital stumped. The faker was taken to her room while I was signing my discharge papers, after having thrown a tantrum. And it drove me crazy. She'll probably have her baby this weekend, and I hope it's okay. People just don't realize...
It started when I called the home health company nurse. J had me freaked out. I just had the lower abdominal and lower back crampiness, which he said is a sign of preterm labor. That is when they had me put myself on the monitor, and I posted the results of that yesterday. They had me bolus myself with brethine, then I got a normal scheduled bolus an hour later. Then it was back on the monitor for another hour.
Instead of the nurse calling me to say she got the strip, she called to say that they were experiencing heavy storms in Georgia, where she is located, and that she didn't get it. So she made me call my doctor, and it just happened to be the only doctor in the practice I have not met yet. I was sure he was going to tell me to go straight to OB Mecca, but he didn't. I told him I would rather have an aneurysm than go back to the hospital...any hospital. So he allowed me to stay home with the agreement that if anything changed or just felt different, I would go or at least call him back.
I settled in for the night, but somewhere along the way, I noticed that Zachary hadn't moved in quite some time. My very active baby was very still. So I got worried, and I called my friends at L&D, who told me to drink something sugary and/or caffeinated. I sent J up the road to get me 2 bottles of frappucino, since everything I had in the house was sugar-free. And I chugged them, laid down, and tried to count kicks. The home health nurse finally called back to tell me they were up and running, and that my last strip had 17 contractions on it...better, but still too much activity. I told her what was going on with the baby, and she gave me some more pointers, and said she would call back to check.
By the time she did, I had felt him move. Twice. In 3 hours. So she tells me I need to go on in to have it checked out, and she calls my doctor and L&D for me. Off I went.
I get there, and they have me pee in the cup an gown up, like always, and put him on the monitor. There it was...the little heartbeat that can make everything better. And then he started moving. Then and there. Thanks, Zachary! I mean, I was so relieved he was okay. I had been so scared that I had even called my RT colleagues to tell them that if they got a call for a 26 weeker, it was my baby. That is how scared I was. But why couldn't he do that at home? Little stinker!
So they watch me and the baby both for a while. And,well, it's me. I was having contractions every 3 minutes. Some resident buddies of mine were down there, and came into my room to chit-chat and keep me company. They stared at the strip of contractions like I was some sort of medical puzzle to solve, even though they weren't my doctors. Not that I don't think very highly of them, but I have a tough time working with anyone who has seen all of my business. That, and I am high risk and need very qualified OB's and not family practice residents. Everyone laughs at my issues with them seeing me naked, but have you ever worked a code at 3 AM with someone who has had their hand in your hoo-ha???
So I laid there. For 2 hours. Amusing myself by listening to the sounds from the next bed over in triage. The OB nurses had told me there are women out there who fake labor/ contractions. The idea was so bizarre to me. Who would do that, and how??? My friend C said they bare down like having a bowel movement, and it makes the toco jump, but you can tell between it and a real contraction, that real contractions are like rounded waves (she showed me mine on my strip as evidence) and that the fake kind were spiky and went straight up and down. As someone who has contracted uncontrollably through 2 pregnancies, this seems so bizarre to me, but apparently women get sick of being preggers and do this to try to get admitted. After hours, the doctor declares failure to progress, and they either get pitocin or a c-section. Well...The woman in the next bed over was a faker. 37 weeks pregnant and wanting to have her baby. She was asleep, and I could hear her snoring the entire time, until her nurse went behind the curtain to tell her that she was not in true labor and would be going home. Then the tears started, and the fake grunting and heavy breathing. I saw her husband leave the room, and when she was in there by herself, the noises stopped and I heard snoring again. As soon as the husband was back, she started up the act again. Unreal!
So my nurse comes in after she has talked to my doctor, and since it is me, they gave me the choice: stay and have them try to stop the contractions or, so long as I hadn't dilated, go home and call/ come back if anything changed. I knew if I stayed and the contractions stopped, they would just start up again sooner or later. Only a handful of them actually hurt, so I said I wanted to go home. The faker heard. And wanted to know why she didn't have the same choice, because she wanted to stay.
And that is how I was able to sleep in my own bed last night. But I left the hospital stumped. The faker was taken to her room while I was signing my discharge papers, after having thrown a tantrum. And it drove me crazy. She'll probably have her baby this weekend, and I hope it's okay. People just don't realize...
Saturday, March 13, 2010
26 Wks, 4 Days: Fed Up
My home uterine monitoring company just called. Apparently I had 28 contractions in one hour. Funny thing is that I didn't feel any contractions, just a mild, all-over crampiness in my lower back and lower abdomen. I have had 3 brethine boluses in 3 hours from my pump and we are trying to avoid another trip to the hospital.
On a seperate note, I got my appointment for my c-section in the mail today: June 3. Any bets that I won't last that long? That is 17 days before my EDD. Ha!
On a seperate note, I got my appointment for my c-section in the mail today: June 3. Any bets that I won't last that long? That is 17 days before my EDD. Ha!
Friday, March 12, 2010
26 Wks,3 Days: Kick Counts and More
Baby Z was trying to kill me last night. Kill me!
This little booger can't be very long yet, but I was feeling him kick down by my groin, and at the same time, up by my rib cage on the opposite side of my body. I couldn't breathe, couldn't do anything to get comfortable. I lifted my shirt to look at my belly and J busted out laughing. Apparently, he had stretched out, and all that could be seen from the outside was this diagonal ridge that ran from my right rib border down to my left hip. I picture him in there, stretched out, arms over head, just chillaxin'.
The doctor wanted me to start doing kick counts this week, twice a day. I understand the value of this, and so I have been complying. Everytime I go to count the kicks, I do as it says in the instructions. I get comfy in a quiet place, settle in on my left side, and wait. And within five to ten minutes, Zachary provides enough movement to satisfy the doctor for 2 whole hours. At first, I did exactly as I was told: I laid there and counted the kicks for 2 hours. One time there was 48,and another time there was 54. They tell you they look for at least 10 in 2 hours. So eventually I started stopping after he got to 20 or so. The whole point is to make sure he is okay in there. I assure you, he's fine.
What I'm worried about, however, is his sleep-wake cycle. I know this seems silly, but when E was born, the patterns he showed in his sleep were identical to the ones he had in utero. Awake all night, asleep all day. But Zachary? Zachary is awake all of the time. He kicks all of the time. All day, everyday. He even keeps me up at night with it. Don't get me wrong: I love his little kicks. It tells me he is okay in there. If I don't feel them, I start to feel this twinge of panic. But what is this baby going to be like when he is born? Either this kid is not going to sleep, or he is going to have restless leg syndrome.
Other than that, this week has been uneventful. No crazy contractions since Saturday. I will have a few here or there, but nothing consistent that would send us to the hospital. I am afraid to admit this, but I think being grounded from work has done the trick. I won't be seeing my doctor this week, but I am sort of afraid. I was planning on trying to get them to allow me to return to work on a reduced schedule. The financial picture in this house is getting pretty ugly. And they could take my lack of contractions as a sign that I can, or they can take it as evidence that I really do need to be on bedrest. It could go either way. Not to mention, I will be seeing the only doctor in the practice I have yet to meet at my next appointment. They want us to meet all of them so we will see a familiar face when it comes time to deliver, in the event that someone new is on call. The only exception is for the women who are to have repeat c-sections. I was in that group, so got to pick the doctor I saw each time, as we knew who would be delivering me. But then my uterus had to go and get all dysfunctional, and I got placed in their high-risk group of patients, and now I have to rotate. Oh well. I have my favorites in the practice, the ones I click with better than the others, but they are all wonderful.
The only other thing I have to mention right now is that J noticed a trend this past weekend that may be the answer to my problems. When the contractions get to be at their worst, it is always at the end of the week. I just thought it was bad luck: weekends, doctors not in the office, etc. But he reminded me that I get my progesterone injections early in the week. When I start contracting like crazy, it is closer to the day I am due for the next shot. Hmmmmm.
This little booger can't be very long yet, but I was feeling him kick down by my groin, and at the same time, up by my rib cage on the opposite side of my body. I couldn't breathe, couldn't do anything to get comfortable. I lifted my shirt to look at my belly and J busted out laughing. Apparently, he had stretched out, and all that could be seen from the outside was this diagonal ridge that ran from my right rib border down to my left hip. I picture him in there, stretched out, arms over head, just chillaxin'.
The doctor wanted me to start doing kick counts this week, twice a day. I understand the value of this, and so I have been complying. Everytime I go to count the kicks, I do as it says in the instructions. I get comfy in a quiet place, settle in on my left side, and wait. And within five to ten minutes, Zachary provides enough movement to satisfy the doctor for 2 whole hours. At first, I did exactly as I was told: I laid there and counted the kicks for 2 hours. One time there was 48,and another time there was 54. They tell you they look for at least 10 in 2 hours. So eventually I started stopping after he got to 20 or so. The whole point is to make sure he is okay in there. I assure you, he's fine.
What I'm worried about, however, is his sleep-wake cycle. I know this seems silly, but when E was born, the patterns he showed in his sleep were identical to the ones he had in utero. Awake all night, asleep all day. But Zachary? Zachary is awake all of the time. He kicks all of the time. All day, everyday. He even keeps me up at night with it. Don't get me wrong: I love his little kicks. It tells me he is okay in there. If I don't feel them, I start to feel this twinge of panic. But what is this baby going to be like when he is born? Either this kid is not going to sleep, or he is going to have restless leg syndrome.
Other than that, this week has been uneventful. No crazy contractions since Saturday. I will have a few here or there, but nothing consistent that would send us to the hospital. I am afraid to admit this, but I think being grounded from work has done the trick. I won't be seeing my doctor this week, but I am sort of afraid. I was planning on trying to get them to allow me to return to work on a reduced schedule. The financial picture in this house is getting pretty ugly. And they could take my lack of contractions as a sign that I can, or they can take it as evidence that I really do need to be on bedrest. It could go either way. Not to mention, I will be seeing the only doctor in the practice I have yet to meet at my next appointment. They want us to meet all of them so we will see a familiar face when it comes time to deliver, in the event that someone new is on call. The only exception is for the women who are to have repeat c-sections. I was in that group, so got to pick the doctor I saw each time, as we knew who would be delivering me. But then my uterus had to go and get all dysfunctional, and I got placed in their high-risk group of patients, and now I have to rotate. Oh well. I have my favorites in the practice, the ones I click with better than the others, but they are all wonderful.
The only other thing I have to mention right now is that J noticed a trend this past weekend that may be the answer to my problems. When the contractions get to be at their worst, it is always at the end of the week. I just thought it was bad luck: weekends, doctors not in the office, etc. But he reminded me that I get my progesterone injections early in the week. When I start contracting like crazy, it is closer to the day I am due for the next shot. Hmmmmm.
Wednesday, March 10, 2010
Watch "Born Too Soon"
Stumbled across this link this morning. How interesting that in my last post, I was just talking about the risk of delivering a 34-weeker. This documentary gives lengthy mention to late-preterm delivery.
This is taken from KET. Some interesting information is discussed on prematurity and social ills, smoking in pregnancy, and more. On an interesting note, the hospital where I delivered E is highlighted.
(Image Credit goes to KET and their wbsite. It isn't mine.)
26 Wks, 1 Day: Perfect?
On Monday, I had my 26-week appointment. Other than losing 12 pounds last month, the pregnancy got a perfect bill of health: perfect blood pressure, perfect 3-hour glucose tolereance test results, perfect little heartbeat, perfect height of fundus. Perfect, other than the contractions and preterm labor that plague me.
By some pregnancy books, have started the last trimester and by others, it will not start until 2 weeks from now, at the 28-week mark. But either way, wow!!! At times, it seems like this pregnancy has lasted forever. At other times, it seems like the time has flown. And other than being on bedrest and having the preterm labor issues, I feel great. My body has adapted to the brethine pump, so I no longer feel the insane tachycardia and jitteriness that goes with it, even after they increased my dosages this past weekend. I'm not nauseated, don't have crazy heartburn, am not as sore as I was in the first trimester. Other than some pain in my left hip, which is sure to be nothing more than pregnancy-induced sciatica, and Zachary's wonderful kicks and punches, I wouldn't even tell you I feel pregnant. I do feel fat, but I have this great baby belly. With E, I just looked horribly obese, to the point that people couldn't even tell I was pregnant. But this time? Ummmm......not the case.
I am starting to get a little apprehensive about the delivery. My doctors tell me they are going to stop everything at 34 weeks, which is when I had E. I am having a repeat c-section and am not even given the option of a VBAC, but they won't even schedule it. One of the joys of having a scheduled c-section is that you know, without a doubt, when your child will be born. You literally get to pick their birthday. But they know that as soon as the brethine pump and progesterone shots are stopped, I am going to go into labor on my own, making any attempt at planning null and void. And I know that, after the prenatal care I have had, the close watch they have kept on Zachary, the steroids, and more, that they will deliver him then. But do I want them to?
This brings up a question of how truly lucky were we with E? I have learned in my line of work that a 34-week preemie can be perfectly healthy or they can have problems. It can go either way. E was perfect: over 6 pounds, which is big for a 34-weeker, but still small. I'm not sure, but even if he would have been full-term, he may not have even been considered low-birth-weight at that weight. He may have tottered on the edge of that line, but I don't think he crossed it. I remember him as baby: he was pefect. Petite features, pefectly proportioned. He was a little on the long side for his gestational age, making him even skinnier as his 6 pounds was distributed over more body length. And I didn't see him immediately after delivery, but I know he didn't even need suctioning, which is so commonly needed for c-section babies, as the trip through the birth canal doesn't occur to squeeze the fluid from the little airway. My mother-in-law was there, taking pictures of him, and I remember her telling me that he cried and screamed when someone would pick him up, but as soon as they laid him in warmer, he would be quiet and still and just look around, as if to say "leave me alone, people, and let me check out my new world". When I was finally taken to the recovery room, and got to hold him, he was perfectly quiet and still, laying there wrapped in his little bundle, on my chest. The only negative thought I could have about his birth is that he couldn't latch on, making our attempt at nursing in recovery awkward and leading to bottle feeding instead of breastfeeding as I had intended. That had as much to do with me as it did with him. Neither of us were in it at the time.
So back to Zachary: If I let them deliver him at 34 weeks from horrific contactions that aren't producing cervical changes, am I taking too big a risk? Because delivery at that stage would be for me, not him. And doctors can tell me what they think the odds are, but even if I were to deliver at a perfect 40-week mark, no one can guaruntee a healthy baby. In this cruel world, babies that seem perfectly healthy in utero can emerge with anomalies no one could have predicted. I am saying all of this now, but at 26 weeks, I can already tell that the contractions are getting more frequent, are harder to make go away, and are more and more painful with each passing week. How bad will they be at 34 weeks? How much will I be able to take? Is the gamble too great a risk?
By some pregnancy books, have started the last trimester and by others, it will not start until 2 weeks from now, at the 28-week mark. But either way, wow!!! At times, it seems like this pregnancy has lasted forever. At other times, it seems like the time has flown. And other than being on bedrest and having the preterm labor issues, I feel great. My body has adapted to the brethine pump, so I no longer feel the insane tachycardia and jitteriness that goes with it, even after they increased my dosages this past weekend. I'm not nauseated, don't have crazy heartburn, am not as sore as I was in the first trimester. Other than some pain in my left hip, which is sure to be nothing more than pregnancy-induced sciatica, and Zachary's wonderful kicks and punches, I wouldn't even tell you I feel pregnant. I do feel fat, but I have this great baby belly. With E, I just looked horribly obese, to the point that people couldn't even tell I was pregnant. But this time? Ummmm......not the case.
I am starting to get a little apprehensive about the delivery. My doctors tell me they are going to stop everything at 34 weeks, which is when I had E. I am having a repeat c-section and am not even given the option of a VBAC, but they won't even schedule it. One of the joys of having a scheduled c-section is that you know, without a doubt, when your child will be born. You literally get to pick their birthday. But they know that as soon as the brethine pump and progesterone shots are stopped, I am going to go into labor on my own, making any attempt at planning null and void. And I know that, after the prenatal care I have had, the close watch they have kept on Zachary, the steroids, and more, that they will deliver him then. But do I want them to?
This brings up a question of how truly lucky were we with E? I have learned in my line of work that a 34-week preemie can be perfectly healthy or they can have problems. It can go either way. E was perfect: over 6 pounds, which is big for a 34-weeker, but still small. I'm not sure, but even if he would have been full-term, he may not have even been considered low-birth-weight at that weight. He may have tottered on the edge of that line, but I don't think he crossed it. I remember him as baby: he was pefect. Petite features, pefectly proportioned. He was a little on the long side for his gestational age, making him even skinnier as his 6 pounds was distributed over more body length. And I didn't see him immediately after delivery, but I know he didn't even need suctioning, which is so commonly needed for c-section babies, as the trip through the birth canal doesn't occur to squeeze the fluid from the little airway. My mother-in-law was there, taking pictures of him, and I remember her telling me that he cried and screamed when someone would pick him up, but as soon as they laid him in warmer, he would be quiet and still and just look around, as if to say "leave me alone, people, and let me check out my new world". When I was finally taken to the recovery room, and got to hold him, he was perfectly quiet and still, laying there wrapped in his little bundle, on my chest. The only negative thought I could have about his birth is that he couldn't latch on, making our attempt at nursing in recovery awkward and leading to bottle feeding instead of breastfeeding as I had intended. That had as much to do with me as it did with him. Neither of us were in it at the time.
So back to Zachary: If I let them deliver him at 34 weeks from horrific contactions that aren't producing cervical changes, am I taking too big a risk? Because delivery at that stage would be for me, not him. And doctors can tell me what they think the odds are, but even if I were to deliver at a perfect 40-week mark, no one can guaruntee a healthy baby. In this cruel world, babies that seem perfectly healthy in utero can emerge with anomalies no one could have predicted. I am saying all of this now, but at 26 weeks, I can already tell that the contractions are getting more frequent, are harder to make go away, and are more and more painful with each passing week. How bad will they be at 34 weeks? How much will I be able to take? Is the gamble too great a risk?
Sunday, March 7, 2010
25 wks, 5 days: Same Stuff, Different Day
I wake up early Saturday morning, and the house is still quiet with sleep. But my body is not. I am contracting like crazy. They came back sometime in the middle of the night after that dreaded trip to Wal-Mart. So I put myself back on the monitor and record them. I really want to push the little button on my pump that will deliver a brethine bolus, but the nurses at the company that manages it have warned me not to do this without them telling me to do so. They keep track, it would seem, and more boluses means I use more of the medicine, which is shipped to my house in pre-determined quantities.
My unscientific timing had the contractions at about every 3 minutes or so until 8 AM, which is when the pump delivers an automatic bolus, and when they call back, the nurse tells me that the monitor picked up 8 contractions in the first half hour, and that they seemed to slow down after that. She tells me the usual, to drink plenty of fluid, to bolus myself, and to run another strip about 20 minutes or so after the bolus has been delivered.
I do as I am told, and run another strip. The nurse calls back, and can hear the tears in my voice through the phone. She is genuinely worried and I have had 20 contractions in that last hour. She asks me how I am feeling, and with my mental filter no longer in place, I am brutally honest: "Like shit", I say. Not "I feel terrible" or any other combo of words I would normally use when speaking to someone in a professional capacity. I am beyond caring about that at this point. She tells me she is going to call my doctor, and I wait.
Dr. D is on call. She is the one who almost sent me to OB Mecca at 21 weeks. When I finally talk to her, I remind her that I just left OB Mecca on last week, and plead with her not to send me back to that place. Se gives me her cell number so I no longer have to go through the paging service to reach her for the day, and gives me some instructions: take 3 tylenol, drink a ton of water, and lay on my left side. Then she wants me to call her on her cell in half an hour. She also tells me that until I reach 32 weeks, if I have to go to the hospital, it will be OB Mecca, and she knows how I feel about it, so she is trying to avoid it. I tell her I will do anything, even standing on my head if I have to. I am ovewhelmed with gratitude at this point. Most doctors would argue that I have to go. Instead, my team of doctors really does listen to me, and tries to keep my feelings in mind. They send me when I need to go, and will not hesitate when it is necessary. But instead of making me rush off to the hospital each and every time, they take me into consideration. After all, I have been hospitalized 5 times since January 29th. If I ran everytime I had these contractions, I would have been at the hospital every day.
So for a few hours, I am in constant contact with both my doctor and the nurse at the monitoring center. Through rest and boluses, the contractions start to spread out, and I am relieved. The nurse wants me to reprogram my pump with her over the phone. My dosage for my continuous infusion is increased, as is for my automatic boluses and the demand boluses, and they move those to every 3 hours instead of every 4 hours. By the time all this is done, the contractions have spread even further: 8 minutes apart. My doctor is pleased with this,and tells me to not hesitate to call her cell for the rest of the day if needed. She also tells me "no more going to Wal-Mart". And that she will assume that if she does not hear from me, that all is okay. And she also says the dreaded word: Bedrest. What I have been trying to avoid from the minute I discovered myself to be pregnant.
So with that, I have avoided hospitalization yet again.
My unscientific timing had the contractions at about every 3 minutes or so until 8 AM, which is when the pump delivers an automatic bolus, and when they call back, the nurse tells me that the monitor picked up 8 contractions in the first half hour, and that they seemed to slow down after that. She tells me the usual, to drink plenty of fluid, to bolus myself, and to run another strip about 20 minutes or so after the bolus has been delivered.
I do as I am told, and run another strip. The nurse calls back, and can hear the tears in my voice through the phone. She is genuinely worried and I have had 20 contractions in that last hour. She asks me how I am feeling, and with my mental filter no longer in place, I am brutally honest: "Like shit", I say. Not "I feel terrible" or any other combo of words I would normally use when speaking to someone in a professional capacity. I am beyond caring about that at this point. She tells me she is going to call my doctor, and I wait.
Dr. D is on call. She is the one who almost sent me to OB Mecca at 21 weeks. When I finally talk to her, I remind her that I just left OB Mecca on last week, and plead with her not to send me back to that place. Se gives me her cell number so I no longer have to go through the paging service to reach her for the day, and gives me some instructions: take 3 tylenol, drink a ton of water, and lay on my left side. Then she wants me to call her on her cell in half an hour. She also tells me that until I reach 32 weeks, if I have to go to the hospital, it will be OB Mecca, and she knows how I feel about it, so she is trying to avoid it. I tell her I will do anything, even standing on my head if I have to. I am ovewhelmed with gratitude at this point. Most doctors would argue that I have to go. Instead, my team of doctors really does listen to me, and tries to keep my feelings in mind. They send me when I need to go, and will not hesitate when it is necessary. But instead of making me rush off to the hospital each and every time, they take me into consideration. After all, I have been hospitalized 5 times since January 29th. If I ran everytime I had these contractions, I would have been at the hospital every day.
So for a few hours, I am in constant contact with both my doctor and the nurse at the monitoring center. Through rest and boluses, the contractions start to spread out, and I am relieved. The nurse wants me to reprogram my pump with her over the phone. My dosage for my continuous infusion is increased, as is for my automatic boluses and the demand boluses, and they move those to every 3 hours instead of every 4 hours. By the time all this is done, the contractions have spread even further: 8 minutes apart. My doctor is pleased with this,and tells me to not hesitate to call her cell for the rest of the day if needed. She also tells me "no more going to Wal-Mart". And that she will assume that if she does not hear from me, that all is okay. And she also says the dreaded word: Bedrest. What I have been trying to avoid from the minute I discovered myself to be pregnant.
So with that, I have avoided hospitalization yet again.
Saturday, March 6, 2010
25 Wks, 4 days: Did a Trip To Wally World End Life as I Know It?
We had to go. We needed some groceries, and while I am to "rest" while off of work, I am not on bedrest. My doctors say there is no real proof it does anything in preterm labor cases, anyhow.
So we go to Wal-Mart. I loathe Wal-Mart, especially on a Friday afternoon. Too many people, all in a hurry. And rudeness. They cut you off with their shopping carts, try to run you over. I have a hard time, because I am having some mild contractions, so I am trying to stay out of the way of the crazy shoppers because I have to go so....slow. J tries to get me to use one of the motorized whelchairs, and I refuse to do this. We get what we need and try to get out of there. The lines are enormous, and by this time, I am really hurting. There is a lady at the front of our line with 2 carts, both overflowing. After the slow cashier gets all of it rang up, she proceeds to hand her a stack of coupons. Several of them don't scan, and there is is one for 25 cents that the cashier tells her they cannot take. She argues. I am just about to give the woman a quarter so she will let the cashier finish and get the line moving, when the cashier concedes. Then the woman pays with her food stamp card, which the machine doesn't want to take, and another battle ensues. J looks at me and tells me to go to the car and wait. I do, but then wait for J in the car for another 40 minutes, as that is how long he had to wait.
Sitting in the car, the contractions get worse. I am sitting there, waiting on J, thinking I am just about to deliver this kid in my car when J finally emerges. And we come straight home, where E, bless his little heart, puts away the groceries for me as his daddy unpacks them from the car. So I am free to strap myself to my monitor and send a strip to the monitoring people. They call back in 10 minutes to tell me what I already knew: I had 15 contractions in that one hour.
Through boluses from the brethine pump, they get the contractions slowed down to a quiet roar, and I am permitted to stay home for the night. But by this point, I am really scared. This was me trying to go to the grocery store. I haven't worked since being discharged from OB Mecca. What is going to happen when I try to work the next night?
So we go to Wal-Mart. I loathe Wal-Mart, especially on a Friday afternoon. Too many people, all in a hurry. And rudeness. They cut you off with their shopping carts, try to run you over. I have a hard time, because I am having some mild contractions, so I am trying to stay out of the way of the crazy shoppers because I have to go so....slow. J tries to get me to use one of the motorized whelchairs, and I refuse to do this. We get what we need and try to get out of there. The lines are enormous, and by this time, I am really hurting. There is a lady at the front of our line with 2 carts, both overflowing. After the slow cashier gets all of it rang up, she proceeds to hand her a stack of coupons. Several of them don't scan, and there is is one for 25 cents that the cashier tells her they cannot take. She argues. I am just about to give the woman a quarter so she will let the cashier finish and get the line moving, when the cashier concedes. Then the woman pays with her food stamp card, which the machine doesn't want to take, and another battle ensues. J looks at me and tells me to go to the car and wait. I do, but then wait for J in the car for another 40 minutes, as that is how long he had to wait.
Sitting in the car, the contractions get worse. I am sitting there, waiting on J, thinking I am just about to deliver this kid in my car when J finally emerges. And we come straight home, where E, bless his little heart, puts away the groceries for me as his daddy unpacks them from the car. So I am free to strap myself to my monitor and send a strip to the monitoring people. They call back in 10 minutes to tell me what I already knew: I had 15 contractions in that one hour.
Through boluses from the brethine pump, they get the contractions slowed down to a quiet roar, and I am permitted to stay home for the night. But by this point, I am really scared. This was me trying to go to the grocery store. I haven't worked since being discharged from OB Mecca. What is going to happen when I try to work the next night?
Wednesday, March 3, 2010
About Mag Sulfate vs. Other Tocolytics
http://www.medindia.net/news/Preterm-Labor-Drug-Causes-More-Side-Effects-22808-2.htm
24 wks, 5 Days: OB Mecca or OB Hell???
An ambulance takes me into Cincinnati to OB Mecca. A registered nurse has to go with me because of the mag sulfate drip. The EMT and paramedic look really nervous when they hear I am contracting every 2 minutes on the mag. They plead with me not to deliver the baby in the ambulance. "We don't want to do that today", they joke. I tell thm I am registered respiratory therapist and have resuscitated babies of this gestational age, that I will not let them deliver my baby in the ambulance. At any cost. The whole experience is kind of surreal. It is about 8 am, and we are driving through Clifton. I know that drive. I take it all of the time to get to my morning pre-med classes at the University of Cincinnati. I know it is wrought with idiot drivers, juggling their coffee and cell phones while trying to navigate traffic. And I am the worst control freak/ backseat driver. But yet here I am, strapped to a stretcher, watching traffic through the tiny windows in the back doors of the ambulance.
We get to OB Mecca, and J is already there. I had called him from my hospital room as the transport team was walking in the door to get me, and wonder first how he beat me there, followed immediately by the question of whether or not he wrecked my car in his rush to get here. I had told him not to rush, that I was fine. But it is J. I've learned not to question anything in our 9 years of marriage.
The OB Mecca staff puts me in their triage, which is the first chance I get to be pissed off. I am on mag, uncomfortable, have been awake all night, and have been sent by a very reputable physician. Why triage? Why not my room, with a bed instead of a stretcher? They won't let J back as they ask me admission questions they have to ask everyone. No, I do not have any sexually transmitted diseases. No, I do not feel I am at risk for them. No, my husband doesn't beat me. In fact, I tell the nurse, if he tried, I could take him. I know they are just doing their jobs, but I am frustrated and tired and miserable. I try to be nice. What is more likely is that my attempt is coming out as a dry, sarcastic version of myself that emerges when I have had it. My mental filter is no longer in place. But it doesn't matter. When J finally comes back to the room that is the size of Harry Potter's broom closet under the stairs, I hear the nurse tell him that his wife is hilarious. At least she likes me.
After changing all of the tubing, a resident comes in. I know it is a teaching facility. All of the OBs in the practice I go to did their residencies here. I expected it. And I am all for being a learning experience for residents. I work with residents. I also let them prescribe my family mmbers antibiotics for strep throat, or manage my asthma. But this? With my OB history? I don't really like being a learning experience in this situation. Anyhow, she does a pelvic exam that feels more like she is trying to extract tonsils from the wrong end of my body, does her little swabby thing to make sure there are no creepy-crawlies in my nether regions, as they do with everyone, and I am on my way to my room finally.
This is when all hell breaks loose. Once I get in my bed, it all hits me, and I am upset. Becuase of the visiting policies at all area hospitals due to H1N1 fears, J won't be able to visit because he will have E with him. E can't visit me. My baby boy will be absent so long as they see fit to keep me here. And by default, J will be also. He has class during the day, and E with him at night.I am going to be alone. Plus all of the smiling faces of my coworkers have been removed from this scene. I don't get the "she's one of us" perk package. This seems silly, but this is what opens the flood gates. And I cry. I cannot stop crying, as a matter of fact, which made what followed all the more worse.
They started asking questions. Why am I on a brethine pump? Why the mag? I'm not dilating so it is false labor. But how can I continue in a pregnancy contracting every 2-3 minutes? At what point do we try to stop them? If the are waiting fo me to dialte, it won't happen. I just don't. I try to explain.
Then there are the contradictions. They will stop the mag drip as soon as I am back on my brethine pump, which had been stopped for the ordeal. But wait! Just a minute ago, I didn't need it. What the hell? Through the course of 2 days, they treat me like crap. Thay act as if my team of OB's in Northern Kentucky know nothing, when in truth, they all completed their residencies there. They act as if the people at my place of business are incompetent, which I take as a personal affront. I am not a NICU therapist, but I am also not an idiot and work for an excellent, award-winning hospital.
The entire experience leaves a bad taste in my mouth. They ended up letting me leave the next morning. I got the home health company to reprogram the brethine pump (that I don't need) so they would stop the mag drip,and I was out of there. I never want to go back, but I know I will eventually end up there again. I have about 8 or 9 weeks to go before I can safely deliver Zachary. And I know that it is the best place for a preemie in this area, barring a local children's hospital. But at the children's hospital, I would not be in the same place as the baby, so it is not as desirable a choice.
We get to OB Mecca, and J is already there. I had called him from my hospital room as the transport team was walking in the door to get me, and wonder first how he beat me there, followed immediately by the question of whether or not he wrecked my car in his rush to get here. I had told him not to rush, that I was fine. But it is J. I've learned not to question anything in our 9 years of marriage.
The OB Mecca staff puts me in their triage, which is the first chance I get to be pissed off. I am on mag, uncomfortable, have been awake all night, and have been sent by a very reputable physician. Why triage? Why not my room, with a bed instead of a stretcher? They won't let J back as they ask me admission questions they have to ask everyone. No, I do not have any sexually transmitted diseases. No, I do not feel I am at risk for them. No, my husband doesn't beat me. In fact, I tell the nurse, if he tried, I could take him. I know they are just doing their jobs, but I am frustrated and tired and miserable. I try to be nice. What is more likely is that my attempt is coming out as a dry, sarcastic version of myself that emerges when I have had it. My mental filter is no longer in place. But it doesn't matter. When J finally comes back to the room that is the size of Harry Potter's broom closet under the stairs, I hear the nurse tell him that his wife is hilarious. At least she likes me.
After changing all of the tubing, a resident comes in. I know it is a teaching facility. All of the OBs in the practice I go to did their residencies here. I expected it. And I am all for being a learning experience for residents. I work with residents. I also let them prescribe my family mmbers antibiotics for strep throat, or manage my asthma. But this? With my OB history? I don't really like being a learning experience in this situation. Anyhow, she does a pelvic exam that feels more like she is trying to extract tonsils from the wrong end of my body, does her little swabby thing to make sure there are no creepy-crawlies in my nether regions, as they do with everyone, and I am on my way to my room finally.
This is when all hell breaks loose. Once I get in my bed, it all hits me, and I am upset. Becuase of the visiting policies at all area hospitals due to H1N1 fears, J won't be able to visit because he will have E with him. E can't visit me. My baby boy will be absent so long as they see fit to keep me here. And by default, J will be also. He has class during the day, and E with him at night.I am going to be alone. Plus all of the smiling faces of my coworkers have been removed from this scene. I don't get the "she's one of us" perk package. This seems silly, but this is what opens the flood gates. And I cry. I cannot stop crying, as a matter of fact, which made what followed all the more worse.
They started asking questions. Why am I on a brethine pump? Why the mag? I'm not dilating so it is false labor. But how can I continue in a pregnancy contracting every 2-3 minutes? At what point do we try to stop them? If the are waiting fo me to dialte, it won't happen. I just don't. I try to explain.
Then there are the contradictions. They will stop the mag drip as soon as I am back on my brethine pump, which had been stopped for the ordeal. But wait! Just a minute ago, I didn't need it. What the hell? Through the course of 2 days, they treat me like crap. Thay act as if my team of OB's in Northern Kentucky know nothing, when in truth, they all completed their residencies there. They act as if the people at my place of business are incompetent, which I take as a personal affront. I am not a NICU therapist, but I am also not an idiot and work for an excellent, award-winning hospital.
The entire experience leaves a bad taste in my mouth. They ended up letting me leave the next morning. I got the home health company to reprogram the brethine pump (that I don't need) so they would stop the mag drip,and I was out of there. I never want to go back, but I know I will eventually end up there again. I have about 8 or 9 weeks to go before I can safely deliver Zachary. And I know that it is the best place for a preemie in this area, barring a local children's hospital. But at the children's hospital, I would not be in the same place as the baby, so it is not as desirable a choice.
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.
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