33 Wks, 1 Day: Relief

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.

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.

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.

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.

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.

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.

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...

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!

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.

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?

25 wks, 1 day, still: A New One at the Call Center?

Ha! Hahaha!

I have to run at least one strip on my home monitor once a day, no matter how I am feeling. By now, I am sure they know when I am having a good day, because my strip is usually transmitted in the evening. More like an afterthought to a good day. As in "Oh, I haven't contracted like crazy today and they are probably wondering where I am...."

Tonight was one of those nights. J and I worked together in the kitchen to cook some penne, then the three of us stuffed our faces to the point that I felt like I had no room to breathe between Zachary's delicious little squirms and kicks, and my full-to-bursting stomach. Then I strapped myself to the monitor as I lay on the sofa, waiting anxiously for the long beeeeeeeep that tells me the hour is up. So I could move, and find a better position for breathing. (Note to self: stop eating so much when it makes you feel so miserable!)

So J transmits the recording for me while I get comfy, and the nurse from the call center telephones to let me know she has reviewed the strip. She seems alarmed that I had 2 moderate contractions. That's all. 2. I giggle at this and explain that 2 in an hour is wonderful for me, and serves as further proof that it has indeed been a good day. And I joke that as long as they aren't more numerous and coming every 2 to 3 minutes, we are good. I don't think she knows how to take me. She keeps asking if I feel okay, and seems puzzled when I tell her I feel great. I decide that she must be new. Or she hasn't seen one of my strips or heard of me before.

J and I get a good laugh out of this. We probably shouldn't. It really isn't funny. But we have to find some humor in it. In the crazy rollercoaster ride. If not, we will go insane.

24 wks, 1 day/ 2 days: Unrelenting

So on this day, I go back to work, and am assigned an ICU at the hospital. This has to be the favorite part of my job, as I get to really use my brain, to an extent. And this is the first time since all of these complications have started that I have had such an assignment. But an ICU assignment can either be easy or hard, and there is no way to tell from one day to the next which it is going to be. This one started easy. It didn't finish that way. I started with 3 ventilator patients and ended my shift with 9. The night was full of patient transports and receiving full arrests from other facilities and other areas of the hospital. I really gave the brethine pump a run for it's money. By about 4 AM, my belly felt so tight I could barely stand it. I couldn't feel any distinct contractions, just tightness and pain. So one of OB RN friends runs into me in the hall, and tells me how crappy I look. Somehow, I ended up on a monitor just to see, and was contracting every 3 minutes. Gah!

The contractions weren't the biggest issue though. My phone started ringing off the hook. This patient had blood coming out of his endotracheal tube. Another patient needed to go for a stat head CT. And they were relying on me. I could have put my foot down and called one of my coworkers to do it, but I couldn't bring myself to do it. After all, my problems are not their problems. I am so tired of feeling like a nuisance, like a non-contributory party. And no one has said anything to me to make me feel this way. I do on my own. I am so used to being independent that have a hard time asking for help that is not offered. Yeah, I talk a good game. I know that the baby comes first and all, but I cannot just suck it up when push comes to shove. In the end, it made for a very exhausting night at work, both physically and emotionally.

The night did have a slight silver lining, however, when I returned home contracting every 3 minutes. Through the home monitor and the brethine pump, and several phone calls between myself and a home health nurse, I was able to get everything stopped without having to go back to the hospital. She would have me run a strip, then call and have me give myself a bolus, then repeat. We did this until the contractions were completely stopped! Sweet!

23 wks, 5 days: The Brethine Pump and Star Trek Crap

So I see my doctor on the Monday morning that is to mark the 23rd week of pregnancy. And he is starting me on the brethine pump. I am a little nervous about this. The brethine I have been taking by mouth has at times had me having such bad palpitations that I have to focus on my breathing, feeling short of breath from the tachycardia. He, on the other hand, doesn't seem nervous at all, but rather excited by the idea. He is sure this is going to solve my problem. Whether or not he is truly happy about it, or whether this is his way of keeping me upbeat remains to be seen. Whatever. I will try anything that has the slimmest chance of giving me a healthy, closer-to-term baby while leaving my life intact.

After a brief visit, I leave the office expecting a call from the home health company that is handling my P17 injections. And it comes about 2 hours later.

They tell me a courier will be bringing the medicine, and the nurse plans to be there by about 3:30 that afternoon. Sure enough, by about 3:00, these boxes start arriving at my home, via a courier who looks like a disgruntled grandpa, angry at having to trudge through the snow to deliver the packages. I am wondering how in blue hell my doctor pulled this off so quickly until I see the garish fluorescent-orange "STAT" labels on each box. A-ha! I know exactly how he did it now, and am picturing his nurse on the phone with the company, making it sound like delivery of this baby is imminent if they don't get the supplies here yesterday!

Shortly thereafter, my nurse is here, looking kind of frazzled too, and I start thinking I may be the rudest person of all: the massive snow we got last week is still accumulated on the front sidewalk, as we use the back door to come and go from the house. In my fight to keep working, I have to get J to do everything, and it is all I can do to get him to do the laundry and keep the three of us in clean undies and socks. The front sidewalk was not at the top of my list. I mentally take note to get him to handle it, while apologizing to the nurse, who is bringing even more boxes into the house. It really does stink not being able to do anything by myself, and having to rely on others, when I am truly used to handling everything.

So we get started. First is the home uterine monitoring. What? The huh???? I had no idea this was even coming, but apparently my doctor wanted it. So she shows me how to strap myself up to a monitor like they use in the hospital to track contractions. And explains that I am to do these recordings for one hour, twice a day. She plugs this huge contraption to the outlet by my kitchen table, extends this antenna, and plugs the monitor box into it. After a series of beeps and flashing lights, it says that data has been sent, and ten minutes later, someone from Columbus, Ohio calls my home to let me know they got it, and it looks great. I am utterly amazed. My amazement turns to the thought, "Wow, I am old!". While pregnant with E and having contractions, the only way to tell the doctor that they were truly contractions was to schlep to the hospital. It was such a pain. Now I can do this from home, and a team of OB nurses will interpret what is going on and call my doctor for me. Fancy Star Trek crap!

Next comes the dreaded brethine pump. I am really nervous now. I guess I had pictured trudging around my house with an IV pole. My doctor had tried to explain it to me, and said it would be more like a fanny pack attached to a little catheter. I remember him laughing when I sarcastically commented on how hot that would look with scrubs. But this is even better than what he explained. It's smaller than a cell phone, and goes in this pouch the size of a large wallet, which can either clip to my waist or fit in a largish pocket. Cool. And the needle is tiny, and not an IV or even intramuscular catheter, but rather a small subcutaneous one. It actually looks like a large thumbtack.

So the nurse is ready to show me how to insert the catheter to start delivery of the medicine, and this is when I start to kind of freak out. My profession has me driving needles into peoples' arteries (which I am quite good at, by the way) without the teensiest bit of squeamishness. But this? This little needle the size of a large thumbtack??? Going into me??? I can't do it. My heart is pounding and my respiratory rate goes through the roof as my hand hovers, frozen in space, above the prepped area of my upper thigh. I cannot do it, until she places her hand on mine and does it for me. And it doesn't hurt, and I feel reallyreallyreally silly. But there it is, attached to this thin blue tubing that snakes its way to the tiny pump. Viola! Continuous brethine infusion, with a bolus every four hours.

I cannot wait to see if it works. I will find out the next night when I return to work.

(Image Credit: Smiths Medical, not mine. )