Archive for February, 2010

No, Really!

Every nurse who has come on-shift since I was admitted on Wednesday has been shocked that I’m not eating. I mean, I get that it’s not normal, but there’s bound to be a notation in my chart somewhere that says “hyperemesis gravidarum” right? They give each other report at the start/end of each shift. And yet? Every nurse that’s come on shift has said, “You ate [dinner/breakfast/whatever], right?” Um, no. I haven’t had a tray in my room since I came in here (a couple of nurses have offered trays – so it’s not that I’m being neglected, it’s that I have no desire to have a tray of food in my room that I know I’ll never touch).

It’s not limited to the nurses, though. The OB on call came in today to assess me and let me know “the plan” – which is to keep me here at least until I get my 17-P injection tomorrow and a new PICC line (one of the lumens on my existing PICC line is completely obstructed and the medication they usually use to dissolve issues like that isn’t used in pregnant women). But she paused and asked where the terb pump was running – it’s subcutaneous. “Oh, well, you don’t need the PICC line then.” Um. Yes, yes I do. The Zofran pump runs through the PICC line and I can’t run that one subcutaneously even if I wanted to – because doses as high as I’m getting would tear up my skin if done sub-q. Oh, and there’s that hydration thing. “Well, you can’t take the Zofran ODTs? You need the pump at home, too?” Yes, I need the pump at home, too. I can’t keep the ODTs down. (Also, they don’t work as well as when the drug is continually infused). “Why do you need the fluids?” Because I can’t drink anything of substance? “Really? How long has this been going on?” Um. September. I get that she wasn’t my doctor back in September when this started, nor in October when I was hospitalized for dehydration due to hyperemesis gravidarum, nor when my first OR second PICC line were placed. But I still find it hard to believe that there’s NOTHING in my chart ANYWHERE that mentions that I’m hyperemetic. The doctor conceded that I do need to keep my PICC, so it’ll be replaced tomorrow.

Seriously – the nursing staff keeps very close tabs on my “I’s and O’s” (Ins and Outs). They know what I’m taking in. They know I’m not drinking. They *should* know I’m not eating (no food trays have come into or left my room since I’ve been here). And yet, they seem shocked when they hear that I haven’t eaten since before I was admitted. How do I make it more clear? I really hope I get to go home tomorrow. I’m growing weary of the hospital (a.k.a. the worst hotel EVER).

In other annoyances:

  • My skin is so dry that it’s becoming abraded. My knuckles are cracking. My legs are itchy. My lips are chapped and split. Apparently the air is very dry in hospitals – and more importantly, I’m not getting a lot of fluids, so my skin just can’t stay hydrated. This is annoying, but hopefully I won’t be here much longer. If I had to move in for the duration, though, I’d have to get a humidifier or something.
  • TMI Alert: One of the best things about getting OFF the magnesium sulfate is that they removed my catheter and let me resume “bedrest with bathroom privileges”. Except, it’s really a pain in the neck to get up to go to the restroom. I have to unplug the toco monitor (contraction monitor) and wrap the cord around my shoulders so it doesn’t drag. I have to untangle my Zofran and Terbutaline pumps. I have to undo the sequential compression stocking things. I have to unplug the IV Pump. And then I have to carry everything to the bathroom. Then I come back and I have to plug in the IV Pump, untangle the Zofran and Terb Pumps, and plug the toco monitor back in. And get myself back into bed, which is a much more difficult task than it sounds. I am ready to be home where it is less of a production just to get up and pee (mind you, even at home it’s a production, but at least there are SLIGHTLY fewer things to unplug).
  • I have the toco monitor on my belly 24/7 to monitor for contractions. It stays on with a softish belt that straps around me. It’s not tight, but it *is* against my skin 24/7 and now the skin on my belly is abraded from the constant contact. At least at home I’ll only have to have have the toco monitor on for an hour at a time (minimum of 2 times per day). That will definitely be an improvement.
  • Several times per day, they do NSTs (nonstress tests) – this means that in addition to the toco, they put a fetal heart rate monitor on also. This evening during one such NST, the baby’s heart rate decelerated with every contraction I was having. This is… not good. Fortunately, I’d just recently gotten Procardia, so the contractions went down shortly thereafter. Hopefully, this will not reoccur because I’m… not actually sure what all the implications of it recurring would be. I’m pretty sure it’s far too early for me to want to find that one out the hard way.

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I’ve been reading far too many online pregnant communities recently. I don’t know why I read them – I can nearly never relate to the posts. I don’t *have* normal pregnancies and no one else seems to understand my own experiences because I’m just not NORMAL. Here are some things I don’t get:

  • Posts that go like this: “My hips really hurt which is making it difficult for me to exercise. Can anyone give me any good at-home exercises that are safe for pregnancy?” I mean, admittedly, exercise isn’t the first thing that pops into my head when I’m thinking of my top 139 favorite things to do, so I probably wouldn’t relate to this one anyway, but I’ve never been ALLOWED to exercise while pregnant, there was never any question about what I could and couldn’t do – I just wasn’t allowed.
  • “I can’t eat a darned thing because I keep throwing up. Well, you know, except for how I finished my DH’s leftovers, bought a gallon of ice cream that’s now mysteriously gone(!), and, oh, right, I accidentally ate my daughter’s birthday cake before I gave it to her. But really, chicken is OUT!” I mean, sure I can relate to throwing up. Except, I can’t. It’s not a contest or anything, and I don’t wish vomiting during pregnancy on ANYONE because it’s not any fun at all. But “gosh it’s so annoying that I have to eat a saltine before I get out of bed in order to feel human” posts just… don’t resonate with me.
  • “I’m 1cm dilated! OMG am I in labor? I can’t be! I’m not due until next month! I have a baby shower next week, and a photo session lined up the week after that, and a pedicure appointment for the day before my due date. I just can’t go into labor now! I mean, also, I want the baby to stay in there and get fat and healthy, too, but think about my pretty toes!” I would have given anything to have this worry with my triplets. I did really well with the triplets and got them to 33 weeks (exactly average for triplets), but we always knew I wasn’t going to be a 36/37 weeker. I figured with this pregnancy at least I wouldn’t be laying in fear of going into labor at any second… except, here I am in the hospital for preterm labor and I’ve still got three months to go. I’ll gladly trade my (nonexistent) pedicure appointment for a couple more months.
  • My baby is 2 months old and I was thinking how nice it would be to have Irish twins. I think I’m ovulating, do you think I should have sex tonight and not tell my husband that I’m ovulating? I’m sure he’d flip out.” Any such post like this is completely alien to me, and I’m shocked at how many such posts there are. I mean, seriously. People PLAN these things? People have sex to get pregnant? I don’t understand.  (there are also the “I went for my annual exam and found out I’m 14 months pregnant” posts – which, you know, I also don’t get, but I figure so few people understand those posts that I’m not alone).

I know I’m being snarky, and I *do* know this isn’t about who’s got it harder. I’m not trying to say the trials and tribulations of pregnancy are always all sunshine and roses even without all the dramarama that I get to have fun with. I don’t think that women should have to love every minute of pregnancy – and I think it’s terrible that society seems to assume that women must enjoy pregnancy or they’re not good mothers. So it’s not that I don’t think the complaints I’ve posted above are legitimate. It’s just that I really can’t relate. Really.

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I’m not being discharged from the hospital just yet. Too much snow predicted (20-30 inches in our area) for anyone to feel comfortable sending me home with this many contractions. It’s the smart decision, if not the ideal. I agree with the decision even if it’s not what I would prefer. I’m off the mag sulfate, on a terbutaline pump, plus indocin and procardia to augment the tocolytic effect of the terb. Can’t stay on the Indocin long, though – so I’ll be off it tomorrow afternoon. Still have the Zofran pump and IV Phenergan. Still not eating/drinking. Still banging out contractions every few minutes, since coming off the mag. Mag’s evil, but I can’t say it doesn’t work, that’s for sure.

On the plus side, I’ve now met most of the doctors in my OB practice who deliver at this hospital, so I won’t deliver my (hopefully full-term) baby with a doctor I don’t know, in all likelihood. It won’t be long before I eclipse the total number of inpatient hospital days during pregnancy with this, my “easy” singleton pregnancy vs. my not-so-easy triplet pregnancy.

Everyone here has been pretty good to me, and the doctors have been on top of everything. I’m pleased with the level of care I’ve been getting, and I know I’m in good hands. I’m just… bored and about to go into shabbos with nothing to really read or do and no way to get anything to read or do b/c of the snow. Not the end of the world, but it *would* be nice if something would give.

Wish I weren’t so boring, but I truly can’t think of anything else useful to say. That’s pretty much all that’s going on so far.

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Pregnancy is Fun

I was admitted to the hospital yesterday with preterm contractions that failed to respond to PO or injectable tocolytics. There was some debate among the doctors regarding how to care for me since I had a negative fFN on Mnoday and wasn’t displaying cervical changes.

Still, no one wants this baby to be born 12-15 weeks early and my contractions were 3-4 minutes apart and pretty painful. SubQ Terbutaline didn’t help; Procardia didn’t help; more SubQ Terb didn’t help, so I got admitted. They kept trying the Procardia, which I miraculously kept down, but to no avail. Finally a third round of terbutaline was tried around 12:30am (1 injection every 20-30 minutes or so). The first two didn’t help, but the third injection worked like a charm.

I didn’t have any contractions from about 2:30a to 4:15am and actually managed to grab about an hour snooze – and then I woke up in agony – horrific contractions 1-2 minutes apart. Not fun. My nurse did a cervical check and noted that I had dilated a little bit and called the doctor. Which meant there was no escaping Magnesium Sulfate. I’ve had the mag running since about 5:30 and my blood pressure has gone down from a respectable 110/70 to 85/42. The rest of the side effects aren’t as much fun as that one.

Mag sucks, pure and simple, but if it keeps my little tenant from breaking its lease early, then I’ll take it.

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So my OB’s office called today.  My iron is low and they want me to take iron sulfate every day.

Of course they do.  But, um, hi?  I’m not tolerating anything PO right now – HOW exactly am I supposed to accomplish this?  Oh, they said.  Um, we’ll check with the doctor.

Well, I checked with the doctor (the PharmD that I’m married to) and he said ferrous sulfate is the hardest of all to tolerate, even without hyperemesis.   He recommended trying ferrous gluconate first and seeing if I can manage that, since I can often tolerate a single pill right after getting IV Phenergan.  We’ll just have to see how it goes, I guess.

Or, you know, just continue to be tired and stuff.  Which I would expect would be a given at this point.

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Bored Now

Dear Self:
While you might enjoy the quiet irony of how well the irritable uterus combines with my sunny disposition, I do not share in your enjoyment.  Please cut it the heck out.
No love,

So another visit to L&D today, but today I got to meet the day shift, which is oh so much more exciting!  Here’s the thing – when I left Sunday night/Monday morning last week, the discharge instructions said to call my doctor if I have more than 4-5 contractions per hour.  Um, except they discharged me with contractions coming 2-3 minutes apart.  Go ahead, do the math.  I’ll wait.

And so it’s quite difficult to imagine what my threshhold really ought to be under the circumstances, capisce?  Needless to say, I pretty much ignore contractions until they really start to get so painful it’s hard to concentrate.  I get my 17P injections Monday evenings and contractions aren’t terrible from then until … oh, Thursday or so.  By Friday, they aren’t any fun at all.  So I spent the weekend thinking, “well, I’ll call if it gets too much worse” but never really figuring there was any point in calling… since contracting is what I *do*.

So this morning I called the doctor’s office  – I just can’t see the point of waking up a doctor on the weekend for something that’s totally normal for me – and got an early appointment with a doctor I’d never met before.  He was very nice, and extremely ticked off that I hadn’t called sooner.  I told him I don’t like to be the girl who cries wolf when, hello?  This is NORMAL for me.  “No, this is not normal,” he said.  “You’re not far enough along to have the luxury of calling this normal.  We’d rather you call and wake us up than wait until 7 or 8 in the morning and tell us it’s been going on all night.”  He found the heartbeat, pronounced it okay, and sent me to L&D.

Hooked up to monitors and… hello there contractions, my old friends… how have you been?  Contractions every 2-3 minutes.  Negative fFN again (good news).  Three shots of terbutaline and my contractions became less severe and slowed down… to about every 3-4 minutes.  The doctor wasn’t a big fan of sending me home with that many contractions, but she let me on account of the negative fFN.  With a reminder that I should *call* when I’m having contractions.  I told the L&D nurse that we’d be well acquainted by the time this baby enters the world.

And when is that?  Not soon enough.  I’m due in May, but don’t ask me when in May and don’t ask me how far along I am.  I’m not going to tell you.  It’s my own neurosis about it – when I start thinking too hard about the numbers, I get severely stressed out, something I can definitely do without right now.

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