Archive for March 23rd, 2010

Just Layin’ Around…

So here’s a hypthetical for you: Suppose you told a healthy, non-pregnant woman (or man for that matter) that she may not get out of bed for four months with the exception of trips to the bathroom and doctor’s appointments. Would she think of that four months as being a mini spa vacation? I think not. And would her friends say “oh how relaxing this must be!”? Unlikely. Now, take a pregnant woman and tell her to lay in bed for four months, and only to get up to use the bathroom and go to doctor’s appointments. Try adding in constant, painful contractions, frequent vomiting, and pervasive nausea. And what do her friends say to her? “Oh how relaxing that must be!” or “Enjoy it while you can!” or “it must be so nice not to have to go to work/class/the preschool fundraiser/whatever.” I’m really not joking.

So I received an email from a friend that went something like this: “As you know, enjoy the bed rest since once the baby arrives – it will be a long time before you’ll be able to ‘just lay around!'”

Honestly, it took me a good long time to respond to that email.  I know, with absolute certainty, that the email was intended to be supportive.  I know, with absolute certainty, that the author expected the email to be a comfort.  I also know, with absolute certainty, that the author simply had nothing better to say.

So let me dispel some myths for any of you who have never been on doctor-imposed bed rest.  First, let’s not lose sight of the fact that I have four children who all have very specific needs.  They are not, at this point anyway, low maintenance children.  Bed rest or not, there’s very little “just laying around” that happens in my house.  Even if I’m not up and chasing them (not to say I haven’t done my fair share of that), I’m inundated with other things that I have to do.  I have to ensure I’ve got coverage for them, coverage for Julian, coverage for getting the house together for Pesach, etc.  I have to do contraction monitoring a minimum of twice per day (for an hour each), and often upwards of 4-5 hours per day.    I have to make sure I’m getting my IV fluids and medications on schedule.  I have to spend countless hours on the phone with insurance companies because coverage that should be straightforward isn’t (and I doubt the latest healthcare reform bill will help that a bit) and I still have to go to the doctor twice a week.   Never mind that we’re in crunch time to figure out Julian’s school status for next year, etc.  

And none of that is accounting for the fact that I feel like hell.  I haven’t kept down a substantive amount of food or fluids since September.  I’m constantly nauseated and often throwing up, whether I’ve eaten or not.  I have reflux so badly that I’m literally waking up choking on stomach acid some nights.  I have gestational diabetes and insulin shots to deal with to help regulate that (plus 4-5 times per day of  checking my blood sugar) – and frankly, my screwed up blood sugars leave me feeling even crappier than before.  I have constant headaches since I can’t take my preventive medications.  And I’m flat out exhausted (it’s hard work growing a whole human).  Mostly?  I feel like hell.    This is hardly a time to “enjoy” myself.  Bed rest is not “restful” and it’s not pleasant.  It sucks.

Oh and then there’s the emotional side of all of this.  Let’s not forget that the whole reason I’m ON bed rest is for preterm labor – so staying on bed rest is, in theory, to help me keep this baby in.  There’s a tremendous guilt-factor if I don’t manage to keep this baby in through some failure to comply with bed rest.  Yes, I say I want this kid out NOW – but we all know that I’m fully aware of the need to keep this baby cooking for another month or two.    The last thing I want is a month-long NICU stay for this baby.  Especially since I’m not delivering at the hospital five minutes from my house, but instead delivering at the one that’s 20-40 minutes away (longer during rush hour, of course).  

Finally – it’s not like it’s possible to store up on rest and sleep.  Sleeping 12 hours a day now won’t make it any easier to get through the sleepless nights that are the hallmark of life with a newborn.  Of course, at least this time, it’s ONE newborn, not three, but it’s still going to be a while before we’re sleeping through the night once this baby comes home, and no amount of sleep now will make that easier later.

I did get myself into this mess.  And I did ask for this (well, I asked for a viable pregnancy, not a complicated viable pregnancy).  But that doesn’t make this any more fun.   No one coul have predicted the rollercoaster that this pregnancy has been for our family, that’s for sure.  I am grateful to be pregnant.  I will be grateful to meet this child (preferably not for another couple months).  But that doesn’t mean I have to enjoy the pregnancy itself.

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Back in the Slammer

I probably should have posted this earlier, but I’ve really been too out of it to write a coherent post.  So better late than never.

If you’re my friend on Facebook, you probably know that I was admitted to the hospital Saturday night.  If you’re not my friend on Facebook – why not??  Anyway, all day Saturday I was having contractions that the terbutaline wasn’t stopping, even with multiple boluses.  More alarmingly, there was a signifcant decrease in baby movement.  I felt 5 or 6 kicks in 2 1/2 hours.  I wasn’t freaked out about that – because as far as I’m concerned, if the baby was moving at all, that was a sign that the baby was still hanging out, even if the medical establishment would have preferred more movement than that (and no, I’m not late enough in the pregnancy that they start saying “well the baby doesn’t have much room to move anymore”).

Anywhozit, I came in and was contracting a lot (shocking).  An extra terbutaline bolus didn’t help.  So the doctor admitted me so he could put me on magnesium sulfate.  A “magnesium holiday” as they call it (whoever “they” is).  In theory what happened was that my body wasn’t responding well enough to the terbutaline anymore, so they pulled it and ran the magnesium instead (called a “mag holiday” or a “mag wash” … another friend said that’s a terrible name for it and it ought to be “antepartum purgatory” which I think comes a lot closer to the truth).  When I was admitted, I was banging out contractions every 2-3 minutes (that’s about 20 an hour, if you’re keeping count).  The mag cut me down to about 10/hour pretty quickly and then finally I had a couple hours yesterday afternoon where I only had a handful and I was able to sleep (blessed sleep!). 

The doctor came in mid-morning yesterday to talk to me and I was, at that point, not too loopy from the magnesium.  I was still pretty uncomfortable, but the contractions had slowed to about every 6-8 minutes, so it was looking good.  Still, I admit I’m completely miserable, and as horrific as it makes me feel to say it – I just want it over.  Of course I want this baby to cook as long as possible, but I also want my body back.  The nurses had called my doctor probably close to a dozen times between the time I was admitted and the time he came to see me mid-morning, including flurry of 3am phone calls to him to clarify orders, etc.  He walked in and I told him I had a deal for him.

Him:  “Oh, you’ve got a deal for ME?  Can’t wait to hear this one!”
Me:  “I won’t have you called at 3am anymore if you get this baby out NOW.”
Him:  “Oh, I don’t mind 3am phone calls.  My wife might have gotten a little annoyed, but it doesn’t bother me.”
Me:  “No, really, think about it!  A whole night’s sleep and all you have to do is GET THIS BABY OUT.  My offer is good for 24 hours – then no promises about quelling the 3am phone calls.”
Him:  “That’s okay.  I’m not on call after tomorrow morning.  I can take it.”
Me:  “Yes, but Dr. H is on call tomorrow – she’s way nicer than you!”
Him: “Yes she is.  You can take your chances with her.”

[for the record, Dr. H wouldn’t deliver me today either… oh well!  And yes, I was kidding.  Mostly.  Well, at least a little bit.]

He asked how I was feeling and I said “Have you ever been on mag?”  He admitted he had not but had talked to plenty of women who had been on it.  He told me I was taking it rather well.  He told me that usually they can get people off the mag within 48 hours.  “48 hours!!???”   “What?  You want me to turn it up?”  Oh hell no.  He did warn that if the contractions got any worse, they’d probably have to turn it up, but he was hopeful that they wouldn’t have to do so.

And that’s what I was hoping for.  Until suddenly I was banging them out every 2 minutes again.  I was in agony.  And unfortunately, that bought me a ticket to purgatory – a 50% increase in my mag dose.  If you’ve never experienced any of the joys of magnesium sulfate, there’s really no describing it, but I’ll do my best.

It starts out feeling as though you are literally on FIRE from the inside out.  Every vital sign check taunted me with ridiculous pronouncements that my body temperature was 98.4 (F) couldn’t possibly have been that low when I was certain I was 4,000 degrees (F).  Then the nausea/vomiting, which fortunately wasn’t a huge problem for me since I am already on high doses of Zofran and Phenergan – so I wasn’t puking uncontrollably like many women do… I just wished I was because I felt so terrible.  The headaches.  The blurry vision.  Seeing thigns in triplicate (I’m not joking!).  And the absolute worst part of all – muscle weakness.  Muscle weakness sounds so benign, doesn’t it?  But my legs were lead weights – I couldn’t move them if I tried.  I coudln’t sit up, couldn’t move my head, could barely lift my hands.  Those who have known me for a while know that the sole reason I’m opposed to ever having another spinal/epidural anesthesia is because I had a small stroke (TIA) when I was 23 – losing control of my body on purpose is not ever going to be a goal of mine.  It’s petrifying.  I got congested, and completely parched – my throat was killing me from being so dry, but drinking a gallon of water (which seemed the only logical solution at the time) was not an option, since between the mag and the preexisting hyperemesis, I would have just thrown it right back up.   There really is no way to describe the horrors of mag and do it justice. 

Thankfully, I have weaned back down, and am now below my starting dose.  The hope is that I’ll be able to turn the mag off entirely tonight (long shot) or tomorrow, and go back to the terb pump.  Hopefully this “holiday” will have helped my body downregulate?  Upregulate?  I can’t keep it all straight. But one way or another, hopefully after this holiday the terbutaline will be working again.  I’m not holding my breath, but I *am* hopeful that I’ll get to go home in the next day or three and that I’ll be home for Pesach. 

My poor husband is stretched to the limit and I don’t blame him.  I know very clearly now that even if I ever thought I might want another baby after this one – I just can’t do it.  It’s not fair to our family to have me this sick for this long.  So we’re done after this little one makes his or her appearance into the world.  For that reason alone I wish I could savor this pregnancy – but there just is so little to like about it.  I’m very grateful to be where I am.  I’m very grateful to be pregnant and to be growing a whole entire human.  But I can’t bring myself to call pregnancy a joyous experience.  I think it’s miraculous, yes.  And I can’t wait to meet this child and move on with our lives.

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