Archive for June, 2010

I’ve been feeling pretty awful, as I intimated in my post the other day. High fever and abdominal pain topped the charts on the ick factors most of the week. Tuesday I was so frustrated with it, I went to my internist who was also puzzled. Since I was scheduled for an endoscopy on Wednesday anyway, my GP faxed over my lab results to the GI doc, since they indicated elevated liver enzymes, among other things. The GI doc did the endoscopy and found that my stomach was in pretty bad shape, so he changed the PPI I’m taking and increased the dose significantly. But that still left the mystery of the liver enzymes, severe abdominal pain and fever. “Well, I think you have gall stones” he said. “But I don’t have a gallbladder” I said at the same time that Seth said, “But she doesn’t have a gallbladder!” Turns out, it doesn’t matter. You can get gallstones even after a cholecystectomy, and although I find this to be entirely unfair, it doesn’t negate the facts. He scheduled an MRI for me for the next day and said depending on the results of the MRI I would either need to have an emergency procedure on Friday or we’d have to talk about next steps. He prescribed me percocet for pain, noting that there was no possibility that codeine would cut it for that level of pain (have I mentioned that I love my gastroenterologist?)

I never made it to the scheduled MRI, because Wednesday night the percocet wasn’t cutting it. Six pills in six hours and I was still sobbing and screaming in pain. My husband told me to go to the ER but I stubbornly said no way no how. By 11pm, I had conceded. I put some things together, defrosted some frozen breastmilk for Tobie, and had a neighbor take me to the hospital. I was admitted to the ER just around midnight, but didn’t get a bed until 1am. And then I laid in bed sobbing until Seth called the charge nurse at 2am and demanded that SOMEONE see me, because I hadn’t so much as had a nurse say boo to me. The nurse told him I couldn’t have pain medicine until the doctor saw me, and he was with other patients ahead of me. Obviously we knew this, the question was how long until a nurse, at the very least, checks in on me. Finally around 2:30 I got seen, and shortly thereafter, Seth arrived at the ER (my mother came to stay with the kids at the house so he could come help advocate for me). I got Dilaudid shortly thereafter and things started looking up. The ER doc was planning to send me home (and what on earth would I have done once the dilaudid wore off?), but my GI Doc had them admit me. The hospitalist who admitted me kept telling me it couldn’t possibly be a gallstone because my bilirubin was not elevated, but I didn’t know her from anyone, and I was more willing to trust my GI doc’s opinion, even at 4am over the phone.

Once I was admitted, I asked for a breast pump. When the shift changed at 7am, I asked again for a breast pump. I acquired a breast pump at 11:30am only after having contacted a friend who is a lactation consultant at the hospital – *she* is the one that made sure I got one. I find this wholly unacceptable, but fortunately, I’ve got friends in high places (hah!), so I know who to send the letters to, and they’re already written. Meanwhile, I was still in the ER waiting for an inpatient bed to open up, which didn’t happen until 3:30pm. The only plus side was that I got frequent visits from the Dilaudid fairy throughout the day.

Dilaudid, at least, cut my pain down to something manageable, but it had curious side effects. Like all narcotics, it can be sedating, it can make a patient itch, it can cause or exacerbate nausea. Turns out, it can also cause hallucinations – in my case both visual and auditory hallucinations. I kept hearing snippets of music out of the corner of my ear, but if I turned toward the sound it was gone in an instant. One day, I watched a tiny little bug crawl on the bathroom tile. Suddenly the tile pattern was swirling all around it in a psychedelic freakish way. Then the pattern morphed and then the tiny bug (I swear, I’m shocked i could even see it, it was teeney!) morphed into an ant and then a, I dunno, something bigger than an ant and then a giant spider and the swirls kept happening and suddenly I said, “Don’t be stupid, Perky, this isn’t real!” and it was gone – vanished as if it had never existed (which, obviously, it hadn’t!). Sometimes I would hear voices, or see people in front of me who weren’t there. For the life of me I can’t figure out why someone would WANT to have these feelings, hallucinations, sensations. There’s nothing pleasant about it, though I’ve heard that people actually get addicted to this stuff. Yuck!

So Dilaudid aside, while I was in the hospital, I did get that MRI that I had been hoping to get as an outpatient, and it showed that the common bile duct was significantly swollen/inflamed, though they didn’t see a stone per se (they hadn’t used a contrast dye in the MRI, so it would have been a long shot to visualize it). I was scheduled for a procedure the next day to take a look, remove the stone, if any, and to enlarge the opening to the common bile duct so that it wouldn’t get obstructed by any future stones. At least I knew that all the pain and misery wasn’t just in my head. There was actually something I could point to. And wouldn’t it be a bonus if it turned out that this was the whole reason behind the continued nausea and vomiting? I was eager for the procedure to be over with so I could find out if there would be relief at last. I was scheduled for Friday afternoon and had hoped to be allowed to go home by Shabbos.

The procedure was supposed to be done under light anesthesia, but because nothing is ever simple in PerkyLand, and I was only 7 weeks post partum, they had to intubate me and do full anesthesia because the risk of aspiration was too high. (Turned out they were right to do so – apparently I threw up a bunch of times during and immediately after the surgery) This meant I’d be staying at least one more night. Not shockingly, my GI Doc was right – there was a stone, which he removed, and then widened the opening to the duct so that it wouldn’t get obstructed in the future. The doc said my pain should get better in about 24 hours.

Unfortunately, the nausea/vomiting hasn’t gotten any better and I’m still in a fair bit of pain. Hopefully, the nausea is related to the stomach issues discovered at the original endoscopy that started this whole saga and fixing the stomach problems will be the answer. But since it was still an issue, my doc wasn’t fully comfortable sending me home Saturday, so we waited until Sunday to see if my pain would go down and if I could eat anything. Seth brought Tobie to me Saturday night so I could see her and feed her and that was the first time I’d seen her since Wednesday. Finally, Sunday morning I was allowed home.

I’m seeing my doc this afternoon to talk about next steps, but mostly, I just want to sleep. I feel like I haven’t slept in days, even though pretty much all I *did* was sleep while I was in the hospital!

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So I am giving fair warning that there is no purpose to this post beyond pure complaining and whining. I just feel like the universe is out to get me. Even ignoring all the other things going on in my life that are going to hell, but the medical issues alone that I’ve got going on right now are becoming overwhelming…

I still am not eating after the pregnancy from hell. No one knows why, no one can explain it. But I’m extraordinarily tired of being sick to my stomach.

I have persistent thrush (so does Tobie). If you don’t know what this means and/or you’ve never experienced it, thank your lucky stars. It is incredibly painful (for me – uncomfortable for Tobie, but probably not painful). I’m now on a more effective treatment – here’s hoping it works. Quickly.

Now I’ve got a high fever and severe abdominal pain. Today is day 3 of the fever and pain. No one knows why.

I have a (new to me) “very pronounced” heart murmur. Apparently new heart murmurs that surface at the same time as a high fever are sometimes really bad juju. There could be a connection, or it could just be coincidental.

I might have a kidney infection. Kidney infections are not fun – I know from experience. Well, it could be a kidney stone (but my guess is no). I haven’t had one of those for a while (since I was pregnant with the triplets), so it’s about time, right? Riiiiiiiiiiiiight. For the record, it’s not like kidney stones are a lot more fun than kidney infection.

I have two broken teeth, and apparently another tooth that has cracked. One of the broken teeth isn’t salvageable – it needs to be extracted, probably followed by an implant. The cost, even with insurance, is overwhelming (dental insurance is notoriously crappy and inadequate). Never mind the time it will take to make this possible. If you have good teeth, thank your lucky stars. I’ve got genetics going against me, but also the fact that I grew up without flouridated water. Apparently, that’s not a great idea. Flouridated water is good juju for healthy teeth.

There are also several other things wrong that are TMI, but aren’t quite so egregious.

I have an endoscopy scheduled for tomorrow. I now also have an echocardiogram scheduled for Friday. Bring it on.

I am tired. I am tired of the emotional turmoil that’s been going on in our lives, and I’m tired of being sick. I’m tired of not being a fully functional member of this family. I’m tired of not being able to carry my weight here (and my weight, if you know me personally, is not insignificant). I’m tired of having to beg my body to get up out of bed every morning.

I’m just tired.

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Like many, but unfortunately not all, Americans, I have private health insurance provided through my employer. I pay a portion of the premiums, but my employer picks up the bulk of the tab. I have enjoyed many benefits of my excellent insurance coverage for years. I had very good, though not full, coverage for the fertility treatment that resulted in the births of four of my five children. I had 100% coverage for the month long NICU stays of each of my triplets (about $100K). And my pregnancy was mostly covered by my insurance. I have a portion to pay for each of my hospitalizations, but the truth is, the amount I have to pay, while sizeable, is nothing compared to the average cost of my medical expenses each month of my pregnancy – never less than $15K/month and often upwards of $40-50K per month during my pregnancy. (No, I’m not remotely exaggerating – my bills for the home health company alone were no less than $15K per month and that didn’t count my countless appointments with OBs and specialists, my frequent hospital admissions [average cost per hospital admission = $10K], random trips to L&D, etc.)

I often wonder what would become of a woman with a pregnancy like mine who didn’t have health insurance coverage. I mean, not that I’ve even ever *heard* of another woman with a pregnancy like that. But let’s say a woman with just one of the problems I had … say hyperemesis, for example… if she doesn’t have insurance, how does she get an appropriate level of care? Answer? Most probably don’t. And what then? If I hadn’t gotten inpatient care, and later home IV therapy, the results could have been catastrophic. I’m not blind to the fact that I’m incredibly privileged, and very lucky to have the coverage that I do. While I did pay a significant amount of money out of pocket for our fertility treatments over the years, I had incredibly good coverage that covered a huge portion of the cost. I would not have my triplets OR Tobie today without having had insurance. And having two high risk pregnancies following those expensive treatments required a significant amount of coverage by themselves.

Yes, I am a lucky woman, indeed.

So I’m not ungrateful for my insurance. Please know that. But there are times when insurance companies cause enough aggravation to make my eyes cross. Like the day that both Ellie and Abby needed the same medication prescription filled on the same day. This shouldn’t be too difficult, right? Except that because it was two girls with the same birthday and the same insurance policy number with the same prescription on the same day, the insurance company couldn’t figure it out. And when I called, they were flat out nasty about it. It turned out there’s a “person code” that isn’t printed on the insurance card (we’ve all got the same number printed on the cards). Without the person code, the insurance company didn’t know it was being billed for two different people, because they were both female with the same birthday. Oh. Except it took 3 phone calls, and a lot of exasperation and even some yelling to get that answer. Now I know the person codes so it shouldn’t happen again.

I hope.

Mostly, I’m just hoping it doesn’t come up as a question again.

And that $15-40K/month in medical bills I had from October through April? It turns out I’ve probably singlehandedly incrased the insurance premiums for everyone in my company. By more than double. It’s a small company, so it wouldn’t be difficult for anyone to figure out who caused the increase. Yep. That’s me.


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