ChezPerky

I know you were all worried that I was sitting around being bored. You were all concerned that what with the Procardia and the renewed sense of cervical stability from Tuesday’s visit, I’d be sitting around complacent and just pulling my hair out for lack of anything more interesting to do. So if that was your greatest concern, fear not. There is no boredom to be had in the perky household today. I mean that bed rest thing? God it sucks. But it’s anything but boring. Let’s back up.

First, my husband was out of town Wednesday through Friday afternoon. That was fun, really. I mean, fun like nailing my hand to the wall would be fun. I had some help with our four year old, but not enough, because certain people who were supposed to give more help than they did, well, didn’t. The monitor equipment I had gotten Wednesday night broke Thursday morning and had to be replaced (they got me a replacement by mid-day). The good news was that the two monitoring sessions I had on Thursday had no contractions. I did have some contractions between monitoring sessions, but I took the immediate-release nifedipine and whipped them right into shape. Friday, same thing, no problem.

Friday night I couldn’t sleep. I had cramps all night. Everything felt funny. I just didn’t feel right. I got up around 7ish Saturday and strapped on the monitor shortly thereafter and curled up with Harry Potter which a friend had lovingly picked up from Borders at midnight and left on my table for me. She rocks. But I was so uncomfortable and weird feeling that it was a lost cause. So I just put the book down and tried hard not to think. When the nurse called back she said that I’d had three contractions which wouldn’t have been alarming except that it was a change. My BP was fine, but high for me (110/74… not high by any stretch of the imagination, but it’s a 10 point diastolic jump), but I was still having pretty significant cramping. The nurse suggested taking the immediate-relaease nifedipine and calling back in 30-60 minutes. So an hour later, I called back and wasn’t feeling any better, so the nurse said I could either call the doctor or monitor for another hour first, but she didn’t recommend just ignoring it. I opted to monitor for another hour, figuring that the nifedipine surely would leave me contraction-free. Right? RIGHT? Wrong. Three contractions, and I still felt weird. And the cramping wasn’t any better. So the nurse thought the best thing to do would be to call the doctor even though I wasn’t over my threshold for contractions. So that’s what I did.

I’ll pause here to note that, as I’ve mentioned before but rarely emphasize because that’s not what this blog is about, I’m an Orthodox Jew. A few of you know what that entails, and many of you probably have some idea, but the greatest impact to THIS particular tale of woe is that it was Saturday, which is the Sabbath (which you’ll often hear me refer to as “Shabbos”). Now, normally all this futzing around with phone calls and electrical devices on Shabbos would not be permissible, but obviously, in this case Judaism is very prctical and I am permitted to monitor and to make and receive the necessary phone calls to ensure the health and well being of myself and the babies. But it was about to become even more complicated, because when the doctor called back he asked if I would mind coming in to the hospital to be checked out. He wanted to make sure my cervix hadn’t shortened more, essentially, and honestly, the last time I felt this weird, my cervix HAD shortened significantly. So I said we’d go in if that’s what he wanted.

However, we actually didn’t entirely know where our four year old was. That sounds worse than it is. My husband had dropped him off at the children’s program during regular services (he had gone to super-early morning services himself) and a friend was to walk him back to us. But she had misunderstood and had thought we wanted her to bring him a different friend’s house (which is often the plan, so not unusual), so it took a while to track him down. This would not normally be disturbing, except that we needed to make this happen so that we could find a permanent location for him for the afternoon. Plus, we needed to find a way to get me to the hospital, which in this case meant my husband COULD drive me, but it would be preferably to have a non-Jew drive us, which meant finding someone or calling for a taxi. So that got taken care of too. But by the time all that happened, it was quite late and I was quite ticked off that it had taken this long, and now we have some lessons learned. Hopefully there won’t be a next time, but if there is, we now have a neighbor who knows how to track down our four year old if necessary (he knows and loves her and won’t be freaked out by suddenly going to her house as he does so often). She’ll simply be told to find him and we’ll go.

And so, three hours after talking to the doctor, I finally made it to the hospital. And, thankfully, my cervix had not significantly shortened. Slightly shorter than Tuesday, but still in the 2.x range. Still having contractions, though, so Dr. P’s feeling was that the nifedipine wasn’t doing a particularly good job. He felt that in his experience a terbutaline pump does a better job and is fairly well tolerated even though oral terbutaline tends not to be. He gave me a shot of terbutaline to see if that calmed the cramping, which it did, but boy did it make me feel crappy. Shaky and jittery, oh my! He said the pump is better tolerated because you’re getting a constant dose over time and even the automatic doses which are bigger are given over a period of 12 minutes, so that seemed reasonable. He told me if I felt more comfortable being admitted, he would absolutely do so, but we all agreed I would more likely be comfortable at home. I frankly didn’t care WHERE I was at that point, I was just so damn uncomfortable and tired at that point I wanted to have SOME sort of plan. So they set up getting me discharged and getting me a terb pump set up at home that evening. This was made easier by the fact that I was already receiving home monitoring from the company that would set up the pump and do 24/7 support for that. So the nurse called someone to come get us, and off we were.

When we got home, I asked the friend who had driven us home to please check the voicemail for me in case I’d missed a call about getting the pump set up while en route home. Long story short we had not missed any calls about the pump, but my husband’s father passed away yesterday. And that’s when the fun began. My husband was off trying to pick up the four year old monster, so I sent my friend out to get him to come home. He was, in fact, at a Rabbi’s house, so I asked her to send home both my husband and the Rabbi. She had the good sense to suggest that J still stay put, which was brilliant and I’m sorry I didn’t think of it, but by this point I wasn’t thinking. My heart was still racing from the terbutaline shot and from everything else that had been happening. So my husband came home wondering what the hell could have happened to me in the fifteen minutes that he’d been gone, let alone anything that would require the Rabbi’s presence (this is a friend of ours who IS a Rabbi, not the Rabbi of our community). And I stupidly didn’t have him sit down next to me when I told him so he took a stop back in shock and just said, “How could you KNOW that?” It was, after all, still Shabbos, and his father lived in New Hampshire. How COULD I know that? Yeah. Lucy had some ‘splainin’ to do.

Now, you may think the rules about what I can and cannot do on Shabbos are weird and restritive (no phone, no affecting electricity, no cooking, no driving, no writing…), but when a close relative (parent, sibling, spouse or child) dies, the rules are quite limiting. In my husband’s case, they are less so until after the funeral for a variety of complicated reasons, but we needed to clear this up PRONTO. So off he went to talk to the Rabbi of the community. Neither of us, thankfully, is personally well-versed in the mourning rituals of Judaism. But after the funeral, my husband will sit shiva (google it, for more information, I’m so exhausted I can’t get into it right now). For Orthodox Jews, this is a complex and regimented process. And worse, I really can’t help AT ALL. So it’s going to be fun, let me tell you.

So my husband went off to talk to the Rabbi, and while he was gone my mother-in-law (LONG divorced from my father-in-law) and brother-in-law came to the house knowing that we wouldn’t have otherwise heard the news under normal circumstances. Except, of course, we had, and S wasn’t around and meanwhile I was expecting a nurse to show up at any time to deal with the pump and it was nearly time for me to monitor again and would this day NEVER END? An hour later, S got home with J in tow, the supplies for the pump and all the drugs showed up via courier, and shortly thereafter the nurse came at which point I begged my husband to get his brother to disappear because I really didn’t want to do this in front of him. The nurse had a billion forms and a bunch of things to go over, which was fine and then she started to go over how to deal with the pump, but we ran into a snag. What, you expected this to go smoothly?

See, as I’ve mentioned before, my husband is a pharmacist and he was pretty burnt out, but fortunately the nurse noticed and asked for his professional opinion… but none of the syringes filled with terbutaline were labeled properly. They had my name on them, and then said Dr. Tincture which is incorrect. My doctor’s name is Dr. P. and I’m allergic to Tincture of Benzoine. And nowhere on the label did it say the drug inside the syringe is terbutaline. My husband is in charge of the IV Lab at a major hospital. This is one area of protocol with which is he is intimately familiar and he said, “I’m really sorry, but this is a clear liquid in a poorly labeled syringe which gives me no indication that it was checked by a pharmacist. It could be anything. I can’t let you take it.” He was right, of course, but for crying out loud! Could one thing PLEASE go right? The nurse called back to the center and got them working on calling the drug company that they subcontract to that had made the mistake in the first place to get them working on replacing the drug ASAP. Meanwhile, she showed us how to deal with getting the pump primed and ready to go, and she showed me how to get the catheter in place in my leg. And she took away the bad drug and told me that once the new one showed up I could call Matria to have them walk me through getting the cartridge refilled if I couldn’t remember how to do it. It was then about 9:30pm. I had received my last dose of terbutaline at about 3:15. I didn’t want to take the oral terbutaline that I had on hadn because I didn’t want the sudden jittery-ness again if I could help it and I didn’t know how long it would be. At 10:20, the center called me to tell me that the pharmacist was going back in to remake the drug and would courier it over to me as soon as it was ready. Stat orders have a maximum 4 hour turnaround time. Yeah, I should have taken that oral dose. Sigh. Finally, it arrived at about 12:30am.

Too tired to figure it out myself, I called to have them walk me through it, which the nurse happily did, and I got it all set up, gave myself a demand dose and the jittery-ness began. Also, even more unpleaseant, I discovered that the side effect I thought I’d been imagining in the hospital was not imagined, it was real… the terbutaline makes me REALLY HOT. UGH. I have managed to avoid that symptom of pregnancy thus far. And now it is drug induced and MISERABLE.n I was able to fall asleep despite the jitters, but I woke up about 4:15 feeling panicky, but quickly realized it was the jitters from the automatic 4am dose that had just finished pumping into me. Gosh this is going to be fun!

It’s now almost 6am, and I would really like for today to be less eventful, please. My husband is going in to work, and my mother is taking J for most of the day (the rest of the day I’ll have several extra pairs of hands in the house to help. I will not be left alone with J… not to worry!). So I’m really, really, really hoping for a quiet, somewhat restful day. Is it so much to ask for?

Read Full Post »

I know you were all worried that I was sitting around being bored. You were all concerned that what with the Procardia and the renewed sense of cervical stability from Tuesday's visit, I'd be sitting around complacent and just pulling my hair out for lack of anything more interesting to do. So if that was your greatest concern, fear not. There is no boredom to be had in the perky household today. I mean that bed rest thing? God it sucks. But it's anything but boring. Let's back up.

First, my husband was out of town Wednesday through Friday afternoon. That was fun, really. I mean, fun like nailing my hand to the wall would be fun. I had some help with our four year old, but not enough, because certain people who were supposed to give more help than they did, well, didn't. The monitor equipment I had gotten Wednesday night broke Thursday morning and had to be replaced (they got me a replacement by mid-day). The good news was that the two monitoring sessions I had on Thursday had no contractions. I did have some contractions between monitoring sessions, but I took the immediate-release nifedipine and whipped them right into shape. Friday, same thing, no problem.

Friday night I couldn't sleep. I had cramps all night. Everything felt funny. I just didn't feel right. I got up around 7ish Saturday and strapped on the monitor shortly thereafter and curled up with Harry Potter which a friend had lovingly picked up from Borders at midnight and left on my table for me. She rocks. But I was so uncomfortable and weird feeling that it was a lost cause. So I just put the book down and tried hard not to think. When the nurse called back she said that I'd had three contractions which wouldn't have been alarming except that it was a change. My BP was fine, but high for me (110/74… not high by any stretch of the imagination, but it's a 10 point diastolic jump), but I was still having pretty significant cramping. The nurse suggested taking the immediate-relaease nifedipine and calling back in 30-60 minutes. So an hour later, I called back and wasn't feeling any better, so the nurse said I could either call the doctor or monitor for another hour first, but she didn't recommend just ignoring it. I opted to monitor for another hour, figuring that the nifedipine surely would leave me contraction-free. Right? RIGHT? Wrong. Three contractions, and I still felt weird. And the cramping wasn't any better. So the nurse thought the best thing to do would be to call the doctor even though I wasn't over my threshold for contractions. So that's what I did.

I'll pause here to note that, as I've mentioned before but rarely emphasize because that's not what this blog is about, I'm an Orthodox Jew. A few of you know what that entails, and many of you probably have some idea, but the greatest impact to THIS particular tale of woe is that it was Saturday, which is the Sabbath (which you'll often hear me refer to as "Shabbos"). Now, normally all this futzing around with phone calls and electrical devices on Shabbos would not be permissible, but obviously, in this case Judaism is very prctical and I am permitted to monitor and to make and receive the necessary phone calls to ensure the health and well being of myself and the babies. But it was about to become even more complicated, because when the doctor called back he asked if I would mind coming in to the hospital to be checked out. He wanted to make sure my cervix hadn't shortened more, essentially, and honestly, the last time I felt this weird, my cervix HAD shortened significantly. So I said we'd go in if that's what he wanted.

However, we actually didn't entirely know where our four year old was. That sounds worse than it is. My husband had dropped him off at the children's program during regular services (he had gone to super-early morning services himself) and a friend was to walk him back to us. But she had misunderstood and had thought we wanted her to bring him a different friend's house (which is often the plan, so not unusual), so it took a while to track him down. This would not normally be disturbing, except that we needed to make this happen so that we could find a permanent location for him for the afternoon. Plus, we needed to find a way to get me to the hospital, which in this case meant my husband COULD drive me, but it would be preferably to have a non-Jew drive us, which meant finding someone or calling for a taxi. So that got taken care of too. But by the time all that happened, it was quite late and I was quite ticked off that it had taken this long, and now we have some lessons learned. Hopefully there won't be a next time, but if there is, we now have a neighbor who knows how to track down our four year old if necessary (he knows and loves her and won't be freaked out by suddenly going to her house as he does so often). She'll simply be told to find him and we'll go.

And so, three hours after talking to the doctor, I finally made it to the hospital. And, thankfully, my cervix had not significantly shortened. Slightly shorter than Tuesday, but still in the 2.x range. Still having contractions, though, so Dr. P's feeling was that the nifedipine wasn't doing a particularly good job. He felt that in his experience a terbutaline pump does a better job and is fairly well tolerated even though oral terbutaline tends not to be. He gave me a shot of terbutaline to see if that calmed the cramping, which it did, but boy did it make me feel crappy. Shaky and jittery, oh my! He said the pump is better tolerated because you're getting a constant dose over time and even the automatic doses which are bigger are given over a period of 12 minutes, so that seemed reasonable. He told me if I felt more comfortable being admitted, he would absolutely do so, but we all agreed I would more likely be comfortable at home. I frankly didn't care WHERE I was at that point, I was just so damn uncomfortable and tired at that point I wanted to have SOME sort of plan. So they set up getting me discharged and getting me a terb pump set up at home that evening. This was made easier by the fact that I was already receiving home monitoring from the company that would set up the pump and do 24/7 support for that. So the nurse called someone to come get us, and off we were.

When we got home, I asked the friend who had driven us home to please check the voicemail for me in case I'd missed a call about getting the pump set up while en route home. Long story short we had not missed any calls about the pump, but my husband's father passed away yesterday. And that's when the fun began. My husband was off trying to pick up the four year old monster, so I sent my friend out to get him to come home. He was, in fact, at a Rabbi's house, so I asked her to send home both my husband and the Rabbi. She had the good sense to suggest that J still stay put, which was brilliant and I'm sorry I didn't think of it, but by this point I wasn't thinking. My heart was still racing from the terbutaline shot and from everything else that had been happening. So my husband came home wondering what the hell could have happened to me in the fifteen minutes that he'd been gone, let alone anything that would require the Rabbi's presence (this is a friend of ours who IS a Rabbi, not the Rabbi of our community). And I stupidly didn't have him sit down next to me when I told him so he took a stop back in shock and just said, "How could you KNOW that?" It was, after all, still Shabbos, and his father lived in New Hampshire. How COULD I know that? Yeah. Lucy had some 'splainin' to do.

Now, you may think the rules about what I can and cannot do on Shabbos are weird and restritive (no phone, no affecting electricity, no cooking, no driving, no writing…), but when a close relative (parent, sibling, spouse or child) dies, the rules are quite limiting. In my husband's case, they are less so until after the funeral for a variety of complicated reasons, but we needed to clear this up PRONTO. So off he went to talk to the Rabbi of the community. Neither of us, thankfully, is personally well-versed in the mourning rituals of Judaism. But after the funeral, my husband will sit shiva (google it, for more information, I'm so exhausted I can't get into it right now). For Orthodox Jews, this is a complex and regimented process. And worse, I really can't help AT ALL. So it's going to be fun, let me tell you.

So my husband went off to talk to the Rabbi, and while he was gone my mother-in-law (LONG divorced from my father-in-law) and brother-in-law came to the house knowing that we wouldn't have otherwise heard the news under normal circumstances. Except, of course, we had, and S wasn't around and meanwhile I was expecting a nurse to show up at any time to deal with the pump and it was nearly time for me to monitor again and would this day NEVER END? An hour later, S got home with J in tow, the supplies for the pump and all the drugs showed up via courier, and shortly thereafter the nurse came at which point I begged my husband to get his brother to disappear because I really didn't want to do this in front of him. The nurse had a billion forms and a bunch of things to go over, which was fine and then she started to go over how to deal with the pump, but we ran into a snag. What, you expected this to go smoothly?

See, as I've mentioned before, my husband is a pharmacist and he was pretty burnt out, but fortunately the nurse noticed and asked for his professional opinion… but none of the syringes filled with terbutaline were labeled properly. They had my name on them, and then said Dr. Tincture which is incorrect. My doctor's name is Dr. P. and I'm allergic to Tincture of Benzoine. And nowhere on the label did it say the drug inside the syringe is terbutaline. My husband is in charge of the IV Lab at a major hospital. This is one area of protocol with which is he is intimately familiar and he said, "I'm really sorry, but this is a clear liquid in a poorly labeled syringe which gives me no indication that it was checked by a pharmacist. It could be anything. I can't let you take it." He was right, of course, but for crying out loud! Could one thing PLEASE go right? The nurse called back to the center and got them working on calling the drug company that they subcontract to that had made the mistake in the first place to get them working on replacing the drug ASAP. Meanwhile, she showed us how to deal with getting the pump primed and ready to go, and she showed me how to get the catheter in place in my leg. And she took away the bad drug and told me that once the new one showed up I could call Matria to have them walk me through getting the cartridge refilled if I couldn't remember how to do it. It was then about 9:30pm. I had received my last dose of terbutaline at about 3:15. I didn't want to take the oral terbutaline that I had on hadn because I didn't want the sudden jittery-ness again if I could help it and I didn't know how long it would be. At 10:20, the center called me to tell me that the pharmacist was going back in to remake the drug and would courier it over to me as soon as it was ready. Stat orders have a maximum 4 hour turnaround time. Yeah, I should have taken that oral dose. Sigh. Finally, it arrived at about 12:30am.

Too tired to figure it out myself, I called to have them walk me through it, which the nurse happily did, and I got it all set up, gave myself a demand dose and the jittery-ness began. Also, even more unpleaseant, I discovered that the side effect I thought I'd been imagining in the hospital was not imagined, it was real… the terbutaline makes me REALLY HOT. UGH. I have managed to avoid that symptom of pregnancy thus far. And now it is drug induced and MISERABLE.n I was able to fall asleep despite the jitters, but I woke up about 4:15 feeling panicky, but quickly realized it was the jitters from the automatic 4am dose that had just finished pumping into me. Gosh this is going to be fun!

It's now almost 6am, and I would really like for today to be less eventful, please. My husband is going in to work, and my mother is taking J for most of the day (the rest of the day I'll have several extra pairs of hands in the house to help. I will not be left alone with J… not to worry!). So I'm really, really, really hoping for a quiet, somewhat restful day. Is it so much to ask for?

Read Full Post »