A Whole Lot Of Random.

It’s been quite a few days since I’ve written, and that leaves me where it usually does… a whole lot of stuff to say, and no idea what to actually SAY.

I got 9.5 hours of sleep last night, and I feel like a million bucks.

I had some contractions…okay, lots of contractions the last couple of days that started behaving a little scary.  I tried not to get into my head about it, but I couldn’t get them to calm down.  Hot baths, epsom salts, lots of water and a ton of rest seemed to be the trick – chasing after a busy 20 month old proved to be a little too much this week.

I had a wonderful/amazing visit with Laura, the sweet friend that keeps Ronan for me while I’m working.  Sometimes it’s easy to forget how nice it is to have simple adult conversation with another human being, even when our kids are in the room being rowdy.

We appear to FINALLY be on the mend.  Ronan had a sinus infection, and he’s been on antibiotics for 5 days now.  YESTERDAY was the first day that we started to see some improvement.  Less coughing, no more green snot, and a little bit of an improvement in attitude.  I’m not gonna lie to ya, I’ve loved the last few days of sitting on the couch, snuggled together, watching movies… but I’m ready to get out of this place and DO STUFF.  Visit friends, play at the park before the good weather is gone, anything to get us out of this house!

Things are so up in the air right now, I don’t know for sure when they are going to settle down.  Next week is Thanksgiving(!) already, and I feel like I have a ton of time to get stuff done.  But really, I don’t.  I want to take a Christmas picture and send out cards, so I’m giving myself until December 1st to get that done.  We’ll see how it turns out.

In other news, I’m getting huge… and I’m okay with it.  I have to be honest with myself when I look in the mirror – 130lbs looks a whole lot better on me than 103.  I feel like I look younger, prettier, and less haggard.  I’m trying not to be too worried about how much weight I gain this time around (trying being the operative word there) because I know how much weight I lost nursing Ronan.  I don’t want to get that low again.

I am 27 weeks pregnant.  More than 2/3rds of the way to a new baby girl.  I’m excited.  I talk to her every day.  I have been doing a lot of visualization and mental planning for the labor/delivery, and I’m excited for that too.  Sometimes I feel like things are trying to wear me down, like I’m being drowned in the day to day… but life is good.

I am 27 weeks pregnant, and Ronan is in his final week of 20 months old.

At 27 Weeks – Part 3

This story began with part 1, and is continued with part 2.

After being discharged, Brock and I left for home with unease.  There were still no real answers as to where all of that terrible pain was coming from, or if it was really gone for good.  Also, there was the added trouble of being on bed rest, and not being able to work meant not being able to save up as much money for time off.  I had a really hard time letting Brock do EVERYTHING for me.  I found it very frustrating.  I wasn’t afraid that I was going to deliver soon, and I wasn’t hurting, so why the bed rest?  The doctors put me on Procardia, which is another tocolytic and I didn’t like taking it; it made me feel loopy and queazy.   So I got permission to only take it when I felt like the contractions where getting troublesome.  I was also on the anti-spasmodic, that seemed to be helping.

Until around 8pm.  I had another attack.  It hit me just like all the other ones, a sudden on-rush of overwhelming, mind-crushing pain.  I couldn’t find a position to ease the hurting, and I was crying too hard to talk to Brock about what we should do.  He took control and packed the car back up with all of our hospital stuff, brought me out to the car, and we headed back in to the hospital.  This time, something changed. It was a whole different experience.  It felt almost as though they didn’t believe anything was wrong.  This time, no pain medication.  This time, we spent over 4 hours in triage before they decided to admit me.  This time, I didn’t hear from a doctor until the next day.

Once I was finally admitted, I was told they wanted to do a CT scan.  I don’t know which doctor ordered it, or what their indication was.  I was in so much pain, I didn’t care.  To my logic, if they ended up delivering the baby at 27 weeks, he would have so many chest x-rays, it would probably be equal to a CT scan, so I consented.  (I found out much later that my assumption was incredibly, completely wrong.)  I was brought down to radiology for an abdomen-pelvis CT.  I sat in the hallway for about 20 minutes while I waited for the Tech.  This, being my business, didn’t upset me.  I know how things work, and what it’s like to do exams in the middle of the night.  I tried to be as pleasant as I could be, despite my pain and lack of meds.  Once my scan was completed, I waited another fifteen minutes for someone to come and get me.  Finally, back in my room where Brock was waiting for me, I got to lay down.  Most of the pain had started to pass, and I fell asleep.

The next morning, I was woken by Dr. Imseis again at 7 am.  He came in to tell me that the CT was normal, and they had no idea what was wrong.  “We want to do a GI consult,” he said, ” just in case it’s something like an ulcer.  But if the GI doctor can’t find anything wrong, we only have two options left.  Exploratory surgery, and delivering the baby.  You can’t stay in this much pain for the rest of your pregnancy.”

Brock and I spent the rest of the day on edge, our minds spinning wheels of what could possibly be wrong.  We imagined every single bad outcome.  At one point, I broke down in tears again and said, “I wish it was just something stupid like constipation.  I wish it was nothing at all.”  We waited, and waited.  Evidently, our GI consult wasn’t very high up on the priority list.  We saw a Nurse Practitioner for the GI office that came and asked a bunch of questions, and said the doctor would be in to see us that day.  He didn’t show up until 7pm, after we’d waited 12 hours to find out what the next scary step would be on this terrible journey.

The GI doctor was a thin, dark haired man with glasses that dominated his face.  His Dr’s coat looked well worn, and he walked into the room with a smirk.  He introduced himself, shook my hand, then Brock’s, and began a little speech.

“I took a look at your CT from last night, just to be safe.  I know they told you it was negative.  The funny thing is, I’m a poop doctor.  And poop doctors look at different things than Radiologists do.  So even though the radiologist didn’t notice anything wrong with your CT, I found something very interesting.” He paused, smirked again.  “I noticed that it looked like you probably haven’t” … pause… “had a bowel movement” … pause… “in at least a month.  Maybe longer.”

I blinked.

And then I smiled.

And then I laughed.

And then I threw my head back with a sigh of relief, and asked, “You’re serious?  That’s what this is?  Constipation??”

The doctor nodded, laughed, and came over to sit down and talk to me about the situation.  He told me that all of the tocolytics and anti-spasmodics I was put on stopped the pain because they stopped the bowels from trying to move.  He said that they were, in effect, making the problem worse.  He also said that even though I felt like I was having normal bowel movements, I was probably not fully emptying my colon each time, causing a slow but inevitable back-up.  He told me that at that point, my entire large bowel was full and had become impacted, as well as most of the small bowel.  He also said that it wouldn’t have been much longer before I had gotten toxically sick from the over-load.

Before the doctor left, I thanked him… and then asked him why he couldn’t have asked my husband to leave the room before giving me the news.  I knew I’d never live this down.

I was so thankful that the problem was something so simple.  I was incredibly grateful that the solution was so easy, and (though embarrassing,) relatively quick.  I spent another full day in the hospital being “de-pooped” and ended up having lost a full 10 pounds by the end.  I swore my husband and family to secrecy, but really, we all know how this ends.

Every time I say something remotely unbelievable, the inevitable response is, “Oh come on, Mandy.  We all know you’re full of shit.

And just in case you don’t believe me, here is a picture of my belly at 27 weeks, and then a week later (post de-poop!) at 28 weeks.

Yes, that really is a before and after picture.

At 27 Weeks – Part 2

This story began yesterday with Part 1.

For Part 2, I must write a few things that I had forgotten to put in up to this point.

Within the first hour of my trip to the hospital, I was given a shot of Morphine.  The amount of pain I was in was unbearable, and they needed me to relax in order to find out if the contractions were going to slow down.  A few hours later, the Morphine had worn off, and I was given a second shot.  The Morphine masked the pain, but it wore off too quickly, and the pain came back just as it was before.  Also, all night long my nurse would come in and check my reflexes and bend my legs, every hour, to make sure the Magnesium wasn’t causing any adverse reactions.  Even though I was almost completely out of it, I didn’t get any sleep.  One of the many times she came to check on me, she shook her head at the IV pump.  “What’s wrong?” I asked.  She said, “I can’t believe the dosage you’re on.  4mg of Magnesium is the dose for someone four times your size.  But every time I try to wean you down, your contractions start again.  I’m sorry.”  I had been telling her all night that Dr. Shaver wouldn’t want me to be on Magnesium, and he’d make them take out the foley catheter.  I said my doctors wouldn’t keep me like this.  She just nodded and went about her work.

After the second shot of Morphine wore off, and the pain was ramping back up again, they told me they couldn’t safely give me any more of that drug.  Instead, they gave Nubane.  I’d never heard of it before, but I was told it causes nausea.  They gave me a dose of Zofran in my IV to help prevent the nausea, and I remember it burning all the way up my arm, and feeling it go down into my heart.  Then they gave me the Nubane.  I’ve never had such an immediate, violent reaction to a drug before.  Within 10 seconds, I sat up and said, “I’m going to be sick.”  I had an extra second to catch a clear container that the nurse handed me before I spilled my cookies over and over.  Once the wretching stopped, I laid back down, exhausted, and fell asleep.  When the Nubane wore off, they came with more, and I cried.  My stomach was empty now, and they weren’t getting my pain under control, they were just covering it with narcotics, all of which were probably harmful to my baby.  They dosed me again, and I dry-heaved until I was crying with pain and fatigue.

Brock was sleeping on the pull-out, convertible recliner-slash-bed.  And by sleeping, of course, I mean sitting by, feeling useless and wishing he could take all of the pain away.  He was getting angry with the frustration of being unable to do anything to help.  I didn’t want him to touch me or try to make me feel better.  And I kept telling everyone it was “too hot in here,” so poor Brock froze all night while I roasted away on drugs.

Around this time, near morning, I figured out that my water hadn’t been broken or I would probably have kept leaking.  When the doctor checked my cervix in the Triage room, he used a large amount of lubricating jelly that melts when it raises to body temperature.  The gush I felt was all of the extra jelly exiting my body.  It was the first breath of relief I’d had in what felt like forever.

My next breath of relief came at 7am.  My doctors, all three of them, came in to check on me.  Even though I was still quite out of it, they managed to make me smile.  They asked the nurses a few questions, check my contraction strips, and Dr. Shaver told the nurse to take me off of the Magnesium.  He also said that I didn’t need a catheter.  I almost cried with gratitude.  Another nurse came in, and I heard her say to Dr. Imseis, “She refused the steroids!  She wouldn’t let us give them to her!”

“Good,” was his reply, “She didn’t need them.”

As Dr. Imseis was the hospital physician that day, he was the one that performed my actual consult.  I had an ultrasound done that confirmed that there was nothing wrong with my pregnancy or placenta, and that my cervix was still long and closed.  Despite the significant contractions I’d been having all night, my baby was not in danger of coming too early – or at least not yet.

However, the problem of my pain had still not been addressed.  Dr. Imseis prescribed an anti-spasmodic, which assumed that there was some problem with my bowels.  After the first two doses, my pain had gone away and they felt comfortable letting me go home on bed rest.

I would return to the hospital in less than 24 hours.  This story will conclude tomorrow with Part 3.

At 27 Weeks.

I don’t know if I’ve ever blogged this story before.  I don’t think I have.  I guess now is as good a time as any.

Around 25 weeks in my pregnancy, I started feeling very strong, crampy pains at the top and sides of my belly.  I knew they weren’t contractions.  I’d been having fairly regular contractions since about 20 weeks, and had been checked multiple times.  My doctor told me I had an irritable uterus (evidently that wasn’t limited to my personality).  They said as long as my cervix didn’t start shortening, I was safe.  So we checked my cervix weekly for a while, and then every other week until we figured out that the contractions, while real, weren’t doing anything scary.

Back to the cramping.  I asked one of the doctors that I worked with what would cause me to ache so badly in the top of my belly, and curve around the sides.  He palpated, and it didn’t hurt.  He listened with a stethoscope and didn’t hear anything unusual.  He said he wasn’t sure what it could be, but to keep an eye on it and let him know.

A week later, I was having the cramping more severely.  Sometimes I couldn’t sit down.  They weren’t related to my contractions, and contracting didn’t make them worse, but I noticed when I started cramping, the contractions came more frequently.

Another week went by, and one evening, on December 5th, they became so painful I couldn’t move.  They would come and go in waves, and as soon as I was hit, I would start writhing and crying in agony.  We called the nurse line and was told we would be called back within an hour.  I was hit with another wave of cramping, and started screaming in pain.  I told Brock I couldn’t wait until they called back.  We were going to have to go to the emergency room.  He took my phone and called Dr. Shaver, and told him what was going on.  Dr. Shaver said to just go straight to OB Triage at the hospital, that he would call and let them know we were coming.

The car ride there was the longest I’ve ever taken in my life.  I was crying in pain the whole time, and Brock was trying to get me to calm down, to relax.  I was so scared, and so tense that I was making everything snowball into something so much worse.  We got to the hospital, and went up to the Maternity ward.  They brought me into the Triage area, had me change into a gown and leave a urine sample, and then hooked me up to the monitor.  A nurse came in to start asking me questions and stopped asking within the first three minutes.  Another nurse came in and started an IV, and then they said they were moving me to a room.  I was going to be admitted.  I had been contracting every minute, which panicked the nurses because of the amount of pain I was in.  They immediately assumed that I was in pre-mature labor, and they needed to get the contractions to STOP.

I was given a shot of Terbeutaline in the back of my arm.  Within a minute, I was shivering and shaking all over.  It’s a tocolyitic, which means it stops smooth muscle contractions.  One of the most common side effects is uncontrollable shaking.  The doctor came in to check me, and I was thrown unceremoniously up into stirrups so he could check my cervix.  “Hmm…” he said as he evaluated my cervix while I writhed in pain on the table, “… your cervix feels long and closed.  Like a tree trunk, really.  I’m going to do a Fetal Fibronectin test, but we’re going to admit you and start you on Magnesium just in case.”  A fibronectin test, or FFN, as it’s abbreviated, is a test for fetal proteins in the vaginal secretions.  They can be present for many reasons, but if they are NOT present, there’s a 90% chance that delivery WONT occur within 2 weeks.  A positive result isn’t a very predictive indicator of outcomes, but a negative test is helpful for easing fears of early delivery.  They told me they wanted to give me steroids for the baby’s lungs, and I refused.  I told them I didn’t want the steroids until the FFN came back positive.  To my logic, as an employee of a High Risk Obstetric clinic, if my cervix was long and closed, and the FFN was negative, there was no reason to give steroids.  If we gave them now, and something actually did occur later in my pregnancy, I wouldn’t be able to get them again.  So I said no.

The next thing I knew, we were moved into a room in Labor and Delivery.  As they transferred me from the stretcher to the bed, I felt a gush of fluid between my legs, and I started crying uncontrollably.  I told Brock, “My water just broke!  They broke my water!”  I couldn’t calm down.  Before, what had just been pain and uncertainty became the realization that my baby was about to be born at only 27 weeks.  Panic had set in, and I couldn’t get myself together.  I cried until I exhausted myself.  My new nurse came in and told me they were going to have to put in a catheter while I was on the Magnesium because I wouldn’t be allowed to get up to use the restroom.  I screamed out once when she put in the catheter, and then apologized.  “I bet you hate having to do that,” I said to her.  “Why’s that?” she asked.  I said, “It probably sucks to have to hurt people all the time.”

“Doesn’t bother me,” she said, “I’m not the one that it hurts.”

I was a little thrown by that, but didn’t have a chance to think on it.  At this point, they started me on the Magnesium.  For the next 12 hours, my life was a blur, a haze of events that I can’t clearly remember or distinguish real from dream.  I remember a nurse coming at me with a needle.  I asked her, “What is that?”  She said, “Steroids, for the baby’s lungs.”  I was angry, and said, “No!  I don’t want the steroids until the FFN is back!”  I could tell she was disgusted with me, but she went away.  About 20 minutes later, another nurse came in with a needle.  “What do you have?” I asked again.  This time, the nurse said, “It’s Betamethasone.”  Unfortunately, none of these nurses know who I was or with whom I was employed.  Betamethasone is the medical name for fetal steroids.  I yelled, “I DON’T WANT THE STEROIDS!” and the nurse shook her head and walked away.

Two hours later, my FFN came back negative.  My chances of early delivery were significantly reduced, and I felt vindicated in my choice to refuse the unnecessary drug.

This is a VERY long story.  We’ll call this Part One, and I’ll continue it tomorrow.