Friday, June 19, 2009

Unexpectedly Early - 31 weeks


On June 4th, I went to the doctor for my regular monthly appointment. I was 31 weeks that day. When I got to the doctor , the nurse took my bp it was some inordinate number that she refused to take it any further. She ran to check my urine. I was spilling 3+ proteins. I told her my blood pressure machine wasn’t working right and wouldn’t read my bp so I didn’t really know what it was. As soon as the Dr. arrived she told him, what she had found and what I said. I had been partially deaf for almost 7 weeks at that point. So it was hard to hear what was said beyond him shaking his head and saying, “That’s scary!”


He took in the first patient. And a few minutes later came out and took me to the Blood Pressure cuff. My bp was 180/120. He took me into the office and we chatted, he told me he that it was possible that I was going toxemic, and he wanted me to head to the hospital so they could bring my bp down and hopefully buy me and the baby some time. I begged and pleaded that he put me on BP meds and let me go home and I’d adhere to strict bed rest or whatever they wanted. He refused saying that with a BP like that I was a ‘Walking Stroke’ waiting to happen or worse yet I was risking seizure.


So I jumped in the car and headed for home. I had nothing with me, and no clue how to get to the hospital. When I was most of the way home, I finally reached dh(who’d been on a conference call.) I told him what was happening and that he needed to get the girls ready ASAP – that we needed to head to the hospital. I grabbed a bag of coloring books and papers for them, and a bag of stuff for a 3-day stay at the hospital for me (just in case!)

We arrived at the hospital around 1:30. And had to wait about 30 minutes for a room. They put me in L&D Room 1. Called the Dr and he had them start the protocol of blood work, and some BP lowering meds (Labetalol and if I didn’t respond quickly Hydralazine.) They also requested a Biophysical of the baby – which is just a high level u/s measuring the fluids, baby’s heart and other aspects of the baby to make sure that my BP wasn’t affecting him/her at that point. After 1 oral dose of the Labetalol and 2 doses of the hydralazine, my bp was still quite high, so they started Magnesium Sulphate and IV fluids. Within an hour I was swelling pretty bad.


At sometime around 7:30, some older doctor, I want to say Dr. Jacobsen came in and gave me his version of the low down on what was happening. His bedside manner left a lot to be desired. The man had not one good word to say. He gave me every possible bad scenario, while not once looking me in the face. He told me the baby would probably not survive etc, etc. I was a mess and the L&D nurse was LIVID. He left and the nurse calmed me down and had a Dr. from Neonatology come down and speak to me. The nurse filled her in on the u/s results and while the doctor was talking with me, the nurse got lung maturity steroid started – a sharp stick in the thigh. It was around 8:30 at that point. And I was pretty scared.


Once everything was started, they gave me an Ambien (sleeping aid) and I was out cold. My OB apparently arrived around 9:30 saw me and determined that I was definitely Severely Pre-Eclamptic. He came back around 11 and we chatted a few minutes. Where he told me they would buy me 48 hours so the steroid injections would take full effect.


Friday passed. I don’t remember anything eventful except the steroid injection where I felt the muscles in my other leg separate as the nurse injected in full throttle. I swear she was sadistic and simple. I also argued with this nurse who refused to let me use the bathroom.


Saturday passed in a delirium… Dh called and said he and the girls were on their way down. I remember being extremely jealous that they were sitting on a patio having lunch when he called. Sometime around 2:30 dh and the girls showed up. I couldn’t see them straight, one eye kept wandering off. They went home had dinner, and around 8:30 the nurse informed me that I needed to stop eating that the doc would be inducing that night and likely as soon as he got there. So I called dh and asked him to come and also to call my doula.


Dh arrived with the girls. Our initial plans fell through. His mum wasn’t due to come until August. Our backup plans (both sets) for them fell through too. We couldn’t reach either party to leave them with so he had the girls pack a little suitcase with their blankets and some jammies. I didn’t expect they’d be allowed to stay in the room, but the nurses and the doctor never said a word. They were fast asleep on the couch by the time the doctor arrived.


Induction began at 11 pm. He inserted a Foley bulb catheter, to open my cervix. My doula had said he’d wait a bit and get started on the Pitocin, but he started that right away. For some reason this caused me some distress. Meaning I felt he was worried enough that things had to progress and quickly. I had a panic attack and couldn’t breathe. I was scared out of my mind to say the least. I looked into the faces of my sleeping daughters, and my poor hubby lying on the floor trying to catch 40 winks, and this calm quiet voice in my head said “You need to be there for them when this is all over. The baby will be fine no matter what, but you are the key.” Crying, shaking, I woke dh and told him we needed to end this now. I couldn’t go through with the induction – something in my head was telling me it wasn’t a good idea, nor was it safe. Not to mention that I hadn't slept since the Ambien on Thursday night - and my body was now just starting to shut down from exhaustion. (I had no idea that there was a standing order in my chart for it, and no one had offered.)

The doctor seemed pretty short. But I imagine that a lot of that was that I seemed pretty wishy-washy in my request. I hadn’t really slept in 2 days, and with the mag sulphate I was pretty delirious and I was very scared. After the paperwork was all signed, they removed the cath, and wheeled me down to the OR, where I sat on the table shaking like a leaf for what seemed like an hour. They brought in blankets and I kept telling them I wasn’t cold, I was hot actually – I just couldn’t stop shaking. They did a spinal, and had me lay down. Where I promptly fell asleep until I heard them say quietly “It’s a girl.” And then she cried.

4 girls can you believe it?

The nurse that took me from the L&D room, came over and told me it was a girl, she was breathing on her own, and didn’t even need the blow by O2 at the time. She was pink and feisty for one so little. She was 3lbs 9oz. 16 inches long. There seemed to be some dispute as to when she really arrived but with a few hours they settled on 4:22 am.

I slept some more until they finished closing up and the doctor asked how much fluid was lost. He was told 5 liters total fluid and tissue. They took me to the recovery, where I slept for a while too. Eventually the nurse had dh come in and chat with me for a few minutes, and then they brought in my oldest daughter (as the youngest was still sleeping.) When they both left the recovery room the nurse who had me and I ended up chatting as we were both from Canada. I spent about 2 hours in recovery, and then they took me back to L&D for the day. Dh got the girls up around 8 and took them home to sleep some. I slept a little more and then phoned a few people about Erin’s arrival.


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My only complaint about the whole childbirth process. Postpartum care in the two hospitals that I have been in sucked. This time – while on seizure watch, I was left alone for more than 12 hours. Hell my children could call 911 and have the paramedics respond and have me at the hospital before the nurses would have found me – if that happened. I felt safer all three times times at home than in the not so tender mercies of Postpartum care.

I don’t understand the disparity between postpartum and L&D nurses. The L&D nurses are almost all cheerful and very good at what they do. Maybe the expectant parents excitement plays a role there, maybe they are just differently qualified. All except maybe 3 of the postpartum nurses I’ve ever met frown and treat you like just another body.

2 comments:

Redinky said...

Wow, that must have been scary for you.

Barb Nelson said...

'm glad she's here and healthy. Wishing you both a speedy recovery and blessings to the whole family!!