Wednesday, August 17, 2005

Pregnancy Complications

I began having complications with my pregnancy in August of 2000. One day I just wasn’t feeling well. My pelvis felt low, sore and heavy. I called the doctor and she said to come in right away. But, I didn’t have a car that day – I had dropped it off at the dealer to get serviced and then I took the shuttle to work. So, since the Doctor’s office is only a block from my office, I walked. That was dumb. Anyway, she examined me and then put a uterine monitor on me for a while. It showed that there was some uterine instability. It was nothing serious but caused enough concern that she wanted me to go to the hospital for further monitoring. Ok, but I don’t have a car and while the hospital was only 2 blocks away from the doctor’s office, it didn’t seem like a good choice to walk there. Nor did it seem like a good idea to ask my husband to swing by and pick me up on the motorcycle. I called one of my coworkers and she drove me to the hospital. The nurses set me up in the room, put a big pitcher of water on my bedside table and strapped me to two fetal monitors and a uterine monitor. The babies were doing fine and Tom and I watched the uterine monitor anxiously. They did a urine culture and discovered that I had a bladder infection. They monitored me for a few more hours, then sent me home with some antibiotics and a drug called terbutaline which stops contractions. I was having Braxton hicks contractions which don’t hurt and aren’t labor contractions but if they happen often enough can progress into labor contractions.

I stayed home for 2 weeks. My doctor told me that if my perinatalogist said I could go back to work, then she would write the order. At my next perinatalogist appointment I was given the ok to go back to work, which I did the next day – Wednesday, September 11, 2002. On September 20th, my birthday, I wasn’t feeling well. I called my doctor because it felt like one of the babies was pushing on my pelvis. She told me to take it easy and call the next day if it persisted. The next day, I was having Braxton hicks contractions again so I called the doctor. She told me to take one terbutaline (which had been discontinued) and if I felt even one contraction to go straight to the hospital. I did what she said and yet, continued to have contractions so we packed up and drove to the hospital. Again, they hooked me up to the fetal monitors and uterine monitors and set a big pitcher of water next to my bed. They gave me a shot of terbutaline, which seemed to calm things down and we were sent home. This time I was told that I would not be going to back to work until after the babies were born. On Tuesday, September 24th I started feeling contractions again. I remember staring intently at the clock, watching the time tick away and counting every tightening I felt and hoping, hoping that it would stop. But it didn’t. My friend and neighbor, Kelly drove me to the hospital. This time, they weren’t fooling around. They inserted a catheter into my urethra and started an I.V. line of fluids to make sure I was hydrated enough. They strapped the fetal monitors and uterine monitor onto my belly and watched. I was having Braxton hicks contractions about 10 times per hour. They told me that my strip looked like a regular labor patient, which scared me. I was 23 weeks pregnant. My doctor ordered that I be put on magnesium sulfate, a smooth muscle relaxer that can calm the uterus and stop the contractions. When you’re on mag, especially high doses, your vision gets a little blurry, you feel a little sleepy and very, very hot. My room temp was lowered to 65 degrees and I was never cold. I kept all my blankets on the chair next to my bed so that my visitors could bundle up and stay warm. By Thursday, Sept. 26th they had lowered my dose of mag and were hoping to put me on oral medications by the next day. On Friday, Sept. 27th they moved me from the labor and delivery ward to post-partum and put me on oral medication. On Saturday, Sept. 28th they sent me home with orders to stay in bed and if I had 4 contractions in an hour I had to go right back to the hospital. Driving home, I felt very uneasy. I still felt contractions and was nervously counting them. I couldn’t relax. I kept drinking water and then I’d be up every hour to go to the bathroom. I didn’t sleep at all, just watched the clock and counted contractions. Finally, at 11:00am on Sunday, Sept. 29th I told Tom that we had to go back to the hospital.

Back at the hospital, they inserted the dreaded catheter and started the I.V. of magnesium sulfate and fluids. They strapped the fetal monitors and uterine monitor on my belly and told me the most important thing was getting to 24 weeks which was the earliest that the babies would be viable. They checked my cervix and found that it was still closed (good). On Tuesday, Oct. 1 they gave me a shot of beta-methasone, a steroid that helps to mature the babies lungs, and performed a test called fetal fibronectin, also known as FFN. A positive result from this test means that you’re 85% more likely to give birth prematurely. I was absolutely certain that my test would come back negative. They administered it in the morning and told me I’d have the results by 2:00pm. When my nurse came in with my lunch, I asked if she’d heard about the test yet. She broke the news that the result had come in and it was positive. I felt my face crumple. Then she did the nicest thing in the world. She came right to my bed, gave me a hug and told me that I had to remain positive. That every moment, every hour, every day mattered and that I couldn’t lose hope, that those babies needed me. She was such a kind nurse. The next two weeks went by fairly uneventfully. I stayed on mag, got blood tests every 8 hours to check the toxicity in my blood, still on the catheter, still unable to get out of bed for anything – not to shower, not to poop, nothing. My baby shower was cancelled – it had been scheduled for October 5th. My mom came out to visit anyway and she stayed with me in my room all day, every day. We did crossword puzzles and watched Oprah.
She left on the 10th.

On Sunday, October 27th, I woke up very late. My nurse chided me for sleeping in. I was usually awake by 7:30am and they’d bring my breakfast at 8:00am. On this day, I slept until 9:30am. I was in a lot of pain. My back was hurting and I thought it was from being in bed for 3 weeks. My nurses let me get into a rocking chair while they changed the bed. I felt a little better but was barely able to keep my breakfast down. They took my temperature and it was a little elevated. I got back in bed and noticed that my urine looked really cloudy and junky. I mentioned it to my nurses and they said they’d do a culture. Later, Tom came to visit and I felt worse and worse. My contractions started getting more frequent and painful and my nurse came in and announced that I was in active labor. She notified my doctor who came directly to the hospital and started ordering tests. First, she said I wasn’t allowed to eat or drink anything else in case I had to go into surgery. Then, she ordered an ultrasound of my gall bladder, kidneys, liver and appendix. The ultrasound tech couldn’t get a read on the appendix but he said the gall bladder and liver were fine. He barely touched my kidney area with the wand and I about went through the roof it was so excruciating. Um, I’d say there might be something wrong with my kidneys? She also had the tech do an ultrasound of the babies to see how they were acting. They were doing just fine. That was a relief. Given my upwardly mobile body temperature, the junky urine and the pain in my kidneys – it wasn’t a surprise to get the urine culture back positive for an infection. They put me on 3 different antibiotics, increased my mag and put an ice blanket on me to get the temperature down. My doctor had the anesthesiologist consult in case I had to have a c-section and she also had the surgeon come in. A hematologist (blood doctor) was called in and ordered several blood cultures. They took 7 vials of blood from an artery on my left arm and 7 vials of blood from a vein in my right. Meanwhile, the contractions continued getting more and more painful and more and more frequent. My doctor kept calling the perinatalogist to see if there was any other medication that I could take to stop the labor from progressing. Finally, he told her she could give me one shot of terbutaline but if that didn’t stop it, we would have to just see what happened. The nurse administered the shot in my left arm and within 30 minutes my contractions began to slow. An hour later, my doctor felt I was stable enough that she could leave. Finally, we settled in to get some sleep. We both slept fitfully but woke the next morning feeling relieved and that we really dodged the bullet. On Monday, October 28th they removed the catheter and told me I would have to request the bedpan when I needed to urinate. Believe it or not – that was a victory. On Tuesday, October 29th I reached the 28 week milestone. We felt this was a truly hard fought victory. My doctor ordered a second round of the beta methasone shots hoping that it would help the boys lungs develop faster. By Wednesday, October 30th I was beginning to feel like my old self again. On Thursday, October 31st I asked to get a tour of the NICU. They put me in a wheelchair and I got to talk to a nurse and see what the NICU was all about.

When I returned to my bed, the hematologist was there to tell me that I was severely anemic. My hg levels were around 7 and they should be between 12-14. If they couldn’t get them up I would have to have blood transfusions. To boost my hg levels, he ordered weekly shots of epogen, a red blood cell booster, as well as, 1800mg of iron per day. I called Tom to let him know that I may need a transfusion. He called my friend and neighbor Kelly who then organized a blood drive with all her friends. People I didn’t know or hardly knew came to the hospital in droves to donate blood just in case I needed a transfusion. That way I’d have “friendly” blood instead of the unknown. It’s at times like that when you find out what kind of friends you have and the generosity of the human spirit. My hg levels were checked daily and by the next week, I was out of the danger zone.

But, there was a new danger. Also on Thursday, October 31st I suddenly felt a little fluid leaking from me. The nurse checked it and it tested positive as being amniotic fluid. This meant I had a leak and that it presented the danger that the amniotic sac could become infected. They did an ultrasound to see how much fluid was surrounding the babies. They looked fine, plenty of fluid. The doctor said the sac could eventually seal over and that we’d just have to wait. The babies would be monitored continuously from now on rather than for a couple of hours a day.

On November 7th I received my final shot of epogen. On November 14th, I was no longer leaking fluid and the doctor determined that the rupture had sealed over. By this time I was having fewer and fewer contractions and they started lowering the mag dose. On Saturday, November 16th my doctor visited me and commented that I was hardly having any contractions. She said that they’d get me to 32 weeks, then discontinue the magnesium. I’d have to stay in the hospital but she thought they would deliver me at Christmastime when I’d be at about 36 weeks.

My water broke the next day and the boys were born at 11:06am and 11:07am.

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