Wednesday, February 10, 2010

Hey, So What Happened?

As most of you know, we had a four day stay at Labor and Delivery last week. Some of you have asked me via Facebook what exactly happened so I will attempt to recall last week's events. Bear with me as I know this shall be lengthy. One of the reasons I blog is for my own personal benefit. It is a means for me to document our life...the good, the bad, the crazy.

***It is worth noting that last week's complications/hospital stay began on Groundhog Dog. Six years ago (to the day), was when I was admitted to the hospital while pregnant with Parker with similar complications...Groundhog Day 2004. How ironic that my first pregnancy and last pregnancy should be connected in such a way!

Tuesday, February 2nd

I had three different appointments scheduled to begin mid-morning...OB, MFM, and dietitian's office (for gestational diabetes education). My OB appointment was fairly routine...weight check, BP (122/80...all is well at this point), no trace protein in urine, Hudson's heartbeat sounded good, and I was measuring right on. We briefly discussed the risks associated with gestational diabetes babies and began talk of a c-section date. I informed my OB I did not believe my bladder infection was completely cleared up (despite the antibiotics) and she ordered another urinalysis. Upon leaving, I set up additional (weekly) visits through mid-March for NST's (Non-Stress Tests) and growth scans. Eric and I left in good spirits with no idea what the coming hours would bring.

Before heading to lunch, we stopped at the Outpatient Lab so I could have my urine tested for said infection. Then it was off to lunch, where my lovely husband had me drooling over the margarita and beer he enjoyed (have to bring some laughter to this post, right?!). At this point, I am thankful for the yummy steak, grilled veggies, and salad I consumed as later in the day I would find myself without food or drink.

We arrive at MFM (Maternal Fetal Medicine) for our second appointment of the day. We begin with the typical weight check, urine specimen, and blood pressure check. The ultrasound tech is alarmed with my blood pressure of 168/101. At this point, Eric and I are speechless. We were not alarmed with the blood pressure itself (sad, I know). Frankly, we have seen it sky rocket much higher in previous pregnancies. We informed the tech that just a few hours prior it had been 122/80 at my OB's office. With that information, we agreed to check my pressure again following my ultrasound (and after I had a chance to relax and lay down).

During our u/s we learned that Hudson was indeed still a boy and looked wonderful. He was sleeping for most of the u/s and the tech joked about him sleeping for endless hours as a teenager. She attempted to wake him up for a good 25 minutes (to see if he was practicing breathing) and he wanted no part of it. He was head down and laying somewhat at a diagonal (exactly the way I thought he was). According to his measurements she estimated him weighing 4lbs 8oz (approximately 1 week, 4 days ahead).

Following the u/s an RN came back in to check my BP again. We were hopeful it had went down, but no such luck. In fact, it was higher. The RN left and a few minutes later Dr. JP entered and declared he had no choice but to admit me considering my BP and previous history with preeclampsia. At that point, he mentioned we may or may not deliver after further testing. My heart sank and we made our way with an RN to Labor and Delivery. Neither Eric nor I said much and we cannot truly recall the path from his office to L&D. I felt a tad bit uneasy being in a different hospital than I had ever delivered in previously, but also fully understood we were at one of the best hospitals should we deliver (as they have a higher lever of NICU).

Upon getting into our room, things seemed to happen really fast. There was lots of people in and out getting additional information. They promptly started an IV and soon thereafter I had magnesium sulfate flowing through my veins. You can click on the link to learn more about this drug; however, I will say its primary purpose in the instance of preeclampsia is to prevent seizures and strokes in patients. I was on ''mag'' for almost 6 days when I delivered Parker and I DESPISE it with a passion. The side effects are nasty. Personally, it makes me VERY hot and groggy (medical staff would tell you this is how other patients feel as well). It feels as though the world around you is in slow motion and your thought process is rather drawn out and hazy. Your words begin to slur, your eyes begin to droop, and blood vessels in your eyes start to ''pop''. Yes, it does wonders. However, it royally stinks.

***A few side notes...Normally, RN's have a difficult time starting an IV on me. Picture a Rocky Horror Show with blood squirting everywhere. However, Jeri (my favorite RN during my stay) was a rock star. I was somewhat hesitant as she started the IV in my arm, but I soon discovered it is far better than one in your hand (take note pregnant ladies). When it does come to deliver, I will request one in my arm again. While Jeri was starting my IV, another RN was busy distracting me with health history questions/delivery plans/etc. This lead to a few ''funnies'' as I was attempting to find humor in the situation. At one point she asked me to relay to her why I was my own words. ''Well, in my own words...I am dysfunctional when I am pregnant,'' I replied. Seriously, that is how I feel. In my own words. I asked if she needed a real answer (you know just to make sure I was fully aware of what was going on and all). No, my answer was alright. We proceed with a few more questions and then she asks if I would like an epidural. "Gosh, I am hoping for an epidural or spinal with a c-section and all,'' I promptly declared. Oooops...she had yet to see I would be a repeat section.

Okay, back to business. We would need to do a 24 hour urine collection to check for protein. It is then I remembered that while on mag you are not allowed to get up. Enter everyone's friend...the catheter...the dreaded Foley...whatever you wish to call it. A few deep breaths and the cath was in place. Next, I received my first (of two) steroid injections to speed up Hudson's lung development should we deliver in the upcoming days. I was ''thinking'' it could be done via IV, but no such luck. It is most effective when given in the hip area (bless Jeri for massaging the area post injection). I am informed at this point I am to not have anything to eat or drink in the event we should deliver and also because of the ''mag''. biggie. However, while on ''mag'' you crave water. It dries your mouth in the worst possible way. I spent the remainder of the evening conning the RN's into sips of water here and there. My bad! Hey, their bad as well;)

After my initial blood work results came back we learned my potassium levels were very low. We also got the results from the urinalysis. As I thought, my bladder infection/UTI was still present. At this point we add an antibiotic and straight potassium to my mixed drink (aka IV). Later on, I send Eric home to be with the boys. I spent the rest of my night texting and calling anyone who would tolerate me at all hours of the night. Lord only knows, I could not sleep.

Wednesday, February 3rd

My OB makes her rounds and declares that MFM is basically running the show (as they admitted me). Personally, she would have taken me off the ''mag'' at this point (as my pressures had come down thanks to bed rest) and would have been okay with me eating. Her thought process was that more than likely we would not be delivering that day for two reasons. One, the 24 hour urine collection was not complete (would end at 3pm). Second, we had one more steroid injection to give (which would also take place around 3pm) as they like to space them 24 hrs apart. After the second dose, it is then ideal to wait 24 hrs before delivering. However, she was no longer in control. Hey, I moved up to clear liquids though...SCORE!

Throughout my stay, we were drawing labs every 6 hours. By early afternoon we learned my potassium levels had dropped from the previous day. Ummmm...haven't I been getting straight potassium via IV? How is this possible? We learn that potassium is directly related to your heart muscle and the doctors are rather concerned. With that in mind we begin a more aggressive treatment. We continue with the straight potassium, change to a saline solution mixed with potassium, and an oral supplement.

Eric returns around 1pm and we enjoy lunch together...he a nice big salad. For me...jell-o, chicken broth, and hot tea. It was lovely;) At 3pm the RN turns in my containers (yes, plural...apparently this is rare) and we learn 300 is the magical number (as in the cut off point) for my protein levels. I receive my second steroid injection and we say a prayer for a number below 300. About two hours later, a very understanding resident entered my room, sat on my bed, rested her hand on my leg, and looked me in the eyes. She did not have to say anything. I knew. The look on her face said it all. I asked her what my value was and she replied ''700''. I started to cry. I asked if it could have been due to the infection, due to this, due to that, etc. Both the resident and RN said the infection could play a small role, but not more than double. Crap. We are informed that more than likely we will deliver at some point the following day.

Shortly, someone from the NICU comes up from the second floor to brief us on what to expect from a 32 week baby....the need for a vent, feeding tube (when the time comes), scan of the brain, possible need of caffeine, eye testing at 6 weeks old, and the list went on and on. We learned who was allowed in to the NICU and such. She asked if we had any additional questions. Normally, I would have been drilling her. However, thanks to my friend ''mag'' I could only manage a few. I politely thanked her and told her I was certain we would be full of questions once our sweet boy arrived. After she left, I looked at Eric and broke into tears. We were both trying to grasp the idea of having a newborn in the NICU for potentially 4 weeks, three additional kids at home, and Eric's chaotic work schedule with the upcoming outage. After a brief discussion we decided there was no way we could devise some master plan and we would have to take each day as it came. My mom, her husband, and beloved Papa arrived for a visit. Thank goodness. My mom (an RN, by the way) began to drill Jeri (my faithful RN) about her own baby laying in the bed and her unborn grandson. I do not recall much of their conversation, but I do know my mom left feeling certain both of us were in good hands. We were where we needed to be. Thankfully, a different room was available within the was smaller, but had a more comfortable bed (compared to hard labor and delivery bed I had been laying in). Again, I would be having a c-section and gladly accepted the smaller room. I welcomed sleep that night. Dare I admit, I was almost thankful for the cath still in place and not needing to get up to pee every 15-30 minutes. Afterall, we have also learned I have overactive kidneys.

Thursday, February 4th

Oh, what a glorious site my OB was early morning. While I know MFM are the specialists, my OB knows me. She has weathered me through two previous pregnancies. I trust her with my own life and that my unborn child. I wish I had discovered her during my first pregnancy. I have been a patient of MFM's for my second and third pregnancies; however, a new doctor took over the practice recently. Honestly, I feel like last week there may have been a slight tug of war between my personal OB and MFM.

Moving on with the good news...Dr. M enters my room and I learn some labs have changed (for the better) and we will not be delivering Hudson. Thank you, dear Lord. Thank you, to everyone who prayed for us. I breathed a sigh of relief. I questioned my ''protein value'' and in her opinion my bladder infection was so nasty it very well could have caused the excessive rise. She said my RN would be in shortly to stop the ''mag'', I could eat, get up to shower (sweet words to my ears), and the cath could be removed in time. She informed me it is highly unlikely I will make it to term and the decision as to where bed rest would occur was yet to be determined. We discussed that my potassium levels were still down and we would keep proceeding with oral supplements. FYI...a value of 3.5 is the low end of normal. My doctors would accept 3.1 and I had been varying between 2.1-2.8 (with three different drugs). I thanked my OB as she left and began to spread the good news.

Overall, Thursday was an okay day (okay for a day spent in the hospital). I learned fairly early in the day I would be staying another night for observation. We needed to see how I faired without the ''mag'', the IV potassium drugs, etc. Yes, I wanted to get home. However, I was thrilled that Hudson was still happily cooking inside me. I was free to shower, get up to use the bathroom, and partake in real food. I managed to get some pretty decent sleep throughout the day and watch quite a few reruns of CSI on Spike TV (miss you, dear Grissom).

Friday, February 5th

I was hopeful for an early morning discharge, but no such luck. Dr. M's husband, Dr. G (a fellow OB as they are in practice together), made the early morning rounds and informed me my potassium levels had dropped again. The oral supplements were not cutting it and we would have to go back to the IV form. We would retest after one round of drugs. If my level was acceptable I could go home, but if not an additional round would be needed. In addition, they had to give me more IV antibiotics for the bladder infection. The RN'S all agreed they had never seen so many antibiotics pumped into someone before and I began to understand just how serious my infection was.

After breakfast, Jeri (who was back on duty after having Thursday off), started the straight potassium. Finally, I broke down in physical pain. Earlier in the week, I had been on the straight potassium as well. However, at the time it was mixed with my other drugs (including the ''mag'' which dulled my senses). With nothing else flowing but the potassium all I can say is ''Holy cow''! It burns. Badly. Jeri commented she had yet to see me break down due to physical pain so she knew it was bothering me. We tried a hot compress over the injection site, but that did nothing. I suggested an ice pack as my body typically responds better to ice. Jeri then added she could piggy back some saline solution to the potassium which would cause it to run through faster. Go for it! Thankfully, when we combined the ice and extra fluids it became more tolerable.

The time came for more lab work and I crossed my fingers. I should have crossed my eyes and toes as such luck going home. I would need another round of potassium for a longer period of time...four hours. We would draw labs an hour after that. As I looked at the clock, I realized the next blood draw would occur around 9pm and I was beginning to think I was not going anywhere for another night.

I called Eric and said he needed to bring the boys up to see me that night. Up until this point, I had not seen them since leaving for my appointments at 9am Tuesday. I have NEVER went more than 24 hrs without seeing any of them. I had been talking to them daily on the phone throughout the day. We connected each night before bed so I could sing them their bedtime songs/say our "I love yous''/etc. We had refrained from letting them visit earlier in the week as they were all getting sick. In addition, I did not want them to see me earlier in the week while I was on the ''mag''.

Eric and his mom arrived around dinner time with the boys in tow. Parker and Garrett had a million and one questions about all of the medical equipment. Ryder was thrilled with mommy's water pitcher/cup and my tube of chapstick. We listened to Hudson's heartbeat together and Ryder danced along to the beat. They each brought me a stuffed animal from home ''to keep me company'' and I assured them their lovies would return home with me. It was beginning to get late, the boys needed dinner (more than what mommy had shared with them from her plate), and the first round of snow was on it's way. Before leaving, Eric informed my RN he would gladly come get me at any hour. In the snow. He just wanted us all home.

Around 10pm, a shining light (in the form of a resident) entered my room and declared I could go home. I did a little dance, but not a big one...that would be too stressful. He reminded me I was to be on bed rest, how sick I had been (and still was), what to be on the lookout for, the meds I was going home one, etc. I called my mom and asked her to go over to our house (she was on her way home from the hospital after visiting) to sit with the kids. My personal Prince Charming arrived at 11:30pm equipped with snow boots, blankets, and a smile. We made our way home in the storm and arrived safely.

Upon getting home, I checked on my boys asleep in their beds. Parker was dead to the world, Garrett looked at me and said ''Hi mama'', and little Ryder opened his peepers and smiled at me. Our bed in the living room never looked so good;)


mustangkayla said...

Oh my word what a ride you have been on! Huge **hugs** to you! Your post brought tears to my eyes, I was sitting here nodding my head to some of your comments thinking "that was just yesterday...I remember that"! I'm so glad you are at home and still pregnant! I hope you are obeying your dr.s orders!

Stephanie said...

What an ordeal!! I'm so glad you are still pregnant and at home baking the baby.

Stacy said...

holy moly! Quite an ordeal, you are a trooper! Keep that little guy baking, so glad you are home, and I really hope the rest of your pregnancy, (however long it may be), is much less eventful!


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