Thursday, February 04, 2010
This last pregnancy we went in a much different direction than we did with our oldest two. I started off care with an OB, and quickly transferred care after my first encounter with her. She was nice enough, but too over eager to assume I was going to be at high risk for preterm labor, and was telling me how I was going to be giving myself progesterone injections starting at 16 weeks. Without even examining me first. That freaked me out. I was not about to hand my pregnancy over to someone who was a fearful care provider. And by fearful I mean someone who treats you with the worst case scenario in mind at all times.
I then began to see a CNM (Certified Nurse Midwife, a midwife who already has her BA in Nursing and has additionally completed a nationally accredited midwifery program, many also have Masters in Nursing). The CNM was one of two who worked with 3 OB/GYN's in a womens clinic in the area. I really liked them, except as I had a few more appointments I was noticing that they worked in the office on their on call days (CNM's did all call during the week and OB's on the weekend). The CNM's would get called out for a delivery and then be back within a hour to see patients. That I did not like. 1) I wanted a midwife because traditionally they are there for you during all of labor and birth, unlike an OB who floats in and out to check progress and catch your baby. If I wanted to have my labor managed by an RN at the hospital, then I would have stuck with an OB. And then the second issue I had was that at my exam one of the CNM's checked my cervix and told me "Oh its definitley shortened, we will have to watch you for preterm labor for sure" and then a week later I had my 18 week ultrasound which showed a 5cm cervix (which is VERY THICK and there is no way it was 2.5cm like the CNM estimated the week before). That made me wary of their care and I did not want to be treated as high risk when I was NOT!
After that ultrasound I was unsure about what to do. I really had originally wanted a homebirth but our insurance would only cover a CNM who did them. And when I was first pregnant I was unable to find one in our area who did those. But late one night in June I began researching again and stumbled upon the website of a CNM with 25 years experience delivering in hospitals, birth centers and home that lived in Denver. I emailed her with my pregnancy history and our location (1 hr from Denver) and asked if she would be available to be our midwife. The next day I found out she was! We set up a meeting for the next week and it was great. Hubs had great confidence in her and I really liked her alot. She does evidence based prenatal care and doesnt stick to all the usual protocols most OB offices do these days. Every test was optional, she would explain in detail the evidence on both sides, risks and benefits and leave the choice to us. She would inform us of her opinion or preference when asked, but for the most part our care was OUR care. I never had to pee in a cup (yay), I declined the gestational diabetes test, but opted for the GBS test but also treatment with antibiotics in labor was also left up to me. (I was negative but would have had antibiotics had my water been broken for more than 12 hrs before delivery). We didnt do cervical checks but once when she was here at 33 weeks and I had been having alot of braxton hicks all day and was concerned, and there was no change. After that the only check I had was the day our little man was born. She is very non invasive, but at the same time she KNOWS her stuff. I was impressed with her knowledge and how much she researches and reads up on the latest studies and medical journals. She truly gave me amazing care.
The plan was to have a home birth, preferably a water birth. Once 36 weeks arrived we had everything on hand that we needed including the tub and hoses to fill it up and temperature gauges, etc. Hubs and I were very very excited for our baby to arrive. During my whole pregnancy my lab work, my blood pressure, everything had been excellent. No problems, no complications, no cause for concern.
That would all change on the evening of September 13, 2009. About 10pm that Sunday night, everyone was asleep except me. I went downstairs to watch TV, I think I was watching a dvr'd Project Runway. I was laying on my side on the couch and all of a sudden I started having this pain in my upper back, between my shoulder blades. I thought I must have pulled something, and adjusted how I was laying. Hmmm, that didnt help. So I sat up and tried to get comfortable. No matter what I did, nothing helped. The pain intensified. The only way I can describe the pain was like a burning white hot pain that was constant. I tried rocking on my hands and knees, I tried sitting on my birth ball. I tried relaxing in the bath tub. By this time it was about 1115pm. I attempted to lay down in bed to relax but I obviously could not get comfortable. I stomped out of bed about 1130pm and woke Hubs up. I was irritable and in pain and frustrated that I didnt know what was going on and that I couldnt get any relief. I decided to try a hot shower and during that time Hubs came in to see what was going on. He was going to run to the store to get some Tylenol as we were out. While he was gone I stood in the shower and cried and cried. The pain was so intense, it didnt let up for second and was only getting worse.
I got out of the shower and tried every way I could think of to lay, stand, whatever to get some relief. I was a mess by the time he got back. I popped the Tylenol and then just sat there and cried as he held me. I remember him saying, we need to call Janet (MW). He called and described for her what was going on and then I talked to her. She said she wanted us to go to the nearest hospital to have my labs checked. She was worried it was my liver (I had had issues with some slight preeclampsia and overly elevated liver enzymes with my first baby that necessitated an induction at 35 weeks 6 days). So we woke up and packed up the kids and headed out to the hospital. It took us about 10 min to get there and they were waiting for us when we arrived as Janet had called ahead.
We were ushered into a triage room at Labor and Delivery and I was quickly hooked up to uterine monitors and a BP cuff and asked to change into a gown. So not how I wanted to be doing things. Let me just say that being hooked up to machines while you are in constant pain SUCKS. Almost made the pain worse. Then the RN asked me to leave a urine sample, which I tried but was unable to pee at all. Weird even though I had drunken alot of water that whole day and evening. My blood was finally drawn about 1am and then we didnt get the results back until almost 2am. About a week before this day I had done a blood draw for Janet, just to check all my levels (liver included) to have a baseline in case something went haywire with my pregnancy. Let me just say that was one of the longest hours of my life. By this point I was shaking uncontrollably from the pain, trying to get comfortable on one of those stupid triage beds was just not happening.
When the results came back my liver enzymes had tripled in one weeks time. THAT IS NOT NORMAL AT ALL. Weird thing is, they were more concerned with getting me to leave a urine sample than with my crazy liver enzyme levels, the huge drop in my blood platelet count (dropped over 100 points in one week) and my high BP readings. They were so determined to get a urine sample to see if I was spilling protein that they decided to do a catheter, as I wasnt cooperating with leaving a sample. I COULD NOT PEE. I would have if I could, but nothing was happening.
Having two nurses chastise you for not holding still (hard to do when shaking uncontrollably) while ramming a catheter in you while you are in no way numb is extremely horrible. I was so pissed and in pain at one point I just yelled let me try the damn cup! Hubs followed me to the bathroom, turned on the water and I prayed Lord Jesus please let me pee, please please please. And within a few minutes I eeked out about a teaspoon. It was enough for them to do a urine dip on it. Which of course took another HOUR to process.
By 3am the RN came in and said the Dr on call wanted her to do a cervical check as the monitor was picking up some contractions. I was apparently dilated to 2. And contracting a bit. The RN went back to share this with the Dr. Which I may add never once came to see me until after I was admitted into my room. Don't get me started! In the meantime Hubs had been on the phone with Janet, who had also been talking to our RN there about my symptoms and results. Janet told Hubs to not let them let me leave there, I needed to be admitted. The RN came back in about 10 minutes later and said "Well Dr. SoandSo said that since you are dilating and contracting, we can go ahead and admit you if you like. Its your choice" THEY WERE GOING TO LET ME GO HOME. Alarms were going off in my head that these people are IDIOTS. Something is very wrong here with me and you are giving me the option to stay or go. WHAT???
Of course I said, yes keep me! And I want something for this pain NOW. At this point the pain had been going on for over 5 hours. Oh and before we got to the hospital it went from just being upper back, to right below my ribs, like a band across the top of my abdominal area. I was vomiting like crazy also. The thing is I had so many symptoms of HELLP syndrome and they were treating me like I had no idea what I was talking about.
to be continued....
0 comments:
Post a Comment