Saturday, July 3, 2010

sleepless night

Warning: this post may contain TMI including talk of bodily fluid. Discontinue reading if this will bother you.
Wednesday and Thursday at two seperate times I noticed some wetness with no color or consistancy. Each time it was probably about a tablespoons worth and soaked through my clothing. Knowing that sometimes the amniotic sack can develop a small tear and slowly leak, I wanted to be sure this wasn't amniotic fluid because this can be dangerous in two ways: if the sack is torn, bacteria can enter and infect the baby and the longer she's exposed, the more danger there is, also if fluid slowly leaks out without me realizing it, her protective cushion goes away and suddently she's in a very hard environment that can easily injure her in many ways including brain damage.
So, I called my doc at about 7am leaving her nurse a message to see what she thought. At about 0930, the nurse calls me for details and says she wll leave a note for the doc to see what she wants to do. At 1330 I still hadn't heard anything, so I called back to see if the nurse had talked to the doc. She said she still hadn't heard anything from the doc (slightly frustrating). While we were on the phone I mentioned that my contractions had picked up again that day, although they still were not painful. She said to time them for two hours and then call back.
I timed them and they were 4-5 minutes apart. I calld back at 1530 and left another message telling her this.
At 1600, she called back and said she had talked to the doc and she wants me to go into L&D right away. UGH. I sighed and said: "really, again? But the contractions don't hurt and I haven't had any fluid since 6am, so I didn't think there was anything to test at that point anyway." I was a little frustrated because I called so early hoping I could just get into the office that day and simply test the fluid. But, now it was so late that the office was closing, so my doc said the only way to do the test was to go to L&D. But, my last experience in L&D wasn't the greatest, so I really didn't want to go back until I was really having this baby.
But, for the safety of my baby, I went back in to check the fluid.
I arrived and they hooked me up to the monitors (standard procedure) and proceeded to tell me about the two tests that can be done to test for amniotic fluid. The first is a little strip of paper that is placed near the outer "area" and will change color if amniotic fluid is present. This can be performed by the nurse, but is less accurate than the 100% accurate "fern test". The second test can only be performed by the doctor and a swab of fluid is taken from the cervix and looked at under a microscope.... if the fluid creates a "fern" like crystal shape, then it is amniotic fluid.
The first test was performed and was negative, and the on call doctor (not mine) decided not to do the fern test. Instead, they had now become more concerned with my "strong" and regular contractions on the monitor.
I told them that I'd been having these for a couple of weeks and that they didn't hurt and they are really nothing to get excited about. Well, they disagreed and decided to "watch" me for a while. They checked me and said I was 2cm, 80% effaced and -2 station (where the babies head is... -4 being far away and +4 is basically the head is out). I contracted every 3-4 minutes and nurse came in once again with the terbutaline to stop the contractions. This time I refused and told them that my doc didn't want me to have that. Nurse seemed annoyed and said she would go out and call the on call doc again.
She comes back in and decides to start an IV to give me fluids and a muscle relaxer because I had told her that this is all my doctor wanted me to accept. Here we go again.
After a while she checks me again and says I am now 3cm dilated, 80% effaced and -1 station with no change in contractions. SHe calls on call doc again because now she tells me they are concerned that I'm having cervical changes with these contractions, but I am not yet 37 weeks.
Doc says she really wants to stop the contractions and would like to give me IV morphine and an extra shot of muscle relaxer three hours before I should be able to have another ( the normal dosing is every 6 hours)
I absolutely refused the morphine and told her I would feel more comfortable not taking an extra muscle relaxer until the 6 hour mark. Annoyed, the nurse agreed to wait. I told her that I have a script of this at home that they had given me last time and I could take another if I needed. But, they wanted to keep watching me, which meant I had to stay until 3am to take this next dose. Sigh.
Meanwhile, they have also started IV antibiotics for my "unknown" GBS status even though I had told them it came back negative on Tuesday. But, the on call doc wanted to proceed anyway with every 4 hour antibiotics.
I fell asleep (as much as you can in a hospital) around 1am and my contractions really slowed down, almost completely going away. I'm not sure if this is from the muscle relaxer or if this shows that they were not real contractions, but simply an irritable uterus that calms when I go to sleep.
The nurse comes in at 3am and wakes me up to take another muscle relaxer, although i clearly don't need it.
Then at 4 she comes in to hang another antibiotic and bag of IV fluids. At this tme, I ask why I'm still here since I'm no longer contracting? She said the on call doc decided to keep me overnight until my doc can come in the morning and decide what to do with me.
So, I'm thinking the on call doc got a little annoyed with me not following her orders and said "fine, let her doctor deal with her in the morning if that's what she wants".
I also asked if I still needed to have so much IV fluid because the point was to rule out dehydration as a cause of contractions and since I was no longer contracting, was swelling up with excess fluid and having to pee every half hour, I thought we could just turn them off. But no, doc has orders to keep running them, along with the antibiotic because apparently my urine sample had a possible infection and the luid would flush it out.
This showed up in my urine sample last week, but when looked at closer they realized the bacteria was simply a contaminate and not really a UTI that needed treatment. I told the nurse this, but it did no good. Antibiotics and excess fluid would continue "just in case."
So, we laid there all night. When my doctor arrived in the morning she was very confused as to why I was there. She said "I sent you in simply for a fluid test, what the heck happened around here?" She said she was confused about what had gone down overnight. I told her the frustrating story and she was also frustrated to say the least. She asked why they didn't do the fern test, because that was the whole purpose of me being there. She quickly performed the test herself, it came back negative and she said I could go home.
She was annoyed that they once again were so focused on trying to stop contractions that aren't painful and unproductive. SHe thinks I just have an irritable uterus and that I will just continue to do this for a while. She said she is frustrated because they are only looking at the monitor and not looking at the patient or listening to anything I say. She said that I probably dilated more because they checked me so much (by day nurse, day nurse in training and night nurse twice, and so rough that I was now bleeding a little) and my cervix is already so soft that she said it would be easy to manually dilate. She didn't think it was the result of the contractions.
She said she would leave specific notes in my chart to not bother trying to stop labor as this is just a slow progression for me. She told me that I will know when it's real because they will definitely hurt. She still thinks I'm close to going into real labor, but that this was not it.
So, we came home at 9am very very tired and frustrated.
Now, we wait some more.
Oh, and the fluid is still a mystery. I refuse to believe I peed myself without knowing it. That's just too embarassing.
Other complaint- hospital beds are the most uncomfortable things in the world. When they asked me to rate my pain I wanted to tell them that the contractions were a "0" but my back and butt were about a "6" from the stupid bed and the fact that I can't really change position being hooked up to the monitors and IV fluids.
I'm going to avoid that place until I'm in some serious labor pain or I'm pretty sure my water breaks. And I really really hope my doctor is there when I deliver.

1 comment:

  1. You just need to have her. She's a girl and with all the preterm labor I'm sure she's been stressed enough to develop those lungs. Just get her out!!!

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