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Hospital Visit - Karen's Musings
Random Rambling
Hospital Visit
Many of you read Seth's blog, so many of you know that I spent Sunday evening and all day Monday in the hospital. I came home last night and all is well now, so not to worry. So here's what happened... It is, of course, pregnancy related, so I'll put it behind a cut for those of you who don't want to read about such things.

I generally do contraction monitoring twice per day: once in the morning and once in the evening. My current "threshold" is 8 contractions per hour. If I have fewer than 8 contractions in the hour of monitoring, I don't have to do anything. That's how many I'm "allowed". If, however, I have 8 or more, I have to re-monitor, and depending on the timing, may have to give myself an additional dose of terbutaline (depends on when my last auto-dose was). The nurses at the monitoring company are allowed to have me remonitor twice (for a total of three monitoring sessions) before they have to call the doctor. If during any of those monitoring sessions my contractions drop under my threshold, the cycle stops and I get to go back to doing nothing. It's a simple enough plan, right? Right.

If I remember correctly I'd had a bunch of contractions Saturday night, but it was easily resolved with one additional terbutaline dose. Sunday morning I monitored from 8:30 to 9:30. This should have been a relatively decent time to monitor contraction-wise because I get an auto-dose at 9am so at least the second half of monitoring should have been relatively quiet. No dice. I had 15 contractions in that hour. So the nurse asked if I could tolerate an additional dose at 10am and I said I thought so, so that's what I did, and re-monitored from 10:30 to 11:30 figuring that all would be well, and that I would still have all afternoon to get a shower, change the site for my terbutaline pump, and laze around. No dice. I had 8 contractions. One too many to be off the hook. I was getting an auto dose at 12, so I was asked to remonitor from 12:30-1:30. This should be a breeze, though. Three doses in that short a time frame... it was getting hard to breathe comfortably, and I rarely needed that many doses to control the contractions. Surely this would get me down to SEVEN contractions, right? No dice. Nurse called me back at 2ish and said I'd had 12 contractions. Honestly, every time she called me, she sounded more despondent. I felt like I was letting her down! So this meant plan B... calling the doctor. So she went to do that and I waited, figuring I'd take a shower once I heard back.

And I waited.

At 2:40 or so the nurse called me again asking if I'D heard from the doctor, but I hadn't, so she re-paged the doctor. I wasn't super-stressed, because I figured the doctor would probably put me back on a 48-hour indocin treatment again which is what happened last week when this happened and it worked, so why not do it again? A little before 3:30, the nurse called again saying that the doctor wanted me to try one more demand dose of terbutaline at 4pm (I'd gotten an auto-dose at 3pm) and remonitor for an hour before deciding whether to have me come into the hospital to be checked. I was hesitant because the cumulative effect of all the terbutaline boluses was starting to get to me, but I agreed to call the nurse back at 4pm, check my pulse and figure it out. By 4pm it was a different nurse (on weekends, it goes to the after-hours center in Philly at 3:30), and she said if I felt comfortable giving myself another dose, I should do so, but otherwise, she'd call the doctor for me. Since my pulse was fine, I went ahead and followed the plan, gave myself a demand dose, and remonitored from 4:20-5:20. Fifteen contractions. And off to the hospital we went.

At the hospital, they did a fetal fibronectin test (thankfully negative), and I was put on fetal monitors (3) and a contraction monitor (for a total of four monitors... Seth threatened to take a picture of my belly, but I forbade him). Since I was still having a lot of contractions (go figure), they put me on IV fluids. The doctor called me and talked about some options and we settled on trying three doses of Nifedipine (Procardia) spaced half an hour apart. If the contractions didn't calm down by the end of that hour and a half, she recommended admitting me overnight for more monitoring/observation and an ultrasound in the morning. Unsurprisingly, the Nifedipine did NOT slow my contractions enough, so I was admitted per the plan. Also, she put me on Indocin for 24 hours (still not sure why she did 24 hours and not 48 hours like they'd done the previous week, but whatever).

The Indocin, unsurprisingly, DID work overnight, and by 6am, my contractions had slowed to just a few per hour. So I went for an ultrasound first thing in the morning and met with the doctor. Now, this is the doctor I see the least of all of the practice members... she spends most of her time in the Silver Spring office, and I spend most of my appointments at the Rockville Office, and also, she's unlikely to deliver me as she's moving back to Boston in September, so I've not made a conscious effort to see her more often. She's a very good doctor, and spends a lot of time with me, so I've got no complaints. I hated her the first time I met her, but when I had to follow up with her the next day, she turned out to be absolutely amazing and perfect, so I completely revised my initial impression of her. (I think the reason I hated her the first time I met her was that I was hearing not good news and I didn't know her... had I already known her, I probably would have taken the news a lot better) Anyway, the ultrasound was okay. Mostly, they wanted to make sure that my cervical length was still stable. It was significantly shorter than last week, but not any shorter than it had been before I went on bed rest, so she wasn't stressed about it. Neither was the other doctor who was in the Silver Spring office that day, who is very conservative about such things. The babies are all doing just fine, which is always the case. Their health and development has always been perfect. The only thing in question all along has been MY ability to keep them on the inside for long enough.

While I was there, she asked if I had any other questions and I said that I wasn't trying to be a nudge, and I would do ANYTHING I was told to do, but that my Matria nurse had suggested I ask... but anyway, since all my blood sugars had been perfectly, utterly, completely, ridiculously normal, and since the only reason I'd been taking them in the first place was because I'd failed the one-hour screening and couldn't sit for the 3-hour test ... could I maybe take my blood sugar levels slightly less often (I take them 4x per day now). She said I could take them twice per day if I wanted to, but warned that the further I progressed in the pregnancy, they'd probably make me go back to 4x per day anyway. Fair enough. May not be worth giving up the four times per day then. It was worth a shot. I don't really mind doing it, but boy are my fingers sore. Anyway, the doctor went off to type up the ultrasound report and was probably going to let me go home mid-morning after a bit more monitoring.

But then... a miracle! She popped her head back in the room and said, "well, hey, while you're in-house, do you want to just go ahead and take the 3-hour glucola test?" Heck yes! Except, uh, I'd already eaten breakfast (and can I just say how unbelievably disgusting kosher hospital food is? ICK!). No problem, she said, they'd just wait until 4pm to do the test, and I'd just not eat anything in the interim. Fair enough? Yep. Worked for me. I'd still get discharged that evening if I wanted (the doctor did say that if I felt more comfortable staying another night or two, that was fine with her... uh, no thank you). I figure it was win-win all around, aside from having to spend a day without internet. Either it will turn out that yes, I DO have gestational diabetes and I have to continue to monitor my perfect blood sugars but I won't have to be bitter about it, or it will turn out that I DON'T have gestational diabetes and I won't have to monitor my blood sugars anymore. Either way, it's a win for me. :) I don't have the results yet, but until then, I'll just keep monitoring my blood sugar and doing what I'm told. It's all good.

So now I'm home. I got home around 8pm last night. I'm very tired, but happy to be home, with Julian & Seth and my precious internet. The hospital wasn't terrible and I know I'd survive extended hospital bed rest if I had to, but I'd rather not find out just yet. The nurses were all terrific, and it could have been far worse. But I am still quite grateful to be home for the moment.

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ginamariewade From: ginamariewade Date: August 21st, 2007 09:08 pm (UTC) (Link)
I'm glad everything turned out all right in the end. How many weeks now?
estherchaya From: estherchaya Date: August 22nd, 2007 07:24 pm (UTC) (Link)
29 weeks. So getting there, but not quite there yet.
buildin_a_bayis From: buildin_a_bayis Date: August 21st, 2007 09:22 pm (UTC) (Link)
Also happy to hear that the babies OK and still inside of you. Hope things keep going well...
journeytoernie From: journeytoernie Date: August 21st, 2007 09:52 pm (UTC) (Link)
i'm glad you're doing ok! that's scary!!!

i am always amazed at how well you're doing karen. you truly are a hero and deserve a pedicure :)
estherchaya From: estherchaya Date: August 22nd, 2007 07:32 pm (UTC) (Link)
There's really no good point in freaking out everytime something like this happens, in my opinion. This is the game that I'll be playing from here to the end, and I know that. It's just the way it is. Sigh. If I got stressed out every time I had too many contractions, well, I'd be having a nervous breakdown every 18 hours.
tigerbright From: tigerbright Date: August 21st, 2007 09:55 pm (UTC) (Link)
I'm sorry you had to deal with all that terbutaline and go to the hospital anyway, but also glad it turned out well in the end. Hoping for good news on the glucose tolerance.
estherchaya From: estherchaya Date: August 22nd, 2007 08:10 pm (UTC) (Link)
terbutaline is far less awful than a lot of the alternatives (e.g. magnesium sulfate, which is evil). The hospital visit was fine, just wish if I was going to have to be admitted that it had happened a few hours earlier rather than remonitoring so many times. But that's okay. Truth is, if I'd gone to the hospital a few hours earlier, they just would have monitored me in triage for longer before admitting me, so it would have amounted to the same thing.

as for the GTT... I almost don't care what the news is... I'll just be happy to have the "real" answer. If I failed it, nothing changes, but I don't have to be bitter every time I take my blood sugar levels. If I passed it, then I get to stop taking my levels, which is great. Either way is a win, though obviously the former would be slightly preferable! :)
ichur72 From: ichur72 Date: August 21st, 2007 10:01 pm (UTC) (Link)
>> can I just say how unbelievably disgusting kosher hospital food is?

Seconded! The best once can hope for is "mediocre". I've even had better food on airplanes, and that is just sad.

I'm glad you're home and that the contractions are once again under control.
estherchaya From: estherchaya Date: August 22nd, 2007 08:24 pm (UTC) (Link)
I had a cheese omelet. It was DISGUSTING. Double wrapped, probably frozen, microwaved. DISGUSTING. And a banana. Much better banana. Obviously if I'd been there longer, Seth would have brought me more real food (he had brought me some bagels the night before).
marag From: marag Date: August 21st, 2007 10:07 pm (UTC) (Link)
Oh what fun! (She says with enough sarcasm to clog the keyboard.) I'm glad to hear you're home and I hope you get to stay there as long as possible. If you get admitted for an extended period, please let us know so we can at least go buy you some more edible kosher food. Surely Max's must be useful for *something* ;)
estherchaya From: estherchaya Date: August 21st, 2007 10:12 pm (UTC) (Link)
thanks. One thing I need to do is get all my contact info together in one place for various people... I have a lot of it ONLINE which will NOT help me since Holy Cross does not have internet access available to patients that I know of. Anywho, I knew I wouldn't be in for long (and Seth had brought me snacks, that I couldn't actually eat since, well, fasting and all). Breakfast was a cheese omelet and a banana. They also offered cereal, which I shouldn't have turned down. And they gave me orange juice, which I didn't drink, because I was worried about my blood sugar. I should have just had the OJ. The cheese omelet was DISGUSTING. And flavorless. Had I been allowed to eat lunch, I would have called in for reinforcements!
arosoff From: arosoff Date: August 21st, 2007 10:35 pm (UTC) (Link)
Ouch! *hugs* Keep those babies inside! ;)

BTW, all hospital food is gross. I survived for nearly 6 days on stuff brought in from home. I wanted to leave just so I could get a hot meal!
estherchaya From: estherchaya Date: August 22nd, 2007 08:27 pm (UTC) (Link)
From what I've seen... the hospital food at this hospital that isn't kosher isn't so bad. But seriously? The kosher food? Abysmal. And if I'd been there longer, obviously, Seth would have brought me more real food (he'd brought me some real food the night before. But I was fasting most of the day, and I only had a couple of bites of the absolutely disgusting awful icky so-called "omelet" that they served me. And I ate a banana. That was it. If I hadn't been attached to so many monitors, I also would have gotten out of bed to dig through Seth's bag o' snacks and grabbed the rest of the bagel he'd brought me the night before.
bookworm1212 From: bookworm1212 Date: August 21st, 2007 11:57 pm (UTC) (Link)
Sorry it was such a scary 24-36 hours or so; glad things turned out okay and you're baking the munchkins for a bit longer. :-)
estherchaya From: estherchaya Date: August 22nd, 2007 08:35 pm (UTC) (Link)
The good news is that contractions really don't stress me out at this point. The nurses at the monitoring company don't love it, but I pretty much just do what I'm told. They want me to remonitor? Fine. They want to call my doctor? Fine. But I basically know at this point that this is the game we're going to play from here to the end and that contractions by themselves are not necessarily indicative of doom, so I don't freak out.

Still, I'm just as happy to be home, and to have the added confirmation that the kidlets are likely going to be hanging out at least a few more weeks.
mrn613 From: mrn613 Date: August 22nd, 2007 12:34 am (UTC) (Link)
You are doing an awesome job.

estherchaya From: estherchaya Date: August 22nd, 2007 08:37 pm (UTC) (Link)
Thanks. I just try to roll with the punches, so to speak. I do what I'm told and hope for the best. So far, it's worked pretty well for me.
hopeness From: hopeness Date: August 22nd, 2007 12:37 am (UTC) (Link)
Very glad everything turned out okay and I hope that you get the added bonus of not having to prick your fingers anymore!
estherchaya From: estherchaya Date: August 22nd, 2007 08:38 pm (UTC) (Link)
me too!
real_bethy From: real_bethy Date: August 22nd, 2007 02:00 am (UTC) (Link)
I'm so proud of you! You are working hard to have healthy babies.

Kosher hospital food is pretty darn gross. When I was in the psych ward last fall, I had burned salmon, mushy peas and rice pilaf for every single meal (breakfast included!) for the whole three weeks I was there. UGH!!!
hipstamom From: hipstamom Date: August 22nd, 2007 02:38 pm (UTC) (Link)
burned salmon, mushy peas and rice pilaf

Wow...reminds me of my MIL's cooking!

Picture this- thanksgiving turkey... cold, wet, dried out and flavorless. All at the same time.

Here's how she pulled it off: she washed the turkey; put it in the oven w/o seasoning; then carves it and promptly freezes it. Oh did I forget to mention that she cooks the bird a week in advance? Then Thanksgiving morning, FIL puts it in the oven at 200 degrees for 3 or 4 hours.

And yes she's proud of this accomplishment.

indigodove From: indigodove Date: August 22nd, 2007 02:29 am (UTC) (Link)
Sorry to hear about that. I am glad you are better and home!

Hang in there :-)
From: gingy Date: August 22nd, 2007 02:40 am (UTC) (Link)
I'll keep my fingers crossed that you don't need to go through this again.

Do you maybe want some reading material? Is there anything I can do to help you? I can't really get down to visit aside from during Shabbos, and I know you guys have other things happening then than visits from me.
estherchaya From: estherchaya Date: August 22nd, 2007 08:43 pm (UTC) (Link)
My guess is this won't be the last time. I'm pretty lucky I made it this far without a hospital stay. All the nurses at the hospital were pretty surprised that it was my first hospital stay.

As for reading material... I'm at a loss. I have plenty of things to read at home, but didn't have anything at the hospital, and couldn't think of anything to have Seth bring me either. And I don't really have the attention span for reading. And I hate TV, which is why the internet is such a great distraction, which is why the hospital sucks.

Anyway, we're fine. It's all good.
gnomi From: gnomi Date: August 22nd, 2007 03:03 am (UTC) (Link)
I'm glad you're home now and that things have settled slightly.
From: proudestmom Date: August 22nd, 2007 06:52 am (UTC) (Link)
wow! you are amazing! keep up the good and hard work!
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