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Frustrated - Karen's Musings
Random Rambling
I spent Sunday night/Monday morning at Labor & Delivery for contractions and other fun stuff.   Tuesday I had my already-scheduled OB appointment.  The doctor said that the goal is to keep me out of the hospital as long as possible (I hadn't known that was on the table, but okay...).  I told him I spent Sunday night at the hospital, and he responded "Oh, really?"  Call me picky, but while I realize it's a large practice, wouldn't it make sense for there to be some sort of notation in my chart so that the other doctors who see me know before they walk into the room with the patient?  

He declared that I'm measuring just right and the baby's heartbeat was fine, so he said, "I guess that's it."  Um, not so much - I had a list of questions both from myself and things the home health care company wanted to bring up with him.  Virtually all of my questions were met with "That's a good question for you to ask the perinatologist tomorrow."    There's a national shortage of adult multivitamins for infusion, and apparently Folic Acid (for the IV) is also in short supply right now, so the home health nurses wanted me to ask him to write me a script directly for the MVI (Seth can get it filled - it's good to have connections) and to ask if it's okay to do the folic acid every other day, or every few days, etc.  Good question for the perinatologist, apparently.  I asked about the extreme pain in my pelvic bone which is making it excruciating to walk (especially stairs) and that was met with "Hmmm."   I asked him what my threshold should be in terms of calling the office or on-call doctor since if I used the standard "more than 4 in an hour" rule, I'd be calling every hour.  Apparently, that was also a good question for the perinatologist, which I don't understand, because if I call someone at 2 in the morning, then it's not going to be the perinatologist I wake up - it's going to be HIS practice members that get woken up.    Pretty much everything was "Talk to the perinatologist."

The one thing that did get resolved was that he said, "The question is, how are we going to get your glucose tolerance test done?"  You got me!  But since I'm eating so little, I doubt it will be an issue.  But since there's a 98% likelihood that I will throw up the glucola (sp?) , there's not a lot of point in suffering through it.  SO, I get to take my blood glucose levels 4x per day.  Fun, right?  Um, not so much.

So I went to the perinatologist today for cervical assessment and a growth scan (the baby's growing just fine and kicked the transducer a fair number of times to prove it).  I told the sonographer I had some questions for the doctor and she said he was over at the hospital with a sick patient.  This is fine, I was happy to wait if need be, but also happy to find an alternative.  So she sent his clinical nurse in to talk to me.  Regarding the contraction threshold, she said I just have to use my gut.  Right, because that's going to work so well.    She said that regarding the glucose tolerance test, probably the only way around it was to do blood sugar testing, but that 4x/day is probably overkill and I could just do some random BG checks.  She didn't have an answer re: the MVI and Folic acid, but said she'd check with the doctor when he got back from the hospital.  Regarding the excruciating pain when I'm walking - well, she said that everything in this pregnancy is going to be more pronounced, as this is my second pregnancy and I'm older now, and...  Um.  Right.  But it's kind of comparing apples to oranges.  The last pregnancy involved THREE baby humans.  This pregnancy involves ONE baby human - so the "it'll all be more pronounced this time around" argument doesn't entirely fly with me.  Nevermind that I know plenty of women who have had two, three, four, five, six or more pregnancies without having excruciating pain with every step just because it wasn't the FIRST pregnancy.  She recommended an abdominal binder to see if that would help.  I'll try it, but I'm not expecting miracles.  She called later regarding the Folic Acid and MVI and Dr. P. was adamant that since I'm not eating/drinking more, I must have both (if they can be gotten - otherwise, well, not so sure what the answer to that is).  

So I'm not a lot more enlightened than I had been Sunday night.  I still don't know whether I should call the doctor, for, say, the extreme cramps and contractions I'm having RIGHT NOW.  Probably nothing to worry about since my fFN was negative, so I'm not going to freak out.  I'd just like to feel better.  Sigh.  I'm just frustrated.  I'd probably feel less frustrated if I didn't have other things going on as well, but obviously, life moves on around me, regardless of how gross I feel.


20 comments or Leave a comment
either_or From: either_or Date: January 27th, 2010 11:53 pm (UTC) (Link)
if you're not really eating, how would they go about controlling GD anyway?
estherchaya From: estherchaya Date: January 28th, 2010 03:21 am (UTC) (Link)
Yes, well, that is an interesting question, isn't it? There are two answers to that question:

1. Most people who don't take in any food during their pregnancy, do not also have gestational diabetes. That being said, I do get 5% dextrose in my IV fluids, so I get as many as 600 calories per day (but usually 200), so it's not that no sugar is ever going into my bloodstream, and there theoretically COULD be issues with the way my body metabolizes that sugar, which is why you still test for GD - if I still had GD despite not eating, they obviously wouldn't be able to control it by limiting my carb intake, which takes us to...

2. If I do have GD, which I probably do not, then they'd probably have to manage it with medication. Preferably, not oral medication. Good thing I'm not afraid of needles. Anyway, that's unlikely regardless.
mrn613 From: mrn613 Date: January 28th, 2010 01:10 am (UTC) (Link)
Pubic symphysis pain in pregnancy seems to be more common in women who have had multiples because the pubic symphysis joint stabilized in a wider position after the multiple pregnancy. so your pelvis went into this pregnancy in a much more unstable position than your pelvis went into your first pregnancy.

Regarding the fFN, I'm pretty sure a negative test does not mean there is a zero percent chance you will deliver in the next two weeks. I think you should go get checked, every night if necessary.
estherchaya From: estherchaya Date: January 28th, 2010 03:24 am (UTC) (Link)
a negative fFN does not mean a zero percent chance of delivering in the next two weeks. What it indicates is the likelihood. Only 5% of women who have a negative fFN deliver due to cervical incompetence within the two weeks following the test. So although it is not a zero percent chance, it is a significant indicator and one that gives some room for comfort.

Personally, I don't take SO much comfort in it, but the problem is, all the doctors do. "Oh, you had a negative fFN so don't worry about those 15 contractions/hour you're having all day. No big deal!"
estherchaya From: estherchaya Date: January 28th, 2010 03:26 am (UTC) (Link)
re: the pubic symphysis pain - that makes more sense than the explanation "It's you're second pregnancy." I get that it's my second pregnancy, but we're comparing apples to oranges here, so I get tired of hearing that my body is much more sensitive to these changes just because I've been pregnant before. Most people don't ever have triplets, let alone have another baby after having had triplets. But the explanation you give is much more fluid and logical.

Of course, it still doesn't stop the excruciating pain that I'm in to know it's logical, but at least this is yet another of the discomforts of pregnancy that I know will get better once this little tenant makes his or her entrance into the world.
mrn613 From: mrn613 Date: January 28th, 2010 03:58 am (UTC) (Link)
a good friend of mine had to walk with two old lady canes (you know the kind with four tennis balls on the bottom) in her pregnancy after twins so I've seen it in action. I'm afraid to tell you this, but it doesn't always get better right after you deliver.
estherchaya From: estherchaya Date: January 28th, 2010 01:18 pm (UTC) (Link)
I know it doesn't always get better right after delivery. But, playing the odds (ignoring the fact that I'm never on the good side of the odds), within a few weeks or months of delivery, most women find significant (if not total) relief from the pain.

Except women who have c-sections. That's the kicker. So this baby has a couple months to TURN AROUND, DARNIT. ;)
galads_forest From: galads_forest Date: January 28th, 2010 09:26 am (UTC) (Link)
I had symphsis pubic dysfunction this time around. It was very painful. I never hit the point of crutches though, mostly because it would be even harder to chase a 2 year old with them (can't imagine chasing 3 + carrying a pump, etc). It started around 22 weeks, got worse by 24 and stayed bad for a few weeks. Thankfully, it actually got better closer to the end.

Stuff I found helped:
* sleeping with a THIN pillow between my legs.
* walking in short spurts (10min at a time)
* sitting on a chair instead of the couch, especially if I put a phonebook under my feet.
* a warm hot water bottle
The big help I figured out in the last few weeks:
* I got Avri to compress my hips by lying on my side in bed in the morning (with the pillow still between my legs) and literally having him put his leg over mine and let his weight compress my hips for 5-10min. It's snuggly and it works. Cuddle time saved me!)

Stuff that made me go OWWW!
* sitting on the floor
* stairs
* getting my bottom half dressed. I couldn't wear socks for 4 months, but with underwear sadly that really wasn't an option.
* staying in the same position for too long (walking in short bursts really helped. If I was stationary for too long, it would hurt more to get up and go. After about 5 minutes up, things got better; after 30min, they started to hurt again)
* pushing a shopping cart (this one kicked my tush. It was easier to shop in short bursts and carry stuff or load up a stroller basket instead. The way the wheels work on a shopping cart is bad news on your hips and knees.)

I saw a physiotherapist who told me to do pelvic floor exercises. They helped a bit too.

Good news is that at almost 4 weeks postpartum and I'm mostly back to normal. Mrn613's right that it doesn't always get better right away, but it can.
estherchaya From: estherchaya Date: January 28th, 2010 12:14 pm (UTC) (Link)
All of the things that you list that made you go OWWW are the things that make me go OWWWWW!!!!

I do know that it doesn't always resolve immediately after delivery. But playing the odds here, most women within a few weeks or months of delivery have significant (or complete) relief from the pain. Apparently, this is less true if you have a c-section, which, frankly, I'm doing my darndest to avoid. Now if only this little monster would TURN so s/he isn't breech any longer. (there's still plenty of time for that, but it would still be nice if this kid would do it NOW).
galads_forest From: galads_forest Date: January 28th, 2010 12:35 pm (UTC) (Link)
I've heard that too (about the C-Section). I hope you avoid it. I managed to, B"H.

Ella was breech until less than 24h before the birth. Mind you, she was heads down until maximum 10 days before that. She was nicknamed "Flipper". But she flipped, on her own no less, and she was 4kg (9lbs). Ok, I know that's really rare and I had a HUGE amount of water (affording her the room to do it), but there's not much you can do about it, except supposedly making sure your sefarim are all facing the right way ;).
estherchaya From: estherchaya Date: January 28th, 2010 01:12 pm (UTC) (Link)
Don't get me started on the sefarim. No, wait, let's get me started on the sefarim (though I know YOU were being facetious). I almost abandoned Judaism (or at least Orthodoxy) all together in the years I was struggling to get pregnant. Not because not getting pregnant tested my faith in Hashem, but because for a religion that is supposed to put so much trust and faith and believe in Hashem's will, a religion that is NOT supposed to rely on superstition, but rather, the Torah... we are a ridiculously superstitious people. The number of times that I heard I wasn't getting pregnant because I wore hats/snoods/tichels, the number of times I heard I wasn't getting pregnant because I wore sheitels (I switched at some point), the number of times I heard "check your ketubah!" or "check your mezzuzot!" or "eat the heal of the challah on Shabbos", or "be kvater at a bris" (I can't tell you how many times we were kvater/kvaterin - it became insulting after a while) or "light an extra shabbos candle" or "wear this amulet" etc. disgusted me. Where was G-d in ANY of those equations? I mean, I suppose it wasn't much worse than "just relax", "take a vacation", or "if you adopt, you'll get pregnant immediately, just like my friend Suzie!" But still.


Okay. Rant over. Sorry to have directed it at you, as I know you weren't being serious. I, um, guess maybe I've got some anger issues?

I'm hoping my best to avoid the c-section. I don't want anything to do with another spinal or epidural if I can help it. Unfortunately, hospitals and doctors here get really touchy about vbacs. And I can't have a midwife, because they won't touch me - too complicated. So we'll see what happens. I know that all that matters in the end is that mom and baby come out of it alive and healthy, but I just want NOTHING to do with another c-section. It was every bit as horrible as I imagined it would be, and then some. Sigh.

Hopefully, I'll have a little flipper of my own.
galads_forest From: galads_forest Date: January 28th, 2010 01:32 pm (UTC) (Link)
Rant all you want (it's good for the soul once you're done). I totally agree with you about segulahs. I feel like people recommend a segulah or other stupid "advice" when they don't know what to tell you otherwise and they want to be "helpful". Seriously though, people have to learn that helpful is most often keeping your mouth shut and mind your own business.

Doctors here are quick to cut and hate V-BACs also. If I had wanted to deliver my baby breech (which, to be honest, I wasn't prepared to at 4kg), no one would have let me. If I COULD have found a private doctor to sign off on it (yeah right), I would have had to waive all their responsibilities for the birth.

I wish you a flipper also. Actually, I wish for you a baby that STAYS heads down and doesn't surprise you the day of delivery with a "Hello! I'm up here!" It wasn't fun, though thank G-d it turned out OK in the end.
estherchaya From: estherchaya Date: January 31st, 2010 02:23 am (UTC) (Link)
in the US, even when you waive liability, you really aren't waiving liability - it's sort of interesting. But the fact is, you can't really be fully informed and if a doctor does something truly negligent, they'll be held responsible regardless of whatever piece of paper you signed ahead of time. Obviously, this doesn't translate into Israeli law, but it's an interesting thing that a lot of people in the US don't seem to understand.
From: (Anonymous) Date: January 28th, 2010 04:16 am (UTC) (Link)
Did you have this type of pain by your triplets? If so, did it go away soon after delivery?

Did they check you for vaginal varicose veins?
estherchaya From: estherchaya Date: January 28th, 2010 11:56 am (UTC) (Link)
I did not. I had many other types of pain (mostly in my hips), but not this kind. All the pain I had with the triplets resolved within a few weeks of delivery. They did not check for anything. The answer I got was "you're going to feel more b/c this is your second pregnancy."
From: (Anonymous) Date: January 28th, 2010 07:03 pm (UTC) (Link)
Did the pain get worse once you started the PIO? I think the pain is a result of the progesterone loosening your body. Are you carrying low?

I also had the vaginal and hip pain. It felt like forever. While I had it I couldn't remember what it was like to ever be pain free. Towards the end it was so painful that I just stayed in bed with the lower end of my body elevated and I kept switching from side to side whenever my hip hurt too much.

I think most people feel less uterine 'stretching' pains in their subsequent pregnancies because they're already stretched out.

But this type of pain I would imagine would be WORSE when carrying triplets, not with a singleton. Unless your singleton is now weighing more than your triplets combined!

Gam zeh yaavor.

B"H I'm fine today :) This has an end date, hopfully later than sooner.
kalki From: kalki Date: January 29th, 2010 01:12 am (UTC) (Link)
Ugh. There is an end in sight, there is an end in sight :)
estherchaya From: estherchaya Date: January 31st, 2010 02:26 am (UTC) (Link)
I am not carrying low - I'm carrying quite high. The pain has gotten worse once I started the 17P (not the same as the PIO used in fertility treatment), but I think that's because it just gets worse over time anyway, not because I started the 17P injections.

My singleton is not now weighing more than my triplets combined. It's about a pound and a half. Yes, you *would* think this kind of pain would be worse with triplets than with a singleton, but I imagine *any* subsequent pregnancy after triplets isn't going to be all sunshine and roses - but some of this is just *not* what I expected!
kmelion From: kmelion Date: January 28th, 2010 05:47 am (UTC) (Link)
I'm sure you've thought of this, but have you gone to a chiropractor?
estherchaya From: estherchaya Date: January 28th, 2010 12:10 pm (UTC) (Link)
I have thought about it, yes, but I haven't gone yet. This pain only started Thursday or Friday of last week - and at that point it was less that it was pain and more that it was intense pressure. By Monday, it had resolved into excruciating pain, but I didn't really realize that until late in the day, because I slept most of the day after having been up all night at L&D. I've had too many appointments since then to work it out (OB on Tuesday, perinatologist and developmental pediatrician yesterday, many work meetings today. Good times).
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