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Bored Now - Karen's Musings
Random Rambling
estherchaya
estherchaya
Bored Now
Dear Self:
While you might enjoy the quiet irony of how well the irritable uterus combines with my sunny disposition, I do not share in your enjoyment.  Please cut it the heck out.
No love,
Me


So another visit to L&D today, but today I got to meet the day shift, which is oh so much more exciting!  Here's the thing - when I left Sunday night/Monday morning last week, the discharge instructions said to call my doctor if I have more than 4-5 contractions per hour.  Um, except they discharged me with contractions coming 2-3 minutes apart.  Go ahead, do the math.  I'll wait.

And so it's quite difficult to imagine what my threshhold really ought to be under the circumstances, capisce?  Needless to say, I pretty much ignore contractions until they really start to get so painful it's hard to concentrate.  I get my 17P injections Monday evenings and contractions aren't terrible from then until ... oh, Thursday or so.  By Friday, they aren't any fun at all.  So I spent the weekend thinking, "well, I'll call if it gets too much worse" but never really figuring there was any point in calling... since contracting is what I *do*.  

So this morning I called the doctor's office  - I just can't see the point of waking up a doctor on the weekend for something that's totally normal for me - and got an early appointment with a doctor I'd never met before.  He was very nice, and extremely ticked off that I hadn't called sooner.  I told him I don't like to be the girl who cries wolf when, hello?  This is NORMAL for me.  "No, this is not normal," he said.  "You're not far enough along to have the luxury of calling this normal.  We'd rather you call and wake us up than wait until 7 or 8 in the morning and tell us it's been going on all night."  He found the heartbeat, pronounced it okay, and sent me to L&D.  

Hooked up to monitors and... hello there contractions, my old friends... how have you been?  Contractions every 2-3 minutes.  Negative fFN again (good news).  Three shots of terbutaline and my contractions became less severe and slowed down... to about every 3-4 minutes.  The doctor wasn't a big fan of sending me home with that many contractions, but she let me on account of the negative fFN.  With a reminder that I should *call* when I'm having contractions.  I told the L&D nurse that we'd be well acquainted by the time this baby enters the world.

And when is that?  Not soon enough.  I'm due in May, but don't ask me when in May and don't ask me how far along I am.  I'm not going to tell you.  It's my own neurosis about it - when I start thinking too hard about the numbers, I get severely stressed out, something I can definitely do without right now.

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Comments
marag From: marag Date: February 1st, 2010 10:03 pm (UTC) (Link)
Hooray for negative fFN. Boo for the wide and wonderful world of "Should I call now? How about now? Maybe now? What about now?" I *sucked* at figuring out when to call, lemme tell ya. And I thought my experience would make it easier the second time. HA! And I say again, HA!

My hatred for terb is epic, but it is dwarfed by my complete and utter loathing for the mag. I'm crossing all fingers and toes for you.
estherchaya From: estherchaya Date: February 1st, 2010 11:13 pm (UTC) (Link)
Dr. Simmonds answer was that I should call any time I'm having 6 contractions or more per hour. I like that he gave me a black-and-white threshhold (which Dr. B did not), but it's... still pretty gray. I was discharged from the hospital having contractions every 2-3 minutes last week, and every 3-4 minutes this week. Should I have called from the car? If this pattern doesn't taper off through the night, but hasn't changed either, do I call? If there are no changes, but this is still going on tomorrow... do I call?

The threshhold makes the most sense for someone who does NOT contract as frequently as I do. Because I don't have a stop and a start to these episodes.

Dr. Helmbrecht was the doc on call at the hospital and she told me not to hesitate to call next time - but still didn't have a super answer about knowing where the threshhold is.

Truthfully, I have a hard time getting all worked up about these episodes - it's hard to believe there's something wrong when this happens AL the time.
yeishlitikvah From: yeishlitikvah Date: February 1st, 2010 10:09 pm (UTC) (Link)
the discharge instructions said to call my doctor if I have more than 4-5 contractions per hour. Um, except they discharged me with contractions coming 2-3 minutes apart. Go ahead, do the math. I'll wait.

buh?

At least the ob you saw today took you seriously, and was genuinely concerned. Did you like this one better/find them more personable then the doctor you originally saw from the practice?

I've been thinkng in terms of gd/bs testing. Sorry it's taken me a few days to find a chance to comment on that. I would say do 3 fingersticks a day. One in the morning to establish a 'fasting' number(I do realize the irony), one roughly midday, and a third either an hour before bed or right before bed.

This way you can see how your bs fluctuates overnite, and in response to the medications you're receiving. Also this way, if you do need to do any insulin, you already have established numbers prior to medication, and already are in that 'routine'.

I know in my case my fasting blood sugars no matter what I did were high.
estherchaya From: estherchaya Date: February 1st, 2010 10:30 pm (UTC) (Link)
I'll do the 4x/day finger sticks if that's what they want. But it's still ridiculous. Testing first thing in the morning is actually NOT the best fasting level to get, because I get IV Fluids with 5% dextrose over night. The closest to "fasting level" I would get would be the one right before bed, most nights. Either way, I'm not super concerned - just annoyed. My "fasting" blood sugars are nearly always around 60. I haven't been taking them every day - because the OB's office hasn't OFFICIALLY set me up with a glucometer, etc. But I happen to still have my old glucometer.

Anyway, yes, I liked both doctors I saw today (one at the OB's office, and one at the hospital). Truthfully, I like the doctor I saw that first day just fine, also. The second time I saw him, he was very personable, etc. So I think I might have just been in a bad (and probably defensive) mood that first time I met him.
cahwyguy From: cahwyguy Date: February 1st, 2010 10:09 pm (UTC) (Link)
Can't you just tell them to hire you already? You're clearly fed up being a contractor.

(ducks and runs)
estherchaya From: estherchaya Date: February 1st, 2010 10:31 pm (UTC) (Link)
Wow. You are lucky you're on the other side of the country!
cahwyguy From: cahwyguy Date: February 1st, 2010 10:43 pm (UTC) (Link)
I'll be out your way in a couple of weeks (a one day trip to Columbia MD -- out 2/17, back 2/18)
estherchaya From: estherchaya Date: February 1st, 2010 11:06 pm (UTC) (Link)
that's super quick. If you find yourself free in the evening of the 17th, let me know. No promises that I'LL be up for anything given today's events, but there's always the possibility.
cahwyguy From: cahwyguy Date: February 1st, 2010 11:10 pm (UTC) (Link)
I don't get into BWI until 630p, so I doubt it. At least it isn't a redeye in and back the same day. I'm too old for that.
estherchaya From: estherchaya Date: February 1st, 2010 11:13 pm (UTC) (Link)
I'm too old to even *think* about that.
mrn613 From: mrn613 Date: February 1st, 2010 11:38 pm (UTC) (Link)
so when do you get to go on bedrest?
estherchaya From: estherchaya Date: February 2nd, 2010 12:07 am (UTC) (Link)
I'm hoping never. Truthfully, in most cases, bed rest for singletons really doesn't do any good - particularly when there aren't cervical incompetence issues at play. So far, my cervix hasn't budged and my fFNs have been negative.

It's not realistic, though - they will for sure put me on bed rest at some point. Just, hopefully not tomorrow.
estherchaya From: estherchaya Date: February 2nd, 2010 11:41 pm (UTC) (Link)
Update: today my case manager with my insurance company said that they would approve a terb pump when it's ordered (no one was sure of that - because sometimes insurance requires failed PO tocolytics first, but I can't do PO, so how to get it documented as failed PO was the question). They won't make me jump through hoops.

BUT. But, she said, with the terb pump, they will require "restricted activity" and home monitoring (which restricts my activity in and of itself). So bed rest is... well, on the horizon unless I can keep myself away from another L&D visit any time soon.
From: atimesif Date: February 2nd, 2010 09:54 pm (UTC) (Link)
I'm glad that you went in. They did slow down your contractions...
estherchaya From: estherchaya Date: February 2nd, 2010 11:38 pm (UTC) (Link)
they did slow them down, but that wasn't why they let me go - contractions every 3-4 minutes (which returned to every 2-3 minutes 3-4 hours after the last terbutaline shot, which is why the injections aren't as useful as a terb pump) are still not a good thing. They let me go home because of the negative fFN. Thing is, they give me a black and white rule: always call if you're having more than 6 contractions per hour; but then they release me from the hospital having more than 6 per hour - should I call them from the parking lot? three hours later if they haven't let up? wait 'til the next day?

It's not a waste of a trip, because it's not like I got to L&D and they said, "well, you're not contracting a bit - why are you here?" but it still doesn't really give any answers. They didn't do a cervical assessment, so they really don't know if the contractions were important or not. Contractions in and of themselves are not the enemy - it's contractions that cause cervical changes that are the enemy. Problem is, I'll never know when I've crossed that threshhold without getting checked, and the fFN isn't infallible.
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