Tuesday, February 27, 2007

S's Pregnancy, Birth, and PIH

So, after 5 long years, dh talked me into trying again. I didn't intend for it to be so long between babies. However, I was terrified of drs, hospitals, obgyns, and anything medical after having K. What if I got severe pe again? What if I had to be on mag again? However, we were not getting any younger. We didn't want K to be an only child. DH said now or never. So we jumped in. I had no obgyn. Had not been seen by a dr for that sort of thing in 5 years. I didn't want to be told that I shouldn't try. Afterall, I had already been told not to have anymore children by two obgyns, one that was high risk. I figured if I showed up pregnant, too late to take it back. That is exactly what happened. I got pregnant on the second try.

Immediately was sick as a dog. I had the worst heartburn and it lasted from 5 weeks till 2 weeks after delivery. I had never had heartburn except a 2 week period when I was pregnant with K. I was extremely extremely nauseated. As soon as the test turned positive, I called my pcp's office and asked who to see. They sent me to my dr and his staff. My obgyn is a solo practice dr that has two midwives that work with him. When I called the office, they immediately set me up with a midwife. Because I was overweight, she immediately wanted me to do the diabetic diet and gain no more than 15 lbs. No problem, except I couldn't keep ANYTHING down whatsoever. This was at 5 weeks. I saw the other midwife at 9 weeks, and she determined I was high risk and that I had to see the doc. She said I was only to see the doc while pregnant, not them. Fine. Was given a rx for a 24 hr baseline and pe bloodwork. I discussed the throwing up with her and she said well I had three boys and was sick with each one of them. You have to eat, and then if it comes back up so be it. Gee you are a lot of help. Oh and my bp was up AGAIN.

At 13 weeks, I saw my ob. I was to see him for the rest of the pregnancy. Honestly, Even though the midwives are good and great and I have nothing against them, I just prefer seeing him. For some reason I am more comfortable with him. Wierd I know. I never thought I would prefer a male obgyn, but I do. I told him about the throwing up. At this point I was losing weight. He said would you like something for it? I said OMG can I please. He gave me a rx for Reglan. All that did was make me throw up more. At 15 weeks, I was seen. Normal stuff. At 17 weeks, my ob was at a conference out of town. BP was high again. Midwife #1 started me on Aldomet. 750mg a day. Maximize rest. She was a GODSEND. She changed the Reglan to Zofran. While it didn't completely get rid of the nausea. At least I stopped puking as much. Somehow she managed to get 40 pills a month approved through my insurance. Retail price is $1700 a month for 40 pills. I had a $20 copay only. Not only that, she managed to give me a 6 months supply! Zofran was my best friend! I also still had the worst heartburn. So Pedcid complete was my best friend too.

I was seen about every two weeks. My meds were adjusted for bp. It seemed as soon as I got it adjusted it just went higher. Protein was on and off. At 26 weeks, my ob referred me for comanged care with my peri. He told me he was sending me to her to prepare for an early delivery. Oh no. Not again. I begged him please do not put me on mag again. At the time, I thought being on mag was the worst thing that could happen. I was wrong. Losing your baby is the worst thing that can happen. My ob looked at me and said, as nasty as a drug that mag is, it is the only drug that can save your life. So if you have any symptom of PE when you deliver or you have even a trace of protein when you are delivered, you are getting it. It is the only drug that can save your life. I was so naive. Here I was worried about how bad mag was (believe me it is AWFUL, imagine the outside like siberia and the inside like hell and you can get an idea). I should have been worried about trying not to die.

So off I go to see the peri. She immediately tells me I have no business commuting and I should be in bed. I said well that is easy for you to say, you are a dr. I have to work. So we agreed for me to work at home at least two days a week. When my boss was told, she said I could only do it for 3 weeks. Well I don't know why she suddenly thought I was going to get better. I was too sick to fight it. I saw the peri every two weeks till 33 weeks. Then I started seeing her weekly. I saw my ob every week from 26 weeks on. In the meantime, I was getting the meds adjusted higher. My bp would behave and then go up higher. At 30 weeks and 2000mg of Aldomet and 30mg of Procardia, I gave in and I went on bedrest. My ob said he wondered when I was going to give in. Bedrest was sooooo hard. Each day I was getting sicker and sicker. I was retaining water. Protein was negative to 2+. Liver enzymes were becoming elevated. Uric acid was a little high. Each week, I saw my ob and was instructed to go home and go back to bed and monitor my bp.

At 32 weeks, I thought I was done for. I saw midwife #2 due to my ob being on vacation. Except he wasn't on vacation but hiding in his office. Unfortnately, my bp was really high, I had two beat clonus, was swollen, had a headache, had been seeing spots, and had 2+protein. She went and talked with my dr. They upped my meds, sent me for another 24 hr urine and bloodwork. I was told to go to bed and not move. Do not go out in the heat. Stay in a cool dark ac room on my left side. Do not even think about not calling the office if something was wrong because I did not want to go to Childrens. I still have that fear of a different hospital/dr and being dumped. Did I mention that I hate to sleep on my left side now?? I got a call the next day saying I needed to go back to the lab because my liver enzymes were slightly elevated. That decisions would have to be made. I have come to HATE that statement. Fortunately my liver enzymes stabalized. S passed each NST and BPP.

At 35 weeks, I was really really miserable. I was sick of throwing up, heartburn, swollen, bedrest. My bp was very high. I had all of the PE symptoms. Oddly, no protein this week. My bp at the ob's office was 160/118. I freaked out the nurses in his office. My ob's response, cool as a cucumber was it's a little high today. Most drs would have stuck me in the hospital. But since my hospital does not have a NICU, it was too early. I was 35 weeks on the nose. You have to be 35 weeks +. So he added more meds, up to 60mg of Procardia now. He told me to go home, go to bed and don't move till my peri appt. This was Thursday. I went home and cried. I had a horrendous headache the entire weekend. I called my ob. He suggested ice and Tylenol, neither of which helped. I saw him on Monday at L&D. He did a NST. Checked me out. Sent me home. My bp was 149/109. Told me not to move till my peri appt the next day.

At 35 weeks, 5 days, I saw the peri. She took one look at me and said you are done. Let's go find a reason to have a baby. Well she didn't have to look to far. My bp was high, I was swollen, had pe symptoms except protein, and baby had decels on the nst. The one that she had passed with flying colors the day before. She called my ob and he said to me back to him and admit and pit.

I of course wanted everything to stop. I was not ready to have her and became upset at the thought. I wanted to eat but dh wouldn't let me. The peri said I could have a little something but not much in case they had to do an emergency csection. That did not give me the warm fuzzies.

I made dh stop at home to get a bag. Then off we went to the hospital. I went to admitting. My ob had set up everything. A nurse came down from L&D and escorted me up to the floor. She said that she understood I was really early and that it was all going to be ok. They put me in a room. Got me changed into a gown. My ob showed up. He said baby had decels and everything was going to be ok. He had the nurse start the pit. No cervadil/progestin gel. Just started the pit. He checked me, 50% effaced and a fingertip dialated. Apparently all of that movement I thought I was having had been contractions. The pit immediately put me into labor. I was admitted at 3pm and by 830pm, I was having uncomfortable contractions and I was 3cms dialated. My dr had been in to check on me several times. I of course asked for my epidural when admitted. That didn't happen. At 830pm, midiwife #1 broke my water. I immediately panicked because of what had happened with K. I started yelling at the midwife, why did you do that? Now I am going to go really fast. I was right, the contractions became immediately intense and unbearable. Next time, NO ONE is breaking my water until I have an epidural in. The midwife takes off and I ask where are you going? I guess no one believed me about the 5 to 10 cms in one contraction with K. She said she was getting my epidural. The original anesthesiologist was in surgery. GRRRRRRRRRR. So they called one in from home. He didn't make it time for one mom down the hall, so I was up next. He came in and put the epidural in. I got very little relief. It didn't work. My dr came in and checked me and I was 7cms at 9:45pm. HOLY CRAP. I had no intentions of doing this natural. But that is exactly what happened. In addition, right around when my water broke, heartburn kicked into high gear. It was the worst heartburn I have ever had. I begged for something for it and my dr said NOPE. Stupid apple juice caused it and to this day, I am no longer a fan of anything apple.

Around 10 or so, my doc was in and out of my room. Mostly staying around my room. I progressed quick. At 11:33, he ordered Demerol. At 11:40pm, S was born. She was born in three pushes and came very quick. Just like K did. She was very healthy and a pound on the nose bigger than her sis. I do have to say that my dr did perineal massage with a numbing med. OMG, I highly reccomend it. All I felt when she was born was her little head go pop. No pain at all.

I only got to keep her for an hour because she was early. The ped ordered her to be monitored in the nursery. After awhile everyone left. But I didn't hold her because I was afraid I would drop her from the Demerol. I also had to pee really bad but was afraid to. That I remembered from the last time and so I held it in. Finally at 4am I got the nurse to help me to the bathroom and peed forever. Then I was taken to my room. My ob stayed overnight in the call room. The poor guy was woken up constantly about my bp. He had taken me off of all bp meds to determine whether it was chronic or pih. No protein on delivery. The nurses were freaking out because it was high. However, it did not go higher than it had been and was dropping. My dr tried to explain that to the nurses that this was good, no meds and it didn't soar.

All through the next day he was called. He also brought in two nurses next day and showed them how to do the PE check. Already the swelling was going down. He started me back on meds. 30mg of procardia. Down from 2000mg of Aldomet and 60 mg of Procardia. S was perfectly ok despite being early. I was ok too and released 36 hours after delivering. I could have stayed till midnight, but who wants to stay till midnight with a new baby?

The next day the hospital called and said that they forgot to do the newborn testing. So they had me bring her back. She also had a bilirubin test scheduled. When I brought her in, midwife #1 was there. She played with S while we were waiting and fed her a bottle. I knew something was wrong though. S was pretty yellow. But they all said she was ok. Her tests were too clotted and they had to rerun them. In the meantime my ob came up on the floor to hang out with the midwife for an induction. He didn't see me at that point in the waiting room. He went to the call room to chart. That was when the lab called and I knew.

They called her ped and handed me the phone. He said I am sorry but S's bili levels are very high and she has to be under the lights immediately. Her level was 23. So she was placed on the light mat and overhead lights. I dissolved into a mess of hormonal tears. I felt like they were constantly taking her from me. The first night she was taken, because she was premature. The second night she was taken because I couldn't sleep and they wanted me to rest. I had to tell them that I had slept. Which I didn't. I simply waited for shift change and lied and said I had. I mean come on, I had been just taken off of max meds. They said that I could stay with her. They admitted her into maternity and we waited to be moved to peds. They put me in bed per midwife # 1's instructions.

After awhile, they moved us both to peds. The midwife told me I needed to go home and be in bed. Let dh stay with the baby. Easier said than done and she should have known better as a mom of 9. Dh and his family came to see her. Dh refused to leave her side and made me go home. The nurses from maternity had called peds and told them to send me home to bed. Mil took K with her so I could rest. It was so hard leaving her there and walking out with an empty carseat. I was near tears. When I got onto the elevator, I had the empty car seat. My ob was there. He asked what was wrong and where was S. I told him she had been admitted for jaundice. He said oh and he was sorry. I got in the car and cried the whole way home. I went home and went to bed but did not sleep. While I had been in the elevator was when the first abdominal pain happened. I thought hmmmm this feels familiar. At the time my sister and bil had come to visit too. BIL is an EMT.

The next morning, I woke up with a fever. I had chills and nausea. Abdominal pain and I had a funky smell. Something wasn't right. I called the hospital and for some reason they gave me midwife #1. She asked me if I was going to see that baby. I said yes. She said I shouldn't and should be in bed. I said I am going to see her. So she said while I was there to stop in L&D and have the girls check me out. They sent me to the ER. The ER was waiting for me. I spent all day in the ER. They did a pelvic and pulled out HUGE clots. They called my ob at home. I had at the very least a big uterine infection. My WBC count was 2 1/2 times the normal rate. I was bleeding alot. They did IV antibiotics. Said I was lucky and glad that I knew to come in. If I had waited till the office reopened, I would have had to have been readmitted. I was to see the ob the next business day. 4th of July was the next day (Mon). They also sent me home on Lortab and a strong antibiotic.

The next day, I went and visited Sara. We got the ok to take her home, so I went and relieved DH. While waiting for Sara's afternoon results, I saw my ob. He was WORKING on 4th of July doing surgery. He didn't see me though. Sara's levels had dropped to 11 and we were given the ok to go home.

The next day on Tuesday, I saw my ob. I was still running a fever, had chills, looked really sick. I also had Ecoli. He didn't like the way I looked and said he wanted me to get a US asap. I got an appt the next day. I could tell by the tech's face that something was wrong. She said go sit in the waiting room. You can't leave till we talk with your dr. He happened to be at the hospital delivering a baby. I heard him talking to the radiologist and he said I had retained parts. But my ob had forgotten to tell the radiologist what to do with me so they called him back. Then my ob's office called. They had the nurse tell me that I needed to have emergency surgery. She said to find a babysitter for the girls and get to the hospital ASAP.

I got to the hospital. I had to have an emergency d&c. My dr was awesome. They gave me really good drugs that made me sleepy. I felt no pain. It was done and over with before I knew it.

I continued to follow up with my ob till 3 months pp. My bp went down quite a bit but never completely normal. At 4 months, my ob transferred me to my pcp and she put me on Ziac. BEST DAMNED DRUG EVER. Dropped my bp within 3 hours and I get great readings on it. Last appt was 104/68!

So I'll be really sad to stop that (hardly no side effects) and going back on the dreaded Aldomet (bad side effects). But my pcp has said to take it as it comes and we'll adjust with my ob's consultation. Then as soon as I get pregnant again, I am right back in his hands.

With S, I was sick the entire time. No I didn't have mag, but I wish that I had because I totally stressed out that I was going to have a stroke or seizure the entire time in the hospital. I ended up being discharged on Fiorinal for the headaches. My ob told me a few weeks afterwards that he had totally been worried about me. He never showed it. I guess that's why I like him. He didn't stress me out. He ran a lot of interference with the nurses.

My next pregnancy, I will be super nerd. It's only normal. I will be asking questions on everything. Fortunately my pcp realizes this and she just sends me my lab results in the mail. Must be much easier for her this way, lol.

Sunday, February 25, 2007

How I met Pre-Eclampsia

I got pregnant with my first daughter at 24. She was very much planned. DH and I had gotten married when I was in college. When I graduated, we left and moved overseas. Dh and I had been married for three years when we got pregnant. We decided that we should go ahead and try. Much to my surprise we got pregnant the very first try. OMG. I didn't really think it would happen that quick but it did. While in the 2 ww, I noticed that I was exhausted. An acquaintance who was a nurse said maybe you are pregnant. I said nahhhhh. But yep, I was pregnant. It was funny, I had a terrible fear of needles an would pass out when my blood would get taken. They couldn't even take blood at the base hospital because I passed out. Little did I know that I would become a pro at giving blood. The base that we were at did not have any inpatient services. So they assigned you a military dr and then you had a foreign dr at the foreign hospital. The military dr's job was to answer any questions and to make sure that the proper tests were being done. The foreign dr was the one that ran your ob care.

I had a normal pregnancy up to 24 weeks. At that point my bp started to go up and I started to have a trace of protein in my urine. My foreign dr was NOT concerned in the least. My military dr was very concerned. She suggested me cutting back at work. I didn't bother. At 26 weeks due to the military dr's urging, my foreign dr put me on bp meds. She put me Visken, which if you have asthma, you CAN NOT take. Asthmatics need as much as their airways open and beta blockers shut them down. My military dr was very upset that I had been put on Visken and had patient services call the foreign dr and change it to Aldomet. I had appts every 2 weeks with foreign dr. She never once checked my blood for anything but toxoplasmosis. I don't own a cat. She never did a 24 hr urine. She never adjusted the aldomet that I was on (750mg). I did get an ultrasound at each visit but that is standard there. Meanwhile, my military dr was getting very concerned. At 29 weeks, I lost sight in my left eye for an hour. Freaked I went to the military dr and she immediately sent me to the hospital. The oncall dr at the foreign hospital ran a NST. Baby passed. She sent me home on bedrest, which I did not do. I had visits each week with the military dr because she was so concerned. By this point, I had pitting edema, stars/spots, headaches. But I blew these off as being normal in pregnancy. Sure pregnant women swell. Sure pregnant women get headaches. So what if I had a little high bp.

The military dr also tested my urine with a dipstick. She wasn't supposed to for some stupid military reason. So she couldn't record the results. But it was ranging from trace to 2+. Each time she sent me back to the foreign hospital for a NST and montoring. She was very upset that I would not bedrest. I did not understand how serious this was. I would find that out later on. My mother had "Toxemia" with all three of her babies. So I didn't think it was bad. Apparently for my mother, it wasn't severe. One day I came into the military dr's office and she was so upset with me. She took off my shoes and socks. She started poking at my ankles. Look at this, this is bad. It is pitting edema. I have pregnant women that come into my office every day and beg me to take them out of work. They are having normal pregnancies and don't need it. You are not having a normal pregnancy. You are high risk. WHY WON'T YOU GO ON BEDREST. She even sent occupational health after me claiming my job was hazzardous to my health. If I had been military, she could have ordered me to bed. As a civilian, she couldn't.

Still, my foreign dr was unconcerned and did no tests. I would say the military dr says I have PE. She would say no you don't. At 34 weeks, I developed what I thought was the stomach flu. I felt nauseated. I had upper right quandrant pain that came and went but hurt really bad when it was there. I couldn't get comfortable. I went to the base's acute care clinic. It was US run, but had foreign drs on staff. I will never forget. I saw a Turkish Air Force Colonel. He said she has indigestion. Give her the cocktail of malox mixed with Lidocaine. In all fairness, to him, even obgyn drs miss the signs of HELLP syndrome. The nurse said, Dr you realize that she IS pregnant right?? He said yes, it will be ok. He was sooooo wrong. I drank the cocktail. I felt a little better. But it didn't go away. The regular military dr that I saw was TDY. At 35 weeks 5 days, I had an appointment with the foreign dr. She didn't even ask me how I was doing. She told me to get up on the table because she wanted my bp. UH OH. It was 160/120. She said you need to be admitted. Well I now know why she was so upset, I had +4 protein on the urine dipstick. I was so innocent. How long am I going to be in the hospital? This was on a Wednesday morning. She said till Monday for observation. She was wrong, I already had a 2 day old baby by Monday. I asked to go home and pack a bag. She said my dh could do that for me, I needed to be admitted now. I said no I have things to take care of. I will be back in a couple of hours. I asked if she would be there when I got back. I wasn't particularly fond of her, but she was the only doc I had seen at that hospital. She said that she would be. I agreed to be back by 3pm. I had still been working. So I needed to let work know and pack a bag.

I came back at 3 and my dr was no where to be found. She had dumped me and left me in the hospital to rot. I was greeted by a midwife who did a full exam. I was admitted into the antepartum area. I immediately had an iv inserted to start bp meds and fluids. At 9pm, they took me for an emergency US that lasted over an hour. I later found out that they were checking out K's lungs and size. The next morning the base liasion called. She said PE Mommy, I don't know why your dr had told you you are there for observation. You are there till you have your baby. You are very sick. I don't feel sick. Well you are. Oh and you are having your baby next week. WHAT?????? No one said anything about having a baby. Ok, well I was told by the military dr that I would deliver early. But I thought early was a week or two early. I still had a whole month to go. I did a 24 hr urine (the only one done the entire time I was pregnant). They drew a ton of blood. I had to document everything that I drank.

The next day (Friday), the base liason called and said I have bad news. You are very sick. You are having your baby on Monday. Your liver enzymes are extremely high and your bp is bad. You have over 5000mg of protein in your urine. Umm ok. I called dh and said we are having a baby on Monday. This was at 1130am. At 230pm, a dr that could speak english came in and said "we are terminating your pregnancy tomorrow". What do you mean terminating? I'm not terminating anything. You are very sick. We are moving you to L&D. You need to call your dh. An hour later I was moved to L&D. They ran more bloodwork. At 8pm, they inserted the progestin gel. It was an excruciating exam because the midwife had horrible long nails. My cervix was very unripe and very posterior and high up. At 9pm, they told dh that he needed to leave. That he could come back at 6am the next day to start the labor. They turned out the lights and told me to get some sleep. Sleep is something that did not happen. At 12am, I got the worst headache ever. I hit the call button and the nurse came in. I told her my head hurt really bad. Could I please have some Tylenol. She looked at me kind of funny. The next thing I know, my room was swarmed with drs, nurses, and midwives. My room was filled and people surrounded my bed. One wass taking a bp, one was drawing blood, one was tapping my knee. Ithought it kind of wierd that my reflexes were so exaggerated that I kicked the dr. Then they all left my room for about 10 minutes. Then the dr and a couple of nurses came back in, with another iv pole pump. The dr said I am very sorry but we have to put another IV in. I said ok, put it in the same arm as the other. He said no. We have to put it in the other arm. What? TWO ivs??? We have to. You are sick. He didn't tell me he was going to mag me. He also told me that I HAD to have an epidural the next day before they started labor because they couldn't chance my bp going up higher. Sounded good to me. I was all for the epidural to begin with.

They again turned out all of the lights and a nurse sat in my room that night through the next night. They also kept taking blood every hour. At 3am, the midwife with the long fingernails came in and checked me. It was excruciating and she wasn't very nice. They did another round of gel. My room was kept quiet and dark. At 6am, Dh came in. I immediately burst into tears. I was swollen up like the michelin man. I had bruises everywhere. I was very pale. I had ivs and wires everywhere. I looked horrendous. DH was very upset that I had one iv in and looked fine when he left and not even 9 hours later, looked very ill. At 9 am Saturday they came in and checked again. No change still. At that point, I was exhausted. I told dh if it was so important to get her out today, then just do a csection. I was too tired and sick to go on at this point. He went and talked with someone. The chief of OB came in to talk with me. He told me I had severe PE. That my liver and kidneys were bad. He also said my platelets were low. That they couldn't do a csection because if they did I would either have a seizure/stroke and/or bleed out/hemmorage on the OR table. He said that they had to deliver vaginally. It was the best way. They had one more thing that they could do. That the baby was stable but I was very sick. If it didn't work, if I declined more, if the baby became distressed that they could do an in emergency csection and have her out in less than 5 minutes.

The last thing that they could do was a manual cervical ripening. OMG. That was the worst pain that I have ever felt in my entire life. Worst than labor and delivery. It left me screaming in the procedure room and dh having to leave the floor. I begged them to stop. It involves a foley catheter being used to force the cervix to ripen and dialate to 3cms. When the cervix is ripened and dialated to three cms, then the bulb falls out. I cried and cried after that. They gave me drugs (stadol and fentanyl) for the pain. I slept after that. At 4pm, they came in to check me. I was now able to start pit. The anesthesiologist came in. Gave me an epidural and stayed with me the rest of the night. She was British and spoke perfect English. She was awesome!!!!! I threw up throughout labor. Fortunately, it went quickly. The mag just made me feel so sick and out of it. Mag is truly awful if you have been on it. At 10:30 pm, they came in and checked me. The nurse asked if she could break my water. I told her she could. I was 5cms. As soon as she broke my water, and removed her hand, I felt K right there. I told the nurse she was right there. The nurse waved me off and said impossible. We argued for several minutes. I finally told her if she didn't check me again, she was going to be delivering a baby. She checked and freaked out. I went from 5cms to 10cms in ONE contraction. Then they made me wait. They had to assemble a team from the NICU, get drs, and nurses. Then they moved me to a larger room because my room was too small. When the NICU team got there, I was allowed to push. K came out didn't cry at first, but then started crying. She was perfectly healthy but small. 5lbs 1oz at 36 weeks on the nose. The NICU team took off with her with dh in pursuit. Dh came back with her and said she was fine. They cleaned me up. Moved me back to the L&D room I had started in. Then K was placed in an incubator with the two holes in it for hands. Then they took her away after an hour. I don't know where she went. I think she went to the nurses station as foreign hospital didn't have newborn nurseries. It was expected that you room in with your baby. If mom was too ill, someone was expected to come and take care of thebaby for you. I spent the next three days in different L&D rooms on the L&D floor. I wasn't moved to Maternity till Tuesday. I stayed on mag till Monday night at 11pm, 48 hours after her birth.

I looked like death warmed over and refused visitors till I got to maternity. The mag makes you feel so sick. Blood was taken constantly. So much so that I had to have it taken from my hands and feet because my veins had collapsed in my arms. The morning after K was born, they tried to take blood. The dr got mad and came in and did it himself. Still no sign of my dr. I was passed from oncall doc to oncall doc. This would later give me a fear of obgyns. K was determined to be perfectly heathy but small.

We were supposed to be discharged on that Friday, but on Thursday the ped and my ob (yeah she finally decided to check on me, mainly because I tossed the ped out of my room) came in and said we needed to stay. K needed to stay till she was 7lbs. I needed to stay till Monday. I called the base. Spoke with the liason. At this point, all ivs were out. I was taken care of K fully. I told her that I didn't care who she needed to contact but I was leaving the hospital with my baby. I would bring K into the base clinic for care. She called the hospital and arranged it. The Commander of the base arranged for the base ped to come in on a Sat to check out K and I followed up with the base's high risk dr.

K was fine, but small. We did weight and temp checks for a long time. My bp was followed. I had been released on Aldomet from the hospital. I didn't take it as my bp at its highest was 140/90. The base clinic followed my bp, and it returned to normal within 6 weeks. I also had gotten a nasty bladder infection from the catheter that took two months to get rid of and I was diagnosed with a uterine infection before I left the hospital. K's birth left me with a distrust of hospitals and drs. So much so that I refused to have any of those women exams for 5 years. I still get upset if I feel like I am not getting enough information from drs. They have to tell me everything, show me lab results, and be prepared to answer questions. I have an awesome obgyn and pcp now, but it took a long time for me to get comfortable with them again. But more on that later. K's birth left some residual problems but not bad and it wasn't long before I was back to normal. The military dr said he would have just done an emergency csection and transfused me while doing it that Friday. But different drs do different things. I also had a very big fear of mag. I also would never ever have a normal pregnancy again.

I'll post about S's birth later. I have a plane to catch!

Sunday, February 18, 2007

So what have we done to get ready to ttc?

I saw my obgyn for my annual exam - PASSED, yeah!

I have gotten what I can and can not take for meds.

I have to start prenatals in September with extra extra folic acid.

I was tested for underlying clotting disorders - passed.

I will be switching from wonderful Ziac to yucky Aldomet in September.

I have written out lists for what to do if I go on bedrest. - hire a cleaning lady, hire a landscaping company, daughter #2 is already in daycare and daughter #1 will be in school or daycamp for the summer, buy a freezer (to put away meals in for dh), and wireless internet (done).

Try and get back on work at home. I did two days a week work at home before getting pregnant with daughter #2. I had excellent performance ratings. I got so much more work done. However I accepted an internship position guaranteed to double my income within 3 years. The catch, I had to stop working from home because as my boss put it, it was a training position. That internship ends Oct 16th. I intend to get back on it. Maybe doing at least one or two days a week will help me out. The problem, my boss can not do it so she thinks no else can do it either. She says she will fight me to get back on it. As much as I hate to, I will file a grievance or an EEO complaint to get back on it. EEO because if I were pregnant, I would be allowed to do it.

Save leave. I have been working on working comp time to build up my leave.

Disability plan. I need to lose 35 pounds to qualify for a disability plan that will pay 70% of my salary tax free. Otherwise right now, I would only get 30% and that is a huge difference. The problem is that I can't exactly exercise till I get healed from my knee surgery. 2 days in PT a week are not cutting it. I totally MISS my walking and stuff! I really want to get back into this. I think I may be allowed to try and doing walking in April, which is not that far away.

I even went out and planned when my last pill for Loestrin will be - Oct 12th. If I start right on time, that would put me at Nov 9th for a period and Dec 7th for a period. We were thinking trying in November, but I am now thinking more along the lines of Dec for various reasons. I also looked at when would 35 weeks would be as that is when I have gotten admitted both times.

I am such a nerd sometimes!

So are you sure that you REALLY want to go through that again?

Hmm, a question asked of me by my PCP last week, Dr. L. God Bless her. She is such a wonderful dr and she truly cares for her patients. I first started seeing Dr.L 2 weeks after daughter #2 was born. I switched to her becuase the nurse in my obgyn's office said, "you know, it would be a good idea to have your pcp follow your bp after you are done post partum". I was instantly horrified at the thought. My pcp that I had then, I didn't like. The nurses were indifferent. The office was dirty and less than desired. You could NEVER get an appt. I was less than thrilled with my care with them. This is how I landed on Dr. L's doorstep. She comes into the room and says, "So I guess you are not going to try THAT again are you?" Ummm, well yes I am. Over the last 2 years we have gone back and forth on it. Last April, she called my obgyn, Dr. E to ask about a med that he had prescribed me that was making my bp go haywire. There was also a possible allergy with it. Along the phone call, she asked him, Did you know that PE mommy wants to get pregnant again? He laughed and told her yes. She asked him, is that ok with you? Again, he said yes, and that I knew the risks. Fast forward to October when I saw Dr. E for a laparoscopy. I had been having severe excruciating pelvic pain since my 2nd daughter was born. We suspected endometriosis. I go to the hospital to report for surgery. They place me in a 4 bed room that they use for triage and outpatient surgery on the maternity floor. I had two roommates. The one girl was there for a tubal ligation. She was the 9 am surgery. The second was me and that was for a lap. The third was there for a D&C, the 11am surgery. The anesthesiologist comes in and says to me, so you are here for a tubal ligation. Ummm, NO. I am KEEPING my parts. Well that is not what your chart says. I said to him, that's not my chart. My obgyn showed up at that moment and rescued me. He said no she is not here for a tubal. So that brings us to the last month. We have definitely decided to go forward as we are not getting any younger. Me because I have enough problems being pregnant without the label advanced maternal age. Dh because he is hitting 40 soon. Dh isn't so anxious about being pregnant this time around. But then I was the one that had to be talked into it for daughter #2.

So I had my regular annual exam with my obgyn this month. Everything was normal there. I had my pcp run my bloodwork for clotting disorders, only protein S came back high. That may be because I just had knee surgery. Currently I am on Loestrin FE continuously and Prometrium on days 12-21 of the pill pack to keep the endo at bay. I also take Ziac to control my bp which it does beautifully. I forgot to ask a bunch of questions while at my annual exam, so I called back and left them with the nurse. No to calcium and aspiring during the ttc phase, will start that at the first appt at 5-6 weeks. I was very disappointed to hear that my ob would like for me to switch my bp meds. I was under the impression from both of my drs, Dr. E and Dr. L that the Ziac would be ok for pregnancy. I was ok with it because it works very well for me. Unfortunately, Dr. E said no and to change to Aldomet. A weak drug that is never used in a non pregnant woman. However, it is the only bp med proven safe for pregnancy. This presents a delimma. The reason is that maybe just maybe if bp is well controlled prior to pregnancy, then maybe the placenta will be nice and big and oxygenated and implant correctly. The downside is you could have a child with birth defects. So it was very disappointing to discover that. I will be starting Aldomet in September.

The nurse from PCP's office called to get dh in for an appt. He has been there for 2 years too and never had a new patient exam. While I had her on the phone, I told her what Dr. E said and asked if Dr. L will change the medicine. She said she probably would but would do a phone consult first with Dr. E. The nurses at my pcp's office are not surprised by my desire to have another child again. With my first daughter, she was hard. She was very sick. We spent time in and out of the various drs office. Then we met Dr. R, who was the Director of Asthma at the local Children's hospital. The very first visit she said we are going to get her better. It took a couple of years to adjust meds, etc. But she did get her better and healthy. THANKS DR. R!!!! Becaue my first daughter was sooo ill and combine that with the possibility of PE again, we waited a longggggggg time for daughter #2. With her, I hadn't even seen an obgyn in 5 years. I just showed up pregnant at my obgyn's doorstep. Sometimes I think it was easier to just show up pregnant like I did the last time.

There is a lot of reaction when we tell people that we are going to try again. My boss, has said that she is banning pregnancy on my performance evaluation. My mil, said why would you want to do that to us again. You must like be sick. Gee thanks for your support. My OBGYN tells me I am completely normal. My pcp thinks I am nuts, but will support me as long as she doesn't have to handle the pregnancy. She knows I am in good hands with my obgyn. I am. He watched me like a hawk, had nurses calling me at home and checking on me, saw me up to 3 months pp before he changed me over. The nurses at my obgyn's office, ummm well let's put it this way, there has been several very long silent pauses. Especially when I called and asked my questions I forgot to ask at my annual. My family are like are you sure, they would never say mean things. My family doesn't live anywhere close to me. In real life, my friends are generally supportive but VERY WEARY. My online friends at PE Survivors and June Board are very supportive and will be there every step of the way. My peri, Dr. W. had it nailed the day I had daughter #2. She told me I would be back in a couple of years and I told her she was crazy, but she was right.

So the answer to the title, "Are you sure you really want to go through that again?" is that no one wants to have PE or PIH or HELLP syndrome. It's not something that someone wants to go through. You are only pregnant for 9 months, well for most people. If you have to go through a couple of months of hell to get a beautiful baby, so be it. I don't regret the mag, multiple invasive tests, etc for my daughters. It's not a question of wanting to go through it again. It comes down to the fact that I don't want to be 45 years old and realize that I didn't ttc again because I was too scared and then it is too late. At that my pcp said true.


Hi, this is my first post. I am a 32 yr old mom of two girls. My first daughter was born at exactly 36 weeks via emergency induction due to Severe Pre-Eclampsia (PE) and partial HELLP syndrome. My second daughter was born at 35 weeks 5 days via emergency induction due to severe Pre-Eclampsia and decels on a NST. DH and I have decided to do this journey again and will be ttc again at the end of the year. This blog will chronical that journey along with other parts of my life.