Archive for August 29th, 2008

Not How We Planned to Spend the Day

August 29, 2008 @ 4:34 pm | Filed under:

We had a bit of an adventure yesterday. Not the good kind. But before I go on, I’ll hasten to say that the baby is fine, and I’m okay, and all will be well.


I seem to have contracted some kind of stomach bug or food poisoning. No one else in the family is sick (a good thing). I woke up early yesterday and the vomiting started right away, along with other kinds of g/i nastiness. When Scott got up and saw what kind of shape I was in, he called his office to say he’d be taking the day off. Which turned out to be a very good thing.

Jane had an early-morning orthodontist appointment scheduled. This was going to be a big day for her: she was supposed to get braces. Scott decided to take her himself since I clearly wasn’t up to it. He dropped the other three girls off at a friend’s house, as planned, and took Wonderboy with him. But: no braces after all: not this day. The orthodontist had decided, upon reviewing Jane’s X-rays, that a consult with an oral surgeon is necessary. Why this information couldn’t have been transmitted over the phone instead of requiring a long car ride and an hour and a half of my husband’s time is a mystery: but that’s a subject for another post.

At any rate, home came Scott, Jane, and Wonderboy about an hour ahead of schedule. This, too, turned out to be a good thing. I had spent their absence alternately lying on the bathroom floor and hovering over the toilet. I had put in a call to my OB to make sure this illness wasn’t putting the baby in any risk and was awaiting the promised callback.

It took two more phone calls before we finally got the doctor on the phone. By this point it was about noon. In addition to the g/i misery, I had begun having contractions. I was also having stomach cramps, but the contractions (which included the kind of burning lower-back pain I have only ever experienced during labor) were real and unmistakable, and they were coming every seven or eight minutes. I am only 22 weeks pregnant, so needless to say this was a bit alarming.

Also, by the time the doctor finally called, my hands and feet were tingling. Pins and needles. Very strange sensation.

The doctor did not believe they were contractions: stomach cramps, he insisted. Since I was having both, I knew the difference. He wasn’t buying it. Said colon cramping might feel similar to uterine contractions. Advised me to drink lots of fluids (I told him I couldn’t keep anything down, not even Gatorade) and get some rest, and said it would take at least twelve hours of throwing up before I got so dehydrated that it would be problematic. But, he added appeasingly, if you get scared enough, just head over to the hospital and check in at Labor and Delivery. Even if all I needed was hydration, I’d have to check in at L&D instead of the ER because I am past twenty weeks.

We didn’t wait anything like six more hours (I had at that point been throwing up for six already): between the contractions and the tingling extremities, Scott wanted me to get some i/v fluids right away. So we arranged for Rose, Bean, and Rilla to stay at the friend’s house for a while longer, dropped Jane and Wonderboy off at another friend’s house, and drove to the hospital.

By then things were getting kind of scary. The contractions were fierce and regular, the stomach cramps were brutal, the tingling had extended to my arms and legs, and—scariest of all—my fingers were contracted into claw-hands, and I couldn’t get them to stay open.

Scott told me later that I was somewhat incoherent during the car ride. All I remember is the pain, and not being able to open my hands.

He pulled up to the entrance of L&D and left me in the car while he ran in to ask for a wheelchair. My leg muscles were cramping too, by that point. I threw up into a bowl balanced precariously between my claw-hands. He came back with no wheelchair (none available) and helped me hobble into the lobby. Wicked contractions. Don’t much care to remember them.

The nurses took me into triage and first made sure that I wasn’t in labor. All good there: no dilation or anything. Baby’s heartbeat sounded great. They hooked me up to a monitor, and sure enough, I was having uterine contractions. The nurse even felt one with her hand on my belly. So: not in labor, but suffering from extreme dehydration or something else severe enough to cause muscular contractions all over my body including the place we don’t want contractions to occur for another 18 weeks. The nurse prepared to hang a bag of i/v fluid.

Just then, another nurse came into the room, or maybe she was a resident. She had just gotten off the phone with my OB. He said that since I was definitely not in labor, they needed to send me to the ER for hydration. He had said, and this new person relayed, that the claw-hands and everything else were probably caused by erratic breathing, and that I should remain calm.

I pointed out that any erratic breathing was because of the pain and the fact that I couldn’t straighten my fingers: not the other way around. In severe pain, you pant, you breathe funny. I hadn’t started hyperventilating and then developed muscle contractions. The contractions came first. I was trying to breathe slowly, but then another contraction would grip me.

At any rate, the verdict was that I needed to be taken to the ER. Also, I should be given some Tums. This will come into the story later, in an unimportant but mildly amusing way.

My nurse wanted to just get the i/v started first but she was told no, they would do that in the ER. They got me into a wheelchair and an aide took me on a fifteen-minute journey to another check-in desk. Scott was right behind her with my bag. Sitting in the chair, my contractions were even more intense. I had four of them on the way to the ER, and two more at check-in.

Before we got to the ER, while we were waiting for an elevator which Scott told me later turned out to be the wrong elevator, and we had to come back and find another one, I felt myself growing dizzy and lightheaded, as if I were going to pass out. I knew I need to get my head down and I would be all right. I leaned forward in the wheelchair, but the kindly aide thought I was slumping over from the pain, and she took my shoulders and pulled me back upright. The room swirled. I made myself as sideways as I could in the chair, and the dizziness subsided a little. Then another contraction hit, and that was all that existed in the universe.

“Your doctor says they aren’t contractions; they’re stomach cramps,” said the ER supervisor who was checking me in.

“He’s wrong,” I gritted out. “I’m having stomach cramps too. I have had—five children—and I know—what a contraction feels like!”

He typed “patients says she is in labor” into his computer. I saw it on the screen and said, “No, I’m not in labor. I am having contractions. I want you to make them stop.”

He made the change, which was the last thing I paid attention to before another contraction took over. After a while they got me into a curtained room, and a bed, and all the ER docs and nurses began to freak out because they thought I was in labor. “Why did they send her down here?? Do we have a delivery kit?”

“You don’t need one,” I said, or at least I think I did. “I’m not having the baby now. It’s too early. You have to make the contractions stop.”

Scott asked if we could get i/v fluids going immediately. There was some hesitation: they needed a doctor’s orders for that. I don’t remember things clearly from this period because by then the contractions were two or three minutes apart, and they were REAL, and all of a sudden my hand was on fire like it had been dipped in acid, and I was yelling “My hand is burning!” and no one seemed at all concerned about that, they were so busy tracking down the gosh-darn delivery kit. Finally Scott figured out what was wrong and murmured that it was okay, they were just taking my blood pressure (for the third time that day), and I understood through the fog of pain that the burning was just what happens when your tingling hand gets tinglier from the squeezing of the blood pressure cuff.

And then there was some blood-drawing for labs and a brief catheterization for urine, and by brief I mean an eternity of pain, and the ER doctor checked me again to confirm that I was not in active labor, cervix high and closed as it should be at 22 weeks, and they got the i/v running, beginning the hydration at last. I still couldn’t unclaw my hands.

“I bet you’re a natural childbirth person, aren’t you,” said the very nice tech who was doing a lot of the bustling in the room. I nodded: contraction: couldn’t speak. “I thought so. Your breathing is so good.”

Which made me realize I was doing my Bradley breathing techniques and that was probably the opposite of what I should be doing at that moment, because the Bradley method is all about relaxing into the contraction and letting the muscles pull your cervix open. So then I almost wanted to laugh, because panicky pain-breathing was wrong and calm breathe-through-it breathing was wrong, and holding my breath was wrong. I couldn’t do the math.

About halfway through the bag of fluids, word came that I was to be transferred back to Labor & Delivery. The ER was uncomfortable dealing with a pregnant woman who was having contractions. But they kept the i/v running, and that was the important thing.

The nice tech wheeled me back to L&D and they got me back into the same triage bed as before. “You again!” exclaimed the nurse.

Lots of chatter back and forth above my head. Scott was called away to deal with more paperwork. We learned later that three separate accounts had been opened for me: first L&D admission; ER admission; 2nd L&D admission. This would cause all sorts of confusion and delays before long.

I was on my second bag of i/v fluid. My hands were beginning to uncurl a little. It seemed to me the contractions were coming farther apart now: a very good thing. The baby’s heartbeat still sounded good. I was still dry-heaving occasionally but even that was less violent. Still a lot of pain, but getting better, I hoped.

Scott and I were left alone in the triage room for long stretches of time. Eventually my OB paid us a visit. Really dreadful stomach cramps, he commiserated, again pooh-poohing my insistence that there were also real contractions. The nurses believed me; the entire ER staff was in terror over them; but the doctor never did buy it. But, he said, clearly I was dehydrated and in pain too severe to let it go, and he ordered a medication to ease the effects of the stomach virus or food poisoning or whatever it was.

So that’s how they discovered that there were three separate accounts for my name, and since my bloodwork had been initiated by the ER, the lab results were stuck under a now-closed account. The L&D nurses had kept pulling up my file on the computer to see if my labs were back, and being surprised that it was taking so long, when in fact the labs had been sitting there for hours by this point: in another account.

When they finally figured it out, they were all somewhat dismayed to discover that my potassium level was low. Dangerously low, in fact.

Hey, guess what? This morning I looked up symptoms of low potassium. Muscle contractions, tingling extremeties, weakness. You don’t say!

Anyway. My OB was hastily consulted and equally hastily ordered a very large dose of high-concentration potassium. This was to run via i/v over the course of four hours. He also ordered: Gatorade, to be given immediately. I was throwing up less often, so everyone hoped I’d be able to keep it down.

It took about two hours for the Gatorade to arrive. It was a small bottle, the same kind you buy at 7-11. I laughed and wondered why we hadn’t just had Scott run down to the vending machine hours ago. At least then I could have picked out a tolerable flavor instead of the horrible red punch they brought me. Not that anyone expected the Gatorade to help with the low-potassium problem. It was just to test whether I could keep anything down yet.

Two hours, but still the Gatorade beat the potassium. These were very long hours with all the contracting and cramping continuing, though growing steadily less severe than they had been. I could tell the hydration was helping a great deal. But my nurse was worried about the potassium taking so long to show up. She’d been given the impression that it was urgent they bring my potassium level up immediately.

Finally she tracked it down: I think it had been sent to the ER.

The first bolus was hung and began to drip into my i/v. Suddenly a line of fire shot up my arm from elbow to shoulder. It felt like army ants were marching up the tunnel of my vein, chewing as they went. I was gasping and writhing, and the nurse said, “Oh, does it hurt?” and told me she’d never administered potassium at this concentration before, had never even heard of it being done, and maybe it was painful in that concentration. She connected a line of saline to the tubing, and after a while the army ants ceased their munching, and merely crept up the tunnel on pointy little feet.

But my contractions had completely stopped by now, and I didn’t care about much else. Baby was going to stay put. That’s why I’d come.

I said I didn’t care about much else; there was one other thing I cared about intensely and had been caring about for quite some time. I was freezing cold, shivering, even sometimes shaking from the cold. In the ER they had discovered that I had a fever. Back in L&D, my temp was 101. Not a high fever, but high enough. The nurse would not let me have a blanket. I begged for one, but she laughed indulgently as if I were a naughty child and said, “Not until that fever comes down!” I asked for some Tylenol, but the doctor hadn’t ordered any, so I couldn’t have any until they tracked him back down. I never did get anything for the fever, although I asked a couple of nurses. “Is there any chance the fever could harm the baby?” I asked, and my nurse said, “Oh, let’s check your temp again and see how you’re doing,” and stuck a thermometer in my mouth, and said merrily, “Look at that! You’re down to 99.7! If you hit 98.6 I’ll let you have a blanket!” and whisked out of the room before I could tell her I had just taken a drink of ice water (this was before the Gatorade arrived) and that’s probably why my oral temp was so much lower, so quickly. But she was gone, and then I had to lie there debating whether to make her understand about the fever so I could have some medicine for it, or whether to suck on some ice so that she would give me a rassafrassin’ blanket.

The first bag of potassium was hung around 6:30. Shift change was at seven. When my i/v beeped at 7:30, ready for the next bag of potassium, the nurse who came in was not assigned to me and therefore didn’t know I was on blanket restrictions, and when she saw me shivering she said, “Oh honey! Are you cold? Why didn’t you ask for a blanket?” and bustled out and came right back in with two blankets—warm ones, fresh from the blanket-warmer, the kind they give you in Labor and Delivery when you have actually had a baby instead of just being a pesky, dehydrated, potassium-depleted, ER-staff-terrifying stomach ailment patient. I snuggled down under my deliciously warm blankets and finally, finally began to feel human for the first time all day.

Scott had left around six to collect the children from our friends’ houses, but after he got them ready for bed, he arranged for yet another friend to come over and stay with them while he came back to see me. (And yes, we are exceedingly blessed in the friends department. I don’t know what we’d have done without them yesterday. I’ve also been given to understand that yet another friend is bringing dinner for the rest of my family tonight. I am still subsisting on a diet of Gatorade and chicken-and-stars soup.)

It was still up in the air as to whether I would get to go home last night or stay until morning. They had me on a 23-hour watch but said if my potassium levels came up high enough, I might get to go home. After 3 1/2 bags of potassium, a lab tech drew more blood. I think it was around 10:30, just after the last bag of potassium was finishing up, that we got the news that I was just barely over the line into the low end of acceptable, and if I wanted to go home, I could.

I did. I have spent more nights than I care to remember in hospitals, and one thing I know is that they are not a place for rest. The i/v beeping, the blood-pressure checks, the banging open of doors, the loud voices and bright lights in the halls. And after everything that happened yesterday, I needed rest. I needed my own bed, with blankets or not, at my discretion.

The nurse went to print up my discharge papers. She returned laughing, waving a tiny plastic-wrapped package of Tums.

“The doctor ordered these for you!”

Um, yes, eleven hours ago.

It was funny at the time, because Tums (or lack thereof) were the least of my concerns yesterday. Became somewhat less funny today, when I checked in with the doctor by phone, as ordered. Turned out he’d ordered those Tums right away because he thought a calcium deficiency was what was causing my hands to turn into claws.

His diagnosis had been wrong, which, as it turns out, is kind of a good thing. Because if I’d really needed that calcium to correct what was going wrong with me, eleven hours would have been an awful long time to go without treatment in such critical circumstances.

At any rate, I eventually got the fluids and potassium that my body was evidently in desperate need of. And I came home, and I’m doing much better, no more contractions, no more claw-hands. Still battling the original g/i unpleasantness, but have managed to keep some toast and Gatorade down. I have a killer headache and I feel achy all over as if I’d been hit by a truck. But I’m happy to be home with my family. I’m glad the baby is fine. I’m glad I can have whatever I need right away instead of hours later. I’m glad yesterday is over.

Scott wanted me to write it all down before I forgot it, so I did. And now I’m going to take another nap.