Saturday, July 23, 2011

I'm Home Again (a.k.a. The Longest Post Ever Written)

I am home…and happy to be here.  My hospital stay actually ended up being quite brief.  I was discharged almost exactly 24 hours after being admitted.  For the most part, the experience was extremely frustrating, and I hesitated to write about it before having some time to contemplate which of my feelings were valid and which feeling were likely over-reactions.  I feel like I’m ready to talk about my experience now and I apologize ahead of time for the length of this post…but I want to get my thoughts out and then just move forward, without dwelling on my frustrations.

After writing my last post, I was moved out of the very crappy treatment room I had been in and ended up in a private postpartum recovery room.  It was much nicer and I can see now why so many women in my area prefer the quaint little hospital over the more impressive larger hospitals in the area.  My care was spectacular during this hospital stay.  The nurses were kind and attentive and really went out of their way to make me comfortable.  The engineering department even brought a brand new air conditioner into my room because I was too hot and the older air conditioner that had been in the room just wasn’t cooling me off enough.  Every nurse was able to find my baby’s heartbeat with ease and, while it was a little slower than normal, the heartbeat was always strong.  Even more exciting, the baby happened to give an impressive kick against the doctor’s hand when she was feeling the baby’s position.  I had been feeling little tugs in that area, but assumed it was my uterus stretching, as 14 weeks is much too early to feel the baby moving (according to the pregnancy books I own and Dr. Google).  However, the doctor confirmed that what I was feeling was actually the baby’s movements.  Our baby, in addition to being quite stubborn and hyperactive, is apparently also quite strong.  So, the doctor explained, I get to enjoy that extra bonding with the baby already…a gift.

That was the good part about the hospitalization.  Here’s the cliff-notes version of the bad parts.  The first night of my stay, I was told that my ketone level was already within normal limits, after taking in only 2.5 liters of IV fluid (pushed through in just under five hours).  Accordingly, I “couldn’t have been as dehydrated as they had thought.”  My blood pressure also went from very high to VERY low – 87/52.  I had to wear a cuff for constant monitoring and was forced to get up three times in the night to walk around to get the blood pressure back up.  There was no explanation about why my blood pressure acted up and no one hypothesized that the fainting could have been caused by a rapid BP shift (which is a logical conclusion I would think). 

By the time the morning rolled around, I was tired, a little scared, and very frustrated.  I was told that Dr. B would be in “early,” and that she would likely be discharging me.   Knowing that I was going to be discharged without an explanation as to why I was getting so sick made me even more irritated.  I spent the whole morning crying and getting more and more agitated, waiting for Dr. B’s visit.

When Dr. B finally arrived at 10:00 a.m. (her “early” and my “early” are very different), I was too worked up to be polite.  I explained that I wasn’t frustrated with her, but I was frustrated.  I had been offered no explanations for why I had dropped five more pounds during the few days that I had been able to keep food and fluids down.  I had received no explanation as to why my ketone level went from insanely high to normal in a matter of hours or why my blood pressure was all over the map, or why I fainted.  Dr. B’s initial response…”It is probably the heat.”  I explained that I fainted first thing in the morning…having been in an air-conditioned room for hours and I really haven’t been in any heat, as I stay inside all day, every day.  Then I got “Well it could have been low blood sugar.”  I pointed out that I ate before getting out of bed (as I always do now), and that my fasting blood sugar each morning has been testing high.  I asked for an explanation of why my blood sugar is behaving so strangely (high when fasting and dropping throughout the day…even after meals).  At that point, it seemed that Dr. B was also getting frustrated and didn’t feel like answering my questions.  She said, “You weren’t as dehydrated as you seemed but your electrolytes are still off.  So we’ll give you some potassium and send you home.”  I asked “Did the electrolyte imbalance cause me to faint…and to have high blood sugar…and high blood pressure…and a high ketone level?”  Dr. B conceded that it probably did not, but that “Some women just have rough pregnancies.”  I am “apparently just one of those women.” 

Then Dr. B added the ultimate insult…”Nerves can also contribute to complications during pregnancy.”  I lost it a little bit, spitting out in between sobs, “Well…fainting for no reason and being rushed to the hospital because my whole body is supposedly going crazy will cause some ‘nerves.’  And being treated for symptoms only, feeling like no one cares to determine and treat the root cause of the problem can also cause ‘nerves.’  Perhaps if I had some assurances that I wasn’t going to end up back in the hospital in another two weeks, with the same unexplained problems, my ‘nerves’ would be better.”  (Perhaps I was a little nicer than that…but perhaps not).  Dr. B said that there is no guarantee that I won’t be back in the hospital in two weeks, two days or two months.  In fact, given my hyperemesis gravidarum, Dr. B feels it is more likely than not that I will end up needing fluids again, but she isn’t willing to give me a portable IV device or to set-up an outpatient IV treatment.  Dr. B then gave me a huge list of things I should do to “help” my pregnancy along, including many contradictory directives.  For example, I am supposed to continue to work, take short chaperoned walks each day, and get out of my chair at 15 minute intervals, throughout the day, to keep myself from getting “muscle fatigue.”  But I am also supposed to limit my physical activity and do nothing that might cause my heart rate to rise.  How exactly do I balance all of that?  Another example is that I am supposed to graze on food throughout the day, eating small snacks at least every 10-15 minutes, and sipping liquids every minute or two throughout the whole day (no full swallows).  But, I am also not supposed to eat and drink at the same time.  Even with my Type-A, schedule-loving personality, I don’t think I could manage that.

Initially after this conversation with Dr. B, I considered changing OBGYN’s.  I am frustrated with her attitude and lack of sympathy.  Her bedside manner was part of why I chose her…but she wasn’t displaying much charm during our last conversation.  However, after talking with The Prince, he helped me to realize that Dr. B is only human and no other doctor is likely to be better, given the realities of an OBGYN’s job.  Dr. B had performed surgery all day on Wednesday, left the hospital at 5:30 p.m. (after talking to my nurse about my condition and seeing that my admission was complete) only to be called back to the hospital at 9:00 p.m. to deliver a baby.  She left the hospital after the birth, sometime after 2:00 a.m. (after, again, talking with my nurse about my progress), and then was back to see me less than 8 hours later.  She doesn’t have the time to research the cause(s) of my symptoms…not when she can eliminate the life-threatening causes of such symptoms, treat the symptoms quickly, and make sure there has been no harm to the baby.  I still wish she would just say that to me, instead of guessing about why I am having problems and then giving me some non-descript “rough pregnancy” diagnosis to explain away a lot of potentially troubling problems.  Perhaps I really want Dr. B to be a fairy godmother…to wave her magic wand and fix all my problems so that I can enjoy this pregnancy a little more.  That’s not realistic…but a pregnant girl can dream (providing she is able to get some sleep).


Kerrie said...

Wow...don't even know what to say. I won't try and placate the situation with at least you are going home, the baby is healthy, etc. It is extremely frustrating and what you are experiencing is totally valid! There is no reason they should be just treating the symptoms and sending you on your way. I can only hope that you don't have another episode and that the orders given, as crazy as they are, help some. Keep strong and hang in there.

Jennifer said...

First, you have all my sympathy. I am pregnant and suffering from morning sickness - not HG - and it is really one of the hardest things I've ever had to deal with, so I can't even imagine what you're going through. I mean, I can imagine it, and it's horrifying.

Dr. B really doesn't sound like she's providing you with great care. I wonder if you there are any OBs in your area that have any kind of specialization in women with HG? Maybe some of the national HG organizations might be able to help you find an OB in your area with special expertise in HG? While what you're experiencing is horrible, and you've certainly been the exception to the rule before, I'd be shocked if there weren't other women who'd experienced similar symptoms. There IS an explanation, and it would be great if you had a doc interested in finding it.

Good luck. Don't apologize for your posts. Hopefully writing them helps you feel a little better.

Anonymous said...

Fellow sufferer of a "rough pregnancy" here, and I just wanted to say that I am so angry on your behalf about Dr B's comment about nerves! Grrr. And double grrr. I would have been furious, and I think your response was absolutely correct! Follow your gut on whether to change OBs. It's true she has a tough job sometimes, but I had an OB who was straightforward, answered all my questions, was reassuring when he could be, and was never patronizing or dismissive of my concerns. So such people do exist!