Saturday, June 22, 2013

Birth Story Act IV: Under Pressure

Cast of Characters
Augusta + Mr. August + Gummy Girl
Dr. Smiley: my dear OB
Sattva: our dear friend and first egg donor. 
Dr. Good: OB who saw me in the office when Dr. Smiley was away
Nurse Eileen: beloved delivery nurse
Nurse Kelly: beloved nurse
Dr. TdC: how could you forget him
Baby Leah and her parents: our friends in Pleasantville who looked after Gummy
Dr. Patel: An internal medicine doctor
Nurse Kim: ER nurse

Before I launch into these next two acts, let me say this. I think that the story so far, what happened to me up to this point is well within the range of what is typical for births. In fact, I don't even think it was particularly harrowing compared to some of the stories I've read on your blogs or what other women tell me, now that I ask because I am interested in birth stories (instead of shrinking away in utter pain when birth and babies are mentioned). I'm pretty sure that what comes next is beyond the realm of what's typical, although I know that these things happen, and that it has happened to some of you. It's been helpful to write this stuff out, ladies. Thank you for reading and commenting. Your Augusta is infinitely grateful.

Scene 1
We have just gotten home with our baby and our Thai food and the millions of bags we brought to the hospital (why I thought I would wear anything else than my yoga pants and my softest fleece cardigan is beyond me). Once home, I realize that I forgot to ask about my labe.talol (blood pressure meds). Because of the epidural, my bp had been low on Thursday (day of the birth) and Friday, but had started to creep up again on Saturday. The nurses would take my blood pressure and pulse regularly and had some  thresholds they followed for deciding whether or not I would get my dose of labet.alol. Because it lowers one's pulse, they avoided giving it to me when my heart rate was below some number (50, I think). Well, I have really slow pulse on a good day. And these, from my body's point of view, were not good days. So I only got the meds a few times during that weekend.

I called the nursing station at 10pm on Sunday and asked what I should do. The consensus was that now that the baby was out, it would do more harm to take it than to not take it. So I should not take it. That sounded fishy to me. My beloved friend Dragonfly had pre-eclampsia and was on this med for 6 weeks postpartum (now, I didn't have pre-eclampsia, just PIH (pregnancy induced hypertension), but still figured I might be on it a few weeks postpartum).

Scene 2
I decide that a call to my OB's office was in order first thing on Monday morning. Dr. Smiley had gone on vacation right after her shift at the hospital Friday morning, so I knew I wasn't going to see her, but I let the nurse at the office know that I needed direction right away. She agreed.

At this point, my feet were unrecognizable.
whaaa? whose feet are those. Also, please excuse the mess in my house.


On Monday, Sattva came over in the morning. It was amazing to share this moment with her. She didn't get to hold Gummy, but did get to see her sleeping.

By Monday evening, I have a strange headache. By strange, I just mean not one of my usual types of headaches. Not sure how to describe it, but I remember noting that this was unusual. When we sit down to watch some television series (was it House? The West Wing?), I started seeing stars. This was a symptom I was told to watch for during the hypertension before gummy's arrival. I make the executive decision to take a dose of labeta.lol.

Scene 3
Tuesday morning, I make my way to the OB's office, praying that of the 3 OBs not on vacation, I wouldn't have to suffer Dr. TdC. The nurse has me come in and asks about my girl and the birth. She takes my blood pressure. Takes it again. Takes it again. She says it's high. Dr. Good, the only OB in that practice I haven't met yet walks in. He tells me my blood pressure is 200/122. Shit. I can't even interpret that number, since it's higher than any readings I've ever had. I start to cry and apologize profusely for crying. Dr. Good normalizes this for me, and says that with what I've just been through and how badly I want to be home with my girl, I have every right to cry. He says things like "we'll get you healthy again, and you can be back with your daughter. "

He reluctantly lets me drive myself to the hospital. He says I can't go home, I must go directly to the hospital. He writes out this page of notes that he faxes to triage. Dr. Good says I should never have been discharged. He thinks the labetal.ol is the wrong medication for me given my history of low heart rate. He insists that I need to be assessed, and likely admitted. He swears that the Family Birthing Unit will re-admit me to fix their mistake, and so I can have Gummy with me at the hospital.

I get into the car and call Mr. A. I sob some more (is there enough sobbing in this story for your taste?). We decide that I'll go to the hospital as directed and that he will borrow friends' car to take Gummy to her first doctor's appointment with our family doctor.

Scene 4
I get up to triage and Nurse Eileen greets me. She is beside herself and with her thick Irish accent, starts to call me sweet pet names I've never heard of. She hugs me and says she has a wheelchair ready for me. Turns out they can't keep me up there and will have to take me down to the ER. And what OB is on call, you ask. Dr. TdC and he has disregarded Dr. Good's directives. It's a busy day in the FBU and nurse Kelly wheels me down to the ER despite not really having time for it. I'm pretty sure they both feel rotten about this clinical decision, but that their hands are tied.

It's March 5. Otherwise known as winter in Canada. Otherwise known as cold and flu season. The ER is packed to the gills. It's noon and I'm starving. I buy a sandwich. Tears stream down as I eat my sandwich. All I can think about, all I can see when I close my eyes is my darling girl. I cannot bear to be away from her.* At 2pm, I am called in and put on a cot, facing the ambulance entrance, next to the resuscitation pod (their version of ICU) and across from the nursing station.

My phone is almost out of juice. I have not brought my charger. Shit. I cannot distract myself by reading about what maternity clothes Kate is wearing.

I use what's left of the battery on my phone to talk to Mr. A. He says he will bring Gummy. Are you effing kidding me? There was a woman with C difficile who just go wheeled 2 inches next to me. Goodness knows what else there is in here. Gummy is only 5 days old. No newborns in the emergency department. He says he will find a pump and bring it to me. I would like to pump. I am thinking that today would be the day that possibly my milk would come in. But I am in the middle of the hallway and feeling very exposed. My boobs are tingling a little, but I am not confident to pump in the hallway of the super busy ER. As the hours pass, I am feeling more powerless.

Scene 5
Dr. TdC saunters into the ER nursing station at about 3pm. He talks to me from a distance of 20 feet. He is an asshole. The nurses hate him. I hate him. You hate him. He quickly decides he can do nothing for me, and says he needs Dr. Patel** Well, I thought, I'm not too sad to bid him adieu.

By 5pm, I am starving again. Look people, I have just given birth and I AM HUNGRY. If I thought I was hungry while pregnant, I was wrong. This is what hungry looks like. I politely interrupt nurse Kim who is doing paper work to ask if I can go get myself another sandwich. Very apologetically says I shouldn't eat until I see Dr. Patel. I gnaw at my fists.

5:30ish, Nurses Eileen and Nurse Kelly come down with a stack of magazines (finally can catch up with the duchess of Cambridge and her pregnancy) and offer to get me coffee and something to eat at the cafeteria (I decline. see above). They ask about Gummy and Mr. A, and say encouraging things to me.

At 6pm, nurse Kim decides that this waiting is ludicrous and decides to get me food (probably has kids of her own and knows how fucking hungry I am). Also, she has seen me cry several times on that cot and feels sorry for me. She gets me a little lunch pack with a sandwich, juice, crackers, and adds an extra chocolate pudding. I say thank you 100 times at least.

Mr. A and Dr. Patel show up at about the same time, shortly after 6pm. Dr. Patel is amazing (and so is Mr. A). He takes the time to hear my story and explain what he is thinking would be a good plan of action. He is kind and charming and everyone in the ER is pleased to see him, most of all me. He decides to try a med cocktail check back on things an hour later. Things are still dire, so he decides to try something else. No change by 10:30pm. He has to admit me overnight. I am feeling defeated, and react very little. Gummy is with baby Leah and her beautiful parents, and they are taking good care of her. And I am missing her beyond words.

I am moved to a medical floor and share my room with an elderly woman who has sustained a fall. Mr. A has brought a pump and I wake up at regular intervals to pump. Each time the bottle is dry. Always dry. But I persist.

The diuretic and blood pressure med finally take effect, and when Dr. Patel arrives at 8am the next morning, he says I can be discharged. I wonder about the effect of the new med (can't remember it right now) on breastfeeding, and he goes and talks to the hospital pharmacist. He says there are no studies with this particular drug with regards to breastfeeding and he doesn't want to turn me into a science experiment. So back on labeta.lol, with an added hydro.chloro.thiazide for shits and giggles.

We go pick up our Gummy girl at our friends' house. More crying when I see my girl, but I am taking her home and I am determined to spend every moment for the foreseeable future in her company.       




*Gosh, that was so intense physically. Every cell in my body couldn't stand being separated.
**He expects the nurses to page him once Dr. Patel pages in to the ER, which is not possible in their communication system and he should know that. So this delays the process greatly.

11 comments:

  1. Aaaaa! Rrrr! AAAAARGH!! While I'm glad that you realized there was a problem before you had a STROKE, all the same, perhaps someone who was your doctor (!) should have been paying attention just a wee bit closer. And from the outside, "we gave you a drug and it worked, so let's send you home *now* on the drug that DIDN'T work" sounds like a bad outcome waiting for a place to happen.

    I also remember reading several article recently that postulate that PIH is a precursor to/ on the spectrum of pre-eclampsia. In any event, not fun.

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    1. Yeah, I'm with you on problem realized before stroke situation. And I agree, there was some ball dropping in my care.
      And yes, I was monitored intensively for the PIH, as it was expected to turn into pre-eclampsia.

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    2. I remember the intensive monitoring during pregnancy - what I was thinking was, people with frank pre-eclampsia are very carefully monitored after delivery too, so what were they THINKING???

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  2. I'm reading along in disbelief at all you've been through. You are one incredibly strong lady.

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  3. I'd probably have cried more than you did. I know the physical pain of missing someone dear, but not my own child, not just days after birth. That has to be even more intense.
    Also, what JF said. And the thought that this still isn't the end of the story is harrowing. To end on something more positive, I'm glad you had these kind nurses to care for you, Mr. A of course, and some good doctors. And that Dr. TdC left the scene.

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  4. Oh, I just can't believe all you had to go through up to this point and know that there is more to this story. Dr. TdC is an ass. I am so very sorry you had to deal with him yet again. I can only imagine the pain of being away from your precious Gummy...how incredibly awful that would have been for you (and any new mom for that matter).
    You are in my thoughts, friend.

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  5. I have been reading along, but have not been able to comment on my iphone, which is how I read most these days (frustrating!) I cannot believe all that you have been through... I am so glad you are getting a chance to write it all out, and hope that is therapeutic for you!

    Loving Gummy from afar, by the way, and so happy for you!

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    1. Jess, if you think there is something I can do to help the commenting on the phone situation, tell me. I'm a luddite after all. I need these things pointed out.

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  6. WAAAAAH! My heart breaks anew at the thought of you being separated from her so soon. It sounds more and more like medical incompetence (or carelessness, or stupidity) is at the root of this dreadful sequence of events. MAD AND SAD. Also GLAD, thinking of the fact that you're probably cuddling her right now.

    I spy a carseat with a shed bunting! And is that a package containing a gift from an enthusiastic Gummy fan?

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    1. I was wondering if you'd recognize your box ;)

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  7. Oh, being separated is so awful. It's a physical loss -- like someone pulling at your guts until you can be with your baby again -- and I'm so sorry you had to go through it. Like previous commenters said, though, I'm so glad you got treated properly before you had a stroke. Dr. Patel sounds like a good 'un -- I hope he replaces Dr. TdC for the rest of the story. It's just terrible to be treated by someone who doesn't understand human interaction, and like you said in your previous installment, if he's such a great surgeon, why doesn't he just ... be a surgeon? He could use his skills and would be able to minimize the amount of time he has to spend, you know, talking to people.

    Also, too, the pictures of Gummy in this and the previous installment are heart-melting. She is a treasure -- and someday she will grow into that snowsuit.

    You just hold on, amazing woman. Think of how strong you are, to get through *this.* Unbreakable is what you are.

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