Friday, February 6, 2015

The Last Two Weeks.... Part five

I checked into my room as Tim ran home and was relieved it was nice and had a couch for him. Not much sleeping would be possible but at least he could lay. We got all checked in and started the night process. Saline IV was given but they said nothing by mouth and that meant no pain relief unless I risked morphine in prep for the HIDA test the next morning. I was thirsty and starving!! I managed to get ice by begging and fed O as needed. Early the next morning my infectious disease team and surgeon came in. He said four days of pump and dump after the nuclear medicine HIDA test. He left and called the infant risk hotline directly for me to double check the time and safety of the drugs and understood my concerns and most of all listened! They confirmed four days of pump and dump. With Tim here, he said he could operate without the test but they weren't certain the gallbladder function was impaired since we found no stones. Fluid could be from pregnancy and internal sludge maybe not affecting function. He was 85% certain. 

Together we decided I'd pump a few ounces before the test then we'd move Oliver to formula when we ran out and have it done. We need clear answers and recovery with everything else happening in February. I need to recover and haven't been able to care for my kids which is devastating and has never happened before. We needed informed answers. Tim had to head home and take care of the big boys and Oliver alone now since no one was here to keep O with me. It was hard for all of us and hubby suddenly had a newborn and two bigger kiddos all on his own. On top of that a Newborn who had never had a bottle and just liked to be held! I'm so proud of how he rocked it even if that sounds cliche. 

The nurses were great and asked where baby went. No one else ever pressured me or acted like it was a burden. They expected a four day old to be with mom!! 

I waited with no pain relief until my scan. It couldn't be booked until Wednesday afternoon. Turns out it is a two part two hour scan. First injects me to see if I'm blocked then you lay still for 45 min under the machine for pictures. My gallbladder showed up so it wasn't fully blocked and we moved to part two the function test. Here I get an injection equal to fatty food and see how it deals. 

My organ pain was under control naturally no meds since morphine a night ago but I'd started getting regular sore back and neck from this bed and especially from lying right where my epidural was. I feel it hasn't healed and some fluid was inflaming the area which is common. At the end of the test I called it five minutes early and had to sit up. I wasn't sure how to get through the next one lying flat but tried. We started the text and every minute was torture with constant ache across my upper back. At thirty minutes I couldn't continue. She said they couldn't pause then restart and take a few more pics at the end but I decided a partial test was better than none and he was willing to go with none so I was done. Then the tech says "we saw what we needed."

A short time after I got back to my room the surgeon came in. Surgery for removal was necessary and my gallbladder was functioning at 17%. The surgery cut off is 35% and I was way below that. Sadly doc was busy so surgery couldn't be until the next day and afternoon. He understood I wanted out ASAP and said I could be released as soon as pain was under control. Once again no food or drink after midnight but that evening I got liquid diet. For the first time since Tuesday I could eat and drink even if it was broth and jello!!

Oliver was at home with dad and took his breastmilk bottles like a champ. We haven't gotten to formula yet as I pumped about ten ounces before the testing but it's coming soon now. Just hope his belly tolerates the change. I hung out and got real pain relief that night in an attempt to sleep. 

A great friend grabbed Oliver and brought him up Thursday morning while Tim managed the boys and Nolan's school drop off and pickup. We had some great friends drop meals so dad just had to reheat Wednesday night and hot dinner was brought Thursday. This is awesome after pregnancy of any kind but beyond amazing after our craziness!!! Everyone at the hospital knew my request to hurry and the surgeon moved patients around for me. At around eleven they came in and said "they are coming for you now." 

Off went Oliver back to daddy wih my good friend and I was prepped. It was a but scary waiting all alone but I knew my babies were in great care and I need to get better. We did the whole process and I entered the OR and was transferred to the tiny gurney. My anesthesiologist and surgeon said hi pre-op but in the OR one second I was strapped in and the next I woke up in recovery an hour and a half later. It was now around 2:30pm. No one told meanesthesia was coming or anything. Totally crazy and my like other surgeries I had but I guess I didn't have anxiety then!

Recovery was rough. Everyone said I could go home when I could manage but I needed IV pain relief to fully wake even. I had to be up, walking, eating and on oral meds only. It was already evening and Tim and I talked. The nurses were understanding but really wanted me to stay. One more night here, take meds and get healthy. I transferred to oral meds only in the evening, got my liquid diet, and made it to the bathroom walking! Apparently after they make four incisions, they insert a camera in one and tools in the other. 

Then they use CO2 gas to inflate our stomach to work in there. This inflation and gas was the main source of my pain. As it worked out, slowly I felt better. Now I have some residual gas in my shoulder but I think it's gone from my belly. Since I'm pumping and dumping I can take the oral strong meds and they help. Now I mainly feel the incisions and my abdomen is sore when moving. It was already separated from birth and now the gas and camera didn't help!

My fun non stop blood clot protection. It squeezes my legs and has been on since Saturday. I hope I'm buff now. 

Yum. Liquid diet. I got fed once Wednesday night, last night, and now Friday morning and that's it since Tuesday midday. 

Tears as I dump another pile of liquid gold. I've dumped ounces upon ounces now!! Hurry up Sunday!!

Well now we are to this morning Friday. Nolan is riding to school with a friend so baby O doesn't have to go in o school yet (thanks!!!). Oliver let dad get one chunk of sleep (he seriously hadn't slept more than 30min at night yet!) and I'm drinking breakfast, waiting to shower and then one dressed and up I'll hopefully be going home again finally. I won't be much help today and probably tomorrow but at least with a big pillow I can hold my baby and feed him (still bottles only until Sunday) and see my big babies again. I left them Tuesday after being home 48hrs and haven't seen them since. I've only ever been away overnight for births and short ones at that. 

I'm hoping the rest of the story goes release midday and better every moment so I can love on my baby and get my big boys back to their calm routine with mommy home!! Grandma C is coming to help now too! Drive safe!!

Thank you to everyone who watched a kiddo, ran an errand for us, or simply just asked how they could help or even better volunteered a specific action!!! I'll post more pictures of the cute parts of baby O and his homecoming once I have non camera phone ones at home!!

Last Two Weeks... Part four

After delivery I had a bit of fear the pain wouldn't be gone. My OB had really addressed it and we'd never scanned or tested the area besides blood work. She said she was going to be hopeful it was a pregnancy quirk and would reset once he was gone. 

With Oliver off my organs, things settled back in place and I took it slow. As the epidural wore off, my cough returned and the stabbing pain I kept thinking was my organs was gone but the overall soreness of my back remained. Once I recovered I actually felt better than I had in a week even though I'd just given birth. With only a small tear and my body having done birth before twice, the relief of the organ pain was liberating. We begged to get home and since my liver elevation bloodwork that morning finally showed the numbers no longer rising but not yet better I was released at 2 pm. As an aside the nurses kept asking how my gallbladder attacks were going but no doctor ever mentioned what the pain could have been. 

Both big boys were ecstatic to get home but had been amazing hanging in my room all day both days. We got a birds eye straight on view of the helipad and it took off jut a few feet then always pointed straight in on our room!

Sunday afternoon and Monday went well with us learning O's routine and getting used to breastfeeding. He nursed like a champ but very frequently (hourly) and was a bit confused on his nights and days. Not much sleep was gotten since he wanted mama all night and drowsed all day. 

Tuesday started off great but after trying to get a midday nap I woke up with a sore back that had been building for a while and www watching myself for upcoming inside organ pain. A few hours later it hit with bad pain but as long as I stayed still the attacks were gone. Crazy enough it was the exact same pain but opposite side now. Tucked up under my rib cage in from, tender abdomen, and radiating around the back and also down the back right side. I called my OB and asked exactly what tests they had and what I could do. They wanted me at the ER so the doctors could see my files and the OB on call could consult if needed but felt this was not at all a post pregnancy issue. They wanted me to get an ultrasound (US) of the area and more bloodwork. Our neighbor ran over to comber dinner time until our good friend could get there for bedtime routine. 

Oliver was breastfeeding hourly so in order to stay with me Tim needed to be there to take him. We went straight in to the ER again. They got us triaged and back to a room which was ironically they isolation but also secure room. I think it was done to avoid exposure for O but it's also where inmates go so everything was on lockdown inside. Very weird! 

On call doc started another IV and talked about my plan. They agreed Uktrasound, bloodwork, and orders a chest X-ray to look for pneumonia since I was still coughing somewhat severe over a week later after antibiotics etc. she checked the area and determined if was likely my gallbladder causing issues like the nurses had kept mentioning during delivery but no doctor had ever talked about with me. The pain from the US pressure was going to be so much so she wanted pain relief. The doc was great and looked up breastfeeding and assured me morphine was best and if I feed him now it'd be gone when I needed to feed again. O was fed and morphine started. I've never Taken so many medicines until this past week and never ever a narcotic. I've only done Ibuprofen after previous births. I didn't like the morphine and while it made me loopy enough to get through the US. One I felt it was gone though there was no pain relief. It seems more like pain distraction. 

Xray was clear but US showed it was my gallbladder. No clear stones but it sludge throughout it and liquid surrounding it. I needed to be admitted and have one more test but gallbladder removal was looking like the solution. A pharmacist came in and talked to me about safe antibiotics for breastfeeding and went with on the one of two possibilities that was safest. I fed O around 9:30pm again feeling no more morphine and so Tim could then run home with him to collect an over night bag. 

This is when I was transferred to the hospitals care and before Tim left my new doctor overseeing me once admitted came in. She took one look at O and made a sour face. Much different than anyone else we had interacted with. "Oh he's going home right?" she said. As my heart dropped I let her know he was staying with an adult caregiver so we could breastfeed plus he was not yet four full days old!! She mentioned I couldn't breastfeed because of meds anyways and might as well with for formula immediately. I wanted what was safest for baby right? At this point I was about to lose it and could tell Tim was really upset with how this was being handled. 

We let her know every step I checked safety and he could and would be breastfeed. She said the morphine was a no go and I said too late he's fed after I've had it and won't even do so for another two hours. She pulled out a small guide gave me letters/classes of drugs on why that and antibiotic were unsafe and said "see!"  Calmly I explained that she was looking in a quick reference and we need a pharmacist to call or use the national hotline for this. I said that is what was done already and we were given the real answers not the easy way out "no meds no nursing". I was not willing to risk his long term nursing on a whim and it was beyond important to me. She said "pharmacists are not doctors" to which we were thinking, "of course not they study drugs in depth which is what we need now!!" 

We just needed to get her out of our room and pray for shift change. She tried to turn super sweet, see the baby etc., and I tried to hold in my tears. I told her I'd call my pediatrician and confirm and she agreed. My pediatrician was great and I burst in to tears as soon as she answered. She said first off trust pharmacist and use the hotline as I had insisted. Morphine is fine if needed but stay away from nursing for a few hours after and there were much better options for the future. We decided to ask for other pain meds as long as nursing jik. I actually stopped all meds for the night. We talked about the test the next morning and she calmly assured me to just figure out each drug that would be given and use the hotline.

Last Two Weeks... Part three

During this time we talked a bit more about my birth plan. First goal was no csection, top priorities were to get rid of this non labor pain, and of course healthy baby. I wanted a natural birth with no epidural again like with C. To test myself a bit I practiced a simple breath hold and immediately the stabbing was there. Tim and I talked and decided although I could get myself through contractions most likely when it came time to push the other pain was just too intense I wouldn't be able to give it my all. I couldn't have the marathon birth I wanted but honestly I had been through so much and decided to take an epidural soon so I could get back relief and cough. 

At eight pm I called anesthesiology in and explained that I was aiming for a numb back and front rib even more than numb for contractions. We got the epidural and I coughed and literally had tears of joy. I could clear my chest productively for the first time in a week. It was the best feeling and energized me. I could talk to hubby again and felt human. 

Once my BP regulated and everything got back to normal, I let my mom know it'd be hours and likely early morning before I called with the birth news. They checked me at 9 something and I was finally 5cm dilated instead of the normal 3cm. She let me know that when I felt pressure to call. I calmed and relaxed and knew I had made the right choice for me with the epidural. 

Within a very short time of the check, I let Tim know that we were wrong and O wasn't waiting long to come. Pressure was there and I started shivering. I remember that most from my natural birth where the hormones skyrocket. This time it wasn't as strong but it was there. OB came in and went to check me but by simply looking from outside she said "oh yeah he's coming. I need to get dressed." 

This is the time when the ten minutes they took to transform the place was only possible because I had the epidural. I could physically not push him even though I knew he was pushing himself out. Everyone got in position and sadly our nurse was a camera police and instructed Tim no pictures until he was actually out. Tim knew I wanted all I could of every step so he did his best. 

With my feet up and ready I held myself and braced for the pushing. Contraction one I pushed through the three times they request. Contraction two his head came out with push one and all of baby O next push. It went to fast I forgot to ask for a mirror so I could only tell what Tim told me. Oliver Quinn was born at 10:29pm on Friday January 30 and he baked for 39w2d. 

Last Two Weeks... Part two

When we arrived we were taken to L&D, since I was 39wks pregnant. I did the required pee test and the nurse mentioned I needed to drink more as urine color was way off. They hooked me up to the monitors again and the same doctor I saw that morning was on call. I sat perfectly still on the hospital bed at a recline that relieved the pain and we waited. The whole thing took a few hours but one of my OB's came in finally and thought it possible some muscles were pulled or even a rib cracked. There's no real solution or reason to test, especially being pregnant, so he prescribed a muscle relaxer and I assumed and hoped it would alleviate pain. 

At this point from sitting still, I could function to walk to the car and get in my bed as long as I didn't cough, breathe heavy, or move unexpectedly. We filled the script, got home late, and headed to bed. The night was rough but I didn't feel any more pain but it did stay consistent. The muscle relaxer didn't seem to do anything though so after Dr. Google was consulted I realized I should probably take an actual pain relief too so good ole barely effective acetaminophen came to the rescue. 

That next morning (Thursday 1/29) Tim handled the boys and together we took N to school then headed to get my liver bloodwork done. The day progressed with me mainly staying in bed or reclining on our couch. I went to bed that night trying to avoid the sore side (mainly left front lower ribs and across my back) and avoiding giant baby bump. 

In the middle of the night, I woke with a startle to the strongest pain I had ever had to date. Sadly that was the trend as this whole thing progressed.  Each time something new happened it was worse than I'd ever experienced. I gasped but it was so severe I was incapable of making noise and doubled over in pain only to quickly find that offered no release.  I couldn't find a single way to move or lay that offered relief. My body was spasming and like it was being attacked. It was stabbing pain that then shot from the front right lower rib are around to my back and then down my side and the new "fun" was seizing the area and extending out to my baby bump. Oliver for crazy active but the pain itself always stopped and didn't make my uterus itself hurt luckily. I did feel confident this was not fetal distress. The first attack lasted thirty minutes straight. Tim wasn't sure what to do and I got to the brink of saying yes call ambulance when the seize slowed. I sat still and upright then propped myself up. It took another two hours of constant pain but I fell asleep and only had a few more seizings during the night. In the morning I was in pain, couldn't turn or touch that side, and coughing made me gasp. I didn't talk and couldn't breathe more than shallow. 

After another call to the OB we all went back in. I was in a constant state of pain sort of out of it with tears and inability to do much or think much. I explained the issue to the nurses and new OB now on call and really tried to reiterate this was not normal pregnancy aches and something was really really wrong. I mentioned the Labwork and one of the two tests had come back. Doctor checked me and asked if I knew about back labor. I assured her this wasn't it and I was currently having contractions but they were a walk in the park compared to what I was going through with the other issues. She looked in my chart said "oh" and then it started. 

My liver values were very elevated. The exact bile numbers (test 2) weren't back and could take a week so not sure why they bothers ordering them in the first place. She stated I needed to be sent to L&D where they would do bloodwork and recheck I my cervix but I had Cholestasis of pregnancy. Basically my liver wasn't functioning right leading to the accumulation of bile. Eventually it gets to baby and can be harmful. We aren't sure how long I've been having issues but it explained the itching and dark urine I'd had. 

It was about 9:15am and C, Tim and I headed back to L&D which was connected to my OB office and just a wheelchair ride away. Once there I want in triage and back on the monitor after blood draws and urine samples. Again doctor commented on color and I assured them although I hadn't eaten I had drank plenty of water already this morning. I was 39w2d, more pregnant than I'd ever been. 

This started the wait. When it was time to pick N up from school at 11 Tim left and then took the boys home for lunch. While they were gone, my OB came back in and said second liver tests had showed my elevated liver levels had doubled again and baby needed to come out. The couple cervical checks I had been given had caused contractions at 10 min but I was in no way in labor yet and left alone likely wouldn't have been. They said they would get me checked in and induced. This was around 12:30. 

C was down for his nap so we got our labor plans for the boys in place and our friend came down so Tim could get back. He grabbed my go bags and while I waited and waited for my room he headed up. 

Eventually we got placed in our room and again hours of sitting still at an incline meant my pain was just moderate until I coughed or strained. The afternoon through evening was uneventful. Contractions coming and labor slowly building. They took a long time to start Pitocin but then got it going. They double the dose every 30min until you get to contractions 3-5min apart that are actually dilating you. After a few doublings of medicine I was at 3cm and contractions 5-7min apart. Doctor manually broke my water (and poked poor O's head) and baby was already really low but shifted a bit more down and we waited.

The last two weeks.... Part one

So on January 22nd a week after Nolan came home sick from school and ended up with an upper respiratory infection, I spiked a fever. After a night full of acetominophen it was under control and gone but left me with insane mucus and a very bad cough. I spent the weekend coughing and hoping I'd recover fast. When it hit Monday and my cough seemed worse I called the OB. Once again, they said they wouldn't see me sick so I had to go to my GP even though I was almost 38weeks. 

GP diagnosed upper respiratory infection that was pretty severe and gave me a rescue inhaler with steroids and an antibiotic. I did saline nebulizer treatments in between. If you know me, you know I prefer no medicine while pregnant and during delivery. Even when not pregnant, I take medicine that heals but not that just masks symptoms. 

After having influenza A a few short weeks before this in December and now this new issue, this pregnancy I have been forced to medicate just to get through. 

For the past week or so before this (all of January) I had been somewhat itchy. No rash was present and it wasn't really where my skin was stretched. On Tuesday Jan. 27 I started getting unbearably itchy. It was enough that I couldn't sleep most of the night. I rewashed all my clothes in free and clear and took a water only bath a few times. Still no rash and only mild normal swelling. I worried maybe the antibiotic I was taking had made normal itching worse and also googled and found out about Cholestasis of pregnancy. Basically it's where your liver isn't functioning properly and bike is building up. Other symptoms fit too. I got in to my OB Wednesday morning and was still coughing horribly and relying on the inhaler. 

Doctor checked and monitored baby who was moving well and then ordered liver rests fearing cholestasis (liver issue) too. He switched my antibiotic as a precaution. He then said they could do the bloodwork draw there immediately and would call results of liver testing back to me ASAP. Turns out when I went to the nurses the test require fasting and they sent me home to wait until the next morning, Thursday, and to go to a lab for the draw. 

We went out to lunch all together and my cough started getting worse again back to somewhat nonstop. During nap time I laid down too and used my rescue inhaler as needed. When I woke I had an intense backache across my lower rib cage along my side and back. It was excruciating when I coughed, which was very very often. Bracing didn't help as this would shoot across my back not really belly. At this point, I rated the pain a 10 out of 10 ranking up there worse than the natural labor I'd done with Carter. It was evening time when I realized I wasn't sure I could wait all night and try to go back to my OB in the morning. Tim agreed after seeing my pain levels and knowing my normal tolerance. We dropped the boys in to bed and called our neighbor who was amazing and hung out at the house. Off to the ER we went.