Single Digits and First Trip to L & D

It's hard to believe but all of a sudden, we are into the single digit countdown and there are only 9 days left until my due date! I had a scare this weekend that made me think that I might not make it this far, but everything turned out okay. Last week I wasn't sleeping particularly well in general but was getting just enough sleep to function and stay healthy. My mom had come down with what seemed to be a cold. She didn't have a fever so we figured it couldn't be a flu virus. Then on Thursday night I had a really bad night where I got maybe 4 hours of sleep and was exhausted all day long. That night (Friday), I awoke around 1 am shivering and shaking with chills, body aches, and the general feeling that I had a fever. I slept restlessly for a few more hours, feeling alternately hot and cold, throwing the blankets on and off, sweating and then shivering. By 4am, I'd had enough and was worried that my temperature was getting too high, so I forced myself to get out of bed to locate a thermometer and some Tylenol.

Sure enough, I had a fever of 101.4, so I popped two Tylenol and slept a few more restless, sweaty hours. When I awoke on Saturday morning, I was a feeling a bit better but my hair was disgusting and matted with sweat so I decided to take a shower (even though normally I try to avoid washing my hair when I'm actively sick since I feel like having a wet head and getting water in my ears and sinuses often exacerbate my illness) and in retrospect I'm so glad I did.

I started to feel worse as the morning went on, and when my mom returned from her doctor's appointment armed with Ceftin for a possible sinus infection and learned about my fever, she called her pediatrician friend who said to call Labor & Delivery and that I might have to be induced early if it turned out I had the swine flu. We called L & D and they told us to head on over, so we did, although at first the front staff who are responsible for screening all visitors for possible flu symptoms didn't want to let us in the building when we said we were sick. When we told them L & D was expecting us, they called to confirm it and finally led us up there (with masks of course). I was admitted to an isolation room, but my mom was not allowed to stay with me. This was around noon.

A nurse hooked me up to the usual monitors for the non-stress test, one to measure baby's heart rate (slightly elevated), and the other to measure my contractions and baby's movements. I also had an IV line placed to administer fluids and a pulse oximeter to measure my heart rate (high) and blood oxygen level (98% on room air). Anyway, this post is starting to get too long already, so I'll try to just focus on the highlights (or lowlights) of the next 24 hours, which is how long I ended up staying there.

Originally they had said I would be discharged later on Saturday, but then it turned out they wanted me to stay the night for observation. A nurse did a nasal swab to test for H1N1, which ended up having to be repeated later by a doctor (unpleasant but I've had worse things stuffed up my nose). The monitor showed I was having some contractions, although I couldn't feel them at all, so at one point an MFM did an internal exam (the first of my pregnancy) to determine if there was any progress. I'm not dilated at all but my cervix has effaced down to about 0.5 cm from 3.5 cm at my 20 week ultrasound, so that's good.

Everyone kept saying that Ziggy looked great--he had nice heart rate fluctuations and was moving well. They did comment that his heart rate was a little high but explained that my higher heart rate from being sick was affecting his. Overnight both of our heart rates did come down. They started me on Tamiflu but failed to mention that nausea is one of the side effects. I also had some heartburn, for which I was given Maalox, but I don't know if that was from the Tamiflu or from lying down for most of the day. It didn't help that I was never brought a proper meal (I hadn't eaten much before heading to the hospital because I hadn't had much of an appetite in the morning). One nurse (I had six total during my 24 hour stay) told me she had ordered me a dinner. When I told her I was a vegetarian, she rushed off to change the order. She then came back and brought me a vegetarian sandwich (American cheese with vegetables) from the staff kitchen to tide me over until my dinner arrived. That was the last I saw of her. When the next nurse took over, she told me there was no dinner service but that my family could bring me food. This was news to me as I'd been told I couldn't have any visitors. So I called AC, who had flown in that afternoon for a brief 24 hour visit and had been hanging out with friends up until then, to ask if he could bring some toiletries over and also pick up a smoothie for me (I'd been craving one all day). So I finally got to see him (he had to don a mask and gown like the nurses and doctors whenever they entered the room) at around 9 pm, which is when visiting hours are officially over, so he couldn't stay long.

After a rough night, during which I didn't get much sleep due to a number of factors (feeling either too cold or too hot, having my vitals taken, being hooked up to all those monitors, which would beep when they got unhooked or my IV fluid bag ran low, having to lie on my left side for so long that my hip ached horribly, having to unhook myself from all the monitors and take my IV pole with me every time I needed to use the restroom, and in general just not feeling comfortable in the hospital bed). I think I maybe got 4-5 hours of restless, interrupted sleep. In the morning they actually brought me breakfast, although it was pretty bad and not what I would have ordered (a muffin and hash browns as my main course?! The oatmeal, banana, fruit cup and milk were fine, but what about some protein?!). The nurse had me fill out lunch and dinner menus for Sunday just in case I had to stay longer. I was taken to radiology for two chest x-rays (they shielded my abdomen), which the pulmonologist on call reviewed. Apparently they looked ok, and since I hadn't had a fever since I entered the hospital, the baby was doing well, and in general, they didn't seem to think I had the swine flu, they decided to discharge me around 1 pm. They did say that I should schedule an appointment with the pulmonary department or call L & D again if I took a turn for the worse.

I ended up getting to eat the lunch I'd ordered (pasta with squash, peas, and mushrooms) because AC insisted that they let me take it to go when they wouldn't let me eat it in my room (they had to prepare it for the next patient) or out in the hall because I had to wear my mask at all times in the hospital. So they put everything on a paper plate and I ended up eating it while sitting on a bench outside the hospital! By the way, the results from the nasal swab didn't get back before I was discharged, but they told me they would only call if it was positive, and since I haven't heard back yet, I'm assuming no news is good news. I was still prescribed Tamiflu for an additional 5 days just in case. Yesterday morning I took it after eating a relatively small breakfast of cereal, and it made me nauseous the entire morning. When I finally ate a mid-morning snack, I ended up throwing it up, so my streak of not vomiting during this pregnancy has finally been broken. My new plan is to eat a substantial meal before taking the pill.

All in all, I'm glad I had this preliminary trip to L & D. It gives me a better idea of what to expect when I go in for real (disorganization and lack of communication on the part of the staff, although most of them were pretty nice and seemed to be doing the best they could) and made me realize how important it is to be proactive, ask questions, and make requests, and to have someone there who can advocate on my behalf (when AC was there even briefly, it made things so much easier!). Mainly I'm just relieved that I don't have the swine flu, that Ziggy's doing well, and that I didn't have to be induced (I think I would have been too weak and tired to push and probably would have ended up with a c-section) and still have a chance to recover and regain strength before my delivery.

Anyway, I need to go and get ready for my day of appointments (car seat installation, non-stress test, and doctor's appointment), but I'll be back on Thursday with more updates from this week.

Weekly Update

I promised to update more about this past week, so here goes...Before my appointment with my pulmonologist last Friday, I first had a short spirometry, which showed that my pulmonary function continues to improve! My doctor listened to my lungs and thought I sounded great. I left a sputum sample for culture, so we'll see if the MAC is still present, but either way he doesn't recommend treating it while breastfeeding. He looked in my ears and sinuses and agreed that they didn't look too good, especially the left side, so I made an appointment with my old ENT (the one who did my sinus surgery back in 2001 and who amazingly accepts my crappy military insurance even though he's kind of a big shot) for Thursday (yesterday).

At that appointment, first this other younger doctor looked at my ears and sinuses and suctioned out quite a bit from my nose, both for culture purposes and for my own relief! It felt great and I could actually smell for the first time in ages, although some of the smells that hit my nose later in the day were not so pleasant (chemical cleaning products in a public restroom, the garbage room at my mom's condominium complex). As for my ears, both tubes have fallen out of my right ear, but the hole remains open. My left ear still has two tubes, but they appeared blocked, so my doctor gave me some samples of Ciprodex. The neat thing about his office is that you get to wear these glasses that allow you to watch along with the doctor as he's looking at your nose and ears (gross but also very cool!). He also recommended increasing my nasal sprays (Astelin and Nasonex) from once to twice a day and using a couple of drops of baby shampoo in my saline rinse (sounds strange, but it's supposed to help thin really thick secretions like I have). But he said he didn't want to do anything more rigorous until after the baby's born, so I'll go back at the end of November for a follow-up, when hopefully things will have improved due to the decrease in hormones. I'm also seeing my pulmonologist again at the beginning of December. So basically the consensus is that pregnancy has been good for my lungs but not for my ears and sinuses, but hey, it would be a lot worse if it was the other way around!

I also had my weekly OB appointment with the MFM fellow since my doctor is out of town. Nothing much to report there other than that my Group B strep test came back negative and everything else continues to look good. I asked her a few questions about what to do when I go into labor and what to expect if I need to be induced. This is what she told me. I should call or go directly to labor and delivery when my contractions are coming every 5 minutes, lasting for 1 minute, and this pattern continues for an hour (the 511 rule I learned about in my prenatal classes). Other reasons to call would be if my water breaks or I think it's broken, if I have severe abdominal pain that doesn't go away, if I have any bleeding, or if there's anything else I'm concerned about or that seems out of the ordinary. They will only check my cervix if I have any symptoms of labor, if I ask to have it checked, or once I reach 40 weeks. If I have not gone into labor by 40 weeks and especially if I show no signs of going into labor, they will start talking about induction, which it turns out can take place at any time, day or night, weekday or weekend, although they usually prefer to do them in the morning on a weekday. If my cervix is not ready, they will admit me to the hospital the night before the induction and administer a cervical ripening agent. Then in the morning they would start the pitocin. I also asked her when it would be safe to try some natural methods of stimulating labor, such as acupressure points, and she recommended no earlier than 39 weeks. I had my NST after the appointment, which showed that baby is doing very well and I'm not having any contractions. I also submitted my preadmission paperwork at the hospital, so that's one less thing to take care of.

In more exciting news, the accumulation of baby gear continues. My mother's psychiatrist gave/lent me the following baby books: What to Expect the First Year, Your Baby & Child From Birth to Age Five, and The Baby Book: Everything You Need to Know About Your Baby -- From Birth to Age Two. I think I'm pretty set on reading material for the hospital and for these first few months, if I even have time to read anything once Ziggy arrives!

Then on Wednesday I went over to my cousin's house for dinner and, after she put her daughter to bed, we went down to the garage and rummaged around for some baby items. This is the haul I ended up with: a diaper changing pad, 3 receiving blankets, a pair of baby socks, 5 warmer all-in-one suits for baby for colder weather (luckily almost all of her daughter's clothes are gender-neutral or even "boy-colored"), baby Avalon Organics Soothing Zinc Diaper Balm and Protective A, D, & E Ointment, Lansinoh Brand Lanolin For Breastfeeding Mothers, 3 sets of used cloth breast pads and a bunch of disposable ones as well, a Medela Harmony Breastpump (a manual breast pump for occasional use), a book entitled Healthy Sleep Habits, Happy Child, and a Diaper Genie diaper pail. The main thing she couldn't find was the bassinet, so she's planning on contacting a friend whom she thinks she lent it to.

Anyway, that's all for now. Hope everyone has a great weekend!