Saturday, 27 June 2015

My 24 Hours of Magnesium Hell

*I wrote the following a week or so ago, and then didn't get free internet at a motel to publish it last weekend!  So here it is now, unedited so chock full of the same errors as the last post.  I sort of look at it as I wouldn't take the time to pick up the house if someone was coming over, so why take the time to sort out my grammar quirks?  They add character.  On another note we will hopefully be home in a week!!  Woot woot!!  So here it is, the next part in the installment!

24 hours of hell (aka I somehow avoid the ICU)

So…Bubs is safely out and stable in the NICU, breathing with the help of CPAP.  The Moose takes the first few pictures of her and comes to update me on how she is doing.  The midwives switched shifts at 11pm and I was left in the hands of a midwife who is extremely interested in and knowledgeable about pre-eclampsia.  I had constant company for at least the two hours after bubs was born.  The Moose came and went between my room and the NICU and eventually, when things were settled down enough, he went to his room at the backpackers where he had secured lodging for the night.  I chatted about politics and the environment and hospital waste with the pre-eclampsia midwife (as she shall now be known) for a while, and I think I was reasonably coherent at the time.
I am writing this nearly 3 weeks later, so some things are a bit hazy, but the one thing that I remember more than anything else was my sense of the world shrinking.  The only things that seemed to exist were the things within my room.  I didn’t think about bubs.  At all.  The Moose said she was doing fine, and I think I just took that for granted. 

The thing is, magnesium really knocked me around.  I thought I was feeling good at first, that it wouldn’t be a problem, but as I progressed through the next 24 hours of it, I grew more and more lethargic, found it harder and harder to concentrate, or to even give a f*ck.  I was on morphine and Tylenol for the pain, and I have no idea what was in the spinal block or how long that lasted or what effect it could have on me, but I am pretty sure that 99% of that hell was the magnesium.  Like I said, my world shrunk down to include pretty much just myself and whatever was within arm’s reach. 
So, after the first few hours of constant monitoring, lots of blood tests, and so on, the night (and the next day) fell into an hourly routine that began and ended on the half of every hour.  The world outside of this reality simply did not exist for me.  Because I was on fluid restrictions, and was receiving fluid through the iv with the magnesium, once an hour I was given 70 ml to drink.  I think that is something like 3 oz.  It had to last me until the next hour, when anything left (ha!) would be dumped and I would get a new 70 ml.  As I was given that, my output through the catheter was measured, my ivs checked, my blood pressure checked, and my reflexes checked (let’s just say those went from pathologically brisk to nearly non-existent).  Periodically throughout the night and following day someone would come to take my blood.  All this would take 5-30 minutes depending on if the midwife stayed to chat (and I chatted a lot with some of them), and during this time I would sip on my 70ml.  Then I would sleep for half an hour until they came back to start the whole thing all over again.

And every 4 hours overnight and 2-3 hours the next day the midwives would come in to express colostrum from me, as I couldn’t do it myself (hands were sooo weak, and still had iv in left and iv access thingy in right).  This they collected in syringes to be sent to the NICU for bubs.  I think if it hadn’t been for them, I would not have had such an amazing supply of breast milk for Bubs.  I am so grateful for this!!  As awkward as it is having nearly complete strangers playing with ones nips…
How I avoided the ICU…well, my platelets continued to fall, but thankfully they stopped just short of whatever level they send you off to the ICU.  Since they were expecting me to get worse before I got better, they were keeping a close eye on everything.  Thankfully I didn’t get that kind of worse!!  Of course, I didn’t find this out until 2 weeks later, but I suppose there are just some things you don’t tell a woman with a high blood pressure problem.

Anyway water became everything to me as my throat dried out and my voice got raspy.  I was obsessed with the time, watching the clock until the long hand hit the 6 and I would get my next bit of water.  I was distraught to discover that the milk I put on my cereal was taken out of my water (and the iv fluid reduced to compensate).  By the time breakfast had come, my throat was too dry to swallow toast, and I barely made it through the cereal.  I did discover I could eat some toast if I dipped it in the milk.  But by this point just the effort of eating and using my hands was getting to be too much (by the time lunch came I could eat only the soup, and by dinner time I managed only 3 bites of pasta and a couple bites of mystery dessert).

Pre-eclampsia midwife’s shift ended in the morning, and incompetent midwife came on.  By this time I was feeling like ass and still had 15 hours of magnesium to go.  Anyway this new midwife is probably perfectly competent in most things, but she admitted to pre-eclampsia midwife in front of me as they were doing the hand-over that she had never dealt with the after effects of pre-eclampsia, and didn’t really know what she was doing.  This became very obvious to me very quickly as she took a very liberal stance with my fluid restrictions and output measurements.  It took a lot of self-control to not drink up the extra water she accidentally gave me, but somehow I did it.
And then she tried to kill me.  Or at least that is how I am interpreting it!

About 10am she thought it would be a good idea for me to go down to the NICU to see Bubs.  I agreed, for one because I felt like I should want to (really I just wanted water and sleep), and secondly I felt pressured to do so.  Had she wheeled me down in my bed things may have turned out a bit better for me.  Instead she decided I should go down in a wheel chair. 

Let’s just say that if you can barely use your hands to eat your breakfast, probably your legs can’t support your weight.  In which case, forgetting to put the brakes on the wheel chair probably won’t help matters!  Thankfully I managed to fall back on the bed when the chair pushed away from me.  By the time I got into the chair, my hearing had gone and the room faded out.  I had enough presence of mind to tell the midwife and the Moose to wait for a minute because I wasn’t feeling well.  I didn’t know it at the time, but it was my blood pressure tanking and me nearly passing out. 

The trip to the NICU nearly did me in.  The chairs here have to be wheeled backwards in order to turn correctly, and me, my catheter and my iv were slow enough to move, but to me it felt like we were zipping along.  I could hardly see straight and was feeling so nauseous!  But we made it to the NICU, I managed somehow to wash my hands (though probably not well). 

Bubs was so small, and with so many lines and cables and things, and she honestly looked a wee bit like a monkey!  Her arms and legs were so skinny and wrinkly that compared to them her head and abdomen seemed gigantic!  It was hard to feel any sort of connection to this poor little thing in an incubator, and as my blood pressure tanked again, I started vomiting.  The midwife took my blood pressure just after this, and it was 90/50.  And vomiting apparently raises blood pressure, so it must have been lower than that!  Also, I vomited up half a litre of fluid.  Half a litre that I couldn’t get back because I could only have 70 ml an hour!  I was a little bitter about that.

At that point I had had enough and wanted nothing more than to get back in bed where I felt at least a little less like death warmed up.  So my first glimpse of Bubs was really just a quick peak at a tiny scrawny baby.  I will write more about this sort of thing in my next post, but I will say it has taken some time for this to feel real, and to feel a bond between bubs and myself (which I know can be perfectly normal).

Other highlights (lowlights?) of my 24 hours of hell:
·         *My boss called, unaware that I was in the hospital, to see if the Moose and I would be coming to his wedding, which was a few days away.  I was sufficiently out of it enough to freak him out, leading him to call the Moose to find out what actually had happened (I guess I was not overly coherent!)
·          *A woman gave birth in the room next to me.  Her screams never woke me up.
·         *Another woman gave birth in the other room next to me, but she never screamed, just grunted twice and then bam, baby.  I like to think that would have been me had it not been for pre-eclampsia.  Of course, I was awake and sipping on my 70ml otherwise I would have slept through her too.
·         *I posted a pic of bubs on facebook to announce the birth (after sending a quick email to my mom and sister).  Of course, I was going cross eyed trying to do this, but I managed.  My sister’s husband was the first to read the news (while facebooking on the loo), and announced it to my sister, who ran downstairs to tell my parents (who were living in the basement for a few months). 

**And best of all, at 10pm, my new midwife came in to announce that the magnesium was finished!  I cheered as best I could (a feeble but enthusiastic “yay!”), and within minutes of it coming out, I was already feeling better!  By morning, I was much more awake and alert!  I could even eat breakfast.  And no more fluid restrictions!!!  And the Moose took me down to see Bubs, and I got to do kangaroo care (or skin to skin or cuddles as I call it!). 
More to come on my next post, Surviving the Fifth Circle of Hell (aka life on the post-natal ward).  

Up next:  Life in the 5th Circle of Hell (aka the post natal ward)

Saturday, 13 June 2015

Bub's Arrival

I finally have some interwebs access!!  I have escaped from the NICU to spend the night with the Moose in a motel.  Of course I am sleep deprived and need to pump some milk, but I will get through as much of the birth story as I can.  And I will change from past to present tense without thinking about it because I am that kind of tired. 


Monday, May 25th.  We wake up to SNOW!!!  Lots of it!!  As I do every morning I hop on the scales, and oh shit, I gained 2-3 kg overnight.  But SNOW!!  Work is cancelled for the Moose, my midwife is running late for our appointment (up to her elbows in vag AGAIN!), so we head out to play.

That is the Moose on his cross country skis.  I followed him around (getting the only pair of shoes that fit my massive feet soaked) and enjoyed the wonderful sensation of visual disturbances on account of the effect of snow on my sky rocketing blood pressure.  Think little blinky bright worms flashing in your eyes.  But only when I am out in the snow, and though I know deep down that this is going to be it (visual disturbances + sudden weight gain = bad things), I choose to be in denial.  All the same, I text the midwife to make sure she is still coming, once she finds her way out of someone's whoo-ha.

So the midwife comes, blood pressure is 160/100 and ++ protein in urine, so after a chat with the consultant we drive through the snow and rain to get to the hospital.  On the way down we choose a name (finally...although the middle name is still up in the air).  At the hospital they have no idea who I am or why I am there (the midwife probably did call ahead).  After much sitting around, I am finally admitted with a bp of 150/106.  My reflexes are pathologically brisk (according to my discharge report they are "pathologicaly brisk" but more on that later), a clonus is present ("pressent"), and my PCR is high.  I also have the oh so sexy pitting edema up to mid shin.  Bloods are normal.  Labetelol is doubled.  I am admitted in what will eventually become the fifth circle of hell to me.  The growth ultrasound I have scheduled for Tuesday is cancelled back home and rescheduled at the hospital.  I spend the rest of the evening having my blood pressure taken and being asked about headaches, visual disturbances, and tummy aches.  Every 4-6 hours.  The Moose heads to a hotel. 

Around this point I became a human pincushion.  A midwife and a student midwife struggled to draw blood from my arms.  Not sure why, I am usually an easy draw (and happy to let the students have a go).  I blame the pre-eclampsia.  They finally get it, and then later with another set of midwives comes the iv access thing.  The student midwife (who will become my favorite midwife) looks on as the other tries and fails three times to put an iv in either of my hands.  I have rolly veins and valves, apparently.  They try to flush the valves away with saline, but mostly fail.  I should mention that this (all of it) hurts like hell and I am gritting my teeth and trying to not show the pain.  Reinforcements are finally called in and the midwife who has since taken over my care manages to get an iv in with one go (hooray!).  In my right hand, which sucks a bit.  Later, at about 10 or 11pm, all three midwives come to my bed with something in hand and a "guess what we have for you!!".  Turns out it is a shot of steroids to the ass!!  My new midwife, I found out later, had to fight to get them for me (the docs were going to wait until morning).

Tuesday, 26th May

Ultrasound!  We find out the baby has hair.  And also has stopped growing.  As we wait for the docs to come around and say it, I tell the Moose that we will be having this baby in a day or two.  We both agree that it is good that we have agreed on a name!  The docs come back in the afternoon, and a c-section is scheduled for Wednesday morning.  I sign all the c-section papers and more anesthesiology papers and lord knows what else.  Then I get to play with med students while the Moose goes out to grab a bite for dinner.  I enjoy this immensely because I am such a nerd, and anyway we make jokes about curry and I get to horrify two young men with stories about bad periods and I get to explain to them medical stuff about pre-eclampsia and small babies (all that internetting finally pays off!!).  Dinner is disgusting and I think it is meant to be mac and cheese.  But I eat it all because as of 2am, I have to fast.  No food, no water.  I get the Moose to sneak me a cookie from Subway. 

And then I get my hospital sinus headache.  I ask my favorite midwife for panadol when she does my blood pressure.  She disappears and comes back with the doctor.  Who grills me down about the headache.  I seriously felt like a criminal at the police station, or a naughty school kid in the principals office.  But it turns out that my blood pressure has just sky rocketed again, despite the increased dose of meds.  Bugger.  The doc disappears to consult the senior doc.  They both come back, and guess what, bubs is being evicted now.  The bad cop doctor stuffs another iv access thing into my left hand, flushes out the valves like a boss and has that thing jammed in pretty quick.  The midwives look on impressed.  More bloods are taken.  Turns out some of them are starting to go in a not so good direction.  Not sure on this, but I know that my platelets, though starting out high, are starting to drop.

Anyway, I am handed over to the midwives, who (according to my new midwife) were running around in a panic to get me ready (though they seemed calm enough to me).  I get moved to the delivery suite, given a sexy backless gown, and get what will become the bane of my existence (apart from the placenta) for the next 26 hours: the magnesium drip.  At first it is hot, and the sensation of lying on a really warm electric blanket spreads over my entire (ENTIRE) body.  When the loading dose had been given and I was put on the maintenance dose, that feeling went away, and I honestly felt alright (that feeling wouldn't last).  I was put on monitors, including one that automatically took my blood pressure every 5 minutes (everytime it started to inflate I had to quick relax my arm).  I got a catheter inserted (I thought it would be worse than it was), and of course I got shaved.  The Moose got dressed in scrubs (I asked if we could keep them to play doctor, but they said no) and was put in charge of the most important task of all: holding my chapstick.  When the theatre (operating room...don't know why they call it a theatre) was ready, we headed out.  It was fecking cold in the hallways, and naturally we stopped to chat with the anesthetists forever. 

The operating room (forget theatre, I am not going to call it that) was really warm, and very crowded.  There was a team of 4 from the NICU, 3 doctors to cut me open, at least one nurse, 2 anesthetists and 1 anesthetic technician, my new midwife and favorite midwife (the third one who had been through all this had to stay behind), and a few students.  And everyone else in the hospital.  I was given a spinal block, and it was probably my least favorite part.  I had to sit with my back hunched, perfectly still, while they threaded a wee catheter in (I thought it was an injection, shows how well I was listening to the 3 anesthetists I had spoken to in the past day).  It hurt, I would cry out, they would ask where it hurt (uh, in my back?  Left or right?  uh, right??), they would adjust, it would move down, and then we would repeat the whole thing.  A day or so later I wondered what would have happened if there had been an earthquake while this whole thing was going on (and a day or so after that pleasant thought we had an earthquake).  So they finally got the drugs in, and I managed to get my legs back on the table as they started to go numb.  Then the nurse tilted the table to keep the weight of the ute off that vein, and I started to fall off, and of course couldn't move my legs!!  The nurse caught my legs anyway and put the things in the table to hold me up (probably should have done that before tilting the table!!).  The Moose, who is deathly afraid of needles, was now able to come into the room. 

Everyone introduced themselves (except me, I was busy trying to think of something witty to say like "I'm Tiggy, I am about to be diced up" but I couldn't come up with anything and someone else introduced me in a normal, boring way), and we got underway.  Almost before I knew what was happening.  Of course, I was fighting with the sheet they put up to block my view because it kept trying to suffocate me.  I had my left arm (magnesium arm) strapped to the table, but my right arm was left free, thankfully or I would have drown in sheet.  So I chatted with the Moose and midwives and anesthetists (I am hating typing that word right now), and felt like people were pulling and tugging apart my innards.  One of the docs started pushing down on my tummy, and then someone called out "Born now!" and bubs gave a brief but angry cry and I saw her being whisked over to the NICU team.  I couldn't really turn my head enough to see her, but she had cried a bit, so I was relieved and went back to chatting to the midwives, as the Moose went to go see Bubs.  A short time later they took Bubs away to the NICU.

Things are a bit blurry from here.  I remember someone saying that the umbilical cord snapped off the placenta and they had to scrape the placenta off the uterus (clingy evil thing), and someone asked if I wanted to keep it, to which I replied "only to stab it" and it was packaged up to be sent off to the lab.  Turns out it was 1/3 the size it should have been.  Bastard.  Anyway, the docs asked for the temp of the room to be turned down and one said he was about to pass out.  I asked if he could kindly not pass out into me, which I think startled him (did he forget I was there??).  So I was sewn up and taken back to the delivery suite to begin my 24 hours of hell.  The Moose went to the NICU and took the first pic of Bubs:
She was on CPAP for 6 hours to help with her breathing, and since then has been breathing on her own!!  Yay for that one round of steroids my midwife managed to get jabbed in my ass!  She weighed in at 1.08kg or about 2lbs 3oz, and no one measured her length because apparently that isn't important except to everyone who kept asking me later.  She got an umbilical line put in, and managed to pull it out on the first day, so got a picc line instead.  Here she is in her incubator without the CPAP:
She looks a bit more tiny here, but she is long...and camouflaged by a white nappy and having her legs hidden somehow...Anyway note the head of dark hair!!  The ultrasound totally pegged that, and her weight as well!!

Upcoming posts:
My 24 hours of hell (aka I manage to avoid ICU)
The fifth circle of hell (aka life in the post-natal ward)
Life in the NICU (aka my life as a dairy cow)

I will write these up and post them on the weekends when I escape the NICU and stay with the Moose in a motel.  Where there is interwebs and I can use the laptop instead of my phone!!  I have probably forgotten important bits from these two days, but I left my notes back at my room in the NICU.  Apologies for grammar issues and switching tenses and all sorts of other confusing and awkward things.  I was going to type all this up in my spare time in the NICU and copy and paste, but I was mistaken and there is no such thing as spare time!!  And if there is, it must be spent sleeping!!

Gotta go pump, my boobs might explode and I am an hour and a half late already!!

Saturday, 6 June 2015

Just a quick update. I will post up the epic birth story and nicu stay when I am home again and have regular interwebs. I am just not up to doing it on my phone! But it will be weeks before that happens so in the meantime,  a quick update!

Bubs is doing great! She is above her birth weight and will get all her food from breast milk in a day or two, which means that the picc line can be removed! I am pumping like a dairy cow and living in a room in the nicu since I was FINALLY discharged from the hospital two days ago. The moose is home during the week and comes to visit on the weekends. We are both so proud of bubs and her progress!

Now gotta go pump before left boob explodes!