Tuesday, October 20, 2015

The First Half - Part 3: Week 8

(Continued from Part 2) [Mandi said we needed to go to the ER] 

So Neil called me immediately to tell me he was headed home, but due to my hypersensitivity to life (sound, light, etc) I had my phone on silent and was sleeping.  He freaked out and thought I was dead! He came running in the house yelling my name! I woke up in a panic, inwardly grumbling that I didn't feel like getting out of bed and going to the ER.  Neil gathered up ice chips and a cold wash cloth and my throw up cup, (you know, the basics *wink*) while I tried to get my shoes on.  While he was doing that, I suddenly couldn't take a breath.  I later found out that was because my right lung had partially collapsed.  I was left gasping for air, feeling like I could only take 20% off a normal breath.  Neil kicked it into hyper speed and we rushed to the hospital.  

When we got to the ER, I was still gasping for breath.  I waved Neil over to the check in desk.  I just knew that if they heard the words "pregnant" and "can't breath" I would be rushed back to a room.  Um, no.  That didn't happen.  The man gave Neil a bunch of paper work, then instructed him to move his car from in front of the building or it would be towed.  As I realized I was not getting a room, but expected to just sit in the waiting room gasping for breath, I started to cry, which isn't a good combo when you feel like you can't breath. Neil went back to the man again, and he came over with a clip to put on my finger to test my blood oxygen levels.  Miraculously, they were showing that despite my feeling like my lungs had stopped working, the test showed my blood oxygen was fully saturated.  This was good, since I was apparently getting oxygen, but bad for getting me quickly to a room.  Finally they took me to triage, then to a pre-check up room, then eventually to a private room.

Once in the room I begged for oxygen.  They put an oxygen tube in my nose and I was so surprised that it didn't seem to help at all.  I still felt like I couldn't get any air.  The Dr ran a variety of tests.  He ordered an X-Ray of my lungs, and then followed up with a CT scan. I felt like a broken record, telling every person that came in (in my gasping voice) "I'm 8 weeks pregnant!" I wanted everyone to be fully aware so that they didn't accidentally give me medication, or do a test that would harm the baby.  Unfortunately, most of their responses were - surprise - verification - statement of risk (what?! you're pregnant? Well, we need to do [XYZ], and need your consent.  It could be harmful to the baby.) The staff was incredibly nice and everyone was very diligent in doing everything they could to protect both me and the baby, but that phrase "it could be harmful to the baby" repeated over and over, while Neil and I had to give our consent over and over, made me just break down crying.  Again, not a good thing when you can't breathe.

The staff tried to be as considerate as possible regarding the safety of the baby, putting extra lead aprons on my stomach to protect the baby and using lower radiation settings in the X-ray.  They ran the least amount of tests possible to diagnose what was going on and why I couldn't breathe.

At this point, I didn't really realize the gravity of my situation.  The ER was packed that night.  A man was lying on a bed in the hall just outside my door.  He had a bad cut of some sort, and I remember thinking, why do I get my own private room, when he has to just lay in the hall. It started to dawn on me a little bit when my nurse was rushing in and out of my room.  She apologized and said that she had two patients right now who were both extremely ill - meaning me and one other person.

The ER Dr. looked at the X-Rays and concluded that we needed to do a CT Scan to determine the severity of the clots.  Neil was hesitant about the CT Scan because of the potential risk to the baby, but there really wasn't a better way around it.  The CT Scan showed that about 40% of my capillary bed was covered in clots.

After the tests came back, my ER doctor came in the room and asked my sweet nurse if she had given me the medicine he ordered yet.  He rather barked at her and we thought he was being kinda rude. She hurried to give me the medicine.

The Dr explained to us that I had a Pulmonary Embolism.  We asked the Dr, is this severe.  He slowly moved his head to one side and replied solemnly, "its pretty severe".

This explained why he was in a bit of a panic and being brisk with the nurse. He needed her to give me blood thinner as quickly as possible to prevent more clots from forming and to start breaking up the clots that were already there, which could put a strain on my heart. Or if a large enough clot broke loose, it could cause death. His urgency was out of concern for me, not his ego like we had originally thought!

The ER doctor called in the pulmonary doctor, Dr. F, who was starting his 7 day shift in the hospital on that Monday when I entered the ER.  This was totally a God thing, meaning I would be under his continuous care for the majority of my hospital stay.  

Dr. F was worried about the PE putting a strain on my heart so he ordered an EKG and and echocardiogram.  Both tests came back showing no hypertension or strain on my heart at all.  He seemed surprised by these results.

Dr. F also explained that the pain I was feeling in my back was called pleurisy or pleuritic pain. WebMD says this:

The double-layered pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. Normally, a thin, fluid-filled gap -- the pleural space -- allows the two layers of the pleural membrane to slide gently past each other. But when these layers become inflamed, with every breath, sneeze, or cough, their roughened surfaces rub painfully together like two pieces of sandpaper.

My OBGYN, Dr. P rushed to the ER when she got word from the hospital that I was there.  She just happened to be in my room when Dr. F came in to decide which medicines would be the most safe for me and the baby.  It was incredible that they were able to consult together on the spot to work everything out quickly.

They also ordered an ultrasound of the baby while I was in the ER.  The sweet ultrasound tech came in and I asked her if she could see a heart beat.  She told us that she was not allowed to discuss what she saw with us, but she strategically pointed to the screen, showing us a flashing flicker, indicating the baby's heartbeat :)

During this time Neil's parents had Hadley, and they were taking turns checking on us in the ER room.  We didn't want Hadley to come to the room since all the tube and machines might be scary to her. They prayed with us and brought Neil dinner.  A. Vicki and U. Mike also came by.

After about 5 hours in the ER they moved me to ICU.  I remember several different people mentioning to me that I would be getting a PICC line.  At the time I didn't know what that was, exactly.  And each time it was mentioned, it was said in a round about kind of way, which made me worried.  Usually something like, "once the PICC line is in... you will really like having it".  Finally I just asked someone straight up, is this PICC line a big deal? -- oh no! they assured me, not a big deal.

If you aren't familiar with a PICC line, it stands for Peripherally Inserted Central Catheter.  Its basically a long term, more stable, IV.  A nurse specially trained in PICC lines uses an ultrasound to insert a tube into a vein in your arm. They can also do it in your chest, but mine was in my arm.  They can give medicine in the line, just like and IV, and draw blood from it, but it can stay in long term, like months and months.  An IV is more unstable and needs to be reinserted every 3 days.

So they wheeled me into the ICU and told me that they were going to insert the PICC line and I basically had a panic attack.  They laid me back to prep for the PICC, which made made it a lot more difficult to breathe.  I was already having so much trouble breathing and was then being faced with a potentially painful PICC line that I didn't understand.  All this combined with the stress of the day was just too much.  I guess they ended up giving me something to calm me down, because the next thing I knew I was waking up in a different room in the ICU and the PICC line was in.  

I don't remember a whole lot from my time in the ICU.  I remember being a jerk to Neil.  At this point I apparently had a million tubes coming out of me.  I had an oxygen sensor on my finger, an IV in my left arm and a blood pressure cuff on my bicep.  I had the PICC line hooked to a different medication than the IV and an oxygen tube in my nose.  I also had sensors all over my body, with wires running everywhere. I needed to go to the bathroom, but didn't want to call for the nurse.  I told Neil that I needed him to help me get up, and he just reached over and pressed the call button for the nurse.  Boy that made me hopping mad! I said, "you can't just call for the nurse without consulting me! Why won't you help me?!" LOL seems so funny now, and obvious that he couldn't juggle 50 things and help me walk to the bathroom! But at the time I wasn't aware of being hooked to all that. I had apparently asked him to do this several times, and he was tired of explaining why he couldn't do it on his own.

Dr. F suspected that I had fluid in my lung and he planned to drain it (ouch). However, when they checked with an ultrasound, there was no fluid. God is good!

I also apparently took some selfie's and video's of myself while in ICU.  My bed automatically aired up and deflated to help prevent bed sores I believe.  But I swear this bed was messed up. The right half would inflate, then the left, then the right a bit more, then they would both deflate... it was terrible.  I called it the "rodeo bed" in my video and apparently wanted documentation so people would know I wasn't crazy! Sadly those videos got deleted, or I would attach one here... but I do have a selfie! Haha!

On the 2nd or 3rd day in ICU I started pulling out my oxygen tube.  It was driving me crazy and it wasn't helping because I didn't need oxygen support.  I guess my lung inflated somewhere in here and I was finally sick of having a tube on my face.  This really surprises me looking back on it, because I'm usually such a compliant person, but apparently not when I'm sick.  The nurses kept encouraging me to keep the tube in, but after having it out for a while with no alarm from my oxygen sensor, they decided to let me leave it off.

After 3 days in ICU, I was moved to the Cardiac floor.  The nurses here were not my favorite.  I think they probably have a tough job, dealing with very sick people who are possibly old, or near death, or cranky.  I don't know, but they didn't seem to enjoy their job very much.  At this point the nausea and vomiting came back in full force.  The Cardiac floor was apparently not used to caring for pregnant patients, especially not HG sufferers.  

One nurse in particular seemed quite inconvenienced when we asked for ice chips, and another nurse grumbled under his breath the whole time he was giving me my medication.  He was concerned about the effect all the medicine would have on the baby, and apparently didn't feel very good about giving it to me, but he did begrudgingly.  I feel so annoyed about that now, because he was basically implying that I wasn't concerned (or possibly the doctor wasn't concerned) about the welfare of my baby.  Like it was my fault I was having a PE? This medicine that was saving my life and allowing me to breathe, and attempting to control my nausea - this implied that I was unconcerned about my child? As if I wasn't already stressed to the max about the effects this could have on my sweet baby.  I'm sure that he is a very caring person and that he did not mean to imply all that I assumed his comments meant.  I probably should have reassured him that I had an excellent pulmonary doctor who had already consulted with my OBGYN and that we were doing everything we could to protect this child. But I digress.

My pulmonary doctor wanted me to do breathing treatments to help my lungs expand.  These treatments started out quite bearable.  This was because the tech was apparently doing it wrong.  Once they figured out the correct way to administer the treatment, it became unbearable.  To the point that after several days of multiple treatments, I finally refused to do it! (Rebel) Basically, you hold a large plastic tube in your mouth, while they pump medicated, humidified air into your lungs.  The forceful blasts of air come in succinct puffs, which helps to... i don't know... inflate the lungs and possibly break up the clots? The force of the air made my windpipe feel like it was about to burst.  But the main problem was the staccato air blasts rattled my whole body, which was just unacceptable with the amount of nausea I was experiencing.

I think I should explain that at this point I still didn't understand how serious PE is.  I was frustrated that the lung doctor was being all high and mighty and ignoring my hyperemesis.  He was asking me to do crazy things, like take walks.  Didn't he understand that I was extremely sick?  I felt like my main problem was they HG, when very obviously to everyone else, the huge problem was the PE.

After 4 days in the cardiac ward they moved me to the OB floor.  WHAT A RELIEF! Everyone was sooo nice! It was really incredible how friendly, caring and happy everyone who worked on that floor was. 

At this point I was still throwing up, and unable to keep anything down.  They had me on an IV nutrition called TPN.  Dr. P came to check on me often.  When I was still on the 5th floor she offered us a steroid to try.  She said that there were some risks associated with it, and we quickly turned her down.  I felt overwhelmed by the threats that had already been presented to my tiny 8 week old baby.  I couldn't risk a steroid treatment just so I could stop throwing up, could I?  --- Well, yes I could.  After several more days of no improvement, she offered us the steroid again.  We gave it renewed consideration and decided to try it.  At this point the risk of malnutrition, dehydration, and stress on my body was a big concern to the baby.  And the risks associated with the steroid, while viable risk factors, were very small.  Dr. P later told me that it broke her heart when I turned down the steroid the first time, because she was so confident that it could help me, and she knew how severely ill I was. 

The steroid turned out to be a miracle drug for me.  It doesn't help all women with HG across the board, and some women relapse after tapering off the drug.  I was set up for a 2 week taper, and thanks to God and a good Dr, the medicine completely stopped my vomiting.  It did not fix the nausea, but at least I was able to eat again, and I even took a shower!

We celebrated both Neil's birthday and our wedding anniversary while I was in the hospital.  I am blessed with the most incredible husband. 

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