Sunday night I had a nosebleed. I didn't think too much about it because it stopped pretty well and sometimes the change in humidity from the beach to other parts of the state.
We had an early start Monday morning, due to my appointment at 8 with Dr. M. Things went fine during the appointment...the basic ITP questions of, "Are you bleeding when you....?" Quick exam, quick overview of how the pregnancy has gone so far (only 10 pounds gained so far, woohoo!), quick blood draw, then we were off to Lakeview for the OB appointment.
The beginning of my OB appointment was a little disappointing. After not eating, they told me I couldn't do my GD test because I wasn't 26 weeks yet. Apparently if they did it at 25 weeks, 4 days, they would have to redo it when I was 26. Hmph! I saw Dr. S for the second time and we really like her. Fundal height was measuring right on track and baby's heartbeat was doing well. I explained to her that my nesting was definitely coming in as nervousness and questions and she was able to help me with both. The plan is if my platelets are still doing this rollercoaster business, I will come into the hospital a few days early, get treatments to increase my counts, then have an induction. Now, if your platelets are under 100k, it is very difficult to find an anesthesiologist who would be willing to do an epidural. I would really like to go without an epidural anyway. *Soapbox Warning* I'm glad people are reading this because then I don't have to see the faces some of you are making. Honestly, I'm tired of the faces. When I've told a few people about my desire to go without, they make an awful face. Thank God for my Nanny, who birthed 6 kids without and laughed about people making that face--"An epidural? What's that?" So, that's the end of it. If people are going to be negative, I'm just not going to discuss it any further. *Soapbox Over* Dr. S said they could induce me without pitocin, which usually makes contractions significantly more painful and increases risks of complications and cesarean. When I told her I was born in 3 hours as my mom's first child with just her water being broken, she was very encouraged. Of course, at the end of the appointment, my nose started acting up. My ultrasound appointment (for monthly growth scans) was at 12, so Jimmy and I got some breakfast.
During the wait, my nose kept getting worse. I was trying to crochet and it just kept trying to bleed. About 11:30, Dr. M called and told me I was at a 1k and we'd need to start Dex again. I truly didn't expect a 1. Around 11:45, they called us back for ultrasound and I mentioned something to Jimmy about my platelets--he had been asleep in the car. The tech said, "Oh you're the one with the platelets! I need to go get the doctor, they want to talk to you!" Dr. S came in and said with my counts being so low, she wanted to admit me for observation until my counts got higher with the steroids. She also nixed the ultrasound because she didn't want to risk the pressure on the placenta. She told us to go straight over to the hospital and up to L&D.
When you go up to L&D, you do have to check in through the ER. Believe it or not, I was forced to put my crochet hook and child safety scissors back in the car because they were considered weapons in the medical detector. So ridiculous! We waited for about an hour to get put into a room--fastest time EVER. Our birth class instructor came out and told us where we would need to go (a floor I was on the last time) and we joked about trying to get a tour of the L&D ward. Obviously Jimmy and I didn't expect to see her again so soon! We get settled...and wait...and wait...for my dex. I actually didn't have to get a line put in, which shocked me. I kept waiting for them to change their mind. I was pretty put out that it took 5 hours from the time we got there for them to give me the first dose of dex. Jimmy went out during that time to get us some lunch since we hadn't had anything to eat since breakfast. Doctors were in and out that night, but nothing remarkable. They did a non-stress fetal test, hooking me and baby up to a heart rate monitor, and the baby hated it! They were kicking away at the monitors, but oh, listening to that tiny heart beat for like 30 minutes was just amazing and makes me teary now to think about. The doctors said Wednesday morning it was one of the best NSF tests they had seen for a 25 week fetus! I got about 5 hours of sleep that night...it always seems like you're waiting on someone else to walk into the room and you just KNOW when you get to sleep, they're going to come in.
Tuesday was Jimmy and mine's 3rd anniversary. Hospital visits on his birthday, our anniversary...I'm half convinced the kid will wait until my birthday to be born. Or a holiday. During the day Tuesday, several doctors were in and out. Dr. M had formulated a new plan since our old one had been failing us. We would do two days of 40 mg dex, one day of 20, one day of 12, then a dose of 2-4 mg/day for the forseeable future. Long term steroid use was on my list of things I didn't want, but if it's going to be the best for me and the baby in the long run, so be it. These rollercoasters are not safe. An ultrasound technician came into the room and did our ultrasound. My heart rate had been increased while doing the morning NSF test and they continued to monitor it during the ultrasound. While they were doing the ultrasound, my heart rate dropped into the 80s, which was great. The baby weighs about 2 pounds and has long toes! The best quote all week came from the ultrasound tech, They may have come from Jimmy's dad.
Labs came back sometime that morning and they were a disappointing 3k. The OB team said they wanted me to be at 25k before I left. I asked my nurse to ask them if they would do another blood draw during evening labs, because I really just wanted to leave (because there was nothing they were doing for me that I wouldn't be doing at home) and thought I could be at 25k 24 hours after a dose of dex. Jimmy went out to get our special dinner from our favorite Durham restaurant because we knew it would be late if we were able to leave anyway. While he was out, the OB team sent in a resident to let me know they would not be doing a blood draw. I have never been more infuriated. To not even check my platelets--I wasn't asking to go home if they weren't 25k, I understood that, but to NOT EVEN CHECK?!?! When I asked why, the resident brings up a few reasons: 1) they don't want to cause more trauma to my arms, 2) they don't want to take more platelets out of my body that could be working inside of it (total crap because I wasn't having symptoms anymore), and 3) it was my anniversary, apparently I was on pelvic rest (which no one had told me so far), and they didn't trust me to not follow it. I completely lost it and told them they were being unreasonable to not even check, and no one had mentioned pelvic rest, did they really think I was going to put myself at more risk? The resident kind of got an attitude and said I could talk with the attending, but I knew it wouldn't make a difference. I called Jimmy and let him know. I also emailed Dr. M after I had calmed down. I am sure that resident will think twice before leaving her people skills outside a room when dealing with a pregnant patient on dex.
Wednesday morning, I got a little more sleep, but as soon as I woke up, I was chasing down the lab people. I'd been told they drew labs at 4:30, so when it was 6:15 I became paranoid I'd missed them. Thankfully, they came in just a bit later and I hadn't. The kindest OB resident came in a little while later. She said, "I've heard it's your anniversary today and we really want to get you out of here." I told her that that it was actually the day before, and no one seemed very encouraging about it Tuesday night. When I told her what the other resident had said, she had the good grace to look surprised and tell me she wasn't sure why the other resident had said that, because that had not figured into the discussions (apparently all these people are talking about me behind my back). She did the courtesy of letting me know Wednesdays were conference days and it would be later in the morning when OB did rounds. However, this resident did call me and let me know when my counts came in, even though they weren't ready for rounds yet. Counts were 55k! Hooray for going home!
Oh wait. The maternal fetal medicine doctor came in and let me know they were concerned about my heart rate being high and my shortness of breath. They thought it could be a blood clot in my lung. I told them I felt normal for being on dex, and didn't think there was anything to worry about, and asked if they truly thought there was a threat. They did. I was going to have to get a VQ scan. That involves an EKG, chest x-ray, and the actual scan. Jimmy and I were nervous about the radiation factor, but the doctors thoroughly explained the risks, which were pretty low. Apparently you would have to have like 500 x-rays to cause damage to the baby, and since I am so far along and major organ systems are in place, they didn't feel it was a risk, and the scan would be slightly different for me--less concentrations of the nuclear medicine. The doctors said they would do everything they could to get me out of there by evening. Around midafternoon, we were taken downstairs to have the scans done. Dr. S actually called while we were waiting and apologized for me being in the hospital for so long! I told her I completely understood everyone wanting to be safe and if they truly thought these things were necessary, I would do them. I told her the night before was just a total shock to me. I do really like this doctor and I would love for her to deliver me. When Dr. M found out about the newest development, he was so exasperated! How ridiculous would that be to treat?! We would be pumping me full of things to increase platelet counts then giving me a blood thinner! By 5:30, the scans were done and found to be normal! Also on Wednesday I was able to get my flu shot and a booster from when I'd gotten a pneumococcal vaccine before my splenectomy.
The nurse I had Wednesday left a LOT to be desired. She was so weird! She left me hooked up to the NSF for like an hour. She tried 3 times to get me naked, or in some state of various undress. Then when we were trying to leave, she's trying to be all cutesy with my discharge instructions. I was so ready to escape her by that point.
Around 6:45 we were leaving the hospital and driving to get our fur babies! We didn't get home until almost midnight because we waited on the rain to slack off before packing all of the animals in the car.
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