Tuesday, July 6, 2010

Reinforcing trust in myself- my night in urgent care/L&D

I have always been very in tune with my body. I am not a doctor, I have very little medical training (CNA certification at one point and took some MA classes in college), but I consider myself educated enough to have a basic knowledge of my body and how it works, especially since it is MY body. Nobody lives in it but me. So in the past, I have had various things go "wrong" with my body and I always have a pretty darn good idea of what it is. I'm thankful that in the past I have had doctors who work WITH me and LISTEN TO ME instead of acting like I am stupid and, because I'm not a doctor, therefore must have no idea about anything medical at all.

A few days ago I woke up at 5:30 in the morning with what felt like a constant contraction. It wouldn't let up. It was more like a Braxton Hicks contraction, but it was painful and uncomfortable and just wouldn't stop. I knew it wasn't labor but I was very confused by it. I got in the bath, called my doula and my midwife, and told them I'd keep them updated. Within a few more hours I was throwing up. I called my doula and midwife and said, nevermind, I seem to just have the stomach flu. It was Saturday so Colby was off and took care of me. A friend also came over, brought me gatorade to rehydrate, crackers to nibble on, and some anti-nausea meds to hopefully help stop the vomiting. She also ran another bath for me and I hopped in. By the end of the day I was feeling quite a bit better and was thinking it probably was a bug.

I woke up the next day feeling mostly alright, but somewhat off, and the pain continued to get worse, and I also noticed it was in my back, mostly on the left, around my kidney. I thought, well isn't this great, stomach flu and then the start of a kidney infection within a day of each other! I have had kidney infections in the past, including during my pregnancy with Ryan, so I was fairly sure I knew what I was feeling. I have also been able to kick an infection with home treatment before when I catch it in the early stages, so I figured I'd just guzzle water, cranberry juice, and nettle tea and it would go away. At one point the pain got so bad I was throwing up, but that's how pain of a kidney infection affects me. It's very intense and I have a hard time keeping anything down. By the end of the day the pain had diminished quite a bit, and we were able to go get a few fireworks so that Ryan could enjoy his 4th of July with a tiny celebration. I was really bummed not to be able to celebrate this year because the 4th is my favorite holiday. I'm used to being surrounded by family and friends, good food, and a lot of fun. This year it didn't even feel like a holiday.

When I woke up the next morning my pain was completely gone and I thought, YAY! I have kicked it! But halfway through the day it started to return. I took Tylenol and it wasn't even touching it. By about 5pm I was laying on the floor, crying, and thinking that I should probably give in and go get some antibiotics. I had held off because I could go into labor any day and I didn't want to risk being on antibiotics when Tyler is born if I could help it, because I didn't want to be worried about yeast and the possibility of passing it on to Tyler and him having thrush and creating breastfeeding difficulties right off the bat. I know there are probiotics for this purpose and of course I take them whenever I am prescribed antibiotics, but most people know I like to avoid medications whenever possible. Anyway, I decided it had gotten to the point where I couldn't deny help any longer. It wasn't going away, the pain was just horrible, so we went to urgent care.

I walked in, told them I'm fairly sure I have a kidney infection as I have had them before and know what they feel like, and am also 38 weeks pregnant and NOT in labor. They took a urine sample and sent me into a room. They took my vitals and when I heard what my blood pressure was I was surprised but not worried. My baseline is 110/60 and it was 140/90. This is very high, but I contributed it to two things: first of all, I was in SO MUCH PAIN, and second of all, I was at the doctor's office... a place I really hate being. This alone can send people's blood pressure through the roof. I knew the high numbers would concern them, so I was not TOO surprised when the P.A. came in and asked me if I knew anything about pre-eclampsia. I told him yes, I'm aware of it, no, I don't believe I have it, I know what my pain is being caused by and I know why my blood pressure is high. At that point he told me they could not do anything further for me there, and that I would need to go to the hospital to be evaluated for pre-e and they would call an ambulance for me. I asked if Colby could take me and he said no, because "you could have a seizure on the way there!" I told him to please give us a few minutes to talk about it and he left the room. I told Colby that first of all, I don't want to go to the hospital as I have no other indications of pre-e, second of all if I do go I am NOT going in an ambulance. When the P.A. returned we asked him some questions. Colby asked if we could be allowed a small amount of time to try and calm me down and retake my blood pressure, and I asked what my other indications for pre-e were. He acknowledged that if it really were pre-e, my blood pressure would most likely not go back down into a normal range, and told me that my only indications for pre-e were high blood pressure and back pain. I asked if I had protein in my urine and he said it looked fine. I told him I was not swelling and he said, "Well, this could be the very beginning of symptoms." It was very obvious that he did not expect questions or enjoy being questioned by us. I looked at him and said, "I am not going to the hospital in an ambulance." He then told me I would have to sign out against medical advice (AMA) and I said, fine. Paperwork was brought to me a few minutes later and it listed possible consequences of not going in the ambulance and leaving AMA as, "seizure, coma, death, death of baby." I signed and we left with paperwork to give to the hospital if we decided to go, and they said they would call the hospital L&D unit and tell them we were on our way.

I still hadn't decided at that point whether I even wanted to go. I KNEW I had a kidney infection, I KNEW I didn't have pre-eclampsia, but they had refused to address any possible kidney infection until pre-e had been ruled out, so there I was with no pain relief or antibiotics to help me at all... I knew I had to go, so I called my friend and, with basically no explanation, said, "Can you take care of Ryan for me for a little while? I need to go to the hospital... I'm fine, we're fine, baby's fine... don't really want to talk about it but... I need your help." She said it was no problem and to bring him over.

At that point, my stupid insecurities started taking over and I thought, what if I DO have pre-e? What if they want to induce me tonight? What if it doesn't work? What if I end up with a c-section? Those of you who know me and know how I feel about normal, healthy birth know that I would consider this to be a horrible nightmare. Obviously if it is what is necessary, I'm not going to decline medical help, but I am supposed to have a beautiful, peaceful, amazing home birth in the next couple of weeks... I'm not supposed to end up with a c-section! This can't be happening! Colby tried to calm me down, saying, "Honey, you don't have pre-eclampsia... you're going to go in, get evaluated, and they're going to give you what you need and we'll go back home tonight, okay? And if by some chance you do need medical intervention, I will be right there with you the whole time, I will help you advocate for yourself and I will punch a doctor if I have to." Lol, what a sweetheart. :-P I called my parents and told them I wanted them to come down just in case I ended up in the hospital, so they could pick Ryan up from my friend and either take him home to our house to sleep or take him back home with them. Like I said, my fears were really taking over and I was imagining the worst.

We got to the hospital, I got hooked up to monitors, was asked a bunch of questions, and had my vitals taken again. BP still high, urine and blood work were sent to the lab. My doula came and helped to calm me down. Got a phone call from my midwife and my blood pressure while I was on the phone with her was only 128/80. Heh. It did go back up a little bit, but I told the resident who was assigned to me that I was sure my BP was high because of pain and stress. She agreed and said she would check it again after I had some pain medication. While I was laying around waiting for my results and my pain medication, Tyler had a deceleration (heart rate went down from the 140s to 80 for a minute or so). At that time, he was moving around a LOT, making me very uncomfortable, and I was about to turn over when the nurse came running in saying that he was having a decel. I turned over immediately, he recovered quickly and was fine the rest of the time we were in there. The nurse asked another nurse to bring in an IV kit just in case of a crash, which was totally unnecessary and ridiculous. I don't even know why they wanted Tyler on the monitor the entire time I was there, anyway. Whatever. My blood work came back showing no pre-e, but high uric acid, my urine showed some blood, leukocytes and negligible amounts of protein (most likely due to the blood in it). She reviewed my records that my midwife faxed in and said that I have been having a very healthy, normal pregnancy and she doesn't see any indication for pre-e besides the blood pressure, which can be explained and monitored, but then she said, "However, due to that little episode with the baby, we now think it would be best if you stayed here overnight for monitoring to make sure baby doesn't crash and you can go home first thing in the morning." Umm... no? If I'm fine and my baby is fine, just let me go home! Unfortunately, she said if I were to leave, it would again have to be AMA. Fine, whatever, give me the paperwork and let me go home! Before I left I got two doses of dilaudid and a dose of IV antibiotics. I also got a prescription for a 10-day dose of antibiotics and some oral dilaudid to get me through the first couple of days until the antibiotics can really kick in.

So, basically, it took me over 6 hours of BS in urgent care and the hospital for them to tell me what I already knew (that I had a kidney infection and no pre-e) and give me the medication I need to get through it. Once again, I am right about what's going on in my body, they have NO idea and will automatically assume the worst, especially in a 38 weeks pregnant woman, and they should've just listened to me in the first place. My trust in my body, in my intuition, in myself, has been reinforced once again. I wish everybody knew how to trust themselves so much. It is so obvious how so many women are pushed into unnecessary procedures and interventions because of fear placed in them by people who should be practicing evidence-based medicine, but are practicing based on fear instead.


  1. *hugs* I'm so glad to hear that you made it home safely with baby still happy inside you. The fact that they don't know how to deal with a very pregnant woman without having the baby on the monitor is a major reason why we chose to deliver out of hospital.

  2. 1. Stupid PA. I specifically remember my Dr. telling me that pre-e cannot be diagnosed without both proteinuria AND high blood pressure both being present. They're all too worried about getting sued sometimes that they can't think straight and actually diagnose you based on your symptoms.

    2. I love Colby's comment about punching the doctor, Ben would have said the same thing.

    3. I had to go to L&D once already this pregnancy (it was nothing), but they hooked me up to monitors too and Elijah started moving A LOT, which is why I am making sure not to be on one for the delivery... well that and the whole not being able to move thing. I talked to my Dr. and one of the L&D nurses and they said that was fine since I'm going naturally.

    4. Yay, glad you're okay... although I've had kidney infections before and they really suck.

  3. What a pain in the butt! This is exactly the kind of idiotic behavior that led me to want to home birth. So sorry you had to deal with that and I hope you're feeling better and have your little guy in your arms soon.

  4. I am almost always right in diagnosing myself. I think I have only been wrong one time in the last ten years. And it's frustrating when doctors don't listen. I finally did find some doctors that must have just written in their chart, "this patient can diagnose herself" because when I go in and tell them what's wrong - they now listen. It's great!

    I have a friend who is a NICU nurse, she started off as a labor and delivery nurse. She's actually my very best friend of almost two decades and I have heard so much from her that I understand (but still don't agree) why they get frustrated and treat people the way they do. She has seen drug-addicted moms, abusive relationships, under-age sex abuse victims and more. The thing that has affected her the most is how these normal "healthy" looking couples will come in, have a baby that has a cleft palatte and then just leave it at the hospital and refuse to take it home. They are wealthy and don't want to be associated with it. They will then go home and tell everyone the baby died and even carry out a memorial service and everything. About once a month, someone just LEAVES their baby at the hospital because they don't want to deal with the handicaps or the stigma of it. One of our friends adopted one of these babies, had his cleft fixed and he's a perfectly normal baby. As a result, my friend feels a fierce protection for each baby that is born that it think over-rides her senses when it comes to respecting the parents too. She and I have talked a LOT about this over the years.

    Okay, so I am writing a blog now on your blog. lol. What I meant to say is that it's TERRIBLE that they are not able to recognize those few of us that are in tune with our bodies and love our babies. But I also understand where they are coming from. My friend has stressed to me that there are not very many mothers like us. When I had Naomi and we were dealing with the low milk supply and the ped. from hell - it helped me to know all that from my friend. Because I knew that the ped. and nurses were operating from a battalion stand-point that they were probably using with another couple on the same day for very legitimate reasons. It helped me, I hate to use the word, "manipulate" them better and get them on our side more. After our experience, I realized that women like us just don't belong in the hospital at all. That was the biggest mistake I ever made.

    This is why it's so important to have blogs such as yours and why it's so important that you post all the stuff you do on facebook. I've learned that yes, the problem is the hospital and the institution. But the bigger problem is all these women walking around with NO clear understanding of how their bodies work and they they are teaching their daughters... well, nothing. So, the cycle continues.

    I for one will be teaching Mimi everything about her body, her cycles, her moons, how the vagina is flat and not round, that her body is a wonderful intuitive working machine, etc. etc. etc.

    Thank you for sharing this Karyn! And good for you in standing up for yourself and staying calm. It's hard not to doubt ourselves in a moment like that. Good for you!

  5. {{hugs}} glad you got out of there ok! I think I was misdiagnosed with pre-e in my PG and ended up with a c-sec and pre-term baby because of it :(

    Glad you know yourself well enough not to get swept up into their warnings and advocate for what you really need!

  6. Hey, you're welcome any time! i'm glad that you are doing so much better!