I'm afraid that this will end up being quite long, so I'd like to apologize from the very beginning. I will be using some medical terms/abbreviations. but I'll make certain that for any of the possible lesser known ones that I explain what it is first.
This is a post to relay my current situation in my pregnancy to family
and friends, as I don't have the emotional strength or patience to
explain it multiple times. We have plans tonight for dinner, and I don't want to sit in the middle of a restaurant that I've been excited to try out, surrounded by my in-laws, bawling my eyes out between profanity laden Tourettes-like tirades, as I try to explain why every doctor that's been treating me seems like they don't know their ass from a hole in the ground.
On October 19th I went to see my obstetrician (OB), the doctor who's been treating me since sometime in May for my pregnancy. I was roughly 28 weeks along at that time and the doctor stated that my "fundal height" was off. Fundal height is the measurement of a pregnant woman's stomach from her pelvis to the top of her uterus while she is laying down. Once a woman is in her second trimester, for every week pregnant she is, her fundal height should be that many inches. Mine had fallen short by a few inches so he asked that I go to the hospital to have a Biophysical Profile (BPP), a sonogram or ultrasound if you will, done. So I did so and the hospital released me and sent my results for my doctor to review.
My doctor called me back to the hospital, stating that my Amniotic Fluid Index (AFI) appeared low and that he'd like to have it rechecked. Amniotic fluid is the liquid that the baby floats in while they're inside of the uterus. After twenty weeks the baby begins producing this fluid on her own, and continues to do so by cycling it through herself while she practices swallowing and breathing and then processes it through her body, to be released as urine. Low fluid can mean that the mother is leaking or that the baby's kidneys, etc are not functioning properly, so this is a pretty serious concern. I went back again and they re-did the BPP to recheck the AFI. It again came out low. At this time I wasn't certain how they measured it or what the measurement scale was so I didn't ask what the numbers were. The baby looked healthy and I wasn't leaking fluid.
Their systems find "pockets" of fluid around the baby and measure it in centimeters. They grid the uterus into four quadrants and try to find the largest pocket that they can that doesn't have any part of the baby in it what so ever. They find the average between those four measurements and that's the AFI. It's said that the average AFI is eight through twenty-two, and that low is considered anything five and under. Six and seven are concerning and should be monitored.
So I was admitted into the hospital. They hooked me up to an IV over night and asked that I drink two liters of water to hydrate me. Some studies show that hydrating the mother can help with this. I drink nothing but water all day long so I doubted that I was actually dehydrated but I understood their reasoning. After a long night and an expensive stay, they re-did my BPP and discovered that my AFI was back up. A doctor came in, apologized for the misunderstanding and stated that obviously my BPPs from the day before must have all been wrong and that they're sending me home. Then what was the point of the IV and the water? Didn't that bring my AFI back up? I immediately dismissed this doctor's apology and assumed that the IV had helped and that he hadn't bothered to really look at my charts at all.
My OB set me up with an appointment with a Maternal-Fetal Medicine (MFM) office for a follow up. He wanted them to do a follow-up BPP on me to check my levels again that Monday (October 22). I agreed and went to the appointment. My AFI was in the sevens and they wanted to keep seeing me on a weekly basis to monitor my AFI. But they also wanted me to get Non-Stress Tests (NST) twice a week and begin seeing my OB once a week as well. A NST is when they hook a mother up to a monitor that both tracks the baby's heartbeat and the mother's contractions. My OBs office is a part of a family practice and he doesn't have the equipment to do BPPs or NSTs in his office so I have to go to other offices or the hospital to get this done. If I go to the hospital, after my insurance, a simple NST is $90 each and I'm not certain how much a BPP is. There was no way that I could afford to go the next eleven weeks having two NSTs done a week, so the MFM office agreed to see me twice a week and soon I had too many doctor's appointments and not enough money or transportation to get to them. I saw my OB and the MFM doctor for an NST on Tuedays and then I saw the MFM doctor on Fridays for a NST & BPP.
This went on for weeks and weeks and my employer happily drug their feet on completing my schedule change, happily lapping up my FMLA that was supposed to be for spending with my newborn baby. They nitpicked every fax my doctor sent in and even forwarded it to the wrong department at times. They become frustrated with how "unreliable" I'm becoming. I couldn't sleep, I began having anxiety and started seeing a counselor at my OBs office so that added another appointment to my Tuesday regimen. Between my job, the gauntlet of endless appointments, insomnia, and my failed attempts at being a wife and mother to my two other children, I felt like I was stretching my self too thin and I was falling apart.
It got to the point where every time I went to see the MFM office they would ask me why I was still coming to them for treatment and not going to the hospital. Every single time I would remind them that I see them weekly by their own orders and I get my NSTs there due to insurance/finance reasons. Can you imagine having to remind a doctor why you're seeing them twice a week every single time you went? I began to feel un-welcomed in their office. The reason why they wanted me to begin my treatments at the hospital were understandable. I am supposed to have the baby at Community East, but I was seeing the MFM doctors at Community North. If the MFM office were to discover an issue that would need immediate attention I would have to be admitted to North, but my doctor only covers East. I understood this, but since no one could give me any other options about receiving my BPP and NSTs at an office related to East that would be a $25 copay as opposed to a deductible, I resigned myself to having to repeat my situation twice a week to a well meaning doctor's office with the attention span of Dori from Finding Nemo.
On 12/14 I attended my appointment at the MFM office for my BPP & NST as usual for Fridays. In order for this next part to make sense, allow me to explain how this appointment usually goes. When I first arrive I get my BPP done by a nurse/sonogram tech, after they've completed it they have the doctor look over it. The doctor comes in and then redoes the BPP and rechecks the nurse/sonogram tech's results. So I get two BPPs from two different people. I then sit in a chair for twenty to thirty minutes on the NST machine. The MFM office has two different doctors. As much as I would love to name names, I'll just stick with MFM Dr #1 and MFM Dr #2 to keep it simple and discreet. So on 12/07 I receive my first BPP from a very chatty nurse. She leaves the room and MFM Dr #1 comes back and tells me that my AFI was reading at 4.2 and that I needed to immediately go to East. She did not re-do my BPP as per normal. She didn't want me to get on the NST, she just wanted me to go straight to East.
At this point I have read a lot about low amniotic fluid complications and even though I'm only thirty-five weeks along, I understand that with an AFI under five that they could possibly be inducing labor. I make my husband stop on the way to the hospital so that I can get something to eat, just in case. We get to the hospital and I'm placed in an actually delivery room, not just a triage room. Their game plan this time is to just have me hang out for twenty-four hours on the NST machine and drink lots of water. They're not going to put me on an IV. No one is going to do another BPP to double check. They aren't going to do anything at all like they did on my October 19th visit. But, damn it, they're going to put the IV stint and lock in my hand and make me sleep with it in, just in case. Sleep being the optimal word here, because nothing says a good night's sleep like being strapped to a NST machine while nurses constantly come in to re-adjust the sensors on your belly, while you're trying not to bump, touch, or rip out the useless needle stuck in your hand.
The next day I wait for my BPP to be re-done. My back hurts. I have chronic GERD (an upper digestive problem that makes indigestion and heartburn look like fun) and I'm in my third trimester of pregnancy, but I've had to stay in bed, in a mostly laid back position so that they could keep the baby on the monitor, for almost twenty four hours. The best the hospital can give me is Pepcid, which is like pissing on a forest fire. It doesn't do much of anything. They lose my BPP orders and have to resubmit them. Finally, after three hours of waiting, they do my BPP and lo and behold my AFI is back into sixes. No IV this time, just water. They're sending me home. They take their time doing this as well. Once they finally release me I have the worst headache ever, my eyes are light sensitive and I feel like I'm going to throw up.
I refuse to miss my husband's family's Christmas party that night and despite feeling like a migraine is coming on I attend it. By the time we get home that night I'm positive that it's a migraine slowly setting in. But it's not. It's a bad headache, yes, but my GERD comes in and kicks the crap out of me all night. I end up sleeping on the couch so that I am elevated, but also so I don't keep waking my husband up every time I leaped from the bed to go puke my brains out. Great first night back from the hospital.
I'm angry over having to be admitted into the hospital. I'm angry with how all of these visits have turned my life upside down. We we're supposed to spend that weekend finishing up Christmas and baby stuff shopping, grocery shopping, getting my hair cut, wrapping presents and cleaning the house. I take off Sunday from work to get the shopping mostly done. I end up taking Monday off to wrap presents, clean the house, set up the bassinet. I am still not sleeping well and it's beginning to become visibly apparent.
I see my OB as normal on Tuesday, 12/18. He tells me that if we get another AFI reading under five that he's going to induce labor and that he would speak with me at my next visit, on 12/26, to finalize a date. My OB's office tries to contact me several times the next day while I'm working but I'm stuck on the phone with customers and can't take his call. Finally, on my first break I try to call back to see what it's about. His nurse tells me that the doctor himself has been trying to reach me and that he would have to call me back, but because he's seeing patients she can't schedule an exact time. I'm concerned about what he would be calling me about when I just saw him the day before. If I log back into work I could be playing telephone tag for infinity, so I opt to wait. Over an hour later he calls me back and he just had some general questions about inducing. He mentions that he spoke with the MFM office and they asked him why I was still seeing him. I explain this to him and he states that he's going to call his sister office that is associated with East and see if they'll be able to do the NSTs and BPPs for me instead. He states that he'll call me right back. By the time our conversation ends it's almost my lunch break time so I eat a peanut butter and jelly sandwich. My GERD acts up. I can't talk on the phone like this, it's disgusting. Nothing is making it better. I try to wait it out. I contact my supervisor and am told to just take the rest of the day off, in the coldest way possible.
So I do just that. Again, that night I can't sleep. I get up to get the kids off to school and my fourteen-year-old son makes certain that before he leaves that he reduces me to tears. I'm an emotional wreck. Completely and totally. He hates that I'm pregnant, he's a selfish person and the baby is going to interfere with his little world. When he sees me crying he doesn't know what to do. He wasn't raised to be cruel and selfish, but he's a teenager and he's on the Autism Spectrum. He's never seen me cry before, because I don't cry, crying accomplishes absolutely nothing. Neither does anger, but at least I feel better after a good, long rant. He ended up calling me from school and apologizing. I reasoned that despite the fact that I don't think children should see their parents cry or despair, that perhaps this was a good thing. It let him see how much his hatefulness hurts me. Unfortunately the waterworks had started for the day and I spent the rest of it crying at everything and anything. My job as a resolution supervisor for a major cellular company requires me to be the verbal punching bag for every piece of shit who's unhappy about an overage or an app that their kid downloaded (because it's easier to call your provider and verbally abuse their customer service agents then it is to take responsibility and punish your fucking kid and make them pay for it). There was no way that I would survive a day at work.
I think it's safe to say that I'm no longer employed.
By 12/21 I still had not heard back from my OB about this supposed sister office so I went to MFM office as planned. A nurse did my first BPP and stated that my AFI was in the 4s again. MFM Doctor #2 saw me today and she came in and did the second BPP just to make certain and confirmed that it was in the 4s. They were concerned that the baby wasn't very active and no amount of prodding my stomach would get her to wake up. They did the NST and towards the end she started to perk up, so she was more than likely just very, very deep asleep. MFM Doctor #2 decided that she didn't think that this warranted a hospital visit and instead insisted that I go to the hospital on Monday, Christmas Eve, for another NST. Her office wasn't going to be opened again until the day after Christmas, so they couldn't do it. I called my OBs office and got the information about the sister office myself. I tried to set up an appointment with them but since my OB didn't treat at their office, his office had to be the one to contact them. I had to convince MFM Dr #2 to do something to help me with this because she refused to call my OB or their sister office. When I explained that I couldn't get in direct contact with my OB, she told me to press the button that says that I'm a doctor's office. My OB had already left for the day, but the MFM office did end up assisting me with getting an appointment at the sister office for Monday morning.
My OB had given me his cellular number. It was just in case I went into labor over this weekend since he was going to be out of town. The number was at home. I hadn't bothered to put it into my cellphone because I really didn't think that I would need it. These inconsistencies bothered me and when I tried to tell his nurse of the AFI issue, she told me that she would "leave him a note". I finally decided to call him. My OB was very concerned with my AFI and stated that he needed to make a phone call regarding it and that he would call me right back. This time he did and he told me to go to the hospital for induction. So that's what I did.
The hospital was ready to receive me. They put me in a room and immediately began discussing what the procedure was going to be like. A doctor came in and saw me and told me that the MFM office had not put in any of the normal reports regarding my care today before they left the office, and that included my AFI. They've been trying to get a hold of someone from that office about it, but they hadn't been able to so they would need to redo my BPP to get my AFI. Over an hour later they finally redo my BPP and find that my AFI was in the nines.
I'm sent home.
I'm sent home after making all of the telephone calls and Facebook posts. I'm sent home after telling my kids about it, and being treated like shit again by my son and being told to keep that "squalling bag of flesh" away from him, like our confrontation the day before had never happened.
I sat in the hospital bed and cried. I didn't cry because I wasn't having a baby today. I cried because I am so exhausted with all of these doctors visits and hospital stays and procedures and tests that really haven't amounted to anything. I cried because I wanted to scream. I've lost my job. Not that I liked it, not that I even wanted to return to it, but because it was something that eased some of the financial stress off of my husband. I cried because the whole thing is starting to feel like it's all in my head and that if my husband hadn't been with me at the last two MFM office visits and witnessed all of this, I'd start to really question my sanity. I cried because between the doctors and my son, I feel like any and all possible joy of having this baby has been sapped away from me and now I'm just left in this emptiness that doesn't even feel like any of this is real. I cried because if I did anything else I would probably have ended up in jail.
But I didn't cry for long, because crying never accomplishes anything. I couldn't even let my husband comfort me, so I just shut down and iced over. Didn't it occur to me that this may be hurting him as well? I guess not.
I have cancelled all appointments at the MFM office. I don't care anymore. I don't believe in AFIs anymore. I just want to be left alone. I just want to try to find some joy in this pregnancy, my new baby, and the holidays, if my son will allow me to at all. I will share my supposed induction date once it's set up, but I'm telling you all now that you shouldn't get your hopes up. If I could tell all of these doctors to just go away and leave me alone, I would. Every BPP and NST on this baby has shown that despite the fact that she's a deep sleeper and a bit chubby, she's a healthy and very active baby. There is no problem, we're fine. I just want these doctors to leave us alone.
