Setbacks

This week has been unkind. I have had a nightmare week for the nausea and dizzy spells. I have been really sick this week. This week I was getting out of bed, blacked out and fell onto the wall on my bell. I had spotting for a while. I had a regular doctor appointment on Monday so I just went straight there to get checked. They sent me to the high risk OB and had an ultrasound. Everything looks good. The baby was healthy and happy and looks like we will be adding boy number four to our family. We are excited and looking forward to a healthy baby.

Last night I was so sick all night long. Then half way through the night I passed out again, this time hitting hard on my ribs. I think I may have injured them. Oh well, par for the course right.

I had more sutures put into my PICC line at my appointment on Monday too. The last dressing change had pulled one side of the sutures loose so she had to put them in on both sides. More fun!

Today I spent most of the day laying flat just to try and keep the pain from attacking my sides. I am hoping that the last few days have just been a bad few days and that things will get better quickly. I have to have a round of fluids tonight so maybe that will get me back on my feet for tomorrow.

My Third HG Pregnancy

I have been promising this for some time and just kept putting it off, maybe because it was my worst and most traumatic HG/Pregnancy experience. It seemed like everything that could go wrong did go wrong.

I found out I was pregnant and was pretty excited. We had tried to get pregnant for several years after my second child and we suffered four pregnancy losses in that time. In that time I graduated from college, passed my teaching exam, went through student teaching, and worked through my first year as a teacher. This was probably the most stressful time in my life. I had two pregnancy losses in my first year as a teacher alone and didn't tell anyone about them, one of them happening while I was teaching at school. My heart was broken, and we decided that maybe God was telling us that we were where we were supposed to be as a family and two was our number. So we stopped trying. In that period I applied for my dream job and wonder of wonders I got it! I was excited. Three months into my new job, I found out we were expecting number three.

The following month, after my positive pregnancy test I started bleeding heavily, I knew what it was and accepted it as best I could. I went to the doctor, he scanned, and there was a heart beat. Apparently we had a twin pregnancy and lost one. I was thankful for having the little one and seeing the flutter of a heartbeat on that screen was bliss for me.

The pregnancy started off rocky, then it seemed like maybe I would miss out on the whole HG mess. I had no sickness for several weeks. I was so happy. Then it hit and it hit with a vengeance. One day I was fine and the next I could not stop getting sick, couldn't even keep liquid down. I was a mess. I called my OB and they gave me a 1 month supply of Zofran. This was after telling them that I was prone to HG and this would probably need to be more than a single month. Even on the Zofran I was still so sick I couldn't keep anything down. I would call and ask them for help and they would tell me that "this is pregnancy" and I should "get used to it" because "it will pass." The trend continued for a couple more weeks until one day I passed out and had a huge knot on my head. My husband rushed me to the ER. I was admitted to the antepartum not for the HG but for the head injury.

They gave me injections and meds through my IV and through other means. I was put on an all liquid diet. Not that it would not stay down anyway. I barely ate anything. I was going down hill fast. The nurses were worried, my family was worried, the only person not worried...my doctor. Everyday he came to my room to talk to me. As time wore on he brought in a GI doctor to figure out if there was a gastric issue. I had a neurology exam for the head injury. Then when those didn't turn up any explanations he got angry. I can recall having a really bad day. Vomiting blood and just miserable. He walked into my room, talked for a minute or two. Then he pointed his finger at me and said, "you just need to tell yourself not to be sick and you will get better, this is all in your head." I started to cry, I was broken at that point. He rolled his eyes and told me that I must be unstable and that was what was causing the problem.

The nurse happened to be outside the door when all this was going on and she came in for a "vitals check." He walked out and she sat on the bed and comforted me until I could stop crying. Those nurses are the best nurses I have ever seen. That night my legs began to twitch uncontrollably. Then the muscles in other parts of my body started twitching. My nurse came in and was immediately worried. Then she did the thing that I know saved my life. She called in the high risk OB. He came in immediately and I was transferred to ICU that night. They ran tests and my body was depleted of every vitamin and nutrient. The high risk doc told my husband that if they could not get me stable in the next couple days I was on the road toward heart failure. He told him to prepare for the worst and that we could lose the baby and possibly he would lose me too.

That night and the next day my heart was beating erratically. They tried to run potassium through my IV but it burned so bad that they had to stop. I could not handle the burn going through my veins. Finally the doctor decided the only way to handle this and to get me stable was to put me to sleep. They knocked me out and started filling me with all the medicines that I needed just to survive. At that point it was no longer about nausea control it became about getting my body to a point that I could live. Dose after dose for a week I was given before they woke me up. They waited until the tests showed my body was ready to wake up and my heart rate was stable again.

When they woke me it was like coming out of a fog. I knew that people had been in the room, I can remember hearing my husband talking to me but I could not respond. When I woke up I spent another week getting more meds and strong antiemetics. I was given shots of vitamin K because my clotting factor was pretty much zero. They wanted to put in a central line. My veins at this point were gone and it took more than three sticks to get IVs started, they also wanted to start me on TPN (liquid food). Once the clotting factor was back, another week, they took me down and inserted the central line in my chest. I was scared and relieved. I was so happy not to have hundreds of sticks and also to know that the TPN would start giving me the nutrients I needed. I was in ICU an additional week. At this point I was in the hospital for two months. The entire time I was in ICU I never saw my regular OB. The GI and the high risk doctor were there every day.

I was moved back to a regular room. I was put on four medicines for the nausea, all were IV until I could handle by mouth. There were days I could barely move but slowly with the TPN I started getting more strength. They moved me step by step from a liquid diet to a full diet. I remember the first day I ate a real meal and it stayed down. I felt like having a party. I knew that I was on my way out of the hospital. During my three months in the hospital I was given weekly ultrasounds. The baby was beautiful and despite the trauma to my body was growing and healthy. We knew it was a boy early because of the numerous ultrasounds.

By the end of my stay I knew every single nurse on the antepartum unit by name and they all knew me. Those ladies were my miracle. Had they not been so attentive and had that nurse not called in the high risk OB that night I fully believe I would have died. I do not believe that my OB would have gone any further or tried any other treatments. I credit my life and the life of my son to those ladies.

I left the hospital after three months. I went back in twice more for other complications, but my HG was controlled by the time I left. I had high blood pressure and high amniotic fluid. In the end I delivered a beautiful healthy baby boy. He was 8lbs and 9 ozs and 22 inches long. My biggest baby by far. After that pregnancy we decided we would not chance another pregnancy. Of course as you know things happen and we are now expecting baby number four.

Much Better!

Yesterday the new home health agency started working with me at the house. The difference was huge and was a big relief. I cannot emphasize enough the importance of good care when you are dealing with HG in pregnancy. The compassion and proactive treatment of my physician has made such a difference in this pregnancy. Even though I still feel horrible most of the time, I have not reached the critical stage like I did in my last pregnancy. Have a doctor who is willing to take time to keep working with me and working through the issues associated with HG means that I am not in such a huge deterioration and have spent way less time in the hospital.

The new home health agency was wonderful. Where the first company was more concerned about what they would not do and what worked best for the, this agency wants to do what is best for the patient. They took extensive time filling out my history and checking my health. When they found out I had been having some issues, the picked up the phone right there and contacted my doctor. Where the last company would have said I should call, they picked up the phone and called her themselves. In addition to the time and care they took finding out my situation, the offered many helpful alternatives should I need the services. For instance, they have offered to do blood draws and take them to the lab rather than my having to make a special trip to the doctor to have them done. They listed several things they can do as long as they have doctor orders. They were more than willing to do things to make my life easier and were most concerned about what was going to be best for my health. Huge difference, they are definitely patient focused!

Currently I am having trouble sleeping at night, this is not uncommon with my pregnancies. First I am usually up sick most of the night and I am prone to insomnia with my thyroid issues. So I am really exhausted most of the time. I am trying to find ways to resolve the insomnia but if it continues I suppose I will have to talk with the doctor about the issue and see if there is some remedy. I seem to have good days and bad days, days where I am sicker than others and am able to keep less down. I try to balance those days by making sure that I eat good foods the days that I can keep more down. I am currently reading through lists of "pregnancy super foods." I will post a good list once I have them down. However, I do always tell people that you are the only one who can decide what you can and cannot eat. Knowing something is good for you will not over rule the gag reflex if you are not interested in eating that particular food.

I am no in my 17th week. Around 20 weeks is when I see a marked difference in the sickness. Usually around that point things start to taper off and I start to hold more down. I am hoping that this is going to be the same trend with this pregnancy. I HOPE!

New Day - Fresh Start

I have sat down to write a post several times and then I get stuck on what I want to write about so I stop.

New Developments: My PICC line was clogged over the weekend. I called the home health on call nurse to ask her to come out and take a look at so it would not clog totally. Her response, "I will just go ahead and tell you that I won't be able to come for a while I have stuff to do." She suggested a few things to try, none of them worked. I called her back and told her it was still clogged and we were not able to run any fluids through the line. Her response was, "Well I have told you all I know to try I don't know what to tell you. I don't know any more than you do."

We ended up going to the ER and the PICC team took care of the line. That night it got stuck again. I called again, and the on call person (someone else) said, "well you will just have to call your doctor on Monday" I reminded her I hadn't had any fluids in a few days and I am supposed to get them every other day so she said she would send someone out to start a peripheral IV the next day. The nurse who came out was sweet and tried a few times to start a line, but no surprise, my veins were not able to accept anything because I was dehydrated. She left without getting a line in and said to just call the doctor.

I called the doctor and they called the PICC team. The girl there said she thought it just needed a good hard flush. She asked why home health would not work on it, and I of course have no idea. She decided to call them to get some answers. She told them that if the line was occluded then they would change the line, but they needed them to come out first to check the line and that she would walk through the procedure for assessment and getting the line flushed if possible. The supervisor said that since I wasn't scheduled they would not send anyone else out. The PICC girl called my doctor to advise them about the response of home health. The doctor called and got the same response except this time it must have been worse. After that conversation, my doctor's office called and said that they would have the PICC team in their office (to save me the $250 outpatient charge) and that I should come in, they were also changing the home health service that day.

I had to call and tell them that I needed them to release everything to the new agency. They said, "Well is there a problem?" I shall refrain from comment. After that conversation, they called 15 minutes later to say they were sending someone out to collect their notebook. Hmmmm...again I will keep the comment to myself. I went to the doctor and they got my line fixed, gave me some education on what to do on my own to keep it from becoming occluded again. I talked to the new agency today and apparently the doctor had filled them in on all that has happened. They are ready to come by tomorrow and get started. I am looking forward to stress free care.

Health issues: Still getting sick and having killer reflux. I am now taking prescription meds for the reflux. I am really tired like I was in the beginning of the pregnancy. I am seeing flashing/floaters which worries me, but so far no protein. That is good news.

Side note: My friend is also pregnant, she is 27 weeks. She has had a rough time, not with HG but with high blood pressure. She is now in the hospital and they diagnosed a 3mm aneurysm in her brain. Prayers for her and the baby are much appreciated.

Patient Care vs. Provider Demands

Today was one of those frustrating days. I had a bad health day today and then I had to use what little energy I had to argue the finer points of care with my home health provider. Nothing frustrates me more than paying someone to do a job (and I am talking a premium rate) and having them tell me they can only provide that service when it is best for them. I am probably the least demanding patient and try to be polite and kind but it always irritates me when I encounter this issue.Today my nurse wanted to come to do my IV when it was a bad time for me, I have a little one and there would be no one to help me with him while I am hooked to the machine. They have also gotten to the point where they only want to start the infusion and then leave it to use to change bags and finish the flush. I don't mind having to finish the job, but I also expect that if I am making things easier for them they can at least make things easier for me. Then when she gets here it is miserable the whole time. She is in a bad mood and determined to make me understand that I am the cause of her problems today. Again I am paying her not the other way around and I expect at the very least civility.

I have decided to call the doctor tomorrow and explain that this situation is becoming more regular and that I do not feel the need to expend what little energy I have fighting for a good standard of care. I also don't want to pay someone to be here caring for me when they obviously have better things to do, I would rather give that money to someone who needs the job. So I think tomorrow I will request a different company and tell the doctor I need a different standard of care.

Today was a rough health day and then the stress of dealing with the problems has worn me out. I think I will end up in bed early. Tomorrow will be a better day. I hold on to that hope anyway.

Allergies

Today's doctor appointment went well in that I was able to come home and not be admitted to the hospital. I always find this to be a positive.

I am having an allergic reaction to the darn tape used in the dressing on my PICC. So they are changing that and I have a cream that has to be applied twice a day. I have huge blisters under the current dressing from the glue. I just laughed when she said that was what it was, silly I know, but better to laugh than to cry.

I gained a couple pounds this week. That is always nice to see, it means I am keeping more in than I am giving up so that is encouraging.

I have another appointment next week for a check and then in a couple weeks I go to the maternal-fetal docs for high risk pregnancies. For now I am just trying to find a sense of normal at home. On the days I feel good I make the most of the day playing with the boys and getting things finished. The days I feel terrible I rest and try to find some energy to get to the good days.That is my "routine" for now.

PICC Line Issues

Starting to worry that my PICC line may be clotting. I am unable to use heparin so I have to flush with saline several times a day. Tonight we did the flush and aspiration and one side went exactly the way you want it to, the other did not give any blood flow. I am freaking out!

They had to try four different spots to place this thing and if it blows then the thought of having ANOTHER put in makes me want to scream in agony.

I also see the doctor tomorrow. Last appointment she sent me straight over to be admitted. I hope this does not happen again. I am on home health now so hopefully this will just be a quick check and then back home. I hope!