Tuesday, February 24, 2009

Learning Patience

So I guess an update is in order.

I saw my doctor on Thursday who at the time was still feeling this was a normal miscarriage. She did an in-office ultrasound which didn't really answer the if this is an intrauterine or ectopic pregnancy. She saw things that made her think it could be either.

Not very definitive.

So she had me do another round of blood tests to see where my beta-hCG levels were. If they were dropping quickly it sounds like a normal miscarriage. If they weren't we were back to thinking it is ectopic.

Blood drawn and waiting commences.

Friday 7am
I'm up, showered, dressed and about to head out the door to a crazy day at work when the phone rings. It's my doctor calling to say that my numbers did not drop, she is concerned the pregnancy is ectopic, she is in the OR all day but had a cancellation and would like to bring me in to do a D&C and then a possible laparoscopic surgery to look for and remove the pregnancy if she doesn't find it in the uterus. She asks, "Do you think you can make that happen today?" Even though my day is full of busy crazy important work, I say "I'll make it happen."
She assures me that my numbers have dropped so low that there is no way this pregnancy is viable even though they are not dropping anymore. They are in the 300's at this point, when they were in the 700's a week earlier and should have been doubling every 2-3 days.
I'm instructed to not eat or drink anything and to come in at noon to be prepped for surgery in the afternoon.
I email my boss to tell him what is happening and he is more than supportive. I try to do as much emailing and work as I can do as I am quickly getting more and more anxious.

Friday 11am
The Operating Room Admin calls to say that my doctor will no longer be able to do my procedure today and that she'll call me this afternoon when she gets out of surgery to talk about the next steps, but that I am clear to eat now.

WHAT?
More waiting....

Friday 12noon
My doctor calls another doctor who's nurse calls me to say that I need to go to the hospital imaging department to get an Ultrasound done at 1pm. There were no appointments available but they have been told I'm coming. I ask if I am to drink the requisite 32 oz of water to have a full bladder for the scan and she says just to drink a little. Usually OB ultrasounds are done by a different department, but the hospital imaging department does them when there is an emergency and I unfortunately know this because this will be my third. AWESOME!

Worry sets in

Friday 1:30pm
I drink a glass of water as we drive to the hospital and of course I get there and they say my bladder isn't full enough for the scan (BECAUSE I WAS TOLD NOT TO FILL IT!). So I chug the 32 oz and sit in the waiting room waiting for it to make its way down.

Friday 2:30pm
HELLO FULL BLADDER!
Scan commences. I chit chat with the technician about iPhones and such. We talk about all sorts of random things. I will say that all of the technicians are so nice there!
And now it's time for the OTHER part of this scan. I never talk during this part. It's just weird. But this part of the scan goes on, and on, and HURTS in certain spots. It's clear she is taking a lot of images of certain areas. This part took almost an hour. She reviewed the images with the radiologist who asked for more images... wee!
When all is done, the tech says I REALLY need to follow-up with my doctor.

I felt like crap after that ultrasound but to avoid the next step we went out to get some dinner. Eric was really hungry and we all needed a break from the craziness of the past few days. But now what?
Do I wait for my doctor to call me or do I call the on-call GYN to find out answer?
I opt to wait... it's a lot easier.

Friday 6pm
Phone rings and it is an anesthesiologist calling to say that she is putting me on the surgical board for Saturday at 1pm to make sure I don't get bumped again.
WHAT?
I haven't heard from anyone about my ultrasound yet. I haven't heard from my doctor about the next steps and I'm pretty sure she wouldn't be the one doing my procedure if I had it done on a Saturday. I'm totally confused.
Just in case, the anesthesiologist did the full pre-surgical interview.

I email my doctor just in case she checks it. I'm a little panicked and am not comfortable with someone else doing my surgery. I trust my doctor and don't want just anyone cutting into me.

Friday 6:30pm
I call the advise nurse who can contact the on-call gynecologist to find out the results of my ultrasound and who has hopefully been in contact with my doctor to know the plan.
With my insurance group I have to first talk to a non-medical rep in a call center and have to tell them my whole deal before they will transfer me to the advise nurse. Once I get to the advice nurse I have to tell it all again. The advise nurse finds out that the on-call GYN is familiar with my name and needs to review all of the reports and would call me in 30 minutes. She says that if I haven't heard anything by 8pm to call again.

Knowing that the on-call GYN knows my name is worrisome. So we continue waiting.

Friday 8pm
Still no call, so I have to make the call again.
Again I have to tell the whole story of the day... twice. Of course I don't get the same rep and nurse.
They tell me he'll call as soon as he can and to call back if he still hasn't called before I go to bed.

Waiting continues....

Friday sometime after 9pm
HE CALLS! Eric wants to know what he's saying and is brilliant and picks up the other phone to join in (I couldn't even think of such an idea my brain was swirling around too much)
Ultrasound results
It is still not clear if the pregnancy is intrauterine or ectopic. WHAT? They see something in both places (that's what we knew about the little in-office machine too). Ok great, no real answers.
While my doctor wanted to do the surgery to get definitive answers, she agreed with the on-call GYN that we should go the route of treating me with medication to end the pregnancy so we do not risk affecting my fertility more than needed. Either way, an ectopic pregnancy is a risk to my health so action had to happen right away.
Usually this drug is administered at the Chemo clinic because the drug is a low dose of chemo but the clinic is only open M-F and my doctor did not want to wait any longer. The doctors set it up that I would get the drug administered at the ER the next day. I had to wait until the main pharmacy was open so they could mix up the drug so 10am the next morning would be it.

Breathing still....

Saturday 8am
My Doctor calls to apologize for all of the drama, waiting and confusion of the day before and to talk to me about the findings, and the new plan and lets me ask all of my questions. She is clearly sick herself and I can hear the beeps of the ER in the background. I later learn she has another patient in there with a REAL emergency in the ER.
She advises that I not eat or drink anything just in case the surgery comes up again while in the ER.
Turns out she was in surgery all day the day before and was already scrubbed in when she found out I was being bumped from the surgical board. She then had issues with her remote access and couldn't look up my phone number to call me herself the night before. She called the on-call GYN and he said he'd do the calling.


Saturday 10am
I'm HUNGRY!
We are back in the ER. Much of the same staff is there who were there when I was there the week before. Oddly comforting.
I'm prepared this time. I bring reading material. My iPhone is fully charged. I bring all of my prescriptions and copies of my EKGs from the previous week because the anesthesiologist couldn't find them in the system. Most importantly I bring a pair of really lovely fuzzy soft socks and a hoodie to put on over the backless gown. I had a feeling we would be doing a lot of waiting around.
I first need some blood work done to make sure my liver and kidneys are doing well and to get a beta-hCG level as a baseline for the post-injection blood work I'll get every few days until my levels are back to zero. They say I need a GOOD IV to get the injection so they want to do that to get the blood too.
My arms aren't so good for blood work and worse for IVs so a few nurses come in and out looking and smacking and then turning to get someone else. One nurse tries and fails but all of the other nurses won't poke without knowing they will get it. A few hours pass and they finally learn that I don't need the IV and that any ol'blood draw will do.
Finally it is time for the injection and the new on-call GYN comes in to do it. She's the only one certified to give a chemo injection on-call at the time. My doctor told me about her and that she had already talked to her about the plan. I ask even more questions and we talk about what to expect and she again reassures me that my beta-hCG levels definitely show a miscarriage and very likely an ectopic pregnancy. She makes sure I am ready and then its time for the shots.
IT BURNS and 4 days later it still hurts.

Now we are back to waiting. More blood work to see where my levels end up. If they don't go down then another set of shots and more waiting. If that doesn't work then we're back to scheduling surgery.


The last few days have been full of ups and downs and side effects. I've been home from work because I feel like crap and hurt physically, am extremely fatigued and admittedly emotionally not all together. Even the bit of work I've done has left me in tears. Thankfully I am feeling physically better tonight and am hoping the nausea I had last night doesn't return.
As I talked to my therapist about, this time is going to be emotionally and physically very different. At this moment it is feeling terribly harder and this time I don't know if I'm going to be strong enough to be as optimistic as I once was.

Tuesday, February 17, 2009

Dr Called....Again

My beta-hCG values have dropped to 398.
So it looks like I'm miscarrying again. I go in to see my doctor on Thursday.

DAMN IT!
CRAP!
GRUMBLE!
POO!
FRICK!


...
sigh

Dr Called...

Turns out my OB was in today so I left her a message that I was concerned about my beta-hCG results. She said the levels are high enough that she's not concerned about ectopic anymore, and that she has seen this slow rise before and it be totally normal. She wants me to go back in today to get another test done.
If they are still low for this many days past ovulation, then she'll want to see me as something is wrong. If they are back on track, then she'll want to see me next week for an early ultrasound or do another blood test. She said as long as I don't have sharp pains or a fever or short of breath then I should be fine.

Next step... get poked again and then wait for her to call me.

Monday, February 16, 2009

Sharing News

Ok, so here is what I want to share....

News#1
After last Sunday, I had another heart palpitation episode which was stronger, longer and scarier. It woke me up in the middle of the night and we went to the ER right away. They immediately did an EKG without me even signing in. They caught the palpitation on the EKG unlike last time. Then over the next few hours I remained hooked up to the monitor with an irregular heart beat, with the monitor alarming every few minutes saying I was in VTACH or Non-sustaining VTACH or some other acronyms I don't remember. They did a few more EKGs while I had an even "funkier" rhythm, as my nurse called it.

The ER doctor ordered lots and lots of blood work, I was given an IV and put on oxygen. He then ordered a chest x-ray which I was very hesitant to agree to because I am ...

News #2
...Pregnant again (just 5 weeks so I probably shouldn't say anything but I am because that's what I do and I have crap to talk about here)

After finally getting them to let Eric back to talk to me, and the radiology tech expressed his concern, we called Eric's friend who is a cardiologist and gave him the low down and he said it didn't sound like I needed the chest xray and he advised we refuse it. After much todo, the ER Doc talked to the on-call cardiologist who said it was fine to skip the xray. I also emailed my OB, who responded that it would have been fine to do but sounded like the cardiologist felt it was also fine to skip.

A bit later, they tried injecting calcium as it can help the heart. Did nothing.
Then they tried injecting a beta-blocker. Slower heart rate, but still palpitating. I did feel the immediate change though. Then they gave me a pill form of the beta-blocker and an hour later..... regular beats between palpitations. YAY! And then all regular beats.
and then it became really boring as my phone battery was dying so I could no longer check email or update Facebook which was the only thing entertaining me because Eric was asleep at this point (he can sleep through anything!).
Since I was stabilizing they decided not to admit me, and a few hours later they discharged me and sent me over to cardiology for a Echo cardiogram and to meet with my brand new shiny Cardiologist. I'm 34 and have a Cardiologist. Oh and by the way, an Echo with pregnant boobs... PAINFUL!

My Cardiologist, cute little blond pregnant thing that she is, felt the Echo was normal but wanted to consult her colleagues and the Electrophysiologist about my EKGs to figure out where the irregular beats were coming from. She also switched me to a different beta-blocker medication which has been studied more with pregnancies. She felt the palpitations are being triggered by the pregnancy and should go away after I deliver.

Since Thursday, I've only had one little heart flutter and have mostly felt ok in the heart department. I'm a little lightheaded and really tired, but that could be a symptom of the pregnancy or the medication. Hard to tell.

Ok, so on to the pregnancy. YAY! First try after the miscarriage last December!
BUT.....
With these heart palpitations, my doctor is a little concerned about Eptopic pregnancy. Since the first episode stopped on its own, she was less worried but still wanted me to do a round of quantitative Beta-hCG testing to make sure the pregnancy is progressing normally. First test was at about 18 DPO and was 615, which is pretty high for that far along. My doctor emailed me and said to go back in 48 hours and then we'd see how it's going. I did the test but didn't hear back from her. Waiting through Friday and the weekend. Then today I went to email her but the email system said she was out until Wednesday. So I decided to call her office to get the results myself which I am now regretting. 48 hours later the hCG level should have doubled, but it was only at 782. Poooo

Could be a vanishing twin.
Could be Ectopic.
Could be I'm miscarrying again.
Could be I'm in that 15% who's levels do not double every 48 hours but even those usually have complications.
Could be no problem at all.
(Stupid internet providing me with more information than I wish to have at this moment)

I should have waited to let my doctor tell me her thoughts but now I get to try not to worry for the next 2 days.

So that's my news. Off to ice my wrists. Too much typing.

Sunday, February 15, 2009

Wouldn't You Like to Know?

I have stuff to share, but I've gone from one bad wrist to both of them paining me so I can't share it here without lots of short spurts of one handed typing.

Blogging without typing is a tad difficult.

Monday, February 09, 2009

Heart All A Flutter

We all know how whiny I've been about the wrist, right?
I will be calling the doctor today to give him an update and to find out the next steps. He had only put me on limited use through the week so I dunno what he wants me to do now. But along with the wrist update, I also get to give him an update on my fun of yesterday afternoon.

Around 3pm I was sitting on the couch, just finishing up some lunch (who says a bowl of meatballs and a can of soup can't be lunch?), when I noticed I was having heart palpitations. I've had them before but usually just a flutter and then back to normal. Perhaps a surge in adrenaline and then nothing. This time they just went on an one. My heartbeat was not regulating. I continued to sit on the couch watching TV for another half hour when my mom come over to drop some stuff off and she didn't stay longer then a few minutes. I didn't tell her anything was wrong because at that point I wasn't really concerned yet.

After she left I realized it was still going on and I asked Eric to Google what to do to get something like this to stop. He suggested resting, so I laid down in bed and he rubbed my back but nothing was getting better. I didn't feel weak or bad in anyway other than the constant flutter which was annoying and now starting to get worrisome. Eric called the advise nurse who asked me lots of questions and asked me to take my pulse and blood pressure. Pulse high, blood pressure low. She wanted me to come in right away and to have Eric drive me and to warn him that I might pass out. Getting up I realized that my arms and legs were shaky and felt weak. AWESOME! Then in the car I started feeling lightheaded. WEEeee!

At the doctor they checked my vitals and my heart rate was even higher but my blood pressure was now really high. Since my Oxygen was good they had me wait to see the doctor. FOR AN HOUR! Well, 40 minutes to be called back, and at least 20 minutes before he saw me. While waiting I started feeling really bad and I was getting scared, and then poof... I could breath again and was able to sit up fine. So of course, by the time the doctor listened to my heart it was all fine and regular. A little fast but regular. Good I guess, but then he said that they cannot diagnose the arrhythmia unless they catch it on an ECG and since it was regular now he could only tell me to contact my regular doctor for follow-up. GREAT!

He went ahead and did an ECG right then to make sure and to get a baseline. But yea, it was normal by then. Kinda frustrated me that if they had done the ECG first, that they would have a record of it.

As I was being hooked up with all of the wires, Eric asked "Do you want me to take a picture for the blog?". Since I felt like crap and was in a gown open in the front, I declined. I know, how prudish of me. How thoughtful of him to ask though! The technician said I could have a copy of the report though, so here you go.... my heart on a page.

Friday, February 06, 2009

Stream of Consciousness

Typing one handed so I don't do permanent nerve damage to my right hand.
I'm right handed so this is difficult.
Sleeping in a night brace makes it feel much better by morning.
Not allowed to pick up the kitties because they are over 10 pounds, and they keep asking why and I can't seem to get them to understand.
Even with a brace and trying to type all day one handed, I still manage to over use it.
I think I over used it just taking a shower and brushing my teeth this morning because it's already achy.
Eating is difficult, Maybe I'll eat less and loose some of the 10 pounds I put on in the last 2 months.
This is doubtful.
My boss's boss threatened to send me home and disable my remote access if he caught me using my right hand again.
I have good managers.
I associate my self-worth with my work too much that it's killing me that my work is not getting done.
It's rainy today.
I should be happy about this, but instead I see it as wet and cold and grey.
My arm hurts and I feel whiny.
I'm reading a Suze Orman book about what to do now that the economy SUCKS. It's freaking me out that we have avoided organizing our finances since we got married and are not in a good situation.
Woo!
I have to realize that taking the time to make my meals is necessary.
And bringing lunch to work and then still going out to eat and wasting said lunch does not help.
It's probably not good when your co-worker's girl,who is a market analyst, writes to say that our Company's earnings call makes it sound like lay-offs are coming.
We've gotten through this before, we can do it again.
My thoughts sound depressing.
My train ride is about over and I'm not looking forward to walking to work in the grey, cold, wetness.
I miss knitting.
I hate sounding so blue, because I'm not. Not all the time.
Last night I cried and was thankful my husband held me. He's good like that.
Today I'm tired but am charged up to get some work done....one handed.
I'm looking forward to a lunch of Dim Sum to ring in the New Year and get to know some co-workers I don't really know.
I hope they don't all speak Chinese the whole time because that is one of the things my father didn't teach me.
Just realized I can't use chopsticks with my wrist situation.
I'll be eating Dim Sum with a fork which seem so wrong.
I'm not that good with chopsticks anyway.
My father gave up on that one too.
My laptop battery is running low.
I had this really great chat with my friend yesterday.
I'm very thankful for her.
I don't keep in touch with friends really, unless they are online. I find that sad.
Thanks to being online all the time I have made some really great friends I would have likely never 'met'.
I hope this wrist business heals up quickly because I have much to write about.
Well, my laptop battery is about done with me and the train ride is almost over so I shall try to quiet my brain for a few moments to let my left hand rest and to prepare for the day.
Ha! My brain is never quiet, so I'll just have to force this to end.

Happy weekend all!

Tuesday, February 03, 2009

Paining

So we all know that I've been a bit of a bummer 'round these parts. Well here is some more bumming news....why stop the trend right?
While I haven't been posting much anyway, I might have to take a real break.

Last Thursday after a long day at work, I noticed a dull pain in my right wrist. Then on Friday it got worse and some of my finger tips got all weird and felt numb and tingly and the pain moved up to my elbow. I stayed off the computer over the weekend and tried to rest it. I read a book almost all Saturday (and napped - Awesome!) but even that hurt it. I wanted to bake cookies for the Super Bowl, but mixing and dishing and dipping them in chocolate was too much wrist action. Needless to say I'm writing this all left handed because I over-used it again doing just one more (or 20) things yesterday.

A massage therapist friend massaged and poked around and he basically said, "You've really F@#$ed this up". Let's hope NOT!

I have a doctor appointment later today. Wish me luck.

**Update**
Icing, heating, using a brace and VERY limited keyboarding. Hopefully being kind to my arm will let some swelling go down will help everything heal. Typing with one hand is a little too slow to do much posting :-( also no knitting which is OK since I stopped a few weeks ago when my left hand was starting to hurt. oh and chopsticks?.... no way.

Monday, February 02, 2009

Done with Being Down

Tomorrow would have been our 18 week Ultrasound appointment. When we would have found out the sex of the baby. Instead, I'm back to peeing on sticks. I had a feeling the shoulda-been blues would hit me during this time, or I should say get worst because they haven't really gone away.

I know I was all upbeat sounding back in December. That this was just a little delay. A little bump in the road. And while I still feel that way, it sucks. Pregnancy and babies surround me. While I don't actively tear up, I do feel pangs of .... SIGH! I don't really feel jealousy. Nor regret. I guess it's frustration and worry. Worry of having to go through that again.

What really gets me are stories of parents. Of loss. Of changes in plans. New beginnings are still joyful and exciting. I am truly happy for those around me who are starting or adding to their families. I will talk about placentas, and sore boobs, and the importance of staying hydrated. Of co-sleepers and brands of diapers, and what diaper bags to buy so that daddy is cool carrying it. And also for the random stranger who is just starting to show or about to pop. But I also feel a sense of wallowing. That I'm feeling sorry for myself. For us. For our little one. And this is going on a little too long.

I know this happens to a lot of people. It happens all the time. I know it could be a one time thing and all will be perfect next time. But I wonder if I'm strong enough to get through this time. To get to the next time. To get through the worry which will undoubtedly overwhelm me next time.

I know no one knows. Know one knows what and when and if the next time will happen. But I know I need to be strong, but I also need to be honest in order to be real, to heal, to be whole. I'm bummed and I'm sick of it.