You get what you need, Part I

As the Rolling Stones once sang, “You can't always get what you want, But if you try sometimes well you just might find, You get what you need.”

The birth story. It’s a much different story that I thought I’d be telling, but you know what? I’m so OK with that.

Part I...

It all started on Tuesday, July 20, 2010. I had been checking my blood pressure several times a day at work because it seemed to be creeping up in recent days. Throughout the entire pregnancy, my BP had been PERFECT. In fact, my BP during pregnancy was better than my pre-pregnancy BP. Starting the week of the 19th, though, that all changed. And it changed quickly.

Tuesday morning, the nurse checking my BP was getting readings of 160+/90+. She took readings several times throughout the morning and it wasn’t coming down. She encouraged me to call Dr. T’s office. Although I was hesitant (you know me and doctors), I knew I what I had to do so I gave them a call.

Angela, his medical assistant, answered the phone. I gave her my BP readings and she said that he’s going to want to see me and that he’s probably going to put me on bed rest for the rest of the pregnancy. This drew a HUGE laugh from me. Me on bed rest for the next 5 weeks? Seriously? My laugh was quickly silenced by a concerned tone in Angela’s voice when she said, “sweetie, I’m not kidding.”

They told me to be in his office in 2 hours.

During the visit, T did in fact put me on bed rest. I asked for modified bed rest where I could work in the AM then head home after lunch and put my feet up in the PM. This was a no-go for the good doctor. He explained that between my quickly elevating BP and the increase in my swelling (if you can even imagine that), my heart was stressing and it needed a break. Badly. He went onto describe more serious complications of continued elevated BP, including seizures, internal organ failure, etc. Don’t you love it when doctors immediately jump to the worse case scenarios?? My heart was working a little overtime, but seizures and liver failure? I wasn’t buying it.

But, trusting Dr. T with everything I have, I immediately went home and started my bed rest. I was really upset. It’s not so much that I resisted the bed rest, it’s just that I never imagined I would have to make such drastic changes so early on. At this point, Bubs was still 5 weeks away from being born. Five weeks is a long time for a pregnant woman. I didn’t want to holed up in our house, confined to a couch or a bed for the next 5 weeks. How is any of that conducive to preparing for labor?

Until that point, I had been faithful at preparing my body for the inevitable labor and delivery. Each night I would spend 30-60 mins on the birthing ball, rocking back and forth, moving left to right doing exercises to open up my pelvis and stretch my hips. And those exercises worked too. I could tell a difference “down there” within just a few days after starting the exercise routine.

With that in mind, it was quite a blow to hear that I would now be confined to a semi-reclining position, which is in no way conducive to labor. I became frustrated that what I had imagined in a birth was being taken away from me.

The good news was that with bed rest, my chances for a vaginal delivery were good. If I could lose some of the excessive fluid and keep my BP in check, I could still have the delivery I planned. And the best rest seemed to be working. From Tues evening until Thurs morning, I lost 4.5 lbs of fluid. My BPs became more normal and I had ankles again! Things were definitely looking up.

I remained on faithful bed rest through the rest of the week and into the weekend. Then on Saturday afternoon, I got a terrible headache that I couldn’t shake. I increased my water intake and took a nap hoping that would help. I woke up with an even stronger headache than before. I took Tylenol and within 45 mins still had no relief. The BP readings on my home machine were elevated (despite having been on bed rest for 4 days) and I wasn’t feel well at all. I called my dad who came over and took my BP which had elevated to 160/100. I called Dr. T’s answering service and Dr H, as the on call physician, returned my call. He said it’s difficult to tell if the headache is pregnancy related or not, but said to give it another 30 mins and if the Tylenol didn’t help it go away then I needed to proceed to labor & delivery at the hospital to be monitored.

Headache worsened so we made our way to the hospital. I was admitted for monitoring and my first BP reading was 176/108. That is crazy high. They took my BP every 15 minus for the next few hours and it remained high. I kept telling the nurse that if she just gave me medication to make the headache go away then I’m sure my BP would drop. I think the pain from the headache was causing my BP to elevate. She said they couldn’t give me anything for the headache until my BP was better controlled b/c with uncontrolled BP, they were limited in which headache meds I could receive. It was a vicious cycle!

They gave me oral medication to bring down my BP and a few hours later, it had normalized. Then they were able to give me oral medication for the headache and my blood work came back “as they would expect” for someone in my condition. I was just about to walk about of there without any further poking and prodding but then Holly, the nurse, came in and said that Dr. H wanted me to be checked “just to make sure” everything was OK. My birth plan is described in more detail below, but one of the conditions I had was to NOT be checked until it became medically necessary (no routine checks starting at 36 weeks for me…I have better things to do with my time!). I guess this time counted as “medically necessary.” Holly checked me and WAUZERS! It was NOT comfortable. She rooted around, dug up and down…eventually almost getting up onto the bed with me in an attempt to find my cervix. Apparently my cervix was amidst a game of Where’s Waldo and was no where to be found. Holly ‘thinks’ she felt it very high up and under the baby. She could barely reach it and in her estimation, I was not dilated at all. After that lovely exam was complete, I was sent on my way. Although I still had a dull headache by the time we left (the physical exam brought back much of the headache intensity…way to go!), I was feeling MUCH better than I had hours before. I left with a RX for BP medication (the second strongest dose a pregnant woman can take) and orders for STRICT bed rest.

Monday afternoon around 4:30pm, Dr. T’s nurse called me. She said that Dr. T just learned that I had been in the hospital over the weekend and he wanted to see me first thing Tuesday morning. I reminded her that I already had an appt scheduled with him for Wed and she said he’s insisting on seeing me Tuesday. *sigh*

Hubby cancelled his patients for Tuesday morning and we went in for our visit. We reviewed the visit to the hospital and then Dr. T started reviewing our options. Ultimately our options were to be induced that night or to wait until Friday to be induced.

Side note: I realize I never posted the actual details of my birth plan, but here were the highlights:
1) Get this baby out of me healthy and happy
2) I do NOT want to be induced
3) I do NOT want a C-Section
4) The end.

That was it (well, there may have something in there about not wanting to be checked routinely starting at 36 weeks, not wanting to have an episiotomy, not wanting to have internal monitoring, and a few other things, but those are the highlights).

Obviously, T’s recommendation of being induced was not a welcome thought for me. Hubby and I talked with him to find out if there any other options. Could I be admitted and closely monitored for my BP? He said that I was already on the second highest dose of BP medication and my in office BPs that morning were still running in the 160/90s. Not good. I had also started collecting more fluid (again) despite being on strict bed rest. By this point, in addition to my ankles, feet, knees and legs swelling, my face, tongue, and lips were swollen too. I now spoke with a lisp. My cheeks were puffy and you could really tell I was retaining crazy fluid.

With my elevated BP despite the medication plus my insane edema, T really started to lay things out for us. He detailed the complications that arise from consistently elevated BPs and swelling. This time, he wasn’t speaking in hypotheticals. He was talking about patients that have my same conditions and their inevitable fate. He expressed he knew I had done everything I could to control my BP, but at this point, it was out of my control. And I knew it, too. The only known way to reduce the pressure on my heart was to deliver the baby.

I love Dr. T. He really had worked with us to get the delivery we wanted and I suspect he even let us go father than he was medically comfortable with (to an extent). He commented that had he been on call Sat night when I went into the hospital, I could have had the baby then.

So, induction it was. We spent the afternoon running around preparing for the baby’s arrival. Remember, I had just turned 36 weeks. I barely had anything ready for the labor and delivery. Sure, the nursery was done. But that was about it. The house was a wreck. We didn’t have our hospital bags packed. I hadn’t off loaded ANY of my duties at work. I wasn’t at all prepared to have this baby. But, as I’m slowly learning, as a parent, things rarely play out the way you thought they would and you don’t always have time to prepare for them.

To be continued…