Linnie's Life

The Ramifications of Technology on Procreation or How to Spend 100 Days in the Hospital Gracefully…The Saga Continues

I watched the drops falling from my IV bag into the drip chamber and waited for the dreadful feeling of faintness.  The doctors and nurses were crowded around my bed with ambu bags, epinephrine, large bore IVs, extra bags of fluids and a crash cart.  Dale was holding my hand and we waited…and nothing happened.  Wonder of wonders…I could take cephalosporins and they did not cause any sequelae at all.  Maybe we were going to make it through this rough patch.

Three days later my fever had subsided, my amniocentesis came back negative for infection and the labor had stopped—or at least subsided to the low amplitude waves I had been having all along.

There are some perks to being a long-term in-patient.  The dietician came to my room and said the doctor was concerned about what I was eating because in all honesty, hospital food sucks.  She told me she and the doctor had spoken to the head of food services and from that day on I had carte blanch.  I could order anything I wanted and someone in the kitchen would make it for me.  What a relief from Salisbury steak and green jello!  So I was eating whatever my heart desired but Dale, who had been eating at least two meals daily at the hospital for the past two months, was not so lucky.  He was a frequent flier in both the visitor cafeteria and the staff cafeteria.  One day after having eaten every offering off both menus, he asked the cook in the visitor cafeteria if she would make him a grilled ham and cheese sandwich, which was not on the menu.  There was a grilled cheese sandwich and a stacked ham sandwich, but no grilled ham and cheese.  She told him she could not do it.  He offered to pay for two sandwiches if she would just take the ham off the one and place it on the other before grilling.  No such luck.  She would not budge.  He came back to my room and was furious.  (frustrated, angry, irritated, annoyed…) and one of the nurses asked him what the problem was.  When he told her, she went to the phone, called the kitchen and had the sandwich sent up to me—because I could get anything I wanted!  And Dale finally got his grilled ham and cheese sandwich!

By now it was the second week of April and I had been in the hospital since Valentine’s Day.  Every day they would check to see if the baby’s lungs were getting close to mature so they could perform the c-section and we could be done with this ordeal.  Every day I got the bad news that his lungs were not ready and we would try again the next day.

Throughout all this I had IVs in both arms and early on it became evident that as caustic as the magnesium was, I was going to need frequent IV site changes because my poor over-used veins kept giving up.  When an IV comes out of the vein it is called infiltrating.  With some medications and fluids it is no big deal.  Others cause necrosis of the musculature and skin.  Magnesium is one of the rougher ones.  I noticed that one of the IVs had infiltrated so I shut off the pump and called the nurse who came down and prepared to restart it in a different vein.  She tried twice and missed both times and called another nurse.  As a general rule, nurses have a limit to the number of times they will try to start an IV.  It saves them from getting frustrated and poking blindly in a haphazard attempt to hit a vein and it gives the patient some relief to think that a different nurse might be a better dead-eye.  I went through all the nurses on the floor and then they began calling the nurses on the Labor and Delivery unit.  I went through all of them and no one could get the IV restarted.  About that time my contractions were ramping up from lack of magnesium so the nurse had to call the doc to get an order to start hourly injections.  He got pissed off and came to the unit to show the nurses how it was done…and Lo and Behold!  Even the doc could not get it started.  By now, my count was at 24 pokes and zero successes.  I was crying and trembling.  It is hard to allow oneself to be stuck a great number of times without feeling something!  All of a sudden I heard the nurse manager say that they were ready for me in the ER.  And then my bed began to move.  They were taking me to the ER to have one of the ER docs try.  There were two there and each tried once and that took my tally to 26.  Finally one of the ER docs got indignant and decided enough was enough so he called for a cut-down tray and decided he was going to do a cut-down…which is a small incision over a vein, exposing the vein and opening it, inserting and suturing in a peripheral central line which is a long-term solution to IVs.   After the short procedure I was such a mess that they gave me a small dose of Valium and I slept the rest of the day and all night.

The next day when I woke, I noticed that I was having some weird heartbeats.  I was not overly concerned, but when my doc came in to do rounds I told him.  He said it was probably just a vagal reaction to my ever-expanding belly.  Placated, I went on with my usual day of bed rest, eating and incubating.  But the palpitations continued.  I told the nurse who in turn called the doc who in turn ordered an ECG.  The tech came and ran the strip and within minutes I had a cardiac nurse in my room babysitting me because the strip showed a partial heart block.  Mind you, a heart block is a different animal altogether than a blocked artery.  A heart block is where the electrical conduction system of the heart is disrupted for one reason or another.   Why me?  What caused this?  Another day, another drama.  I was rolled down to the cath lab where they thought I might need to have a cardiac catheterization if the echocardiogram I was about to have did not show another reason for the heart block.  As the echo tech began, she placed the transducer on my chest and within 15 seconds she was on the phone with the doctor.  And off I went to the ER.  It was a whirlwind of confusion.  No one was telling me what was happening but there was ton of furious work being done around me and it was more than a little frightening.  So here I was back in the ER and the same doc who had done the cut-down for the peripheral central line came into my curtain and said that the line had advanced into my heart through the valve which separates the atrium from the ventricle and the presence of the catheter in my cardiac ventricle was causing an irritable heart so the line had to be backed up.  He took the sterile dressing off and pulled the line back about 5 inches and the palpitations ceased completely!

So another crisis averted!

On weekends Dale generally came in a little later than during the week and stayed a little later.  It was a strange perversion of date-night.  We would watch a movie or play cards or chess…anything to pass the time.  In all honesty, Dale kept me going.  When I was down he let me be down, but only for a short period of time.  When things got scary, he was my rock.  When we got bad news, we cried, and when we got good news, we celebrated…but all of it was because he was there for me.  He knows all this so this is not a Facebook declaration of love and affection or a surprise admission on my blog…but you, the reader, needs to understand that as difficult as it was for me, it was equally difficult for him.

So Saturday, April 14, (1990) rolled around and Dale brought in an Easter basket for me.  The next day was Easter Sunday.  We were celebrating a milestone.  Our baby had made it 7 months!  His lungs were immature and I was a mass of wasting muscle, I had nearly lost my ability to walk and most certainly could not tend to myself to shower or dress.  I was far too weak for that, but we did not care.  We had survived 7 months.  In all honesty, we sort of looked at the pregnancy as a terminal disease which was not terminal.  Every day we wondered if that was the day we were going to get the bad news.  I got weaker and weaker as time passed.  My spirits were low most of the time and Dale was living all alone in our lovely new townhouse in Plymouth, MN!  But we were celebrating the 7 month mark.  We spent the day and evening together and about 10pm Dale decided it was about time to go home.  It was a twenty minute drive from the hospital to our home so if he left at ten he missed the change of shift traffic and made it home by 10:30…sat down and watched a little TV, had a beer and unwound from the long, tiring, boring day at the hospital and then went to bed.  I had my own routine.  Being limited to the number of times I was allowed out of bed, I planned my day around washing up and having to use the facilities.  I would use one trip in the morning and one in the evening in order to wash up and brush my teeth.  I was a master at getting all my routine completed in less than five minutes!  So Dale left at ten, which was the same time Cheers came on (in syndication), so between the shows I would make my five minute run to the bathroom and then return to bed to watch Cheers and drift off to sleep.  This night was not any different than any other except for my return to bed.  I crawled in and got myself comfortable on my left side (contractions decrease when the mother reclines on her left side) and suddenly something seemed wrong.  My bed was wet!  I felt under my covers and the entire mattress was wet.  I called the nurses’ station and cried out, “I think my water just broke!”

To be continued…

The Ramifications of Technology on Procreation or How to Spend 100 Days in the Hospital Gracefully

I am in one room and my 21 year old son is in another.  I can hear him laughing but I am not sure at what.  It doesn’t matter, though.  Just hearing him warms my soul and brings back so many memories of his life.  I guess I am feeling slightly nostalgic about him because he is about to start his last semester of college at mine, and soon his, alma mater.  Where have those 21 years gone?

Andy was a techno-conception because of the loss of our daughter a year earlier.  Our fertility specialist was a kind man who knew the agony of the loss of a baby and did everything in his power to get prospective parents back on the horse, so to speak.  We were on fertility meds and when we went in for the ultrasound to check the status of my ovaries, we had three follicles ready to go.  The doctor asked us if we were willing to accept the possibility of triplets and even with all the trouble we had, we said yes, so we were off to the races.  (note: second horse reference!)  Anyway, I know the exact day of his conception—no doubt in my mind. 

Because of the issues we had with our prior pregnancy we knew I was going to be on bed rest to some degree.  I took a medical leave from work and just puttered around the house.  Dale was working as a golf product salesperson for a huge company and had a big territory which included Minnesota, North and South Dakota and part of Wisconsin.  Luckily he did most of his traveling in the spring and fall and was home for the winter. 

13 weeks into the pregnancy I began having cramping and some spotting.  I called the doctor in hysterics and he said I needed to go to the ER and he would call ahead and they would know what to do for me once I arrived.  We got there and we were rushed into ultrasound and were told that I had miscarried one of the babies but the other looked fine.  I was not even aware I was carrying twins despite knowing the possibility.  I was then put on moderate bed rest for the remainder of the pregnancy.  That pretty much meant in bed, all the time, other than trips to the bathroom and sitting up to eat.  What a huge pain in the ass, but I was willing.

One week later the cramping started all over again and I was sure I was going to lose the one baby I had left.  Again into the ER…Again rushed into ultrasound…Again, told the good news that the baby was alright, but then came the foreboding news.  I was in preterm labor and was going to be admitted so the doc could attempt to stop it before I actually did miscarry. 

IVs of magnesium sulfate stopped the contractions but made me sleepy and weak.  IVs of Terbutaline made my heartbeat faster than 120 bpm and made me shake like a leaf.  Those two pack quite a punch when administered together.  But, it worked and 6 days later I was ready to go home.

Just as I thought I was going to get out of the hospital unscathed, a woman walked in and introduced herself as my home health nurse and she had a surprise for me.  I was going to be the first person in the country to ever go on a home Terbutaline pump.   They had managed to convert an early insulin pump, which was similar in size and weight to a brick, into a pump for Terbutaline so I could get a constant subcutaneous infusion at home, as I laid in bed 24/7! 

So now, I was in bed all the time.  I was allowed up to the bathroom as needed but preferably no more than 4 times per day, I could shower once per week and the other days I had to wash up in bed.  I could not take the stairs so I had to choose upstairs or down and since our bed was up…up it was, so I ate in bed.  The one concession the doc made was that I could sit in a recliner as long as I was nearly flat.  Dale went out and bought a navy leather recliner and put it in the corner of our bedroom and I spent an hour or two daily in that chair just for a change of scenery.

As she informed me, the home health nurse came daily to take my vital signs and put a monitor on me to see if I was having contractions.  I was having a problem called low amplitude waves, which pretty much meant mini-contractions all the time.  They never stopped and came one after another without fail.  They were not painful, but I knew they were happening.  Luckily the Terbutaline was keeping them very low amplitude and everything was fine.

16 weeks of pregnancy rolled around and I was admitted to the hospital to have surgery to put a wide metal suture in my cervix to make sure there was no issue of incompetence.  The surgery was quick and easy but irritated my already high-strung uterus and I once again went on all the IV meds to stop the contractions.  I was in the hospital 12 days.  I returned home with my bathroom privileges even more restricted, my chair time decreased based on my monitor strip reading and no showers.

Everything was status quo for a few weeks.  The nurse came daily; I ran strips three times per day and sent them via the phone-line to the doctor who would adjust the Terbutaline accordingly.  The worst part of the whole thing, after I had resigned myself to my plight, was that cotton nighties were uncomfortable in bed all day long.  They didn’t slide across the sheets when I rolled over and they bunched up underneath me.  I asked Dale to go out any buy some satin nighties for me because I knew they would be more comfortable.  He came home with the perfect, prettiest satin nightshirts in lovely deep colors.  I immediately changed and was ever so pleased at how much more comfortable the satin was compared to the cotton.

Later that night I heard my pump alarming.  I looked at it and it was flashing the code for an interrupted delivery.  I called the home health nurse who instructed me in stopping the pump and giving myself injections of Terbutaline hourly until she arrived with a new pump.  Six hours later she arrived with a new pump and hooked me back up.  Being the first to try this experimental treatment, no one knew what the problem was, but since it had been rectified, we figured it was a fluke and we all went on with our lives.  A day later, I heard the pump again.  Again, I called the nurse who again, told me to go on hourly injections and she would be out with a new pump as soon as she could.  This happened a third time and the nurse decided to call the pump company and request one of their technicians  come to our home and see if he could figure out the pump problem.

The next morning a nerdly guy rang the bell and Dale escorted him through the house.  He had meters and things with light and bells and whistles and I think maybe even a set of divining rods.  Anyway, he said he was checking out the house for anything strange which would cause the pump to short out.  As he got closer to me the bells, whistles and lights began to go off.  It was me!  I was causing the pumps to short out.  Why?  SATIN!  It gets static-y when rolled across bedsheets.  I would roll around the bed and build up a static charge in my oh-so-comfortable satin nighties and it would short out the pump.  The technician had two suggestions to rectify the problem.  I either needed to be grounded or I had to go back to cotton nightgowns.  When I asked what he meant about “grounding,” he said he would have to fashion a system similar to handcuffing me to the bedframe, so back to cotton I went!

A little less comfortable than the weeks prior, the winter was passing like Minnesota winters do.  We made it through Christmas, New Years and as Valentine’s Day rolled around, something seemed wrong.  The cramping was worse and I was spotting and I was maxed out on Terbutaline—at least for the amount the doc was comfortable with me taking at home and not being on a cardiac monitor.  So February 14th I went back into the hospital.  I was admitted to Labor and Delivery but they were able to stabilize me and I was transferred 4 days later to the antepartum unit where I would forever be known as the worst patient to ever set up housekeeping in the hospital.

Little did I know what I was in for when I was transferred but when my doc came in that day he told me that I would be in the hospital for at least a week.  Shee-woo…I can do a week in the hospital without batting an eye.  No problem.  Dale was in his slow season so he came to the hospital daily and spent all day with me.  He would arrive about 11am and stay past dinner although usually he went home about the time the 10pm news came on.  He knew I could not stand daytime TV so bought a VCR and Playstation and brought them in and hooked them up in my room.  I watched countless hours of Mario Brothers while hospitalized.  I’m surprised Andy does not jump up and try to knock something out of a cloud with his head whenever he hears the Mario Brothers theme. 

One week turned into two and because the low amplitude waves were requiring more and more medication to keep me from going into full-blown labor, two weeks turned into four.  I was frustrated and depressed.  They sent a psychiatrist in to evaluate me.  His conclusion was that anyone who was young and otherwise healthy would be depressed if she could not experience her pregnancy in a normal fashion and would be even more depressed to be stuck in a bed in a hospital for weeks.  They also sent in a physical therapist who tried to keep my strength up.  It is amazing how much muscle-wasting occurs when one is non-ambulatory.  Unfortunately, not being able to get out of bed, the most exercise I could do was kick a taped up, rolled up bath towel around the foot of the bed.  They sent in an occupational therapist to see if there was anything she could do to help pass the long hours, days and weeks.  I was completely disinterested in crafts and puzzles so she never came back.

The one thing for whom I will be forever grateful were the nurses.  I learned about each of them as they took care of me day in and day out.  I loved them and hated them at the same time.  They were like my jailors.  I knew they were not and I was free to get up any time I wanted and leave but I knew the ramifications of anything that impulsive, so I took the bad days along with the good ones and learned to love the nurses.  I could, however, hear them in the hallways warning each other at shift change as to whether it was a “good Linda day” or a “bad Linda day.” 

In case I have not already mentioned it, this hospital happened to be the very one in which I worked one floor below where my room was.  I worked nights on 2E, which was the psychiatric unit.  It was there that I met one of my best friends in the world, Lynda.  We worked nights together and we lived in the same city and car-pooled to work.  We had an absolute riot working nights together.  If you ever get a chance to talk with a psych nurse, ask her about the crazy things which happen on a psych unit at night.  The stories are incredible.  Anyway, Lynda and I became fast friends and while I lay in bed day after day and night after night, Lynda continued to work one floor down from where I slept.  But…every night she worked, she came in to work a half an hour or more early and brought me a muffin and visited with me until time for her to start her shift.  It was the kindness of that simple act that made her my best friend and even though we live a few states apart now and do not speak often, she will be my close friend for the rest of my life.

When a person is in a hospital for a long period of time along with others who are in the same predicament, they are bound to get to know one another.  There was a woman across the hall from me who was having multiples and she was in the hospital to be medicated and see if they could not coax a few extra days out of her pregnancy to give the triplets a better chance at lung development.  She already had two children and the kids and her husband came to the unit to visit her frequently.  Dale and her husband met up in the hall and soon were on speaking terms and then to my surprise, in waddles my across-the-hall neighbor.  She was given privileges to get out of bed and she decided to come over and introduce herself in person.  We visited daily and she had a young son who liked to come over to my room and watch TV with me in the evening.  He came one night and was not feeling well so did not stay long.  Two days later, on a Saturday, I began to feel sick.

I started to feel feverish.  And then my skin began to hurt.  Then my joints began to ache.  Then I started having contractions—not the puny ones, but big, mean, hard and painful contractions.  Dale went to the nurse’s station and asked them to come take my temp.  No response.  He asked again.  Finally, when they did not respond quickly enough he took the thermometer from behind the desk and came down and took my temp.  It was 102 degrees.  He reported this to the nurse who immediately called the doctor.  My doctor was out of town but his partner was covering for him.  He gave the nurse some orders for Tylenol and fluids to stop the “bug” but in less than an hour my temp was 104 degrees and I was in active labor and hallucinating.  I do not remember much but I do remember being surrounded by nurses and doctors and Dale standing beside my head swinging a towel to move some air in a desperate attempt to cool me down.  At one point I hear the number 105, so I assume my temp went that high but I do not remember it clearly.  My doc had left word that he could be contacted should there be an emergency with me, so even though his partner had given some orders, my doc came back to town and came to the hospital on Sunday.  I was still gravely ill.

I have a severe allergy to penicillin.  There is a class of antibiotics which are closely related in chemical composition to penicillin.  They are called cephalosporins.  Some people with severe reactions to penicillins cannot take cephalosporins either.  I did not know whether I was one of those people or not, but I was between a rock and a hard place.  I needed the antibiotics, but if I took them, I might have had an anaphylactic reaction to them like I do when I take penicillin.  So, knowing that I am going to either deliver the baby WAY early and he will die or I take the antibiotics, the docs devise a plan.  They called the code team—who are the ones who respond when you hear “Code Blue” in a hospital.  They are the ones who wheel in the crash cart and do everything in their power to save lives.  They called respiratory therapy and they called the ER docs.  They called them all to my room in case when they started the IV cephalosporins, I went into anaphylactic shock.  Scary?  You bet.  So the nurse hung the bag and opened the valve and pushed the power button on the pump and I waited for the anaphylaxis to start…

…to be continued

Molecular Gastronomy, Spherification, or The Birth of a New Word

My son is coming home and we are going to make fruit caviar!

We will document the process and post it assuming it is not a molecular gastrotastrophe.

(yes, I just made up that word, but feel free to use it the next time you attempt to make little gelatinous spheres from juice, alginate and calcium chloride and fail.)