Tuesday, December 23, 2008

Resident Evil

So it's my doctor free week (sort of) meaning that I don't have to go to Tower. Instead, I have the usual appointments with my acupuncturist, o.b. and perinatologist. God forbid I actually have a drama free week. Monday started out like usual. I had acupuncture with Dr. Dao and then saw Dr. Ottavi. Miracle is doing great. I even have the energy for Pilates and then go home to play with Miles. Around 430, I realize that I've tried to pee about 27 times in a 10 minute period and think that I must have a bladder infection. Nice. I call Dr. Ottavi who orders pregnancy safe antibiotics for me. I take them at 500. But by then, I also have intense pain along the right side of my belly. My brother comes over and insists that we go to the emergency room. I think I'm okay, just in pain, but am convinced it will go away. It doesn't. I call Dr. Ottavi and Dr. McAndrew. I speak to both and both agree with Seth and insist that I go to the emergency room. Boris comes home as Seth and I are piling into his car. He jumps in and we head to Cedars.

Walking into an emergency room 7.5 months pregnant with abdominal pain is never a good thing. It's even worse when your o.b. only has privileges at St. John's. I'm ushered up to the maternity ward immediately. As I'm crying in the elevator, people are congratulating me. I realize it's normal for them to think I'm in labor, but I want to shoot them. I'm taken to a triage room. It's the ghetto and I'm very glad I'll be delivering at St. John's. A nurse enters the room and wants to know what's going on. I explain to her that I have cancer, am on chemotherapy and am having horrific pain on the right side of my abdomen. I tell her that I thought I had gotten a bladder infection about an hour ago so maybe the infection has spread seeing as I have no immune system. I explain that I am not in labor, that I know my baby is fine, that I have had a child and know I'm not having contractions and would like to see a real doctor immediately. She smiles, but says they have to ask me routine questions and need to monitor the baby. She asks me a ton of questions about my pregnancy and then hooks me up to a fetal monitor. I can't sit still because the pain is too intense and have to take the monitor off after a few minutes. I tell her that if I can't see a real doctor soon, something terrible is going to happen to me. She doesn't seem to care. The pain is so crazy that although I haven't thrown up once from pregnancy or chemo, I proceed to throw up a truly shocking amount. I fill an entire bucket and then some. Then some that ends up on the floor is ignored by the staff and Boris ends up cleaning it up because I'm so grossed out. After 2 hours of excruciating pain, a doctor comes to see me. Let me rephrase - a resident comes to see me. I answer her questions and ask her if a real doctor is coming to see me any time soon. No offense to her, but she's 12 and an ob/gyn. I want off the maternity ward immediately.

I wait in agony for another 30 minutes and then the "chief resident," also an ob/gyn comes to see me. He's incredibly handsome and I wonder if he's a fake doctor - like on t.v. His name is Jeff. By this point, I'm hoping to die the pain is so horrific and I have no patience for people who aren't going to help me. I hear Boris telling my Dad that I'm "hostile." I prefer to think of it as advocating for my rights. No one else is. I tell Jeff that I need drugs 2.5 hours ago and that I'm pissed that no one seems to care about me, just the baby. "My baby is fine," I tell him. Jeff says that I'm there as a mother too, and he needs to take care of both of us and he can't give me pain medication until he's monitored the baby for 20 minutes. "Well, Jeff," I tell him, "I've been here for over 2 fucking hours so you and your stellar team have certainly had ample time for monitoring. And please don't patronize me about motherhood. I was diagnosed with cancer and opted to risk my life to have this baby. My tolerance for pain is more than you could possibly imagine. I have all kinds of pain and side effects on a daily basis that I suffer through without so much as a Tylenol for this baby. So if I tell you that this is the worst pain I have ever experienced in my life - like more than trying to push a 9lb+ baby out of my vagina without an epidural, which yes, Jeff, I tried to do for over an hour - I am totally fucking serious and need drugs NOW." Jeff tells me that he has treated pregnant women with cancer and that his mother had cancer (thanks for sharing) and promises that I can have pain medication after the 20 minutes of monitoring. Fine. In the meantime, I ask him why no one has taken my blood or ordered other tests to find out what the hell is wrong with me.

A nurse comes into my room a few minutes later and I ask her to hook me up to the fetal monitor (it's clear that that is not why she came into the room). I'm watching the clock like a madwoman counting down my 20 minutes. Actually, we're watching The Hills Live Aftershow and Boris is trying to understand why it's a show and why anyone cares about these people. I have less than 5 minutes to go and I tell Boris that he needs to find the nurse or doctor to make sure they give me drugs the second the 20 minutes is up. He says they'll come to us when it's time. Are you kidding!? I start screaming at him that if he doesn't get someone to ensure I get drugs the second my 20 minutes is up, I will run out into the hallway half naked in my gown and bald head and take care of it myself. It was very Terms of Endearment of me. Before either of us can leave the room, a beautiful nurse named Rachel comes in. She should be on t.v. with doctor Jeff. She tells me she's come to hook me up to the fetal monitor for 20 minutes. I go a little ballistic and tell her my 20 minutes are up in 2 minutes and she better have drugs for me. "What is going on here?" I ask. "Do you people speak to each other at all?" She leaves the room and returns to tell me that Jeff didn't order pain medication for me and he's gone into a c-section. "Rachel," I say, "I suggest you get him out of the c-section or find another doctor or nurse to write the order. This is a fucking hospital, right? Surely you can find someone to write a prescription and I know for a fact that most narcotics are safe during pregnancy." She leaves the room. Finally after 4 hours of suffering, I get a shot of morphine. It barely helps at all. Jeff comes back and tells me that he's going to order some additional tests (after 4 hours they asked for a urine sample, nothing else). It's about time. What doctor doesn't take blood immediately when you tell them you're pregnant and on chemo. Hello infection anyone!? Nurse Rachel tells me one of the ordered tests is for preeclampsia. I turn to Boris and lament that they are going to kill me. Preeclampsia?

I have to wait another 30 minutes for someone from the "i.v team" to come access my port. I totally understand that nurses on the maternity ward don't know anything about ports which is why I had wanted off the ward like 4 hours ago. My blood is taken and I'm given fluids. Jeff tells me that he's thinking I either have a kidney infection or might be passing a kidney stone and that I can no longer eat or drink anything. Not that I was chowing down or anything but I had lunch at 230, barfed it up and then some up, and was feeling weak and thirsty. Oh well. He also tells me that he's ordered an ultra-sound of my liver, kidney and gall bladder. Amazingly, even though I'm on the Labor and Delivery floor, there aren't any portable ultrasounds available so I have to go to the imaging center for my scans. Before I'm wheeled away, Dr. McAndrew comes to see me. I've never been happier to see her. "A real doctor!" I exclaim. "Dr. McAndrew, you have to help me," I cry. "No one cares that I'm in pain. They only want to monitor the baby and no one knows what they're doing." She assures me that Jeff is doing a good job but promises to get me more pain medication. She says that the results from the urine test are fine so no one is really sure what's going on. "You would have blood in your urine if you had a kidney stone," she explains, "and there's no sign of an infection. You're always rare and never an easy case," she says and smiles. "We're working on it. If the ultrasound doesn't reveal anything, we may want you to have a CT scan. Even though there is some risk to the baby, the risk is outweighed by something being wrong with you and we need to find out what it is." I'm still in so much pain that I agree to the scan if it's necessary. I also beg Dr. McAndrew to make them give me more morphine, which they do. I'm still in pain, but am no longer writhing around in agony, so I guess that's progress.

The good news as I inform Boris is that I am now totally at piece with my scheduled c-section. Initially when I got pregnant, my goal was to have a vaginal birth. I had watched The Business of Being Born and not only wanted a vaginal birth, I wanted to deliver at home, with a doula or midwife in my bathtub without any drugs. I'm serious. Ask Boris. But after 4 hours of the worst pain in my life, I'm 100% over the whole natural birth thing. I want to be hooked up to an epidural as soon as humanly possible. Pain free and civilized sounds damn good to me.

Rachel wheels in a wheelchair and I'm taken to the imaging center for my ultrasound. I'm freezing (it's crazy how warm hair keeps you and how cold chemo makes you) and nurses are wrapping me up in blankets as I'm pushed down the hall. It's very sweet. Even though I'm bald, they're asking if this is my first baby and are smiling because they think I'm in labor. I just look at Boris and roll my eyes. It's a nightmare. The ultrasound technician asks me a few questions and then starts the scan. He's running the machine over the top portion of the right side of my belly. Not at all where I'm in pain. Then he moves to the left side. "Are you going to look at where I'm actually in pain?" I ask. "I know what I'm doing, okay?" he says. "Absolutely. But I have no pain whatsoever on my left side, so just asking." Jesus. He asks where the pain is and does run the machine over the area before dismissing me. I go back up to my shitty room with the most uncomfortable bed on earth (the kind that breaks down - mommies - you know what I mean) and I wait some more. It's almost midnight and Jeff comes to the room to tell us that there's nothing out of the ordinary on the scans. He's waiting for a portable ultrasound and wants to take one last look at me and the baby and then he'll let me eat, give me more drugs and let me go to sleep. He says that all of my tests are normal. No signs of infection whatsoever and he doesn't think the CT scan is necessary. Scary that no one knows what's going on with me, but I'm relieved to not need the scan.

An hour later Jeff returns with the ultrasound. Miracle Warrior is moving around like a superstar. His foot is jammed up against the right side of my belly, right where I'm hurting most. Interesting, but highly unlikely that such a teeny tot is causing so much pain for so long. Everyone is at a loss, but I get Vicodin which actually relieves the pain, so I'm finally happy. Exhausted, starving, but not in pain. Rachel wheels me to my new room which has a bed for Boris (poor guy has been trying to sleep in a rocking chair) and orders us food. We meet our new nurse, Beverly, who tells me that the second I start to feel any pain, I should call her so she can bring me more drugs. Rachel assures her that she doesn't need to worry about me asking. Now that I'm not in agony and am not starving, Rachel and I talk about my pregnancy and my cancer and she's very sweet and caring. Boris and I eat, drink, I take Vicodin and we pass out at 300am. We get a few hours of sleep before the pain comes back and I have to call Beverly for more drugs. When she comes in she tells us that the doctors are changing shifts and they are going to discuss me at 800am. They'll determine whether I have more scans or go home a mystery.

At 730am, Miracle Warrior kicks the crap out of me and the pain is gone. Poof. Just like that. No pain whatsoever. Doctor Jeff comes to see me after the changing of the doctor guards and says that the full work up from my blood reveals absolutely nothing except for a potassium deficiency. "You were my most boring labs of the night," he says. "I can give you potassium pills or you can eat a banana." I tell him I've been potassium deficient for several weeks and I'll eat a banana and the next time I go in for hydration they'll give me potassium. I tell him that Miracle Warrior beat me up and now I don't hurt at all. "Fascinating," he says. Then he tells me that the doctors all agree (read he spoke to an actual doctor not a resident) that I can go home. Dr. McAndrew also comes by and agrees. She says that she's called Dr. Silverman and I'm to go straight to his office from the hospital. Done. She says that they're going to find someone who can flush out my port (I've been receiving fluids all night) and discharge me. A nurse enters the room and gives me my discharge instructions (all labor related). I'm to come back if I don't feel Miracle Warrior kick me 10 times in a 1 hour period (he kicks me 10 times every few minutes, so no problem there), start bleeding or a host of other totally irrelevant problems. She reminds me many times not to forget to go to Dr. Silverman's. Then she flushes my port and tells me we're free to leave. "Um, there's a giant needle in my arm," I tell her. "Aren't you going to take it out?" She says "that's your port, not a needle." OMFG. "I need to speak to someone who knows about ports, now." She tries to convince us that she knows about them and then has some sort of an epiphany, realizes I'm correct, and says that she can just pull the needle out - but there's no way I'm letting her near me. I tell Boris that we should just leave and go to Tower and have someone who knows what the hell they're doing take the needle out. That's what we do and hot nurse John is a dream after the nightmare of Cedars. He removes the needle and Boris and I go to see Dr. Silverman.

We're seen after a short wait and Miracle Warrior is a miraculous warrior who is doing great. He's actually big for his age. He's in the 66% for size and we couldn't be happier. Dr. Silverman assures me that the morphine and Vicodin didn't harm Miracle Warrior at all (he says there's very little I can do to really harm him at this point) and then we discuss my delivery. I tell him that I want to deliver at 38 weeks. He says that it's much better for me to deliver as soon as possible so that I can get on with my treatment. After my experience at Cedars, it's so shocking to hear a doctor (particularly a baby doctor) take me into account and want to do what's best for me. He says that statistically, Miracle Warrior's lungs will be fully developed at 37 weeks, and says that we should do the amnio then. If his lungs are fully mature, we'll deliver. He promises me that once his lungs are mature, there is no difference in delivering at 37 or 38 weeks and reiterates that it's better for me. He says I should come back in 4 weeks and wishes us a better and happy new year. "Things can't get worse," I say, "so it just has to better." Always a realist and never one to mince words, he says "well, it can get worse, but we're going to hope that it doesn't."

We are. We are. We are.

We go home. Miles is so happy to see us and we him. We eat lunch together and then we all nap. I don't wake up for 4 hours. I wake up to Miles yelling "hi!" and hear him toddling down the hallway. Later that evening as I'm filling up the tub for his bath, Miles pulls up my shirt and kisses my belly. Swear. He bathes, has his milk and then we snuggle before I put him to bed. After about 5 minutes of the most tender snugglage ever I ask him if he's ready for bed. "Noooo" he whispers. "Okay, monkey," I tell him. "You let me know when you're ready. We'll snuggle until you are." After a really long time in Miles minutes, he looks at me, smiles and says "bye bye." I kiss him a zillion times and put him in his crib.

Over the next few days I've experienced a few twinges that are similar to the pain that drove me to the hospital, but nothing as severe and nothing that lasts longer than a minute or two. Yet again, I'm a medical enigma. The mystery of Sharon continues.

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