The plan and the high risk OB

After yesterdays amazing ultrasound and fabulous appointment, I thought I should take a minute to speak about the details.

First all OB doctors run behind schedule. And it woul be wise to know that you should come prepared to
Wait for quite a while. My appointment was at 0900 and it was nearly 1100 before I saw the doctor. While this might irritate me in family practice I dont mind waiting for the OB doc. He took his time and wasnt rushed with me so I actually dont have any complaint.

Dr. H was amazing! And since he is the Complicated OB doc it looks like I will be staying with him. After a basic summary of my health history and discussing my previous losses he decided that it would be best to run a ton of tests. In my distraction from the ultrasound I didnt even ask him what all they were going to run but I will make sure to get the results.

After the basic meet and greet it was time to strip and get into the gyno stirrups for the exam. My uterus is swollen and maybe a little
Larger than it should be for the gestational age, but that could be due to my friendly fibroid. The ultrasound was wonderful! He showed me Baby Bean and I could see the little flicker of a heartbeat, it was beautiful and I couldnt help but cry.

Then he turbed up the volume and played a little snippet of the heartbeat tracing, WOW! I can honestly say that I have never heard such a beautiful sound in my life!

According to the previous doctor I was to be dur on 9/15. That date was based on my last period. Now I knew that the date was wrong because I know when I ovulated. The current measurement of BB (baby bean) shows that He will be due when I originally thought on 9/19. I am measuring approx 7 weeks and 1 day now.

So where I had originally intended to post my 8 week questions tomorrow, they will wait until Sunday.

The doctor is sending me for some additional testing, an NT scan (A test for down syndrome) and to talk with a genetic counselor.

My next appointment is in two and a half weeks and he will likely do another Ultrasound and somemore blood work. Im waiting for the fetal medicine doctor to call me to schedule to extra testing and that should also be happening in the next 3-4 weeks.

Dr. H and I discussed the benefits and risks of continuing on the Progesterone and since he has no specific
Opinion on it, I am going to continue taking it but reduce to nightly instead of three times daily. The reason is that the amount of absorption is increased while sleeping due to bed rest and the lack of gravity (they are NOT oral people!)

So Here I am. I am pregnant with a little fighter in me who is growing like crazy. The Dr sees no reason that this wont result in a real live baby and gave me the statistic of 90%+ chance of survival now that we have seen a heart beat.

Am I convinced? Not totally. But Im surr excited to get to keep moving forward with every single moment of this baby. I will enjoy as much of it as I can and be eternally greatful for every day that I am given. And then Im going to pray like crazy an do everything I can to ensure this babies safe
Arrival!

Next up… The Dr visit versus Centering choice.

Baby Bean picture

Again I apologize for the photo of a photo….

And..

Its a baby!! 140 beats per minute! Due date has been readjusted to 9/19. (the date i originally said!) I cried when I heard the flutter. Best day so far!

Thank God for giving me another day to be this babies Mom!

Things I cant comprehend

Im sitting at the lab and this 60-70 year old man walks in carrying an oxygen tank (portable one) he has a cannula in his nose and is breathing heavily.

He sits down behind me and I start to gag on the smell of cigaretts. I turn to look at him and can see the pack of Marlboros in his breast pocket.

At what point to people realize that smoking is going to kill you? And at what point are they going to stop offending me senses with their nastiness.

The hospital is a odor free facility. We are asked not to wear colognes, perfumes or incredibly smelly lotions and yet stinky people waltz in with no problem.

I think the Glucola is making me grumpy.

Ultrasound day update number 1

Had to get some pre-appointment blood work. Im actually a little surprised that they ordered a one hour blood glucose test.

Not thrilled that it looks like a 12 year old will be drawing my blood. And the crap to drink tastes like caro syrup. Yuk

All my thoughts are focused on tomorrow

Tomorrow is the BIG ultrasound. I say it like that because this is the ultrasound that determines the fate. Its dramatic, right? If tomorrow there is a heartbeat then the babies survival rate jumps to 90% or more. If there is no heartbeat then it mean end game.

Its hard to stay in the moment with this looming over me. I wonder when all of this will stop being such a big deal and start just feeling like a normal pregnancy? Im guessing I will start being less stressed about the pregnancy the day the baby is born.

In the mean time I have classes today and the rest of the Neuro content to learn. I did well on the Neuro quiz and am hoping that it is a sign of how well I will do on the Neuro exam next week.

Only 11 days until I get to see the hubby! Its been almost a month since I saw him last. I cant wait!

Dealing with alcohol withdrawal

Working in just about any type of clinical facility you are likely to run into alcoholics and those who are going through withdrawal symptoms. I never really realized how dangerous withdrawal can be. It can be deadly. Amazingly the booze can kill you but so can discontinuing drinking abruptly.

I was talking with a Nurse on the unit today about a withdrawal patient and she was telling me about it is imperitive to ask patients if they drink and how often. And if it sounds like they drink frequently to push for how long it has been since their last drink. She said that sometimes she will even warn them about the importance by telling them that they can go into seizures and die if they go into withdrawal without the proper precautions inplace.

I knew a person a few years ago who was embarassed by his drinking and therefore lied to the doctors and nurses about how long it had been since his last drink. Sadly after 10 hours in the ER for an issue unrelated to ETOH and then being admitted and on the floor it had been about 20 hours since his last drink and he had a grand Mal seizure.

This poor guy wound up in Status Epilepticus secondary to alcohol withdrawal. Status Epilepticus is a serious medical condition that can be fatal.

Long story short, it is important as nurses not to pass judgement and to find a way to gain the trust and establish a relationship quickly with your patient so that they are willing to share this type of information. Never judge a book by its cover, just because the patient isnt a 50 year old homeless man with rotten teeth and booze breath doesnt mean that they arent possible alcoholics. Ask everyone. It can save a life.

And for those non medical folks, it is very important not to lie to your Nurses and Doctors. The information that they ask for is not because they are curious, it has a valid place in preventing serious complications.

And now, I step down from my soap box.

Happy Tuesday Everyone.

The controversy deepens

So remember the other day when I said I was going to stick with the family practice doctor because I was treated so badly by the receptionist in OB?

Its amazing how quickly things change. After I made the appointment to speak with the CO of the hospital, suddenly on Monday everyone who had treated me badly (I havent had the appointment yet BTW) start calling me to see what they can do to make my experience less stressful. Seriously.

Suddenly, the complicated OB Doc (the one whose receptionist said wouldnt see me until 10 weeks) has an appointment available for me for this afternoon. Suddenly the radiology department (the same one whose tech verbally assaulted me a few weeks ago) has appointments this week to recheck Baby Bean for a heart beat, even though last week they were booked until the middle of February. Its amazing, huh?

I have to say that the stubborn part of me wanted to tell them to “shove it” and just continue with my current plan. But the responsible person who is choosing the best for me and my baby knows that I need to see the complicated OB doctor. So I conceded and accepted the appointments.

That brings me to today. This afternoon I attended my Nurse intake appointment and filled out all of my health information. I got the information, handouts and consents for the NT scan. I had nearly all my blood sucked out into 7 little vials. I was weighed, measured and told to continue doing what I am doing.

I see the complicated OB doctor on Tuesday, where I will get my physical, an ultrasound and he and I will discuss the future plans for this pregnancy, assuming that Little Bean has a heartbeat.

Now I dont mean to get too pessimistic about this, but I know that there is a chance there wont be one. I know that in my brain. But my heart prays that Little Beans heart is beating away as fast as a nearly 8 week fetus’s heart should (relatively 130-190 beats per minute (BPM)). Im praying, because Little Bean has my heart already in love with his (hers).

I had my moment today. I hope that saying it doesnt jinx it, but I had the moment where I really thought about how amazing it will be to bring home Little Bean. I thought about being a Mom to him here on Earth. I started fantasizing about nursery gear and diapering and breastfeeding and labor. Those are forbidden things. Scary things. Those things allow me to venture into creating memories with this baby that can be broken if something bad happens.

But I wont think about that today. Today I am pregnant and I love my baby. And I am thankful for the 7 weeks that I have had with Him. I am praying for another lifetime of memories, but for now I am happy with my 7 weeks and counting.

Week 7

How far along? 7 weeks

Total weight gain/loss: -1.0lbs, -2.5lbs so far

Maternity clothes?: Still wearing the sleep bra, and I love one of my pairs of maternity pants. With the new weight loss I am easily wearing my old pants again. Amazing what 2lbs will do for the bloat.

Stretch marks? Still no new ones….

Sleep: Im exhausted, but cant sleep more than two hours straight because of potty breaks.

Best moment this week: This week hasnt been the best week. Im so ready to be onto week 7.

Movement: Still have alot of cramping.

Food cravings/aversions: Rather than Morning sickness, I have horrible food aversions. I will go to eat something and I can feel it in my bones not to take another bite, if I push that then I will vomit. Otherwise the only food Ive been interested in in Pineapple. I went three days eating nothing but a little pineapple.

Belly Button in or out?: In and will be for awhile.

What I miss: This week I food alot. I just couldnt eat. I wanted to eat but couldnt. God I missed food this week.

What I am looking forward to: Starting with the new doctor and consulting with the High Risk OB doctor.

Weekly Wisdom: Pregnant until proven otherwise.

Milestones: This week baby has working kidneys! And is developing a tongue and mouth. The arm and legs are budding too!

Symptoms: Exhaustion, moody, crying spells, repulsion of all things with smells, spending the day gagging, and this week on top of everything else I have a cold. So that is making me feel miserable.

On to a new week! Grow baby Grow!

Controversial

So I promised to ellaborate on my controversial health care decision. And so I will.

If you have been reading for any length of time and recently, you may have noticed that I am pregnant and have had a miserable time with my healthcare trying to get appointments.

That being said, I needed to make a decision that would be the best for me and my anxiety level and one that would relieve some of my stress. I opted to stay in family practice and have my PCP be my OB doctor. In my hospital it is not unusual for Family practice to be used as OB care for the lower risk population. I am still planning on going to see the high risk OB for a consultation and I will express my discontent with the OB department then.

Why would I decide to do this? Well….after calling for an appointment I was soured by the support staffs general attitude. And I walked away feeling like my pregnancy had somehow incovienced the OB department. One conversation was enough for me to want to just walk away from any type of prenatal care (it was my gut reaction and not a choice I would truly make).

Here is the conversation that caused me to come to my decision:

I called OB to make my appointment (refferal is in place I just needed to schedule). I gave the receptionist my name, SSN, DOB, and EDC. She looked up my referral and said that I needed to be seen by DR. Keepmepreg (fake name obviously) and that his first available wasnt for 3 weeks. I would be nearly 9 weeks pregnant by then. I agreed to the appointment and hung up. Then it occured to me that I had seen flyers around the hospital stating that the first prenatal appointments are done at 6-8 weeks, so I called back. JoAnne (the bitchy receptionist) answered my question and confirmed that in a healthy normal pregnancy the first appointment is at 6-8 weeks, but that I would not be being seen until 9 weeks. When I asked why, since that doesnt seem to make sense to me. SHE stated “Well, lets make sure you are still pregnant by then before we give you an appointment”

I would love to say that I am exaggerating, and that all of my recent experiences with Tricare have been all in my head, but Im not. This is totally serious.

Due to all that I have been through and all the hassle and stress that this has caused I needed to make the best decision for me. One that would leave me feeling secure and stress free.

I have an appointment in 1.5 weeks with the CO (commanding officer) of the Naval Hospital to discuss the ongoing issues that have come up in just the last couple short weeks. This will also be my meeting to try and get the ultrasound tech removed from her job, a plight that I have not given up on.

So there you have it. What type of doctor did you use for your pregnancies? Family practice, OB/GYN, MidWife, Birthing center, hospital birth, or home birth?

The first baby picture

Dont be embarassed if you cant see it, I had to be educated and now I see a bubble.

Last night I had some unusual bleed and cramping and was worried that something was wrong, so off to the ER we went. I am fully aware that there would be nothing that they could do if there was something wrong, but I needed to know one way or the other.

I got to the ER and was fully prepared for a long wait, but things went smoothly. After blood work and an ultrasound they sent me home as “Threatened Miscarriage”. My Hcg was 11,451. The ultrasound did show a little blood in my uterus, so I am hoping that it is nothing to be worried about.

The tech was phenomenal! She was able to visualize the gestational sac and a yolk sac. She did not see a fetal pole or heartbeat but said that it may just be a couple days early.

All in all, its just a wait and see game. Grow baby Grow. I have a follow up ultrasound (my original ultrasound) is on Wednesday. So hopefully we will have a heart beat then and my chances of this babies survival will go from 50-50 to 70-90% chance.

When was your first ultrasound? And what did you see?

Hating Tricare even more….and some people are idiots.

Lets start with the simple facts, I have an ultasound next week on Wednesday. The reason for this ultrasound is so that I can get in to see the OB doctor early and get some additional workup to try and keep this pregnancy. Makes sense, right?

So I get a phone call from OB today, and they want to schedule me for an appointment for Feb 2 to talk with the OB doc. Thats not too bad. But then I ask, how soon do they usually start the Ob visits? And this just blows me away. The lady says that they like to have the first visit between 6-8 weeks. So I mention to her that I will be 8 weeks already by that time and then she says “Well this appointment isnt for your first OB visit, you will have to schedule that a different time, this is just a visit to discuss your history of loss.”

SO let me get this straight, I am higher risk and therefore you are going to give me an appointment LATER than the average pregnancy? WTF? What is wrong with people? Is this making any sense to anyone else?

Im trying to keep my cool, because it seems that no one seems to understand whats going on. At this point I think the only thing on my side is prayer, and thats because the doctors and staff arent doing their jobs.

Here’s to praying that the ultrasound goes well and that all this was nothing but a speed bump.

Sleep log

There has been no hiding the fact that for the last week I have not been able to sleep…at al! Not at naps, and definitly not at bed time. Ive tried everything. I have not had caffiene, I dont eat right before bed, im not working out before bed, I dont watch anything exciting or overly stimulating before bed either. And yet…. No sleep.

Yesterdau was the last straw, a hormonal, tired Me is not a happy or functional me. So I decided to implement a little prebed routine. On top of my already very exciting regular activities (brushing teeth, combing hair, washing face, etc) I decided to use a little lavendar lotion and put on some soothing music and I laid in bed and talked to my little orange seed for a few minutes. And… It worked!

I slept a glorious 7 hours last night! With only hourly visits to the bathroom, it was excellent!

In other news I finally got my lab tests back from last week. All negative! So I dont have antiphospholipid antibody syndrome, no clotting or bleeding disorders and nothing else that seemed to pop up as suspicious. This is all fantastic!

I also finally got my 12dpo progesterone level back at 12.89. The normal range for the first trimester is huge 9-47 is considered normal. And since I was not even 4 weeks pregnant when I got those labs I am quite impressed.

Im am a tad disapointed in my doctors staff and cant wait until I can be transferred to the OB. His RN was giving me some shady advice that made me really think that the information wasnt coming from the doctor. Maybe I am jist being overly sensitive?

5 days until the ultrasound! Grow baby grow!

Ethics class

In my Nursing Ethics 2 class we are assigned a group project (GROAN!) and I was lucky to actually get into a small group that seems like they have their shit together. The topics were all put into a bowl and each group pulled one topic, my group got Cloning.

The project includes a paper and a presentation, and the part of the project that is mine is to find the common grounds between the pro and con sides. I started reading on Cloning tonight and I have to say that I am generally confused about where I stand, I dont know what position I would take.

Lets be specific here, Im talking about human cloning. Do you think that it is right? Moral? Should it be made legal? If you think it should then why? And if you think that it should remain illegal then what are your reasons for thinking so?

Cloning makes me worry that the clones wouldnt have rights because they wouldnt be “regular humans”. Would this be breeding a society of people to be abused and taken advantage of? Would the clones be used specifically for growing organs for transplants? There are just so many questions.

And what about eating cloned meat? Would you eat a burger if you knew that the meat was from a cloned cow?

Wow, what an interesting project.

More Tricare screw-ups

And today the shit hit the fan. Really. I show up for my ultrasound at 0645 for a 0730 appt, and at 0715 the ultrasound tech comes out and asks me to follow her. So I head back and once we get into the hallway the lady starts lecturing me about how it is too early to have an ultrasound and that I need to just take a chill pill and go home and come back when I am 12 weeks along, because until then there is nothing that anyone can do for me. Then she proceeds to tell me that I am a hypochondriac and that there is no need for an ultrasound this early, and that this isnt her job it is family practices job.

I am standing there all flabbergasted and I couldnt think of anything to say while she was lecturing me. I really couldnt even catch my breath, I just said “oh oh ok….” and thats all that could come out of my mouth.

And then as I walked away, I felt Typheni starting to come out of her cage. I could feel my heart rate raise, my skin got flushed and my mind got incredibly clear. This means war.

I stormed over to family practice and got a walk in appointment with my PCP. He said he would get started on getting me an ultrasound in a different location, and he would call me later today. From there I headed o
ver to the Tricare service desk, I filed a complaint there and then discussed with them moving to an outside provider. After that I headed to Customer service, I spoke with the lead HR lady and explained the situation to her. She wrote down all my details and everything that was said by the tech, after she finished writing she asked me what I hoped to achieve (as that is part of her proceedure), I explained that I completely understand that I am still early and that there may not be much, if anything that can be seen yet and that I might end up coming back again in another week, but my goal in coming to her is that I want the tech fired. I want her gone.

She looked shocked at me response, and I explained to her that I have atleast 6 more months of my pregnancy that will be spent here (God willing) and that I have 6 months until I transfer for the Big Move and I intend to spend that time pursuing the conclusion of this event. I will have justice, I will have her job. I will not let anyone treat me like this ever again. EVER.

This is war.

Ultrasound day.

Im up and heading out to my ultrasound. My bladder is full as they require and I can feel my knees shaking. Im praying for the absolute best.

Some questions that have been asked:

1) Why are you so nervous? Well that question is a little more difficult to answer. My blood results look great, everything points to the greatest possible outcome….However….I have had a couple losses in the past for no explainable reason. I believe that the catalyst was the horrible amount of stress I was under during those pregnancies, I was not in a good marriage and times were very unhappy. Things are different now, and since there is no reason (that is known) for those losses I find myself at the mercy of the medical world. Losing a baby is impossibly hard, and I can still feel the memories of those losses fresh in my mind. Im just scared because I already love this baby so much and am so attached to it (as I was with my other babies).

2) Why are you having an Ultrasound so early? THis is simple, the doctors are also unsure what caused my previous losses and so they are observing me closely.

3) What will be seen on the Ultrasound? Well, as previously mentioned I am very early, only 4 weeks and 5 days. This means that there isnt a ton of stuff to see on the ultrasound. Hopefully the tech will be able to visualize the gestational sac but other than that, I am just hoping to get a good visualization of my fibroid and to be told to come back in two-three weeks to see the heartbeat. That is the best case scenerio. I wont go into the bad stuff since I dont want to think too much about it.

Any other questions?

I will post more when I get home and know more. Happy Monday everyone!

Forced or persuaded?

My school was nice enough to send out an email a couple weeks ago stating that some of our clinicals sites would not be allowing students to do their clinicals without proof of H1N1 and seasonal flu vaccination. They would accept confirmed medical or religious reasons, but would not accept only the standard “decline” form. The email also stated that any student who was not vaccinated would be required to wear face masks the entire time on the clinical site whether symptomatic or not.

So against my personal beliefs about the flu shot I went and got vaccinated for both of the schools required immunizations. So why am I upset about this? Because now I am being informed that the school mis-spoke and has recanted their original statement. And now they are just strongly encouraging it.

What would you do? I am now vaccinated there is nothing for me to really do. But what do you think about the program being able to require an injection? Does anyone elses programs do this?

Could it be cancer?

As a very pale caucasian and a blonde, I am at an increased risk for skin cancer. I try pretty hard to keep the sunscreen on, but my love of warmth causes me to burn a bit.

With my last pregnancy I had a funny mole that changed substantially. It grew, changed shape and even got a funny black spot in it.

So I went to the dermatologist and he called the mole suspicious. He then suggested a shave biopsy.

Now my ugly possibly cancerous mole is now a hideous spot on my back that hopefully wont scar too much.

Fibroid fun

I have a fibroid. Here is a little fibroid education in case you were wondering….

A fibroid is defined as a non-cancerous tumor that originates in the smooth muscle layer and connective tissue of the uterus.

Mine is relatively small. Should not pose any problems, however I am going to have to have routine Ultrasounds every 6 months to make sure that nothing is growing.

Anyone else have any experience with these?

The other side of the curtain

Last night I had the priveledge of experiencing nursing from the patients perspective. After being told that my PCP could not see me, the nurse sebt me to the ED.

8/10 abdominal pain and 4 hours later I was diagnosed with an ovarian cyst and my appointment with the magic dildo camera was moved up to today.

Some of the things that I learned last night are valuable lessons for nurses to know. For example, sitting naked in an exam for for 20mins really does feel like hours. And when someone is having an exam done it really does make the patient feel little when there are a dozen people that walk in and out of the room during the exam.

My experience really was positive though. I was seen by an amazing nurse who even went to the same school that I do! She is good friends with one of my favorite professors!

All in all…Im gonna live.

I hear whispering between my legs

To the wonderful Doctor who performed my annual exam,

Thank you so much for insisting that I need a same-gender standby. It made me reassured that you as a male doctor were looking out for me.

However I do not think it was appropriate to have the standby be a woman who you are obviously having a relationship with.

And, I do not think that flirting with her and whispering in her ear while you have you hands on a speculum is acceptable.

I know that the world of dating is incredibly diverse but hitting on a woman while standing between another womans legs is just plain weird.

Thank you for being gentle and good luck with Nurse Betty.

Sincerely,
The head attached to that who-ha you were working on.

Im blind, and going to see Wicked!!

<20/30 OD, 20/60 OS>

I finally got my eyes checked the other day, and it turns out that I need glasses. Annoying but at least I will be able to see, and maybe this will stop the concentration headaches! So above you will see my amazingly cute new school glasses!

They should be coming in sometime in the next week or so, hopefully just in time to see WICKED at the Paramount Theater!! Im super excited!!

T-18 days until school…..

Mr. Poo Eye

Dear Mr. Poo Eye,

Its really gross that you dont wash your hands after taking a shit. Its even more disgusting that you managed to wipe your own feces into your eyes. You are not a child, the lesson is simple…WASH YOUR DAMN hands.

You deserve to be laughed at by your girlfriend….you are pretty gross.

Signed,
People who dont want conjunctivitis.

Dermabraision gave me hickies

What an adventure today, on my way to my “Girl Date” I stopped at my friends office to pick her up and was given the opportunity to have dermabraision done for FREE!!

Always loving free stuff I willingly submitted, I was fully prepared for a horrible encounter and screaming as my face is scoured off……but that wasnt how it worked out at all! The Aesthetician was the nicest lady and was very entertaining!

I started out by cleansing my face of makeup (eyes excluded!) I used a gentle facial cleanser. Then headed into the room. The feeling was interesting, the machine has a suction attached to a derm pad. As it lightly abraises the skin the dead particles are sucked into the vaccum and will be disposed of later. It really doesnt hurt, it feels, as my friend put it “Like a giant cat licking your face”. Ah yes G, I couldnt have worded it better!

Below are the pictures of my encounter:

On the drive to get the dead skin sanded and sucked off my face....

It doesnt hurt, see...Im smiling!

It feels kinda like a cat licking your face....really!

Almost done...

The Magic skin sucking machine

The after picture, red splotchy face, but oh so soft!

The only downside to the proceedure is that I noticed I have tiny micro hickies all over my neck from the vaccum! Oh well….it keeps things interesting!

Do it yourself rectal temp

Patient comes in for possible heat stroke, or over-exposure to sun. The staff needs to get a VERY accurate temperature on the adult patient, meaning rectal temp.

Turns out the patient is a NURSE.

So what does she say?

“Go out of the room, I WILL do it MYSELF!”

The funniest part….she really did….and even wore a glove!