Tuesday, February 5, 2013

Still Workin'

Well, saw the doc and I'm good to go back to work if I want to.  (I forgot to ask about improv shows, but I figure if I can work a 12-hour nursing shift, on my feet, then I can do a 2-hour improv show.) 

It's up to me now when I want to stop working.  "Let me know when the twelve-hour shifts get to be too much," the doctor said.  "Usually somewhere between 28 and 32 weeks, they get to be too much."

"Ok," I said.

I'll see how I feel.

Sunday, February 3, 2013

Issues

So last Thursday night I did an improv show.  We do one once a month, and this was like any other.  I am pregnant onstage, which is kind of special, but my belly is still remarkably small, so it's not like I'm super pregnant.  We make pregnant jokes as part of the show, but actually we've always done that.  Turns out pregnancy is a great thing to joke about.

Anyhoo, we came home after the show, had a late dinner, watched some TV, and went to bed around 1am.  As I'd been lying on the couch watching TV, I'd noticed some contractions.  Now, I've been having quite a few contractions off and on throughout the last few weeks -- the previous Sunday I'd had so many at work that I called the doc (he told me to call and describe my contractions if I had four or more in an hour).  I ended up talking to the nurses at the Childbirth Center at the hospital, since the doctor was temporarily unavailable.  They told me to go home, lie down, and drink lots of fluids.  They told me that's what the doctor would tell me to do, too.  So I left work early, at 2:30pm, went home, lay down, and took a little nap.  That didn't quite make my contractions go away, but after I woke up, I got up and walked around a little, then sat at the computer and surfed the net for a while and that made them go away. 

Then Monday, Tuesday, and Wednesday were quite normal.  I even worked on Wednesday and it was a hard day, but I was fine and didn't have any contractions worth mentioning.

Back to Thursday night.  Well, the wee hours of Friday morning, really. 

I went to bed at 1:00 and fell asleep immediately.  Then I woke up at 3:00.  Or was awakened, I should say.  By a very strong contraction.  I got up, peed, and went back to bed.  But the contractions kept coming.  Every few minutes.  And it felt like my uterus didn't even relax between contractions, really.  Like it was just really tense.  I laid in bed for an hour or so, wondering what was going on, whether I should call the doctor, what I should do. 

Trent happened to be up, so I got up and went to talk to him about it.  As they had the previous Sunday, my contractions slowed and even stopped once I got up.  We talked for a while, then went back to bed around 5.  It took me a while to get to sleep; I think I fell asleep around 6.

Then I was awakened again.  At 8:30.  By another strong contraction.  My uterus started doing its contracting thing again.  I didn't know what to do.  I peed again, then went back to bed.  I lay in bed exhausted, not knowing what to do.  Should I get up in hopes that that would make the contractions go away?  But I was so tired...

And worried. 

I mean, I've worried a lot throughout this pregnancy (I worry a lot in general), but this was making me especially worried.  Was I in preterm labor?  Was our baby ok?  Was his placenta getting perfused enough with all these contractions?  His little home kept shrinking on him -- what effect did that have on him?

So I decided to finally call.  The hour was decent; it's a lot easier to call the doctor at 8:30 than it is at 4:00. 

I got the answering service, who asked my name and how far along I was in my pregnancy.  "Twenty-nine weeks and five days," I told them.  Then I was connected to one of the midwives.  I described my contractions -- uncomfortable but not painful, maybe five minutes apart.  I told her there was a lot of pressure in my pelvis.

"Well," she said, "it sounds like you're in early labor.  Wait until the contractions are three minutes apart, then come in."

"But it's so early!" I said.  "I'm only twenty-nine weeks!"

"Twenty-nine weeks?" she said.  "They told me thirty-nine weeks.  Oh yeah, you better come in and get checked."

So Trent and I got up, got dressed, grabbed something to read, and headed out to the hospital.  I had no idea how long we'd be gone for.  I made sure I had a toothbrush and a cell phone charger, just in case.

Were we on our way to have a baby?  Oh how I wished I were thirty-nine weeks along.  If I were thirty-nine weeks along, this would all be so happy.  Not terrifying.  Visions of premature babies danced in my head.  

When we got to the hospital, they took a urine sample to check for a UTI (a common cause of contractions) as well as signs of preeclampsia.  Then they put two monitors on my belly.  One to measure baby's heartrate, one to measure contractions. 

Baby's heartrate was fantastic.  140s-150s with all the nice variations they like to see.  Whew.

I sat there in bed and waited.  The contractions had slowed down in the car on the way over.  I wondered if they would come again.

The nurse came back in and did a vaginal swab to test for the presence of fetal fibronectin, a protein that binds the fetal sac to the uterine lining and which leaks into the vagina if a preterm delivery is likely to occur.

Then we waited some more.  The contractions came back.  I was sort of glad (one does want the doctor to be able to see the thing about which one was worried), but also scared.  They were regular and sort of strong.  Painful, even.  I sat very still, and they kept coming.  You could see them on the monitor.  Their little waves were recorded on the strip.

They were really happening.

"You are showing some uterine irritability..." the nurse said.

The fetal fibronectin swab went to the lab. 

I watched the clock and felt the contractions.  I knew, from talking to OB nurses previously, that our hospital's NICU didn't take babies born at less than 32 weeks.  Less than 32 weeks went to UCSF.

An ultrasound tech came in to do an ultrasound of my cervix and check its length.  They do an ultrasound rather than a manual exam so as to avoid irritating the cervix and causing it to efface or dilate where it hadn't before.

The midwife came in while the ultrasound tech was there.  "How's her cervical length?" she asked.

"Three centimeters.  No, three-point-five," the tech said.

"Great!" the midwife said.  "And your fetal fibronectin test was negative, which means you have a ninety-nine percent chance of not delivering in the next two weeks."

Translation: Everything is ok.

I asked the midwife about working, like whether I should keep doing it.  I was supposed to work the next three days -- three twelve-hour shifts in a row.  I told the midwife I was nurse, that I worked right upstairs. 

"Oh yeah, you're done," she said.  I had told her I had a doctor's appointment the following Tuesday and that I would talk to him about work then.  She told me to call in sick until then.  I asked if I could have a note.  A note from a doctor (or midwife) never hurts.

She wrote a note recommending I be off "for the duration of [my] pregnancy."

I wasn't sure if I was ready for that, really, though.  I didn't know what to do.  I was so damn tired.  And still recovering from such a terrible scare.

Trent and I sat down in the lobby to talk about what to do, vis-a-vis work.  We decided to buy some time, to explain what the midwife had recommended, but to say that I wanted to talk to my doctor about it before making any decisions regarding the entire rest of my pregnancy.  My manager was out, so I wrote a letter to her and to the staffing office explaining I needed off till Tuesday, that I would see my doctor then. 

As I dropped it off, I ran into one of my coworkers complaining about how grossly understaffed our unit was.

"That is not my problem!" I thought loudly.  "Right now, I have several problems which are undeniably mine, which I cannot delegate, which belong to no one else, but that is not one of them!"

"Oh," is what I said.  "Gee."

As soon as I dropped off the notes, I speed-walked out of the hospital, almost losing poor Trent.  I didn't want to talk to anyone else just then.

It was sunny and gorgeous as we walked out to the car.  I felt a bit worried as to what to do about work.  I felt tired.  I felt relieved.

"Well," I said to Trent, "at least we're not on a plane to UCSF right now."

At least the baby's still inside me. 




It is now two days later.  I've gotten a lot of sleep since then.  I've had no abnormal bouts of contractions.  What was all that? 

I feel like it's a little early to go off work.  Like 30 weeks is too soon.  Even though I'd be eligible for disability benefits, I like going to work.  It makes me feel secure.  The paychecks are steady, whereas disability would take a while to kick in. 

It feels a little too soon to even enjoy going off work.  I think I'd enjoy it more 3-6 weeks from now. 

If the doctor says it's ok, I want to go back for a while.  It's just a few weeks we're talking about, after all. 

And, while I'm asking, can I keep doing improv shows?