Well certainly don’t get too comfortable

I learned yesterday that my health insurance now requires that all women less than 34 weeks pregnant with symptoms of labor go to the other hospital. As in, the hospital where I delivered Natan (old hospital) and not the hospital affiliated with my current doctors (new hospital). I knew that after January 1, my insurance would no longer be covering deliveries at new hospital, and was very glad to know my due date falls on the right side of the cut off. But I didn’t know this additional immediate detail. I’m not happy about it. At all.

How’d I learn that? By having contractions. Lots of ’em. (I’m okay – skip to the last 2 paragraphs if you just want the details of my condition) Off we went to the old hospital, which I know is also good, so I perhaps just ought to be grateful. But I’m not so fond of it. Starting with the worst memory that isn’t their fault. But beyond that, there’s a lot wrong with that place. First of all, it’s a freaking labyrinth. As I walked from the parking lot to L&D, I remembered the same frantic walk so many months ago when I knew I should not be walking so far but had no choice. I wondered why, when new hospital manages to have nice old men with wheelchairs to take you the 10 steps from the entrance to the elevator and then 10 more steps from the elevator to the check in desk if you need it, old hospital can’t manage the same for a walk about 50 times as long and vastly more convoluted.

Upon getting into the waiting room, I compared the dinginess of the old to the fresh cleanness of the new hospital. When another pregnant woman and her male companion arrived reeking of fresh cigarette smoke, I lamented the tiny size of the room with stained and faded carpeting. I couldn’t escape from them.

After what seemed like a very long time we were taken back to a room for the examination. A midwife examined me, which is fine. Except she called me “sweetie,” and said “I know, I know, it’s so hard” as I tried to explain my history and physical condition. Oh, and she told me my cervix was measuring around 1 cm and she could feel the baby’s head was very low. I sort of panicked but not completely because my rational side was asking, “How can that be possible? Where the hell is the stitch?” Lo and behold when a doctor performed the ultrasound it revealed my cervix was still over 3.12cm and the baby’s head was not low. When the midwife later performed her examination again, with that knowledge, she found that my cervix had returned to a long state and the baby’s head was no longer low! She said that could be because I was now resting. I’d been resting all day. I know these things are variable, but the 1cm seems ridiculous. The distance between the bottom of my cervix and my stitch has been twice that since the start. And I could feel the baby’s butt in my lungs anyway.

But the monitors were catching the contractions, more than they liked. So I stayed overnight. Of course, since I arrived there at 3:30pm and by the time that decision was made it was 7:30pm, I was hungry. I asked if I could eat. Nurse said no. Doctor said yes. Nurse said a different doctor told her no. A different doctor came in and said no. Nurse came in again and said doctor said yes. I said but the doctor just said no. Nurse went out and came back with the word from the attending physician, Yes. Of course by then it was 9pm and the cafeteria was closed. There were other options and a little hunger is no tragedy. When it’s food, it’s humorous.

When it’s a tocolytics regime, however, it’s not. Imagine the above story, only it’s last December and food is replaced by indo.methacin. And I’m supposed to have it every 3 hours and my last dose was at 3pm. And the problem is not that I’ve just arrived but I’ve switched wards. And instead of laughing at the doctors’ inconsistency, the nurse responds with “indo-methacin isn’t a tocolytic and there’s nothing in your chart about you getting those anyway.” And behaves as if she’s just discovered that I’m a drug seeker. Of course she’d be forced to apologize later, through her gritted teeth, and wouldn’t be treating me anymore. The next nurse would be extra compassionate and infer that the previous one is a known b*tch. But really, how does that help resolve a 6-hour lapse in treatment?

Thus the food flap was small but not confidence inducing. I remembered I’d promised myself at the beginning of this pregnancy that I’d bring a notebook to each encounter with a doctor and would write down everything so at least we wouldn’t get confused. But my current doctors and new hospital have been so freaking consistent and have presented such a unified plan for care that I’d forgotten that vow. Many opinions are good, certainly, but it’s probably not the best approach to fight them out in front of the frightened patient and her husband.

Finally, I’ll get to the point. I’m fine. Quite good actually. My hips and back and butt are sore from the night in the hospital bed. My other parts are kind of sore from all the prodding. But the great news is that the contractions didn’t change my cervix any over night. And the fetal fibronectin results came back negative, which means I’m very unlikely to deliver in the next two weeks. The nurse midwife said it has an accuracy rate of 85%. But then a doctor said 95%. And yet another doctor said 98%. For whatever all that is worth. It’s a good test. I seem to have a urinary tract infection, however, and that may have caused the contractions. My uterus got very calm after they filled me 4 bags of IV fluids and an antibiotic. That makes me concerned about dehydration. I will talk to my doctor about it next week when I go back. I know it’s important that pregnant women drink a lot of water. And I do. I drink way way more than the recommended 8 glasses a day – 4 times that at least. I wake up thirsty in the night and drink at least 3 tall glasses of water over the course of my 8 hours in bed. Seriously. I keep getting reminded to drink lots of fluids, and I try to explain how much I really do do that. I think we need to look into this further. I’m getting sick of insisting that I am drinking lots of water only to be told to drink more water. Especially if I’m contracting because of dehydration.

The most exciting news though, perhaps, was that the baby’s actually measuring as big as the average 30-weeker! As in he weighs over 3 pounds! Considering my fears that this will happen early, that’s fabulous news (although I realize the measurements are not always precise). Because of the fetal fibronectin results and because my cervix seems to be holding up, the doctors decided not to do steroids. They want to hold onto that option in case I do go into labor early because it’s apparently best to administer the shots as close to delivery as possible, but they can’t be done more than once. Can I write again though that he’s measuring big! That’s an incredibly comforting thought. Off to rest and drink even more water. We’re spending record amounts on toilet paper, I tell you. And I’m still pissed that I can’t go to the new hospital again until I’m at term.

21 responses to “Well certainly don’t get too comfortable

  1. Well, your post certainly has a happy conclusion (over three pounds!), but the whole experience sounds very scary and unpleasant. It’s a good thing that you wont’s be delivering at that hospital, because they sound kind of confused. And what a coincidence that the midwife’s estimates changed so dramatically after the ultrasound.

  2. Yes, old hospital is definitely sucky. Truly truly sucky.

    About the UTI and the water intake. You actually may be getting too much…yeah sounds odd but a large on-going study on some people up here in Walkerton discovered that many people were overdoing it on the water intake and were giving themselves kidney damage.

    So how about a nice middle ground? Keep hydrated, but realize that showers and juice and milk count too. Don’t force it, and don’t go without? Maybe?

  3. That’s interesting Aurelia. I’ll look into it. It’s really frustrating to constantly have docs and nurses assuming I don’t understand the meaning of at least 64 oz a day. What’s bothersome though is I don’t force it. I truly am constantly thirsty. We’ll see what I can figure out.

  4. Have you checked your sugar? Thirst can be a symptom of impaired sugar metabolism.
    Glad to hear you are ok, but the old hospital is definitely not inspiring any type of confidence.

  5. I’m so glad you and your (giant!) baby are OK. It must have been scary, though.

  6. Glad to hear all is well and baby is growing so nicely. I want to second Aurelia: my very first thought was that you’re drinking too much water. I dunno, that and the constant thirst and the UTI … well, I agree it’s something to ask about.

  7. I’m sorry you had to go back to that other hospital. I would be the biggest b* ever if I had to go back to my old hospital. Actually, I was very grumpy and upset when I had to go to L&D at the better hospital… I’m just an emotional wreck anyway.

    I’m glad everything is okay. So glad baby is measuring big! Let’s hope he stays and bakes some more in there!

  8. Old hospital does sound like it ought to have a giant neon “L” welded to the side of the building. Sorry you can’t go to the shiny new one.

    For whatever it’s worth, I also had the fetal fibronectin thingy during one of my preterm labor episodes with Little A, and people claimed it was 95 percent accurate. Like you said — good test, and terrific news for you that it came back negative!

    Did they check your amniotic fluid levels? Like all other scan-related measurements, they can be off in the 3rd trimester. But if you suddenly had a lot more fluid, it could cause your uterus to get annoyed with you while it got used to the sudden extra load on it. That could also trigger contractions without cervical involvement …

  9. Most importantly, I’m glad you and baby boy (the “large” baby boy) are doing ok. Glad to hear the cervix is still long and the contractions have abated. I agree, there maybe an underlying reason that you are thirsty. Perhaps mention it at your next OB visit. Sorry about the “old hospital”. That stinks!!!

  10. I am glad I decided to check in on you one last time before I leave for the weekend. And I am super glad this story had a happy ending (I had my doubts for awhile, even with the disclaimer at the beginning). Old hospital sounds dreadful. So, do you have to get past 34 weeks to deliver at the new and improved hospital, or am I misunderstanding that? I realize we want you to get past 34 weeks regardless, but I am just wondering if we have an extra reason to stay focused on that goal!

  11. Oh wow, you’ve been through so much. I am beyond happy to hear that things settled down and also that baby boy is growing so well. And the negative on the ffn test is good news. From what I know about it it is extremely accurate when you get a negative but not so accurate if you get a positive. When I read about the fluid intake I thought similarly to Aurelia that you may be drinking too much water. In my marathon training I was advised to be careful not to drink too much. Anyway, it sounds like you will look into it. Here’s to many more weeks of baby boy getting even bigger and a birth in the nice, new hospital.

  12. I’m glad your scare remained that, a scare. As for drinking water when I was in the late stages of pg with Moksha, I drank more than I ever have and still woke up in the middle of the night with raging thirst. Yshould get the underlying tests for a problem like sugar intake, but if there isn’t one and you’re still thirsty, you probably need to drink yet more.

  13. I’m so glad that you are still doing well. The water/dehydration thing definitely seems worth getting checked out, because you can still be dehydrated despite drinking tons of water and if you are dehydrated, drinking tons of water might not necessarily help. I hope you don’t need to make any more visits to the old hospital!

  14. that sucks about your insurance! Do you get the New Yorker? There is a cartoon in this week’s issue which is pertinent to this situation!

    What a lousy midwife, too. ^%$##@!!! Glad all is well…and yay for big boys!

  15. Thanks all. Wabi – I assume that when the doc did the ultrasound she also checked fluids. No one said anything about it. I’ll see if my doctor has anything to say about the report.

    Lori, Yup. You understood right. If I deliver before 34, I have to go to the old hospital. If I deliver after, I can go to the new hospital. But, that said, I was just looking at newly launched website for old hospital and it seems that with a new area opened in the building old hospital might now be better equipped for preemies than new hospital. When I checked into this in February, it seemed both were equivalent but I liked new hospital better because it had more space and privacy. I’ll look into it more. I just hope their staffing can match their fancy new environment.

  16. I’m just coming back to say that after reading all these stories about U.S. healthcare, I still don’t get why any of you put up with it. I know it can’t change right now, but holy….all I ever hear is about how single payer is so bad because you get no choice, except that no one would EVER make a pregnant woman change without a critical medical emergency up here, and yet, they will make you change?

    I’m just confused, maybe? sigh…

  17. You’re not confused Aurelia. Like I happen to have just said on your blog, I wish I knew how to effect change in the US. I’m certainly not just capitulating, but health care activism is incredibly difficult here. I can’t think of much to say that’s not cliche around it – but seriously I know people who’ve lobbied for years ineffectively & are so burnt out. So many Americans are convinced that costs are rising through frivolous use rather than unfair insurance and drug practices.

  18. And I doubt we will get universal healthcare here regardless of who gets in office next year. The debate is one of entitlement. Are people entitled to healthcare and if so, who pays? I think the verdict is still out for many voters.

    I am glad you are doing so well. I don’t understand all the inconsistency between the doctors and nurses. You would think they could at least be consistent in what they tell you. I agree with Aurelia about the hydration…you can be over-hydrated too. Just something to watch for. We know where you spend a far amount of time these days *sigh*

    Still everything is looking like a green light!

  19. Until the unfair insurance and drug practices happen to them, Americans don’t seem to care.

    I know that you don’t have the energy to fight it, but not allowing you the right to go to your hospital of choice, based solely on the amount of weeks gestation you are seems hardly sustainable.

    I’m praying for 32 weeks for you. I assume that you have had the “lung” shots already, so you “should” be in okay shape. poo. poo. poo. Most babies aren’t able to suck, until 34 weeks. From experience, you should double pump, not single pump to bring on and up your milk supply, if you are interested in nursing. Your colostrum and breast milk will be used for tube feeding, if necessary.

  20. I happened to see this link on Monica’s blog, and I am so glad I did – I had been checking your old blog and wondering if all was well, but I didn’t want to bug you by posting a comment to ask. So I will say it now – I am glad all is well with you and your little guy these days. I’m glad to have found you!

    I have no pregnancy/fluid advice, other than reiterating to make sure your kidney output is normal (if you are putting out somewhat close to the amt you are taking in) and your blood sugar is normal, and if they are, keep drinking water!

  21. i know, i’m like an elderly aunt, calling to nag and find out if you’re still good.

    you still good, right? fine? just hanging out, drinking exactly the right amount of water?

    i know, i know…i’ll go mind my own business.

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