A Few Bad Apples Make Me Go something Something

Just a warning. While I have many friends who are doctors and nurses, most of this should not apply to you. But know that the bad apples in your respective professions make it hard to be sympathetic to those who complain about how hard your job truly is. This scenario played out yesterday with one of the bad apple nurses.

A bit of background on me. I am on very few medications; Vitamin D, Folic Acid, Vitamin B6 (in the event that I am nauseated), and Zantac for the days when my stomach decides to share duties with my esophagus. That's all. Pretty simple. I also love Zantac. Moving on...

All of the nurses I have had up to yesterday have been diligent about reading my drug order. They know that the Vitamin B is something they have to offer, but I won't accept it most of the time since I am not usually nauseated. They also know why my dosage of Vitamin D is so high (because my neurologist said so). All of this information is contained within my fancy chart. A chart that I assume is there so that at shift changes it can be read to ensure a nice seamless continuity of my care.

Enter my day nurse yesterday. I have been on this unit going on 4 weeks and have never seen her on the unit. Pretty typical considering that the nurses rotate around to other units or are on schedules that have them on vacation or work a wonky schedule for whatever reason. So, having never seen her, I expect the same high level care as with all of the other nurses who come and go. 

She went through the typical exchange that I have with my nurses in the morning about my vitamin consumption. But this time she asked why I am taking so much Vitamin D and tried to insist that I take the Vitamin B regardless of the lack of nausea. She seemed quite put out that I was turning down the Vitamin B. To which I replied that I understood that it was noted in my chart that the Vitamin B is as needed. Her reply put me into astonished silence. She actually said, "I don't have time to read your chart." She went about her duties, taking my vitals, fetal monitoring and confirming that I have had no changes overnight. At the end she said if I needed anything to call her and she would be back in 20 minutes, to take me off the monitor.  So 15 minutes later (typical strip time is 20 minutes) she came back and looked at my strip and asked if I was having contractions or cramping. I did admittedly move to grab my iPad so I had something to do for the 20 minutes, which caused a bit of a blip on the contraction section of the strip. Again, astonished that she can't tell the difference between a contraction and maternal movement I said no. Coupled with my "you're a complete moron and if I have an issue today I'll be walking down to the nurse's station to find someone competent" look. AKA my "well duh" look. I have moved AND sneezed while on the monitor prior to this and have never been asked about it before. From what I understand (having asked one of my regular nurses) a contraction looks like a big round wave. Movement or sneezing is a sharp quick mountain looking wave. These also happen when the monitor bits are repositioned when the baby decides to roll over. Needless to say my confidence in her was completely gone.

Now it may look like I don't understand or respect a day in the life of a nurse. But I actually do. I had to go through a hospital practicum on my road to becoming an EMT. I had to work closely and communicate thoroughly with all of the nurses I came in contact with during my career. So I know how busy their schedules are. How crazy various units can be. But I have never seen such an obvious lack of respect for the discipline. I cringe to think of the errors that could be made by this nurse for not having enough time to pay attention to something as basic as the Four Rights of Medication Administration. Luckily I'm not on anything stronger than a few vitamins and a wonderful antacid. But it made me question my level of care, which is one thing that I shouldn't have to do. 

The bottom line: If you are working in a industry where if you make a mistake people can die, read the information you are provided to mitigate that risk. If you don't have time to read said information then make time, go home or make a leap into a career that has nothing to do with people. Or reading.

33 Week Update

Time is ticking down to our new arrival. And dirty diapers. And sleep deprivation. Oh wait, I already have sleep deprivation. 

My medical team is aiming for 34 weeks (which is next week) and then it will be day to day. If I continue being stable after that milestone has passed, then we a looking at a 36 week delivery (but nothing further). For those keeping track, 36 weeks is September 11. Interesting birthday gift for Wade.

I had my regular weekly ultrasound and the Ninja has wedged herself into a transverse position from a footling breech position last week. This would explain why I went from a cute belly to a monster belly in the span of a day. Hopefully she continues this trend of transverse or footling breech to keep the pressure off the blood vessels. 

The cool thing about this ultrasound was the doctor performing it completed a 3D of the Doppler. This showed how messed up all of the blood vessels are in 3D. All I have to say to my surgical team is: Good luck with that. OK, maybe not. The surgery will be very quick and there will be more people in the OR than a typical beer league hockey team.

Aside from the mess that is the blood supply inside the membranes, the Ninja continues to grow well. She is approximately 4.1lb this week, up from 3lb 10oz last week. Hopefully the weight and size accuracy has been good since it can potentially be off by a pound or two. Unlikely that she is only 2lb at this point, but nothing is ever set in stone. 

The doctor who completed my ultrasound asked that someone take a picture of the placenta and membranes when the baby is born. I definitely want to see what all the fuss is about, probably more so than the doctors. 

Soiled?

There are a few observations I have made while staying here at Chateau Foothills. One of them is the overuse of the word "soiled". It appears three times on the unit which I reside. 

The three instances are: Soiled Holdings, Soiled Linen and Soiled Pads. I understand the reasoning for the labelling, being that this is a hospital. But to me, the word soiled is to be used in the case of the Code Brown. Code Brown for those unfamiliar with the code system in the hospital is a hazardous material spill. Brown and hazardous material points to the most vile of human excretions. Yep, I'm talking about poop. 

The term used on this unit is obviously geared towards the body's form of pregnancy related paraphernalia and the various residues therein, rather than poo. Let's face it, walking around this unit in bare feet (yes, I do this since the floor is washed almost as much as the one in an OCD sufferer's house. And I am too lazy to consistently put on socks) can be treacherous, especially with the ladies labouring and pacing the hall. I wouldn't say the floor is soiled if the labouring lady's water breaks along my path to the kitchen. I would say it's more like a slippery watery mess. Or wet clean up on Unit 41A. 

I am also fairly certain that my linen and the linen of the other patients are not covered in poo. Maybe sweat because it's like a hot house in here. Seriously, I am thinking about doing some gardening on my window sill. Or cooking a steak.  I would associate soiled linen with geriatrics, paediatrics and those with communicable diseases. Soiled Holdings just sounds like a scam Bernie Madoff came up with, to launder money in plain sight. But here, there is a whole room dedicated to the soiled linens waiting to be processed. A gross, probably poorly paid and under-appreciated job. 

The coup de gras, in my mind, is the sign on the back of the washroom stall door, suggesting to the dimwitted to wrap their soiled pads prior to disposal. No shit. No one wants to see that. Again, not soiled, but definitely not something that an unsuspecting roommate or cleaner needs to have infesting their eye holes. Aside from a girl going through puberty or a socially inept bachelorette who has no hope of ever having anyone in her bathroom at "that time of the month", there is positively no need for a sign like this. Of course societal rules clearly state that all signs of this nature are geared toward the lowest common denominator.

32 Week Update

Things are progressing smoothly so far. This week's scan showed a weight gain of nearly a pound. Her estimated weight is now 3lb 10oz. The big contrast this week is the doctors are starting to be more forthcoming about a birthday for the Ninja. If everything stays stable with both of us, she will be born during week 36. This is a relief because a lot of the typical preemie issues are no longer factors. Or the negative factors are greatly lessened. Not to mention I have a grand total of 2 preemie onesies at home.

I am now looking at another 4-5 week stay in Chateau Foothills. The end result is potentially walking (READ: limping) out of here with a baby in tow. Or there will potentially be a shorter stay for her in the NICU or nursery. 

I would like to thank everyone who has made the trip over here, paid for parking and brought me food. Having visitors has been a great way to pass the time. If you haven't made it over, that is understandable. Life is continuing to happen for those lucky bastards outside of the hospital. 

I miss my doggy. I never thought I could miss the little poop machine as much as I do. I am looking forward to seeing him when all of this is over.

3D Ultrasound: Cute Preview or Anxiety Inducing First Look?

Yesterday I had my weekly ultrasound to make sure nothing has shifted or is being compressed. At the end of the Doppler portion the tech started focusing on her face. One push of a button and several baby slices were taken. Then they were formed into my first 3D look at the baby.

Oh. My. God. 

First, I had sworn up and down that I was not going to seek out the 3D ultrasound. I wanted to leave how my baby looks for when she is out, screaming and covered in goo, to be a surprise. 

Second, I find 3D images of babies in uterine look like creepy doll masks.

Third, no one needs to see the other contents of my uterus.

Fast forward to yesterday and I can trash my hope of not seeing her until her birthday. I received 4 images, which I totally wasn't expecting. 

The first looks like a legit baby. As seen through a very narrow window. Bulbous nose, big squishy cheeks and eyes that are (thankfully) closed. 

The second is the same angel as the first, as shown through a wider window. Cheeks are much squishier with a shot of some weirdo structure that is very much not baby related. 

The third is where it gets weird. It's a side profile of the right side of her face. Her nose is very visible (which makes me wonder if it will be adorable and button like or a beak that may bring on taunts and whispers about looking at the kid on that nose). But it the scanner also caught bone. As in skull and facial bones. Skeletor comes to mind. I don't remember seeing that on the screen as the images were being captured. But the images were in sepia on screen and printed in black and white. I would like to think that would make a difference but am not optimistic.

The fourth is downright scary. Think Sloth from Goonies. With a cute baby size nose and mouth. That's right. Sloth. Eyes all over the place, enormous forehead. Sloth. I would hope that she would save the day like Sloth did, if she was helping some kids find a lost pirate ship.

I can't be one of those parents who brags about how adorable their baby is on a 3D ultrasound. You know the ones, they show you a picture of a gargoyle and then expect you to ooh and aww over how adorable they baby is.  These images are examples of her not at her best. I am not about to inflict them on anyone outside of those who have already seen them. These images will be neatly tucked away (with her name on them) with my divorce papers and will only come to light when I have passed on. Like a confusing and scary care package.

I sent one of the better pictures of her to one of my closest friends. His response was to say it looks like a paint blob. Another asked if it was a butt shot. 

Needless to say, I'll be happy if the shades of her features come out cute and look nothing like on the ultrasound. Until she is out and cleaned off, I'll make note of what kind of distortion 3D ultrasound has to offer and will hope for the best. On the bright side, my expectations of what she could potentially look like are pretty low. 

Hospital Food - The Highest of Highs and Lowest of Lows

When I talk to my visitors about my stay in the hospital, the food inevitably will come up in the conversation. Unlike a movie theatre, I am allowed outside food and drinks. I could even have it delivered if I loiter by the nurse's station to pay for it.

I think a lot of people don't realize that I am given a menu in the morning to pick my meals. The menu lays out exactly what I will be consuming for the day. Baring in mind that I am attempting to add some weight to the baby, some of the meals leave a lot to be desired from a caloric perspective. This drives me to the patient kitchen for snacks in the afternoon and evening or the generous flow of treats my guests bring me, to pad out what I am lacking. Especially when I don't get what I ordered.

Yes. This has happened a fewtimes now. 

I understand that if I choose to leave the hospital grounds to have a nice meal at the Keg, I am doing so against medical advice. Since I am curious about this whole parenting thing, I heed the advice and stay on the hospital grounds. Having said that, I really hate it when I am actually looking forward to a meal only to have it not materialize. In it's place I have received meat like substance, powdered potatoes, faux gravy, an apple, apple juice, cream of celery soup, well you get the idea. 

When faced with a 4-6 week hospital stay, you have to take it a day or meal at a time. Having meals that I choose means something to look forward to three times a day. The weekly menu is the same. Fridays are all about Turkey (log) and faux gravy or Spinach and Cheese Ravioli. Or should I say, fantasy Ravioli since for the past 2 weeks I have received the disappointing (not to mention gross) alternative: The near turkey and packet gravy. If Chef Gordon Ramsay lifted the lid off of my platter he would surly burst into a song of coloured speech so foul, it would wilt my flowers. 

I am not expecting the hospital to be the recipient of a Michelin Star. Far from it. But I do expect that my order be filled so I can find out how good or bad their packet ravioli tastes. 

Worse is that the medical staff, that take care of me, and I joke around about the food. My OB and I have come to the conclusion that no real eggs were harmed in the making of my scrambled eggs. The nurses strongly suggest bringing in my own food. Especially when I tell them that I didn't get what I asked for. I don't do this in the typical whiny patient manner either. I am far too engaging to be one of those patients. 

The pink frosting on this shit cake is that I actually filled in a survey regarding the mediocre excuse they call "food" and then at the very next meal did not receive the meal I had so hoped to have (stupid turkey log). Back to the survey. They received high marks on the people who deliver my food and it was downhill from there. They asked for suggestions, which I gave my two cents about diversifying the protein at breakfast to include sausage and bacon (even if it has to be turkey).

I am hoping that my survey wasn't a waste of time.

At the end of the day the best way for me to cope with the food is to just bring in my own. The added bonus is the extra calories for the baby. Or to pad out my post pregnancy before picture.

Perhaps AHS needs to hire someone who actually worked in the food industry as a chef who actually cares about the quality of food, the flavours and that variety is the spice of life. Failing that I know a couple of lovely aunts who would utterly rock the food in this place. I have never been more jealous of the elderly people in the home they work in.

12 Days of Hospital Fun - How Am I Doing?

Time actually flies when you're this bored. I have managed to occupy my time with reading, sewing, word searches, Netflix, visitors and sleeping. Even with all of these great activities, I still have periods of complete and utter boredom. The best part of the stay and the boredom is that I don't feel guilty about doing nothing. 

I think a lot of people are actually wondering about my feelings through this process. The ones that I do share my feelings with (which is rare) may think that I am cold or perhaps not taking the situation seriously. Or that I am just barely coping in my own way (which if you know me, you would know better). I would like to hope that there are no assumptions of me being a snivelling mess. 

Feelings. I do have them. I guess the easiest way to describe my feelings towards life and all things that what would crush and utterly destroy one person generally doesn't effect me the same way. Sure I tear up watching The Biggest Loser. But when it comes to my life as a whole, not much gets under my skin. I don't bother worrying about things or dwelling on the past. Fretting, to me, is something that you do to a guitar. 

How did I get to be so rock like in my ability to be rational? Bullshit. Lots and lots of bullshit. It took me a long time to lose the pettiness and jealousy of my early 20s. A divorce helped to lower my threshold for assholes and bullshit in my life, while raising the standards of the people I voluntarily let in. My EMS career provided me the ability to look objectively at a bad situation, find the good, acknowledge the bad and move on with life. No dwelling. Few regrets. Being married to a guy who has an eerie calm about him most of the time also helps. Sometimes his eerie calm disappears, but not often and only for a second or two.

Fast forward to now. How am I coping? Like I always do. Through education, intelligent questions and communication with those who hold the information. Accepting that they are not going to give me the wrong information and that they are thinking and acting in our best interests. I accept that although this can be considered a precarious situation, it's not one to fret about. That's why the specialists who are taking care of me make the big bucks; to worry about what I am not going to. 

This is why I reiterate in conversations that I hope for the best, know the worst and keep my expectations relatively low. It's those who walk around with an unreasonable level of expectations, that get crushed on a regular basis. Those people who find out they are pregnant and have the nursery set up in the first trimester. I wouldn't let any baby related paraphernalia into the house until after the foetus became viable. The baby clothes and toys started to flood in from my circle of friends and family with 2012/2013 babies, but it took me until last Friday to actually make my first purchase for the baby; a dinosaur mobile.

The longer I stay pregnant, the more real I am allowing the baby to become. Right now she is someone I see through a weekly scan, hear twice daily on the fetal monitor and am at the mercy of her little bony body kicking and punching to remind me that there is a developing human inside of me. Or I assume she's human. I assume that there was no face hugger involved in the making of this pregnancy. 

We have a name for her. I used it a couple of times to see if it fit. It seems to. Given her ability to deliver a roundhouse kick to my bladder at 3:00am, "the Ninja" seems vastly more appropriate than the name that will be on her birth certificate.

So, how am I coping? Just fine. Really. No faking. No lump in my throat. No tightness in my chest. No worries keeping me up at night. What keeps me up at night? Reading or Netflix, cause I don't have to be anywhere but here in the morning.

Room With a View?

Monday July 29 started with a phone call just before 9:00am from my new OB. My room was booked, no rush to check in as long as it is today. I took my sweet time packing, Wade walked the dog and the last brunch was had at Cora's. 

I was shown around the room, my washroom and the kitchen. Tagged three times with ID, allergies and the lab note that I've been blood typed and cross matched. I had my first experience with a fetal monitor, which showed that the Ninja (as we now call her) was doing well. Wade took the day off and spent it in an uncomfortable chair.

My room has a southeastern view of downtown and the parking lot. It is dry as a bone in here and super hot in the morning. I have no roommate which is totally awesome. The washroom has stalls assigned to each of the two adjoining rooms and strict signage stating it's for patients only. No men. No outside fluids allowed. The shower is small. But the water pressure is stronger than a mouse peeing on you and the temperature is good.

Once settled, the parade of doctors begins. It starts with a first year resident. Young and shitting her pants. She lacks confidence but I attribute that to the fact that she has been on this rotation for less than a month. Her head is probably overloaded with information and she is trying to make sure she doesn't miss anything. The second resident is in one of his later years. He's overly keen and continues to search the ceiling for his answers. Both are going to be awesome doctors, though it is very hard for me not to mess with them. What I do is ask anyone who comes to my room if I am allowed to leave for weekends or to go across the street to the Keg. Consistently, I am told no. 

The next morning I have my first in-hospital ultrasound. The reviews on the pictures are that they are "scary" and the neonatologist actually said "wow". She also shed some light on my new due date. They usually deliver between 34-36 weeks via Caesarean section or when their nerves can no longer handle what they are seeing. Under no circumstances am I to go into any form of labour and given the location of the placenta and the fetal vessels, one drop of blood is a dire emergency because there is no way of telling who the blood belongs to. "So, no Keg then?"  They are slowly starting to get my sense of humour.

The next doctor who visits us is a neonatology fellow. So he's a legit doctor, who I call Dr Doom and Gloom, with the goal of being a neonatologist. He starts off strong by stating that as of 30 weeks our baby has a 94% chance of survival. This number will go up with each additional week she bakes. He failed to state the stat improvement with each week. But then he started in on the complications of a preemie. They range from eye issues, feeding issues, breathing issues, brain development issues to brain hemorrhage and death. Not to mention a lengthy stay in the NICU. I watch Wade gradually change to a paler colour. I keep all of these things in mind and make note of when 34 weeks will be on the calendar. He leaves and I start trying to make Wade feel better. It's good to know the worst case scenario, but better to focus more on best case while keeping the expectations low.

All I have to do now is sit back, rest, relax and wait. And grow a baby.

At week 30 and she is 2.12lb. Only 3 more to go to get her into her fancy car seat.

Low Risk to DEFCON 1

This adventure Blog is intended to document the goings on of my current experience and should not be used as medical advice under any circumstance. If you are pregnant and currently don't bother talking to your doctor about your issues, start. Seriously. Get off the Internet and interact with the person who has more training on the subject than the panicky Patrice with the shit outcome. 

If you are a member of our extended family or friends and are just learning about what is going on with Wade and I, please understand that we needed time to digest everything prior to freaking everyone out, in our opinions, unnecessarily. With our strong support network of friends and immediate family and each other we will get through this and accept it for what it is: Unchangeable and under full control. Yes the situation sucks, but stressing out about it is pointless busy work. Read on.

On July 17 my pregnancy went from low risk to high risk in the span of 2 hours. We arrived for the 9:15 ultrasound like good patients, 15 minutes early. During this whole pregnancy adventure, I had been prepared for appointments by leaving the requisitions in the car. This requisition had been in my hands for over a month and I hadn't actually looked at it. Until that morning. Which is probably a good thing considering what was written on it. 

At my June 19 doctor's appointment, my doctor mentioned that I had a low lying placenta. No big deal given that I was 18 weeks on the ultrasound and the placenta usually migrates north as the pregnancy progresses. I made a mental note and moved on, given the lack of concern the doctor had for the placenta situation. 

Fast forward a month and I read over the requisition, thinking that they were just following up on the placenta. But there was another note. ¿Vasa Previa? I knew what a Previa was. But vasa was a new word. Given that I have a grotesque thirst for medical knowledge, I Googled it. That was a bit of a shock. (I'll spare you the need to Google it).

Vasa Previa is a complication that occurs when unprotected fetal blood vessels within the fetal membranes cross over the internal cervical os. And my requisition had that, surrounded by question marks. The side effect of this issue is the very large potential (50-100%) risk of fetal death, if it is not diagnosed.

I felt a bit nervous sitting there in the waiting room. I was just hoping to find out what we're having, since the baby opted for being shy at the last ultrasound. Now we were facing a complication that would take me from a marginally uncomfortable low risk pregnancy to an extraordinarily high risk pregnancy. 

We were called in and the nice nurse took a set of vitals and moved us to yet another waiting area. Shortly after that we went in for the ultrasound. My back and pelvis were super sore and I was put flat on my back. Not a fun combination. The ultrasound tech was a nice young lady who quickly identified that we are having a girl. Apparently 3 lines and nothing sticking out is the telltale sign. This threw me for a bit of a loop since I was thinking I was having a boy. So much for the old wive's tales. Bitches all.

She changed over from the standard black and white 2D ultrasound to the Doppler to take a look at the placenta and other vessels. She really needs to work on her poker face. Her expression was a mix of confusion and concern. She then mentioned that she would be doing an internal. Oh the internal. For those who are unfamiliar with this wonderful type of ultrasound, it involves a condom sheathed probe and instructions to insert it yourself then the tech takes over. Yeah. As in the professional version of a no touching bi curious probing. 

You have to have an empty bladder for this. MS prevents the full emptying of one's bladder. I tried my best and went back for my probing by the female tech, while holding Wade's hand. Does this count as a threesome? I didn't bother asking anyone at the time.

She was gentle and efficient. Her concern and confusion continued. Once she was done, she mentioned that she would have to have someone else look at the scan. She left the room. 

Wade immediately asked about names and putting one name he had consistently wrinkled up his face at, back on the table. We had already picked out boys names and were set one one. Now we would have to come up with a girl's name. The one he brought up was on the table briefly and taken off again.

The tech returned with an older man. He introduced himself as a doctor. I was expecting a more senior tech, as opposed to the radiologist. He took over the scan with her help with the typing. In addition to a confused and concerned look, he provided a running commentary of the internal goings on of my uterus. 

Some of his comments surrounded the cord insert and questions like where does that go, and a lot of huhs. He also completed both internal and external exams. The tech was super fast at putting on the new condom, which impressed Wade. I questioned her technique when the tip was not properly burped.

With all 4 ultrasounds completed and my back screaming in protest we were moved to the waiting area. After a while, we were lead into a small room with a very large recliner to discuss what the doctor had found. As with most doctors (and most front line medical staff for that matter) he started off pretty grave and quiet, judging my reaction. He explained that I have a marginal placenta Previa, vasa Previa and a abnormally placed (velamentous) cord insertion. He drew me a picture of my uterus (which looked suspiciously like a party balloon) detailing all of the things that were going on. He mentioned that I would probably be admitted to hospital at 29 to 32 weeks for the rest of my pregnancy. He said he would call the clinic I was being seen at with his findings.

We left the ultrasound clinic with a creepy picture of our daughter (think emperor from Star Wars) and our new found knowledge of her ability to lack attention to detail when forming pregnancy associated supporting structures.

The appointment with the low risk clinic was brief. I was hot potatoed out of there. They referred me to a high risk OB with a dry sense of humour and a no non sense way of dealing with complications. The appointment as set for one week later. I was given strict instructions to take it easy (no exercise) and go on full pelvic rest. No more sex. No more walks with the doggy. Nada. Zip. 

Of course Wade would be scheduled to go out of town that week. My friends and family rose to the challenge of helping me out. I walked Ringo a grand total of twice the whole week. 

The day of my appointment came and with my good pal Jen in tow, I met the new doctor. The appointment was short. And blunt. I had the weekend of freedom and I would report to the Antepartum unit at the Foothills Monday July 29. For the rest of my pregnancy. He was also intentionally vague about how long that would be.