Frequent Flyer

Well, my hiatus from Hotel Northside lasted for exactly 10 days. Sunday night I began having stabbing pain in my upper back, just under my right shoulder blade. Every time I took a breath, the pain was horrifically unbearable. This made it totally impossible to breath normally, so I resorted to taking these short, shallow puffs of air because it hurt less.

I decided to play Dr. Kristi and diagnose myself .... afterall I'm practically halfway to my medical degree, right? Thinking I had a kidney infection, I ignored James' pleas to go to the Emergency Room and insisted that I just wait until the morning to see Dr. Garcia. I remember the last time I had a kidney infection I had the same pain in my back and deep breaths were painful, so this made perfect sense to me.

Apparently my medical skills aren't quite as sharp as I thought.

I went in to see Dr. Garcia first thing Monday morning, telling him I had a kidney infection. Roughly five seconds into the exam Dr. Garcia informed me that my kidneys are located nowhere near my upper back/ shoulder blade area. Furthermore, he said what I was experiencing was actually CHEST pain. I protested, because my chest did not hurt at all; the pain was in my upper back. Dr. Garcia then proceeded to give Dr. Kristi a quick anatomy lesson: the pain I was feeling in my upper back was inside my chest cavity. Sometimes chest pain is felt in the front, and sometimes it is felt in the back, he said.

Hmmm. Who knew??

He then spent the next two minutes YELLING AT ME because I hadn't gone to the emergency room as soon as the pain started. He actually raised his voice and wagged his finger at me! Defending myself, I explained that I truly thought it was just a kidney infection, and yes it hurt terribly but I didn't think pain would kill me. His eyes nearly popped out of his head and he snipped, "WELLLLL, if it's a pulmonary embolism, then yes actually that CAN kill you!!!!!"

OOPS.

Apparently chest pain + shortness of breath + pregnant girl with Protein S Deficiency = pulmonary embolism. Perhaps I should resign my medical license?

As it turned out, my faulty self-diagnosis didn't spare me a trip to the ER afterall. Dr. Garcia sent me straight there. I signed myself in and sheepishly explained to the triage nurse why I was there. She pulled up my name and social security number on the computer and quipped, "Oh my! You're a frequent flyer!"

Ummm, yes I am. Does this mean I get VIP status? Do I get bumped to the front of the line???

No such luck. After waiting 1.5 hrs, I was given a room and a really fantastic doctor named Dr. Funk. Her name was laughable but her medical skills were much better than mine! She was super thorough and openly offered a detailed explanation of everything she was thinking and why she wanted to order certain tests. My kind of girl.

Seeing that I was in terrible pain, Dr. Funk gave me a shot of morphine in my IV. Wow. It made my head super loopy, but sadly it only masked the pain for about 15 or 20 minutes. So I just went back to holding my breath again! About an hour or so later she suggested we try a dose of IV Dilauded. I did find that it helped the pain, and I could finally catch my breath. But again it wore off after about 20 minutes and then my pain level was back to being a 10+++. So after two tries with the Dilauded I decided to give up on the pain meds and just grit my teeth.

Dr. Funk's initial plan was to try and avoid exposing the baby to lots of radiation. Normally she would order a CT scan right off the bat, she told us, but since I was pregnant she wanted to try and rule out a pulmonary embolism using other means.

Two chest x-rays, an EKG, a renal ultrasound, 700 bottles of bloodwork and 8 hours later ......... we still had no answers. The x-rays and ultrasound came back normal, but my EKG was "suspicious" and my bloodwork showed elevated D-dimers, which could possibly indicate a clot. So Dr. Funk decided that we had no other choice but to do the CT scan of my lungs. Exposing the baby to the radiation is not ideal, she explained, but it's a matter of determining which is worse for the baby. Obviously if I have an undiagnosed pulmonary embolism and drop dead, that's far worse for the baby than the radiation he would receive from the CT scan. Seemed like a no-brainer to me! So I consented to the scan.

Incidentally, I had this exact same thing done 5 days after Jamin was born. In fact, when they got me down to the CT room I realized it was actually the exact same radiologist that had done my last CT scan roughly 18 months earlier. Gosh I've really spent way too much time in that hospital.

After prepping me with the contrast dye and getting me all situated inside the machine, Mr. Radiologist proceeds to pull out his clipboard and read aloud a two page long legal disclaimer. So I had to sit there and listen to him inform me of all the risks to my baby because of this radiation I'm about to receive ... birth defects, later development of cancer, up to and including death, blah blah blah. So I burst into tears, signed the stupid paper, and cried through the entire test.

I find it incredibly unfair that I should have to make such a decision. As if I don't already have enough things to worry about regarding my baby?!??

Thirty minutes later we were told the CT scan showed clear lungs! No clots! Dr. Funk decided I must have pleurisy. This is normally treated with anti-inflammatory drugs, but those are a no-no during pregnancy. So we would have to let my body fight the pleurisy on it's own, with pain medication to keep me comfortable in the mean time. I was given a prescription for Percocet and quickly discharged.

Since my return home I've been resting and recovering. Fortunately my pain is drastically improved, and so far I've only had to take 1/2 of one of the pain pills they gave me. So I'm considering myself lucky. A pulmonary embolism would've been a disaster, but pleurisy I can handle.

THE FIRST WEEK HOME

So it turns out that caring for a brand new little life while simultaneously trying to recover from immese physical trauma will make it pretty much impossible to do any blogging.

My apologies.

Our first week home with Jamin was ...... well ....... a DOOZY to put it lightly. We were discharged from Northside on Easter Sunday in the afternoon and happily limped home to settle in. I had been having a lot of pain in the hospital, which I couldn't really understand because I don't remember being in much pain after Gracie was born. They were giving me 2 percocet plus 800mg of Motrin every 6hrs around the clock, which helped but never really took care of it. Since it was a holiday, the hosptial was a ghost town .... my doctor never came by for rounds on Sunday, and so as it turned out I was sent home with zero medication. I didn't sweat it though, just figured I could just take 4 over-the-counter Motrin and tough it out.

First thing Monday morning I made arrangements for Jamin to be seen by Dr. Kaufman, our fantastic pediatrician, because I could tell he had jaundice. We noticed it developing in the hospital, but the stupid on-call pediatrician there refused to test his billirubin levels for some reason. He is high risk in the first place simply due to his prematurity, and also the fact that we were exclusively breastfeeding. We could see him turning yellow, but they kept telling me he was fine.

Lukily Dr. Kaufman knows I am a vigilent Mommy, so when I called they told us to come right in. They confirmed that he was definately jaundiced and did a heel stick to test his billirubin. We also saw the Lactation Consultant while we were there to work out the last few kinks in our breastfeeding routine. At this point Jamin was nursing well and we were really starting to get the hang things. He and I make a really good team!

We had to run next door to Douglas Hospital to drop off the blood sample at the lab for the billirubin test. But to do this, we had to register Jamin as an "outpatient" of the hospital. Ahhhhhhh, yes ......... that means ridiculous waiting for some slow hospital employee to fill out 2 pieces of paperwork. While sitting in the waiting room I suddenly had this excrutiating pain in my upper-middle back. It was a sharp stabbing pain on my right flank. It came suddenly and the tears were immediate. James kept asking, "What happened? What did you DO?" and holding back sobs I could only manage to say "Nothing! I was just sitting here!" The pain was so intense and it hurt each time I took a breath. Mercifully, the slow lady finally called our name, processed our admission and got us out of there. I crawled home and took another 800mg dose of Motrin, which pretty much did nothing.

Tuesday morning I called Dr. Garcia's office about the pain and they instructed me to come in at 3:00. But first we had to go back to the pediatrician's office, as Jamin's jaundice was worsening. He was nearly glow-in-the-dark yellow at this point! They did another billirubin draw, which they found to be 14.1 (in the moderate range) and checked his weight. He was down to 5lbs 6oz. I left there and went straight to my own doctor's appointment, but had to see Mia the midwife since Dr. Garcia was in surgery. She walked right in and told me I had a bladder infection .... had the prescription for an antibiotic already filled out and in her hand. She didn't listen to a single word I said or give me more than 2 seconds to ask questions or voice my concerns. I explained that the pain I felt was high up in my upper-middle back on the right side, how could this be since your bladder is way down low in your abdomen? She brushed me off and mumbled something about me feeling much better by tomorrow on the antibiotic. I tried to explain that I was in immense pain and 800mg of Motrin was not helping ... to which she suggested I could also take some Tylenol.

As if that was going to help.

Annoyed, I grabbed my prescription and left. I figured I would just tough out the pain one more day, since she assured me that I would notice a huge improvement in 24 hours.

That night I woke at 2am to feed Jamin. I literally could not stand up out of bed, the pain was so horrible. All I could do was lay there and moan. I also began shaking uncontrollably with chills, which I've never had before. James panicked and called Dr. Garcia's emergency line, and the nurse there of course told him to take me to the ER. I refused to go. Why would I want to sit in the ER waiting room at Douglas Hospital for another 6hrs, to have some yahoo give me a pain pill and tell me to follow up with my doctor? NO. If I'm gonna sit in pain for 6hrs, I'd like to do it from the comfort of my own bed, and by 8am Dr. Garcia's office will open and I can actually receive some treatment. James thought I was nuts but knew that once my mind is made up it's a fruitless arguement on his end.

So as soon as the office opened Wednesday morning, I called and went in to see Dr. Garcia, who was thorough and attentive as always. He said his guess was something with my kidneys, since they are way up high in the flank area (right where my pain was), and since I was having pain while breathing. Apparently your diaphram is adjacent to the kidneys, so each time you take a breath your kidneys get "bumped" a bit and can result in intense pain. The midwife, of course, would have figured all this out if she had taken 5 seconds to LISTEN TO ME the day before. The other possibility, he said, could be pulmonary embolism, since the pain was sudden onset and followed a "thrombophilic event" (i.e. giving birth) by 2-3 days. With my blood clotting disorder, a PE is one of the most serious risks I face and the highest time of incidence is the post-partum period. He assured me that a kidney problem was way more likely than a PE, but given that a PE can be fatal ......... we want to be 100% sure of course.

So off I went, BACK to Northside Hospital. My new home away from home. I told the admissions lady that I wanted a frequent-customer punch card .... "stay 10 nights get the next night free" or something similar. Soon after getting a room and settling into bed the chills came again and a new wave of pain had me in a heap of tears. The doctor came in to get my history, at which point I cried, apologized for being a wimp, and then cried some more. Apparently he could tell I was in serious pain because his first order was for IV Dilaudid. That marked the first time I had been pain-free, which felt fantastic, but sadly only lasted for about an hour. This was followed by a CT scan of my lungs, which required contrast dye to check for PE .... then an ultrasound of the kidneys to check for kidney stones .... followed by more Dilaudid .... followed by more IV meds to keep me from puking because of the Dilaudid .... followed by an IV of antibiotics ... and finally ending with something in my IV which just knocked me out cold. Seven hundred hours later I was finally discharged and sent home with a diagnosis: super-duper infection of the kidneys, with a touch of pleurisy. And, oh yeah, I still had that bladder infection too, but compared to the rest it has gone pretty much unnoticed.

So .... Good news: Kidney infection + pleurisy = easy to treat. Bad news: More painful than childbirth.

And worse yet, as a result of my latest hospital adventure, we were forced to stop breastfeeding. I was at stuck there for 8-9 hours (during which time James was at home feeding Jamin a bottle), and then when I got home I was unabe to move for another 8-9 hours (more bottles). James did 100% of the baby care during this time. Once I was finally up and around again, I had to "pump and dump" for 24 hours, because the contrast dye I was given during the CT scan is excreted in breastmilk. By the time I had pumped for 24hrs and had reached the point to safely feed again ...... my milk was gone. Seriously, dried up, not a drop left .... GONE.

I proceeded to cry about it the remainder of Thursday and most of Friday.

I am still completely devastated about the whole thing. He and I were getting so good at it, he was happy, I was happy, and then ....... we lost our milk. SO. NOT. FAIR.

Friday we were back at the pediatrician, again ...... to check billirubin and weight a third time. Good news on both fronts: billirubin is down, and weight was up to 5lb 9oz.

James returned to work Monday so this week it's been just me and the kids! We are adjusting well. Jamin is a laid back, roll-with-the-punches kind of guy. Thank you LORD! He is so precious and sweet and insanely tiny and omigosh he smells so good. Gracie has totally embraced the "Big Sister" role and adores her brother. I am sleep deprived, and physically functioning at about 40-50%, but otherwise fine. Emotionally I feel good, much less hormonal and wacky than I felt after Gracie was born. I did have one weepy moment two nights ago .... at 2am rocking Jamin is his blue chair. I was professing my unending love for him (!! don't all new Mommies do this ??), when I was suddenly overcome with sadness wishing I'd had the same opportunity to say those things to Isaac before he died. I only cried for a few minutes, then pulled myself together and moved along. I think one weepy moment is allowed considering all we've been through.

We are hoping that weeks 2 and 3 are much more relaxing and less drama-filled! Thank you all for your continued prayers and sweet thoughts. I will try to update more regularly as my (lack of) schedule allows!