Wednesday, December 5, 2007
In exactly one week, I would go into labor. But from my ignorant standpoint, I still had a month to go, and I was feeling great - very optimistic about my upcoming maternity leave, which I welcomed with outstretched arms and swollen ankles. My last day of work was to be the coming Monday, December 10. I would work a 6 a.m. to 10 a.m. shift and then later that same day, a 5 p.m. shift into the evening, getting off at 11 p.m. (or whenever the crowd calmed down, depending on how busy that evening happened to be).
Things were looking good, and I was psyched about all the time off I would have to prepare for the baby - three whole weeks! It seemed like an eternity from where I was standing, having worked 50 to 60 hour weeks throughout the entire pregnancy. My big plan was to read the 20+ books about labor, delivery and the care of newborns that I'd been given by helpful friends.
But more importantly, I was excited about having my first weekend off in years (with the exception of when I'd been out of town). In eager anticipation, I booked myself for an introductory tour, recommended by my OB-GYN, about what to expect during my hospital stay. It was scheduled for December 15, my first Saturday off.
Better yet, my gal pal, Amanda (she who had kindly sent me a "Happy Birth" DVD out of totally-touching concern for my lack of preparedness - I literally had tears of gratitude and love in my eyes when I opened her mysterious package from Amazon) and I were going to sign up for an all-day class at the hospital the following Sunday, the 23rd: an eight-hour crash course in Lamaze. She'd even volunteered to attend the birth as my labor coach, so it would be a major mental cram for both of us. I was thrilled, knowing that it was highly likely that the wee one would decide to make his appearance during the large bulks of time in which Baby Daddy (BD) would be overseas.
Anyway, that Wednesday morning found me en route to the hospital for my 36-week checkup (by this time, they were weekly). It was scheduled for 8:45 but after a long wait, and an even longer wait once led to an exam room, Dr. L finally burst into the room at nearly 9:30.
He was a very funny guy - young and an eager newbie doctor-in-training, filled with flip advice, and often in a rush. But he was good-hearted, and I liked his youthful enthusiasm, which made me confident that he was up-to-date on recent medical developments, which for whatever illogical reason, I found reassuring. Maybe it was just that I always felt like at least ONE of us knew what the hell was happening to me!
Anyway, he burst in, breathless and apologetic. Basically, besides being late, he'd decided to head out of town in a week, so I'd have to see someone else for my next-to-last prebaby checkup. He assured me, however, that it was actually good timing on his part to leave town before the holidays because this meant he would "definitely" be back in time to be my delivering doc.
Mmmm-kay.
Famous last words; the following week's appointment was the last time I'd ever see him - at least, while I was pregnant. Also, they were humorous, in hindsight. He was such a newbie! He lived and died by the due date he'd assigned me, and from his point of view, since he'd be back in town by The Big Day - i.e. New Year's Eve, the due date - that baby would be caught by none other then his own hands, probably complete with a bottle of champagne in his back scrubs pocket. LOL
Anyway, there was a nasty storm that morning, and tons of snow dumped all over Chicagoland. Driving conditions were brutal and the entire world was running late, my doctor and his delayed morning's worth of appointments being no exception. Plus, his stress level was all ratcheted up from trying to pull this last-minute trip in a week's time, so it all added up to one frazzled resident.
I had the morning off, though, so I assured him it was no biggie. He'd warned me the Wednesday before that each weekly appointment from there on out was going to be different, much more involved, internal exams and possibly more tests and ultrasounds. But contrary to what he'd warned me, that morning, he rushed through his average perfunctory exam. Here are some highlights from an email I sent BD describing the events of the exam:
Doc started with his normal stuff, only performed at that day's wildly-accelerated rate.
Weight gain thus far: unbelievably, just a hair under 29 pounds. I swear, that scale was off. I was feeling soooo cumbersome in those final days, it was unbelievable. Then he advised me to pack on one to six more before the baby came, and I had to resist the temptation to roundhouse him. Ugh.
Blood pressure: the pediatric BP cuff came out from its hiding place. By now, the nurses knew to have it on hand for my appointments. It wasn't that I had lovely, sculpted, petite arms, unfortunately, but rather that I tend to have - and did, as always, have again at this appointment - staggeringly low blood pressure, which is more easily taken with a kiddo cuff, since they tend to be more sensitive. (Humorously, my chronic low blood pressure never entered into conversations about pain control, which always consisted of Doc L emphatically shouting his favorite mantra at me: "Get an epidural!" But more on that enlightening conversation in a minute.)
Fundal measurements (uterus size): enter the tape measure. Both my doc and the nurse tried several times to get a measurement, but ultimately they told me that the baby was "just too big" and my belly was too - what did they say? I don't remember. Certainly, not that I was too small, but anyway, for some reason, they were unable to get a fundal measurement, and they found this very cute and funny. I wasn't laughing, though. They were making the boy-to-be sound enormous (another funny aspect, in hindsight, since he ended up just being a peanut with a giant head). Hence, our conversation about pain control...
By this point, the baby was awake and on the move. (He never appreciated me lying flat on my back, as I was made to for the fundal measurements; I suspected that it cut down on his already-cramped space). In fact, he appeared to be showing off for the doctor and nurse, as he commenced a workout that would impress any athlete. Through the thin cotton of my maternity shirt, furious movement - punches and kicks and elbow throws - were apparent with clarity. He was worked! I stopped worrying and started smiling at the entertaining show.
We talked a bit about fetal movement, then, and another nurse entered the room to let the doc know that his next appointment was canceled on account of the snowstorm, so he relaxed quite a bit at that point and began a long conversation about stuff that made impending delivery suddenly much more realistic. Detailed stuff, like what to expect in labor and delivery, and what signs and symptoms should make me hightail it to the hospital versus which ones only merited a phone call for further instructions. He talked about what to pack for the hospital - I only noted the warm socks bit, unfortunately, being distracted by the distinctly-uncomfortable turn our normally-brisk appointments had taken into the land of Seriousville and Thisisactuallyhapenningtown. (Which might account for why, when I arrived on the big day, I literally brought a couple pairs of warm socks. No camera, no appropriate underwear except the thong I rode in on, and no comfortable nightgown!) But again, I'm getting ahead of myself...
Anyhow, he spoke on and on: about where whoever was driving me to the hospital (crap - another detail I'd previously forgotten to ponder) should park, and where they should check me in when we got there, and how to get a wheelchair to take me to the labor and delivery ward.
I cut him off and said something like, "Doc, you're scaring me. I'm supposed to have another four weeks left!" but he just laughed and said not to worry, that we would have this same talk at each of the next four appointments, to really cement the information in.
The last thing he brought up was pain control. He busted out his above-mentioned, oft-repeated, standard commentary regarding pain control, but this time, seeing the serious turn our conversation had taken, and the fact that for once he was not rushed, I decided to venture out on a limb. "And if I happen," I tentatively ventured, "not to have an epidural...?" I hadn't actually given much thought one way or the other to anything regarding my pregnancy, labor and delivery, since I knew about as much as a three-toed sloth did about all that stuff, and since I figured I'd wait to ask questions until after I'd worked my way through my mountain of loaner books during my maternity leave. But, naive as I was, even I knew that things didn't always go as planned. I figured sometimes epidurals were impossible, or didn't do what they were supposed to, or maybe even ended up being not wanted. And I wanted a little bit of a backup plan, since Dr. L's birth plan was pretty much a one-sided diamond.
But apparently, he really saw no other facet: in his best shaggy-haired, frat guy, bedside manner, he launched into a soliloquy which frankly, would have sent any midwife or doula worth her salt into paroxysms of horror. His rambling spiel went something like, "I don't get why women would choose to suffer. You know, I've had patients say stuff like, they want to go natural to 'really experience the moment'. Experience what, exactly?? Like, tons of pain and feeling like crap? I mean, once upon a time, women had no choice, but now medicine has made awesome advances for a reason, ya know? Since epidurals are there, I mean, I tell all my patients, just use them. You won't feel a thing. Forget all that natural stuff." There was more, about how breathing exercises were basically baloney, as I'd find out in the heat of the moment should I choose the dreaded 'au natural' route. I timidly advanced my concerns about the baby being born 'on drugs' but he just scoffed. He wasn't condescending towards me in his attitude; he really was just a naive, cocky, newbie kind of doc. But nicer than this conversation makes him sound. But - yeah - totally unhelpful in terms of exploring all options!
So we hacked our way through this conversation, and my head was swimming with all the new information I was trying to process and retain. He took note of my bubble baby-brain moment and put a reassuring hand on my arm. "It's alright; I won't give you a pop quiz before you go, I promise. It's just like I told you, we'll talk about all this stuff again next week, and the week after, and the week after, and you'll know it all by heart by the time the baby comes."
He got up to leave, and I was gathering my book and cell phone when he turned at the door. "Any other questions before I go?" he asked.
Suddenly, it occurred to me that I should probably mention the fact that only my right leg was daily ballooning up to alarming proportions, while my left leg remained - well, not svelte, exactly - but hardly as elephantic as its puffy partner. And that's when the spit hit the fan.
Dude went into a minor panic. He examined my left leg, then my right. Then took measurements of each and whistled at the differences. Then palpated. Then called in another OB-GYN to get her take on my stompers, who repeated all the previous actions. They conferred and called in a third doctor, a vascular specialist from "upstairs". Cue a third repeat.
I was starting to feel a little worried. Had I known my Stay-Puft marshmallow leg would cause such a stir, I would not have neglected to mention it at previous visits; I just always happened to forget about it since most of my previous prenatal visits had been brief.
Anyhow, I got stuck at the hospital for two additional hours. The vascular specialist ultimately ended up doing a whole bunch of bilateral measurements (both ankles, both calves, middle of both calves, etc.). Ultimately, he determined that the problem was isolated in one area, which was the lower half of my right calf.
I guess I'd dismissed this absurdity as being simply related to my pesky sciatica (I'd had a lot of discomfort throughout the second half of my pregnancy because of my sciatica nerve, ugh), but since it was one-sided, and in fact, as it turned out, one-aread (if that's even a word!), they were concerned about the possibility of a deep vein blood clot.
I'd had some other issues previously like the visible, pounding migraines that hospitalized me around six months, and I guess this combination of issues, for some reason, had them particularly worried, so a wheelchair was brought (much to my amusement, since I was perfectly capable of walking), and I was wheeled to the radiology department. Hung out there for a while, then was wheeled to a huge room with two curtain-partitioned areas. I got gowned and lay on a massage-table looking thing.
The Eastern European radiologist I saw had a wicked strong accent, which I loved, and absolutely no sense of humor, which made me sad. She ultrasounded and Dopplered both legs, pressing the probe's end into my flesh with such vehement force that the entire procedure was alternately painful and ticklish. Since I respond to both with laughter, I cycled through bouts of agonal and then humorous hysterics. She was so pissed. She kept hissing at me to "stay still" and "stop laughing" but I just could not comply, try as I might. That made the whole thing take longer, as she kept imperiously informing me. I really felt bad, but I have these monster tickle spots inside both thighs and calves, and I swear, she hit every one with extra power!
In the end, after she and another radiologist, plus the original vascular guy, consulted at length, they decided there were no blood clots, just lots of unusual one-sided swelling (lightbulb moment). They speculated that the baby might be "favoring" the right side of the womb, possibly putting the majority of his weight on that side when he was at rest. This would be unusual but not impossible - and if that was the case, and if he was big, as they all seemed to believe, the pressure he would be exerting over the veins of my right leg would cause a decreased return blood flow from the bottom of my leg back up to the top, causing "pooling" around that ankle and calf. On the plus side, they seemed confident that my legs would return to normal postpartum, which I was vainly relieved to hear.
I was given the option of hospitalization with observation. Otherwise, I could head home, keep an eye on my leg, and call if there were any major changes. There were a lot of go-home instructions, though: I was supposed to be very aggressive about elevating both legs constantly; staying off my feet; resting or sleeping as much as possible for the remainder of the pregnancy; drinking at least ten glasses of water daily to get my circulation pumping; sleeping on my left side to pull the baby's weight, by gravity, down to that side; and, above all... NO MORE WORK! I could see - nay, even dream about - complying with all except the last bit: I only had four more shifts to go, already a reduced load, and the girls I was training were not ready to "fly" on their own quite yet. My bosses had been amazingly above and beyond fair and I didn't want to jump ship any sooner than I was already set to and screw them over.
In the end, I made a compromise (with myself. To the doctors, I simply crossed my fingers behind my back and swore to complete obeisance): I finished off my workweek, with the exception of Saturday, the 8th, which I managed to get covered on all fronts, since that was always my most difficult day (I worked all three jobs on Saturdays, for sixteen consecutive hours), and on the days I did work, I let my bosses know the prescribed ground rules, and they were all totally cool with letting me follow them, to the extent that my various shifts allowed.
Anyhow, long story short, I left the hospital around noon and raced home through the gathering mounds of slushy snow which was still heavily falling. I was in a hurry to get ready, as I had a lovely afternoon ahead of me, and the fun was set to begin in only one hour...
But more on that in the next post!
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