I am currently sitting in a hospital bed, hooked up to a contraction monitor and receiving IV fluids. This is not really what I expected when I left to go to my OB appointment 14 hours ago. I knew I had been experiencing some symptoms of pre-term labor, but I only had one time when I thought I might have been having braxton hicks contractions, and even then I wasn't sure.
My main symptoms have been menstrual-like cramps, low back pain (definitely not musculoskeletal - more like the pain you get when you have to poop, but you don't actually have to poop), and, for the past few days, a recurrence of nausea. These symptoms seemed fairly benign, so I figured that I had been overreacting during the past couple of weeks when I had been telling people that I thought I might be having pre-term labor. Sometimes people who are pregnant just cramp for no real good reason. I mean, I am carrying a 4 pound baby (weight estimated from my ultrasound last night) in there after all. It makes sense that things might get a bit crampy. And low back pain? All pregnant women get back pain. Add in the fact that bowel habits aren't necessarily normal during pregnancy and you get a pretty good explanation for low back pain. As for the nausea, this is not a new symptom for me. I got a reprieve from nearly constant nausea and "sour" stomach starting at 26 weeks, but usually once or twice a week nausea would come back for a visit. Three days in a row of nausea seemed a bit worse than it has been, but since when can you compare things to the "usual" in pregnancy? Nothing is usual.
I told my doctor about my symptoms and he said that he wanted to do a cervical exam just to make sure that I wasn't dilating. I had talked myself out of thinking I was having pre-term labor at that time, so I thought this was no big deal and I was going to get a normal report of no dilation or effacement. However, when he checked me I found out that I was 1 cm dilated. 1 cm...that's only 10% of the way there. I'm sure that's not a problem. It's probably pretty normal to dilate just a little bit during early to mid third trimester. He was a little bit concerned and told me my options. He said that he wanted to send me to the hospital for 1-2 hours of monitoring just to see if I was having contractions (I told him I wasn't sure if I had been having them and he said that it is likely that I wouldn't be able to tell if I was). He also said that he might put me on a calcium channel blocker just to calm things down in my uterus a little bit. And if they found that I was contracting I might be put on bed rest. Either way, I should take it easy for the rest of my pregnancy.
Keith and I went to the hospital. Since I wasn't too concerned (I just thought we were heading to labor and delivery for a 3 hour detour of our normal day, and that we would be going to Bible study just a little bit late) we made a pit stop at Java City. I wanted some milk because they told me that I would have to pee for another urinalysis, and I had to prime the tank. I also hadn't eaten for a few hours, so we grabbed a couple of snack to sneak up to triage in case I felt the need for nourishment.
We went up to triage, we found out that when my doctor phoned over to labor and delivery that I would be coming he said I was 1-2 cm dilated. Was he just telling us 1 cm so we wouldn't panic? Or did things get exaggerated going through the grapevine? We hung out for a little while as paperwork was being processed. I gave my urine sample, I got hooked up to the fetal heart rate monitor and the contraction monitor (toco), and then waited for the next 1.5 hours as they collected data. Thankfully, baby's heart rate is strong, baby is moving around a lot, and I maybe had one mini-contraction during the entire 1.5 hour stretch (the nurse told me it was a contraction...when I looked at the read-out it looked pretty unremarkable to me, but I suppose I should trust the judgment of a labor and delivery nurse over that of a myself, a medical dietetics graduate student).
Unfortunately, when the nurse checked me she said I was 3 cm dilated. Here's the thing about checking dilation: it's all by feel. It is not the most scientific measurement. One persons 2 cm may be another persons 3 cm. They train their fingers by reaching into circles of different sizes and learning by feel how far apart their fingers spread for each cm. So the question at this point was if I was always 2 or 3 cm dilated, or was I progressing? Had I started at 1 cm in the OB's office and now that I was at the hospital I was at 3? Or was I always 3, the OB didn't want to alarm me so he told me 1 instead of 1 to 2, and then he measures differently than the nurse? It was time to call in a third person to check my cervix. Person number three is a resident in OB (he and Keith actually got to bond a bit talking about rotations that you have to do as a first year resident). He checked my cervix and said he was pretty confident that I am 3 cm.
Because of the uncertainty of always being 3 cm or progressing from 1 to 3 cm at just 32 weeks pregnant they decided to admit me overnight. There were several reasons for doing so. First, they wanted to make sure that I wasn't contracting, so I have been hooked up to the toco for about 10 hours now. Second, they want to make sure that I am 3 cm dilated today, and no more. Third, they want to pump me full of several medications. Since I have been here I received IV fluids (this is my first IV ever!), IV antibiotics (they don't test for Group B Strep until you are 35-36 weeks preggo, so they gave me abx as a precaution. Also, if I have an asymptomatic UTI (the reason for the urinalysis), it could cause the cramping and dilation. The antibiotic essentially could kill two birds with one stone, or if I don't have a UTI or GBS it could be yet another case of antibiotic overuse. But I guess it is better to be safe than sorry when it is my baby's health that could be affected), calcium channel blockers (to calm down my uterus...however it hasn't felt calm over the past couple of hours), and a steroid shot (to help the baby's lungs finish developing so they are surfactant filled if baby happens to be born early).
I've got to say that I'm glad I have a husband who is a doctor at this hospital. I have made sure to casually work into conversation with each and every one of my caregivers that he is a doctor here. I want them to know that we are medically educated people and to talk to us like we understand, and I also want a little bit of the VIP treatment. I have no shame in saying that, and from interning at this hospital I know that staff and family members of staff (especially family members of doctors) get a little extra TLC. Also, he ran home to get some essential supplies and then came back and slept in my hospital room last night (even though it meant that he only got 4 hours of sleep). It was nice because he was able to roll out of recliner (he slept in the chair in my room because he didn't want to bother with a cot), shave and brush his teeth, and then go straight to work just a couple of floors away from here. When the doctors come to talk to me today or if any decisions need to be made, he told me to page him and he will come to see me to help me to sort through everything. He also said when he gets a chance he is going to come to my room to do his charting. He is a good one. :-) I'm very glad to have such an amazing husband!
Hopefully things will go as planned, baby Vogt will stay in cookin' for another 5 weeks or so (or at least 2 or 3 more weeks when major milestones have been met by the fetus, like the ability to eat without a feeding tube and the ability to breathe without assistance), and I won't find out the gender of baby Vogt before I cut my cake open on Sunday. Somehow I think that the cake cutting might be anti-climactic if we already have a baby born of a known gender...
My main symptoms have been menstrual-like cramps, low back pain (definitely not musculoskeletal - more like the pain you get when you have to poop, but you don't actually have to poop), and, for the past few days, a recurrence of nausea. These symptoms seemed fairly benign, so I figured that I had been overreacting during the past couple of weeks when I had been telling people that I thought I might be having pre-term labor. Sometimes people who are pregnant just cramp for no real good reason. I mean, I am carrying a 4 pound baby (weight estimated from my ultrasound last night) in there after all. It makes sense that things might get a bit crampy. And low back pain? All pregnant women get back pain. Add in the fact that bowel habits aren't necessarily normal during pregnancy and you get a pretty good explanation for low back pain. As for the nausea, this is not a new symptom for me. I got a reprieve from nearly constant nausea and "sour" stomach starting at 26 weeks, but usually once or twice a week nausea would come back for a visit. Three days in a row of nausea seemed a bit worse than it has been, but since when can you compare things to the "usual" in pregnancy? Nothing is usual.
I told my doctor about my symptoms and he said that he wanted to do a cervical exam just to make sure that I wasn't dilating. I had talked myself out of thinking I was having pre-term labor at that time, so I thought this was no big deal and I was going to get a normal report of no dilation or effacement. However, when he checked me I found out that I was 1 cm dilated. 1 cm...that's only 10% of the way there. I'm sure that's not a problem. It's probably pretty normal to dilate just a little bit during early to mid third trimester. He was a little bit concerned and told me my options. He said that he wanted to send me to the hospital for 1-2 hours of monitoring just to see if I was having contractions (I told him I wasn't sure if I had been having them and he said that it is likely that I wouldn't be able to tell if I was). He also said that he might put me on a calcium channel blocker just to calm things down in my uterus a little bit. And if they found that I was contracting I might be put on bed rest. Either way, I should take it easy for the rest of my pregnancy.
Keith and I went to the hospital. Since I wasn't too concerned (I just thought we were heading to labor and delivery for a 3 hour detour of our normal day, and that we would be going to Bible study just a little bit late) we made a pit stop at Java City. I wanted some milk because they told me that I would have to pee for another urinalysis, and I had to prime the tank. I also hadn't eaten for a few hours, so we grabbed a couple of snack to sneak up to triage in case I felt the need for nourishment.
We went up to triage, we found out that when my doctor phoned over to labor and delivery that I would be coming he said I was 1-2 cm dilated. Was he just telling us 1 cm so we wouldn't panic? Or did things get exaggerated going through the grapevine? We hung out for a little while as paperwork was being processed. I gave my urine sample, I got hooked up to the fetal heart rate monitor and the contraction monitor (toco), and then waited for the next 1.5 hours as they collected data. Thankfully, baby's heart rate is strong, baby is moving around a lot, and I maybe had one mini-contraction during the entire 1.5 hour stretch (the nurse told me it was a contraction...when I looked at the read-out it looked pretty unremarkable to me, but I suppose I should trust the judgment of a labor and delivery nurse over that of a myself, a medical dietetics graduate student).
Unfortunately, when the nurse checked me she said I was 3 cm dilated. Here's the thing about checking dilation: it's all by feel. It is not the most scientific measurement. One persons 2 cm may be another persons 3 cm. They train their fingers by reaching into circles of different sizes and learning by feel how far apart their fingers spread for each cm. So the question at this point was if I was always 2 or 3 cm dilated, or was I progressing? Had I started at 1 cm in the OB's office and now that I was at the hospital I was at 3? Or was I always 3, the OB didn't want to alarm me so he told me 1 instead of 1 to 2, and then he measures differently than the nurse? It was time to call in a third person to check my cervix. Person number three is a resident in OB (he and Keith actually got to bond a bit talking about rotations that you have to do as a first year resident). He checked my cervix and said he was pretty confident that I am 3 cm.
Because of the uncertainty of always being 3 cm or progressing from 1 to 3 cm at just 32 weeks pregnant they decided to admit me overnight. There were several reasons for doing so. First, they wanted to make sure that I wasn't contracting, so I have been hooked up to the toco for about 10 hours now. Second, they want to make sure that I am 3 cm dilated today, and no more. Third, they want to pump me full of several medications. Since I have been here I received IV fluids (this is my first IV ever!), IV antibiotics (they don't test for Group B Strep until you are 35-36 weeks preggo, so they gave me abx as a precaution. Also, if I have an asymptomatic UTI (the reason for the urinalysis), it could cause the cramping and dilation. The antibiotic essentially could kill two birds with one stone, or if I don't have a UTI or GBS it could be yet another case of antibiotic overuse. But I guess it is better to be safe than sorry when it is my baby's health that could be affected), calcium channel blockers (to calm down my uterus...however it hasn't felt calm over the past couple of hours), and a steroid shot (to help the baby's lungs finish developing so they are surfactant filled if baby happens to be born early).
I've got to say that I'm glad I have a husband who is a doctor at this hospital. I have made sure to casually work into conversation with each and every one of my caregivers that he is a doctor here. I want them to know that we are medically educated people and to talk to us like we understand, and I also want a little bit of the VIP treatment. I have no shame in saying that, and from interning at this hospital I know that staff and family members of staff (especially family members of doctors) get a little extra TLC. Also, he ran home to get some essential supplies and then came back and slept in my hospital room last night (even though it meant that he only got 4 hours of sleep). It was nice because he was able to roll out of recliner (he slept in the chair in my room because he didn't want to bother with a cot), shave and brush his teeth, and then go straight to work just a couple of floors away from here. When the doctors come to talk to me today or if any decisions need to be made, he told me to page him and he will come to see me to help me to sort through everything. He also said when he gets a chance he is going to come to my room to do his charting. He is a good one. :-) I'm very glad to have such an amazing husband!
Hopefully things will go as planned, baby Vogt will stay in cookin' for another 5 weeks or so (or at least 2 or 3 more weeks when major milestones have been met by the fetus, like the ability to eat without a feeding tube and the ability to breathe without assistance), and I won't find out the gender of baby Vogt before I cut my cake open on Sunday. Somehow I think that the cake cutting might be anti-climactic if we already have a baby born of a known gender...
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