January 16, 2008

Quaid Twins Double Jeopardy

Whoa! If this can happen to a Hollywood power couple (well, certainly somewhere up there on the scale) at one of the world's most exclusive top-ranking, not to mention expensive, hospitals... What chance have the likes of us got?

Caught a quick highlight of this on E! during my lunchtime Telly-surfing (not recommended with curry in a plate precariously balanced on one hand). Had to find out more:
Quaids Recall Twins Drug Overdose
Before actor Dennis Quaid went to bed Nov. 18, he gave one last call to Cedars-Sinai Medical Center, where his newborn twins were being treated for staph infections. "Oh, they're fine," Quaid recalled a nurse telling him about 9 p.m. "They're just fine." Actually, they weren't.

Earlier that day, nurses had mistakenly given Thomas Boone and Zoe Grace 1,000 times the recommended dose of the blood thinner heparin.....

The first that Dennis Quaid learned of the medication error was at 6:30 a.m. the next day, he said, when he arrived at the Los Angeles hospital. Treatment decisions had been made without them, he said.
Can you imagine finding out long after the fact, realising, not knowing. And two lives, one is bad enough, in the balance. This sounds absolutely terrifying:
The Quaids said they spent the day watching in terror as doctors and nurses hovered over their critically ill children. At one point, as a bandage was being changed, blood spurted from the area around Thomas' clipped umbilical cord and hit a wall about 5 feet away, Dennis Quaid, 53, remembered.
Apparently, the mixup was due to the confusing labelling of the Heparin bottles by manufacturer Baxter Healthcare. According to:

Quaids Sue Makers of Blood Thinner

The Quaids didn't sue Cedars-Sinai, which acknowledged after the news broke that a "preventable error" had resulted in three patients receiving vials containing 10,000 units per milliliter of heparin instead of vials with a concentration of 10 units per milliliter. The patients were receiving intravenous medications and the heparin was used to flush the catheters to prevent clotting.

Confusion over packaging? What're they on about? All medical packaging looks more or less the same. If a nurse is a bit short-sighted or has difficulty telling a light blue from a deep-blue, or if one label is a bit faded... that means the patient is done for? To a non-layperson's eyes, i.e. to hospital personnel, the packaging is probably not as confusing as, say, to me. Still, reason to be extra-extra careful what you're squeezing into a hypodermic needle, no?

Can't help shudder when I recall them "flushing" the I.V. line in my hand during my recent hospital stay. It was a clear, colourless liquid, which could just as easily have been water, as lethally high dosage Heparin. The midwife did have her senior double-check the medicine once, though not every time. And, even if I do repeat myself, it bloody hurt. And still hurts.

January 8, 2008

Both Sides of the Csection Divide

Week 35

So what I overheard that night in the ward was one of the two women trotting between the curtained off areas (a bit inconsiderately I thought since the other lady might've wanted to sleep) to share her woes. She was the lady in the corner bed (we'll call her cornered lady, for more reasons than one as you'll see) who was visiting the lady in the other window bed just across from me (we'll call her window lady).

It seems Cornered Lady was eager to discuss her plight with what she hoped was a sympathetic person in the same position as herself. Hence, barely waiting till both their attendant midwives and partners had gone. Her plight was one that is increasingly usual nowadays. She had had one child by emergency c-section a couple of years ago and it was a bad experience. She said the scar hurt for a year after, that it was a raised, ugly scar besides. But for (probably pretty sound) medical reasons the doctors were not in favour of a VBAC (vaginal birth after c-section) in her case and had scheduled her op the next week. She, however, was determined to go the all-natural way and avoid any intervention if possible. Which is why at the first sign of any contractions, she had booked herself into the hospital. She was obviously hoping for much sympathy and praise for her courage in putting evil medical practictioners in their place. But she was disappointed.

It turned out that Window lady, who had a pleasant voice and a rather posh accent, had chosen to have an Elective C-section. And not her first either. She had been pleased with the elective section she had with her last child. It had healed fast and the scar was negligible. She was all booked in to have her op that Thursday. She only came in today because of very strong contractions and was worried that she might go into labour before the scheduled op.

The two women couldn't be further apart in their approaches to birth. One was close to hysterical, panicked that she might not be able to avoid another c-section; while the other was not taking any chances of missing out on an planned c-section.

As it happened, Cornered Lady was still in the hospital when I was discharged 3 days later. Within that time she had managed to upset two midwives by demanding to be sent up to te Delivery suite, had a public altercation with the senior midwife and a hissy fit with her partner in the ward with all the rest of us pretending not to listen. What the midwives and her partner were telling her was that she was being unreasonable and uptight. That there was a good reason the doctors did not reccommend a VBAC for her. Also that she wasn't anywhere near going into labour and that it would be wrong to induce her against doctor's orders. She sent her husband away and took to arguing with the midwives that they should send her upstairs.

The whole situation seemed messy and unnecessary (perhaps you're thinking I'll see it differently once I go through it all myself?) I blame the atmosphere of distrust that has been created around hospital births and the illogical campaign of misinformation against c-sections.

Night at the Antenatal Ward

<----No, the ward wasn't anything like this, it was rather nice, this is what I had actually been expecting.


Week 35.
To continue from a more interesting point in my hospital saga two weeks ago...

After I'd had the intravenous drip going and had ingested one whole bag's worth (no antibiotics in sight yet, just the saline) and several loo trips (dragging the IV stand and fetal monitoring tubes with me), we were told I might have to stay overnight at the hospital. I'd been expecting to go home that night, so was surprised. Note however, neither I nor DH had any idea how serious my condition was. Even though the three young female docs had stood at the end of the bed and muttered together about Nephritis, it didn't mean anything to us. It was clever of them to have diagnosed it, though, its hard to catch when there're such few symptoms.

So after an hour or two of me and DH just waiting, listening to the hair-raising screams of women in labour in the wards all around us, a midwife came and told us I'll be shifted downstairs to an antenatal ward and be kept overnight. This meant DH would have to go home too as he wasn't allowed to stay beyond 10pm in the wards. So there followed another wait till midnight when the next shift came on and transferred me downstairs. I wasn't looking forward to being a shared ward (not that we could afford a private one ever) but would have to walk out to use the shared loos (wheeling my faithful IV stand with me). Ultimately it wasn't so bad, I got a window side bed in a still empty 4-bed ward. DH unpacked the stuff he'd got for me from home, clothes etc into the tiny locker and took the bags away (like the sign said to do, he's a very good boy). No dinner for me though as it was so late and all hospital catering had gone beddy-byes hours ago. DH left, and I was left alone to wheel myself to the loo ever so often.

Could not sleep though I was absolutely exhausted. The I.V. tube in my hand hurt like hell and the blood congealing in it made me feel sick. So I was all too awake when two other women were brought into the ward at different points in the night. wanted to tell them not to bother whispering and tiptoeing around since I was wide awake but didn't have the energy. As it was, I overheard a very interesting conversation...

January 7, 2008

Shaking For England

WEEK 35
Was finally rushed to hospital on Monday night after dialling 999.

After calling round all Sunday and Monday - tried NHS Direct, then my GP, then the Antenatal ward maternity helpline. No one said go to A&E immediately. My GP even said it was "up to me" to call an ambulance, if I felt it was an emergency. But how could I tell? My symptoms weren't that severe, or that obvious, as symptoms of UTI go. Just this intense, debilitating, constant pain in the left lower back, under my ribs. Where even laypersons like DH and I know the kidney is located. Had been applying heat compresses, massaging with deep heat muscle pain ointments. This helped manage the pain a little. In addition, what the neophyte doc had diagnosed last week as SPD seemed to have gotten worse, the whole pelvic joint area felt very tender, I could barely walk. Then, since Sunday night, had increasing urge to urinate but not being able to (yes, yes, I know, TMI, but just you wait until you or yours is pregnant and see what dignity or daintiness remains).

Around 6pm, I was sitting in our living room desultorily working on laptop. Watching The Return, a most depressing film. DH was logged into skype and occasionally piping up with useful advice like "Call NHS Direct" (yeah, did that) or "Call the GP, ask him to come see you" (did that too and no, they don't do home visits). Suddenly, I started feeling cold. Despite the heating turned up to 21.5 (which is high for us). Within seconds I was shaking uncontrollably. Alarmed, I typed to DH: "i i iiisss shhaaakkkinn". He said to just type "Y" as he asked questions. After not managing to type anything sensible, I speed-dialled him. Listening to me hyperventilating and teeth-chattering, DH said to dial 999. So I did that, half-afraid they will tell me off for wasting their time ("what, no gunshot wound? no stabbing? don't waste our time, lady!").

I'm still impressed at how fast the response time was. Mind, this was my very first 999 call. So the whole asking "Fire, police or ambulance?" thing was a bit exciting. Got through to the ambulance service and I mainly recall how it took ages to give my name and address: "Haa-ha am Soh-oh-so..." "Sorry, madam, could you repeat that" and on and on. Am guessing they had caller ID, could they not extrapolate my location from that? Hmmm, another nifty little programme that DH could write.

Then DH called and kept me on the mobile when I should have been staggering upstairs to put on some decent clothes. I was in my most bedraggled, ragged unsuitable-for-the-public-eye dress, bra and no woollies (had a blanket and shawl wrapped round me). The ambulance was there much too soon (no time to grab a coat even). And there was the comedy moment of me trying to pick up the front door key and unlock the door in an insane parody of how-not-to-pin-the-tail-on-the-donkey.

The ambulance crew were expecting nothing very much I think. At this point NHSDirect and the GP all thought it was just a bad case of UTI. I remember reading one of my favourite blogs, a London paramedic's, who considers a 999 call for a UTI as pretty routine. So, anyway, this very pleasant man and lady came in (our hallway was filthy and I hadn't been able to grab our cat who was skulking above-stairs). As the lady put it, I was "shaking for England". They sat me down on the stairs. And I guess I sounded lucid enough to cross many life-threatening sicknesses off the list. The "I'm 35 weeks pregnant" bit always gets people's attention. Leading to the usual "have you had contractions/bleeding/waters broken" to which it was still all "nope". She was kind enough to go upstairs to our (very messy) bedroom and get my bag which had my maternity notes in it. And then get my mobile from the coffee table.

They decided to take me to the maternity hospital after all (not A&E, note). They would probably not have done so had I not been 35 weeks, hence in danger of going into premature labour. Since, I had few other symptoms than the lower back pain, chills and high pulse. And how did I reward their kindness? By chucking up (well, I waited till the lady produced the cardboard bowl) and then being incontinent on their ambulance seat. After which, the shaking stopped. I was so embarassed. Not only did I look like bedraggled-bag-lady-from-hell now I probably smelled like one too. I was able now to send a text message to DH who was on the Tube somewhere hurrying in my general direction.

January 4, 2008

An Overachiever Gets Pregnant

We had technically had little more than a few months of TTC (Trying To Conceive) but being the overachieving, type-A, hyperanxious person that I am I had to GET PREGNANT NOW:
The Overachiever's Guide To Getting Pregnant Fast

MYTH: There's something wrong with you if you don't conceive within the first three months of trying.
This is a particularly nasty bit of misinformation because it causes a lot of couples a tremendous amount of anxiety and grief for no good reason. Although some couples do manage to conceive within the first three months of trying, a large number of other highly fertile couples take considerably longer than that. Consider the numbers for yourself:

Your odds of conceiving in any given cycle are approximately one in four.

Approximately 60% of couples who are actively trying to conceive (having intercourse two to three times a week) will conceive within the first 6 months of trying, 75% within 9 months, 80% within a year, and 90% within 18 months.

Despite such gentle reassurances, I was panicking within 3 months. We hadn't got to the buying-ovulation-kits stage yet though we'd got the calendar method going (also see previous post's note about, um, frequency). So, after a very determined holiday period, with no result and when our laidback NHS couldn't come up with any answers, I decided to consult a specialist back home during our annual visit to the ancestral home.

To begin with I listed everything that had changed or was different about me since I went off the pill. First, there was this embarassing amount of weight I'd piled on, I felt literally inflated. Even my face. My cheekbones had disappeared. Second, my bra size was climbing alarmingly and my favourite Victoria's Secret bras didn't fit anymore. Boy, that sucked. The third sign was only discovered when I actually saw the Ob-Gyn in Delhi. She showed me I was leaking colostrum! She immediately sent me off for blood work, a serum levels test. And bingo! they caught the pesky Prolactinemia. The doc prescribed a mystifying dose of delayed-release aspirin, cabergoline and folic acid. Within 4 weeks I was pregnant!

The Prolactin level in my blood was only off by a tiny bit. But that was enough to yield potentially devastating consequences. I came that close to being stamped "infertile", had I waited a whole year. See, there are advantages to being a hyperanxious overachiever!

Babe, You Ain't Infertile

No you've probably just got some (normally obscure) protein or hormone in your body that tiny bit askew throwing your baby-making factory off course.

So many couples give up so soon. Here's this rather scary story from India - scary to all of us thirtysomethings in the West with our kidulthood lifestyles lasting well into our 40s. Out there, folks, if you hit 35 without dropping a sprog, that's the end of it.
Are Modern Lifestyles Causing Infertility?
“This is my last attempt. I am not trying anymore. After this I will give up all treatments,” 35-year old Aranya breaks down in front of her close friend and confidant. Her frustration is due to the fact that she has not been able to bear a child in the last nine years of their marriage.
Note that the people quoted, and the story itself, originate from Southern India where fertility has always been a very high priority, culturally and sociologically. The specialist Doctor (who must be minting it) lists the leading causes of this epidemic (1 in 2 of 1920 couples in a niche population) of infertility. In her opinion: late marriage (i.e. after 30s... that's late?), stress, obesity, bad diet and low libido. Duh - the last one is like bloody obvious. I mean, what's the first step in baby-making? Then, like most ills in India nowadays, she blames high-earning I.T. jobs and career pressures that keep couples apart. Obviouser and obviouser, I say. But, anyhoo, other than not doing the obvious and having sex as often as you can get alone together, the main culprit is hormonal imbalance. That is, once you've stopped abusing controlled substances, smoking and slathering yourselves in sperm-killing oils and lotions.

I'd advise any woman faced with a dour prospect of the word "infertile" being stamped on her medical record after little more than a year to get her serum Prolactin levels checked out.
See next story.

January 3, 2008

Mystery Pain

WEEK 4
This was back in May 2007, at the begining of the pregnancy.
Woke at about 3AM to go to the Loo. "Thus begins the famous frequency of pregnancy", I thought, as I stumbled across the landing. I was also feeling quite bloated, wondering if it was acidity or just another pregnancy-related discomfort. But there was really no other symptom. Suddenly, I felt this excruciating pain in my left abdomen, just above pelvic bone. Face went clammy, vision went funny.

Feeling light-headed, I staggered to the sink and splashed face with cold water. Dropped down onto toilet seat for somewhere to sit. Sat gasping in pain, feeling about to faint for some time. It passed in a few minutes. Staggered back to bed, DH was fast asleep. Feeling drained, I nodded off pretty fast myself.

Next morning I obsessed about the pain. Thinking the worst. What if it was Ectopic Pregnancy? Called to see our GP. He said it was probably a UTI. But I hadn't any other signs of it. I hadn't had any bleeding, and it wasn't hurting anymore, so I tried to forget about it. Though I looked up all the signs of ectopic pregnancy, to be sure. In particular, I was looking out for the shoulder tip pain. All has been fine, for these 9 months, until last week.

In hindsight, I wonder if it was an early warning sign for the nephritis I would suffer 8 months later.

Mom-to-be Freebies

WEEK 3
Two days after the +ve HPT, went to see my GP. Not expecting him to do anything much (having the previous day been told by the Nurse-practitioner that she couldn't do anything "more" to confirm the pregnancy). But he was lovely, quite a bit pleased, recalled we'd been trying (well, not for that long). He repeated what the Nurse said, that the NHS accepts HPTs to be accurate, that false positives are extremely rare.

He agreed I should stop all meds, including Aspirin. Prescribed more Folic Acid, which I was already on (a humongous dose as prescribed by the Ob-Gyn I consulted in India) and to take whichever dose was higher. He filled in a few forms for me. One for free meds during pregnancy. One to book me in for the birth and antenatal visits at what is probably the UK's top 3 teaching hospitals' maternity wing. I was really pleased we're in its catchment area. He gave me a free booklet Emma's Diary (which got me excited, little did I know it was the first of many free booklets) with freebie coupons and fun things to read.

As I left the Gp's, I called DH, he was pleased that we could take it as confirmed now. Called mom and told her doc had confirmed it.

January 2, 2008

Positively Pregnant

Back in May 2007 when we found out... before the realisation of the things to come kicked in...

WEEK 3
A few days after usually clockwork efficient period had been delayed. Had been feeling very tired lately. Expecting the worst i.e. any reason other than this for missed period. Was looking up all sorts of horrible conditions on WebMD. Confessed fears to DH, he said to wait, not to buy pregnancy test as yet, since I'd just wind myself up, set up for huge disappointment etc. Just like a bloke, eh? So while I was out to post stuff, obviously I had to go and get one, no make that two, of the most expensive HPTs. Had to know, because if it wasn't the obvious, it was some horrible condition.

The very next morning, took pregnancy test at 6AM since you're advised to test first pee. Couldn't believe the cross forming in the results window. Shook it, stared hard, blinked, looked again. Didn't have to wake up DH - I ran in and bounced on the bed so hard, he kinda looked up all bleary-eyed. One look at my face and the classic ad-world pose, HPT stick in hand, and he went "You're joking!". Then we squealed and hugged for what seemed a long time.

From that very day, stopped taking all unnecessary medicines, Aspartame (sweetener) and stopped drinking more than one coffee. This last bit has been the toughest of all for a dedicated caffeine-fiend. How much do I love my baby huh?

DH said it was hard resisting the urge to tell everyone. We had agreed to wait till Week 12 as advised by pregnancy pundits everwhere. But we both decided it was ok to tell Ma cos she'd been having such a terrible time lately. She needed one bit of good news. Telling her was fun, making her and dad very happy.

Spent the rest of the day reading about first trimester pregnancy and the accuracy of HPTs. Managed to freak self out with all the talk about "false positives" and so on. My HPT result was unmistakable, as clear as a laser printout, I could have no doubt. However, if you've had a vague result, and you're not quite sure, it's worth checking out this mine of information on different HPTs and their prediction stats.

January 1, 2008

Mommyblogging

I'm starting this blog about halfway through the ninth month. I figured that, since I'm no longer able to think, read or talk about any topic other than babies, birth, parenting or hospital labour wards, I need a place to articulate my own thoughts on the same.
No doubt, in about a month's time, all bets will be off and you'll see the start of an ongoing first-time-mom diary, albeit with a multicultural twist. Alright, that word. I've co-opted multicultural, even though I can never agree with any of the definitions on offer. Well, I'm not monocultural and, let's see, I'm opposed to any normative cultural homogeneity by acculturation. Though I'm in favour of diffuse assimilation. Basically, what this alphabet soup of isms vaguely boils down to is this:
I'm a non-white, foreign-born mom-to-be in a big city married to a "native" (white) man and I speak several languages, celebrate a variety of cultural festivals and try to live a secular, tolerant life. And our baby will enjoy the best of both our cultures and others besides.