Tuesday, March 6, 2007

Visiting 101

I think I'm going to start a bedrest handbook.
Chapter One - Visiting Tips

TIP ONE - USING THE PHONE
If you are going to visit the hospital, please call and tell the "patient" when you are going to come.

TIP TWO - FIGURE OUT AN APPROXIMATE WINDOW OF TIME
Try to avoid calling at 9am on Saturday before you start your day of whirlwind errands and tossing off "I’m thinking of coming to see you today" and then:
a) never showing up
b) showing up 7 hours after you called and assuming that the first call was sufficient notice.
A nurse explained this phenomenon to me. Something happens when you are in the hospital. People know you can't go anywhere so they don’t observe the same courtesies as if they were coming to your house. If you are going to visit, call, and try to pinpoint a time.
c) showing up between appts and telling said patient how "busy" you were today and said patient was squeezed in
Believe me, the patient knows you are busy. He or she was likely busy too before s/he were admitted. Chances are they s/he isn’t in the hospital for a lobotomy and s/he both gets the effort you made to come in and doesn’t need to be reminded of your supreme sacrifice.

TIP THREE - USING THE PHONE #2
Even if you DID pick a time, call from downstairs when you get there anyway. Your patient may be hooked up to something, in the bathroom, whatever and needs time to adjust. That tiny little tap on the door you make before you push the door open just doesn't cut it.


TIP FOUR - FINE DINING

Like most Americans, you probably can't go anywhere without food. Yes, it's been almost an hour since you have had access to food. God forbid one doesn't eat at every social gathering. Maybe you were rushing to get there and you were so "busy" you didn't eat? There is something positively Pavlovian about a hospital. "Oh a visit? We should eat."
DON'T.
Unless you called, see #'s 1 and 3 above, and the patient said "sure".
DON'T bring your dinner. DON'T walk in chirping “oh I haven’t eaten yet” and then proceed to unpack your paper take-out sack. DON'T place your food on the radiator, chair, tray table, foot of the bed, then proceed to feast like the last supper all the while talking. You do know that from the laying down position, most mouths are eye level? I assure you, the patient is not interested in seeing the food rolling in your mouth, or hearing you talk through it.

TIP FIVE - SANITATION ENGINEER
If you must eat or throw away the take-out that you ate BEFORE you came, your coffee cup, etc., DON'T throw your trash in the rooms trash. For most patients, trash is emptied once a day. In the morning. Whatever you throw away, the patient is going to smell for the next 12 hours.

TIP SIX - SANITATION EXPERT
There should be hand sanitizer near your patient's room door. Use it. There are germs are over you, your hands, your clothes, the elevator buttons you pushed to walk in the room, the handle on the door you opened to walk in. Likely that guy from Oprah could do the cotton swab test on you and you'd be rife with feces. You are one big nasty germ and the patient is the Iran Hostage to your Typhoid Mary.

TIP SEVEN - SHIRLEY TEMPLE AUDITIONS ARE NOT BEING HELD IN THE HALL
Keep your kids with you. The kitchen isn't a field trip, the halls aren't a track meet, and the cavernous hallways are not for your little darlings dulcet tones. No matter how cute your kid is, some other patient already hates him.

TIP EIGHT - GIFT BAGS ARE NOT GRAB BAGS subtitled HOSPITAL ROOMS ARENT RUMMAGE SALES
Try not to rifle through the patients things. Things in the patient’s room belong to them, and just because limited space necessitates that those items are on display, it doesn’t mean they are for your consumption or your perusal. Get well cards, gift bags, closets, bathrooms and bedside drawers are off limits. And lord knows, you're hungry right? Ask before you eat their snacks.

TIP NINE – THIS ISN’T A POPULARITY CONTEST
Does it really matter to you who else has come up to visit? Ask yourself why.

TIP TEN – ENQUIRING MINDS WANT TO KNOW
If you normally demonstrate your care by expressing an interest through a series of questions, never is this a more inappropriate time. Questions such as “What did the Dr say” or “Do they (the ubiquitous “they”) know why this happened?” Inevitably, these questions lead to one of two scenarios:
1. the patient is forced to relive his or her appointments, medical history, prognosis and feelings about said prognosis to satisfy your curiosity (I’m fairly certain the patient already is aware of all this information so the sole purpose of repeating it is because you either nosy, or too lazy to look it up on the internet)
2. the patient is forced to listen to your subsequent platitudes as to “gods will”, “everything will work out” and “everything happens for a reason” or some derivative there of
And finally, the answer to “Do they know why this happened?”
Yes. They do. It’s because the patient is a bad person.

TIP ELEVEN – WWYD
The patient will not likely care What You Would Do. Try to avoid dispensing advice that begins with “If I were in your situation…”. While it’s highly unlikely that you are going to be in the same exact situation, it is fairly likely that your life experiences, personality, and general attitude are going to be dramatically different. The patient will not find your speculating interesting but will instead likely offer to trade spaces to give you the opportunity to display your poise and control over the situation.

And finally (and my personal favorite)

TIP TWELVE – BORED GAMES
The patient will be sorry to hear in any variation how bored you’d be if it were you. The patient wants to assume that you are bright. If you choose to profess the fact that you are neither self-aware enough nor self-entertaining enough to occupy your own mind, the patient is not likely to find you very interesting either. hances are, if the patient is in the hospital for any length of time, it’s fairly serious. And “being bored” is the furthest thing from their mind.

Tuesday, February 27, 2007

I Had A Dream

…last night that my Dr told me that the only way to keep the baby was to eat more chocolate. That chocolate secrets a chemical that binds the placenta to the uterus. So to “save” the baby, I’d need to up my intake.

Odd dream.

I also dreamt the hospital was floating over the ocean. I dream I’m in a house over the ocean every time something big is going on. Like when I bought my house, I dreamt I could look under the rug in my bedroom and see water splashing pier pilings. Last night I dreamt my purse and all my stuff floated out to sea and if I rolled over in bed I’d land in the water.

I don’t particularly care for either the ocean, or chocolate.

I’ll be posting an advertisement today for a new subconscious.

Thursday, February 22, 2007

And so I ask myself, how did I get ths way?

Our pregnancy has been both difficult and high risk since conception. No one knows why. It’s possible I had issues pre and we never looked b/c I was never “trying”.

So – the long, why I am here - excepted from diary...


I felt great until week 6, and then I had bright bleeding (more then light spotting). After having had a miscarriage in 2003, I resigned myself to the “what will be, will be” thought process. And of course after my Dr.’s nurse (of whom I was NOT a big fan, I confess) also gave me the “Its nature’s way of dispelling a bad pregnancy” pep talk. (Rest assured, I’ve been with this practice for 11 to 12 years so this is not my pregnancy dislike of said nurse, but a long standing growing dislike…I’m sorry to say.) Anyway, the spotting happened a few hours after intercourse so we thought “hmm, maybe we shouldn’t…???” We go to the Dr, they confirm the pg. My doctor suggests a single week of rest – couch rest, she says, not necessarily bed but to lay low and no exercise save for walking. So that’s what we do. We are still careful. She says it’s not b/c of the s*x but we decide to avoid it anyway. Then I start to experience the Worst Morning Sickness Ever – lasts all day until about week 12 but I digress…

After every assurance that we could have s*x, 3 weeks later, we carefully try again – week 10. The next day, about 14 hours later, I’m speed walking (b/c stupid babycenter.com makes you feel like a moose if you are not doing Pilates while eating flax and bananas) – and I’m rounding my second mile when WHOOSH, I start pouring blood. Down my legs, saturating bleeding. Off to the ER. I’m not at my “good” hospital but the local “let me fix your broken arm” hospital instead. They are surprised to find the baby on the U/S. I’m told we possibly had a second pg, a twin, owing to the amount of blood and that I have some blood clots still that should resolve. My dr requests I be transferred by ambulance to the “good” hospital and they essentially tell me the same. My cervix is closed, so go home, couch/bed rest 2 weeks. Home I go, rest two weeks. At this point, I can’t fall in love with the baby. I’m having nightmares every night, I wake up panic stricken, I feel moisture, think its blood. I can’t sleep, I cry at night. I hate being pregnant, I hate not being able to feel good. Of course we have the mildest fall on record and im too sick, and too immobile to enjoy it. Argh!

So we wait. 3 more weeks. We go to the Dr on Nov 27 – and have our first “big” ultrasound. We are week 13, and all is good. Wow! So we start to feel safe. We are past the first trimester and ON OUR WAY! That Friday night we go away with friends to celebrate. I’m just beginning a bump and we are on our first date in over 5 weeks. Very happy romantic time. There are candles, and twinkly lights – it’s Dec in New England and we are in this gorgeous restaurant having a 3 hour dinner. We are SO in love. We go back to the house to sleep, and wake up the next day and just hold each, happy, "in the predawn light". The drs have all assured us that this is ok, that we are totally safe. I stand up to go to the bathroom - and blood is pouring again. I can barely make it to the bathroom. Then we start losing chunks of tissue. 40 minutes to closest hospital. I have now bled through my pants and the towel. ER again. Collection hat in bathroom. There we lose about a hands width of tissue plus. The ER nurse is fairly certain it’s a miscarriage and she holds the tissue for analysis. Back to U/S. Hey! The baby is still there. My placenta is pulled from the side of the uterine wall and huge clots are formed behind it. we have two areas of separation and it looks iffy. We are given the bedrest talk, along with the “50% chance” talk. The Dr won’t make eye contact. More crying. That’s Dec 2. I stay on the couch until Dec 18 or so. I hate the baby at this point b/c im sure its not going to live. Crying of course b/c I can’t do Christmas for my nieces and nephews, b/c we don’t have a tree, b/c it’s Doug (my fiancés ) birthday and I can’t bake him a cake. Crying b/c I’m offered contract work at $** an hour that I have to turn down. Crying b/c I spent almost 3 weeks in Nov on the couch and only got to get up a week. Cry cry cry. A month goes by. We are now into January. It’s January 4 and we are back at Dr. My placenta has completely reattached! Wow, it’s a miracle.

But there’s a spot on the heart. So now we have to get an amnio. The directive is to rest again, b/c the placenta separation puts you at higher risk for a miscarriage – that in combo with the amnio. Oh, and by the way, my cervix is a bit short. 2.4. Restricted movement and can I come back in 2 weeks? 2 weeks later, amnio fine- no Downes, but my cervix is shorter still and funneling – it’s 1.6. Take it easy, restricted movement and partial bedrest – sit or lay as much as possible. So I do. Two weeks later it’s .9 still funneling. Total bed rest. We move the furniture downstairs, we hire help…it’s stressful. 2 weeks later - .5. nothing is slowing it down. I have .5 millimeters left before my cervix thins and may dilate. I’m 24 weeks and they hospitalize me.

The baby will not survive if its born. The goal is to get to 32 weeks. Each week carries its own risks. In my drs words, “these next few weeks are critical. If the baby is born, it will be disastrous”. Doug looks it up in ob journals. Theres a a 31% chance of the baby surviving labor and a 90% likelihood of dying by its 85 day after birth. If we can get the baby to 2lbs, it may survive. Maybe. That’s 4 weeks away, with no cervix.

And that was last week. Today we are 25 weeks, and I go to the dr next Friday. I expect by then that my cervix will be gone, and likely dilating. They monitor me for contractions daily, and I expect by the following week, I’ll be upside down in a Trendelenberg bed.

Coffee in Bed

There's a stain on my notebook
Where your coffee cup was
And there's ash in the pages
Now I've got myself lost
I was writing to tell you
That my feelings tonight
Are a stain on my notebook
That rings your goodbye


Through no fault of her own, my nurse last night spilled a cup of lukewarm coffee from atop my nightstand.... Down the side of the bed, on the sheets, the floor, the cords, the call button....

After I drank it, I fretted about premature labor, caffeine contractions, whether the beans were shade grown to protect songbirds, whether it was FreeTrade. ... (ok, not the last two. But I WAS worried about Baby Butler. It was decaf, but still...)

regardless, spill it did.

About an hour later, the coffee was still on the floor, and had saturated the side of the bed.

"They are NURSES" I thought "They are busy saving lives. I'm not going to push the red button for clean sheets."

But bedrest or not, I'm still pregnant!!! ...AND IT SMELLED. (It smelled sticky sweet, and not like in an uptempo Def Leppard way but grossly so.)

"I have a headache" I think. "I hate coffee. I'm laying here (lying here in fact, but to be truthful, in my mind I was grammatically incorrectly laying) "I'm laying here in smelly coffee hell. Why won't she come back, why isn't she here, what's going ON??"

So Doug comes in.

me: Hi (sullenly)
Him: Hi
me: Do you smell coffee? (accusingly)
Him: No
me: well, I do (nastily)
Him: Oh
me: It spilled (obviously)
Him: Oh, I'm sorry, do you want me to get you some more coffee?
me: No (petulantly)
Him: oh

me: It spilled and the nurse said she'd call housekeeping and they didn't come and there's coffee all over my bed, and the floor, and I've been here for AN HOUR and it SMELLS and I have a headache and I hate coffee and I don't know why she said she'd come change the sheets when she didn't and now I don't feel good and I'm so mad at her and it smells and I know it shouldn't have been there but I really wanted it and now it's spilled and all I can smell is coffee and it smells. (plaintively)
Him: oh. Do you want me to call the nurse?

Me: No, she said she'd come and I don't want to bother them. (irrationally)

Silence

Him: So what do you want me to do?
me: Make it stop smelling.


I'd love to tell you that I'm graciously reclining in bed like Mary Steenbergen in a Lifetime movie. That I only get angry with pretty non-face puffing tears and that my hair fans across the pillow and my lips are glistening with peach gloss. That we hold hands clasped in prayer for "our little angel" and I receive visitors in a linen white nightshirt with a brave face.

In reality, I watched Doug get on his hands and knees, gangly in his suit, and mop the floor with the worlds tiniest towel, and then do it all over again with antibacterial soap. And then wash the mattress side, change the sheets, and then get dinner. All while I'm hysterical because I feel so guilty (plus he's doing it all wrong)and he's snapping my head off because housekeeping should have handled it, he's hungry, and he really can't smell anything anyway.

It occurs to me that although together, for better or worse, we can handle anything, climb every mountain etc., I can ALSO see why spouses suddenly snap after 40 years and shoot one another.