10 things I learned on an unexpected trial run to the hospital

Nobody freak out. I appear to be, as far as anyone can tell, totally fine. But mix the word "pregnant" with the word "hospital" in any way that isn't about delivering a baby and it gets people pretty riled up. Me included I suppose.

So this all started Saturday afternoon when I noticed it was a little bit more difficult to breathe. Then I woke up Sunday morning around 5:30 gasping for breath. Once I got myself calmed down enough to take slow shallow breaths, propped up on a mountain of pillows, I was okay. I still couldn't get a full breath, and it hurt to breathe into more than half of my lung capacity, but I knew I was getting enough oxygen anyway. So I laid like that for two hours or so--trying to get back to sleep without success--until Terry woke up and we got ready for mass.

I kept having breathing problems for the rest of the day. But I didn't know quite what to call it. Shortness of breath seems to imply that you aren't getting enough oxygen. I was pretty sure I was getting enough. I didn't feel dizzy or anything. But I just could not draw a deep breath and every time I tried, or just forgot to breath shallow, I had this burning ache in my lungs. Being somewhat naturally inclined not to make a fuss or be "that patient" who calls about every little thing, I think Terry and I were both inclined to just tough it out and call during regular business hours on Monday. But when I hopped on the internet to search a little on difficulty breathing in pregnancy and hydrocortisone and breathing (because I was recently put on Hydrocortisone). That is when I learned my first new thing:

1. Difficulty breathing is one of the conditions when you are always always supposed to call and check in with your OB.

2. Difficulty breathing is also one of the signs for an allergic reaction to hydrocortisone.

So now a little more freaked out, I call the off hours answering service. Wrestle with a surly phone operator who is being sort of a rude ***** to me. Lose my composure and start crying in response to rude operator. As a result still crying when Dr. Gupta calls me back about five minutes later. I rejoice that it is my beloved OB Dr Gupta who just happens to be on call. I describe everything that has happened in the last 24 hours and try to include as many details as I can to help explain it. Could it be the hydrocortisone? (Turns out no, not in small topical doses). I have asthma, but this feels nothing nothing like any asthma attack. This feels nothing like any breathing problem I've had before.

Gupta, bless her heart, says that if I am concerned she is concerned. And that particularly with my family history and risk factors for clotting, she wants to get me looked at to run a few tests, make sure I and the baby are getting enough oxygen etc. So off we go in our trusty little 1995 corolla downtown to Prentice Women's Hospital. Where I learn another new thing:

3. Each of the departments in this facility is world class. But the communication between departments totally blows.

This was a theme that came up again and again, but I first learned it because when I said to the main desk that I had been instructed to go to the 8th floor (Labor and Delivery) they pointed me through the triage first (which is where you have to go if you are, well, actually laboring and delivering at that moment). We sat in triage for 30 minutes while they tried to work out how to enter me into the system, what to do, where to send me etc. I found myself glad that I wasn't actively short of breath (or of oxygen) because I likely would have been passed out on the floor before they figured out how to print my bracelet out. Finally L&D just told them to send me upstairs without entering me into their system the way they normally would for the flow of delivering women.

Up in L&D we got placed in one of their smaller triage rooms (rather than the spacey hotel quality delivery rooms). We had an incredible warm funny nurse named Amy who hooked me up to all sorts of gadgets that go boop: a continuous electronic fetal monitor, a contractions monitor (just for good measure, I wasn't contracting) and a "pulseoximeter" that went on my finger to make sure oxygen was circulating through my system. She also took my blood pressure and then left the cuff on for a while, so that was dangling there for a bit too. Right away I learned a few more new things:

4. Black ankle socks with yellow thread is not a good look with a sexy hospital gown. Looking at my black socks at the bottom of my bare calves kept making me think of hollywood movies of wall street executives getting caught cheating on their wives.

5. Prentice has some truly amazing nurses. I was concerned by their 94% epidural rate that they would have nurses who just wanted bed-bound compliant patients, but I felt so reassured by every nurse and resident that we met and now feel excited and confident about delivering at Prentice.

6. Electronic fetal monitoring is a giant pain in the tukus. They strap these two belts around your rotund abdomen, but the minute you move around they stop getting a good reading. So if I was reclining it would read the baby's heartbeat just fine, but if I sat up cross legged it got nothing. I can tell this is going to be a pain during delivery, but it was not something I couldn't cope with. They have pretty firm policies on fetal monitoring at the hospital, and it doesn't appear that opting out is an option. The only way you can even get extended intermittent monitoring (3-4 minutes every 15-30 minutes) is before you are 4cm. Once you are in active labor they have a firm every 15 min policy, which seems more trouble than just wearing the darn things all the time.

They had me take a few hits off an inhaler because the resident felt that my symptoms, combined with my history of asthma, seemed most indicative of an asthma problem. The inhaler helped temporarily, but if only gave me more air before I hit the painful part, it didn't take the pain away. And even though four hits would have been enough to pull me out of a full-on vision-starting-to-black-out attack back when I was playing sports, the four that I took in the hospital only helped for about an hour, and then I was right back where I started.

The resident was in favor of a CT scan to be sure that I didn't have a pulmonary embolism, or blood clot in my lungs. But bless Dr Gupta she said she wanted to run the less invasive less risky test first to try to get a diagnosis on the basis of that. So I was ordered down to have an ultrasound done of my calves, where I had previously had some bad pain after flying for Christmas, to see if there was any evidence of blood clot remnants down there that might have broken loose and gone to the lungs. And so I discovered two more things.

7. Dr Gupta reaffirmed my belief that while she is committed to being sure dangerous medical conditions are ruled out, she is consistently in favor of the least invasive, least risky intervention possible to achieve the important goals of maternal and fetal safety. Go Gupta!

8. When you have to be transferred from one dept to another within the vast complex of Northwestern Memorial Hospital (of which Prentice Women's is but one part) you have to wait (and sometimes wait and wait) for a "transport person" to come and get you, who wheels you in your little gown through a labyrinth of poorly-lit underground tunnels. This whole transport business added a considerable amount of time to our visit. But on the upside, all the transport guys we met were friendly and chatty and we felt like old friends by the time we arrived at our destination.

So we got the ultrasound done of both my calves and she was incredibly thorough, really seemed to be an expert at what she was doing, and found no evidence of clots. So we wait another eternity for transport (seriously about 40 minutes) to arrive and then we are zooming back to L&D.

When we get to L&D once again we discover that communication between departments is not so hot. The L&D folks can't find any report of what she just did, so I just have to verbally report to them that she told me she found no evidence of clots in either leg, but she had said she could only find clots or remnants, but if a clot had previously been there and broken totally free then she would not be able to detect that.

Thanks to transport taking so darn long, we get back to L&D at 7:10. Which sucks because it means Dr Gupta is no longer the OB on call for my practice. We are now dealing with Dr Shaw, who is totally nice and wonderful in her own right, but there was something comfortable about having my Gupta on the case. We have now been there since 3 PM.

More sitting. The residents and nurses in L&D are changing shifts at 7:30, so now I meet a new resident (also super nice and awesome) and a new nurse (ditto). We do a little bit of catching up on the case, and the new resident decides to get back on the phone with Dr Shaw and evaluate whether the risks of a CT scan is worth the benefit of ruling out Pulmonary Embolism, which is the big thing that would be concerning for someone like me, with my history, who is having breathing problems.

The resident explains the risks to me. Words like "childhood leukemia" get spoken far more often than I would ever like to hear them. Essentially the big risk of exposing a fetus to radiation is childhood cancer. In the first trimester there is also a risk of birth defects and miscarriage, but at 30 weeks I was safely past that. She explained that at high levels of exposure--5 rads or more--babies had a higher chance of developing childhood cancer, but according to her those numbers were still so slim it meant going from a 1:3000 chance to a 1:2000 chance. I found myself thinking I'd like that extra 1000 people standing between my kid and his chances of cancer. But she also explained that the full radiation to my lungs would be 1 rad, 1/5 of what was shown to cause any problems to the baby, and that furthermore the baby would not be directly exposed to the full rad. They would lead shield my abdomen.

Terry and I talked. I called my mom for what she thought. I wished really hard that it was still Gupta making the call, and then I cried. We decided to have the test. Because if I really did have a PE, that would be life threatening to me and the baby.

So more interminable waiting. Because it turns out that radiation has a set of demands they want met before they will scan me. So the L&D nurse (now Brenda, a warm but take-charge woman) has to put an IV port in me for the scan, and has to draw a vial of my blood to send to the lab to confirm that my kidneys are functioning well enough to handle whatever contrast dye they use in the test. So Brenda is setting up all these needles and sharp business on the tray next to my bed, and I am sort of confronting a fear I have been cultivating lately of needles, but of IVs in particular. So this is going to be my test run. Brenda lands my vein in her first try, which is exciting because I don't have large veins and often RNs have to stick me multiple times. And the gauge of the IV needle is huge. You could drive a tonka truck through there. So the IV gets in place and taped down. And I discover another new thing.

9. I hate having the IV line there. It is just as annoying as I thought it would be. It is like a constant low grade sting. Like the physical version of the whine of a mosquito. I just couldn't figure out how to totally ignore it despite my good efforts. And although Brenda told me it was all in my head, that the tube was flexible and I could have full range of movement, I just wasn't comfortable moving my arm around while that thing was in, and it felt more uncomfortable to bend it. I could tell I would be annoyed as all get out if I were trying to go through active labor with that thing. So I asked the nurses about refusing the port unless medically indicated and they all said yes yes it was totally an option. Woohoo!

We watch TV for a while, which includes the not-so-good international dance competition hosted by that Lord of the Dance guy, followed by a much more entertaining episode of Fraiser. Eventually kidney labs come back a-ok and transport is called and once again we are back through the maze to the radiation department. We sit and wait even though the department is totally dead. Not much is happening on a sunday night elsewhere in the Northwestern Hospital complex, although L&D was still relatively busy with about 15 women laboring. When the radiation technologist comes to take me away for the first time I have to be separated from Terry.

She wheels me into a little room with the big giant Cheerio machine that is the CT scan. She explains that I have to take my necklace off and that the doctor will be in shortly to explain the test to me. The necklace is a little silver charm of a baby boy that my mom gave me for Christmas. I take the necklace off while I wait in the room alone, and somehow looking at that little silver charm in my palm, and the big giant machine, and being without Terry, and my emotions go crazy. I'm not sobbing, but I have tears rolling down my cheeks. I have done everything I could to avoid unnatural crap during my pregnancy. We only drink organic milk now. I went three days with a continuous crippling migraine before I took so much as a single tylenol for relief. I haven't had caffeine at all. And here I was about to expose my son to radiation that might, however slim, increase his chances of childhood cancer.

They explained it all to me, shielded my protruding belly with lots of lead, and then into the Cheerio I went. The dye made my hands feel incredibly warm, but thankfully no nasty metallic taste in my mouth. I had tears on my cheeks the entire time I was in the Cheerio.

When I got wheeled back out to Terry I really lost my composure and started crying. At this point I was tired, because I hadn't really slept well the night before because of the breathing trouble. I was starving and running out of energy because I had a bowl of brothy soup for lunch at 1 PM and had now been at the hospital for more than 7 hours with only a small pack of trail mix from the vending machine. I was emotionally exhausted from having to make decisions that potentially placed my son at risk. I was just at the end of wanting to deal with all of that. And Terry was amazing. He got me tissues and a garbage can. He was comforting and confident and warm. He was perfect in every way. Eventually he even got me laughing. And that is when I learned the last best thing:

10. Terry is the most amazing partner I could have ever asked for. They broke the mold in every way when they made my husband. I have no idea how I got so lucky to have someone like him to love. I do not even have words to say how grateful I am that he is the one by my side both when things are wonderful but also when things are bad.

The tests for PE came back negative, so they sent me away saying that they didn't know what was causing my breathing problems, but that they had ruled out causes that were immanently life threatening. We had parked at 3 PM. We left at 11:44.