Monday, April 11, 2011

As if I could ever forget.....

I dont think I will ever forget the horrors of the first 15 weeks of this pregnancy, but for purposes of journaling and posterity I have decided to put it down on paper (or rather this blog).


January 24th- very faint positive on home pregnancy test. So faint in fact one could think that it it was just an error, but I felt differently. So I waited a day and retested.
January 25th- Another positive home pregnancy test- still faint but obviously darker than the first. At this point I was still a day or two away from my expected cycle so this confirmation was very early, but I was already feeling nauseous at night. Hence the reason for testing.
The next two weeks went on as normal. I would have periods of the day where I was very green and steered clear of all smells and foods. But I also had periods of the day where I could eat normally and felt just fine.
February 2nd- I went to the dr. to confirm pregnancy and get a prescription for some anti nausea meds just in case Hyperemesis were to rear its ugly head.

The storm....

February 8th- My 27th birthday I had to leave for 4 days of meetings for work at a hotel. I was nervous about dealing with morning sickness while in meetings for 12 hour days and eating hotel food but I was optimistic about the way things were going. At this point I was a little over 5 weeks pregnant.

February 10th- I spent the morning in the hotel bed and missed about 2 hours of meetings. I was very green to say the least and had spent the night in the hotel bathroom. Got a little better by lunch, freshened up and went down to attend the rest of the days meetings.

February 11th- Green ALLLL day long. Threw up every meal I hate, even just fruit and water. Frequent hot flashes throughout the day. Attended a mixer that night, for about 20 minutes then went back to my room and threw up some more. Packed my bags and got ready to go home. Just could take any more. And all the different smells in the hotel were making things worse. Particularly, and very strangely, every time I walked from the elevator to my room, I could barely make it to my room before dry heaving and loosing my cookies. Something about the smell of the hallway triggered me every time. And this was no dump of a hotel either, the Little America is a very posh place and very clean.

February 18th- Between 2/10 and 2/18 hyperemesis was full blown. I was waking up in the middle of the night to throw up. throwing up all day, all night, not able to drink even water. Zofran medication was making no difference at all. Saw my OB who was very concerned about my dehydration levels and rapid weight loss. I had lost 5 lbs since 2/10. She ordered IV therapy 4 times a week where I would receive 8 mg IV Zofran, 1 liter of vitamins, and 1 liter of lactated ringers. I went to the hospital every other day to have this administered (what a nightmare). It did nothing. I would throw up in the car on the way to the hospital, in the hospital flowers while walking in, in the room while they were administering the IVs, and in the car again on the way home, and so on. Having the fluids would help a little with dehydration but nothing else.

3/1- another Dr. appointment. Another 6 lbs lost since last appointment. Switch from IV therapy to home health care with daily IVs. This is where the real torture would begin. Ideally a peripheral IV can last 7 days, but with my veins that was out of the question. Everytime they would come to poke me it would take 3-4 stabs before starting an IV and then many times the vein would blow, collapse, or clot. It got to where I was having to have a new IV started every single day. Just imagine that for a moment. I already felt like I was litteraly dying from starvation, malnutrition, and just sheer emotional hell and now I got to look forward to being a pincushion daily. Not to mention the fact that the IVs themselves hurt like hell. I would cry and night wondering how long this was going to go on. I would soon have an answer. Two weeks into home health they could no longer find veins to start an IV, my arms and hands were shot. The last day of home health the nurse said all she could find was a vein in the palm of my hand. I had reached my emotional breaking point. I was not going for an IV in the palm of my hand. I called my dr. who agreed that we needed to stop. It was time for the next step. An NJ tube. Also my hair was continuing to fall out in large chunks.

3/18- I can't remember the exact weight loss increments between 3/1 and 3/18 but by 3/18 the total was 20 pounds. On this date, after seeing the OB, I was sent to the hospital for one my IV rehydration and placement of the NJ tube. She was adamant about the rehydration- I was balling. Where were they going to stick me now? She said they might have to try my feet. Once I got settled in at the hospital, they called in a Anthesthisiologist to place my IV. Angels, really. The nurse was smart enough to recognize that I couldn't take more than one try so she called in an expert. He was able to place it in one try. They took some blood to measure various levels and started some fluids. Just using gravity, I absorbed a liter of fluid in less than 30 minutes. My blood work came back showing all kinds of trouble so I have to have another liter infused with some potassium for my heart and some other things that I can't remember. Once we had done that it was off to radiology for the tube placement.

Journey of the 4 NJ tubes...

Tube Placement #1- Radiologist was very nice and helpful. Used lidocaine jelly on the tube for my nose and a numbing spray on my throat to ease the pain. but still, there is no getting away from the uncomfortableness of shoving a tube up your nose and down past your stomach. It was torture and I vowed to never have to do this again in my life.
Started on the enteral formula that night- very slowly, getting about 400 calories in a 24 hour period. Getting through the tube placement was the worst, but even after it took quite a while to not gag and dry heave every few moments from feeling the tube in my throat.
3/22- threw up NJ tube #1

3/23- Tube Placement #2- This radiologist was not quite as good as the 1st. he seemed to have lots of trouble pushing the tube past my sinus. He just kept pushing and pushing and I swear it felt like he was going to push the tube into my brain. It was much more painful than the first time. He also had to take alot more xrays than the first dr, increasing my radiation exposure.
3/24- threw up NJ tube #2

3/25- Tube placement #3- This radiologist was like a godsend. He gave me some extra number spray in my throat, had my actually "snort" some lidocaine to better number my nose area and inserted the tube with me sitting up instead of laying down so that gravity could help advance it a little faster. He was done in like 5 minutes. Amazing. Still I gagged and vomited the whole time (who wouldn't?) but the pain factor wasn't there like the previous times.
3/28- threw up NJ tube #3

3/30- Tube #4 placement- There were some nurse errors at my dr.'s office which caused me not to be able to get my tube replaced the day after I threw it up. There was almost 48 hours in between losing tube #3 and placing tube #4. During that time, I was sooooo very ill. I thew up over 30 times in a 24 hour period. I hit a new emotional low. I literally wanted to not wake up any more. Tube #4 placement was by far the worst. The radiologist did not use any numbing whatsoever. What the heck is up with that? He apparently has never had this done! He also could not get the tube to go from my stomach into my intestine. My stomach was so small by this point from starvation he had to pump it full of air multiple times just to see the opening to the intestine. (OUCH!!!) Not only that but he didn't like the fact that I was gagging and coughing up little bits of bile so he made me put a washcloth over my face "so it didn't get on him". I was so annoyed. no one wants to be thrown up on, but really, let ME make YOU, the dr, a little more comfortable can I? I was bitter. I was hard to breath with the cloth on my face and the heat from my breath made my nausea and gagging even worse. This went on for over 10 minutes. The radiologist just kept staring at the x ray screen saying "i dont know, it just wont go". way to instill confidence. I was done with this guy. But it wasn't like I had a choice. 5 minutes or so later he finally got it and sent us on our way.

Perinatology...

4/6 Appointment with perinatologist at hospital- Baby looks great! They did a very detailed ultrasound where they measured the size of the bladder, kidneys, heart, brain, bones, ect. Took about 30 minutes, but it was nice for my to be able to see the baby for a long time. The baby is measuring exactly on track- so despite my deficiencies, we have a healthy babe. They also believe it is a girl! They want to see me back in 1 month to track progress again and recommended starting steroids in the mean time and really not eating much orally for fear of throwing up the 4th tube.

Since 3/30 I have been able to drink little bits of water- I guess the nutrition from the feeding tube is helping to even me out. But all my food comes from the formula through the tube. I'm up to 1800 calories a day now and gained 5 lbs back in the last 10 days. Dr.s were practically jumping up and down at my appointment this morning. Here is my current medication protocol:

16 mg Methylprednisone 3 X a day, crushed and mixed with water through feeding tube (steriod to help with nausea, just started this today)
8 mg Zofran 2 X a day, crushed and mixed with water through feeding tube (anti emetic)
1 Prilosec daily for acid reflux, crushed and mixed with water through feeding tube
1 Ducolax daily to keep my bowels moving from the effects of the other drugs.

Feeding tube will be in place until I can eat a minimum of 50% of my daily caloric needs orally. Currently I can't do much more than a bite or two of food every few days so it is going to be a while until we reach that point. but my dr. says I can keep the tube until delivery if needed. Can you imagine how FUN that sounds??!!! And just for record keeping sake here is an image of me with my tube. I was able to take a shower today for the first time in 10 weeks!! (I did bath before but had to have help because I was too weak so taking a shower was a big milestone)