From: larrabee@cse.ucsc.edu (Tracy Larrabee)
Newsgroups: misc.kids
Subject: Long story about preterm labor set off by flu
Date: 13 Nov 92 02:01:04 GMT
Organization: University of California, Santa Cruz (CE/CIS Boards)
NNTP-Posting-Host: arapaho.ucsc.edu

It seems like I'm always telling my stories to this group.  But it
seems to me that this one, like the others, might actually contain
small bits of info that might be helpful to others (to say nothing of
the bald-faced plea for information that might help me from those of
you who have been through this before).  This story is about
intestinal flu setting of preterm labor.

I was tooling along, almost 30 weeks pregnant, feeling mostly pretty
good (except for my rotten lower digestive tract), when on Monday I
suddenly came down with what everyone (including official medical
personnel) is calling intestinal flu.  My lower intestines got even
more spectacular, I vomited long and hard if I put any food or fluid
in my mouth, and by nighttime I had a temperature of almost 101.  But
I'm getting ahead of my story.

I went to work and was trying to cope (that is one thing about
pregnancy: you get so used to feeling like crap that you can't
necessarily recognize an actual illness when it comes).  I finally
started increasing the vomiting and feeling the whigged out, emotional
overload that usually means a fever for me.  I called my doctor: not
in.  I called her back-up: not in, and the nurse/office manager
directed me to emergency care (this turns out to have been a mistake
on her part).

I went to the emergency care at the clinic where I normally see one of
my doctors, and the doctor said I had no temp, my baby sounded fine, I
just had the flu, and I should go home.  I drove home, feeling more
and more like crap and more and more upset about not feeling right.
This feeling was probably increased because I live 35-45 minutes from
my doctors or my hospital even in the best of traffic (and there are
really no closer alternatives).

By the time I got home I felt dispondent and incapable.  I knew I was
supposed to keep hydrated, so I tried to drink some heavily diluted
ginger ale and as a result spent several minutes vomiting all over
myself and my bathroom and trying ineffectually to clean it up (I just
didn't get any warning).  I tried my fail-safe for feeling just about
any type of awful and I got in my bathtub and tried to relax.  I was
really worried about the baby.  I was feeling contractions, but I have
been very conscious of my braxton hicks contractions for several
weeks.  They seemed a bit more intense, but I told good old "Doc in
the Box" about that, and my description didn't bother him much.

Finally, in desperation I did what I thought I would probably get
yelled at for when I 'fessed up:  I stuck my perfectly clean hand up
my recently bathed vagina and felt a cervix that felt like wet bread
with a quarter-sized spherical bulge of smooth, slimy, hard in the
middle of it.  

Now I really paniced.

I called up my doctor's office and cried into the phone.  I said I
knew she wasn't on call, but her back-up hadn't helped me either, and
I was desperately in need of reassurance.  I said I had lost too many
to risk it now, and maybe I was being paranoid, but I needed to hear
my Doctor or her backup (who I sort of know) tell me why I should stop
worrying.  I just couldn't tell if I was over-reacting or endangering
my baby's life.  After hearing my voice they didn't even argue with
me.  They talked me down, put out a call, and told me to wait by the
phone.  

When my doctor called me back and I told her my story, she told me not
to panic, but to come in to labor and delivery to get checked.  She
said this wasn't an ambulance trip kind of thing, and I could wait for
my husband to get home to drive me, but we should take it easy on the
ride in and I should come in expecting to stay at least the night.  I
was *very* happy to be taken seriously.

So Monday night I got to the labor and delivery department that I had
just toured two days before (and I thought that pre-registration was
being done so early).  I was still a bit defensive about being
paranoid, but the nurse assigned to me was very gentle and motherly
and helpful (in fact, each and every one of the nurses I dealt with
seemed to be very wonderful).  She got me set up on the fetal monitor
and gave me an exam.  Her call: 2 cm dilated and 50% effaced with the
baby at -1 station.  Contractions coming irregularly at 2 to 4 per 10
minute period, but usually only one of the group would look big enough
to be productive.  

They gave me a shot of tributaline (sp?)  and started the 1.5 hour
quest to get an IV into me.  Man, but you people who complained about
IV placement sure weren't kidding.  It is Thursday now, and one of the
failed placement spots still hurts like hell.  People asked me if my
contractions hurt, and I said the worst of them was nothing to IV
placement.  (I know these weren't contractions weren't anywhere near
the ballpark of real productive labor contraction pain: just slight
discomfort.)  With my being so dehydrated it was especially hard to
get the thing in.  But once they did, I started feeling better soon
after.

Doctor came in and confirmed nurses take on the baby.  She was
impressed with my ability to tell her I was starting a contraction
before the monitor did.  The baby looked great: obviously whatever was
wrong with me wasn't concerning him.  His heart rate was a bit high
when my fever was on the high side, but it came down when my
temperature came down.

I spent the night.  My night nurse spent quite some time chatting with
me when it was clear I couldn't sleep (the tributaline sent my heart
rate to 120 and left my shaking, and I still had nausea and a fever
and sore hip bones and boy, but those labor and delivery beds sure
weren't designed for sleeping).  She asked me in amazement how I knew
to check my own dilation.  (I was pretty floored since I expected to
be told I had done a very naughty thing, and I hastened to assure her
that my hands were clean and that I had done it only out of
desperation.)  She said they were glad I did, though now knowing I
have an "irritable" uterus, I should be very careful about anything
nudging my cervix or irritating it in anyway (so much for that kind of
fun for several weeks).  When she heard my story of emotional turmoil
stranded between feeling paranoid and negligent she reminded me that
even when I don't feel comfortable "bothering" my doctor (which is a
feeling I should ditch anyway), I can always call labor and delivery
and get a quick reaction from them; they are always there, always
someone is awake, and pregnant women are their business.  I
appreciated the suggestion and I plan to take it to heart.

I got checked in the morning, and we ran into the mystery of how--when
the rehydration and tributaline seemed to have stopped my
contractions-- I had gone from 50% effaced to 80% effaced.  I was
still running a temperature, but it was headed down.  I spent the
night again, and things seemed a bit better in the morning (still a
healthy baby on the monitor and not much in the way of contractions).

My doctor sprung me.  Current optimistic theory is that the
dehydration and excessive smooth muscle activity convinced my uterus
to join the party.  Perhaps if I make my uterus be totally quiet until
Monday everything will reset, though I am probably stuck with my
dilation and effacement (but the baby was now at -3 instead of -1).
She said she was willing to send me home mostly because she had so
much confidence in my ability to act as my own fetal monitor.  The
rules are that I can lie on my side, sit semi-upright briefly to eat,
get up to use the toilet, and take one bath or shower per day.  I am
to monitor myself and call if anything seems to be getting more
exciting.

Yesterday, the day I came home, the process of transporting myself
home seemed to get me going, and I had about five contractions per
hour at the start, but only two or three per hour by bedtime.  Today I
am back to perhaps one per hour.  And one more quick and guilty
cervical examination leaves a non-medical me convinced that my cervix
feels firmer and my baby's head isn't really accessible to me.  I feel
optimistic.  I get to drive myself to my doctor's office on Monday
to be checked.  In the worst case, I am transferred back to the 
hospital and in the best case I am given a bit more freedom.

In the meantime I get to learn of the frustrations of a side-lying
life.  My hips are screaming at me (and it is my fault for wanting a
firm mattress), my husband is over-loaded, and it is very, very hard
not to just get up and open a window when I would like some air.  I
did answer the door today when someone knocked; how do I get around
that?  I plan to send for the bedrest FAQ soon.  If one more person
tells me how nice it must be to just relax in bed all day, I may put
out a contract on them.  Thank goodness for a husband who was willing
to go to quite a bit of trouble to get my bedside-computing (though
the talent required to type while lying on my side is coming slowly).
I have all sorts of potential complications in my professional,
social, and emotional life, but I think I can handle them.  We seem to
have caught this early, and it seems like the whole thing can be dealt
with.  I plan to follow my very reasonable doctor's directions to the
letter.  I would really like to get back to my nice boring pregnancy.

Thanks for listening, send me any comments you think I should be aware
of, and I hope this story helps someone else some day.  Oh, and I have
really enjoyed the responses to my hospital tour posting: I hope this
posting explains why I haven't responded to any of them. "Thank you
very much" to all of you who sent me mail.

One more thing: if it looks like I am going to have the baby before 33
weeks I will be transferred to Stanford because they have a level-3
nursery.  Any comments on that?  
-- 
Tracy Larrabee		larrabee@cse.ucsc.edu