For the Record

On Tuesday I called to make an appointment with my OB (Dr. S) - even though I haven't been released by the RE (Dr. A) yet, obviously - because she will be the one sending me to the Maternal Fetal Medicine (MFM) specialist to monitor my cervix (among other things) and place a cerclage if necessary.  


The nurse making the appointment was just following their normal procedure - to see me at 8 weeks for a 1/2-hour appointment including an ultrasound to see the baby's heartbeat and then another 1/2-hour appointment 2 weeks later (I don't recall if I'd have bloodwork between those two appointments that we'd discuss at the 2nd one - I think that's the plan).  So I asked the nurse if she could just let Dr. S know that I am pregnant, because I just had a miscarriage at 16 weeks in February, this pregnancy is through IVF, and Dr. S had previously indicated that she'd want me to see an MFM, and I am just wondering if she'd like to do anything differently with me.  The nurse said she'd give Dr. S a note and call me back if anything would change.


On Thursday she called back and said that Dr. S would wait to refer me to the MFM until after she's seen me (still at 8 weeks, which is fine - I won't really be released from Dr. A until then anyway) and that she wanted me "to get my records from my first pregnancy, when I had that diagnosis."  Erm...that was a confusing statement.  I should have said, "what diagnosis?" because the conversation got more confusing from there.  I asked, "Do you mean from the hospital?" She said, "Just whatever doctor you were seeing for that pregnancy."  I was assuming (and still assume) that the "diagnosis" to which she was referring was incompetent cervix, so I said, "Well, my doctor was Dr. S - it was just in February" and she said "Oh. Let me look through here. Hmmm. She must mean your first pregnancy. Back in '94. Yeah. Yes. That's the one."


Okaaaaay.  I really don't see what anyone would expect to learn from my records from when I had Katie.  The only complication I had was preeclampsia at delivery (which Dr. S already knows about, and for which monitoring is pretty well-established).  Wouldn't the more relevant records be from the hospital where I delivered Jack?  I decided I'd request both, since I'm pretty sure that nurse was, to put it nicely, confused.


I still have to go by and sign a release for my records at my first OB's office, but I called the hospital in Springfield where Jack was delivered and faxed over a request on Thursday.  Yesterday I got the records in the mail (that was fast!).


So, it turns out, I definitely had an infection.  


I sort of knew this because I'd had an appointment with Dr. S on the Wednesday before that fateful Saturday.  The results of my bloodwork and urine culture I'd had done the week before had come back and she said that the urine culture was positive for "mixed vaginal and urethral flora".  She said that was weird because, usually if you have a urinary tract infection, the report will say something like "E. coli > 100,000/mL."  So, she seemed a little confused, but not very concerned. She gave me a prescription for 6 Macrobid (to take twice a day for 3 days), which I did not even have filled until THURSDAY.  I didn't even start taking them until FRIDAY morning.


When I was in the hospital, shortly before I was discharged, a new house OB had come in - different from the one who ordered my epidural, gave me pitocin, and evaluated me after I delivered Jack, which I did around 5 am, during an Ambien-induced slumber.  


After they had given me the epidural and pitocin and put on the contraction monitors, they said they would check on me and to call them if I felt anything different. They had offered Ambien previously, which I didn't think was necessary until I realized that I was just going to be lying there, waiting to deliver, by myself all night.  I requested the Ambien (my first experience with it) and it kicked in pretty quickly.  Apparently I asked Forest to "tell me a story".  I used to do this a long time ago, and the "story" I always wanted him to tell was his version of the night we met.  So he started telling the story and he said that I kept asking him to repeat "the sweet parts".  I don't have any recollection of this, but I think only part of my brain could hear the story and the other part was already asleep.  Forest said that only went on for 5 minutes or so and then I was completely out.  I woke up off and on throughout the night - I'd remember where I was and what was happening and then decide to go back to sleep rather than wallow in the situation, alone, in the dark.  But then around 5 am I woke up from a wave of anguish so overwhelming I can't describe it.  I burst into sobs which woke up Forest and we talked and cried for awhile.  He was adjusting my blankets for me and he noticed a lot of blood and "stuff".  He said, "I think it's happened" and called the nurse's station.  They came down and I had delivered Jack.  They told us we'd had a little boy, took him off to clean him up, and cleaned me up.  Forest held me the whole time.  I can't even imagine how I could have endured that without him.  Any of this, really.  He gives me strength and comfort I never knew was possible.


Anyway, I think the shift changed at 6 am so a new OB came in before we left.  He asked me if I had any questions.  Most of the questions I had were for God, and not for him, but I asked him "What would cause my cervix to just dilate all of a sudden on a Saturday afternoon?" Honestly, I can't even remember what he said - I know he ended up talking about what they do if you come in with bulging membranes that haven't ruptured yet.  Apparently they invert you, pretty much upside down, for months and months.  I asked him if it could have been an infection and he said that, if it were, I would've been in labor, which I wasn't.


So, this is what made me think that my body had just betrayed me - my cervix just randomly dilating and expelling my beautifully formed baby 24 weeks early. My RE disagrees.  Without seeing any records or hearing much at all of the story, Dr. A said that it was way more likely to be an issue with the placenta or an infection and that I was in labor, but just didn't feel it.


Well, my records confirm that I had an elevated white blood cell count (specifically neutrophils and monocytes).  So, I definitely had an infection somewhere.  The placenta had no pathology - the cord insertion was eccentric (which Dr. Google says means "in the center", which is where it's supposed to be) and there were no signs of infarct.


It was, as you might imagine, pretty emotional to go through the records and relive that horrible night.  But I am very glad I got them.  I don't know why I didn't request them sooner, actually. It helps to have an indication that there was a reason for what happened (if not, like, a cosmic reason, at least a medical one) and that it is something that can be monitored for to *hopefully* prevent another occurrence. 


So that was my Saturday.  Today we're going to go to Fair St. Louis to celebrate our Independence from those meddlesome Brits (ha ha).  We're going to see the air show, the B-52s and fireworks. If any cute pictures emerge from these festivities, I'll be sure to post them.


I hope you all have a great day :)