Appt #30 – OB, NST, triage, frustration, medication, BLAH!

So Thursday started off pretty uneventful. Had another OB appt just to have an NST. My doctor wasn’t in the office but his partner was. I called him in to ask some basic questions. He noticed the frequent contractions on the NST and told me if they continue — 6 or more per hour — that I needed to go to OB triage at the hospital. My instinct was telling me these contractions weren’t going to stop, and I contemplated calling off of work and just heading home to rest. But I made the drive to work  anyway. This was my first mistake.

During the next hour I had 8 contractions. I was pounding the water with my feet up, trying to stay busy talking with my co-workers, trying not to focus too hard on my tightening uterus. The next hour I had at least 10. They weren’t letting up despite my taking it easy, some felt pretty intense for Braxton Hicks, and I felt aches in my lower back. So I decided to leave work.

During traffic hour.

With my Dr’s hospital over 25 miles away.

GPS said it would take 1 hour and 20 mins. OR I could go to the hospital the partner works out of, which was a mere 30 mins away. I opted for the closer option as the frequency of contractions was freaking me out. This was my second mistake.

I arrived to triage and thankfully there was no wait. They got me right in, had me pee in a cup, hooked me up to the monitors to check baby’s heartrate and the contractions, my blood pressure and O2 sats.  Sure enough it showed contractions, but less than the 8-10 I had been having. The nurse checked me and there was no dilation change. She left to phone the doctor on call (she said she “couldn’t” call my doctor’s partner even though I told her she could….blah).

Here’s what I was expecting: based on previous conversations with my Dr, if I continued to have multiple contractions an hour, even without dilation, he would recommend placing me on a med to stop the contractions so that baby would have the best possible chance of staying in the womb until AT LEAST 37 weeks. He said being proactive is important.  I have excess fluid, am a diabetic (which means baby’s lung development may be delayed compared to a non-diabetic) and come on, I’m only 35 weeks.

Here’s what I got: nothing. Absolutely nothing.

Doctor on call said for me to just go home and take it easy. That was it.  I asked the nurse what to do if this keeps happening, I can’t keep running to triage every time I have too many contractions.  The nurse said most doctors won’t do anything to stop contractions at 35 weeks because “you’re so close anyway” and that I shouldn’t come back unless the contractions start to cause pain, bleeding or my fluid was leaking. So basically everything opposite of what my doctor said.  Basically it didn’t matter to them if I went into labor before 37 weeks. So I’m quite irritated at this point. And just disappointed. I’ve been having these darn Braxton Hicks for weeks and weeks and each week they get more frequent and stronger. It’s very stressful.

Then the kicker – the insurance gal comes in and tells us we owe $1000.

ummmmm, WHAT?!!

Every OB triage visit I’ve ever had (including one at this same hospital) gets charged basically as an ER visit co-pay, it doesn’t come out of my deductible. WTH.  I called the insurance and they said its all up to how the hospital decides to bill the insurance. So I paid the very minimum and will follow up on the claim. How can you charge that much for doing nothing?  So I pretty much went to the hospital for them to do nothing and charge me $1000. I was so angry. And when I get angry I cry. So I cried. And cried. And the tears didn’t stop.

I cried all the way home. Cried out of anger and frustration and anxiety and stress and discomfort and of all the uncertainty.  I hadn’t had a massive meltdown type of cry in a while (probably since my last OB triage visit, come to think of it….hmmmm). So I was due a good, stress-relieving cry. Lets just say I didn’t sleep peacefully that night.

This AM I called **MY** doctor as soon as the office opened. I explained what happened. He was very kind and understood completely why I went to the closer hospital instead of his. He said in the future its ok to call the on-call service and ask for him, he will always call his patients back even if he isn’t technically “on call.”  (That was my 3rd mistake, btw, I should’ve called before going to hospital. When you’re contracting so much and doctor’s have repeatedly told you to go to hospital if you have so many contractions, you tend to do exactly what they say ;-).  Then he said we really need to slow down the contractions and called in an order for nifedipine 10mg every 6 hours for 7 days.

I’ll admit I was scared to take it. Nifedipine is typically given for high blood pressure. I don’t have high blood pressure and one of the worst feelings is to have your blood pressure go too low. He reassured me it was a low dose and shouldn’t cause me any issues. Of course, being a nurse, I looked it up in my drug book and read the long list of side effects (some interesting combos like: diarrhea, constipation and anxiety, drowsiness…hmmm). I had a long chat with the pharmacist and happened to have a visit with my cardiologist as well today.  They both said its a low dose and if I get lightheaded to check my BP and not take it, call OB, etc. I’ve had 2 doses and so far so good. I feel a little sleepy headed and have a mild headache (which could be from all the crying, ha!). But no other side effects so far. I had a handful of contractions over 4 hours and then as soon as I got in the car to come to work, I got about 4-5 per hour. It’s less than last night and they don’t feel as intense, so I’m going to count it as a success thus far.

I’m SOOOOO ready for the weekend, I can stay home and rest, relax, put my feet up and watch 101 Dalmatians 18,000 times at my daughter’s request.