Planning for emergencies

Why it keeps happening is unexplained, but it does seem that we can expect it to keep happening.

After week of normality, I experienced another big bleed on Thursday night, in the middle of the night. I had been out for a lovely evening with friends and my husband had been in to London to see a band. He was home, I got up for a glass of water at about 01:30 am. We had a brief chat about what nice evenings we’d both had, and then, whoosh, I was covered in blood again.

We knew what we were supposed to do. I phoned the labour ward and explained the situation. They told us to come in. Since the bleed seemed to have stopped and there had been and was no pain whatsoever, I drove. Whilst my husband wasn’t drunk, he had had a couple of drinks during the evening, so driving would have been unwise. I specifically asked the duty midwife whether it would be OK for me to drive – had the advice been ‘no’, we would have taken a taxi.  I hasten to add that, at 28 weeks, I really don’t think its unreasonable to carry on with some kind of normality. However, under the circumstances of constant uncertainty, we have now reviewed this high risk ‘going out’ policy.

On the way to the hospital we saw an owl, which was pretty cool. But we were rather too preoccupied to really enjoy our Springwatch moment.

Upon arrival we were shown into the maternity triage area and I was treated to the usual procedures of monitoring, blood tests, cannulation, internal exam, showing people the contents of my underwear etc. This time we even got a scan. Was I in pain? No, except for the needles and intimate examinations. This, once again, didn’t seem to be the onset of early labour. Whilst we were being seen, another lady was brought in who was in labour. I think that this was the first time that my husband had ever heard someone in pain like that before (i.e. in real life, not how its portrayed on the telly). I think he found it really rather alarming.

By about 5, it had been agreed that rest and monitoring were the way to go, However, the labour ward was full, so we were put in a delivery suite for the remainder of the night. I had the bed, my husband had a beanbag on the floor. He commented that the beanbag was somewhat lacking in beans. We put this down to NHS cuts. (Bloody Tories!) I was also given an(other) anti-D injection due to my Rhesus -ive status. Apparently you can’t overdose someone on this, so I can expect another jab every time I’m in, as well as the routine one I’m getting next week from my midwife.

We got a couple of hours’ sleep and then were transferred to the Observation ward. This was a private room, which was nice. More monitoring, and baby continues to do well as far as heartbeat and movement are concerned. I was not being fed, which is of some concern, because that means that someone, somewhere thinks that surgery could still be on the table (so to speak). My husband went in search of food (he brought me back a croissant, but I had to wait to get permission to eat it). As we awaited the doctor’s rounds, we realised that we could overhear the phone calls being made at the desk just outside my room. The patient under discussion was me, and there seemed to be some degree of disbelief over the position of my placenta. The doctor doesn’t believe that my placenta praevia could have resolved so much between 20 and 27 weeks. This is consistent with what we were originally told; it might move, but it has a long way to go, so we shouldn’t hold out much hope of that happening. But, according to the scan last week, move it has. She’s not convinced and another scan is required. I am sent, by wheelchair, to radiography. It’s weird being wheeled around. i feel like a bit of a fraud, but I don’t have a choice.

The scan confirmed that the placenta has moved, and that everything is looking good. There was still no obvious bleed site, so, really we’re no further forward, except for confirming something that today’s consultant thought was unlikely, but which was, in fact, true.

After this, I was allowed to eat, and the staff on the observation ward arranged for me to be sent upstairs to the slightly less observationy communal ward. They just needed to check that the bleeding had stopped. I was happy to comply, and sat up, and Gush. The clock started again. I’m not going anywhere for 24 hours. On the plus side, I got to stay in the private room, which is good because I’ve just bled all over it.

Fortunately, the rest of that evening and night passed without further incident, although I did manage to get a couple of hours ‘off cannula’ in the evening. I got a new one before going to sleep, though. No-one wants to have to put in a new one in a midnight emergency. I was told by the evening doctor that no-one knows what keeps causing the bleeding, but that they’re going to treat it as if it is the placenta. Better safe than sorry. It’s a balancing act; as long as the baby is fine, they’ll leave it in as its far better off where it is. However, if the baby starts to become distressed, or growth doesn’t carry on as normal, it could mean that the placenta is failing, and then they’d take the baby out as, at that point, it would be better off in an incubator. Hopefully those things won’t happen, though.

Another morning, another doctor. The same ‘we don’t know so we’re going to be cautious’ message. It was the same doctor that we saw on Tuesday. No, it looks like I can’t keep away, lol. Actually, I do keep running into medical staff when I’m out and about (by which I mean walking between my bed and the toilet), and they greet me like old friends. I’ve been here too long.

So, my current instructions are to take it very seriously, keep as active as I can but don’t go too far from the hospital. I can go back to work (assuming that work will have me) as long as I come straight back to hospital if there is any further pain or blood or anything else that might cause concern. As long as my and the baby’s obs are good on the evening rounds, I will be free.

I spent the rest of the afternoon upstairs on the regular ward. The food, which has been good up until now, was rather hit and miss on Saturday and I got an egg salad sandwich in place of the ordered macaroni cheese, but I was hungry, so I ate it. Dinner took its sweet time, too, and by the time it arrived, I was laying flat so that they could listen to the baby’s heartbeat on the monitor. My husband had to spoon feed it to me in bit size chunks. As if this wasn’t a strange enough experience, at the same time the lady in the next bay, separated from me by a curtain went in to labour very quickly after her baby kicked her hard enough in the cervix to break her waters (she was overdue, so they were probably ready to go). Less than metre away, my husband was leaning over all the machines trying not to get ketchup on everything whilst this poor woman was begging for an epidural. It wasn’t funny really, but it was such an odd situation, that, whilst we and I were trying to be quiet and discrete, we were failing because we kept getting the giggles. You couldn’t make it up, but there is a comedy sketch in there somewhere.

I’m back home now, enjoying the comforts that that entails, hoping we don’t have to return to hospital anytime soon.

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I need instructions for normal

We had our consultant appointment yesterday, and we have the all clear to carry on as normal. No bed rest or even house arrest, because apparently all this lying around might lead to blood clots in my legs and the risk of that is now greater than the risk of bringing on any further bleeds or, indeed, labour. On the subject of labour, given the shortened cervix, at 28 weeks we have been advised that the baby is pretty much ‘done’, if small, and, because it’s had the course of steroids, it would have a very good chance if it were to arrive early. It would have to go in an incubator, but it would be considered a better option to let nature take its course rather than try to delay things. The only reason that they would give treatment to delay things is if they needed to move me to a different hospital where there were available incubators.

BUT, all of this is ‘worst case scenario’, because there is every chance that I will carry this baby to term and have a totally normal, emergency free delivery at some point in June. This really is something to get my head around as we had had it in mind for the last 2 months that we would have a planned C-section at the end of May. I have not done any of the mental preparations that the books have been going on about, because I didn’t think it would apply to me. Being something of a control freak, I was quite comforted by the idea that we would go in to hospital at 36 weeks and come out a few days later with a bundle of joy. Job done. Not so straight forward anymore, but normal is good.

The consultant encourages me to take gentle exercise and go swimming, and to take regular stops to stretch my legs in long car journeys. My waking life is now to be treated as if I am on board a long-haul flight; support stockings are on my mind, if not yet on my legs.

My blood pressure was taken (still fine, at the low end), the bump was measured (ahead a little, but I expect that’s down to the growth promoting steroids), and the baby’s heart beat was listened to. We’re keeping the appointments at the end of April ‘just to be extra sure that things are still looking normal’, and we remain on the kind of alert that is normal for women in their third trimester (amazing to think we’ve made it this far!).

Back at home, and in the absence of anything proper to worry about, I decided to read my notes for the day. I was alarmed to see that, under the heading of ‘Hb’ the number 106 had been written. Heart beat of 106? Whose? Not mine! Mine is closer to 80bpm. The baby’s? Should be 140. It was 140 last week! What’s going on?! To add to the confusion, the 106 was written in a different hand writing and a different pen to the rest of the notes from yesterday. Underneath this, in yet more different handwriting, it says ‘x low hb’. This is even more alarming. My husband, upon studying the notes more carefully, notices that the box for ‘fetal heart’ is ticked, indicating that it was heard but not measured today. Looking back, it is this box, not ‘Hb’ where the numbers are usually written. I am reassured that we would still be in hospital if there were any real concerns. After all, they were very cautious with us last week, why suddenly become reckless now? It’s much more likely that I simply don’t understand the notes, he advises. I agree, and bow to my husband’s logic in this matter. Then I secretly google ‘decoding antenatal notes’ and discover that the code ‘Hb’ stands for IRON!!! Not heart beat. What an idiot! (To be fair, heart beat does seem reasonable… maybe I’m not supposed to understand the code?). I have low iron. I mentally note to eat some leafy dark green vegetables tomorrow.

With that panic firmly put to rest, I relax into my new status of ‘normal’ and look forward to remaining ‘normal’ for the next couple of months, at least. Then I awake at 4 am and, realising that I am now 28 weeks and am supposed to no ‘count the kicks’. Unable to get back to sleep, I start counting. I get 10 in 20 mins (apparently you should worry if you don’t feel 10 within 2 hours). More normal, more reassurance. I go back to sleep and have a very vivid dream about blood transfusions…. I think this might be my normal life, now… 🙂