!La Penultima!

So when we were living in Spain, my parents were fond of a tradtional toast. Every new drink was toasted as “!La Penultima!” (the second to last). I’m kind of feeling that way about the hospital. I came in on Wednesday for “a few hours of monitoring” and ended up being admitted “for 24 hours”. Then all hell broke loose and I landed myself on Mag Sulfate for a day and a half, and they said they’d probably try to let me go Friday. Friday they didn’t let me go b/c I was still contracting and there was the impending snow. Saturday they said “just one more day.” Sunday they said, “Just one more day.” Yesterday they said, “just one more day.” I feel like I’m on my perpetual penultimate day of this almost-week-long hospital stay. I’m frustrated, and I’m sure Seth is even more frustrated. I’m tired. I’m ceasing to feel confident in the medical care I’m receiving (I think the DOCTORS have been totally on top of things – but the nurses are… not always, and THEY are the ones providing most of the direct patient care.

This takes me back to that one summer I spent in North Carolina in summer camp. I was miserable there, not because camp wasn’t good and not because I wasn’t learning a lot. But the people. The other campers in particular… It was just too much to be cared for by strangers for that long. I just wanted to go home. And now? I just want to go home. I really hope today isn’t another penultimate day in this endless stay in my hospital room.

I wouldn’t care so much about being here for days and days on end with no real definitive timeframe for parole, except that the longer I’m here, the more things that are falling through the cracks. Or maybe they’ve always been falling through the cracks and I just didn’t notice in the first few days. Either way, the devil is in the details, and no one here seems to be a devil worshiper.

I’m tired of whining, but there’s also a piece of me that feels like some of these things ought to be documented. So that when I look back on these things I’ll know that I wasn’t just being a hormonal, over-reacting pregnant lady. Or maybe so that when I look back on things later I’ll *know* that it was actually just me being a hormonal over-reacting pregnant lady. Most of the nurses here are very nice, but some are more on top of things than others. Many of the nurses can relate to aspects of my pregnancy – several were also on terbutaline pumps, zofran pumps, bed rest, etc. Somehow, their ability to relate doesn’t translate to consistent care, but hey, at least they’re personable, right?

When I was admitted on Wednesday, I made it clear that my PICC line hadn’t been flushed with heparin yet that day and that it needed to be flushed with heparin at least once every 24 hours. Nurses kept telling me that it did NOT need to be flushed with heparin, particularly if continuous fluids are running through it. That’s a nice theory, but I know from experience that when that PICC line wasn’t flushed at least daily, sometimes more, the line wouldn’t run very well. Nevertheless, the answers I got were “we don’t do that” or “you’re wrong.” Needless to say, it turns out that I know what I’m talking about. No one could get a blood return from the PICC line, and it stopped running very well, and ultimately became completely occluded. When I spoke with the IV Therapy nurse who replaced my PICC line with a new one (a saline-only flush), she was appalled that they didn’t at least flush it with normal saline 1-2x per day. When she pulled out the old PICC line, she could see that a fibrin sleeve had formed over the end of it. This is a common issue that happens with most PICC lines eventually, but had it been flushed regularly, it might still be working.

Yesterday’s day-shift nurse was nice enough. She, too, had been on both Zofran and Terbutaline pumps during her recent pregnancy (she has a 4 month old). She had the same primary nurse from the home health care that I’ve got. She empathized with the whole “not eating” thing. But she was also really flaky. When she hung my new IV Fluid bag in the morning, I told her I typically get a banana bag in the morning (IV Fluids with multivitamins for infusion, thiamine, pyridoxine, and folic acid). She said she’d look into it, but I never heard about it again. My OB had wanted me to stay in the hospital at least through Monday so that I could get my 17-P injection, so I had Seth bring in the injection and I kept telling her it was there and saying I needed it and she kept saying “oh good!” But I never did get the 17-P injection.

I have an order for 25mg of Phenergan every six hours. It took a few days to convince the nurses that this is a scheduled, not PRN, medication, so at least she got that part right. But I didn’t have a working PICC line until yesterday afternoon, so the Phenergan was being run through a peripheral IV that they had put in on Saturday. Phenergan is extremely caustic to the veins, so it can’t be pushed directly into a regular IV (though it can be pushed through a PICC line); it is supposed to be diluted into saline and dripped into the IV slowly. My orders are for 25mg of Phenergan in 100ml of saline infused over 30 minutes (200ml/hr). The nurse ran the Phenergan through at 999ml/hour – FIVE times what it should have been. I was in tears from the searing pain up my arm. I kept trying to tell her (and others) how much the line hurt (I’d actually tried expressing this for days), but I kept getting told that IVs in the hand are ALWAYS painful and that Phenergan is ALWAYS painful going in. Call me a skeptic, but I’ve always heard that once it’s in place, IVs shouldn’t hurt to the point of tears. I told Seth about the infusion rate and he said that’s just plain not SAFE. Yeah. Plus, hello? It hurt! When the IV therapy nurse came in later they had just started running ampicillin through my peripheral IV and I was near tears from the pain again. The IV Therapy nurse stopped the infusion, moved it to the working part of my PICC line, and pulled the line out of my hand. I realized then that my hand was swollen to 4 or 5 times its normal size. The vein had sprung a leak and fluid (painful, caustic fluid) had been leaking into my hand. (the swelling has gone down since, for what it’s worth).

Yesterday evening I was sicker than I’d felt since getting admitted to the hospital. In fact, yesterday was the first day that I’d thrown up since being in the hospital (I rarely go a day without throwing up – but since being in the hospital I’ve made no attempt to eat food and I haven’t moved out of bed – moving always makes me sicker). It turned out that although my medication order is for 25mg q6h, the nurse gave me 12.5mg of Phenergan. Normally, I’d be really annoyed about this, but it turns out that the hospital policy is that no more than 12.5mg may be given at a time because it is so caustic. While I think the hospital policy is stupid (there’s no reason they couldn’t just dilute 25mg in 200ml and infuse over an hour – that would have the same effect in terms of dilution to avoid the dangers of the drug in small veins), I am fine with the policy being enforced. I am *not* fine with it being enforced willy-nilly. How is it possible that in six days only one nurse picked up on the fact that the order wasn’t written per policy? My doctor this morning was willing to rewrite the order to 12.5mg/q3hours if I need to stay, so that is also a reasonable workaround that is compatible with the hospital policy.

Just as frustratingly as the Great Phenergan Snafus of 2010, was yesterday’s MVI snafu. I’m supposed to receive continuous IV Fluids at a rate of 125ml/hour (which boils down to about 3 liters per day). In one of those liters of fluid, they are supposed to add adult multivitamin for infusion (MVI), Folic Acid, Thiamine, and Pyridoxine (also known as a banana bag). I’ve been getting the MVI bag in the mornings, but as far as I’m concerned, I don’t care WHEN I get it, as long as I get it. Since I’m eating nothing, this is the only way I’m getting any vitamins in me at all. Yesterday when the nurse hung my first bag of the morning, I noted that it was just plain D5LR – with no MVI (it’s easy to tell – the bags with vitamins added are flourescent yellow). I let the nurse know that I typically get MVI in the morning and she said “Oh, okay, well, I’ll go check your chart,” but I never heard about it from her again. Normally the shifts here are 7-7 and 7-7, but for whatever reason, I had a different nurse (Nurse Ratchet – stay tuned for an entire post about her alone!) from about 4-7 yesterday bridging the gap and when she came in to hang a bag of fluid, I noted again that it did not have the MVI and I told her I hadn’t gotten MVI yet. “You get that at night.” No, no I do not. “well, I’ll check your chart, but I was told in report that you get that at night.” I don’t give a crap WHAT she was told in report, I’M the one who’s been here for nearly a week and I’m the one who’s seen how often and when I receive various medications. I’m pretty sure I know the routine by now. When the night shift nurse came on and hung a new bag, I noted again that I still needed an MVI bag. “I’ll check your chart.” Only this nurse DID check my chart – and she came back and said, “You’re supposed to get the MVI in the morning.” Yes. That’s what I’ve been saying all day. Well, the bag they had was expired (you can’t premix these bags too far in advance), so she said she was working on getting a new bag from the pharmacy. I finally got my MVI bag this morning – meaning I went a full day (with three different nurses) without any MVI. If I were eating ANYTHING while I’m here, then it wouldn’t be that big of a deal because obviously food has vitamins and minerals and you know, other good stuff. But obviously, that’s not the case.

Nurse Ratchet was in a league of her own, and deserves her own post. But the long and the short of it is that I got a visit from the charge nurse today after I nearly lost it on my nurse this morning.

The good news is this: My OB came in this morning and said she was inclined to keep me here in the hospital for another couple of days to get me through this next snow storm. I told her that if there was a clear medical advantage to me staying here, I would do whatever she recommended, but if she was still on the fence about it, I’d just as soon go home and see my kids. She conceded that I could go home, and noted that if I need to return to the hospital in the middle of the snowstorm, I should simply go to HC (which is five minutes from my house vs. this hospital which is 30 minutes without traffic or snow). My OB doesn’t have privileges at HC, but better that I get to a hospital safely and receive appropriate care from a hospitalist or resident on call than risk coming out here and getting into an accident. So I get to go home today and no more torture by nursing staff.

I’ll write more about it later, but I *did* speak to the charge nurse today and she had a very appropriate and acceptable response.

No, Really!

Every nurse who has come on-shift since I was admitted on Wednesday has been shocked that I’m not eating. I mean, I get that it’s not normal, but there’s bound to be a notation in my chart somewhere that says “hyperemesis gravidarum” right? They give each other report at the start/end of each shift. And yet? Every nurse that’s come on shift has said, “You ate [dinner/breakfast/whatever], right?” Um, no. I haven’t had a tray in my room since I came in here (a couple of nurses have offered trays – so it’s not that I’m being neglected, it’s that I have no desire to have a tray of food in my room that I know I’ll never touch).

It’s not limited to the nurses, though. The OB on call came in today to assess me and let me know “the plan” – which is to keep me here at least until I get my 17-P injection tomorrow and a new PICC line (one of the lumens on my existing PICC line is completely obstructed and the medication they usually use to dissolve issues like that isn’t used in pregnant women). But she paused and asked where the terb pump was running – it’s subcutaneous. “Oh, well, you don’t need the PICC line then.” Um. Yes, yes I do. The Zofran pump runs through the PICC line and I can’t run that one subcutaneously even if I wanted to – because doses as high as I’m getting would tear up my skin if done sub-q. Oh, and there’s that hydration thing. “Well, you can’t take the Zofran ODTs? You need the pump at home, too?” Yes, I need the pump at home, too. I can’t keep the ODTs down. (Also, they don’t work as well as when the drug is continually infused). “Why do you need the fluids?” Because I can’t drink anything of substance? “Really? How long has this been going on?” Um. September. I get that she wasn’t my doctor back in September when this started, nor in October when I was hospitalized for dehydration due to hyperemesis gravidarum, nor when my first OR second PICC line were placed. But I still find it hard to believe that there’s NOTHING in my chart ANYWHERE that mentions that I’m hyperemetic. The doctor conceded that I do need to keep my PICC, so it’ll be replaced tomorrow.

Seriously – the nursing staff keeps very close tabs on my “I’s and O’s” (Ins and Outs). They know what I’m taking in. They know I’m not drinking. They *should* know I’m not eating (no food trays have come into or left my room since I’ve been here). And yet, they seem shocked when they hear that I haven’t eaten since before I was admitted. How do I make it more clear? I really hope I get to go home tomorrow. I’m growing weary of the hospital (a.k.a. the worst hotel EVER).

In other annoyances:

• My skin is so dry that it’s becoming abraded. My knuckles are cracking. My legs are itchy. My lips are chapped and split. Apparently the air is very dry in hospitals – and more importantly, I’m not getting a lot of fluids, so my skin just can’t stay hydrated. This is annoying, but hopefully I won’t be here much longer. If I had to move in for the duration, though, I’d have to get a humidifier or something.
• TMI Alert: One of the best things about getting OFF the magnesium sulfate is that they removed my catheter and let me resume “bedrest with bathroom privileges”. Except, it’s really a pain in the neck to get up to go to the restroom. I have to unplug the toco monitor (contraction monitor) and wrap the cord around my shoulders so it doesn’t drag. I have to untangle my Zofran and Terbutaline pumps. I have to undo the sequential compression stocking things. I have to unplug the IV Pump. And then I have to carry everything to the bathroom. Then I come back and I have to plug in the IV Pump, untangle the Zofran and Terb Pumps, and plug the toco monitor back in. And get myself back into bed, which is a much more difficult task than it sounds. I am ready to be home where it is less of a production just to get up and pee (mind you, even at home it’s a production, but at least there are SLIGHTLY fewer things to unplug).
• I have the toco monitor on my belly 24/7 to monitor for contractions. It stays on with a softish belt that straps around me. It’s not tight, but it *is* against my skin 24/7 and now the skin on my belly is abraded from the constant contact. At least at home I’ll only have to have have the toco monitor on for an hour at a time (minimum of 2 times per day). That will definitely be an improvement.
• Several times per day, they do NSTs (nonstress tests) – this means that in addition to the toco, they put a fetal heart rate monitor on also. This evening during one such NST, the baby’s heart rate decelerated with every contraction I was having. This is… not good. Fortunately, I’d just recently gotten Procardia, so the contractions went down shortly thereafter. Hopefully, this will not reoccur because I’m… not actually sure what all the implications of it recurring would be. I’m pretty sure it’s far too early for me to want to find that one out the hard way.

Snarky

I’ve been reading far too many online pregnant communities recently. I don’t know why I read them – I can nearly never relate to the posts. I don’t *have* normal pregnancies and no one else seems to understand my own experiences because I’m just not NORMAL. Here are some things I don’t get:

• Posts that go like this: “My hips really hurt which is making it difficult for me to exercise. Can anyone give me any good at-home exercises that are safe for pregnancy?” I mean, admittedly, exercise isn’t the first thing that pops into my head when I’m thinking of my top 139 favorite things to do, so I probably wouldn’t relate to this one anyway, but I’ve never been ALLOWED to exercise while pregnant, there was never any question about what I could and couldn’t do – I just wasn’t allowed.
• “I can’t eat a darned thing because I keep throwing up. Well, you know, except for how I finished my DH’s leftovers, bought a gallon of ice cream that’s now mysteriously gone(!), and, oh, right, I accidentally ate my daughter’s birthday cake before I gave it to her. But really, chicken is OUT!” I mean, sure I can relate to throwing up. Except, I can’t. It’s not a contest or anything, and I don’t wish vomiting during pregnancy on ANYONE because it’s not any fun at all. But “gosh it’s so annoying that I have to eat a saltine before I get out of bed in order to feel human” posts just… don’t resonate with me.
• “I’m 1cm dilated! OMG am I in labor? I can’t be! I’m not due until next month! I have a baby shower next week, and a photo session lined up the week after that, and a pedicure appointment for the day before my due date. I just can’t go into labor now! I mean, also, I want the baby to stay in there and get fat and healthy, too, but think about my pretty toes!” I would have given anything to have this worry with my triplets. I did really well with the triplets and got them to 33 weeks (exactly average for triplets), but we always knew I wasn’t going to be a 36/37 weeker. I figured with this pregnancy at least I wouldn’t be laying in fear of going into labor at any second… except, here I am in the hospital for preterm labor and I’ve still got three months to go. I’ll gladly trade my (nonexistent) pedicure appointment for a couple more months.
• My baby is 2 months old and I was thinking how nice it would be to have Irish twins. I think I’m ovulating, do you think I should have sex tonight and not tell my husband that I’m ovulating? I’m sure he’d flip out.” Any such post like this is completely alien to me, and I’m shocked at how many such posts there are. I mean, seriously. People PLAN these things? People have sex to get pregnant? I don’t understand.  (there are also the “I went for my annual exam and found out I’m 14 months pregnant” posts – which, you know, I also don’t get, but I figure so few people understand those posts that I’m not alone).

I know I’m being snarky, and I *do* know this isn’t about who’s got it harder. I’m not trying to say the trials and tribulations of pregnancy are always all sunshine and roses even without all the dramarama that I get to have fun with. I don’t think that women should have to love every minute of pregnancy – and I think it’s terrible that society seems to assume that women must enjoy pregnancy or they’re not good mothers. So it’s not that I don’t think the complaints I’ve posted above are legitimate. It’s just that I really can’t relate. Really.

Snowbound

I’m not being discharged from the hospital just yet. Too much snow predicted (20-30 inches in our area) for anyone to feel comfortable sending me home with this many contractions. It’s the smart decision, if not the ideal. I agree with the decision even if it’s not what I would prefer. I’m off the mag sulfate, on a terbutaline pump, plus indocin and procardia to augment the tocolytic effect of the terb. Can’t stay on the Indocin long, though – so I’ll be off it tomorrow afternoon. Still have the Zofran pump and IV Phenergan. Still not eating/drinking. Still banging out contractions every few minutes, since coming off the mag. Mag’s evil, but I can’t say it doesn’t work, that’s for sure.

On the plus side, I’ve now met most of the doctors in my OB practice who deliver at this hospital, so I won’t deliver my (hopefully full-term) baby with a doctor I don’t know, in all likelihood. It won’t be long before I eclipse the total number of inpatient hospital days during pregnancy with this, my “easy” singleton pregnancy vs. my not-so-easy triplet pregnancy.

Everyone here has been pretty good to me, and the doctors have been on top of everything. I’m pleased with the level of care I’ve been getting, and I know I’m in good hands. I’m just… bored and about to go into shabbos with nothing to really read or do and no way to get anything to read or do b/c of the snow. Not the end of the world, but it *would* be nice if something would give.

Wish I weren’t so boring, but I truly can’t think of anything else useful to say. That’s pretty much all that’s going on so far.

Pregnancy is Fun

I was admitted to the hospital yesterday with preterm contractions that failed to respond to PO or injectable tocolytics. There was some debate among the doctors regarding how to care for me since I had a negative fFN on Mnoday and wasn’t displaying cervical changes.

Still, no one wants this baby to be born 12-15 weeks early and my contractions were 3-4 minutes apart and pretty painful. SubQ Terbutaline didn’t help; Procardia didn’t help; more SubQ Terb didn’t help, so I got admitted. They kept trying the Procardia, which I miraculously kept down, but to no avail. Finally a third round of terbutaline was tried around 12:30am (1 injection every 20-30 minutes or so). The first two didn’t help, but the third injection worked like a charm.

I didn’t have any contractions from about 2:30a to 4:15am and actually managed to grab about an hour snooze – and then I woke up in agony – horrific contractions 1-2 minutes apart. Not fun. My nurse did a cervical check and noted that I had dilated a little bit and called the doctor. Which meant there was no escaping Magnesium Sulfate. I’ve had the mag running since about 5:30 and my blood pressure has gone down from a respectable 110/70 to 85/42. The rest of the side effects aren’t as much fun as that one.

Mag sucks, pure and simple, but if it keeps my little tenant from breaking its lease early, then I’ll take it.

Breaking News: Woman Who Doesn’t Eat Has Low Iron!

So my OB’s office called today.  My iron is low and they want me to take iron sulfate every day.

Of course they do.  But, um, hi?  I’m not tolerating anything PO right now – HOW exactly am I supposed to accomplish this?  Oh, they said.  Um, we’ll check with the doctor.

Well, I checked with the doctor (the PharmD that I’m married to) and he said ferrous sulfate is the hardest of all to tolerate, even without hyperemesis.   He recommended trying ferrous gluconate first and seeing if I can manage that, since I can often tolerate a single pill right after getting IV Phenergan.  We’ll just have to see how it goes, I guess.

Or, you know, just continue to be tired and stuff.  Which I would expect would be a given at this point.

Bored Now

Dear Self:
While you might enjoy the quiet irony of how well the irritable uterus combines with my sunny disposition, I do not share in your enjoyment.  Please cut it the heck out.
No love,
Me

So another visit to L&D today, but today I got to meet the day shift, which is oh so much more exciting!  Here’s the thing – when I left Sunday night/Monday morning last week, the discharge instructions said to call my doctor if I have more than 4-5 contractions per hour.  Um, except they discharged me with contractions coming 2-3 minutes apart.  Go ahead, do the math.  I’ll wait.

And so it’s quite difficult to imagine what my threshhold really ought to be under the circumstances, capisce?  Needless to say, I pretty much ignore contractions until they really start to get so painful it’s hard to concentrate.  I get my 17P injections Monday evenings and contractions aren’t terrible from then until … oh, Thursday or so.  By Friday, they aren’t any fun at all.  So I spent the weekend thinking, “well, I’ll call if it gets too much worse” but never really figuring there was any point in calling… since contracting is what I *do*.

So this morning I called the doctor’s office  - I just can’t see the point of waking up a doctor on the weekend for something that’s totally normal for me – and got an early appointment with a doctor I’d never met before.  He was very nice, and extremely ticked off that I hadn’t called sooner.  I told him I don’t like to be the girl who cries wolf when, hello?  This is NORMAL for me.  ”No, this is not normal,” he said.  ”You’re not far enough along to have the luxury of calling this normal.  We’d rather you call and wake us up than wait until 7 or 8 in the morning and tell us it’s been going on all night.”  He found the heartbeat, pronounced it okay, and sent me to L&D.

Hooked up to monitors and… hello there contractions, my old friends… how have you been?  Contractions every 2-3 minutes.  Negative fFN again (good news).  Three shots of terbutaline and my contractions became less severe and slowed down… to about every 3-4 minutes.  The doctor wasn’t a big fan of sending me home with that many contractions, but she let me on account of the negative fFN.  With a reminder that I should *call* when I’m having contractions.  I told the L&D nurse that we’d be well acquainted by the time this baby enters the world.

And when is that?  Not soon enough.  I’m due in May, but don’t ask me when in May and don’t ask me how far along I am.  I’m not going to tell you.  It’s my own neurosis about it – when I start thinking too hard about the numbers, I get severely stressed out, something I can definitely do without right now.

Itchy

So I started getting weekly progesterone injections (17P) to reduce the risk of pre-term labor this go around. I’m not new to progesterone injections, they don’t scare me, and honestly they don’t even hurt me. I can’t for the life of me figure out why a nurse has to come out every week to administer the injections… it’s not like I’ve never done it before. (The nurse is here anyway, because of the PICC line, but even if she weren’t already coming, they’d send her out to just doe the injections if that’s all that was going on with me)

I’ve had about 100 progesterone in oil injections and never had any issue. Despite dire warnings about the sesame oil that it is in, I never reacted in any way, other than some discomfort at the injection site as the PIO got absorbed into the surrounding muscle.

The 17P injections aren’t quite the same as the PIO I used, but the 17P is also progesterone in oil. And now? I am itching like MAD at every injection site. It’s worst very shortly after the injection is given, and it starts to fade toward the end of the week, and then when I get the next injection, it’s all itchy at that site, as well as all the other injection sites that have been used. It is maddening.

Fortunately, this is but a minor issue for the moment, but it’s still annoying.

Frustrated

I spent Sunday night/Monday morning at Labor & Delivery for contractions and other fun stuff. Tuesday I had my already-scheduled OB appointment. The doctor said that the goal is to keep me out of the hospital as long as possible (I hadn’t known that was on the table, but okay…). I told him I spent Sunday night at the hospital, and he responded “Oh, really?” Call me picky, but while I realize it’s a large practice, wouldn’t it make sense for there to be some sort of notation in my chart so that the other doctors who see me know before they walk into the room with the patient?

He declared that I’m measuring just right and the baby’s heartbeat was fine, so he said, “I guess that’s it.” Um, not so much – I had a list of questions both from myself and things the home health care company wanted to bring up with him. Virtually all of my questions were met with “That’s a good question for you to ask the perinatologist tomorrow.” There’s a national shortage of adult multivitamins for infusion, and apparently Folic Acid (for the IV) is also in short supply right now, so the home health nurses wanted me to ask him to write me a script directly for the MVI (Seth can get it filled – it’s good to have connections) and to ask if it’s okay to do the folic acid every other day, or every few days, etc. Good question for the perinatologist, apparently. I asked about the extreme pain in my pelvic bone which is making it excruciating to walk (especially stairs) and that was met with “Hmmm.” I asked him what my threshold should be in terms of calling the office or on-call doctor since if I used the standard “more than 4 in an hour” rule, I’d be calling every hour. Apparently, that was also a good question for the perinatologist, which I don’t understand, because if I call someone at 2 in the morning, then it’s not going to be the perinatologist I wake up – it’s going to be HIS practice members that get woken up. Pretty much everything was “Talk to the perinatologist.”

The one thing that did get resolved was that he said, “The question is, how are we going to get your glucose tolerance test done?” You got me! But since I’m eating so little, I doubt it will be an issue. But since there’s a 98% likelihood that I will throw up the glucola (sp?) , there’s not a lot of point in suffering through it. SO, I get to take my blood glucose levels 4x per day. Fun, right? Um, not so much.

So I went to the perinatologist today for cervical assessment and a growth scan (the baby’s growing just fine and kicked the transducer a fair number of times to prove it). I told the sonographer I had some questions for the doctor and she said he was over at the hospital with a sick patient. This is fine, I was happy to wait if need be, but also happy to find an alternative. So she sent his clinical nurse in to talk to me. Regarding the contraction threshold, she said I just have to use my gut. Right, because that’s going to work so well. She said that regarding the glucose tolerance test, probably the only way around it was to do blood sugar testing, but that 4x/day is probably overkill and I could just do some random BG checks. She didn’t have an answer re: the MVI and Folic acid, but said she’d check with the doctor when he got back from the hospital. Regarding the excruciating pain when I’m walking – well, she said that everything in this pregnancy is going to be more pronounced, as this is my second pregnancy and I’m older now, and… Um. Right. But it’s kind of comparing apples to oranges. The last pregnancy involved THREE baby humans. This pregnancy involves ONE baby human – so the “it’ll all be more pronounced this time around” argument doesn’t entirely fly with me. Nevermind that I know plenty of women who have had two, three, four, five, six or more pregnancies without having excruciating pain with every step just because it wasn’t the FIRST pregnancy. She recommended an abdominal binder to see if that would help. I’ll try it, but I’m not expecting miracles. She called later regarding the Folic Acid and MVI and Dr. P. was adamant that since I’m not eating/drinking more, I must have both (if they can be gotten – otherwise, well, not so sure what the answer to that is).

So I’m not a lot more enlightened than I had been Sunday night. I still don’t know whether I should call the doctor, for, say, the extreme cramps and contractions I’m having RIGHT NOW. Probably nothing to worry about since my fFN was negative, so I’m not going to freak out. I’d just like to feel better. Sigh. I’m just frustrated. I’d probably feel less frustrated if I didn’t have other things going on as well, but obviously, life moves on around me, regardless of how gross I feel.

Low, High, Soft, Firm, Long, Short, Closed, Open… ????

So, um, I get that I’m a disgrace to this prestigious community of infertile myrtles, but I have a confession:   I never checked cervical position when I was trying to get pregnant prior to heading to Ye Olde Fertility Clinic.  That’s right – back when we were still deluded that sex = pregnancy.  Hah!

Anyway, I never checked cervical position, because (honestly) I never could make heads or tails of it.  I can’t figure out what it’s supposed to be, what the difference is between them, and truthfully I wasn’t really all that eager to learn.    Since I didn’t do any of that, I never really took the time to learn what it *should* be.  You know, say, during pregnancy, for example.

The nurse at the L&D unit last night seemed really surprised that I apparently had a very low cervix.  Um.    But what does that mean?

ETA: Jess did explain it to me, and I’m gathering there’s nothing to be alarmed about (I wasn’t terribly alarmed – I was putting more stock in the negative fFN than in a nurse’s guesstimate on cervical competence)