Tag Archives: healthcare

It really is a business

I was annoyed by it at the car wash. Frustrated with it at Albertson’s.

But this is over the line.

As if the posters, stirrup covers and diaramas of the female anatomy sponsored by or advertising various forms of birth control, osteoperosis medications, STD prevention vaccines, PAP tests and fetal doppler monitor rentals at my OB’s office were not enough… now they’ve installed these HD flat panel TV screens in each “pod” with a constant stream of advertising and sporadic short “news” (I use that term very, very loosely as I have HIGH standards for what should be considered news) stories from CNN and Discovery Health. At least with the posters and other forms of advertising I could just choose not to look at it by reading a book or knitting while waiting.

Well anyway, other than that nothing really exciting to report about the visit. My labs were all normal except the anemia thing and my OB wants me to find a pediatrician before the next visit.

After this appointment I started to feel more like I want to switch to my midwife’s backup OB. Even after our last appointment it seems pretty clear that my current OB assumes I took his “warning” and I’m going to go through with a hospital birth. I don’t want to deal with the confrontation and I don’t want to lie either. Plus, he seemed annoyed that I was asking about the actual levels from my last lab results.

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11 weeks 6 days

I have a small rant today.

I love my OB. He is really meticulous, caring, aggressive in treating what I have and ruling out all options.

However, my OB is part of a large OB group. The group has a phone bank of receptionists that take in all the calls and relay messages back to each of the doctors.

I do not like these receptionists. They brush me off when I call with statements like, “Well that just isn’t high on their priority list because they have urgent situations they have to deal with.” They are usually pretty rude too.

It is impossible to actually be transferred to one of the staff members in my doctor’s office. The staff members back there know me and my situation and are always so compassionate.

That is why on occassion I have had to just go in without an appointment or not wait for my message to be relayed to my doctor. I always feel like I have to bypass the phone bank.

I’m not a person who really likes to cheat the system or cheat in general, but sometimes I guess you just have to in order to make sure you get what you need.

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10 weeks 5 days

So yesterday and the day before were probably the most stressful, awful days yet.

I have never thrown up so much in my life. At one point, it was every 5-10 minutes.

I was finally able to take a Phenergan at 10 am and it slowed the throwing up to every half hour and then every hour which was an improvement.

Every muscle in my abdomen was so achy from throwing up so much that sometimes when the urge came I had to stop it somehow. I don’t know how I did it, but basically unless there was really something coming up I had to make my body stop. I don’t even know that stopping it voluntarily is the right way to describe it. It was more like my whole body just gave out and said, “NO MORE!”

As soon as everything opened up at 8 am, I started calling. First I called the home healthcare nurses. It turns out that they were certified to put in PICC lines, but they don’t do it on pregnant women because they’ve had too many complications with it. They said I should call my health insurance case manager and that they would be the ones to organize everything, rather than my doctor. I called my doctor’s office anyway because that’s what he told me to do in the morning if the home health nurses couldn’t do it. Man, I did not want to go to the hospital! The receptionist took down all my information and promised to pass it on to my doctor and his nurse practioner.

So then I called my GEMcare case manager. My case manager is a nurse and she’s been great through this whole thing. She calls every few days to check up on me and see how things are going. She used to work at the same OB group where my doctor is and is really familiar with HG. So she said that she would call and get everything set up for us to where we would have a specific appointment and not have to be in the hospital for days. Thank goodness!

Well after those phone calls is when the throwing up every five minutes began so Stephen handled everything else. It turns out they can insert a PICC line at a radiologists office and so all of that was set up.

At 12:30 I went to get some pre-lab work done at PAL’s main location and then we went to Truxtun Radiology’s southwest location. While we were waiting for my appointment I threw up twice in the bathroom. I was so afraid I was going to puke while they were inserting the line or something.

There was some confusion at the radiology place because they didn’t realize I was pregnant and so they wouldn’t be able to give me the contrast to find my veins. Finally they got it all straightened out and I was able to go in.

I had to lay all the way flat on a x-ray table which was really hard and uncomfortable. I thought for sure that was going to make me throw up. The nausea is always worse when I lay completely flat.

Somehow my adrenaline took over though as I started to get more and more nervous about the PICC line. I had read a little about it a few weeks ago on this HG message board that I check out from time to time. Some of the ladies said that it hurt really bad going in and that they bled a lot.

I think the concept of it just freaked me out a lot too. For those of you that don’t know a PICC line is like an IV, but it has a really long catheter which goes all the way up your arm and into your chest where it hangs out in a centralized artery. Because it is so deep, it is a much more permanent IV that can last for several months which is much better than getting poked every two days and my arms looking like those of a drug addict.

So first a nurse comes in and does a little prep work. She layed out a bunch of towels under my arm so it would be comfortable laying across the table and down onto the tray. I think this was also for the blood, but I can’t be sure. I never actually saw any blood. She used an ultrasound machine to check out my upper arms to see what would be the best veins to use. Then the doctor came in. There was further prep work They layed a bunch of blue papery stuff over my shoulder and part of my head and then also over my lower arm. Then they covered my arm with iodine and alcohol to sterilize it. Then the doctor used the ultrasound probe to look at my arm.

I got a shot of anesthetic right around where they had decided to insert the line. My arm never felt numb though so I’m not sure it even worked. Maybe I’m developing my dad’s insensitivity to anesthetics?

Then the insertion began. It felt just like getting an IV: a small poke to go in and then a little discomfort as it reached down into the vein. I couldn’t see most of what was going on because my view was covered. That was probably a good thing.

I know that the line went in next I could feel it a little bit until it reached my arm pit and then after that I couldn’t feel the rest. It didn’t necessarily hurt, just like I could feel that there was something there where there normally isn’t. My arm pit was a little uncomfortable the rest of the day. They cleaned up the area and taped me up and it was over.

Then I got an x-ray of my chest while wearing a protective abdominal shield. The x-ray showed that the line was in a little too far. So the doctor and the nurse came back in and pulled the line out a little bit then retaped me and sent me home.

After the adrenaline let down I threw up in the car. We got back home and I was able to take another Phenergan. The nurse came out and got my line all set up so I could use it and we started a new bag at around 6:30 pm. I was finally able to get a dose of Zofran and I didn’t throw up anymore after that.

I fell asleep on the couch and stayed there until 3:30 this morning when I went to our bed.

A nurse will be here later this morning to change the dressing on the line. I can’t even really feel the thing now. The discomfort in my arm pit is gone. My abdominal area is still sore from two days of throwing up, but hopefully that will be done for good. I haven’t thrown up since yesterday’s dose of Zofran, so that’s much better.

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10 weeks 3 days

I’m going to the doctor. He’s going to admit me to the hospital. Still can’t keep anything down. Feel like crap.

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9 weeks 6 days

Well the bladder feeling went away. So I’m not sure what that was all about.

I’ve thrown up 6 times today so I had to get an IV started again. Not sure at this point if we will be making it the Barone Chinese New Year celebration which I’m sad about.

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9 weeks 5 days

I had to take my IV out last night because my hand got puffy again.

I wasn’t feeling that great last night and this morning. So I thought for sure that I was going to have the nurse come out again and restart my IV.

I took a shower though and then afterward I felt pretty good. I ate some cereal and I’ve decided to try the no IV thing again.

I have a follow up appointment with my OB today so I’ll update later with what he has to say.

I just can’t wait to not feel crappy anymore, for good!

Update 6:27 PM

If I can go five days without IV hydration then I can take this blood test to evaluate my TSH levels again. The doctor thinks I have developed an overactive thyroid in response to the pregnancy. Which could be why I feel so crappy.

He says 14 weeks is generally when most hyperemesis patients start to feel better. I know a few women on this hyperemesis message board that would definitely beg to differ.

So far today I’ve managed to hold everything down. So that’s a good sign. I just hope I can keep it up.

We got to hear the heartbeat on the doppler today. It was going strong at 160.

He also says that I’m 10 weeks according to the revised due date and “the wheel”. I don’t know… last week I was measuring at 8 weeks 5 days at the ultrasound so I’m just going to go with that one.

So of course as we are driving home after the appointment I start to feel like I have a bladder infection. Which is apparently very common in pregnancy and when you are dealing with dehydration. Lovely. Another thing for me to deal with.

I am seriously ready for the first trimester to just be over with already. Yeesh!

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Last night I did my first IV bag change by myself

Last night I did my first IV bag change by myself. I pricked my finger on a needle. Then like two hours later my arm started hurting, my wrist got puffy the IV site hurt and it itched. So I called the nursing service and the nurse told me to take the IV out. It was hard to peel off all the tape and then pull that thing out. It hurt.

The nurse couldn’t come put it back in until this morning.

I woke up at 5:30 this morning and just had to eat something or I knew I would be sick. So I had some applesauce. Then I went back to bed.

So I got up for real at about 8 a.m. I threw up twice while trying to get all my stuff ready to take a shower. Then I threw up again after my shower. Then I threw up when I got out to the couch.

The nurse arrived around 10 a.m. and got a new IV line started in my other hand. I actually like the placement of this one better because it gives me more use of my hand.

All of my good veins that nurses are always praising seem to have disappeared now that I’m pregnant.

She said it is normal for the irritation to happen. The IV is a foreign object and during pregnancy our bodies are very sensitive to foreign objects and reject them. When it happens I can just pull it out and she can start a new one for me.

I’ve thrown up a couple more times today. Still can’t keep anything down, but at least I’m getting vitamins and hydration anyway.

Tomorrow is the big day for the ultrasound. I’m very excited about that.

I also feel very blessed. Our pastor’s wife offered to come help us or sit with me recently. So sometime this week she’s going to do a little tidying up around here which really hasn’t happened since right after Christmas.

Stephen has tried to keep up with things, but he’s usually pretty busy studying and stuff so things are starting to pile up. I can’t wait to have clean floors again!

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Home care

Yesterday was another day of not being able to keep anything down.

Last week my doctor said if this happened again that I should come in. So Stephen came home at lunch and we went there. My doctor was actually out for the day so I had to see the next available doctor.

The first thing he tried to do was find the heartbeat with one of those little doppler machines. He couldn’t find one, but said that wasn’t necessarily cause for concern especially considering that I may not be as far along as they think I am. Still, I’m freaked out about it.

He said that being sick is a good sign and I shouldn’t worry.

He also decided that my ultrasound to correct the due date ought to be moved up. So this Thursday all my questions will be answered at that ultrasound appointment followed by an appointment with my regular doctor.

To alleviate my nausea and dehydration, he ordered home IV care. So last night a nurse came to our house, got my IV started, and showed Stephen and I how to change out the bags and add medicine and vitamins to the IV.

I don’t know about the nausea just yet. Each hydration bag already contains a dose of Reglan and lasts 24 hours. Every time I try to move too much though I throw up. Even just scooting across the couch to get my laptop so I could write a couple blogs caused it.

I’m just tired of feeling this way all the time.

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Ode to good health insurance

One of the nice things about Stephen working for a healthcare management company is that he works for a healthcare management company.

He knows all the people that process our claims. He can make sure by talking to people at the company that we are getting the best care possible. It really is very nice. The other nice thing about the company is that they flag cases of employees and family members as “VIP” which means that not everyone in the company has to know what is going on with us. Our information is kept confidential between us and some senior company members.

Today I got a follow up call from a case nurse. This particular case nurse said that she has a lot of background experience in OB/GYN offices. So she is very familiar with hyperemesis gravidarum. She gave me some tips for coping like not trying to eat three meals a day, but just snacking instead and even to obey my cravings. This is some of the stuff I read online, but it had I not been such a research nerd it would have been really helpful.

The most exciting part though was she gave me a phone number where I could reach her. She said that if I’m not feeling well during the week, I can call and she can have someone come out to our house to give me an IV. That way I don’t have to go to the ER all the time.

My veins are super sore from all these IVs lately, but if I have to have another one it will be nice not having to call Stephen, make him come home, go to the ER, wait in the waiting room and then wait forever while the bags drain with Stephen sitting in an uncomfortable plastic chair or me on a bench in the hallway, both of us exhausted and cold.

This is how healthcare should be all the time.

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10 weeks 4 days

So because of flu season the hospital didn’t have any beds available. My doctor sent me to the ER to at least get some hydration, more on that later.

I am supposed to call the home health nursing company today to find out if they have anyone that is certified to put a PICC line in. If so I can skip the hospital and my doctor can just put in an order for them to do it. I hope that is the case.

If not, then I am supposed to call my doctor this morning and he’s going to check on the availability of beds at the hospital. He’ll have me admitted and then we just get to play the waiting game because the nurses that can put in PICC lines are not always available right away. I could be in there for days.

Yesterday a home nurse came out and after four very stressful digging pokes, she was unable to start an IV line. It seems my veins are all used up and they don’t want to participate in this mess anymore. So that is why I had to go in to see my doctor.

My doctor called over to the ER ahead of me to see what their situation was like. Luckily there was a “lull” so I got in and got a bed pretty quickly. A nurse was able to get an IV started right away and I got 1 liter of fluid and some Reglan.

I was feeling pretty good until they told me that my potassium was low. Then they made me drink this most vile substance to bring up my potassium levels. That didn’t stay down long. Since I threw it up they tried to make me take potassium pills. Those were just like the drink. They burned all the way down and all the way back out. They finally let me go home anyway and said it would be good if I could take the pills at home. I figure I’m getting a banana bag sometime today one way or another so there’s no sense torturing my stomach anymore.

They didn’t really want me in there, I could tell. That was OK with me because I didn’t really want to be in there myself. Tons of sick people that were coughing and sharing their flu germs were all around. The last thing I need is to get something like that. Actually, a few weeks ago my doctor said it could even be fatal.

I threw up several times during the night and didn’t get much sleep. I felt like my heart was racing and I was shaking the whole time.

We had several great people to thank last night. First, the church gave Stephen tonight off when he told some people what was going on. So no worries there. My best friend Megan went to our house, took care of our dogs and then brought Stephen food and sat with me for awhile. And Ruth called and I could tell it helped Stephen to talk to his big sister and calm down a bit.

I’m just so ready for all of this to be over. What a night.

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