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Tracy B's Pregnancy Journal

Week Twenty-Six
~ Bed Rest

Week 1 of bed rest. Even though I knew this was more than likely going to happen during this pregnancy, it still seems like I wasn't prepared for bed rest. I guess a lot had to do with my thinking that it would come around week 29, the same time when I ended up on bed rest with my third son, Matthew. Doug, my husband was wonderful this week. He works very long odd hours, and I know it wasn't easy for him to do all the extra things he did. But I do think one week was his limit and lucky for all of us that my Mother is coming in today from Austin, Texas to stay for about eight weeks. This should really allow me to get more rest than I have been and allow my husband to not have to focus much more then his work.

I also made a huge decision this week. I had my husband call my OB. I had really only gotten verbal instructions form L&D nurses while in the hospital and the perinatologist's office prior to my admission to the hospital. I did speak to the OB briefly last Friday (after having waited since last Thursday for him to call only to find out he called by my caller ID on last Thursday but never left a message - he said he did leave one but there was not one). But what he told me only vaguely backed up what I was told at the hospital. After thinking about it and the fact that my prescription was only for one week of Brethine and my next OB appointment wasn't until the following week, I started having questions. I felt that I could not clearly question my OB (he has many times made me feel stupid for asking questions) so Doug called at 9 am. It took till 2:30 to get a return call from the OB. And to my surprise this is what he told Doug (in a nutshell):

That he will NOT prescribe Brethine past this week, that he feels that it will not stop pre-term labor. That he feels I was not in pre-term labor but only having pre-term contractions. He is not at all worried and says it is normal for a person of multiple pregnancies to dilate and efface this early. He says that bed rest is at my discretion, but not needed, basically if it makes me feel better then do it.
What I question is this . . . why was everyone else concerned last Wednesday when the on-call OB sent me for the ultrasound to check for funneling, and the perinatologist's office (CNM, RNP, and Perinatologist), and of course L&D nurses saw my contractions on the monitor? Since they were never called by my OB to tell them I was coming and tried for half an hour after I was there to get orders, they went ahead and started treatment. Also when I was at the Perinatal Center, they called my OB to tell him what was going on. and he never called back. They finally got the office manager at my OB's office to tell them to send me to the hospital. The Perinatal Center couldn't send me directly as I am not their patient.

And if I wasn't in pre-term labor, something caused me to dilate and efface. Could be my very weak cervix alone but certainly contractions cannot help. He also is not worried about the length of my cervix at all. Shoot!! It is only 1.3 cm in length and holding closed only because of the cerclage. Cerclage is not a guarantee it will stay closed either . . .

Being on the Brethine this week has calmed my uterus, and I had only a few contractions since being on it. He told Doug to call if I am in "Booming Timeable Labor." I can assume that I am not alone in thinking that waiting until I get to that point is not a good idea!! Especially with the way my cervix works, once I get to that point it is far past the stages of early labor.

I could go on and on about how dissatisfied I am with the level of care or lack of care. I know that at this point all that can be done is buy time . . . bed rest and medication are the only options, and why he feels it isn't necessary is beyond me. I made the mistake once where I took the advice of a doctor that all was well and to "go about my life" and lost Alicia because of it. I know better now; I will not make that mistake again!! Oh and I wasn't happy that he hadn't called me other than the supposed message he left on Thursday; wouldn't most doctors want to make sure they spoke directly to the patient or have gone to see them in the hospital??

So here is what I did . . . I called the Perinatal Center today to see about having them take over my care for the duration of this pregnancy. I am high risk and that is what they specialize in. They were more than happy to take me on as their patient and scheduled me this week for an OB consult and visit for right before my vaginal ultrasound. I did have to go to my old OB's office to sign a release form for my records and get copies to bring to the new group. When I was there and when I called to tell them I was leaving their office, I received apologies from the office manager for the way my care had been handled.

On Thursday, September 2, I had my first visit to the Perinatal Center as "their" patient. And I knew it!! I knew bed rest was necessary for me; my cervix went from 1.3 cm to 2.8 cm in length!!!! My cervix is still funneling but the increase in length is great. Yippee!! I am still on bed rest and most likely will be until the end. I saw the Midwife at the practice and she was surprised at how Dr. L was treating my pre-term labor (and yes it WAS pre-term labor, despite what Dr. L told my husband). I also am on a new medication for contractions, Procardia XL, and I will be on this until I deliver and possibly a pump, if this medication doesn't work. The nice thing about Procardia is that it is only once a day and less side effects. But I was warned that it causes really bad headaches the first few days, so I am to take Extra Strength Tylenol with it. I did not see the perinatologist; she was at the hospital delivering and while I was at the office, a women that was there for monitoring went into pre-term labor and was taken by EMS to the hospital. I tell you this office does not waste time. The Perinatologist, Midwife and ARNP all deliver and they are all female. The Midwife made it very clear to me that I am to call ANYTIME, for anything and my calls will be returned quickly, not hours or days later. She said the sooner we catch labor starting, the better, not to wait until you were having "BOOMING TIMEABLE LABOR"!!!

So that about describes this week. I had my first dose of Procardia XL and I did get a headache even with the Extra Strength Tylenol but it wasn't too bad and I took it before I went to bed so I didn't have to try and deal with a headache during the day with three loud boys in the house. What I like the best about this medication is that for the first time in a week, my heart is not racing, I do not feel shaky and nervous and in general I feel like me.

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