Monday, December 28, 2009

Morphine And Julie Andrews

I was feeling pretty good about this whole pregnancy thing, really. I had passed my glucose test, my anemia was improving and the little guy is so active that I finally decided to send the doppler back. Sure, it's hard to get comfortable sometimes when I'm trying to sleep, and I have been getting a lot of heartburn lately, but all in all things have been going well.

But yesterday I was pretty sure that I was going to have an emergency C section and then possibly die. I had the worst pain I have ever felt in my life, including having given birth without pain medication. And being run into by a school bus and having a pinched piece of nerve stuck between two of my lower vertebrae. This was worse, to the extent that I wondered why the pain scale that doctors use only goes up to 10.

The pain started suddenly, radiating down from my lower ribs. It was so intense that I had to double over on the couch and cry into my pajamas. It didn't feel like contractions - those are somehow familiar pains, a stronger version of monthly cramps that comes in waves. This was a constant, unwavering torture. I went to L&D only because the pain was covering the whole area of the uterus and I wanted to make sure the little guy was okay. I could feel him kicking and wiggling around, but other than that I needed definitive information.

They ran lots of blood and urine tests and the covering doctor (a Sunday, and a holiday weekend of course) ordered a CT. But having read so many articles recently about CT machines being calibrated at up to 1,000 times more radiation that recommended, I wondered about the risks of exposing the baby to what can possible trigger serious cellular problems later. By that time, I was on morphine and felt like my brain was made out of something light and fluffy, like cotton candy. Nice, but useless. Luckily my husband talked with the radiologist who said CT is only used in pregnancy for dire life threatening conditions and converted my orders to US and an MRI.

Which showed nothing. Nothing! By this time a gaggle of doctors were mulling over my reports, telling me they were stumped. Appendicitis would likely show elevated white cells, pancreatitis would show elevated enzymes, kidney stones would show red cells in the urine... but all of my tests came back normal. So, they dosed me up on morphine and I watched The Sound of Music on the giant flat screen TV in my L&D room. I kept dozing off and having dreams about singing nuns and outfits made from curtains, but at least I was beginning to think I might not die.

Here's a little something I learned about MRIs, by the way. I had one once before to diagnose the nerve damage in my back, and the experience was horrendous. I swore I would never again let myself be slid into that glowing tube and assaulted with those space-alien heavy metal sounds that seem to go on forever and fill your whole body with concentrated distress. However, the morphine kind of took the edge off. It still sucked, especially since they had to do a lot of the scans two or three times because the baby was seriously freaking out during the noise, but it was somehow less drastic.

At a certain point, though, I realized that what with waiting for the MR tech, waiting for the radiologist and waiting for the transport guys to wheel me back to L&D, a lot of time had gone by. Even just realizing that made me think that my brain might be functioning properly again, and I asked how long it took for the morphine to wear off. The nurse checked her paperwork and said it was probably time for another dose, But the thing is, the pain was gone. The most horrendous pain I had ever felt in my life seemed to have gone as mysteriously as it had come. We waited another half hour to see if the drug would clear and the pain would come back, but nothing happened.

The doctors were stumped again, gathering around and asking a million questions. Mostly ridiculous questions like "Has this ever happened to you before?" Um, no - pretty sure I would have mentioned that when I got there. They kept me overnight for observation. I was attached to the contraction monitor, which showed very minor uterine irritation that is considered normal at this point. The fetal heartbeat monitor was driving the nurses crazy, since most bigger babies can't move around as much as my little guy did - he was constantly scooting out of range so the alarm kept going off at the nurses station. But he was fine, very active and the US hadn't shown anything unusual.

Weird, eh? In the morning my OB came to check on me. She just confirmed that everything looked normal and wants me to see her weekly from now on. It was the shift change for the nurses, so I was checked out by my third nurse, who hadn't been there when I was writhing in agony. While she was going over my chart she suddenly stopped and asked me if the pain had started right after breakfast. When I told her yes, she asked what I had eaten. Whole wheat waffle, half a pear and a veggie soy-sausage patty.

She said that when she was pregnant the same kind of thing had happened to her. It turned out to be an inflamed gallbladder - not necessarily stones that would show up on an US, but a condition brought on by the hormones of pregnancy combined with a gallbladder, pancreas and small intestines that are squished up by the expanding uterus. The pain works itself out as the bile levels slowly seep into some kind of equilibrium. She had several bouts before a gastroenterologist diagnosed the problem and put her on a very low fat diet and extra calcium. She recommended some diet options and a stool softener (keeping the intestines from being irritated really helps, apparently) and gave me her direct number at the hospital in case it happens again.

Of course, I don't know for sure that that's my problem, but it seems like such random luck that she showed up for the last fifteen minutes of my stay and was the only person with some kind of information that clicked with what I had gone through. I will absolutely put myself on the low fat diet. All fat will be brain-development friendly rather than just basically whatever seems yummy at the time. Believe me, I will do whatever it takes to avoid that pain again, even though the weird yodeling goatherd daydreams were almost worth it, really.


lastchanceivf said...

Man, what a story! First of all, kudos to you for NOT getting a CT scan. People are so unaware of all that damn radiation exposure--getting serial calcium scores and other unnecessary radiation exposure and it makes me crazy. And while an MRI is noisy and freaky, at least no radiation.
I'm glad the nurse maybe figured out the problem. Every now and again, nurses are pretty cool :)

But mostly, I'm sorry you had to go through that. What a nightmare to be in so much pain!


Mad Hatter said...

Holy! I was on the edge of my seat reading this! Thank goodness you and baby are okay, and I'm so sorry you all had to go through such a scare! What your nurse said makes a lot of sense to me...I hope it never happens to you again!
Take good care!

PJ said...

Oh My Goodness!!!

I'm so sorry you had to go through that. It sounds horrible!

I hope your nurse was right and all you have to do is change your diet a little. It's kind of crazy that the last person you see would have the best explanation!

Seriously, I SO hope that the rest of your pregnancy is very noneventful!!!

just me, dawn said...

geez, that sounds so painful, can't imagine! but glad that it is gone and that you have a glimmer of what might have caused it so you can avoid it. Hopefully the rest of your pregnancy will be uneventful :)

Lara (NoodleGirl) said...

OH, Lorraine, I'm so sorry you had to go through that!! Mad props to you for refusing the CT scan and while under the influence of morphine no less!

I'm so happy that you and the bean are both OK. And how crazy that your final nurse may have had the answer! I have the gallbladder info filed into my memory banks if that ever happens to me or anyone I know. It sounded horrible!

Jules a.k.a. Julie said...

Oh my goodness! I am soooo glad to hear that everything is ok, but how super, super scary! That is crazy that the nurse may have the answer. Seems plausible especially since the drs were stumped. I'm really just glad you and baby boy are ok!

Anonymous said...

The same sort of pain happend to my friend, but it was AFTER the babies came. Did you bring that idea up with the docs? If you gallbladder is compromised, you can have the laproscopic surgury while pregnant. When my friend had this, it took 3 attacks to get the diagnosis right...2 times they told her it was gas. Turns out gallbladders are often overlooked.

Natika said...

I'm glad you feel better!
I expected the worse, thank God it wasn't!

Gwynn said...

OMG how scary!! So glad that you are feeling better. I hope that evil pain never shows it's face again.

Loved the description of your hallucinations!! If you have to be on morphine SoM is so the way to go.

My little guy did a jig during my prenatal MRI as well. With all the crazy noise, I don't how they ever expect a baby to stay still.

Here's hoping that you pregnancy goes back to its previous blissful boringness asap.

* said...

Wowsa, that must have sucked. Hope it doesn't happen again and the rest of your pregnancy passes by without incident.

RoseAG said...

Yikes! Shades of Michelle Duggar.
Yes, I know, I watch too much TV!

I'm glad somebody had the presence of mind to think of your gallbladder. I certainly hope a revised diet will keep that quiet for the time being. Did she mention beet juice? Ugh....

Celia said...

Wow babe, I am so glad you are ok. That must have been very scary. I think morphine is the only way I could handle The Sound of Music.

Lost in Space said...

Yikes, girl, that is quite the scare! I'm sorry you had to go through any of it at all and hope things are going better now. Hope to hear an update soon!

Oh, and on that 7-year boxed up china that you don't like - take some photos of it for sentimental reasons and sell it off. You need to make room for baby stuff. (-;

Wombded said...

I love the provocative title of this post. So glad that the pain went away...hopefully for good. How wonderful that your pregnancy is going so well.

MoDLin said...

Your post rang a huge bell. When my daughter was pregnant a year ago I was visiting when she went into writhing fits of excruciating pain. All of us were freaked out... long story short is that she had an inflamed gallbladder. She had to change her diet and be quite strict about it, but it made a world of difference for her and she got through the following four months without another attack.
Shortly after the baby was born she had her gallbladder removed (stones in the sludge) and has been fine ever since.
Hopefully your diet adjustments will do the trick for you. This is no fun and you have my sympathies.

Midlife Mommy said...

I am so glad that you are feeling better. What a scare! I went through gallbladder hell for over 20 years without realizing it before I finally had it removed. It can hurt quite a bit.

I think I read somewhere (or maybe a doctor told me?) that the bile in the gallbladder gets "sludgy" in pregnancy because of the compression and it can lead to stones. I understand that they remove quite a few of them, preferably in the second trimester. I hope that yours is just sludge (the first time that I ever wished sludge on anyone!) and that you never, ever have to go through that again.

Anonymous said...

it could have been what i have which is hydronephrosis, it's where the expanding uterus puts pressure on the kidney and ureter, urine can't get through to the bladder and it is excruciatingly painful. i have/had pain in my right flank area and also on my right side radiating down from my ribs. i think in most cases it resolves itself, i just happen to be one of the lucky ones that has an extra severe case which required surgery where they placed a stent to hold my ureter open. ask your ob about it, kidney stones was one of the things they thought i had at first too. whatever it was i'm glad it resolved itself, being in pain while pregnant really sucks.