Thursday, September 18, 2008

Doing the Research

So I got good news and bad news from my doctor yesterday at my appointment. We'll start with the bad news so we can end on a positive note.

~My contractions are coming too frequently for her comfort.
~Doc wants me to start taking terbutaline every 2 hours instead of every 4, around the clock.
~If baby comes before 36 weeks (Oct 8), I can't deliver at the local hospital (Castle). I'll have to go to Kapiolani where they have a NICU.
~My doctor doesn't go to Kapiolani so I'd have a random Dr I've never met before deliver baby.
~Baby is still breech. :(

I was kind of stressed out about this stuff last night. Upping the dose of the Terbo drug doesn't help at all as my heart rate is now through the roof and I'm more shaky than ever. Add headache and nausea to the list of side effects. It's truly the worst I've felt through this whole pregnancy so far. And the thought of delivering in an unfamiliar place with an unfamiliar doctor doesn't excite me in the least. And I was surprised that baby is still breech. I was sure I felt all this new pressure in my pevic area... turns out that's baby's feet stepping on my cervix. Oh. Ok. Time to start the moxibustion burning.

In more reassuring news...

~My cervix is not effaced and has not started dilating. Yea!
~Doc did a fetal fibronectin swab and it came back negative, which is great, because that is an indication that I am not going to go into labor in the next 2 weeks. Yea! That puts me at least to 35 weeks. At least.

I laid awake for hours last night... most of the night in fact... not due to stress about all this but rather because my heart was pounding so hard through my chest that I just couldn't doze off. I actually took my heart rate while watching the clock without touching a blood vessel- I could feel it that strongly- and it was 104 while I was laying down. I just kept thinking that this can't be good for me or my baby.

So I have contractions all the time. But they're not causing any change in my cervix. So I'm trying to understand why this is even an issue? Why am I on this terrible drug that makes me feel as bad as I've ever felt since before I peed on the stick? My understanding is that contractions, if they are not causing cervical changes, are fine and normal. My body knows how to be pregnant and deliver a baby. I really don't want to mess with it any more by adding pharmaceuticals to the mix when it seems to me they are unnecessary...

So then I did more research on this drug terbutaline. Turns out, it's indicated for asthma. Not pre-term labor. And in fact, there's much debate about whether or not it should even be used for pre-term labor. Apparently it has only been shown to work for the first 48 hours to delay impending labor. And in fact, I'm not even in pre-term labor b/c that's defined as cervical changes, which I don't have.

Clearly, another conversation needs to take place with my doctor. I'm definitely thinking that I'd rather deal with around the clock contractions than all the adverse events this drug is causing. I feel like I just want to trust my body... that it knows what its doing...


TrainingtoTri said...

Oh wow, you have a lot on your mind right now, you poor thing. That drug does sound a little scary if it is making you so sick. Definately talk to your doctor again. I sure hope you make it into Oct so you can have your doctor.

The Chapples said...

Hmm... I think I'd have a lot of questions for my doctor too if I were you! I am sorry you're so uncomfortable.

Clare said...

interesting. i often think i know more than my doctor (too often, i do). i'd trust your intuition at least as far as asking all these questions and demanding satisfactory answers. i've been having what i think are braxton hicks contractions since around 20 weeks, sometimes frequently, but i don't want to mention then to the dr because i don't see them as anything but normal and i just feel like i know my body. are your contractions painful??

hatfields-in-hawaii said...

This sounds oh too familiar! Same thing for me...tons of contractions and no effacement or dilation. I really think that laying down for 10 weeks helped keep them at bay (as miserable as it was :-). Fortunately, I didn't have to go on the terbo drug. Definitely ask the doc about it and maybe if you promise to not do anything she'll let you off of it?? Hang in there...only a few more weeks!!!

Mama Simmons said...

Sometimes the BH are *really* tight and uncomfortable, wouldn't call it pain though. And the tightest ones come when my bladder is on the fuller side.
I was a pharmaceutical sales rep for 5 years so I have a good amount of background in drugs and clinical studies, etc... so I'm not afraid of drugs in the right circumstances but I don't think this is the right circumstance for me and this drug. I have an appt with Dr again tomorrow to discuss it. Should be an interesting conversation! :)

IVF Running Mama said...

I am definitely a big believer in listening to your body...I had the same thing at 26 weeks. Lots of BH contractions, but no change in cervix. They come and go. I'm actually going through a period with a lot of BH contractions. Mine weren't/aren't that painful. More like pressure. Can you stand up when you have them? Can you talk normally? Just curious.

Mama Simmons said...

Yes, I can stand up- they usually come when I stand up... I can talk and breathe and all that pretty much as normal- just with a rock hard belly! It's uncomfortable, but not painful.
As a side note, when I was in the hospital hooked up to the monitors the other day, the contractions it was picking up were WAY lighter than what I've typically been feeling. I was like, "That's a contraction?" And the instructor of the birthing class the other night said early labor would feel like painless tightening, so I think the only real way for us to tell (without checking our own cervix!) is to time them and see that they are consistently coming and going and intensifying. My new rule is as along as the contractions are irregular, I'm not worried. :)

hatfields-in-hawaii said...

That's the same conclusion I finally came to. Since my cervix hadn't thinned or dilated I just made sure they weren't coming at a regular interval. Definitely got more when I had to pee too.