Saturday, September 26, 2015

Information Accessibility

The seriousness of my health issues aside, I'm really loving how a lot of the health care systems are now using an online chart system to track patient care and as a patient, I have access to it. I feel empowered, reading my own test results. I loved looking back and reading the notes my midwife took throughout my labor with Kaylee and similarly, I like having the details, the down and dirty data. I think it's the scientist in me. I can accurately educate myself to a level of detail that a doctor might not delve into (even though I desire it, it's honestly my biggest gripe with standard medicine. This is why I loved my midwife in Washington, he would send me research articles and really get into the nitty gritty once he found out I had a science background. It made me feel like a valued and contributing member of my own healthcare, rather than a marginalized idiot)

Henry Ford Health Systems uses MyChart, which seems to be standard. I think I have a crazy number of accounts with them now from all of the different hospital systems I've been seen by (from back in Washington especially).  MyChart is why I chose to go to urgent care further from home when I had the cramp and it's why, when given the choice of ER, I chose to drive 40 minutes away. I had not heard good things about nearer hospitals and since my prenatal care was within Henry Ford, I found it prudent to have my whole health care team reading from the same page.

I checked  MyChart tonight and saw the results from Vascular Imaging (right above my negative Gonorrhea test, thankyouverymuch). My clot was found in the right peroneal vein, it was called a total occluding acute thrombosis. Very shallow google research informs me that this is a common spot to get a clot. Obesity and pregnancy are my only two risk factors. I'm around the same weight as my previous pregnancy (only 10 lb heavier, really) and didn't have an issue then. But I am thankful things were caught in time.

Interestingly, given my symptoms, I had low probability of my symptoms being a DVT (deep vein thrombosis). My only symptom was pain. I had no swelling or edema, recent long distance travel or immobility. Go figure. This low probability was why they chose to do the D-Dimer test first, rather than jump immediately to ultrasound.  (I found a professional grade Merck manual on the subject, it's been fascinating to read!)

Over the past week I had been breaking down over random things. But reading this very clinical report on what I've been diagnosed with and what the prognosis and expected risks and probabilities are, it's actually quite reassuring. Eric and I both agreed we wish we had this last week. It would have eased our minds significantly.

Now I can't wait for the results of my CT scan to be posted to my account so I can get more specifics on my PEs (pulmonary embolisms)

Tuesday, September 22, 2015

That damn cramp....

I mentioned, in the same paragraph no less, that I'd been having a cramp in my leg combined with out of breathness.

Well. It wasn't a muscle cramp, tear or strain, like I thought.

Eric finally had enough and made me go to urgent care on Sunday. I drove myself in, arriving an hour after they opened (11am) to find I was the only one there. Sweet! I got seen immediately and related my symptoms. The doctor on call asked about shortness of breath and I did say I'd been having trouble walking up stairs. I think her face paled and she told me that I was going to the ER for suspected blood clot. She asked which one I preferred. We're in this healthcare desert so I could travel to several, all about 25 miles away. I chose to stay with Henry Ford.

The clinic called ahead and gave me paperwork to expedite my ER admission. I drove myself and called Eric and my Mom to give them a heads up. I walked into the ER and again, was seen right away. Sunday morning was slow, apparently, or I was near top of the triage priority. I got brought back and the nurse practictioner explained what the plan was going to be.

The first thing was they were going to do the D-Dimer test with my blood. It's the least invasive test for blood clots(and probably cheapest) but you can test false positive if you're pregnant. If I was negative, that was awesome.

I was positive.

Next I was sent up for an ultrasound of my legs. They were looking for a blood clot, or deep vein thrombosis.

The tech found a blood clot. When I was wheeled back down to my space in triage, the nurse practitioner kind of laughed, and said, "You're staying with us tonight."  In other words, they were admitting me.

Blood clots are serious business. Pregnant women are at a higher risk for blood clots due to excess clotting factor in their blood. Several doctors (both General and OB) explained that there was a risk that the clot broke off and moved to my lungs (where it could cause a pulmonary embolism if untreated) but the treatment was the same. The ER was declining to perform a CT scan because they were just going to treat me anyway if a clot was found in my leg. If one hadn't been found in my leg, I was going to CT next.

I was given a shot of blood thinner and sent up to my room. My phone was getting low in battery so I called Eric and he arranged for his sister to bring me a charger and a book to read. He was busy keeping Kaylee occupied and we both thought that a hospital visit at night would make bedtime a gnarly mess.

I settled into my room and enjoyed a brief visit from family. Then I settled in for the evening. My only hospital experience previous was when I was helping my friend Cheryl with her labor. You get checked very regularly by nurses when in labor at the hospital and I guess that's labor specific because I was not checked or bothered regularly and was basically left to my own devices with instructions that they didn't want me wandering the halls since I was on blood thinners.

It did not take long for me to go stir crazy.  Thankfully the hospital had free wi-fi. I called Eric after Kaylee was asleep and we chatted. Then I was in for a restless night. I slept for 3.5 hours before tylenol wore off and my leg pain was back. I was debating calling the nurse when an alarm started going off in the hospital. I figured she had to be awake anyway, so I called and asked for more tylenol. Apparently there was a fire drill. At 3:30 am. By 4:30a the tylenol was working its magic so I  started trying to get back to sleep. At 5:30 a resident came in to talk to me.  I was ready to kill her. I rolled over but at 6 a patient transporter came to get me. I was heading down for an echocardiogram to make sure my heart looked good.

I zoned out for part of the  morning and people were in and out. The big thing was the doctors changed their minds. They still wanted me to have a CT scan to check for clots in my lungs, even though the treatment wouldn't change.

I went for my CT scan around 1pm. It didn't take long and the contrast dye made me feel like I was peeing my pants for a brief moment and then I had a moment where it felt like I was struggling to breathe but it passed.

My midwife came by to talk to me and that felt really nice that she took time in her day to do that. She splits her time between being at this hospital (why I chose it, so all my care was under the same account) and being at a location closer to me. I really like her and I'm hoping I can still be somewhat under her care for this pregnancy.

I called the home birth midwife and canceled my appointment for today (tuesday). I've effectively risked out of home birth, which REALLY sucks but there's nothing I can do about it.

The obgyn came back with my CT results. I had multiple clots in both of my lungs. It was likely the source of my out of breathness. After she left I had a minor breakdown and just cried. Thinking about how close I came to potentially dying  is nervewracking. My midwife came back to talk about that too, gently and jokingly scolding me for going all out with the risk factor, hah. She also got me in for an appointment with the Maternal Fetal Medicine specialists. All of my appointments now are going to be at the hospital. No choice in the matter, but I may be able to alternate and keep seeing my midwife.

It's weird. The pregnancy is high risk, but me laboring is not, because I'll be pulled off of the blood thinners for that. I just don't know if the OBs are going to be super controlling about timing or if they'll let me go into spontaneous labor (my desire). I absolutely cannot be on blood thinners if I need a C-section, but the plan is that I stay on my current medicine until 35 weeks, then switch to heparin, which can be easily and quickly reversed when the time comes for labor.

Eric came down to the hospital and brought Kaylee. It was so nice to have them with me and Kaylee definitely missed me. She was very cuddly but also fascinated by my IV and the bits of blood that had leaked a little. You could see the little gears turning when the internal medicine doctor came in to talk to me and listened to my lungs with his stethoscope. She plays with her play stethoscope at home and does similar things.

All of the doctors were basically agreeing that I was clear to be discharged at that point. But we also had to talk to the patient advocate at the hospital about my medicine cost. Even though Eric has a great job, and an arguably good insurance policy, my medicine will cost us $3000 for this first month's supply and $2000 for next month (when we meet our deductible) and after that will just be a copay. Until January, when it starts all over again. Of course, some of this might change as we pay for the hospital stay.  The hospital pharmacy only had 10 doses on hand. For me, that's 5 days worth. It was $895.

If I was on medicaid, it would be free.  Thanks insurance companies, screwing over the middle class. Never have I wished more for single payer insurance. We can pay it. We're not going to be broke because of it. But it certainly affects how we had budgeted. I can't imagine how I would be able to get my medicine if Eric made a little bit less.

After getting a flu shot, I was officially discharged at 6 pm. I am forbidden from risky activities where I could fall and experience an internal bleed.

So no more riding for this pregnancy. I am going to go crazy. I did decide that I'm going to ground drive Gwyn, and maybe get her working on the farm and doing the arena dragging and pasture dragging. That would be something we could do together. I have also offered her for lease, so she continues to be ridden, per the suggestion of Jim, my old dressage trainer.

I don't think Eric has fully process this. We were going to have a heart to heart after Kaylee went to bed last night, but I laid down and just passed out, I was so tired. He doesn't have anyone to talk to about this stuff except me, so when something happens to me, he's stuck. I have my online group of moms and this place to get my verbal vomit down and deal with shit. He doesn't have that outlet.

All in all, it was a crazy Sunday/Monday. I'm home and that feels so good. My health issues were found before something more serious than a leg cramp cropped up, and I'm keeping myself healthy for Babydos.

Friday, September 18, 2015

Incubation update

The pregnancy is going well. Exhaustion isn't as bad as it was, or I'm just taking it easier early in the day so I don't crash later. However morning sickness is full upon me. It's worse this time with Babydos than it was with Kaylee. With Kaylee the only time I really threw up was when I was car sick on the way to Eric's grandfather's funeral.

This time I've out vomited myself. I'm also not really into eating red meat this time around, which is similar to last time. When I think about what I'm in the mood for, the thought of a meat dish roils my stomach.

Kaylee has been absolutely sweet about the whole thing. I don't like to sugar coat or dumb down the facts about things in her life so she's aware I'm pregnant and she also knows that the baby is in my uterus. She asks every day if the baby is coming out and if she's a big sister. She confirms that she also has a uterus but will kiss my belly and say she kissed my uterus. It's utterly adorable how excited she is.

I went for a dating ultrasound on Friday because I was slightly doubtful of my last menstrual period. I wasn't sure if the 2-3 days of spotting immediately beforehand were my period starting or if I should count from when the flow started in earnest. There's a 3-4 day window so I guess my CNM (Certified nurse midwife, associated with OBs) wanted to be sure. It was comforting to see the heartbeat and hear it thump away. Up until now the only indication that I was still pregnant is the fact that I'm not bleeding, so anything could have been going on in there. I wasn't overly concerned, but it was still a worry that I can banish now. This child is very much desired and wanted!

I've been getting out of breath really easily. Just walking up the stairs has my heart pounding. And lately my right calf is in an eternal charlie horse. It goes away with two advil but it's annoying and keeps me awake.

Speaking of awake, I realize it's the middle of the night but lately Kaylee has been wanting to sleep in our bed to start so we all climb in and pass out. I went to bed at 8:30 and woke up at 1am. I actually feel pretty decently rested at this point, and my leg was starting to cramp again so I did the dishes and now I'm writing this until I'm tired enough to go back to sleep. Eric already moved Kaylee back to her own bed, so it'll be nice to spread out and snuggle directly with him.

Only an inch long! Like a grape!

Friday, September 11, 2015

My own jump standards

I finally have my jump standards done! Eric helped me only a little bit, otherwise it was all me!

4 4x4 6ft treated wood posts
2 2x6 8ft treated wood planks
deck screws made for treated wood
1 gallon flat white exterior paint
1 toddler 'helper'

I started by measuring and then cutting down the 2x6 boards into 1 foot increments. These would become the feet. Because my saw was lame, I had to make each cut twice in order to go fully through the board. 

Always use proper PPE!

Mock up of how the feet will become the base of the standard

My 1 ft pieces

I wanted to make sure the hand-me-down jump cups were going to work. This particular one does not require holes in the post. I planned to drill them anyway because I do have some jump cups that need a hole

Next I measured out where I wanted my holes for jump height. I decided to drill every 3 inches starting at 18 inches high and ending 18 inches before the top. I doubt I'll ever use the top holes, but maybe I'll need a massive x-rail, lol

Everything drilled through. I discovered after the first post that I needed to offset the holes to one side so that the pinned jump cups I had would be at the correct angle to support the poles. Dead center was too tight a fit.

I sanded down the rough edges from drilling.

My first finished standard with helper in the background.  I used 2 screws per base piece to attach it to the standard and put them on a diagonal so there would never be interference with another screw from a different side. 

All four finished!

I decided to paint them white, but since they're treated wood I could have left them alone. I like the look of the white though. Kaylee helped me paint them, which was hilarious. It took two coats to get the coverage I wanted and two sessions to get paint on the bottom. 

The truck was handy for moving the standards to the arena from the garage. 

I set up the jumps in the arena and had a handy model to photograph. 

This is how I left the arena and when I came back, one pole had been knocked over already.

Because I have a naughty pony who likes to push things over.

Monday, September 7, 2015


Last spring my Mom volunteered to go on the 8th grade trip to Washington DC. While there they went to the Air and Space Museum. She asked me if I wanted anything in particular since it was basically a clone of the KSC visitor center souvenir shop. She also asked if I wanted an astronaut suit for Kaylee.

I, of course, said YES!!!!.

She also bought one for an infant. She knew we were trying to conceive at the time and jumped the gun but I honestly don't mind. It meant we got to make this awesome announcement!