The Best of Bear: Part 4

Parts 1,2, and 3 found here, here, and here.

Originally posted 3/13/13: A Dark Day
I slept fitfully after the middle of the night move. My head still ached, and I was working on my caffeine intake. I tried desperately to sleep, but it was rather elusive. I was really glad that Brad was able to sleep; he'd been pretty worn out himself.

We'd attempted a trip to the bathroom once during the night, and it was horrible. Standing up was absolute agony on my head. I sobbed and sobbed. Brad, hero that he is, held my head in a vice-like grip as I shuffled to the bathroom with my i.v. stand. I cried the entire time I was in the bathroom (and was back to having to collect urine again; they seemed determined not to let me regain my dignity) and the whole way back to my bed, which felt like the length of a football field, rather than the few yards that it actually was. Brad helped me back to bed and got me lowered back into my flat-on-back position asap, letting me bawl my eyes out and hunting down a box of tissues for me. It was an excruciating 10 minutes of my life. Thankfully, returning to my flat position granted a great deal of relief.

7:00 am rolled around and with it two new nursing students: another gal and another guy. Remember, I really have no problem with students observing and practicing. I really don't. However, I am not crazy about being in those rather revealing hospital gowns and having male students in and out. Call me old school. They came in (after their instructor came and got my permission) and began taking vitals. Y'all. After my week in the hospital, I'm a pro at offering my bicep (for blood pressure cuff), index finger (for oxygen level monitor), and opening my mouth (for thermometer) all at the same time, without being asked. I dare ya to try and prove yourself more adept at those skills. Between the two students, they checked my vitals about twice. They also inspected my incision and poked around my stomach (not my favorite, as I'd just had surgery on my abdomen), all while talking each step over with one another. It's just so strange to listen to people talk about you right in front of you...and it had been a daily occurrence for me so far. I definitely wasn't going back to sleep after my thorough going-over.

The students had barely left the room before Meagan the Resident (from my first night of labor) came in to check on me. She asked about my headache, having read my chart, and encouraged me to get the blood patch. She also checked my incision and poked my stomach. I realized that I just needed to get used to that part. She was sympathetic to my plight and wished me luck.

She'd been gone for about 5 minutes- long enough for me to notice that the sun was coming up and realize I'd only slept about 3 hours. Next thing I knew, another somebody came in. She introduced herself as the nurse's aide on duty and then said a bunch of things that- between her strong Massachusetts accent and my overly tired brain- I didn't understand the first time through. Before I knew what was happening, she was using the automatic lift function on the bed to raise me to a full sitting position. I was too disoriented to tell her, "No! Stop! My head!" By the time I could get my mouth and brain on the same page, I was already fully upright and in agony again. 

I told her I had a spinal headache and needed to be lower, which she didn't seem to love; I'm guessing she had a plan, and I was not playing along nicely. She also told me she would be helping me go to the bathroom during the day. I mentioned that Brad had helped me during the night, and she told me, in no uncertain terms, that helping me to the bathroom was not his job and that he shouldn't be trying to do the nurses' job. She also scolded me for not consistently collecting urine specimens. I tried to tell her that I'd done so during the night for the night nurses, and they told me I could stop. She cut me off to tell me that the night nurses didn't understand the day nurses' procedures, and they had no business telling me I could stop. (I should interject that the night nurses also took away my specimen collection device, so I really couldn't collect anything else).

I didn't know what I should say. I felt as though everything I said was getting a scolding, and my brain wasn't working fast enough to process anything. So, I just sat there. 

She took my vitals- for the third time in 30 minutes, reminded me that I was not to go to the bathroom without calling her, and said breakfast would be arriving shortly.

As soon as she left, my hormones took over, and I just started crying. Couldn't stop. I tried to be quiet so Brad could stay asleep (he'd been asleep the whole time), but he woke up nonetheless. It took me a while to stutter out everything that had happened (nursing students, resident visit, nurses' aide) and how overwhelmed and tired I was feeling. And how my head was torturing me from the abrupt bed raising. And how I had just gotten scolded and wasn't awake enough to be a big girl and take care of the situation. AND, how I was going to have to hold the urge to go to the bathroom all day...until that nurse's aide went off duty, because I was NOT calling her to take me...

Brad was such a hero yet again. He apologized for sleeping (as if that's a crime...I wanted him to sleep) and promised to be the gatekeeper from then on out. 

That's exactly what he did. Fell in love with him just a little bit more. (You can gag at that line, if you need to. Maybe it's a little over-the-top. But, it's my blog, so I can write the gag-worthy on occasion.)

Originally posted 3/15/13: What to do?
Later that afternoon (the afternoon of the day that we were moved downstairs), I was visited by an anesthesiologist that I had not previously met. He had come to discuss the option of a blood patch to deal with my spinal headache. He was incredibly kind and compassionate. We spent quite a bit of time talking in detail about where and how I felt the pain in my head, how it differed from my migraines, what treatments had already been done (the hydrocortisone and lots of caffeine), and what I knew about wet taps and blood patches. 

He very patiently explained how the wet tap had happened (I already knew, but it was helpful to hear again) and how the blood patch works (click the link above to read what wikipedia has to say about blood patches and how they work). At this point, it had been 48 hours since the wet tap happened, and he suggested I wait the recommended 72 hours to see if I really needed/wanted a blood patch. He did that thing that they all do, where they give the disclaimer that, in most every case, a blood patch works, but occasionally, one won't. Included in the disclaimer was a little comment that, yes, it is possible for another wet tap to happen when receiving a blood patch.

After he left, I told Brad how wary I was of getting the blood patch. I'd already had 6 major sticks in the spine, and the disclaimer of the blood patch not working or even causing another wet tap was almost too much for me to deal with. I just didn't think I could do it. I know that it had a reputation for almost instantaneous relief, but it sounded like a gamble to me- one that would involve a good deal of pain, whether or not it worked.

Like the good husband he is, he told me he wouldn't push me either way, and if I didn't want to do it, that was fine with him. 

The rest of the day passed much like the day before: my parents came and spent the afternoon/evening with us, we spent time with our little Bear, we discussed the blood patch option (Mom had had one that was very successful and Dad knows things because, well, he's a doctor) and everyone distracted me from the headache, in general.

Nighttime came again, though, and with it a lot of difficulty. I woke up around 2:00 a.m. with a wretched surprise: I had a migraine behind my left eye. So, in addition to the debilitating pain from the spinal headache when I was anything but horizontal, I now had a pounding migraine even in my flat-on-back position. I paged the nurse with frantic requests for something to put me out of my misery. I think they maybe gave me something, but I definitely know it wasn't strong enough. They loaded me up with more caffeine, and I prayed to high heaven that the Lord would either do something about my head or just go ahead and take me. I was past the point of being able to handle the pain. 

Oh, and I started crying (thank you, hormones), which made the situation even better. And by "better," I mean much worse. Much, much worse. 

The next morning was my Day of Reckoning. I had to use the bathroom pretty soon after waking up (an activity I put off as long as I could each time) and had Brad help me get to the bathroom (you can read through previous posts to refresh your memory about what an ordeal that was). 

It was absolutely the lowest point in my recent world of pain. I sobbed and sobbed and sobbed. And then I told Brad to get the nurse on the phone with Anesthesiology pronto. Or "stat," I guess...we were in a hospital. I would get the blood patch. My only condition was that they needed to know there was no way I could walk or even ride, sitting up, in a wheelchair to the pain clinic. Also, I wanted Brad with me.

Originally posted 3/16/13: Big Ouch
Things were a little complicated by my c-section; blood patches are usually performed while the patient is lying on his or her stomach, which was not possible with my incision and sutures. They put me on my side and I found myself rather disconcerted, again, by the discussion going on around me. This time, it was regarding how difficult a time they were going to have because of having me on my side. It just does not inspire confidence in a patient to hear the physician performing a procedure discussing how difficult he thought it would be. Goodness.

After general prep, the doctor explained that I would feel a "big pinch" and a "big sting," two phrases I had grown to loathe. When someone says those things, you are guaranteed pain. Which happened. I gritted my teeth and tried to focus on anything but my back. It hurt...hurt some more...kept hurting...then I heard him mutter that it hadn't worked and he would try again. Of course.

I closed my eyes when he started again. Someone ( a nurse, I guess) squeezed my hand in sympathy. I felt the "big pain" and the other "big pain" again, hoping that it would be over soon.

No such luck. It hadn't worked again. I started crying ever so slightly and trying desperately not to get caught doing so.

Ew coming up: He picked another spot on my spine and went for it once more. Thankfully, it took. He instructed the assistant who was positioned in front of me to start taking blood. She did. A lot. They have to take blood on the spot for the procedure, and the anesthesiologist began filling my wet tap puncture. He put in three rounds (25 cc's, if that means anything to anybody) before he felt it was complete. The frustrating element of this part was that he would insert blood until I told him that it was painful. So three times, I got to the point of intense pain before he stopped and reloaded with more blood. By the time he was finished, it wasn't a secret that I was crying.

The rolled me back to my hospital bed and helped me back onto it. The doctor explained things to Brad, while I was given instructions to stay on my back until dinner (as if I'd been doing anything else). Everyone wished me luck, and they took me back to my room.

I followed the flat-on-back instructions until evening, at which point I definitely felt better. I still had a headache, but I made it to the bathroom without crying and took a two-minute shower (my first in an ungodly number of days) before heading back to my bed to talk about how awesome it was not to be in excruciating pain.

It was such a nice reprieve...for about two hours.

Originally posted 3/18/13: Anti-climactic Ending
The fact that the blood patch hadn't worked was extremely frustrating and disheartening. I had had what I can only describe as a "bad feeling" (for no particular reason...just a gut feeling-ish) about the blood patch from the beginning, but I'd felt somewhat pressured by the medical community (or at least the part of the medical community that was caring for me) to have it done. And, I think I'd talked myself into believing it would immediately and completely erase my pain. When it didn't, that was a hard blow.

I was very discouraged but realized that there wasn't anything else I could do about it. I didn't realize how discouraged I was until I woke up talking about the blood patch one night. Because of all the pain medication I was on, I found myself waking up disoriented more often than not. So, the night after the blood patch, I woke myself and Brad up by crying and begging him not to make me get another blood patch. Poor Brad... He reassured me that he had no intention of doing so. I then fully woke up and felt a little silly.

Thankfully, after that, the last little bit of time left in the hospital was fairly uneventful. I continued to deal with my headache the same ways I had been: flat-on-back and lots of caffeine. Getting a taddy bit more sleep probably would have been nice, but middle-of-the-night feedings kept that from happening. #newparentsprobs? (I don't know if that's a thing...I don't tweet. Not cool enough.)

Because the anesthesiologist who performed the blood patch procedure had been so confident that it had been successful, the doctors in the pain clinic were flummoxed by the fact that it hadn't. Yet another anesthesiologist came to talk with me about what was going on. It was a disjointed and confusing conversation, but what it boiled down to was that it should have worked and nobody knew why it didn't. The only "answer" anyone had is that I have a "difficult anatomy." Isn't that such a comforting thought? He also recommended that I have another blood patch done. Ha. Yeah, right.

My parents came every day to visit and also made sure that our apartment was stocked and ready for us when we went home. Such a blessing. I was growing very weary of the hospital and just wanted to go home with my family. I had the option of going home on Saturday (rather than waiting out the full amount of time and going home on Sunday), but after the failed blood patch, I reluctantly agreed with Brad and my parents that I should take the extra day.

On Sunday, I was discharged shortly after lunch (I was prepared to have to wait for a really long time to be discharged), and Brad thoughtfully prepared the car for me by lowering the front seat back as far as it would go, to accommodate my persistent headache (which eventually dissipated about two days later and morphed into a dull ache...I'm actually still dealing with headaches, although they are sooo much less of a difficulty). Our apartment is only about a mile from the hospital, which is a blessing, so I didn't have far to travel, and when we got home, I was able to crash on the couch for the rest of the day.

Finally, I was back at home. With my baby.

It's rather an anti-climactic ending to a generally dramatic story, but I'm not complaining. In the time that has elapsed since the hospital, I've been able to reflect quite a bit on the wonderful blessings we experienced and some of the kind people we met. 

Many thanks to those of you who have read, commented, and encouraged me through messages, emails, and cards over the past few weeks. It has been a blessing to hear from friends and acquaintances; I'm so thankful for your kindness and compassion. Thank you, friends.