Going against doctors advice.

I'm 34 weeks with di/di girls and yesterday, after my NST and BPP, I decided to stop into L&D to mention all the contractions I'd felt like I'd been having, with more discharge than usual and a seemingly heavier weight on my cervix, hoping to get my cervix checked for dilation. I also mentioned I'd had two headaches in the past week and that the little star bursts in my vision were still there, they have been for the past three weeks or so (my OB is aware) so maybe they should check my urine/blood.

After waiting for three hours, they come in with a gown and tell me they're going to admit me for the rest of my pregnancy. I was showing trace amounts of protein (less than the week before, when I was +1 but then proceeded to pass a 24 urine jug two days later) or any signs of pre-eclampsia in my blood work but because of the two headaches I'd had and slightly elevated blood pressure (142/93 was just about the average). The attending who wanted to admit me was the same attending who, two weeks before when I was hospitalized to complete the 24 hour urine jug (again - sheesh), told me I'd be there until my delivery until *her boss* said she was crazy and that if I felt fine and my numbers were good, there was no reason I couldn't go home.

I just about fell apart when the nurse brought in that gown and told her that unless I am showing protein or if there's something off in my blood work, I don't see any reason why two headaches should be a sentence to stay in the hospital for the next three and a half weeks (assuming I make it to my 38 week c-section). This whole pregnancy has been full of what I feel are unnecessary medical interventions and I keep feeling like things are out of my hands, because the doctors keep telling me they know what is best.

I talked to the OB on call and told her that there was no way I was staying; that I'd gladly go home, buy a pressure cuff and take my B/P readings at home. I have 5 appointments a week at my hospital and if I felt I needed it, I'm *obviously* not afraid to go to L&D to get myself checked out. She went on to tell me how the babies could die and I told her that I don't think two headaches (both days I'd also been bad about eating enough, they both happened at night and I was pretty sure they were low blood sugar related) constitute a state of emergency, especially since I had just come from my NST/BPP, where the babies were showing no sign of fetal distress and both passed 10/10. I also asked why it was that since I have gestational hypertension and that my medication hasn't been adjusted in over two months, is it possible that since I'm pumping more blood and that their placentas are growing (just like with GD), I might need my dose increased? and I never got a straight response from that question, which seems to be a plausible scenario to me, with my B/P increasing and other high B/P symptoms. Why does it have to be pre-e and not just the hypertension worsening as my pregnancy goes on?!

I had to sign out against medical advise, which pretty much guarantees I'm going to get billed for the entire triage visit and I had nightmares all night, in regards to the babies and the state of things. After I left yesterday, and all day today, I've just felt horribly depressed and confused about what to do. I guess what I'm asking for is some moral support or else constructive criticism. Am I a horrible mother for thinking I know my body, and can read the signs it gives off, better than an OB who I've seen once before, also at a triage visit? Am I being reckless? Would you have stayed? *sigh* Basically, I'm asking, what should I do?

 

I'll tell you my story. I was scheduled for a c/s at 38 weeks. At just over 37 weeks, I was having some stomach pain. I went in to L&D and they checked my bp, which was not elevated. They did a NST and the babies were not in any distress at all, they were moving, kicking, etc. I was not having contractions at all. The OB from my practice came in and said "Everything looks good, we are sending you home ." The nurse looked at her and said "How was the blood work?" The doc said "Oh, I didn't order any, let's do it as a precaution". When the blood work came back, it showed that I had developed HELLP Syndrome. My platelet count was 40,000. The OB came back in and said "Girlfriend (yes, this is what she said), we're going to have to deliver those babies today." I had to have two platelet transfusions before they could do my emergency c/s. From my reading afterwards, this is a very life threatening condition for the mother. They put me under general anesthesia and my husband could not be in the delivery room. I was put on mag sulfate among other drugs, too. My babies were born that day and were very healthy. I, however, was not so healthy. They kept me in the birthing unit overnight to monitor me. They did blood work every couple of hours to ensure that I was improving. I ended up with high blood pressure AFTER the delivery. I could not get out of bed for two days. I almost had to stay in the hospital longer than the 5 days. When they did release me, they sent a visiting nurse every day for a week to monitor my blood pressure, etc.

Not trying to scare you, but at this point in your pregnancy, you should take these precautions seriously...for you, for your babies, for your family. For myself, I would have stayed. I would never have signed myself out against doctors orders.

 

QUOTE(Holly Orlando @ Apr 29 2009, 03:01 PM) [snapback]1293631[/snapback]
Am I being reckless? Would you have stayed?


Yes and Yes. ardon: Pre-E is nothing to mess around with. You can have seizures from the elevated BP. I had it and I was on hospital bedrest for mine and the babies safety.

 

If it were me I would follow my drs. orders, and if she felt it was best for my babies that I be admitted to the hospital until I deliver, that's what I would do. I trust my OB and trust she was making the best decision for me and my babies. I wouldn't take any chances, I would have stayed.

Plus you did mention you stopped in L&D because:

QUOTE
all the contractions I'd felt like I'd been having, with more discharge than usual and a seemingly heavier weight on my cervix,

 

I am sorry you are having so much trouble. I have no idea what to say except that it's your body and babies. You seem like you are on top of things and would go back to the hospital if needed. Just please becareful and listen to your body, at the first sign of a problem I would go back. You can never be too safe when it is your children and yourself that you are worried about! I wish you the best!

 

QUOTE(summerfun @ Apr 29 2009, 12:14 PM) [snapback]1293645[/snapback]
If it were me I would follow my drs. orders, and if she felt it was best for my babies that I be admitted to the hospital until I deliver, that's what I would do. I trust my OB and trust she was making the best decision for me and my babies. I wouldn't take any chances, I would have stayed.

I have to agree with Amy and Rachel here. As inconvenient as it may be to you to have to endure being in the hospital, the health and well being of your babies should be #1 right now. Good Luck.

 

QUOTE(moski @ Apr 29 2009, 11:12 AM) [snapback]1293640[/snapback]
Not trying to scare you, but at this point in your pregnancy, you should take these precautions seriously...for you, for your babies, for your family. For myself, I would have stayed. I would never have signed myself out against doctors orders.

I agree

QUOTE(Kyrstyn @ Apr 29 2009, 11:30 AM) [snapback]1293669[/snapback]
I have to agree with Amy and Rachel here. As inconvenient as it may be to you to have to endure being in the hospital, the health and well being of your babies should be #1 right now. Good Luck.

I also agree.

I know that the prospect that anything would really happen to your babies seems so unreal right now but there are too many ladies on this site who no longer have twins in this world that proves it can and does happen. I think you are being very unresponsible and reckless with your children's lives.

 

QUOTE(summerfun @ Apr 29 2009, 03:14 PM) [snapback]1293645[/snapback]
If it were me I would follow my drs. orders, and if she felt it was best for my babies that I be admitted to the hospital until I deliver, that's what I would do. I trust my OB and trust she was making the best decision for me and my babies.


I feel like I should mention, too, that I've been hospitalized three times before and while I don't enjoy the idea of hospital bed rest, it's not something that I haven't had to endure before. Every time I cooperated because I knew it was the best thing for the babies. This time, however, I felt like it was completely unnecessary and being prescribed by a doctor who doesn't know me or my pregnancy. I've seen her once before and it was in triage, for maybe two hours.

I see my OB on Friday morning and am planning on bringing packed bags with me; if he wants me to stay, I will, because I trust him and his decision.

 

QUOTE(Holly Orlando @ Apr 29 2009, 03:01 PM) [snapback]1293631[/snapback]
Am I being reckless? Would you have stayed?

Yes, and yes. Pre-e/eclampsia/HELPP is extremely dangerous for both you and the babies. I don't understand why you would want to take the risk??

 

As someone that's been on hospital on bedrest for almost 7 weeks now, in my opinion yes, you're being reckless. You already have medical issues that are a concern and just because your bp isn't through the roof (it is most definitely high though) doesn't mean that can't change very quickly. My cousin just delivered her little girl at 31 weeks, her bp had been fine two days before at a checkup, then she started with a headache and seeing stars, by the time she got to the hospital her bp was so high she was rushed into an emergency section and on seizure meds for two days. Both her and her little one are lucky to be alive. Honestly, I don't think it matters how many times this OB has seen you, they obviously think there's a need for you to be on bedrest and they are professionals, this is something they see everyday. For a matter of a max couple of weeks I'd suck it up and go in.

 

QUOTE(Holly Orlando @ Apr 29 2009, 12:38 PM) [snapback]1293679[/snapback]
I feel like I should mention, too, that I've been hospitalized three times before and while I don't enjoy the idea of hospital bed rest, it's not something that I haven't had to endure before. Every time I cooperated because I knew it was the best thing for the babies. This time, however, I felt like it was completely unnecessary and being prescribed by a doctor who doesn't know me or my pregnancy. I've seen her once before and it was in triage, for maybe two hours.

I see my OB on Friday morning and am planning on bringing packed bags with me; if he wants me to stay, I will, because I trust him and his decision.

That is great that you have been hospitalized before and nothing came of it. You should consider yourself very lucky. I guess it is within your right not to stay, however it doesn't mean that is the best thing for you and your babies. The Dr's would not have had told you it was necessary just for grins. They are trained professionals that know what they are doing. They were looking out for the best interests of you and your babies. I sincerely hope that everything turns out OK for you and the babies. Something to think about though, is what if something DOES happen and you knowingly took that risk? That is not something I would be able to live with, can you? I think it is always better to be safe than sorry. The actions you are taking are far from safe. Good Luck!

 

QUOTE
This time, however, I felt like it was completely unnecessary and being prescribed by a doctor who doesn't know me or my pregnancy. I've seen her once before and it was in triage, for maybe two hours.


So what happens when you have to have an emergency delivery because you have pre-e or worse and your doc isn't around? Will you tell them no because they don't know you or your pregnancy? Not a good way of thinking in my opinion.

If you were so concerned about that docs opinion wouldn't it have made more sense to have stayed and called your OB to get a second opinion rather than checking yourself out of the hospital?

I doubt you are going to find much support here for your actions if that is what you are looking for. Twin pregnancies are tough(for most). And I think most of us were scared to death to go against doctors orders(any doctor), because of the potential consequences, I know I was.

 

QUOTE(becky5 @ Apr 29 2009, 04:04 PM) [snapback]1293728[/snapback]
I doubt you are going to find much support here for your actions if that is what you are looking for. Twin pregnancies are tough(for most). And I think most of us were scared to death to go against doctors orders(any doctor), because of the potential consequences, I know I was.


No, I wanted honest answers, definitely.

I think it's a bit unfair to equate my situation to a refusal of medical intervention if I developed pre-e (or worse), though.

 

I would have stayed unless I had other children at home. Then I would have gone home for a few hours to pack a bag and prepare my child/children for my absence. This is coming from a girl who put herself on home bedrest when OB and Peri said it wasn't necessary and believes it saved my IUGR baby. So much can happen so quickly and I would rather be safe than sorry. I would probably be asking for steroid shots too.

 

I agree with all of the other thoughts expressed on this thread, but especially Becky's.

Why you would knowingly put yourself and your babies at risk like this is beyond me.

 

QUOTE(Holly Orlando @ Apr 29 2009, 03:38 PM) [snapback]1293679[/snapback]
I feel like I should mention, too, that I've been hospitalized three times before and while I don't enjoy the idea of hospital bed rest, it's not something that I haven't had to endure before. Every time I cooperated because I knew it was the best thing for the babies. This time, however, I felt like it was completely unnecessary and being prescribed by a doctor who doesn't know me or my pregnancy. I've seen her once before and it was in triage, for maybe two hours.

I see my OB on Friday morning and am planning on bringing packed bags with me; if he wants me to stay, I will, because I trust him and his decision.


The people caring for me in L&D when they discovered the HELLP syndrome did not know me or my pregnancy either. It was a very uneventful pregnancy and that was my first and only trip to L&D. I really think you are not taking this seriously enough. Friday is a long way away and I would call and talk to your doctor now. The link I provided to you lists all of your symptoms as symptoms of HELLP. I didn't have any of them and my life was in danger.

 

QUOTE(mommymeg @ Apr 29 2009, 04:10 PM) [snapback]1293735[/snapback]
I would have stayed unless I had other children at home. Then I would have gone home for a few hours to pack a bag and prepare my child/children for my absence.

I would probably be asking for steroid shots too.


They wouldn't even let me go home for a few hours, to pack a bag, without signing the release form. I asked. Also, I've already had the steroid shots. Every time I think about it, I have flashbacks to the size of those needles. Oh, man.

QUOTE(moski @ Apr 29 2009, 04:12 PM) [snapback]1293743[/snapback]
The link I provided to you lists all of your symptoms as symptoms of HELLP. I didn't have any of them and my life was in danger.


They ran all of my blood work and it came back perfectly normal. I would assume that since they feared for pre-e, that they tested for HELLP but to make sure, I will call L&D right now and check if they ran my platelets. Honestly, thanks so much for that link. I've read about HELLP but it was ages ago; it's good to do a refresher course.

I wonder what a "pain band" consists of? Just because I had been having lower abdomen pain, hence my initial reason for stopping into L&D.

 

QUOTE(Holly Orlando @ Apr 29 2009, 03:01 PM) [snapback]1293631[/snapback]
This whole pregnancy has been full of what I feel are unnecessary medical interventions


I hardly think doing a 24 hour urine collection is an unnecessary medical intervention.

QUOTE(Holly Orlando @ Apr 29 2009, 03:38 PM) [snapback]1293679[/snapback]
I feel like I should mention, too, that I've been hospitalized three times before and while I don't enjoy the idea of hospital bed rest, it's not something that I haven't had to endure before. Every time I cooperated because I knew it was the best thing for the babies.


What makes this time any different. You can die from pre-e.


http://en.wikipedia.org/wiki/Eclampsia

 

Why don't you want to stay a the hospital? Do you have kids at home or some emergent thing that needs your attention? Just asking because you would have the best monitoring there?

 

QUOTE(Holly Orlando @ Apr 29 2009, 04:09 PM) [snapback]1293732[/snapback]
I think it's a bit unfair to equate my situation to a refusal of medical intervention if I developed pre-e (or worse), though.


But don't you see, that is WHY they want you there! The high BP, the headaches, seeing stars, etc, are all signs of developing pre-e! It can develop rapidly and they are just looking out for you and your babies. How can you argue with that???

 

QUOTE(Holly Orlando @ Apr 29 2009, 03:38 PM) [snapback]1293679[/snapback]
I feel like I should mention, too, that I've been hospitalized three times before and while I don't enjoy the idea of hospital bed rest, it's not something that I haven't had to endure before. Every time I cooperated because I knew it was the best thing for the babies. This time, however, I felt like it was completely unnecessary and being prescribed by a doctor who doesn't know me or my pregnancy. I've seen her once before and it was in triage, for maybe two hours.

I see my OB on Friday morning and am planning on bringing packed bags with me; if he wants me to stay, I will, because I trust him and his decision.



I guess I am curious why you went to L & D if you didn't think there was anything wrong that couldn't wait til Friday in the first place. If your tests showed everything was fine, then I guess I am confused. Going in to be seen would indicate that you felt something was wrong and it couldn't wait. I understand the oncall dr eas not your own, this happened to me a couple of times, but they are trained for this. I don't mean to be harsh, but there were women pregnant when I was who thought they knew better than the dr's and ended up losing their babies. Don't you think that a little time in the hospital is a small price to pay for a lifetime of joy!!!!!!!! Things happen very quickly. I know that you will go back if there are any other symptoms, just don't think that any symptom is too small to go in for, it will be well worth the time.

Jen

 

In the time it could take for symtoms to develop enough for you to decide they warrant heading to the hospital and then actually getting yourself there, you or the babies could be in serious danger. I absolutely would have stayed. Even with older children at home, I would have had dh bring them that evening or the next day to see me and we could talk through what was going on. Unless it something ridiculous, like the doc telling me I was pg when I wasn't, I would never go against what they recommended.

 

I called L&D and they did test for HELLP when they ran my blood work yesterday and it came back fine. I was lucky enough to speak to the same doctor I saw yesterday and she and I chatted for a while. After speaking to all the moms in here, I've decided to go back. I'm packing up a few bags, one for me, one for the SO, and he'll be getting off of work early to take me in.

Honestly, thanks for all the good advice. I do appreciate it greatly. :thanks:

 

Holly, I am SO glad! SO glad! You are making the right decision!! :grouphug:

 

Good luck, Holly! Please update us when you can. :hug:

 

QUOTE(Holly Orlando @ Apr 29 2009, 01:40 PM) [snapback]1293790[/snapback]
I called L&D and they did test for HELLP when they ran my blood work yesterday and it came back fine. I was lucky enough to speak to the same doctor I saw yesterday and she and I chatted for a while. After speaking to all the moms in here, I've decided to go back. I'm packing up a few bags, one for me, one for the SO, and he'll be getting off of work early to take me in.

Honestly, thanks for all the good advice. I do appreciate it greatly.

I am so glad you are going in!! You are definitely making the right decision!! Good Luck!!

 

:woohoo: WTG Holly. Best of luck to you and your babies.

 

Good luck Holly, I am so glad you are going in :hug:

 

I'm so happy to hear that Holly! Take care and we can't wait to hear how things are going...and meet those babies soon!

 

:good: Good choice Holly! You can't take back the regrets...so I'm glad you are taking the doctor seriously! Good luck, and keep us informed!

 

Holly, I hardly ever post in Expecting because I really didn't enjoy my pregnancy and I've blocked most of it out. But, your post really struck a chord with me (no, I'm not going to blast you!).

OK, let me get one thing out of the way and say ITA that hospitalizing you to collect urine for 24 hrs is utterly ridiculous. I had to do it too, but at least I was allowed to pee in a bucket in the privacy of my own home!
I spent most of 26 weeks on in about the same situation. I was borderline pre-e and felt like I was on the verge of "this could be it" the whole time. I also had +1 protein, but then passed the bucket test, had gestational diabetes, and had BP around 140/90, got headaches, was swollen by the end too.
From about 32 weeks on (I think?) I had to go to the hospital at least once a week for bloodwork, NST, and if one of the babies failed the NST (which towards the end, Baby A always did) then I would have to get a BPP. You know what? By then, I WISHED they would just hospitalize me so I would have to stop traipsing to the hospital every week (or more). I was exhausted. I hated sitting in the lab, sometimes for over an hour, getting the stupid NST, blah blah.
So no, I'm not going to say you're risking yours and your babies' lives. I made it to 38 weeks as planned. But, you might just want to go ahead and be in the hospital for your own comfort and convenience. It was a total PITA having to go to the hospital in July/August big as a whale!

BTW, I did have complications at delivery, but I really don't think being in the hospital would have made any difference. Baby A had an anterior placenta, which was making it hard to detect her with the NST's. The doctor had to cut through the placenta to get her out, which caused me to lose a lot of blood. Ainsley was also born with no thyroid gland, which there is no way they would have known before birth, but she was born in respiratory distress and had a brain bleed, possibly because of not having a thyroid. I am not telling you this to scare you or anything, it's very rare, but just letting you know how my delivery turned out.

 

I'm so relieved with your update! Good luck - we all can't wait to hear your story of "healthy babies' arrival"!

 

Holly, I am glad to hear you are going back. Best of luck to you and keep us posted!!

 

:yahoo: I'm glad you decided to go. It just wouldn't have ben worth it to have something happen. regret is just too strong. Hang in there. you are making the right decision!!

 

So glad to hear you are going back in. I hope you know that it was just out of concern for your health and that of your babies that we were so adamant about you going back in. :hug: Make sure you keep us updated!!