Friday, August 28, 2009

Unexpected Events

Well, this pregnancy had been pretty uneventful so far, until Thursday came around! Here's the story:

I woke up at around 5am as usual, ate a small breakfast and had some juice and left for work at about 5:30.

Lately things have been pretty crazy at work. So many nurses have left in the past 5 months but none of them have been replaced so the staff that is left is doing double the work. We have all gotten pretty used to not getting our allotted 15 min break in the mornings and have even been known to not get our legally required 30 min lunch till 1 am. Now, if you do the math, thats a long time between eating when you get up in the morning and having lunch around noon (7 hrs to be exact). For a non-pregnant person, its tough but you get through it, for a pregnant person it's not as easy to "get though" and not healthy for the baby. Thats what happened to me.

So I get to work and start getting ready for another busy day in the OR. I have back to back cases all day and of course not enough people to help a 31 week pregnant woman do things like move heavy equipment, move heavy patients, and run around the OR getting things for 3 different surgeons who are all demanding things at the same time. Im in the middle of this big liver resection and I start feeling kind of dizzy. I sit down for a minute until they start asking for things again and I have to get up and get it for them. I can feel my heart rate is probably high cause my pulse is bounding out of my neck. This has happened before but I have always just sat down and it has gone away. I've never checked to see what my pulse actually was. I wasn't able to sit down and let it pass this time. Actually it got worse, so I decided to just run next door to an empty OR suite and take my blood pressure and throw a probe on my finger to see what my oxygen saturation/pulse was.

These were my vitals at 11:00am:
BP - 150/95
P - 200 bpm
O2 - 89%
Heart Rhythm - SVT or Superventricular Tachycardia

I had no idea my pulse was so high. I knew then that I couldn't keep going with vitals like that so I walked up to the front desk where the charge nurse was. There happened to be an anesthesiologist friend of my up there too. I told them I didn't feel good and showed them my vitals. They freaked out!!! They grabbed a stretcher and put me on it and wheeled me to the recovery room next door. They hooked me up to monitors and started an IV. They called Labor and Delivery to tell them what was going on and that they would be bringing over an employee who was 31 weeks and had passed out. (I never actually passed out but I would have shortly if they had not found a stretcher) The anesthesiologist told me he called a cardiologist over to come see me right away. I kept trying to turn my head and look at the monitor. I wanted to know if my vitals were any better yet. My pulse had decreased to about 150 so that was good. The labor and delivery nurses came over to get me and take me so they could hook up a fetal monitor. Just about that time the Director of Surgery (the woman who hired me, my "bigtime" boss) came over and asked me what had happened. I told her I almost passed out because I had not been given a break for 5-6 hours to eat or drink anything. This was sorta humorous to me that she would ask me this because she's the one that determines how many staff we hire and how many surgeries we do in a day. (too little staff and too many surgeries!!!) and she's the one that determines if we get breaks or not! Im really glad she was able to see the consequences of her staff not getting breaks because she is usually in her office and doesn't see what we deal with a lot. The cardiologist was also there at this time and said that dehydration and malnutrition in pregnancy can cause abnormal heart rhythms and that staff (especially pregnant staff) should be given adequate breaks every few hours. He also showed her my EKG that they had taken and said " This EKG is not normal, I didn't expect to see this. It's not dangerous now that her pulse has decreased, but its not normal either". He ordered another one to be taken after my heart rate came down to normal. He called it a Accelerated Junctional Rhythm. My heart rate at this time was about 110. Much better.

Well, by that time Lacie, my roommate from college who I work with, had called Matt at home to tell him what had been going on. Of course he jumped in the car and drove straight to my work. When he got there he was so freaked out! He said he drove 90 mph and even parked in the physician parking lot!!! LOL! I told him my heart rate was now down to 110 and that I was feeling a lot better. They had taken me to Labor and Delivery and hooked me up to a fetal monitor. We were able to hear Addison's every move and see her heart rate which was so comforting!!! I kept wondering why they wouldn't let me eat anything but ice chips so I asked my nurse and she said "just incase we have to do an emergency c-section. " Holy Cow!!!!!! That kinda scared me but I was stable enough by then and Addison was doing fine, that would have to be a last resort kind of thing.

I had an echo and another EKG over in Labor and Delivery and both showed up as normal so at 6 pm they finally discharged me. I had not eaten in over 12 hours! Poor Addison! On the way home Matt and I stopped and got a burger, chocolate shake and french fries!! Soooo good! I felt a ton better but was tired and went to sleep right when I got home.

I didn't go to work today of course. I went right in first thing this morning to see my OB doc who had gotten many calls about me the day before while all of this was going on. She told me that with pregnancy the body is put under a lot of stress with all the extra blood volume the heart especially can go into abnormal rhythms if we don't get adequate breaks. She said nurses are some of her worst patients when it comes to taking care of themselves because they are always so short staffed and they give to everyone else and not to themselves. She wasn't too please with me but she knew that I didn't really have a lot of control over the issue. It's not like this happens when I'm at home. She said she would write a note saying that I require a break every 2 hours and that I cannot be involved in long cases where I cannot leave the room. She did an ultrasound to make sure Addison was ok and then told me to take it easy over the weekend. I have another appt in two weeks and I'll give her an update on how everything goes this next week.

Over all the cardiac arrhythmia was induced by dehydration so I don't think I have any underlining heart problem which is very good!!! Addison seems to be ok and so am I. I am more aware of my limit and what I can handle now so thats good. Hopefully work will be more understanding too. I think I kinda scared them which hopefully will start a chain of events that gets everyone a break now. We shall see. Matt has been so wonderful and caring. I am so thankful for him.

PS- On a lighter note... Addison weighs 3 lbs 8 oz as of this week!!! Yea!!! She's getting so big!!! I can't believe I only have 8 weeks to go!!! Hurry Hurry!!!