Contractions
So far I have no complains - I'm still trying to figure out the difference between a Braxton Hicks contraction and a real contraction. In triplet pregnancy, real contractions are often painless and less obvious - something that many nurses here may not agree, as they are of the opinion that only those contractions that are painful are real contractions. It doesn't help that they do not have a contraction monitor here, so if they do want to time my contractions, they do it the archive manual way - by putting their hands over the top of my belly for 10 minutes. They did this for a while after my 24-week pre-mature labor scare, but they have since stopped doing this.
One midwife in the labor room actually told me that it was standard international practice for contractions to be monitored for a 10-minute period only - WRONG!!! That's the typical practice here, but base on my readings, if a contraction monitor or a Home uterine monitoring system was used, contractions are monitored for an hour. So advises Dr. Luke in her famous multiple pregnancy as well. Also, a church member who had to go on hospital bed rest for both of her pregnancies due to pre-mature contractions shared with me that she had a contraction monitor and they did count the no. of contractions per hour.
So I guess it is really up to me to monitor my own contractions! Right now I'm not too concern because any tightening in the abdominal I feel does not last very long. Sometimes I do get a real contraction and I can actually see my parts of my babies sticking out in my belly - I try to guess which is the head and what part of the body I'm seeing!
The 'At Own Risk' discharge plan
I'm a bit nervous about my ultrasound appointment with my Peri this Wednesday. First, I don't think he'll be too happy with my decision to take an AOR discharge to attend my brother-in-law's wedding this weekend. I'm afraid he will state all the things that can go wrong and scare us all into changing our minds and then I'll be stuck in here while the rest of the family is out partying. I'm only 50% through in my hospital bed rest stay, and for the sake of my psychological well being, I really, really need to get out of here for a bit. It doesn't help to know, after spending the past 2 months reading every triplet mother blog and forum I can get my hands on, that I have yet to meet another triplet mother who was sentenced to hospital bed rest as early as 20 weeks for no reason other than for observation. I even found a journal article that highlighted the psychological effect of confining triplet mothers to early bed rest where there is no medical complication. So knowing that I was admitted in here at 20 weeks when it was not a medical necessity, but more for the convenience of the system (aka government hospital management system that does not do well for emergencies) makes it even more difficult for me.
Secondly, even if they do want me to be on hospital bed rest, for the reason that the hospital is the safest place in the world for me to be in, it is common practice (based on my readings of what other triplet mothers, yes, including Malaysian mothers who have been on bed rest) for bed rest patients to be discharged or get weekend privileges to go home. Again, I've not been allowed to go home at all during my stay here. Not even out for a little while. I can't even step out of the ward on my own! My MIL was concerned that I would be vitamin D deprived due to my non-exposure to sunlight, so she managed to get the nurses to agree for her to take me down to the garden on the wheelchair. The garden is nothing much to shout about, but at least I do get under the sunlight!
Risk of blood clots
Since I've been here for such a long period, i.e. long hospital bed rest, my Peri has instructed that I am injected with a Clexane, a blood thinner on a daily basis to prevent blood clots. I have had those before when I was hospitalized with OHSS back in January this year, and they were not fun! The Peri had initially ordered these shots at 24 weeks, then he later changed his mind and ordered them at 26 weeks. They were going to start jabbing me from 26 weeks onwards, but I refused the jabs on the ground that I was still ambulatory and I am not on restricted bed rest. They kept on coming in and persuading me to take the jabs to prevent blood clots, which is very serious. Finally, the Obs said to wait till my next scan for my Peri to decide what to do. Of course he will insist that I get the blood thinners since he was the one who prescribed it!
I did some research, and I can't find any triplet mother on modified home bed rest who was on blood thinners. Those pregnant women on blood thinners are those with a history of a clotting disorder or strict bed rest. Even those who are on hospital bed rest don't seem to talk about taking blood thinners, but then again they are discharged as soon as their condition stabilizes. Either that or those long-term ones just do not talk about the blood thinneers. The lady from church who visits me regularly was on modified hospital bed rest for 10 weeks, and she did not have blood thinners either. Some of them are made to wear a compression device on their legs that massages their legs to keep the blood circulation going. Of course, like the contraction monitors, we do not have such devices here in ulu land, sigh! Right now, to reduce the risk of blood clots, I wear compression socks most of the time. I exercise by walking up and down the ward several times a day. I also do leg stretches. And of course, I need to go to the loo every 1.5 to 2 hrs all day and night! But the Obs is telling me that this is still not good enough because in here, my mobility is not normal.Here's one lady's sharing:
- By norahd
- Reply 253093
- January 15, 2009 at 8:47 am
- Report post
I hear you. I was tired wearing the leg cuffs. When my MFM Dr saw me several times without the cuffs, she suggested heparin. I did not want the shots, so I told her I will wear the cuffs without taking a break, but she said she is worried about me getting blood clots. I have been too long on strict bedrest.I just have a bed feeling that I won't be able to avoid those darn injections for long now.
I did not realize you are getting up to go to the bathroom, then may be you do not need heparin. Once I was released from the hospital, with bathroom privilege, the MFM did not want me to be on heparin anymore (getting enough movement to avoid blood clot)
(https://www.inspire.com/groups/preemie/discussion/bed-rest-and-blood-clots/_
Steroid shots
Yup, Peri has also ordered that I get two of these really painful steroid shots, Dexa every fortnightly. I had my first set at 24 weeks, and another set at 26 weeks, so the next one is coming up! These are to strengthen the babies' lungs, and I know that they are commonly given to triplet mothers who are at real risk of going into premature labor. But once every fortnight??? Again, I've not come across any triplet mother sharing that she had one every fortnight but I really do not know enough about how often they should be given. I've mostly read about triplet mothers having a steroid shot only if they are at real risk of going into pre-term labor. I have not refused these shots, though.
Sigh, I'm so full of complains today! I'd better stop now. Truth is, everything has been going rather smoothly apart from the premature contraction scare. Till this day I do not know if I was actually having real contractions or Braxton Hicks. When they timed my contractions using the traditional hand-on-upper-belly method, they were unable to detect more than one contraction per 10-minutes. But that was after they gave me all that medication. I think the doctors are getting bored of me during their morning rounds. Nothing new for them to ask, nothing new for me to report.
As difficult a patient as I may be, boring is good, though! Let's hope I'll remain boring for another 6 weeks :)
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