Taking baby to the ER: Tips

Baby J has inherited from me, the nasty habit of getting seizures when he has a fever. I've discussed seizures before, this post is about taking babies to the ER. As a nervous mom who lives 5 minutes away from Medical City and has a kid with medical insurance, it doesn't take much for me to decide to take J to the ER. We have taken him for fever/seizure 3 times, and for diarrhea countless times. Our family is there so often the floor nurses at the pedia area and at the ER pediatrics section know us already.

All this experience has taught us how to prepare for a trip to the ER. If you can't bring all of these when you first get there (emergency and all), get them immediately afterward or have someone bring them for you. SOme of these are for convenience and others are to save you money.

1. With every trip to the ER make sure you have with you (no matter the reason for going):
       -a feeding bottle or sippy cup: if he is there for diarrhea they will give him rehydration salts and they don't supply feeding bottles
       -a change of clothes for the baby: if he has a fever they will give him a sponge bath and he will need to change afterwards
       -a washcloth: spongebaths in the ER, if you don't have one they will charge you for one
       -disposable diapers even if your kid wears cloth: among other reasons, they use disposables to wrap around the area where the IV is tapped
      - drinking water, snacks for the baby (cheerios are good food and entertainment): it's annoying to have to run to the store when someone gets thirsty
     - sandals/shoes, socks: it will be tough getting your child to stay on the bed, they will be restless so having shoes will give them some mobility, the socks are primarily for the cold

2. Before the nurse puts in the IV tube, have her give you some time to decide where they will put it. They can put it on a foot or on a hand. If your baby walks, foot is a bad idea. If the iV will be on a hand make sure you pick the non-dominant hand (read: the one he doesn't use to play with the ipad). They do these things in a rush and don't consult the parent. If you end up at the hospital for several days the baby will be miserable if his right hand is all tied up.

3. Bring paracetamol and other medicine with you everywhere. Nurses know to ask if you have your own medicine. It is much much cheaper to bring your own than let the hospital supply something as simple as paracetamol drops.

4. Ask your resident/doctor incessantly if the IV drip can be disconnected. As soon as we knew Baby J was safe, we asked his doctor and he said it was fine. It bought J back a lot of comfort. The IV was pointless once his fever broke. They will just keep the tap open through a Heplock but the tube and bottle goes.

5. Bring chargers for your electronic devices. These are mostly to keep baby entertained.

6. If you plan to sleep at night, ask the nurses and housekeeping staff to minimize their visits to your room in the middle of the night to the absolutely necessary ones. I swear it is much harder to get well at a hospital because they just don't let you sleep! They are in there every 15 minutes mucking about. If you were not able to sleep at night, consider putting a sign on the door in the morning indicating you don't want any housekeeping visits. Housekeeping folks are noisy, they do their work in the morning so they are confident about knocking loudly and screaming "housekeeping!" when you and the baby are trying to catch up on sleep.

Lastly, sleep next to your kid on the bed if it's possible. They feel so much better when they are being cuddled and sleep very soundly when next to mom or dad. Also if you have a toddler it'll help avoid nasty falls from the bed :)

Hospital confinement: Keeping baby sane and saving money

The entire ManilaMom911 family stayed in the hospital from Monday to Friday while Baby J went through his illness, just in case he got more seizures. It was tough. Tough to watch my kid call out for me with pain in his eyes. Tough to wait for test results to rule out serious conditions. Tough to bully the nurses into giving him meds when his fever spikes.

The illness was not painful, but all the pricks and meds were. In all he must have gone through 10 injections combined for various blood tests and his IV. Poor little man is not a bleeder, so the nurses would often prick him once, tap an unproductive vein and have to prick him again. Ugh. It was terrible hearing his screams as they squeeze his tiny arm to try to get 2 drops of blood out.

A few tips on being hospitalized with a baby, although I really do wish nobody would have to go through it:

1. Bring lots of toys. After 2 or 3 days your baby will become very very bored. Confined to the bed with an IV means no crawling and no leaving the room. By day 3 we would walk him down the halls with IV in tow just so he can see different color wallpaper. Iphones and Ipads come in really handy, equip them with baby apps.
2. Bring lots of diapers and leave the cloth ones behind. The nurses weigh his soiled diapers to see if he is peeing enough, then they throw them out. Also bring a lot of wipes, with an IV (Baby J's was on his foot) we couldn't clean his poop in the sink so we had to rely on wipes 100% of the time.
3. When packing clothing for him, pack a diverse set. Include long-sleeved shirts and socks because it can get really cold in the room.
4. I don't know why I forgot about this, but I learned the lesson on parking when I gave birth. Somehow I made the costly mistake again. If you think you will be in Medical City Hospital parking for more than a day, have someone bring your car home and just get picked up when going home. Don't rely on the "discounted" parking for those who are admitted. We were there for 4 days and we paid close to 700! It's 190 or something per 24 hour period.
5. Bring a wash basin if you have it, for his sponge bath. Otherwise you'd have to pay the hospital for one.
6. In Medical City upon discharge, they don't tell you that you own the pillow. You paid for the pillow, take it home with you. Leave the pillowcase though.
7. A discharge by 11am means you only pay for half the day. Our doctor made rounds at 12pm, but we insisted that we get discharge orders at 10am so we can pay only for half a day. It means clearing the room by 1:30, we had plenty of time to pack up and wait for the doctor.
8. Before you let them hook your baby up onto something, make sure your pedia ordered it. They hooked my baby up to a blood oxygen level monitor overnight. During rounds the next day my pedia said "what is that doing here? take it out!" I have no idea who ordered for it, maybe it's hospital protocol. I didn't think much of it until I studied the bill. I paid more than 2,000 for them to hook it up to my kid, then another 850 per day renting it.

Moms and dads, you are your own kid's best advocate. You know if something is wrong, don't let the nurses and doctors ignore you. I had to insist several times to get medicine to my baby half an hour before it was scheduled because he was spiking a 40 degree fever and feared a seizure. Be especially insistent at night, all you are dealing with at night are these residents who themselves look like they just got out of diapers. I wouldn't trust them with a headache, and I sure didn't trust them with my child's seizures.

TWENTY-FOUR (COUNT ‘EM, 24) HOURS OF LABOR

“Childbirth is not beautiful,” she writes. “Children are beautiful. Childbirth is disgusting. Anyone who says otherwise has never met a placenta. I’m surprised ob-gyns don’t have post-traumatic stress from seeing a few of those a day.” - Scottoline

What does it mean to go through 24 hours of labor? What does one do through 24 hours of labor? How does one keep sane through 24 hours of labor? Have I mentioned I went through 24 hours of labor? Only to end up with a C-section, oy. 

It is true that the pain and the details can get blurry in one’s pregnancy and post-birth brain. I can’t exactly remember all the pain, but I remember getting pissed. Pissed that they don’t tell you how unpleasant and violating it can sometimes feel to be in labor in a hospital. So I’m telling you now what to watch out for.

1. Several doctors peek into your hoo-ha. The longer you’re in there, the more doctors and nurses you will encounter because they change shifts. These doctors, they do internal exams every few hours. One might poke you in there to break your water, another might go in there to check how far you’re dilated, and yet another might go in there to check that the estimation of dilation of the first doctor was correct. 
2. Internal exams are a bitch. They are a bitch. A bitch. I am aware that the previous two sentences are not exactly grammatically correct, but it just feels right. In the medical shows they say so-and-so cm dilated, but they don’t tell you how they know. I went into labor mistakenly thinking that they measure the cervix through ultrasound. But NOOOOO! They measure it by sticking their fist in there and seeing how many fingers they can poke through your cervix. For me this meant check at 1cm, 3 hours later it’s 1.5, 3 hours later it’s 3, 3 hours later it’s 1.5 again! It took a lot of strength not to smack the doctor upside her head. 
3. When they say they will break your water, watch out. They will come in with a monstrosity of a crochet hook. It really looks like a crochet hook, a really big one. It will be scary, I can allay fears only by saying that it doesn’t really hurt. After all those internal exams a skinny metal wand with a hook at the end is a piece of cake.

If you've never met a crochet hook, here's what it looks like. Photo credit watermarked.

1. If you are in a teaching hospital there may be up to 50 doctors and nurses attending to you by the time the 24 hours are through. Some of them will stand around doing nothing, learning I guess. It’s annoying. It sort of makes you feel like you’re part of some  freak show as they watch someone else stick their fist up your hoo-ha.
2. Boredom. Bring all your gadgets and tricks to entertain yourself.
3. The royal annoyance of hearing activity in other delivery suites. As I lay there for hours on end, I had to listen to squads of nurses and shouting “push!push!push!” in unison as they cheer on the nth woman lucky enough to be at that point. This is followed by rehearsed gushes of cheerful congratulations. I must have heard 5 deliveries by the time they wheeled me to the OR.

OK so those are the annoying and painful things. I don’t want you to think that there is nothing magical about childbirth, after all most other women say it is magical. It can be fun if you have someone around to talk with. I was lucky that my husband can see the humor in the smallest things, so a lot of chuckles were shared as we ribbed nurse after nurse about their silly uniforms. 

So after giving the little guy a more-than-fair shot at squeezing himself out of my womb, my wonderful and unusually-perky OB decided it was time to open up a new door. They had already popped my water bag which made my belly deflate considerably. It was sort of freaky, like my skin was shrink-wrapped around the baby. To be honest I was glad he made the call to do a c-section. I was exhausted beyond the ability to push. It is a total cliche, but it needs to be said, it truly is worth it.

The Day I was Admitted to Give Birth

*I realize these posts are out of chronological order, sorry about that. This blogging thing started out late in the game so am just now catch up with the birth stories.

I had already been “phoning it in” at work for a couple of weeks, partly because I was expecting Baby J to arrive at any moment, but mostly because it was just getting too darned difficult to move around. I felt huge, heavy, unwieldy, and all other synonyms of “large” you can think of. Mostly I was sitting on the couch watching reruns of Law and Order until it was time for naps. Except for random Braxton-Hicks-type contractions several times a day, which were painless, this pregnancy was exactly where it should be at 38 weeks. 

Photo from: http://www.totalfitnessexperience.com/wp-content/uploads/2012/01/pregnant-belly.jpg

On one of these weekday mornings the contractions suddenly felt painful, very painful! I was groaning in pain, holding my belly, and kneeling on the floor waiting for each wave to subside. Time to alert the husband to take me to the pre-delivery room at Medical City, where I was going to give birth. This was a first pregnancy, so I had absolutely no idea what contractions would feel like and how to know when I was supposed to go to the hospital. We texted the doctor and he said just go and get checked. When we got there, I was hooked up, checked, poked, and put on standby. Wouldn’t you know it, contractions stopped when I was there. Feeling silly for pressing the play button too soon, we were discharged and sent home with instructions from the doctor to come back only when contractions were 15 minutes apart and coming in regularly.

After the false alarm my husband, my giant belly and I went out to lunch with friends, hung around the house, I may have even gone to the mall to walk around. In the early evening the painful contractions started again and this time we know enough to actually time them. 

You know how some women who give birth say they have a high tolerance for pain? Well, this one has a very low tolerance for pain. I was squeezing B’s hand, twisting and writhing in pain with each wave of contraction. At 10pm, we went back to pre-delivery room. There they waited and waited and waited, contractions were very irregular but very painful. Internal exams show I was dilated 1cm, that’s nothing! That’s a polite way of saying “honey you are so not ready yet but i’ll say 1cm so you don’t feel stupid for taking up our time.” Baby J hasn’t dropped into my pelvis, he wasn’t going anywhere. Still, since I was in so much pain the residents probably took pity on me and got me ready to move to the delivery room.

Brilliant tip from our OB, book the Lamaze room, the best room and you don’t actually have to use Lamaze techniques to give birth. It was huge, had a couch, a tv, its own bathroom and enough floor space to do a Zumba class for 6 people. Sure it was windowless, but it had an entire wall covered with a mural of a pretty garden of flowers! I had my Kindle, my ipod, my phone, and my husband, I was ready for the wait. So we waited, and waited, and waited. 12 midnight became 4am which became 11am and became 6pm. This baby was not dropping! There were long stretches of time with no contractions, then some contractions close together, then they’d disappear again. Poor intern had to sit there half-asleep recording all my contractions. 

Photo from: http://www.mommylace.com/2010/02/21/cost-of-giving-birth-normal-and-ceasarian-delivery/

I don’t remember exactly when I asked for an epidural, it was probably halfway through my labor. My OBs resident asked me if I was in pain and I enthusiastically said hellz-yeah I’m in frickin’ pain! At this point I sheepishly asked when I can get pain killers to which she replied “ anytime you ask for it ma’am!” See, if they had explained this to me when they admitted me then I could’ve asked for it 6 hours earlier and I wouldn’t be so exhausted. 

There were all manner of unpleasantness during this period of labor which I will warn all you out there about in a following post.