7 ER Visits And Health Drama During My Pregnancy Journey

If you’re more into the summary of tips & tricks I have for pregnancy, labor, and dealing with a GI obstruction…you can jump to my post here “Tips & Tricks for Pregnancy and Medication Free Labor”. Otherwise, I hope my story helps you prepare or deal with your journey!

I had been married for a few months and was getting settled into my new life as a “wife”. It still sounds weird and we’ve been together for years now haha. Anyway, I had started to feel a little sick and decided to improve my eating. Given my ulcerative colitis/j-pouch past, I figured I ate poorly long enough to trigger a flare (pouchitis). When diet changes didn’t resolve things after a couple days, I contacted my GI specialist and started some antibiotics to resolve the flare (nausea, bloating, and difficulty evacuating bowels yet feeling urgency and frequent need to “go”). However, after 3-5 days on antibiotics I was still feeling sick…usually I was better after 2-3 days of medication. I knew something was wrong and didn’t want to play the waiting game until I finished my antibiotics, so I called my GI specialist with an update and to get their thoughts on why I wasn’t responding like normal and feeling better. The GI specialist recommended that I go to the ER for an x-ray, just to make sure I didn’t have a bowel obstruction. Once we knew more from the x-ray, we could explore other possibilities. So, my new hubby loaded into the car with me and he drove us to the ER so I could be evaluated for an obstruction.

“Did you know you’re pregnant?”

When I was taken back for triage, we did the usual series of questions and blood/urine samples before I was told to sit in the waiting space until they could take me to an exam room (they also pulled my husband from the lobby so he could sit with me in the waiting space). A few minutes later, one of the staff came and pulled me back to “ask a question”…so, I left hubs and followed her back to the other triage room. I sat down and she asked “did you know you’re pregnant?” I stared at her thinking, ‘if I knew I was pregnant I would have said yes when you asked earlier if I was pregnant’. I kept staring and said “What? No, I didn’t know that. Wait, really?” Since telling my husband and family I was pregnant while sitting in an ER worried about me being sick wasn’t exactly my idea of a nice announcement (let alone remotely like I had planned in my mind the few times the thought came up), I decided not to say anything and solely discuss the GI issue at hand and treatment options. With that in mind, I asked the ER staff not to discuss the pregnancy in front of anyone, but that all things GI related were fair game to discuss. They took me back to an exam room and I waited for a doctor to come and speak about my GI history, my j-pouch, what symptoms I was having and why I had come in. It turns out, the staff and doctor never wanted to discuss my GI concerns about an obstruction and only wanted to discuss the pregnancy. It was like they literally heard the buzz word “pregnant” and stopped evaluating anything else. They took me for a quick ultrasound, where the tech barely spoke a word and I couldn’t see or hear anything (not knowing how far along I was, they didn’t do it on my belly like the movies which only made the silence increase my anxiety and sense of violation of privacy. The least a girl could do was say hello and let me see the baby or say all looks good when I’m worried about being sick, have never been pregnant, and she’s shoving implements into my body). They told me I was about 12 weeks pregnant and my symptoms were normal for pregnancy. I asked whether we could do anything to check for the obstruction, since that was the reason I came and could match the symptoms I was having, given my health history. They said they couldn’t do an x-ray because I was pregnant and that it probably seemed like a GI issue because this was my first pregnancy. I was told all my symptoms I was explaining were “normal” for pregnancy and should improve over time; just be sure to stay hydrated, eat foods that help relieve constipation from pregnancy, and wait for it to pass. That was how my first ER visit went; a couple hours, complete ignoring of my obstruction concern, and being sent home as “pregnant”. 

It was like they literally heard the buzz word “pregnant” and stopped evaluating anything else.

A week or two later, there was no improvement in my symptoms but rather they were getting worse. I wasn’t able to eat much because every time I put anything into my stomach (crackers, water, a bite of lunch) my stomach went crazy like it was gnawing on itself instead of the food. I now had increased nausea, periodic vomiting, inability to poop or pass gas, and severe bloating with abdominal cramping. I called my OB and they didn’t really know what to do, aside from trying to stay hydrated and go to the ER if I needed fluids – her best guess was bad pregnancy symptoms and potential onset of “hyperemesis” (a condition in pregnancy where you have high rates of nausea and/or vomiting that require IV fluids to maintain hydration). I called my GI specialist again to update and ask for advice but was told “since you’re pregnant, your OB is now your primary care provider so you should work with them”….we ended the conversation and I literally hung up the phone in shock. I couldn’t believe that my GI specialist wasn’t interested in partnering with the OB for my care or even considering the potential existence of the obstruction they had been concerned about only a couple weeks before. 

My GI specialist wasn’t interested in partnering with the OB for my care or even considering the potential existence of the obstruction once I was pregnant.

Since neither doctor had ideas and I was now sick enough to impact normal life, I returned to the ER to be told the same thing…you’re pregnant, these symptoms are normal and usually pass, and you can get IV fluids to help hydration level. I was also told to try an enema to help breakup the stool blockage (completely ignoring the fact I said my GI situation rarely, if ever, resulted in solid stool for the last 8 years…so not sure how liquid could magically turn into solid stool that would compact together and cause a blockage). In any case, I headed home to try their recommendations of hydrating the best I could, trying to continue to eat tiny meals and snacks (despite extreme discomfort it caused and the inability to get any of it out of my body later) and then use the enemas as prescribed. 

Repeat this process about 4 more times where I was in a lot of pain from abdominal cramping, had extreme bloating where I looked like a watermelon had been shoved into my stomach, couldn’t eat anything or keep much fluid down, and would eventually get to the point where I couldn’t stop vomiting and had to go to the ER (once it happened at work and my colleagues had to drive me, yep – add embarrassment to the list). Nothing that I tried caused any relief. I knew this wasn’t how “normal pregnancy” went otherwise nobody would get pregnant more than once…but I couldn’t get a doctor to listen in the ER and my GI specialist wasn’t interested in troubleshooting or seeing me because I was pregnant. 

I was told at the 3rd ER visit I had hyperemesis and was sent home to wait it out. My “waiting” would last a week or so before I couldn’t stop heaving and landed right back in the ER. Anytime I mentioned the consideration of an obstruction it was brushed off or I was told “if that is the case, we can’t check anyway because we can’t do an x-ray when you’re pregnant”. It got to the point I was constantly miserable and hunched in pain, could barely walk around at work, unable to eat more than a few crackers a day, and unable to drink more than 30-40oz a day without throwing it up …. the only solutions provided by the GI specialist when I called was “work with your OB”, the ER docs were dismissive, and the OB was confused and worried with the only idea being a permanent IV for nutrition (PICC line). I’ve had a PICC line before but it brings its own risks, along with still meaning I would feel horrible – possibly until the baby was born because my GI tract still wasn’t working. I was getting depressed, worried about baby, frustrated and angry about the lack of concern or “care” from the medical folks, and scared about what was in store for the rest of the pregnancy. 

I was sick for roughly 10 weeks, spoke with 6 doctors, and visited 2 hospitals.

When I was about 18 weeks pregnant, having lost roughly 20 pounds, I finally decided that I didn’t have any option other than the PICC line because I couldn’t continue not getting any nutrition myself and the baby couldn’t afford it either. But, it was about to be the weekend so I would go to the ER for more fluids and finalize plans with the OB afterwards. However, I had taken the day off work so this time I was home sick and decided to go to a different hospital that was closer to my house. When I was seen at the ER, it was the 6th doctor I had seen/spoken to during this ordeal. He was much more insistent on evaluating for a GI blockage. He wanted to do an x-ray but I was hesitant because I’d been sick for about 10 weeks now and for 8 weeks I was told I was “just pregnant” and I couldn’t get an x-ray because of the dangers to the baby. I wanted to feel better and avoid the nightmare scenarios running through my mind, but I also didn’t want to risk the baby’s health by doing the x-ray. He stated that the risk to the baby was less severe now because I was further along in the pregnancy and that the risk to me and baby if I had an obstruction that perforated my bowels was much worse than a single x-ray (sepsis anyone?). So, I finally agreed to the scan and the results confirmed an obstruction…a stricture at the connection between my anus and j-pouch caused by scar tissue build up. I was admitted to the hospital and a surgeon was contacted to do a consultation. The surgeon saw me and was able to confirm what they saw in the x-ray with a simple rectal exam (“simple” but as awkward and uncomfortable as it sounds). He had seen this commonly in j-pouch patients, although usually closer to their surgery date and not years later. He said he could do a quick procedure to dilate the stricture which should resolve the obstruction and get me feeling better. We scheduled the procedure and I was both relieved to hopefully be healthy again, and upset that the whole issue I wanted to rule out months before was the actual problem that multiple doctors had ignored and dismissed flippantly. Thankfully, once the procedure was done I was able to get some relief in the hospital and feel much better within a day after the procedure (I could even eat a little without feeling instantly worse). Once I went home, I was able to continue healing and have a healthy remainder of my pregnancy. 

Are you coming, baby?

Fast forward 5 months and I was at my due date. The second half of the pregnancy had been so much better! No severe symptoms, healthy baby growth, and the ability to eat lots of sweet treats (I mean, it’s rude not to eat cake from the baby shower or donuts your colleague brought, right?!). I had decided to work until the baby was delivered so I could save all my PTO for when my baby was here. I had my 40 week appointment where they evaluated my blood pressure and measurements and began discussing options for a possible induction (I had left the OB practice and was now a birth center patient). Most first time pregnancies deliver around 41 weeks, so there was no real concern until after that time had passed. At 41 weeks, I was having higher blood pressures and ended up seeing a high risk OB just to ensure everything was ok (heart rate, growth, amniotic sac, placenta, etc). Everything looked good but they recommended I not work at the office and instead work remotely, if possible, or take some time off until the baby was born.

Eviction time!

At my 41.5 week appointment, I decided I didn’t want to risk waiting for a natural labor to start for fear something would go wrong with the baby in the 43rd week and I would have caused it to avoid an induction. We scheduled an induction for week 42 and I tried all I could until then to induce labor naturally. I tried teas, curb walking (yes, you look and feel ridiculous), stair climbing sideways, sex with hubs (yup! There’s a component in semen that naturally primes the cervix and can help to induce labor), having the midwife ‘strip membranes’ (again releases something that helps to induce labor but it’s not comfortable or as effective as intercourse, so I only did this once), and an induction massage. Sadly, nothing worked and my induction day arrived. I was nervous about the induction but excited about finally getting to see and hold my baby! 

I checked into the hospital at 7pm and was taken to a delivery room. Around 9pm they inserted the induction medication (Cervidil), started an IV, and hooked me up to the baby monitor to track the baby’s heart rate and my contractions. My family had come just to hang out, so they left around 10-11pm and my husband and I went to sleep. Around midnight I started feeling some cramping, it would wake me up and then I’d fall back asleep and wake again to cramping later. Around 2am, I couldn’t sleep anymore because the cramping was too frequent for me to fall back to sleep. When my husband went to the nurse’s station and asked the night nurse about warming a heat pack for pain relief, she said they can’t do that (which confused me because I specifically asked about that when I checked in and was told it was fine). He also mentioned the cramping and ideas to help and she simply stated that some patients get that from the medicine and it’s normal….she didn’t come to check on my or tell him “Oh, great! She’s in labor” so I didn’t put together that ‘cramps’ were actually ‘contractions’ (duh Jennifer 🤦‍♀️). A few more hours went by and I was clearly in labor because contractions were getting closer and I was pretty nauseous. I decided to try the jetted tub in the room but we couldn’t get it to work correctly. So, again we asked the night nurse if she could help us get it setup and she was very grumpy, like we were the worst to interrupt her, and got it started but said “We don’t use these for labor” (again, not what the hospital advertised or what I was told at check-in). I tried to get some pain relief from the tub, but it just ended up annoying me because it was splashing on my IV (making me worry about infection at the IV site) and I was worried the heat might make me puke. So I just got out and tried to relax in bed for a bit (relaxing was not possible, but I tried). 

A little while later, around 5:30am, the night nurse came into the room talking about starting the Pitocin (which I didn’t want because there is evidence that ties Pitocin to mom’s getting extremely strong contractions and requesting an epidural, which then results in fetal distress and an unplanned C-section). So, to prevent the ripple effects and insist on my medication free labor, if possible, I said I didn’t want it yet and would wait for the rest of my support folks (family in the L&D field) to join my husband and then evaluate what to do. Around 7am, the new shift came on board (seemingly much nicer than our night experience) and I moved from the bed to a chair. I was still really nauseous and, despite my aversion to medication, I requested a little nausea medicine for fear I would vomit soon (this extreme nausea can happen in labor and as a general physical reaction to lots of pain). 

I continued to labor while my support team (husband and my relatives) took turns massaging my lower back and applying counter-pressure where most of my contraction pain was happening. Contractions were strong and, unlike all the birthing stories you’re told in class, there was no valley between them….a contraction would start, it would peak, then decrease some and start right back up again. I deal with pain best by closing my eyes – just focusing on breathing – and tensing somewhere else like my legs or hands. It was now around 10:30am and the nurse came in to ask about moving from the chair to the bed to check my progress. I had stopped opening my eyes because I got annoyed from checking the clock and realizing that what felt like an hour was actually about 10 minutes… it was agonizing and a bit annoying. So, it’s a bit fuzzy exactly what was said by people or who came in and out of the room after about 8am. 

The doctor came in to check things and break my water because I was fully dilated and effaced, ready to start pushing. He asked for approval to troubleshoot things to help the baby deliver, in an effort to avoid a c-section, and I agreed. Then he said he would return later to check again if I was closer to delivery. I mentioned to my support folks that I wasn’t sure how much longer I could do this, because it really was the worst pain I’ve felt! About 5 minutes after the doctor left, I said that “something feels weird”…. I didn’t know what had happened  but my contraction pain was a lot lower all of a sudden and I would get the urge to, well, push – like when you are sick and involuntarily heave? Same kind of thing where my body wanted to do something but I wasn’t sure if I was supposed to so I just kinda laid in bed. Next thing I know, my support folks said “May want to get the doc, I see hair” and I’m hearing a bit of chaos…. someone says that the doc is running back because that weird feeling I had was the baby crowning and if the staff wasn’t quick my support folks were gonna end up delivery the baby 😆 Just a moment later, I was holding my sweet baby and the world disappeared as I snuggled and reality set in. 

Tips and Tricks for Baby #1:

• YOU know your body. If something doesn’t feel right, check into it. Look for a GI specialist that listens, instead of writing you off as “pregnant”. Becoming pregnant doesn’t magically erase the fact your GI system may react, or physically be, different and you need expertise in both OB and GI.
• It’s usually the patient, you, who is responsible for piecing things together. If you can get doctors to speak with each other, that’s great…but if they don’t, you are the coordinator to ensure you get the quality care you deserve. 
• Have a personal advocate. This can be your partner, a friend, or a relative. Someone who you share details with and who knows what you want so they can relay to the medical staff if you’re unable to. 
• X-rays of your abdomen during pregnancy pose risks to the baby. However, that risk may be outweighed by the benefit of diagnosis once the baby is further along in the pregnancy. If you’re pregnant and think you may have an obstruction, try seeing if a GI specialist or surgeon can evaluate you with a rectal exam. If you happen to have a stricture in the same location I did, this could help diagnose early without the risk of the x-ray. 
• If you have symptoms that sound like an obstruction, whether pregnant or not, have them do a rectal exam. It saves you the physical risk and insurance costs of other scans and tests…and it could result in a faster diagnosis if your issue is at the site of attachment for the pouch and anus. Sure, it’s awkward and uncomfortable but could save you in the long run. 
• There are lots of ways to try and induce labor naturally. I tried many based on research and my midwife and OB relative’s recommendations. Some natural induction methods include: raspberry tea, curb walking (yes, you look and feel ridiculous), sideways stair climbing, sex with hubs (yup! There’s a component in semen that naturally primes the cervix and can help to induce labor), having the midwife ‘strip membranes’ (again releases something that helps to induce labor but it’s not comfortable or as effective as intercourse, so I only did this once), and an induction massage. I’ve also heard moms talk about spicy foods, but given GI concerns I wouldn’t recommend that one 🙂 You can also try acupressure/acupuncture, which is included as part of induction massages.
• First pregnancies are notoriously late arrivals and long labors, statistically speaking. The average first time mom delivers around 41 weeks and the labor can be over 24-48 hours. So, when your due date rolls around and baby is still happy and cozy inside, don’t worry. Also, when packing your go bag, take a couple changes of clothes because it could be a while (if you plan to do the hospital and not an alternative option). Here’s a study you could also read about lengths of pregnancy and potential factors.
• You can have the delivery you want, if you’re clear about it up front. Having an induction in a hospital wasn’t my “plan”, but it was the hand I was dealt. What was in my control was how I labored. I moved when I needed to, I had support to help with anything I needed (not the hospital staff), and I was clear that I wanted no medicine and to avoid a c-section or perineal tearing. I also made everything clear to my husband so he could advocate and act as a buffer for me to ensure I got what I wanted if it was safe for me and baby to do so.
• There are tons of ways to labor or manage labor pains, be prepared and then do whatever works best for you in the moment. Maybe it’s sitting on a workout ball. Maybe it’s counterpressure from a partner. Maybe it’s standing or walking/swaying. Maybe it’s water. Maybe it’s focused breathing. Maybe it’s just squeezing the life out of the sheets or your support folk’s hand. Whatever you find works for you, do it. Remember the pain is terrible but temporary and chase your goal!
• Delivering your baby isn’t the end, you also need to deliver the placenta. For a few hours after delivery, there are abdominal massages that need to happen to ensure you are all set and clotting appropriately. 

Wanna try this again??

I always wanted multiple children so we decided to try for another kiddo! I had no idea if the obstruction situation would recur, but I believed it would take at least a few years for scar tissue to build up enough to cause an issue like before. Either way, I knew I would be more assertive and get things addressed ASAP if I had symptoms that were too ‘deja vu’. Thankfully, my second pregnancy was “normal”. No strictures or ER visits. No procedures or misery for months. Just the typical symptoms and planning for all things baby and sibling related. Symptoms were slightly different from my health time with the first pregnancy. Things like periodic heartburn and lower tolerance to foods I had been able to eat more of before were added to the list but overall, symptoms were mild and matched the general timeline the pregnancy apps note (I used the What to expect when you’re expecting app). I had some nausea in the beginning, even after I had eaten, so crackers and pretzels were my friends along with mints. I noticed my body was happiest when I hydrated quickly, drinking at least 60-80oz by 6pm. Small meals weren’t required, but since I did get heartburn periodically this time I would avoid large portions at dinner. Other symptoms were the GI slowing, insomnia, back pain (chiropractic and massage helped), and lack of endurance later in pregnancy (I really wanted a nap all the time).

The months went by and the usual mix of nerves and excitement continued to build. Labor and delivery was smooth, albeit also different. This time I didn’t have to wait weeks, just a few days after the due date before labor began naturally. At first, I didn’t even realize I was in labor. I had been at work all day and after dinner I began to feel some mild cramping around my pelvis (much like menstrual cramps). I figured it was just muscle aches from being super pregnant and walking around too much at work. I decided I would take it easier the next day at the office and went about my business. A few hours later, when I was trying to lay down for bed, I realized I’d been feeling the cramps off and on for a while. I checked the clock and then waited to see how long it was before feeling another cramp. I noted it was about 30 minutes between cramps and it could be labor, since I was over 40 weeks. I couldn’t fall asleep, so I moved to a chair to rest during the night and see how things progressed. I was in “pre labor” all night until I got up in the morning and started walking around. If I was moving/walking around, I had contractions every 15-30 minutes….if I sat still, they would stretch every 30-60min. 

I had been in labor about 12 hours now and my husband asked if he could start a bath to try and help relieve my pain. Sure! The bath did help relieve my pain but also caused my contractions to slow, which wasn’t what I wanted. I was obviously a bit sleepy and unsure the next time I would get a chance and feel up to it,  so I took a shower. I rescheduled things with work and notified my boss and team mate that I wouldn’t be in that day and would likely have the baby soon and start FMLA. I drank a smoothie for breakfast to help get hydration and nutrients without being heavy on my stomach, in anticipation of the baby coming. Around lunch time, I was so tired I decided to try and lay down for some rest. Amazingly, I was able to get 1-2hrs of sleep before waking up to contractions again.

I started pacing around the house to try and get things moving along….after reading that pre and early labor could last days or longer, I was not interested in that being my situation 🙂 I waited for some family to join at my house, then we loaded up and drove to the mall to see if walking laps would cause any labor progress. We walked laps and did a little shopping for about 2 hours (who can resist adorable baby clothes/blankets?!). Now that it was dinner time, I said we should head home so everyone could get some food….my contractions were now roughly 15min apart so the walking had helped. Once I was home, we all got some dinner. I ate a small helping, I was hungry but didn’t want too much on my stomach. Sadly, during the drive home and dinner my contractions slowed again to every 30min or so. I’d been in labor almost 24hrs now …. having multiple relatives and in-laws at the house was a bit tiring because I didn’t have the energy to entertain/host everyone and really wanted the contractions to stop or hurry up so I could hold my baby. I went to my room to try and relax a bit because I was tired and then my husband suggested trying the acupressure points we had some papers on from our childbirth class for the first baby…this was something in my hospital bag that was sitting in the car trunk. I had completely forgotten about all that stuff and said yes we should definitely try that! It worked like a charm… after a few rounds of doing the acupressure points to progress labor, contractions increased frequency to every 7-10 minutes and I didn’t have to walk around to maintain that frequency (one happy, sleepy momma!). Finally, after consistent contractions for about an hour, my family and husband convinced me to go to the birth center. (I wasn’t wanting to show up, only to be told I wasn’t far along and could go home and keep laboring. If I showed up, I wanted to be well on my way to delivering my sweet baby.)

Just in the nick of time.

On the drive to the birth center, my contractions increased to every 3-5 minutes and when I arrived they said I was almost fully dilated and effaced. I was so relieved! I really didn’t want to be told “you’re only 2cm” after laboring 24hrs and counting haha 

I was taken back to a labor suite and continued to progress for roughly 1.5 hours. I did this without any medicine but since I hadn’t been induced, I actually did get a slight break between contractions. I didn’t have back labor like before, it was all in the front like a reeeeeeally bad period (the worst!). Because of the location of most of the contraction pain I didn’t have my support folks do much, I breathed through the pain and squeezed the fluff out of the comforter on the bed as I sat on the edge of it. A short while later, the midwife said the baby’s heart rate was dipping low when I had a contraction so I repositioned from sitting in the bed to laying so they could check on the baby and then I moved into another position, all fours on the bed facing the mattress. The cord was wrapped around the baby’s neck so they had to adjust that before I pushed a few times and my sweet baby joined us on the outside! It was great just to snuggle and soak in that sweet baby smell. Life would be different with two kids now, but I loved them both and looked forward to navigating the new chapter. <3 

Tips and Tricks for Baby #2:

• Pre labor can last days or weeks. Not exactly the first choice for a laboring mom. If you are close to your due date, try walking or acupressure to see if you can give your body the jump start it needs to progress into active labor. 
• Contractions may be different depending on how labor starts. My contractions were stacked on top of each other when I was induced, causing no break in between and making them feel intense. Contractions the second time started on their own and, while still painful, started more like a normal cramping period before getting stronger. There was also a break between them until the final hour or so when I was about to start pushing. Both deliveries I didn’t take pain meds, exactly like I wanted, but the experiences with contractions weren’t the same. One was stacked contractions with lots of back pain. The other was paced better but most/all of the pain was in the front like a terrible menstrual cramp.
• Acupressure to progress labor is something I tell every mom about! After having been in labor over 24 hours, I was exhausted but it only took about 30 minutes and a couple rounds of acupressure to progress labor and get things going without requiring me to walk miles.

But wait, there’s more!

Along came another musketeer. My third little sweet pea was on the way. When I began having symptoms of pregnancy, on a fluke I decided to take a pregnancy test. Having been through this twice already, part of me knew what I was feeling but it was also a surprise. When the test result was visible (almost instantly, didn’t need the full time) I was both shocked and excited. I wanted to tell my husband immediately but decided that for the first time, maybe I would finally get to try a cute way to share the news. I made a little note, printed it off and placed it where he could find it after work. It was a fun moment and we got to share the secret for a little while before telling our families. Unfortunately, the deja vu expanded beyond typical pregnancy symptoms and on the day of my first OB appointment I was sick. Much like the first time, I figured I had been eating poorly for a week or two and was desperately hoping it would resolve if I was more strict with my eating. After another day or two, I decided to try and preemptively explore whether this was another obstruction. I was roughly 8 weeks pregnant, almost exactly the time my first symptoms started with the last obstruction. I didn’t want to be sick again for months, so I contacted a new GI specialist but he had transferred practices to the same as my previous specialist. Given the events of my 1st pregnancy and obstruction, I didn’t want to see my original specialist but when I asked about scheduling an appointment with the other specialist, I was told I couldn’t do that because I was still documented under another doctor and “the doctors don’t see each others’ patients”. I questioned why I, the patient, couldn’t say that I specifically wanted to see one doctor and not the other and was told they could submit a change of provider request that should be reviewed within 2-3 business days. I asked her to do the request for me and I would wait to hear back so I could schedule an appointment (spoiler alert, they never called or did the change process). I then hung up the phone and tried to think of timelines and what would happen to me if I was stuck waiting for the change of doctor process, then scheduling an appointment, getting an evaluation and possible referral…all before getting treated for the obstruction and feeling better. That process could take weeks and, if I had an obstruction, I wasn’t going to last that long before ER intervention was required.

It’s not “health care” anymore, it’s the medical “industry”. Make the system work for you!

I had a chat with my husband which triggered the idea to try and find my surgeon’s name. I contacted my OB, along with checking my medical information through the hospital app, to see if anyone could find the name of the GI surgeon who had done the procedure to resolve my obstruction several years before. The next day I got a phone call from the OB nurse and she had been able to find the surgeon’s name. I decided, why wait for medical industry red tape to see a specialist and have him refer me to a surgeon and possibly face another hurdle or two? That whole process could take weeks I didn’t have. I could just go straight to a surgeon for evaluation and treatment….and who better than the doctor who saw me for the same issue and treatment before.?.

I called the surgeon’s office to schedule an appointment, telling them I thought it was a repeat of the previous obstruction he treated before. That was a Wednesday and I was able to be fit into his schedule on Friday (wow!). During the appointment I compared symptoms and said I wasn’t able to eat much but was trying to maintain hydration and was just hoping I could get resolved ASAP and skip the 10 weeks of misery I had experienced before. The surgeon verified the obstruction with a quick rectal exam and believed he could see me within the next 2 weeks. He would make a note and his scheduler would call me Monday. I was excited! I had caught things early, thought of a way to fast track treatment by avoiding red tape and delays. Monday rolled around and I was feeling worse but waiting on the phone call to schedule my outpatient procedure. That afternoon, I ended up reaching out to make sure they had me on the radar. I was on the books but the scheduler had just returned from her own procedure and was having trouble finding a time the OR was available to be scheduled. She said she would keep in touch when she had an update. Tuesday came and I started throwing up and couldn’t keep anything down. Ugh! I got a call from the scheduler that I was on the books for Friday. I couldn’t believe it: issue rings the deja vu bells on a Monday, by Wednesday I’m contacting the GI doctors and get an appointment with my previous surgeon on Friday. The procedure then gets scheduled for the following Friday. In the world of medicine, at least in my experience, that level of efficiency and speed NEVER happens following the standard process! I was impressed and excited and just hoping I could make it until then. Unfortunately, I got progressively worse through the day and knew I at least needed to get some IV fluids because I wouldn’t make it to Friday without them. So, I loaded into the car and my husband drove me to the hospital. I got checked into the ER; when I was taken back I told them my issue and that I was scheduled for a procedure that Friday. They called my surgeon, who decided to admit me. I got settled in a room and was told I would speak with the doc the next morning. When the surgeon came by in the morning, he said “I’ve got you scheduled for 12pm today so I will see you then and we can see about sending you home tonight”. The procedure went smoothly and I was able to go home in time to help put my kiddos to bed. Sadly, recovery was not what I expected. Within a few days I had the same symptoms as before the procedure; nausea, bloating, inability to pass gas or stool, inability to eat or maintain oral hydration. I was confused because I had instantly begun to improve last time, so why wasn’t I doing better this time?! I called my surgeon after two days to give an update and he recommended Miralax to help things move through for a while and just focus on fluids and liquid nutrition to give my gut a break. I did this for 2 weeks but saw no improvement, instead I continued to get worse. Cramping, bloating, inability to evacuate bowels, nausea, and I couldn’t lay down because of the pain so I just slept in the chair or couch in my living room. When I saw the surgeon for my follow up, he wasn’t pleased with my condition and did another physical exam….my obstruction had re-strictured! He did a manual dilation this time (yeah, it’s as uncomfortable as it sounds) and prescribed a steroid suppository to try and prevent the scar tissue from swelling/building up and repeating the obstruction again. I went home with a follow up appointment scheduled in 2 weeks. I was able to relieve myself some for the rest of that day and the next but then I began to revert right back to being sick. 

Let the roller coaster begin…

Two weeks later, just before my follow up with the surgeon, I was vomiting again and couldn’t stop. I knew that I’d been struggling to keep hydrated and was getting progressively worse at it over the last 5 weeks and needed IV fluids. I did not want to go to the ER, so I called two nearby urgent cares to ask if they could do IV fluids. They said no and I would need to go to the ER. My husband and mom recommended seeing if one of the doctor’s offices could call ahead or something so I was seen quickly at the ER just for the fluids. I called both the OB and surgeon’s office and both said they don’t call ahead and I would just need to go to the ER and wait to be seen. However, when I spoke to the secretary at my surgeon’s office she recommended calling the OB back and seeing if they could do it in the office because her last office was an OB and they saw hyperemesis patients there for fluids. I called and left a voicemail for the nurse (also sent a message through the hospital app) but after roughly an hour, I knew if I waited to hear back and the office didn’t offer anything I would have wasted time to feel better and the ER would have gotten busier, causing a much longer wait time. So, I loaded into the car and my mom drove me to the hospital. (Hubs would have driven but I told him to go to work and save the PTO.) Literally, as we were sitting at the light waiting to turn into the hospital entrance I got a phone call from the OB office. The nurse said they can do IV fluids and I could be seen as soon as I could get there. I said “I’m on the way!” and we did a u-turn away from the ER and headed to my OB’s office. Once I had 2 units of fluid, the nurse checked me out and said I should get a call from their infusion center office to schedule regular appointments to help manage dehydration until I was feeling better. Wow! Above and beyond…. I had no clue the infusion center existed but was thankful the idea had been brought up and now the nurse was getting the ball rolling for me. Wish this had been brought to my attention without me asking…and could have been so helpful during my first pregnancy. Very glad I got lucky and it existed now!!

My condition just became a cycle where I would be seen by the surgeon for a manual dilation, feel a tiny bit better immediately after that, then get worse and struggle to stay hydrated, let alone eat anything. Every time I had a hint of feeling better and tried to eat solid food I desperately regretted it for the next 1-3 days because of the increased pain, constipation, and bloating it caused (go figure, it happens when something comes in and can’t get out). Every week, I would go twice to get IV fluids at the infusion center. After repeating this cycle for a month, I finally had an appointment with the surgeon where he said my stricture was still recurring but not as badly as before. Since the re-stricturing had been happening for about 6 weeks now, we had been talking about alternatives for both during pregnancy and after delivery. Things like maintaining what we’d been doing and planning exploratory surgery after delivery to find and resolve whatever was happening (can’t do GI surgery when pregnant because the baby and uterus block everything). Another option was to do a temporary ostomy so I could keep myself and baby nourished (because I couldn’t eat this whole time and was solely doing liquid nutrition as best as I could, but was still losing weight). Having had an ostomy for my j-pouch, I wasn’t thrilled at the idea…especially being unsure how a growing baby would impact it as my stomach grew. All plans had been discussed but I didn’t like any of them, especially since they all meant I would be sick and miserable until some time after the baby was born – months later. Then there was the concern beyond myself and hoping the baby didn’t grow to have some health issue caused by my GI obstruction complication. So, to hear that things were even seeming a tiny bit better gave a glimmer of hope (and I totally cried because well, hormones haha). 

Can we change things and get better results??

After the tiny bit of good news with the surgeon, I started wondering what would happen if I got 3 units of fluids for each infusion visit? Since each unit/bag is about 30oz, I was barely breaking even with the level of hydration I should be getting each week. But if I could get 3 units (about 90oz total) then I might actually start getting hydrated and staying that way. So, I contacted my OB to ask if they could adjust the order. Several days later, they said usually it’s only 2 units because of the time it takes to infuse (1-2hrs per unit) and because if you get too much fluid too quickly there can be cardiac issues (fluid builds up around the heart/lungs and that’s not a good thing). I said I would like to try 3 units if it wasn’t too risky. The next week, at my second appointment for the week, I was surprised when the nurse said “oh, you’re getting 3 bags today?” I replied “What? Well I asked them about trying it but didn’t hear back…I guess she changed the order. Sure, I would like to try 3 today. Can we do them a little slower? Like maybe 1.5-2hrs just to see how my body handles it?” So that’s what we did. The first two bags as normal, total infusion time of 2hrs. Then the last bag was 2hrs itself, just to see how my body did. Things went well (the infusion was Thursday), and by Saturday I was still feeling decent. It was the best I had felt for more than 12-24hrs in 2 months and I was scared to say anything or I would jinx it. Seriously, I refused to say anything to anyone…they would ask how I was and my reply was “the same”. 

The following week I continued getting 3 units of fluids for the two appointments and also saw my surgeon who said the stricture was there but again, noticeably improving. I told him I had been able to eat tiny snacks for a couple days and not have bad effects afterwards…and I could poop and pass some gas, albeit not normal but relieving myself some was better than nothing for days/weeks! I repeated what I was doing for another 3 weeks and when I saw my surgeon this time, he said my stricture was barely – if at all – repeating this visit. That was amazing news! The additional hydration via IV and the timing in the pregnancy being almost exactly the 18 week mark, where things resolved the first time, were clearly the reasons I was finally improving. Weird but wonderful! For the next 4-5 weeks I continued slightly increasing my food intake to see how things did, and I was able to orally drink more. I was very weak but finally not losing weight and continuing to feel better with my GI system. At my next surgeon follow up, he said the stricture seemed to only need the slightest dilation and I could see him in 6 weeks, unless I got worse. After that news, I decided to start weaning my body from the infusions, ensuring I was able to comfortably eat small meals and drink enough myself to be consistently hydrated. After about 4 weeks of IV fluid weaning (process noted below), I was able to stop infusions and work on regaining my strength and independence. 

• 3 units by infusion, twice a week
• 1 week: 3 units of fluid the first visit and 2 units the second, increase oral intake to 60oz minimum daily.
• 2 weeks: 2 units of fluids both visits and see how that goes. Increase daily intake orally to 80oz standard.
• 2 weeks: If the above goes well, reduce to once a week infusion instead of two days. Increase daily intake orally to 90oz standard.
• Finally: Try no infusion and if all goes well, cancel all future appointments.

It took about 2 months of eating and actually moving and living life before I started feeling more “normal” again. It was nice being able to go on a walk with the kids without needing to stop and rest after 10 minutes, or walk for 30 minutes and then need to sit and wait for the nausea and lightheadedness to end after clearly doing too much. The rest of the pregnancy was pretty smooth sailing on the GI side. I had lots of aches from my body, especially my back, but that wasn’t new or unexpected (my body isn’t a huge fan of being out of shape and then carrying an extra 20 lbs in front of me haha). The two things I did have consistently were heartburn and swollen ankles/feet. To help with the feet, I would avoid eating anything with too much salt and prop my feet as much as I could during the work day. For the heartburn, I ate smaller portions (or 1 serving instead of getting seconds). I also tried to load up on fluids between meals so I wasn’t stuffing 30oz of water and 8oz of food simultaneously. The last thing I did was try not to eat or drink much/anything after 7:30pm so I would be able to lay down for bed. If none of that worked to relieve heartburn, I bought a sleep wedge pillow so I could sleep on my back but be propped and not worry about cutting my circulation (plus I could use a heat pad for my back 🙂 ).

Tips and Tricks for Baby #3:

• Don’t let the industry lead to your suffering. If you need something like a change of physician, get details about the process and timing and then be active in following up. Contact them regularly, frequently if needed, to check on status and ensure you get what you need in a reasonable time. If you don’t follow up, it’s likely you will never get what you need in a timely fashion, if at all.
• If you’re struggling with an obstruction or hyperemesis during pregnancy, see if your OB is partnered with an infusion center that could provide you with IV hydration to help reduce your misery until things can get better. Calculate how much you’re able to hydrate on your own, and see if they can do IV fluids to compensate for what you’re lacking on your own.
• To reduce pregnancy pains and try to get some sleep, especially towards the end, I used lots of pillows. Pregnancy pillow, body pillows (in front and behind), and a foam wedge. These really helped try to get a safe positioning so I could sleep on my sides or back. I also used a heat pad to help with muscle aches in my back and some gas/muscle aches on my sides or belly (like when I had clearly eaten too much for dinner).
• I’m a very independent person and don’t like feeling like I “need” help. However, when you’re pregnant you are literally growing another human. It’s ok to say you’re tired and need someone to help out (cook a meal, help bathe the kids, skip that social event to prop your feet). Whatever your situation, don’t run yourself completely ragged being independent…if someone in your life is willing to help, let them – at least a little 😉 

To read more about what I learned as a pregnant poucher with an obstruction/stricture, check out my post “You’re Not “Just Pregnant”: 7 Things I’ve Learned Being A Pregnant Poucher”.