On the Plus Side, Now I Know the Terbutaline Works...

Yesterday for hours I was having pretty uncomfortable contractions spaced exactly 5 minutes apart. Eventually they shifted to exactly 4 minutes apart. I wasn't loving this development, but having a lot of contractions wasn't the end of the world. After all, that's what I DO, right? Yes, they were more uncomfortable than usual, but they weren't alarmingly so, so I wasn't sure whether it really mattered. I decided that I'd see if I could sleep through the night to decide how alarmed I should be. And that's when the fun began. The contractions didn't get better through the night, and I never did get more than about 20 minutes of sleep at a time, but there were only 2 stretches in the night where I even got that many. I spent the whole night trying to figure out when it was appropriate to call the doctor or at least call Matria. Calling at 2:30 seemed silly, I rationalized, since I'd be getting a bolus at 3am. At about 3:15, I fell asleep for 20 minutes, which seemed to me to suggest some improvement, so I figured calling wasn't strictly necessary. By 4:30 I was in agony, so I considered calling and asking for an additional bolus, except that the auto-doses really weren't doing much good, so why would I think another bolus would? By 5:30 I was in tears from the pain (as I had been intermittently through the night), but again, only half an hour away from a bolus, so calling seemed premature.

All night the contractions themselves were not only stronger and more regular than usual, but I had cramping so severe I expected to see blood every time I went to pee and pain into my back along with the cramping so strong that I would have sworn I had a kidney stone had it not been so definitely in sync with the contractions. Once I dragged myself out of bed at 6:30ish (with less than an hour total sleep to show for myself), I couldn't quite figure out WHAT to do with myself. I still felt crappy, but at that point, I wasn't feeling any worse than I'd felt all night, so I decided to wait to call Matria until it turned over from After-hours to the local center, so that I had a higher likelihood of talking with a nurse who knew me. At 8:30 I called over there and spoke with a nurse who, as it happened, I'd never spoken with before. She suggested giving myself an extra bolus, but also said that she'd recommend contacting the doctor, since this was a change from the norm for me. So she paged the doctor for me.

Dr. P. was on call, which surprised me, since he's going to be away all this coming week, but that was good since I saw him twice this past week, so he knew what was going on with my medications, etc. He called me directly, rather than trying to relay everything through Matria, which I appreciated. He first told me to raise my basal rate on the terbutaline, and then said he could bring me into the hospital and get me onto a monitor and possibly mag sulfate if I wanted. Alternatively, this is about the last opportunity I've got to use Indocin (they won't use it after 32 weeks), so since I haven't been on it for a few weeks, and since historically it works well for me, that was my other choice. So I decided to try the Indocin again and he said if I wasn't feeling better in several hours, I can always come in to the hospital. Fine and dandy, except today is my foster son's 4th birthday party, so I'd like to avoid that if possible. Obviously, if I need to go, I need to go, and that's all there is to it. However, if there's any way to avoid it today, I'd like to. I do want at least my husband to be at the party, and I'd rather not go to the hospital alone (I'm not going to be at the party regardless).

So that's what we agreed upon. And then... shortly after I talked to Dr. P., I pulled out my pump to give myself the extra dose that my nurse had suggested and I realized that the pouch that holds the pump was a little damp, as was the area around the pump where the tubing attaches to the syringe in the pump. How odd... And I peered closely at the tubing and watched it for a good long while. And I realized that absolutely NO medicine was going through that tubing. In fact, probasbly no medicine had been going through that tubing all night. And in retrospect, when I changed the syringe last night, I vaguely remember that ther was a subtle "crack" sound as I put the tubing on, and I DID check to see if anything looked cracked but didn't see anything, so I'd sort of forgotten about it. Obviously, I didn't look closely enough. Whoops. In the two months that I've had the pump, this is a first. Still, I feel foolish.

However, at least now I know that the terbutaline really IS serving a very important purpose. Because if that was just a tiny glimpse of 12 hours without terbutaline (bearing in mind that the half-life of terbutaline is, I think, 4-5 hours, so I theoretically still had terbutaline in my system that whole time, just less and less of it through the night, then boy, do I not want to know what life woud have been like without it all together. So as many contractions as I feel with the terbutaline... at least I now know that the Terbutaline DOES work. Really well. Sheesh!