Thursday, February 20, 2014

My IV Port: Trauma at the ER

On December 27thth 2013 I gave birth to my second son at home.  I knew I wanted a home birth even before I was pregnant, but it wasn't until an experience I had at the ER about a month or so before that I really realized why a home birth was absolutely the ONLY option for me.

*** I am writing this down partially to reflect back and partially to deal with what happened.  It could be very triggering if you've had a bad experience in a hospital or if hearing about needles is hard for you. ***

Late in my third trimester I got very ill with some sort of norovirus type stomach bug.  It hit me very hard, and I could not keep liquid or food down.  I spoke with my midwives about it, and they said that it was very important that I stay hydrated.  They suggested that I go to the ER for an IV of fluids if the situation did not improve. I did not want to go because I didn't want to expose myself to something worse, but I knew that if I didn't stay hydrated things could go sideways very fast. I'm also terrified of needles and IVs.

The situation did not improve; I could not keep liquids or solids down at all, despite my best efforts.  That afternoon I waddled up the hill to the nearest ER and explained the situation.  I explained that I was pregnant, the illness I was experiencing had come on very quickly and was not typical of my pregnancy, I was unable to keep food or water down, and I was experiencing vomiting and diarrhea. I explained that my midwife was currently attending a birth at another hospital but had told me to go to the ER and ask for fluids.

Once I spoke with the triage nurse I was asked to go sit in the waiting room.   I waddled over very carefully, as not to trigger vomiting.  The waiting room was quite filthy and I tried not to breathe in too deeply because I didn't want to catch anything else. I also tried not to touch anything so I wouldn't spread what I had to other patients.  An orderly came around to take blood from me while I was sitting in the waiting room, so they could get that process started.  He was very kind but he smelled like cake.  I asked why he smelled like cake and he said "It's my cologne. What's wrong, you don't like cake?"  I explained that I loved cake but not when I was nauseous and on the verge of vomiting.

When it was finally my turn to go into the treatment area, I was assigned a bed.  I laid down and waited for the doctor.  When the doctor came, he was nice enough.  I explained to him exactly what I had explained to the triage nurses.  I also said that I am very afraid of needles but realize I desperately needed the fluids.  He said he understood and that a nurse would come around and give me the fluids I needed.

The doctor left, and a few minutes later, the nurse came.  She put an IV port into my wrist.  I looked away while she did it.  She then attached the bag of fluids.

I tried to not look at the fluids or my wrist, but of course, I eventually did.  And that's when I noticed that there were TWO bags attached to the IV tube; a large bag and a smaller bag.

I flagged down the next person I saw, who happened to be the doctor.  I asked "What's that second bag?"

"We've given you an anti-nauseant as well"  he said, proudly.

"Um, I'm pregnant.  Is it ok for the baby? Can you tell me what it's called?"

He uttered the name quickly and said it was "perfectly safe" for the baby.

Let's stop right now.  You see, here is my first issue:

I asked for IV fluids for dehydration.
I did NOT ask for an anti-nauseant.
I know, I know, they are the doctors.
They went to school for 8+ years.
They see patients every single day.
Maybe the anti-nauseant was the greatest and most safe thing ever.

But WHY ON EARTH would he or the nurse have NOT mentioned it to me before it was attached to a tube being pumped directly into my body? 

I have a serious problem with this.  It is my body, and my baby, and it is my choice to decide what I am comfortable with when it comes to medicating while pregnant.  Or even when not pregnant.  If they had asked me if I wanted the anti-nauseant, I would have said "hold on" and quickly checked to see if it was ok, if ONLY for my own comfort.

Moving right along.

Now, remember how I said earlier that I am not comfortable with needles?  This is actually an understatement. I've had quite a few saline drips in my adult life, and all but 2 of them resulted in me having a panic attack.  A needle that goes in and out quickly is one thing, but the idea of a little rubber needle being stuck in my body for any extended period of time is just horrifying.  Fortunately I held it together pretty well during this one because I was trying so hard to remind myself that I was doing this for the baby and that it would be over soon.  After all, IV fluids don't take more than 30-40 minutes to empty, right?

While mindfullness and focusing on other things in the room were helping me keep my cool, toward the last few minutes of the bag emptying I started feeling myself on the verge of losing it.  I wanted the bag out, and the IV port GONE, and I wanted it out now.  When the nurse walked by I would ask "how much longer?" and finally she said "2 minutes."  Those 2 minutes were long.  When they were over, I was hoping the nurse would run over to remove the IV port and the bag but it didn't happen that way (such is the nature of a busy ER).  I held my cool until I saw her walk by again and asked if she could please remove it.

She was happy to remove the tube and the bag, but the offending IV port, well, she left it in my arm.

"Can you remove this please?" I asked.

"No.  The doctor said to leave it because you may need it for later." She remarked.

"It's really bothering me." I said. "It's making me feel nervous and uncomfortable."

"It won't be in much longer but you need to keep it in just in case they need to give you something else" She said.

"If they need to give me something else I'll just have them put another one in." I said, certain I wouldn't be getting anything else.

"I'm sorry I have to leave it in for now." she said.

I was annoyed but sort of understood.  I tried my best not to think about it, careful not to bend my  arm at all.  The thought of the little rubber needle inside my veins made me feel even sicker.

A few minutes later another nurse came by with a cup and asked me to go into the washroom to pee.  I got up as best I could, super careful not to bump the offending IV port, and waddled to the washroom.

When I got there, I tried very hard to pull down my pants.  I know this must sound ridiculous, but I was 9 months pregnant and unable to bend my left arm.  Despite my best efforts, I could not do much of anything.  Peeing in a cup was not going to happen. 

I waddled out and explained "I can't get a sample with this thing in my arm.  Can someone please take it out?"

I was told once again that it could not be taken out.

Frustrated, I went and laid back down on my bed.  They brought me water and crackers and said I needed to do a test to see if I could hold the food and liquid down, and eventually I could.  This was a good sign that I could leave soon.

The doctor came around again and asked if it would be ok if there was an NST done on the baby.  I was more than happy to have one, but I asked if first my IV port could be removed from my arm because it was terrifying and freaking me out.

"We really need you to keep it in just in case we need to give you more fluids." He explained.

"But if you need to give me more fluids that's fine, but you can give me a new one, then, if that's the case? Unless I'm getting more fluids right now."

"Oh we just leave them in." He said.

Still frustrated, and sort of on the verge of totally bugging out, I waited for the NST.  Since I had possible flu-like symptoms and at the very least had the norovirus, I could not go up to the maternity ward in case I infected the babies. I fully understood this.  Instead, two women came down from the maternity ward in basically full hazmat outfits with a rolling NST machine.  One was a nurse, one was a student.  I was asked if it was ok if the student was present and I said yes that was fine.

The nurse explained the NST to me and then asked if I could lay on my left side for the NST. I explained that I could not, because I could not lay on my left arm because there was an IV port in it and it felt horrible and gross to lay on.  She asked if I could anyway, but if I could put my arm over my head.  I said I guess so, but that the baby moved more when I was slightly inclined and on my back.  She said it would be better if I laid on my left side. I asked if maybe she could have someone take the IV port out of my arm so I wouldn't be stressed myself during the NST.  She said no, as it "wasn't really her place" to discuss having the IV removed.

I made it through the NST feeling absolutely disgusting.  I could feel the IV port and was trying hard not to panic more about it.

When the test was over about 25 minutes later, all was well with the baby, but they still wanted urine.  I asked again if I could PLEASE FOR THE LOVE OF GOD HAD THE IV PORT REMOVED FROM MY LEFT ARM and was told AGAIN that it needed to stay there.

"Just in case."

I went to the bathroom, I held my breathe, I struggled through the pee sample, I put it where it needed to be, and went back to my bed.

A few minutes later the doctor came by and handed me a discharge paper.  It had my blood test results on it. He also handed me a prescription (that I never filled) of the same anti-nauseant that had been in the second IV bag.

Of course, at this point I asked "Can I please have this IV port removed from my arm now?"

To which he responded "Yes, the nurse will come and remove it soon."

He walked away and about 5 minutes later a different person (orderly? nurse? I'm not sure) came and said "we need this bed, you can be on your way." to which I said, "I'm waiting for someone to remove this IV port!"

His response? "Oh they can remove that when you are in the waiting room.  If you sit out there we will send someone out to remove it shortly."

I was annoyed beyond belief at this point but did as he said.  I went outside and sat in the waiting room for exactly 15 minutes.  No one came. So I went to the triage desk and asked "I've been waiting for 15 minutes for someone to remove this IV port.  What would happen if I just ripped it out myself, would something bad happen?" to which she responded "I'll go get someone now!"

She went in pretty quickly, and within 3 minutes someone was out to remove the IV port.

So ramble, ramble ramble. What does this all have to do with my birth?

If I had to have an IV port in my arm during my birth, I guarantee I would have ended up with a c-section.  There is just absolutely no way my birth would have progressed.  The amount of anxiety and stress I would have experienced would have been so great due to the IV port, I don't think I could have relaxed.  I guarantee it would have delayed progress.

When I think back to all the positions I was in during my labour, I know now that I could not have been comfortable tethered to an IV port during them.  I could not have thought about anything else but that horrible little rubber tip, and how disgusting it felt felt when I brushed it even ever so slightly.  Or how nauseous I felt thinking about what it must be doing when I bend my arm.  There's just no way I could have felt free to move around in the way I need to while I birth.

I know it may sound very silly to some of you, because it's JUST an "IV port."  But to me it was a barrier, a huge wall that kept me from being comfortable and able to relax. We all have these things, these potential barriers, and for some reason in a hospital environment they are so often overlooked as they are perceived as irrelevant or insignificant.  What is insignificant to one person can be huge to another.  Try to imagine one of your worst fears, and someone insisting you stare it in the face for hours against your will for basically no good reason.

The scariest thing of all that I took away from this experience was how unimportant my own comfort was to any of the caregivers at the hospital during this visit.  I told multiple people multiple times that I was:

- Terrified
- Uncomfortable
- Disgusted

and that I wanted something out of my body.  Despite all this, no one seemed to care.  After all, to them it's just a simple IV port that they see hundreds of in a day.

This IV port was not a life saving device in this situation.  It would have taken about 60 seconds for someone to remove it, and if I had needed a new one, it would have taken about the same amount of time to put in a new one.

No matter how I begged and pleaded, no one seemed to think I was enough of an authority of my own health and comfort to know that I wanted the IV port out of my arm.  On a larger scale during a birth, this could have been so very detrimental.

So I left the hospital that day aggravated, and a little sad.  But most of all, I left knowing that I didn't want to ever have to endure a hospital environment again unless I knew my very life depended on it.  Between having unwanted drugs pumped into my body and having my request to have the the IV port removed when I wanted it to be, I will certainly think twice the next time I'm considering an ER visit.

One last thought: for me, this was bigger than just the anti-nauseant and the IV port.  To me, it's about feeling safe.  I feel like when you are in a medical situation, you need to feel safe and you need to feel like you can trust those around you.  I did not feel safe, and I did not feel like I could trust those around me as a result of this experience.  I felt terrified and uncomfortable as I explained above, and worse yet, I felt like my comfort didn't matter.  I don't know how someone is supposed to heal if they cannot be comfortable or if they cannot feel safe.
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