Wednesday, July 28, 2010

Blood clot information and thanks

So while I've been scolded lovingly by some (and told by a friend that she was mad at me for not going to the ER sooner), I have been VERY upset with myself. I was *sure* the pain in my leg would go away and that it was just a sore muscle from being on my feet more than usual for my new job. And there were times where the pain did seem to go away, reaffirming my belief that I was just making a big deal out of nothing. Until, that is, I realized that it was what I'd feared... a blood clot. And by that point in time, it may have already spread to my lungs. I'm grateful that I'm still alive, knowing full well just how close I was to dying. I know I'm not in the clear and will be on high alert for the rest of my pregnancy and then the rest of my life, but I'm grateful for the gift of my life and grateful the baby appears to be okay.

I wanted to thank everyone for their support as I've been going through this. I received various texts, phone calls, emails, visits, prayers, comments on blogs, etc during this time, which has helped me realize I'm not alone. And when you're stuck in a hospital bed for about a week, it can be easy to feel alone at times!

So, I have an acute blood clot in my left leg. Apparently it starts around mid-calf and goes up past my knee (holy cow, this thing must be huge!). And part of it broke off and traveled to my lungs. I have bilateral pulmonary emboli (or, in other words, blood clots in both my lungs), but I don't know how large they are. I do know that I started breathing well enough to get off of oxygen on Wednesday or Thursday last week, so I'm taking that as a good sign. I still feel a little short of breath sometimes, especially after walking or talking a lot, but I seem to notice it less and less.

I am on blood thinners and will be taking them the rest of my pregnancy and after. However, the pill-form of the blood thinners are not safe to take during pregnancy, so I will be giving myself injections in my stomach twice a day for the rest of my pregnancy. I did talk to a doctor who recommends being on blood thinners the rest of my life, but I may be able to switch from the injections after I'm no longer pregnant. Blood thinners don't help dissolve the blood clots or help with pain. They simply prevent any future blood clots from forming.

Your body slowly breaks down the blood clots on its own, which I was told might take a few weeks. In the meantime, I'm still in pain, but I have found that lying down with my legs up seems to hurt the least. However, walking helps promote circulation, so I was told to walk around as much as I can handle with the pain but not to push myself too hard. I will be wearing compression stockings too, which will help with circulation.

Other than the blood thinners, I’m not on any different medications than I was when I went in to the hospital. In a couple weeks (when I’m 12 weeks along), I will stop taking both Metformin and progesterone, which I am happy about.

So what caused the blood clot? I have no idea. I didn’t go from being really active to being inactive. In fact, I’d say I was pretty active right up to when I got the blood clot (and even attempting to continue being really active despite the pain the blood clot in my leg resulted in). I didn’t go flying. I did have some risk factors for developing one, which include having had one before, being pregnant, and being on progesterone. But as to whether any or all of these played a role, I doubt I’ll know. A doctor I met in the hospital wants to run some genetic tests after I’m no longer pregnant because he said that despite my risk factors, it is very abnormal that I would get a blood clot on two different occasions by my age.

What is to prevent the blood clot from breaking off more and traveling to my lungs or elsewhere? When I had my first blood clot, I was sent to the ER right away and given injections in my stomach for (I think) 5 days, which I was told would help the blood clot from breaking off. So now that I’m actually on those same injections, I guess that will help. But an IVC filter (or blood clot filter, also known as a vena cava filter) was surgically placed through my neck into the large vein that carries blood from my lower extremities. So it will catch any clots that might break off before they make it to my lungs or heart.

I went to my OB today for a follow-up appointment from the hospital. She did an ultrasound and the baby looked okay. I heard the heartbeat, and the baby measured at 10 weeks 4 days (although I’m pretty certain that is at least 2 days later than it should be, and it is 4 days later than the baby measured when I had my first ultrasound at 6 weeks 2 days). The OB said she wanted to refer me to a perinatologist, and she gave one a call. The two of them decided I should transfer my care from my OB to the perinatologist. So, I have my first appointment with him on Monday. I hope I like him. And I hope I can deal with the pain in my leg long enough to make it through the 90-minute appointment.

I am also grateful that I had the blood clot I did back in 2003, because the blood clot in my leg felt the same and was more or less in the same place. If I hadn’t experienced that blood clot, I might not have realized what was going on until I was in much worse shape than I was (which was bad enough, granted).

And, again, I am grateful for all the support I have received and am still receiving. I know that many people out there were worried about and praying for me, and I have felt a lot of love at this difficult time despite the trials I’m going through. So thank you!

Monday, July 26, 2010

FINALLY home!

I have a long recovery still ahead of me, but I am home from the hospital and hanging out on my couch with my leg propped up. I finally got discharged this afternoon around 2 and my cousin Kristine picked me up from the hospital and drove me home. It was a painful ride. Right now, I can only spend about 3-5 minutes sitting with my leg down or walking before the pain starts to increase more and more. My leg turns a purplish tinge as the blood rushes to it. And apparently I'm still getting wiped out when even walking short distances. So I'm going to be making myself quite comfortable on my couch for the next week or two or three until this blood clot has dissolved more. I'm so glad to be home! And I'm so grateful for everyone who visited or called or texted or emailed or even just prayed for me during this tough time. I'm trying not to stress too much as I continue to deal with this throughout the rest of my pregnancy (and prepare for lifelong treatment), praying that I have a healthy pregnancy despite this challenge.

Saturday, July 24, 2010

Where I've been since Monday

While my super sweet, supportive, sleepy husband takes a nap in the recliner next to my hospital bed, I figured I could take this opportunity to update my blog with the events of my crazy week. This is the first I've been on a computer since early Monday.
I thought I had a blood clot in my leg as early as last Wednesday or Thursday but hoped it was just some sore muscles from standing on my feet much more than I was used to with my new job. By the time Sunday rolled around, however, I was pretty sure it was a blood clot. And still, I didn't want to have to pay an ER bill if I could get testing done to confirm it in another way. I had Monday off work, so I figured I would call my OB's office and see what she suggested I do. I didn't get to talk to her, but a nurse told me to go to the ER to get a doppler on my leg (and medication for a blood clot if I actually did have one) because they wouldn't be able to do that at their office anyway.

So I let Joe and my parents know I was going to the ER. Then I took a shower. Right after the shower, I had to lay down and prop up my leg because of the pain. After a while, I got up again and dressed, but I had to lay down and prop up my leg again. Clearly something was wrong. I finally got to the ER. There was one other person who was waiting to be taken back as well, but when the check-in desk saw that my heart rate was 130 and my blood pressure was something like 140/101, as well as the fact I was pregnant and had a history of a blood clot and was short of breath, they took me back to a room quickly.
I had an EKG done immediately. I also had blood work done. I was put on oxygen and a blood thinner, given a doppler and an ultrasound, given a CAT scan on my chest, and was admitted to the hospital.

Not only do I have a blood clot in my calf, but the blood clot in my calf extends up the back of my calf past my knee and part of it had broken off and traveled to my lungs. So I have blood clots in my lungs too.

On Tuesday I was taken in to surgery to have a filter put in to catch any more blood clots that might break off so no more travel to critical organs (I'm really lucky to be alive, actually). Because I'm pregnant, I can't take the most common blood thinner out there (which is a pill form) and instead have to give myself shots in the stomach twice a day throughout the rest of my pregnancy (and a doctor recommended that I be on blood thinners the rest of my life). Eventually, my body will dissolve the blood clots that are in my leg and lungs, but I am having some shortness of breath (mostly after talking and walking) and pain my leg (especially when I'm not lying down with my leg elevated). So I will be out of work for a few weeks when I return home from the hospital.

I had to stay to make sure there was a therapeutic level of the blood thinner in my blood (too much or too little is a very bad thing!) and was supposed to be released on Thursday. However, the hospital learned (on Thursday) that my insurance company won't cover the blood thinner injections they started giving me on Tuesday, so they'd have to switch to a different brand and make sure I was at a therapeutic level of that blood thinner. That extended my stay until today.

But I'm still in the hospital and will be here until Monday. Apparently pharmacies don't carry the dose of the blood thinner I will be taking and will have to special order it, which takes overnight. However, apparently pharmacies don't do the overnight deliveries from Saturday night to Sunday, so the blood thinner won't make it in to the pharmacy until some time on Monday (my doctor made it sound like it might not get there until Monday evening). So once I'm given my first injection on Monday, I will finally get to go home! But I won't be very mobile for a while!

I have had a lot of visitors, which I appreciate. I have some nice flowers to look at which helps improve the view some. We're going to have dinners brought over for at least a couple days when I get out, which will also be nice. My OB came in to the hospital on Tuesday and met me, and I will be seeing her on Wednesday after getting out. I'll also be buying $200 compression stockings to help with my leg circulation (and hopefully the pain eventually). I have a feeling I'm going to be basically hanging out on the couch for a couple weeks.

Saturday, July 17, 2010

"Morning" sickness? Yeah, right!

So, I've heard some people say that while their morning sickness consisted of nausea, they never threw up. I was hoping that might be the worst I'd get it. If only!

And why do they call it morning sickness? For the past few days, I've been sick every time of day EXCEPT the morning. I've already had to call in sick to work once and left early today after puking in the store's bathroom (I'd puked at home right before leaving for my shift, so I let my supervisor know I'd still come in but might need to leave early today). I told my boss I'd understand if he decided the job wouldn't work out for me because of what I'm going through, but I'd like to work 4 days a week instead of 5 as long as this morning sickness lasts, hoping that extra rest might be helpful in getting me through the shifts I do work. Guess we'll see.

Thursday, July 15, 2010

Timing

As I write this, I'm feeling kind of depressed. Yes, I'm glad to finally have a job, even if it's part time without benefits (except for a discount on purchases) and is so far away that I have to work almost an hour just to pay for my gas to and from work (or spend about 2 hours each way on a bus to get to work, still paying about the cost of a gallon of gas each bus ride). However, it's depressing to think that retail is all I can get (and not even a local retail job) after getting not just a bachelor's degree, but a master's degree as well.

Still, I'm trying to have a grateful attitude about the whole thing. I made it through the first two days at work, and I came home with very tired, aching legs. It's been a long time since I worked a job that required me to be on my feet basically the entire shift (as a waitress when I first started grad school), and even longer since I worked retail (as a second job after getting my bachelor's degree). I have to get used to being on my feet so much.

Plus, while the timing seems to be completely off to start a job, especially one that requires me to be on my feet so much, even though I don't exactly want to share this news right now but may as well since the cat is out of the bag, I'm pregnant. And today I am nauseous. I don't know if it's stress related or the first signs of morning sickness, but I am miserable. So, while today should be my third day on the job, I'm calling in sick, filling up my water bottle, emptying my garbage can, and going back to bed. I'm smelling I-don't-know-what that is making my stomach turn like crazy and I'm feeling beat up.

I'm about 8 weeks along and the due date is February 21st, 2011. I have my first OB appointment next week, but I've already had an ultrasound (at about 6 weeks) and saw the heartbeat. Other than some cramps early on in the pregnancy and low progesterone levels discovered early on (and for which I'm currently taking progesterone twice a day), things seem to be going well. If I can't handle this job and being pregnant at the same time, I will quit the job in a heartbeat. If I do, we may have some financial challenges as a result, but having a healthy pregnancy is my number one priority (and it's already a high-risk pregnancy too).

I went in to the fertility clinic I've been frequenting since January again today. Our insurance changed over as of July 1st, and the fertility clinic doesn't take the new insurance (even though I could've sworn I saw my doctor's name on the insurance company's website when I looked it up). So while I was going to have a second ultrasound today, it wouldn't be covered and would cost about $300. I passed. Too bad I didn't figure that out before dragging myself out of bed this morning and making the drive to Tacoma. Oh well!

Friday, July 9, 2010

I got a job

So I will be starting work in Bellevue (about a 45-minute drive) next week, working about 30 hours a week. I'll be working in a church bookstore. I hope I can keep myself from spending all my money on books.

Monday, July 5, 2010

Family

So there was a cousins' reunion going on in Utah, starting around the 1st of the month and ending right around now. I wish I could've gone. But I had previously planned on attending a cousin's wedding here on Friday (which was a nice wedding and reception), and the thought of spending 12 or more hours driving to Utah to spend what would amount to approximately one day with family, only to spend another 12 or so hours driving back just made it difficult to talk myself into.

I miss my family and wish they were closer. I'm so glad I have an aunt & uncle and cousins who live close. We attended a BBQ at my cousin's house on Thursday night (she had a lot of family in town for her daughter's wedding the next day) and then attended a BBQ of leftovers at my aunt & uncle's house yesterday. It's not quite the same as spending time with my parents or my siblings, but it's nice to know that they treat us like family and welcome us to their get-togethers.

I wish I had more money so I could visit my family regularly. I'm so glad I'll get to spend a handful of days with my parents this week. It's looking like we probably won't be going on any vacations that aren't local and cheap for the rest of 2010 and maybe even a decent part of 2011.

Saturday, July 3, 2010

An explanation

So I mentioned the job didn't work out, but I didn't go into it too much. I figured I have some time right now, so I might as well. But first, a little background...

I have a bachelor's degree in psychology and a master's degree in counseling. I have a little over 2 years experience working with seriously mentally ill adults. (I received that experience after receiving my bachelor's degree. I decided I wanted to do a little more than what my job description entailed, so I ended up going back to school for my master's degree.)

I was what was called a case manager. And after a year doing that, I got a "promotion" to a team where I'd work with acutely ill clients who needed more attention, so I had a smaller case load. I also had to be on call, and my job title was changed to mental health worker.

After receiving my counseling degree, I ended up moving from Arizona to Washington. The mental health field has been difficult for me to get into up here. Most jobs that require a master's degree are looking for one in social work (and although I have applied for some of those jobs, I haven't been interviewed for even one of them), or they also want you to be licensed (which you have to have post-master's experience to get). So I have been looking into jobs that don't necessarily require a master's degree. I'm "over-qualified" for some of these jobs, but I need to get my foot in the door. Some of them require certification as a Mental Health Professional (MHP). In order to get that certification (which doesn't exist in Arizona, by the way), you have to have 2 years experience working in mental health (got that) under someone who is a MHP (don't have that, because the certification doesn't exist in Arizona).

So when I was told about an administrative job (clearly not my ideal or anywhere near it, but I'm desperate!) with a company that provides mental health services, I looked into other jobs with that company on their website before the interview. Unfortunately, I didn't find any I would be qualified for. So I went to the interview for the administrative job anyway. And while there, they saw my experience and education and suggested I apply for a job title very similar to Mental Health Professional and told me that working in the job would help me get the MHP certification (at least a step in the right direction to finally open some doors after living here 3 1/2 years). I told them I either didn't see it on the website or realized I wasn't fully qualified for it. But the man interviewing me insisted I was qualified and suggested I apply. So I told him I would when I got home.

Looking at the qualifications for that position, I definitely didn't feel qualified. But I took their word for it and applied anyway. And they hired me. Why didn't I feel qualified? Well, they wanted someone with knowledge of basic nursing skills, including nursing interventions. And they said certification as a CNA or its equivalent was acceptable to indicate the nursing skills knowledge.

So when I showed up for my first day of on-the-job orientation, I wasn't feeling very confident about the job. And within the first 10 minutes, I knew I was not in the right place. The position is basically an orderly position. I finally got my hands on a position description and understood why the nursing skills part was important. In the job description there are lots of things I'm comfortable with or even would be okay with (although not ideal). However, the "collects stool, urine and other specimens, as requested, on assigned clients" was a HUGE red flag for me. Yeah. There's a reason I didn't go into nursing. And there was also the "assists clients with hygienic care" part I wasn't comfortable with. I'd been told that first day something about wiping adults' butts when they refused to after they used the facilities. I honestly don't think I could handle that. I also was offered a series of the Hep B vaccine, with a warning that I might be exposed to various diseases through contact with bodily fluids, etc (I'd been told people might fling bodily fluids at me). There's even a note on the job description that indicates I'd be working with bio-hazards such as blood borne pathogens, sewage, hospital waste, etc. Woah. SO out of my league.

I admire people who can do that sort of thing, but I know I'm not one of them. Besides, while the pay was decent, I don't think I should have to go to work and suffer doing things that make me want to vomit or otherwise repulse me (or even make me extremely uncomfortable) just for the sake of having a job.
Administrative work is sounding mighty appealing if this is the only kind of mental health job I can get.