When I arrived at the hospital they put me into the assessment room on the gynae ward fairly swiftly. The Dr came to see me but had to go off to a delivery briefly so it was about an hour before he came back and got me admitted properly. I was able to get myself a bit calmer by this point because I at least knew somebody was going to take me seriously. When the Dr came back he put in a cannula, took some bloods and started a bag of IV fluids to begin getting me rehydrated. I was still trying to hold out and not take anything stronger than Paracetamol so they gave me an IV dose as I was still quite nauseas. Just as long as a clutched my pillow and stayed on my back with my knees up I could manage.
Before too
long the senior Drs – Registrar and Consultant – came round and confirmed that
they would be admitting me and that they felt that it was likely to be Ovarian
Hyperstimulation Syndrome (OHSS). The
plan was to do an ultrasound, rehydrate me with a few quick bags of fluid and
keep those running overnight, get my pain under control and monitor my fluid
balance closely as one of the complications of OHSS can be kidney failure. I never thought I would be that glad to be
admitted to hospital but by that point I was just so relieved to be somewhere
where they could help me. Unfortunately
they weren’t able to organise the ultrasound for the same day as it was a bank
holiday Monday, obviously it would have been done if it was urgent but since
the scan wouldn’t have changed the management then it was reasonable to wait
until the next day for this. My blood
results at this point just showed that my white blood cells had gone up but my
CRP – inflammatory marker – which I though was usually raised in OHSS was
normal, the Dr informed me however that this isn’t always raised.
I forgot that
sometimes Drs don’t communicate everything with nurses so despite the fact that
I had told the Dr I had diarrhoea I was move to a bay with 5 other ladies. By the time I’d got my head together enough
to inform the nurse that I had had diarrhoea however I was then faced with a
long wait for a side room. In the mean
time I was fairly settled in the bay.
Matt went home to walk the dog and pick up a long list of things that I
gave him. While he was away a couple of
the sisters from the ward where I work came down to visit me. At that time I
was still resolutely trying to stand the pain for fear of taking anything stronger
than Paracetamol in case I was pregnant.
When they got there however they basically told me that I was being
silly, that the Drs wouldn’t have prescribed me anything that would be harmful
to any potential baby and that I should have some proper pain relief and
anti-sickness medication. This was of
course excellent advice and within half an hour of giving in to some oral
morphine and some IV anti-sickness (ondansertron) I was feeling an enormous
amount better and was almost acting like a normal human being when Matt and my
sister arrived. I think I’d just become
so tense and terrified that I didn’t realise just how much pain I was in until
it began to ease. I consoled myself by
knowing that while taking morphine wasn’t ideal, being super stressed wasn’t
going to do any potential pregnancy any good either.
The rest of
the first day was spent being rehydrated with 3lts of IV fluid, keeping a close
eye on how much urine I was passing to check my kidneys were ok and trying to
keep myself calm and comfortable. They
weren’t able to move me to a side room until 11pm but once I was in there I was
able to get settled down for the night and get a few hours sleep. I woke again at 1:30am and got myself into a
bit of a panic. With all the fluid I was
having I was just getting more and more swollen, my tummy was getting tighter
and tighter and even my back was swollen.
I was terrified I was going to go into kidney failure and just couldn’t
imagine how much more swollen I could get.
I went to see the nurse at the desk and just had a bit of a meltdown I
was so terrified. She was lovely and
somebody made me a cup of tea and she got the Dr to come and see me a reassure
me that I was having all the right treatment and being closely monitored. I knew exactly what she would say but
sometimes when you’re in such a state you just need somebody else to tell you
it. This helped to calm me down and when
she’d gone I had some more morphine and managed to get a solid 4 hours sleep
which is the most I’d had in days.
The next
morning is a bit of a blur, I passed the time just listening to radio, dozing and
playing with my phone and hobbling backwards and forwards to the toilet. I managed a very brief shower which made me
feel a little better but really took it out of me. They’d weighed me when I first came in and I
was 67.3kg, 3kg over my normal pre IVF weight.
The second day they came to weigh me, the plan was to weigh me and
measure my girth around my belly button every day to monitor how much fluid I
was retaining – and I’d gone up to 68.4kg and 92 1/2cm round the middle showing
just how much fluid I was retaining. I
hadn’t been weighing myself at home because I don’t have scales but I knew this
was now 4.4kg more than normal and my girth was getting bigger and bigger, I
don’t know what I measure round normally but I’d measured myself a few days
earlier when I was already quite bloated and I was 86cm so this was definitely
increasing significantly.
The Dr popped
in and took some blood but there wasn’t a lot for her to add other than carry
on with the IV fluids and wait for the ultrasound. I went down for the
ultrasound at about 1400 and wasn’t allowed to eat or drink for about 4 hours
before (I think it was meant to be 6 hours before but they didn’t tell me until
a bit late). I made sure I timed some
decent pain relief before I went because I was sure that somebody pressing on
my abdomen with an ultrasound was going to be painful.
Diagnosis
They did an
ultrasound of my abdomen and pelvis. The
ultrasound of my abdomen showed extensive ascites – fluid in my abdomen – with
quite a lot of fluid either side of my liver.
They also did an internal ultrasound which showed my ovaries were
significantly enlarged, they did tell me how big but I can’t remember now I
think they were about 8cm. I felt quite
distressed after the scan, in some ways it was good that it had confirmed the
diagnosis but at the same time it was quite terrifying to wonder what they
could do about it.
When I got
back to the ward I was rather frustrated as I’d been nil by mouth for the scan
but because the Dr hadn’t specifically said in the notes ‘can eat after scan’
the nurse wouldn’t let me eat, of course as she said I could have ignored her
but I didn’t want to blatantly go against her instructions. It was very
frustrating because it was the first time I was beginning to fancy eating
anything in days, the day before all I’d managed was some jelly and a little
bit of shepherd’s pie. What was even more frustrating was that the catering
staff aren’t allowed to treat you like an intelligent human being so they
wouldn’t leave me some dinner for once I’d spoken to the Dr. The consequence of this was that I had a
complete meltdown in front of a student nurse and the catering staff. It wasn’t so much about the food itself, it
was more that that was just the final straw, I felt so awful, I was getting
bigger and bigger, I wasn’t sleeping, I couldn’t get comfortable, I was
terrified about whether the condition would start to affect my kidneys and now
I couldn’t even eat or drink.
I managed to
pull myself together and the Dr came to see me and explained that the results
of the scan confirmed moderate OHSS and that the plan was to stop the IV fluids
now that I was rehydrated, carry on monitoring my fluid balance, carry on with
the pain relief, continue with anti-coagulants – blood thinners – and
compression stockings to reduce my risk of blood clots and if things steadied
out I could potentially be monitored as an outpatient. I had mixed feelings
about this information, while in some ways it was good to be reassured and I
knew that in the logical part of my brain it was all the correct treatment the
thought of being sent home was really scary as I just didn’t know how I’d cope
with the pain and discomfort.
Not So Restful Night
That evening
they moved me again to another side room as the one I was in really belonged to
the obstetric side of the ward and they needed to move me back to the gynae side. While this was a bit of a pain I didn’t
really mind as I know what it’s like trying to juggle beds and the new room was
actually nicer than the first. That
night I was a bit stressed as I was worried that the Dr would turn up the next
day and send me home. I managed to get a
bit or sleep to start off with however when I had a couple of very
unsatisfactory tiny wees of only about 30mls of dark urine the nurse, and me,
got a little bit worried about my kidneys. Since they didn’t want to start any
more IV fluids they kept waking me up every hour or so and making me drink a
few glasses of water. As difficult as
this was it did work quite nicely and onne they were happy things had steadied
out I got a solid 4 hours or so sleep.
The next
morning they weighed me again and I’d gone up to 70kg and 94.5cm meaning I’d
put on a total of 2.7kg since I was admitted, 6kg (nearly a stone) over my
normal and grown 2cm since the day before.
This was of course all the fluid that I was retaining in my abdomen –
when I looked at my fluid balance for the past few days it showed that I was
4lt positive over 2 days, this means I’d had 4lts more in than I’d passed out
and it was all sitting in my abdomen.
The problem with OHSS however is that you still have to keep drinking
really well because the fluid is all in the wrong places meaning that if you
don’t keep well hydrated the fluid leaves your circulation and goes into your
abdomen leaving your circulating volume dangerously low and meaning your blood
can get very thick and sticky and at risk of blood clots.
As they’d
hinted about managing me as an outpatient I was terrified all that day that
they were going to just come and tell me I could go home. I really didn’t want them to send me home
when my size and my weight were still going up significantly, I just couldn’t
see how I could get any bigger and was still scared I might start to get more
complications if I continued to expand.
As it happened however the Drs didn’t come round to see me until about
5:30pm which suited me quite well as I didn’t want to go home that day and they
couldn’t send me home that late. When
they saw me they informed me that my bloods were still ok and that I still
fitted into the ‘moderate’ category of Ovarian Hyperstimulation as I hadn’t
developed any of the nasty complications.
This was good to know however believe me, nothing felt moderate about me
situation, I was enormous, a stone over my normal weight, in pain, short or
breath and unable to take deep breaths.
The plan from
the Drs was to keep me in one more night, continue to monitor my fluid balance
for the moment, see if I could manage going from the oral morphine onto codeine
to control the pain and if everything was steady in the morning to send me
home. I was happy with this by this
point, still scared of going home because I’d been in such a mess before I came
in but I knew I was starting to get things under control now. That night I slept quite a lot better, I think
I got 2 solid blocks of about 4 hours which was the most I’d had in a long
time. The next morning when they weighed
me I’d stabilised at roughly the same weight and girth which was
reassuring. I managed on just codeine and
oral anti sickness medications overnight which was good so I felt ok about
being discharged home and the plan was to bring me back in 2 days later for
further blood tests.
All in all my
experience of being in hospital was not one I’d wish to repeat but at the same
time I was so thankful to be in hospital and being looked after and monitored
after having such a horrendous few days at home. So Thursday I packed up my things which took
an enormous amount of effort and waited for my medications to take home with
me. Matt was at work so the plan was for
my Mum to come and pick me up and stay with me for a few days. We got home by about 4pm and got settled in,
there’s more drama to come but I’ll stop this post for now for fear of sending
you to sleep with my rambling.
To be
continued…
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