Take my breath away...

Baby Girl takes my breath away. Quite literally.

Around midnight last night I woke up with the sudden sensation that I wasn't getting enough air in my lungs. No matter how deeply I breathed, I couldn't breath in enough air - it just wasn't satisfying. I consistently felt short of breath.

I got up, walked around. Sat down at the computer and tried to distract myself. Tried watching tv. Tried yoga breathing. Tried sitting up in bed to sleep. Tried sitting up in the living room to sleep. Tried laying on my left side. Laying on my right side. No matter what I did I couldn't satisfy my desire to take in more air.

Baby girl continued her usual late night movements - nothing abnormal. Nothing that felt different. I was taking in oxygen - it wasn't like I couldn't breath at all. But I couldn't breath deeply, and it really didn't feel like I could take a deep enough breath to satisfy my lungs.

After about 3 hours of this it started getting to me. I was exhausted, and frustrated, and by now starting to become a little anxious. And all the attempts to breath deeply were causing me to start to feel a little dizzy and tingly.

So I called my OB's office 24 hour nurse line. By now Tim was awake and trying his best to help me, but there really wasn't anything to be done. I described my symptoms to the nurse. No allergies. No history of anxiety or panic attacks. No history of asthma. No medical conditions. No medications except for the prenatal vitamins. No extraordinary physical exhertion earlier that day. No unusual activity. No complications with the pregnancy to date. No pain or bleeding or cramping symptoms. No apparent cause for what I was experiencing. After going through her procedures and protocol list, she ended up referring me to 911.

So we called 911. Went through the same questions and procedures. Took a while to get through it all because I could only speak so fast due to my breathing attempts. And by now my back was starting to hurt as a result of being strained while I tried breathing deeply. The 911 operator said she would send an aid car out to take a look at me. When I hung up they were already at our front door, quite literally. No sirens, thank goodness! They came inside, and checked me out. The good news - my blood pressure was fine. My pulse was fine. My lungs and breath sounds sounded good. My oxygenation was measuring 100%. I had good colour, and I was holding complete conversations with them
(if a little strained and slow) as I answered their questions. But because I am 30 weeks pregnant and clearly short of breath they asked if they could take me in for further examination at the hospital.

So I walked with them out our front door to the aid car. They pulled out the gurney and lowered the side rail and raised the head so I could sit down and swing my feet on board and lean back. They loaded me into the back of the aid car. Tim followed behind in our car.

In the ambulance they hooked me up to 100% oxygen, and continued monitoring my oxygenation via that little clippy thing they put on your finger and continued to check my vitals, all of which were normal (blood pressure was a little low relatively, but my blood pressure has always been that way, and never low enough to be diagnosed as low blood pressure - it's always been considered quite healthy).

4 minutes later we arrived at Stevens. Tim was there there waiting for me when they lowered me out of the back of the aid car and wheeled me into the E.R. The triage person came out to meet us. I was still short of breath but able to walk into the check-in room and provide him with my information for registration. He took us back to the ER room. The EMTs finished checking me in with the registration desk.

They took my vitals again, and also listened to the baby's heart beat. I was still breathing rapidly and still short of breath. The doctor came out and listened to everything. My lips and nose and fingers were tingly and he explained it was because I needed to slow down my breathing - that the release of the carbon dioxide was what was causing the tingly feelings. He had me concentrate hard on my breathing and slowing it down. The oxygen they had given me had helped a little with that as well.

The doctor explained possible causes of shortness of breath. In pregnant women especially, when this type of thing is experienced, they are concerned about the possibility of a blood clot causing the shortness of breath and inability to breath. He also explained though that if a clot was the cause, It usually would be accompanied by other indicators, none of which I had - eg lower oxygenation (mine was continued to be 100%); pain in my back or chest or legs (I had back pain but it was muscle strain due to my breathing attempts), lower or higher blood pressure (mine continued to be normal). But they wanted to do everything they could to rule out the possibility, so ordered a blood test that checks for a particular enzyme that can be a predictive indcator to a possible blood clot. If the test comes back negative, it is 98% indicative of no blood clot. However the test also has a 30-70% chance of coming back with a false positive. And under normal circumstances, if it came back elevated, further testing that would include radiation, would be required to eliminate a clot in my lungs as a possibility. However being pregnant those tests are not an option. However the first step was to have the blood taken and the test performed, and then we'd decide from there.

They took my blood - had to draw from my hand because my veins in my arms had been exhausted by my 3-hour glucose screening earlier that day (which had left me slightly bruised).

And then Tim and I settled into the ER to wait. It was around 4:50am when the nurse had drawn my blood and sent it to the lab for analysis. It wasn't until 7:30am that we got the results back. By then my breathing had improved, I was relaxed and my back muscles were no longer strained and causing pain.

The results did come back slightly elevated. Apparently anything less than .50 was the 98-100% predictive indicator of no clot. Anything higher was considered "elevated". My reading was 0.72. However the doctor had decided based on my presentation, vitals, and the fact that by 7:30 my breathing had improved, the tingling had subsided, and my back ache had eased due to my being able to relax, that anything less than a 1.5 he would treat as acceptable and not recommend further course of action that included radiation. However because it was elevated above a 0.50, and their hospital policy dictated that any pregnant woman over 20 weeks be seen by the on call OB after being discharged from the ER, I was sent upstairs for further monitoring, and for non-invasive testing via doppler to eliminate the possibility of any presence of a clot in my legs and tummy veins.

So Tim and I headed upstairs. The registration desk was waiting for us and we were placed in a screening room. I was put on a monitor that monitored our baby's heart beat, as well as my uterus for contractions. Interestingly enough they monitor did register contractions - my braxton hicks, which I've been experiencing pretty much daily now for several weeks.

The on-call OB arrived about 9am. she checked the monitor results. Because of the contractions that were showing she also did a physical exam to ensure I wasn't in early stages of labour. Which she confirmed I was not :-) She was able to tell that the baby had turned and is facing head down now. This explained the swift and direct kick to my ribs the other day, and she said could also explain an increased pressure on my diaphragm which could explain the shortness of breath symptoms. However she still wanted to have me undergo the doppler screening in my legs and tummy to eliminate the possibility of a clot at least there.

It was around 9:30am at this point. They gave Tim a coupon to go and get us some food and something to drink from the cafeteria while we waited. I was hungry. Tim was exhausted (he's actually been suffering a really bad cold the last couple of days himself, and not getting much sleep; plus he had to work today.

While we were waiting for the doppler tests, another couple arrived (I was in a semi-private room with the curtain drawn). We never saw them but we heard them. She was due last thursday and was in for a screening to check the baby's heartrate and for signs of contractions and early labour. She still had a week to go before they would consider inducing her labour. As it turned out, today was not "the day" for her - no signs of labour yet. She was scheduled to return next tuesday for more screening. It was interesting to overhear the conversations ;-)

Around 10:00am the ultrasound technician arrived to do the doppler screening. Everything checked out well. I was still breathing ok. Occasionally still needing to breath deeply and not able to fill my lungs, but nothing close to what I was experiencing when this all started. All we needed was the official clean bill of health from the doctor after examining the doppler results, and we could go home.

At 11:00am we were finally discharged.

The final diagnosis: Shortness of breath that was either being caused by the pressure on my diaphragm by Baby Girl possibly shifting, or possibly caused by anxiety/sudden panic attack (or a combination of both - not being able to breath as a result of Baby Girl's position relative to my diaphragm, which escalated into anxiety/panic attack). What I was experiencing was not uncommon and apparently something they see fairly regularly in the E.R. I was given instructions to take it easy the rest of the day, follow up with my primary care physician, and return if symptoms worsened.

And I've been following their advice. Taking it easy has consisted in staying home from work the rest of the day (although I did slog through work emails that had built up by 11:30am),and then napping soundly for about 4-5 hours to catch up on the sleep I lost as a result of this whole ordeal. I was exhausted. Poor Tim was moreso - battling a cold, not getting any sleep, and then getting in a 1 hour catnap when we got home before having to head in to work. He is my true hero.

So that was our adventure last night. Baby Girl - she's totally fine as she always has been. She's been squirming and kicking and doing her usual in-utero-gymnastics likely oblivious to her mommy's discomfort and overnight ordeal. As she should be :-) . They were quite impressed with her activity and responsiveness on the monitors in the hospital. We also got a very slight glimpse of her on the ultrasound when they were checking my veins around my tummy. And I am now fine, if a little tired and still feeling slightly challenged in my ability to fill my lungs to capacity, but nothing on the order of last night. And apparently shortness of breath is going to be the norm for me from hereon out so I'll have to get used to it.

I wonder what else is in store for me in these final 10 weeks!

---

Comments

Post a comment

Name:

Email Address (never shown):

URL:
Remember Me? YesNo

Receive email notification of further comments.

Comments: