Friday 1 July 2011

OHSS after IVF - Bloating stomach and paracentesis

When I was admitted I never thought I’d spend so many days here.. Anyway, I am still here. In the first few days here I could not completely believe it that I was really pregnant. It is only when the sisters who come on a regular basis to check my vitals take a look at my file and comment something like ‘Won’t the baby be hungry? You should eat something, no?’, that I actually believe that I might indeed be pregnant. I befriended most of the nurses, especially the head nurse SisG, who is about 30 and the mother of two school going kids. She had passed IELTS and had a UK work visa but somehow could not go. This made me respect her even more. The other nurses were also quite friendly and helpful except for a few. I spent my days watching the variety of patients coming and going from SICU, and their behavior. They watched me curiously from a distance because I looked so much at home sitting and walking and calling nurses by their names and talking to them and laughing and all. My mind was numb because I did not want to think about all the work I had to do, especially regarding my course, job etc.

A second paracentesis was needed the day after I got admitted itself, that is the very next day after the first tapping, on 26th. This was done in the afternoon, 3 pm, I think. In the morning when DrTC came, he checked my Beta HCG and said there is a high probability that I have twins. It had become a routine to look forward to the blood test every day morning, and to see beta HCG count mounting. I felt thrilled at the prospect of having twins, but doctor warned me against over hopefulness. When I was taken to OT for tapping in the afternoon, plasma IV was given along with saline. During tapping my body started itching, as if I was being bitten by mosquitoes. I complained many times to the doctor that mosquitoes were biting me in the OT during tapping. Now that I think about it, it is to their credit and the way they cared, that they did not laugh at me, though the doctor just said that OT is free of mosquitoes, even free of bacteria. Then I realized the stupidity of my complaint, and rephrased it to say that I feel allergic to the bed sheet. Then my body started swelling here and there, and DrA, the young and cheerful general physician who was in charge of the IV said that it was an allergic reaction to plasma.(I didn’t feel one bit conscious of the fact that a handful of people, men and women, mostly of my age group itself, were present in the OT during tapping. I had not felt any awkwardness even before, when I was having ovum pick up or embryo transfer. They were all very professional, and I did not feel any more embarrassment than I would have felt if they were looking at my hands. I noticed that DrA turned away when the nurses pulled the sheet from my legs to start tapping, and I assumed that he must have joined recently, and might not come often to see this kind of procedure. On the other hand during my treatment with DrTC, he rushed to the OT one day saying that he wanted to see a particular delivery in progress because he wanted to watch a particular gynecologist at work. These young doctors shared their knowledge, and shared the opportunities they had to learn new information from each other’s case patients). That day also, the painful part was cleaning the pelvic area. Everything else went well, and approximately 3 liters of fluid was drained. At one moment I laughed at some joke someone cracked, and jerked slightly, and felt something sharp against my skin: 'shh don’t move', said DrTC, and I saw him look at me with sudden concern. (I don’t know if my skin was cut, or if something else happened,  but later in the years that followed, whenever there is a brief but sharp pain in the pelvic area, I regret that moment).

After the tapping I was brought back to SICU and DrA gave me an Avil injection for the plasma allergy. Drowsy darkness washed over me, such intense sleep, that my eyes were instantly shut from the effect of Avil. Rght then my parents reached from Alappuzha. Amma came to see me at SICU. My eyes kept closing, my body was still swollen, and I was tired from the tapping. Amma got really frightened seeing me in that condition. I told her what the doctor said in the morning- about the possibility of twins. I expected her to jump with joy, but she remained unhappy and worried about me.  She said that Ramesh had already given the news, and that he was really excited and happy. Then she left and I slipped into a sort of coma. 

The next tapping was done two days later, on 28th noon time. I was determined to get two days between the tappings, like the doctor said, and I barely got it. He had instructed me to exercise slightly by walking a little, and every day I walked as much as I could inside SICU. At least one hour each every morning,evening and night. Besides this, when there was no one to occupy the bed on my right side, which was at the far end of the nurses station, I used to go behind the curtain there and jog and jump slightly, just to reduce the heavy, full feeling in my stomach. In order to stop the IV saline I started drinking 5-5.5 liters of water daily, including tender coconut and my daily couple of cups of tea. However try as I may I could not get myself to eat the egg whites. Hospital canteen had good rice gruel, and I forced it inside. I hate gruel, however good. All this effort had only one aim- I desperately wanted to get discharged from hospital before 8th July, Friday, and reach Chennai before 11th, when classes would start, since I could not afford to break the course. My mind was set upon release. I had no idea how silly I was to even faintly assume this possible. Thus the days in SICU were hard work, sincere, tough effort both physically and mentally, to get over OHSS. SICU was not very strict in my visiting hours unless there was a patient who needed solitary care, and I had four visits every day-Ramesh came every morning and night with breakfast and dinner, and mother and father came every noon and evening with lunch and tea. The food smelled delicious each time, with mouth watering mango pickle, but my taste buds were not functioning. So I just smelled the food heartily, tried to eat mightily by reading Archies and Balarama and all (for which DrTC and DrA regularly teased me saying that this is what they teach at Engineering Colleges), but still everything tasted bad and worse, my stomach could not take anything in. The nurses’ company was good fun, DrTC came twice everyday (including Sunday when he came with his new wife- a pediatrician), still I felt lonely and just wanted to get back home somehow, and move on. May be, if it was not my QIP course period, but my vacation during college, or leave during college/office, I would not have minded the stay, probably would have even enjoyed all the attention, but that was not to be.

Today (30-6-11) when doctor came, he was ready for the fourth tapping. I was taking my regular walking exercises, and I thought he would appreciate that. He did not, and he even looked a little concerned about the way I was exerting. I said I don’t need the tapping and he suddenly looked skeptical. How come you are all right so suddenly, he demanded. Then he checked and understood that it was not that the fluid was not there, but just that my body was adjusting to it, the strain was still there inside the stomach. He checked beta HCG also and was satisfied and left. Later I asked SisG to inform doctor that I felt heavy and would like a tapping. Doctor came, checked and said that we’d wait for a few hours, and if the heaviness lessens we would not tap, let’s not introduce foreign stuff into the body unnecessarily. The heaviness and bloating was not my imagination, it was very real, he said. But because my abdomen muscles were strong the girth of belly was not increasing beyond a limit, and that did not mean that the strain was not there. However it was best to wait for some time. So here I am, waiting to see how it will all go.

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