So, my appointment was Tuesday at 5:30 pm. I was taken back and the usual work up was done by the assistant. Then the optometrist, Dr. Bonds, came in and first tried to correct my vision without success. I was seeing 20/40 out of the right and 20/20 out of the left eye. Before looking in the back of my eyes, she mentioned that she thought it may be the same retinal problem I was thinking. After she looked in my eyes, she informed me that it was definitely not the retinal problem because the retina looked great, but instead that I had a lot of swelling in the right eye, the vessels looked very irritated and the optic nerve was swollen. She called in another optometrist and after he looked in my eyes, he seemed very concerned. He was very honest and said that they needed to do a visual field test as well as other testing. So, during the visual field test Dr. Bonds came in and asked me who my OBGYN was and if I had her phone number. I handed over that information and proceeded with the testing. Once I was taken back to the exam room she came back in and told me that they had called the OB on call as well as the neurologist at the hospital and felt that I needed to go to the Emergency Department for an MRI as well as some lab work to rule out any type of tumor or giant cell arteritis that could be causing the swelling or ocular neuritis. So I texted one of the doctors I work with, Dr. Hemstreet, and asked him to call the ED for me to try to expedite things, which he of course agreed to do. So off to Druid City Hospital Emergency Department I went.
When I arrived at the ED at 7:30 pm, it was jammed packed with a six hour wait. I registered at the desk and they took me directly back to a triage room where I was triaged within 5 minutes, and then back in an exam room within another 5 minutes. Talk about service. I got tickled when the registration clerk came in my room and kind of looked me up and down and asked puzzled if I was in an accident or injured. I told him no. He said, "Well I am trying to figure out why they have you as a Category 2 which is the highest acuity category you can be unless you are receiving CPR." I just chuckled and explained to him that one of the doctors I work with called ahead and talked to Dr. Posey, one of the ED docs. Thank the Lord for Dr. Hemstreet.
After being in my room about 15 minutes, Shane showed up with his backpack full of study material as well as snacks. It just so happens that my timing is impeccable because he had two tests scheduled for Wednesday, each being in his more difficult classes. I hated that he had to spend his time in the ED with me instead of studying at home. Within 30 minutes Dr. Posey came in to see me and took a history and then ordered the MRI as well as lab work. He explained to me that with optic neuritis there is a strong association with MS (multiple sclerosis). He said that this is one of the first signs and how people figure out that they have MS. They were looking for lesions on my brain as well as any type of tumor. Shortly thereafter, a very sweet RN (who is also pregnant) came in and started an IV and drew some blood. Within minutes the MRI tech came and took me to get an MRI/MRA of my head. That was a very interesting experience. It was very loud which must have startled Camden because he was very active during the whole 20 minute test. But the MRI tech was very personable and nice and I appreciated the time he took with me. I was taken back to my exam room afterwards at which time I was able to eat the snacks Shane brought me, but I didn't eat them all because I was ready to eat a good supper upon our discharge. Within 30-45 minutes Dr. Posey returned to tell me the MRI was normal. YEA!!!! But the bad news was he needed to do a spinal tap to make sure that I did not have increased intracranial pressure and also to obtain spinal fluid to send off for further testing, including an MS profile and that they wanted to admit me for further neurological testing by Dr. Lucy (a neurologist) as well as probably start me on IV steroids. Now I was not a happy camper and extremely concerned. I have worked in an ER and know all about spinal taps and that is one of the many things on my list that I never wanted to have done to me - mainly because I just don't like the idea of someone sticking something in my spinal column. I questioned him about who was going to do it and he had informed me that he would be the one to do it. Again, I was leery, but up to this point I did have a good feeling about him and appreciated his honesty with me as well as his bedside manner.
They moved us to a different exam room and within 15 minutes Dr. Posey came in with a nurse and explained the spinal tap to me and had me assume a fetal position, which I must admit is not easy with a baby in your belly. But whatever I needed to do so that he could successfully do the spinal tap with one stick, I was willing. He talked me through the whole procedure, and to be very honest, it was not bad at all!!! He was able to measure my pressure right then which was right where it should be. He told me afterwards that he was actually going to send me to radiology and let them do the procedure under fluroscopy, but knew they would not check my pressure and if you want something done right to do it yourself, so that is exactly what he did. Sounds just like my father, so once again I was reassured!! The other thing I learned while sitting and listening to the nurses in the hall, was that Dr. Posey was to leave at 11:00 pm and it was 11:15 pm when he did the procedure, so he actually stayed over to do the procedure!!! Also, as he left the room, he requested that I call him on Wednesday after 3:00 pm when he returned back to work and let him know how things had turned out. What does that tell you about him? Another point for him!! So I was told to lay flat for 40 minutes or so to let the area clot off to help prevent the dreaded headache that can occur after a spinal tap. I did just that and after about 45 minutes they came to get me to take me up to my room on the OB floor.
At about 12:00 am we ended up in the room and I was greeted by two wonderful nurses. Once again I was tickled because the RN's name was Warreen (who while she was pregnant craved seafood and always ate ice cream with shrimp on it) and the LPN was Classie. They were just great. I told them both I would be looking for them upon my return in February. They were baffled as to why I was there, thinking that I must be having problems with my pregnancy, and were intrigued that I was there due to an eye problem. Even so, they were interested and eager to learn about my diagnosis, as was the other nurses I had throughout the day. I was really concerned about Shane getting home to get some rest prior to his two big tests, but when the nurses asked him if he was staying, he talked to them like he was going to go home and let out the dogs and come back. After they left the room, I told him he had to go home and stay home because if he did what he had planned, he would be lucky to have even 2 hours sleep before his tests at 8:00 am and 10:00 am. After the nurses came in and out to get things situated and bringing me some chocolate ice cream and graham crackers (since by now I definitely missed the supper I thought I was going to eat upon discharge), I convinced Shane to go home and stay there. But bless his heart, you could tell that he did not want to leave. He probably stood there with his back pack on his back for thirty minutes before he finally left at about 1:10 am. Around 1:20 am, the OB doctor on call, Dr. Poist came by to see me and told me that the neurologist would be in to see me later that day, that it was really out of the OB realm.
I was able to sleep from about 2:00 am to 6:00 am with only a few interruptions. Warreen came in about 6:15 am and gave me a menu and told me I could order whatever I wanted from the cafe for breakfast. She was aware that I have been loving breakfast food while pregnant and recommended their omelets. So at about 6:40 am I called and ordered a bacon, cheese with tomato omelet, a biscuit with gravy and grits. It arrived within 30 minutes, and I must say was very good, especially the biscuit with gravy!!! That morning, the cardiologist I had texted, Dr. Hemstreet and Jeremy, his CRNP, came to visit, as well as another cardiologist I work for, Dr. Lewis and John, her CRNP. It meant a lot that they came by to check on me. When Dr. Hemstreet was there, he asked if I heard anything from Dr. Dipiazza and informed me he thought she may be on vacation because he had not seen her car in the parking garage in a week. Shortly after they all left, one of the other OB doctors came and checked on me so I figured that Dr. Hemstreet must be right about Dr. D.
Up to this point, I had been really doing well, but after I was left alone that morning, I had a huge meltdown. All I could think about was that somehow the steroids they wanted to put me on would affect Camden and as a mother you do everything to protect your child and now I may do something to harm my child. Luckily as I was having my meltdown, Lorrie (one of my dear friends from Houston) called and she was able to look on the internet and tell me all about ocular neuritis as well as how that and MS are related. It helped give me a grasp of the whole situation and let me really think things through so that when the neurologist showed up I could have my questions in order. Also, with the information she gave me I felt like I could be more specific with my prayers since I was really at a loss. Amazing how God works!!
Well, much to my surprise, Dr. DiPiazza showed up around 9:15 am. I was so relieved to see her because I trust her completely. She told me that they would probably want to start me on steroids which would definitely be fine at this point in my pregnancy and not to worry. She asked me how I was doing and I told her about my meltdown and she was very comforting. I could see that she too was concerned and as of yet the spinal fluid results had not yet come back, but she did know that the MRI showed no lesions which was positive. I had told her what Dr. Hemstreet said about him not seeing her vehicle and she laughed and said that she had gotten a new car - a convertible Mini Cooper!! That so fits her. She said it is very different from her hand me down Exterra she had and that her children, age 14 months and 5 years old were very close to her now in the Mini Cooper. Too funny!!!
Shane had emailed all of his professors the night before and informed them of the situation that was going on. He emailed his 10:00 am professor (which was his second test) and asked if he could take it earlier. He never did hear from him and stayed at school till about 9:30 am waiting to take the test and when the professor never showed up, he headed to the hospital. He knew that this particular professor would not have a problem with him taking the test later. I was surprised to see him that early, but very glad he was there. We both took about an hour nap or so and finally a little before 12:00 pm the neurologist, Dr. Lucy, showed up. He asked me a battery of questions and did a very thorough neuro exam on me. He probably stayed in the room 20 minutes or so and then said he was going to go review all the tests that had been performed up to this point and then would return to talk to us about everything. While he was gone, two of my coworkers, Sonya and Cheryl, came by to visit which was nice. Not too long after they left, Dr. Lucy came back in and told me that he had reviewed all the tests and there were definitely no lesions on the MRI and the blood tests were fine. Three of the four spinal tap results had returned, which were good, but the MS profile would take about 2 weeks to receive the results. He had done further research on optic neuritis and had looked at the different studies as of how to treat it with high doses of steroids IV for four days and then oral Prednisone for two weeks thereafter. He said he had talked to Dr. D and she was in agreement with the steroids. The studies show that someone at my age has a 50% chance of developing MS within 15 years due to the optic neuritis, but there is a decreased chance with taking the steroids. He did say that he is very conservative and does not even like to give Tylenol (which I so appreciate because I am conservative in that respect also) but if I was his wife or daughter, he would recommend taking the steroids. He said that he would hate for five years down the road for MS to show up and me wonder "what if I would have taken the steroids." I questioned him about if my vision would improve and the studies show that some do and some don't, but he thought it would improve. Before leaving he told us a lot about MS and how treatment had improved so much in the past 25 years he had been practicing and if I did ever receive that diagnosis not to think that I would automatically end up in a wheel chair. He was very matter of fact and informative, which we both appreciated. He told us to think about everything he had said and he would go ahead and write the order for the steroids as well as an MRI of the neck to make sure I had no lesions since MS lesions can be in the head or neck and leave me the material he had researched about all the studies regarding treatment for this. He said that if I would like to talk to Dr. D before I decided that would be fine too. After he left, Shane and I decided to proceed with the steroids and it wasn't 15 minutes later and there was Dr. D. She was so excited that it did not appear to be MS - she was very concerned about that. She again reassured me that it was fine to take the steroids. She said the only side effect to the baby could be a cleft lip and palate, but that is completely formed by day 56, so that should not be a worry since I am well beyond that. I asked her if I could go back to work and she told me I needed to wait until Monday. I asked her if I could go to the football game on Saturday and she told me no!! UGH!!! I didn't want to miss a game. She told me that I would probably not feel well at all on this high dose of steroids and may have nausea. She said I would likely gain weight, that she had a friend who gained 15 lbs on this regimen and that my appetite would increase. Boy, everything I was so looking forward to!!! ; ) In the meantime, our pastor, Jon Quitt, and associate pastor, Jonathan Cook came by and visited and prayed with us. Amazing how news travels (via Facebook I am sure). I appreciated their visit more than they could imagine!
So they came to get me for the MRI and at that time Shane left to go take his truck home and have a friend bring him back to the hospital so he could drive me home. When I got to MRI there again was the same MRI tech from the night before, Michael Allgood, and come to find out, he is the son of one of the sweetest RNs I work with. He got his personality honestly and I was glad to see him again! After the MRI, I returned to my room and the lab tech came and drew the lab, and then my nurse came and started the Solumedrol IV as well as gave me my discharge paperwork. The case manager came in and got my infusions set up for home and before leaving the hospital I had already spoke with the home health as well as the infusion therapy nurse who would be arriving to the house upon our return to instruct me on how to give myself the infusions. Right before I left, Dr. Bonds (the optometrist) called to check and see what all they found, and I did call Dr. Posey and gave him an update. I told him that I would not get the MS profile results for 2 weeks, and he asked if I again would call him and let him know how they turned out. (At this point I have decided that I must be a freak of nature since they are all really anxious to find out the findings and end results!)
We left for home and arrived at 5:30 pm. On our drive home, Lorrie called to tell me that she stays in touch with a pathologist she worked with in the lab and his wife happened to be a Neonatologist. Now Lorrie had spent the whole day on the internet researching ocular neuritis as well as MS and was concerned about me receiving the steroids. She actually had the opportunity to talk with the neonatologist who reassured her that what they had planned was the right regimen and she had never seen any adverse effects to a baby from this. She states that I was at the best part of my pregnancy for this and if I had been closer to 32 weeks or so, they probably would not have given me the steroids. So, all things seemed to be pointing in the right direction. By 6:00 pm or so the infusion nurse showed up and I had him go ahead and move my IV from my right hand to my left forearm so that I would be able to better maneuver the infusions. I was given the orders of giving myself infusions of a high dose of Solumedrol every 6 hours through Sunday, and then I would change to Prednisone by mouth for 14 days. The nurse told me he was concerned about the high dose I was receiving due to my pregnancy, but his wife has been a neonatal nurse for 32 years and he called her and she reassured him that was the proper dosage and it would be fine, so he felt much better about it. Once again, good confirmation!!
I decided that I would put myself on a 10 and 4 regimen so that I would only have to get up once in the middle of the night to infuse myself. Since then, the infusions have gone well. I have not had any nausea or really felt bad. Although, I do think it has increased my heartburn. Also, Camden is very active after the infusions are complete, which to me is not surprising. This morning the home health nurse came to draw my blood because they have requested that my electrolytes be checked daily while I receive IV infusions and then once a week while I take the Prednisone my mouth. UGH!!! I do believe I am already tired of being stuck. At 2:30 pm today I attended an appointment they set me up with an ophthalmologist and after a full dilated exam he confirmed everything we knew and wanted me to follow up in 2 weeks. My vision did improve to 20/30!! When I asked him if my vision would return fully, he said he thought it should, but there was a chance it would not be as clear. I am also to follow up with a neurologist in 2 weeks, but it will not be Dr. Lucy because he is just a neurologist in the hospital. Since my hospitalization, I have found out that all the doctors I had were the best there is from Dr. Posey to Dr. Lucy. I must say I had an awesome experience which I was not expecting from the stories I had heard from many of my patients.
How you will find me receiving my infusions at 10 am, 4 pm, 10pm, and 4 am!
How you will find me receiving my infusions at 10 am, 4 pm, 10pm, and 4 am!I know that God has had a hand in every bit of this and I realize even more that all of life's experiences prepare you for what will come in your future. I worked for an ophthalmologist all through nursing school and my first job out of nursing school was for an ophthalmologist who owned a surgery center and we did eye surgery. One of my greatest loves has always been eyes and I would love to work in that field again. Also, I worked in an emergency room and was very prepared for what I was in store for. I believe that all these things as well as my relationship with the doctors I work for helped me with this whole experience and am grateful for everyone that was involved in my care. I really don't think this experience could have been any better. I am also so grateful for all my friends that have been praying for us and continue to pray for me and the health of Camden. As we all know, prayer is a powerful tool!!!
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