Back from the ER: Ketones again!

[megs4413]

I went ahead and went into the ER this afternoon...it was an interesting experience to say the least...i don't appear to have GD (YAY!!!!) as my sugars were OK. I had moderate ketones in my blood which were helped by the IV fluids. It turned out taht the antibiotics i have been taking for my kidney infection just weren't working. They said my infection wasn't any better from when i was there last saturday so they switched antibiotics. i also had hypokalemia and had to have a potassium drip. i always feel 100 times better after fluids so i was able to eat this evening and it felt amazing! I hope that the pain subsides tomorrow or saturday and then i should be doing quite well. my kidney function tests were good so that's a big relief for me. i guess it was just the infection, dehydration, and malnutrition causing the trouble. they also got me a referral to the high risk OB's office and I should get an appointment some time next week (with any luck...). It was a productive visit, it's just too bad i had to pay the ER copay for it...thanks for all of your advice and support. I won't be seeing my old OB ever again!!!! I wouldn't even give them his name becuase i didn't want him called. i've had enough of him. I wonder how long it would have taken for him to find out that my kidney infection wasn't getting any better....can anyone say septic?



Some of you will remember the thread I started last week about my pregnancy woes and battles with dehydrationa and ketones in my urine. I ended up in the ER on saturday. I just got out of the hospital on Monday and am on antibiotics now for a kidney infection. They pumped me full of fluids so I haven't been so dehydrated. I have been testing my urine for ketones all along in this pregnancy (a habit from my last pregnancy) and decided even though i wasn't dehydrated today to go ahead and test to see how things were going. I got the worst result so far of this entire pregnancy. I'm wondering if it warrants a call to my doc, who is pretty much sick of me I think. I have no explanation for why these results came out this way and that's what has me most concerned. I'm hoping someone on here has some medical knowledge or RL experience that would tell me why i would be testing large for ketones just two days out of hte hospital where i was treated and recovered well. I'm sorry to post this here, but I'm really scared and dont know what to do. I have been in so much pain the last couple days and just really have no explanation...the doctor thinks it's nothign to worry about...but i don't know why he would think that without doing any diagnostic tests to make sure. Should I just go to the ER again? How am I going to explain this to DH?

[Tondi G]

First off call your doctor and tell them the Ketones results and see what they say! If you feel bad enough to consider going to the ER then GO! There is nothing to explain to your DH.... you feel awful and your doctor isn't helping you to feel better! Do what you gotta do girl!

~Tondi
Mommy to Mason 7/8/01 and Aidan 5/4/05

[Marisa6826]

At the risk of being blunt, Meg, you need to get yourself to the hospital. Kidney infections are NOT something to screw with. Not when you're a regular every day person, and CERTAINLY not when pregnant and dealing with HG. Your kidneys are under the additional stress of running the baby's blood through them, while they're already taxed, doing their regular job under less than optimal conditions (dehydration due to the HG).

Why should you even have to entertain explaining this to your DH? Does he really need a justification when you are doing nothing more than ensuring the health of yourself and baby?

Seriously, you need to stop sitting and contemplating, and get up and GO. You would never forgive yourself if something happened to your pregnancy.

-m

[ShanaMama]

I'm wondering if it warrants a call to my doc, who is pretty much sick of me I think.

Too bad on him- he's your doc for a reason!! I don't mean to be harsh, but I'm a little concerned that this would prevent you from calling.
I would definitely call the doctor. Maybe ask him for some guidelines as to when you should be concerned. My sister had HG with twins & was given very specific guidlines of what level is a concern. That might reassure you when it's borderline, but you'd know when to take it seriously.
I don't have any other practical advice, but I'm sorry that your going thru such a tough time- I hope things get easier soon.

[saschalicks]

Have no experience with this, but CALL GO. Doctors are there for a reason. There is no messing around here.

[deenass]

With regard to the dr, PLEASE remember, YOU are the PAYING customer and he is the provider. If you want to call his office 100 times this month with VALID health concerns, then you should do it or find another dr. If he is "poo pooing" what seem like significant situations then maybe you need another doctor.

I learned very recently through my own experience (something MUCH less serious than what you are describing) that if you think there is something wrong with your body, there probably is.

[egoldber]

You could be relapsing. The antibiotics may not be working. You could now have a secondary infection. You need to go to the ER. NOW. Seriously.

If your OB is "annoyed" by this, then you need to find a new one. You are paying an OB for their medical expertise, and they should be happy to provide it.

[megs4413]

well i talked to the doc and he said that i should call the office tomorrow schedule a 3 hour glucose tolerance test. I realized a few minutes ago that both times I got a really bad result that I couldn't understand...i had had a soda. The last time, I retested several times and got negative results so i couldn't undersatnd why my ketones were going from horrible to nothing in a few hours time without me doing much differently (except not drinking soda...) so I'm starting to think maybe he's on to something. I had blood sugar problems last time with DD but it was becuase i was getting my nutrition through a central catheter directly into my blood stream and I had to use insulin. I was accidentally injecting ten times the amount of insulin that i was supposed to. when they finally figured it out my blood sugar was at 30. I have wondered since then if i caused myself any permanent damage. i guess this is my answer....i will let you know how the 3 hour test goes.

do you think this is a reasonable course of action? i will retest my ketones tonight and make sure they went back down, but do you think there's a reason to pursue this further tonight by going into the ER?

Is it obvious that I don't feel like I can trust my doc? I will look into getting another one soon...but for tonight there's nothing I can do about it.

[mommyoftwo]

Megs, get thee to a doctor. It's just not something that you should mess around with. My biggest regret with my prenancy with Linnea is not going in to the ER often enough. I just hated to be a bother so I would suffer in silence which is just about the stupidest thing I could have done. If your doctor is tired of hearing from you, you need another doctor. I saw my OB every week for my entire pregnancy starting at five weeks. I was sick of seeing her but she was always wonderful and answered my questions over the phone all the time. She told me to never hesitate to call if I was worried about something. I hope you are feeling better soon. HG sucks!!!!!

[mommyoftwo]

Sorry, I posted before I saw your update. I would keep an eye on your ketones and see if they are going down. If they are, it's probably fine to wait until tomorrow if you are otherwise feeling okay. If you feel dehydrated, then I would go in to the ER.

[Saartje]

Definitely cut the soda. Period, 100%, do not drink it again until all of this is entirely resolved (and, given the problems you've been having, I'd strongly suggest not even drinking it again until this baby is born). One thing I learned from my MIL's years-long battles with kidney stones that at times threatened her life is that soda (of any variety -- it doesn't matter if it's sugar free, non-caffeinated, etc.) is HORRIBLE for your kidneys.

Other than that... I've got to agree with everyone else's posts here. You are WAY too reluctant to seek medical attention. Go find a doctor you can trust. If you even *think* about coming here to ask if you should go to the ER again in this pregnancy, go to the ER. Do not pass GO, do not collect $200, don't stop to check the computer, don't second-guess yourself, don't wonder how you'll explain to your husband. What is there to explain? You needed to go to the ER, so you went. Even if it turns out to be something that could have waited, it's much better to err on the side of caution than the reverse.

[mommyoftwo]

I couldn't agree more.

[megs4413]

boy i wish my DH felt the same way! He's trying...but he's not good with this stuff...he has a "suck it up" mentality....I'm doing what I can...but I don't have anyone to take care of DD while I jaunt off to the ER every couple days....it's become a real strain....I'll go into the doc tomorrow and in the meantime I'll cut out the soda! I do'nt usually drink soda at all, but I thought it might help my stomach (7up).

I can't promise I won't come on here before I go to the ER next time something comes up...i'm never quite sure what to do...at this point in my last pregnancy my kidneys began to fail so i was hospitalized...this time around has been so different, that I feel like I don't know what's "serious"....last time was so much more serious...i almost lost my life....i'm nowhere near that this time so it's hard to know how bad it really is..in comparison it's a cake walk.

[Saartje]

Megs, with your ketones where they are and reacting the way they are to the slightest stimulus, you are endangering your health and the life of your baby (even if your own life is not in danger this time) by not seeking medical attention. This is not a matter of just sucking it up because you don't feel well. If your DH tries to give you any of that crap in the future, have him give me a call and I will give him a piece of my mind. (I am entirely serious. I will give you my phone number if you PM me.)

Kidneys are a delicate thing, and they're very strained in your situation. I don't want to hear about you going into renal failure or something because you were so busy sucking it up, mmkay? :)

[kijip]

>Megs, with your ketones where they are and reacting the way
>they are to the slightest stimulus, you are endangering your
>health and the life of your baby (even if your own life is not
>in danger this time) by not seeking medical attention. This
>is not a matter of just sucking it up because you don't feel
>well. If your DH tries to give you any of that crap in the
>future, have him give me a call and I will give him a piece of
>my mind. (I am entirely serious. I will give you my phone
>number if you PM me.)
>
>Kidneys are a delicate thing, and they're very strained in
>your situation. I don't want to hear about you going into
>renal failure or something because you were so busy sucking it
>up, mmkay? :)

ITA! My brother did the same thing to my SIL (discouraged her from going to the doctor while in a complicated pregnancy) so I have little patience for that risky game. Take care of yourself. Take care of your child. You deserve your husband's support in this (getting to the doctor as needed) and I hope he comes around. But even if he does not, you still have to do what needs to be done.

[MeAndMyStar]

Hello, I know you don't know me and I don't want to pry, but do you have gestational diabetes or type 1 or 2? Just asking because if you do, testing your blood sugar is the first step in *preventing* your ketone level from getting out of control. I'm pretty sure high levels of ketones in the urine is a sign of fat metabolism which means your body is *starving* for fuel because not enough insulin is available to utilize the sugars you take in. You probably know this already, i'm sorry, but if you are not checking blood sugar regularly you should! Please call your doctor if you feel the need to. And don't feel the least bit guilty about it...it's your health and your baby's. Nothing is more precious than that!

-Sarah

[BaileyBea]

Hey Meg... XXXXXXXXXXXXXX I may be wrong though. I would ask her for a list of foods that may be contributing to your problem.

FIL, MIL, and my Mom all have kidney problems and my Mom also has diabetes. Besides the soda, they can't eat foods rich in potassium like Bananas. MIL can't drink tea or eat spinach.

When they cut these things from their diets they are much healthier. This may mean a very bland diet for the rest of your pregnancy. It's worth asking about those types of foods.

I thought of you and I am glad you went to the ER. Take care. I hope you feel better soon and most of all I hope you get some answers to help you through the rest of the pregnancy.

ETA. to remove reference

[megs4413]

uh oh! Bananas are one of the only things i've been able to keep down conistently! I've been eating them every single day!!!!

[megs4413]

well now i'm really pissed off. the doc told me to call this morning and get a 3hr glucose tolerance test, but the nurse in his office said the next opening they have is monday....i can't let this go to monday....what to do now? i called the insurance co. and found out that i dont' need a referral to go to a high risk OB (i had one last time but the OB refuses to refer me this time...) but the one i had last time is out of network....GRRRR....back to the ER i guess...

i don't have type 1 or type 2 as far as i know and i don't have GD as far as I know yet (to ansewr a PP). I don't have a meter anymore or else i woudl be checking my sugar all the time...i dont' know what i'm going to do now.

[elliput]

Megs -

Do these two things in this order - go to the ER now and then find a new high risk OB in network your insurance carrier should be able to provide names over the phone.

If I lived anywhere near you, I would be at your house and driving you to the ER. And I would be giving you a good tongue lashing because I give a damn.

What do we, as a community, need to do to convince you this situation has become dire?

[Saartje]

Seconded, Erica.

>Do these two things in this order - go to the ER now and then
>find a new high risk OB in network your insurance carrier
>should be able to provide names over the phone.

Megs, please do this.

[mommyoftwo]

Megs, this is getting rediculous. First of all, any lab can do the glucose tolerance test for you. All you need is a prescription. I had to get a fasting glucose done with both girls because my blood sugar was high and I just had to take my prescription in to the lab of my choice. Insist that your doctor write one for you and get it done ASAP. Next, you really need a new doctor NOW. I can't believe what you are dealing with. My OB would NEVER have let things go like this. I got appointments the same day when I needed them often as soon as I could get to the office. Your insurance company can give you a list of providers that are in your network. Finally, please get yourself in to a doctor or the ER today. I also would take you myself if I lived anywhere near you. I totally understand what you are going through and you need to get help NOW. If you have a church family, call someone from your church to get some help. Call a friend. Do whatever you need to do to get the help you need.

[egoldber]

Does the nurse KNOW that the OB said to come in today? Call back and push back. Do NOT let them tell you no! Tell the nurse if she is willing to risk you and your baby's life over not having an "opening" until Monday. That'll get her attention! You also can go to an independent lab and have it done although you usually do have to call ahead.

There has to be an in network high risk OB. But they do sometimes have wait lists for new patients, so call today! And if your ketones are still out of whack PLEASE go to the ER!!!!

[JustMe]

Megs,

I am so sorry the medical system is making things so hard for you. It must be so hard to be in pain, be scared, and have to fight for what you should easily get. I agree with other posters who say just make sure you get the care you need and deserve. Doctors and the medical system have a way of making us feel subservient (sp?) and unknowing, when many times we really do know that something different needs to be done for us.

Robyn
single mommy to a 3 yr old from Guatemala

[megs4413]

I did end up calling the nurse back at my OB's office. She said the reason she couldn't do it today was because you need to fast, but of course I haven' eaten since ten o'clock last night....which she scolded me for, but I take medicine in the morning that you can't eat with....what am i supposed to do? she said she is going to talk to the doc and call me back so hopefully they are going to get me in for the test today. I put in a call to the high risk office and am waiting on a call back from them. it's really hard to get into a peri, especially without a referral so I'm hoping i get somewhere with that. You all are absolutely right about this doc...my relationship with him needs to end...i will go to the ER if i don't get an appt with him today.

[mommyoftwo]

I'm glad you kept pushing the issue. Keep us updated.

[megs4413]

the doc's office called back and said that it could wait until monday...so i'm back where i started. i'm waiting to hear back from the high risk OB, but i think it's doubtful that they would be able to squeeze me in today. so i'm looking at the ER. i think i will call the high risk office back and explain that it's pretty urgent and hope that they can do something for me...if not i'm headed to the ER this afternoon...

[ShanaMama]

I really feel for you. Just when you want someone to take charge & take over for you, they are not pulling thru. It's hard to be so assertive when you feel so horrible & uncertain.
Just an idea- can you get any personal recommendations for high risk OB's from ppl in your community? It's crucial that you get to see one, but I would hate for you to go thru the same thing, dealing with a doctor that you don't 'click' with. You may not have much of a choice in the matter, but maybe a friend or even a nurse in the ER can recommend someone, so you don't get burned again.
Keep us updated

[MeAndMyStar]

Any doctors office that will have a problem *squeezing you in* for something of this nature sounds absolutely whacked IMNSHO!! Please get somewhere to at least have your blood sugar tested, even if they can't do a fasting one, it's a simple 5 minute thing! If BS is too low it could be disasterous. Hoping you can get some answers TODAY about this. BTW, if I were you I would do everything I could to find a new doctor that listened to my concerns and would not feel the least bit bad about it!

-Sarah

[mommyoftwo]

That's rediculous! I'm so sorry the doctor's office is being such a pain. Go to the ER if that is the only way to get some help. Maybe you can call your old peri and see if they have any recommendations for someone in your network. I'll keep praying.

[lisams]

You are doing the right thing. I cannot believe how non chalant (sp?) your dr. is being, especially since you just had a kidney infection and have a past history of problems.

I hope you're able to get the care that you and your baby *need*! Please keep us updated.

[chlobo]

Megs,

I agree with everyone else. Get to the Dr. Find a new OB.

Also, you can get a glucose meter at any pharmacy. Just ask the pharmacist which one is best for your situation. Most come with a rebate making them free. Don't forget test strips & lancets, as you'll need those as well. Testing blood sugar is really an easy thing.

And don't be fooled. Just because your last pregnancy was "dire" and you were in the hospital, doesn't mean this one is a cake walk. There could still be something seriously wrong. If your husband needs a lickin, send him over here.

[Sillygirl]

>Hey Meg... isn't Katie on the BBB a kidney Dr? I may be
>wrong though. I would ask her for a list of foods that may be
>contributing to your problem.
>

Since I've been mentioned by name directly, I'd like to address this. In the past I have offered general medical advice to posters on this board. I have tried to always be careful to emphasize that my advice is no substitute for the care of a physician with whom the poster has an established relationship.

Several months ago, and I want to emphasize this because it was not Meg's thread that triggered this, I decided that I would no longer offer any medical advice. I have been concerned about a number of instances where people are posting medical questions that are matters of some urgency, and they seem to be doing this INSTEAD of calling their doctors.

No internet board should serve as a drop-in ER. For all that most of you know, I could be a pimply 15 year old boy in New Jersey masquerading as a mom and a doctor. There are other doctor-moms that post here, and they may choose to continue to offer their advise and expertise where they see fit. I will no longer do so. If anyone feels that they need a nephrologist's advice that urgently, PM me and I will send you my clinic phone number. You can call and make an appointment.

[BaileyBea]

I'm sorry Katie... I apologize. I really didn't mean much by mentioning you. Very innocent mistake on my part. I edited to remove the reference. Please accept my apology.

[Sillygirl]

You have nothing to apologize for - I've never made my profession a secret, and I have offered advice in the past. When I realized people might wonder why I wasn't speaking up on a thread like this, I figured it was time to explain why. I didn't mean to give the impression that your post was offensive in any way; I just quoted it to give some context to my own comments.

[Alice523]

I am sorry that you are going through so much right now, especially with a young DD at home. You were smart to go to the ER and I'm glad that you got rid of the old doc. I hope you are out of pain soon!

[mommyoftwo]

Megs, I'm so relieved that you went in and got proper treatment. Please don't wait so long or second guess yourself again. I would write a strongly worded letter to your former OB telling him exactly what you think of him and his handling of your case. Sorry you had to go to the ER again but I'm glad you are finally feeling a little better.

[ribbit1019]

Hugs Megs! I am glad that you aren't in pain anymore and that you are getting a new Doc. :)

Christy
My Waterbabies
http://b3.lilypie.com/uVw3m4/.png
http://b1.lilypie.com/tbvhm4/.png
http://www.tickercentral.com/view/172x/6.png
http://img.photobucket.com/albums/v221/steitzsmith/Other/jump.gif

[maestramommy]

Megs, this is my first reply, although I've been keeping up with your post. SOOOOOO glad you are okay, and doing better. Good riddance to your OB!

[Saartje]

>I have been
>concerned about a number of instances where people are posting
>medical questions that are matters of some urgency, and they
>seem to be doing this INSTEAD of calling their doctors.
>
>No internet board should serve as a drop-in ER.

Katie, I just wanted to quote this part because it's been worrying me, too. (And no, Megs, I'm not just referring to you, either!) Well said, and I support your decision to not offer medical advice here, period.