Thursday, March 10, 2011

The Doctor's Orders, part 2

The night before last, my son asked for some kombucha with ice to drink with his dinner. When I gave it to him, he took a sip and then pushed it away. "This," he said, "is not good for my tummy." I should have listened.

The thing about three-year-olds (well, one of many, many, many things that I could tell you about three-year-olds) is that they make a great number of statements - like "Yesterday, you make me cookies," or "This is a choo-choo train," or "I'm clean already, I don't need a bath," or "I don't like vegetables" - that are not true and/or can be safely ignored. So I didn't pay much attention to his kombucha comment, despite the fact that I knew the bottle had spent a fair amount of time out of the fridge. It bears repeating: I should have listened.

The next morning, I drank half of the remaining kombucha. Within a couple of minutes, I started feeling oddly gassy; within ten minutes, I was writhing on the sofa, in the grip of the most painful abdominal cramps I have ever experienced outside of post-AROM labor. Indeed, if I did not have so much experience with birth, I would have thought that I was in labor. As it was, I spent a few minutes attempting to use some labor coping techniques - the old-standby breathing, vocalization, movement, and positioning strategies - to manage the pain, but it was no use. The cramping worsened and persisted. I began to think I was going to die.

So I called my husband. I always call my husband when I feel like I am going to die, even when it is obvious that he is the absolute wrong person to be calling. This is because he is really the only person from whom I feel truly comfortable asking for assistance, even when he clearly will not be able to provide it.

"My stomach," I groaned to him. "My stomach is cramping. I feel like I'm going to die. I don't know what to do."

"Okay," he said, feigning infinite patience, "you need to CALL YOUR MIDWIVES ABOUT THIS."

"Right," I groaned, "my midwives. Okay."

So I hung up and dialed my midwives' emergency number. My main concern, besides the fact that I felt guilty for imposing upon them and calling so much attention to myself, and besides getting them to tell me how to make the pain stop, was to make clear that I was not having uterine cramps or going into preterm labor. If they thought I was in preterm labor, they would make me go to the emergency room, or worse, come over to check on me, which would make me feel really guilty, even guiltier than calling the emergency number made me feel.

"I'm sorry to bother you. I have awful abdominal cramps," I said between groans and gasps, when my Midwife M answered the phone, "BUT IT'S NOT MY UTERUS. I'm in so much pain, BUT I CAN TELL IT'S NOT LABOR. My whole abdomen is tight and distended, BUT IT'S NOT MY UTERUS. I'M NOT IN PRETERM LABOR. IT'S CRAMPS IN MY TUMMY, NOT MY UTERUS. But it's really, really bad. Please make it stop. Sorry to be a bother."

"Okay," said Midwife M, after asking some clarifying questions that I mostly answered by telling her that it wasn't my uterus, "I want you to heat up your heating pack and put it on your tummy while you draw a bath, as hot as you can stand. Then get in the tub, with your tummy in the water, for at least thirty minutes. Then call me back."

I crawled to the kitchen and then to the bathroom to follow Midwife M's instructions, groaning like a dying animal all the way. And now I want to tell you something about hot water on a bad tummy. IT WORKS. Why does it work? I have no idea. In my Certified Lactation Counselor training, we were taught that water, whatever the temperature, contracts myoepithelial cells (smooth muscle tissue), which is why it is the correct treatment for breast engorgement during lactation. Is this the same mechanism that made the bath work for my tummy? I don't know. All I can say is that, the moment I got in the tub and began pouring hot water over my tummy with my son's red plastic sand bucket, the cramping released like magic. As long as I kept my tummy in the water, the intestinal distress disappeared. After about thirty minutes, I cautiously emerged from the water, dried off, clapped the hot pack back on my tummy, and went to lie down on the couch. I felt weak and nauseous and hideously unready for any actual eating, but the pain was completely gone.

All I could think was, Why didn't anyone tell me about this? How did I get to the age of thirty-two without ever learning that hot applications, particularly hot water applications, are a good remedy for stomach aches? It seems mind-boggling that I never knew this, and that if I had an obstetrician rather than a midwife, I would probably still not know this. It is mind-boggling, too, that I am currently receiving the best, most meticulous medical care that I have ever received in my entire life - from two home birth midwives (a CNM and a CM) and a heavily tattooed, fatally forgetful acupuncturist. There is something profoundly destabilizing about this realization. I mean, what kind of world (country? region? state? city?) am I living in, that I have arrived at proper medical care only via a combination of luck, personal curiosity, and slightly off-kilter lifestyle choices? I mean, what if I were not so lucky to have met certain people and had certain experiences, or not so inclined to research things on my own, or not so foolish as to routinely make life choices that leave me penurious and somewhat culturally isolated? Would I then not deserve proper medical care? Or would I simply never know that I wasn't receiving it? Would it even matter, as long as I felt satisfied? Truly, these are deep waters, and, for now, today, not ones that I am willing to take the full soundings of.

All I can say is that if I had the medical care that is standard for this city (state? region? country?), one of several things might have happened to me yesterday. I might have been directed, in my shaking, gasping, groaning state, to somehow crawl to a doctor's office and then a pharmacy. I might have been condemned to simply wait it out, writhing on the couch for the day and calling someone in the morning. I might have been commanded to go straight to the ER - after all, a preterm pregnant woman complaining of abdominal cramps is no laughing matter. But instead of any of these things, I got to take a long, hot bath, and then curl up on the couch, damp and warm in my bathrobe, to sleepily sip lukewarm water and nibble crackers, watching movies on Netflix until my husband and son came home.

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