Tuesday, March 1, 2011

Bed Rest

I've been faithfully following fellow blogger TJ's postings about her pregnancy. I'm addicted to her writing style. While reading her accounts of being put on bed rest and other pregnancy adventures, I found myself wondering: Would I have gone on strict bed rest? I mean, I did trek cross country at eight months pregnant to see Damm after six months apart. Against doctor's orders, I might add. It got so bad with my doctor that I threatened to wait until I went into labor to grace the hospital with my presence. I don't do confrontations like that over the phone. It was quite unnerving.

So I'm not a model patient. I don't think I'd take a sentence of strict bed rest lying down (a pun! a glorious pun!). I didn't have an actual reason at first to hypothetically disobey my doctor. It was just a feeling. Usually my feelings are right. So then I asked myself: is strict bed rest safe? Has there been any controversy over this?

Now before I go further I have to say two things: One, I am in no way critiquing TJ. She is doing what she thinks best for her baby, and I have nothing but admiration for the lengths she's willing to go to keep her child safe. If she thinks something is right for her kid, then that something is right. I hold that to be true for all mothers (within the usual boundaries, of course. I am not talking about drug addicts). Two, I am not pregnant. I have no plans to become so. I, like my mother before me, love creating controversy with our doctors. It's totally my mother's fault this post is being written.

So back to strict bed rest: yes, there is a camp that thinks it's harmful to put a mother on it. Here is an article I found. I have no idea what the Science Daily is or whether it's trustworthy. I was just looking for evidence that this notion is disputed.

Cue my reasons for doubting strict bed rest's effectiveness: We are always being told that sitting around is harmful. It's bad for circulation, it's bad for our weight, it's just bad. So sitting around all day in bed would basically make our bodies not function at maximum capacity. Furthermore, what about the psychological effects of sitting in bed all day? I always say that sports is half mental, half physical. Actually someone else said that, and now I repeat it. I know that for me, bed rest would feel like a Doomsday sentence. It would leach most of my hopeful, bubbly personality.

But Wulfa, you say, these doctors are highly trained people who know what they're doing. This is true. But does that automatically make them right? What if they haven't kept up on the latest research and findings? What if they're stuck in their ways and unable to change? All of this can happen, and does. And if another doctor criticizes me for getting information off the internet just because it's the internet we are going to have serious words. I am aware that some (many!) sites on the internet aren't trustworthy. But the Mayo Clinic webpage? Or the American Pediatrics site?

But I'm about to run after a rabbit trail. Back to topic: I have no firm convictions that strict bed rest is wrong. I merely have doubts. And I would not dream of telling a woman on bed rest that she should go against her doctor's instructions. I'm just concerned that even if strict bed rest is shown to be harmful, most doctors will choose to continue the practice simply because it's what has been done in the past. And that annoys me. Because if ever a third Orc child should be conceived, and I get put on any type of bed rest, there is going to be a mighty fight a comin', which could've been prevented if my doctor was up to speed. Although maybe I'd get an avante-garde phsyician. It could happen.

Given that I have issues (when do I not?), what would my solution be? It is this: modified bed rest. I think that is a wonderful idea. Some light and easy yoga, puttering around the house, lots of naps, absolutely no strenuous activity. But some activity. It would keep the circulation going, not put serious dampers on the psyche, yet would not endanger mother or child.

Of course, I am not a medical professional. I am merely babbling. I thought I should point that out. In no way should my words be taken as medical advice. Perhaps I should've put that at the beginning of my rambling. Also: I originally was using the phrase "bed rest" and then went back and changed it to "strict bed rest". I attempted to make sure the different phrasing fit, but if I missed something now you know why it sounded awkward.

Perhaps now I can stop thinking about this issue. I've expressed my doubts, given some thought as to why (don't judge my research/thinking abilities by this post), and have even given a solution. I even bought a lava lamp today. I am officially "cool".

6 comments:

TJ said...

I can see where you're coming from, and believe me, I am suffering some definite downsides and negatives to being on bed rest.

However, also keep in mind that I, specifically, am not on bed rest specifically for the health of the baby, but for my own health. I have preeclampsia, and there is literally no cure other than delivering a baby. Any activity that raises my blood pressure - and that includes being upright for any length of time, as has been demonstrated repeatedly at my doctors' appointments now (my first reading is always high enough to warrant sending me to the hospital - now they let me lay down for a few moments before taking another reading that is better), can lead to seizures, stroke and death - for me. Not preterm labor for the baby, but debilitating medical events or even death for me.

When you consider whether or not you'd listen to your doctor in my situation, you have to consider more than just wanting to move around the house and wanting to avoid the down sides of bed rest (which, due to the nature of my blog, I don't discuss nearly as much, but I'll tell you - I'm in pain, I'm stressed out, and I'm unhappy), but the very real chance that something with long term health ramifications will happen to you, or that your blood pressure will take such a sudden spike (as is known to happen with pre-e) that the baby will need to be delivered, no matter the fetal age.

Like you, I'm not trying to be argumentative for the sake of it. I read the article you linked as well as a couple of others, and I see them all acknowledging the downsides of bed rest, but not proposing any solutions. Is there a NEED for a better solution? Hell YES. Numerous times I have said to Phil, "I can't believe it's 2011 and all they can tell me is 'lay down.'"

I can't speak to conditions like incompetent cervix or other preterm labor stuff, but I can say that with pre-e, my blood pressure is going to either continue to climb, or stay steady for a while and then spike up. It's just what happens, in 3-4% of all pregnancies. They've got nothing to stop it except to remove the baby. In order to preserve her and my health, I have to do everything I can to keep my blood pressure low. I'm only just now really grasping the mechanics of blood pressure and how little it takes for mine to climb, but just like you said that we all know that laying around is bad, we also all know that high BP is bad. And as of where science stands right now, there's just nothing else that can be done.

I don't feel like my doctor has recommended bed rest because he's not up to date on things. He does tend to err on the side of caution, but my doctor is not the old school, do it my way, deliver flat on your back because I said so and that's how it's done kind of doctor. This wouldn't be happening if there was another way, and hopefully, someday, there WILL be another way.

I think what I am saying is that there is a lot more to consider than just the inconvenience and wanting to be able to move around the house. It's embarrassing, bordering on humiliating, that I have to plan when I can take a shower around when Phil will be home, but standing up so messes with my blood pressure that I don't want to be alone in the house, standing in the slippery shower, with the dizzy spells, headaches and blurred vision that happen. But what I haven't really gotten into on my blog, since I don't traditionally deal with heavy topics, is that this is a very real, very dangerous situation for me, to the point that as soon as my health begins to decline, the baby WILL be removed. WILL. It's a weird concept, and I tend to think of her delivery as far off (kind of far off - I won't be allowed to go pat 36 weeks), but it could actually be ANY day. And she's only 29 weeks along.

TJ said...

(Whoops, part 2, I over-commented)

I do think that if you found yourself in the same medical circumstances as I am, you'd cheat a little. I cheat a little, sometimes. More often in the first couple of weeks, when I was still starting to put together the connection between how I felt and how my BP reacted, but even now. I have to chase the dogs around, I putter around the kitchen and help get dinner going. But you're a researchy kind of person, and I think you'd come to the same conclusion I have - there's nothing else, right now, that can be done. There really should be and I'm sure some day they will be, but in 2011, the best they've got for you is "lay down." Which blows.

Sorry for the epic ramble, I don't really get to get into the details on my own site too much.

TJ said...

(Now I lost part 1. I'm a terrible commentist.)

I can see where you're coming from, and believe me, I am suffering some definite downsides and negatives to being on bed rest.

However, also keep in mind that I, specifically, am not on bed rest specifically for the health of the baby, but for my own health. I have preeclampsia, and there is literally no cure other than delivering a baby. Any activity that raises my blood pressure - and that includes being upright for any length of time, as has been demonstrated repeatedly at my doctors' appointments now (my first reading is always high enough to warrant sending me to the hospital - now they let me lay down for a few moments before taking another reading that is better), can lead to seizures, stroke and death - for me. Not preterm labor for the baby, but debilitating medical events or even death for me.

When you consider whether or not you'd listen to your doctor in my situation, you have to consider more than just wanting to move around the house and wanting to avoid the down sides of bed rest (which, due to the nature of my blog, I don't discuss nearly as much, but I'll tell you - I'm in pain, I'm stressed out, and I'm unhappy), but the very real chance that something with long term health ramifications will happen to you, or that your blood pressure will take such a sudden spike (as is known to happen with pre-e) that the baby will need to be delivered, no matter the fetal age.

Like you, I'm not trying to be argumentative for the sake of it. I read the article you linked as well as a couple of others, and I see them all acknowledging the downsides of bed rest, but not proposing any solutions. Is there a NEED for a better solution? Hell YES. Numerous times I have said to Phil, "I can't believe it's 2011 and all they can tell me is 'lay down.'"

I can't speak to conditions like incompetent cervix or other preterm labor stuff, but I can say that with pre-e, my blood pressure is going to either continue to climb, or stay steady for a while and then spike up. It's just what happens, in 3-4% of all pregnancies. They've got nothing to stop it except to remove the baby. In order to preserve her and my health, I have to do everything I can to keep my blood pressure low. I'm only just now really grasping the mechanics of blood pressure and how little it takes for mine to climb, but just like you said that we all know that laying around is bad, we also all know that high BP is bad. And as of where science stands right now, there's just nothing else that can be done.

I don't feel like my doctor has recommended bed rest because he's not up to date on things. He does tend to err on the side of caution, but my doctor is not the old school, do it my way, deliver flat on your back because I said so and that's how it's done kind of doctor. This wouldn't be happening if there was another way, and hopefully, someday, there WILL be another way.

I think what I am saying is that there is a lot more to consider than just the inconvenience and wanting to be able to move around the house. It's embarrassing, bordering on humiliating, that I have to plan when I can take a shower around when Phil will be home, but standing up so messes with my blood pressure that I don't want to be alone in the house, standing in the slippery shower, with the dizzy spells, headaches and blurred vision that happen. But what I haven't really gotten into on my blog, since I don't traditionally deal with heavy topics, is that this is a very real, very dangerous situation for me, to the point that as soon as my health begins to decline, the baby WILL be removed. WILL. It's a weird concept, and I tend to think of her delivery as far off (kind of far off - I won't be allowed to go pat 36 weeks), but it could actually be ANY day. And she's only 29 weeks along.

TJ said...

Ok, apparently the first half of my comment is never going to appear. But it had a lot of words! Heh.

Wulfa said...

You are absolutely correct. There is far more to consider than the discomforts of bed rest and the psychological effects. I have never been in a situation like yours, and all of my rambling can only be that: rambling.

It is hard to accept, for me, that is, that BP can only be controlled by not moving. All my life my BP has improved with exercise and movement. On the other hand, Damm has an incredibly high BP that does not budge. It's annoying how BP has a mind of its own.

And in 2011 there should be a better solution. My "solution" was really no solution, just a milder version of what is already being done. What can you do when your body betrays you? And the doctors have no answer? (And I was not trying to insult your doctor. I have just run into too many old-fashioned ones for my own good:)

As to what I would do if I had the same problem? I cannot honestly answer that until I'm in the situation. I knew, without a doubt, that Miniorc and myself were healthy enough to take a cross-country trip at eight months pregnant, contrary to doctors orders. I'd like to think that same faith would manifest itself in doing whatever it took to keeping any potential future children safe. It is likely, however, that I'd do what you yourself are doing: bed rest, but cheating a bit.

And I kept my thoughts to my blog because #1: it's just rude to contemplate on the effectiveness of what ANY pregnant lady is doing to her face and #2: I'm not, as I said, critiquing what you are doing, just ruminating on the subject itself, and it would have been highly improper to do so on your blog.

And thank you for your thoughts on the matter. Both Damm and myself are praying (which I hope is ok) for a safe delivery for both you and Garlic Bread.

Wulfa said...

Oh and I got the first half on my phone. Your words did not go to waste! This is the second time my blog has eaten a comment. I must find out why.