This week I was supposed to be writing.
A Writing Vacation
After a little bit of preparation, I am finally doing it. I am taking a mini writing vacation. Writing that post in June about craving time and space for my writing practice must have kicked something into gear for me, because as soon as I hit “publish” I started researching writing retreats and writers residencies. Instead of going that route, though, I decided on just doing a little solo getaway.
It’s something I had been looking forward to for a long time. Two whole days and nights to myself, holed up in a fancy hotel room, drinking bubbly water and tip-tap-typing away on my keyboard. Unfortunately I have to put that dream on hold until next month while I recover from an annoying pregnancy complication.
The baby is fine. It’s just me. My body is being a little brat right now. And not in a fun way, but in a “I know you were happy about previously laid plans so I decided to throw some frustrating symptoms at you and laugh at your expense while you suffer in discomfort for two or more weeks” kind of way.
What’s going on right now happened in my first pregnancy, and everything ended up being fine, but at the time I felt like I was going through absolute torture. I’m trying to not be so melodramatic about it now, because it doesn’t help. But I am depressed. And bed-bound. And generally feel useless and pathetic. Though I have been getting a lot of mundane tasks done, sending a lot of emails.
So what is it? If you did not already know, I’m 14 weeks pregnant. Very exciting stuff. Of course there are some downsides to pregnancy that they don’t always tell you about, downsides such as the thing I didn’t think I wanted to share this with my lovely substack readers and friends, but I might as well because it’s real and it happens to people, and maybe talking about it will help inform someone who may be going (or who may one day go) through a similar thing.
It all started on Sunday morning during a long walk I was taking with my husband and baby. We decided to leave the house around 9am to stroll up to the Schuylkill River trail and back while it was still relatively cool outside. After about 30 minutes I suggested we stop at a coffee shop near Rittenhouse Square so that I could use the bathroom there, while my husband bought a pastry to share with our daughter. It’s pretty normal for me to make a random bathroom stop. I drink a lot of water during the day, but especially in the morning, and I pretty much always need to pee. It turned out to not be too normal though, because I sat in that bathroom for nearly ten minutes and nothing came out. This has happened a few times already this pregnancy, where suddenly I’m unable to empty my bladder, but always after a few hours it’s resolved on its own. I decided not to sweat it too much and just continue our family walk.
We went up to Chestnut street and took the ramp down to the trail, then walked up toward the Art Museum, but then cut over to Ben Franklin Parkway to walk in the direction of home. While we were passing the Franklin Institute I said that I wanted to try using the bathroom again so we went inside and my husband and daughter waited in the lobby while I used the bathroom. Again, nothing. By this time I was feeling pretty uncomfortable and just wanted to go home, so we headed back quickly where again I tried using the bathroom and again ended up frustrated with a full bladder. I chugged a Mason jar’s amount of water thinking it might help “move things along” or something, since that seemed to do the trick the last few times I’ve had this issue, but I think it only made things worse. Once three and a half hours passed, I was getting very desperate and decided to call the ER.
Okay, now here’s a backstory. In 2022, during my first pregnancy, I flew with my husband from San Francisco to Portland, Oregon to meet his family for the first time. On the airplane ride over, I spent the last thirty minutes of the journey in the plane’s bathroom trying to pee unsuccessfully. When we landed, I decided immediately that I had a UTI and tried to get a prescription for antibiotics using some app, but the app wouldn’t let me pick up the drugs without a doctor’s consultation. As someone who’s had multiple UTIs over the course of my life and know exactly what they feel like, I was annoyed. But looking back now it makes sense that antibiotics aren’t just doled out like candy.
As soon as we got in the car and I greeted my husband’s parents and said, “This might be too much information but I think I have a UTI and need to go to an urgent care right now.” They seemed surprised, but didn’t make me feel weird about it. My husband looked up urgent care centers nearby and we picked one and drove over to it. It took a while for me to be seen, and I spent most of my time in the waiting room bathroom until they called my name, trying and trying and not being able to pee. When a doctor came to do the exam they told me my urine sample was negative for an infection, but because I insisted that it was a UTI they wrote me a prescription for antibiotics and sent me on my way. They asked if I needed a catheter to drain my bladder, but I was like, “No I don’t think that’s necessary,” since it had never been necessary before.
Long story short, I spent almost the entire weekend in the bathroom at my husband’s parents’ house. They only have one bathroom, and there were five of us at the house at that time, so it was an extremely awkward visit and inconvenient for everyone and I felt really bad for hogging up the potty particularly because I wasn’t doing much in there. But if you’ve ever had a UTI, you know that it always feels like you have to go, and being on a toilet just feels psychologically safe even if there’s nothing coming out.
And as it turned out, I didn’t have a UTI, so the antibiotics did not help, and the over the counter AZO drug that helps with urinary pain only provided a little relief. The morning after we got back to San Francisco, I had an appointment with my OB, just a regular prenatal checkup. I waited until she was almost about to leave the room at the end of the appointment to mention my little pee problem. She looked at me like I was nuts. “This is very serious. You haven’t peed for three days? Go right now to the Emergency Room and tell them you need to be seen by OB triage immediately.”
So I did. I went over to the hospital nearby, went to the Emergency Department, told them that I needed to go to OB triage. They made me wait in the lobby. I couldn’t sit down because my bladder was so full, so I just stood uncomfortably in front of a chair while tears welled up in my eyes. I was in so much pain. I finally went up to the main desk and told them again that my doctor said I needed to go to OB triage immediately. I was full-on crying and told the guy call up to the OB triage department so he could verify that my doctor okayed it. After that they sent me up and checked me out and after the OB nurses ran a few tests they put a catheter in me and pulled two liters of pee out of my body. Because I had waited so long, my bladder got super stretched out and needed time to heal. I was told I’d need to see an OB urologist, and the urologist told me I’d need to use a catheter for two weeks. My doctor also said that I probably have a retroverted uterus, positioned in such a way during this period of my pregnancy that it was preventing my bladder from working correctly.
Flash forward to now. I was hoping I wouldn’t run into this issue with this second pregnancy, and thought I might even be home free because I had those few close calls the last few weeks that ended up working themselves out. The first time I went several hours without being able to fully empty my bladder, my OB nurse practitioner (who I’ve been seeing regularly as my point of contact for my prenatal visits) told me to wait at least three hours, and if I go four hours without being able to pee then I should go to the hospital. My little incident on Sunday proved that I’m not so lucky. I’m at the same point of my pregnancy now as the last time I needed a catheter, so I’m thinking that what my doctor in San Francisco said about my weirdly tilted uterus must be true.
According to the National Library of Medicine:
Acute urinary retention (AUR) is defined as a sudden and painful inability to voluntarily void urine [1]. AUR is a rare but serious complication of pregnancy. It can lead to serious consequences, such as acute renal failure, spontaneous abortion, permanent bladder dysfunction, and bladder rupture [2], and occurs more often between 10 and 16 weeks of gestation [3,4]. According to previous reports, AUR occurs in approximately 1 in 3,000 pregnant women and is often associated with uterine incarceration [5]. However, as shown in our report, even without uterine entrapment, retroversion of the uterus itself can cause AUR.
Okay, so it is pretty serious.
We spent the majority of Sunday afternoon in the Emergency Department at Jefferson, which is nowhere near as nice as the facility I went to in San Francisco. The Jefferson waiting room only had two bathrooms, and one was smeared with feces rendering it unusable. I definitely bogarted the cleaner bathroom during the time we were waiting (it wasn’t much cleaner, but it also didn’t have poop all over the walls and toilet seat). When we were taken into the triage center and given a room, I was able to sit on a commode and feel psychologically safe despite no pee coming out. And it didn’t take too long for a nurse to come and run tests and finally administer a Foley and drain a liter of pee from my body. All told, we were there for probably four hours.
I had forgotten how uncomfortable having a catheter is. I think I had blocked that memory out from my first pregnancy. It is a relief to not have a full bladder, but it’s also just very weird having this piece of plastic shoved inside of me in a place where a piece of plastic should not be shoved inside. When we got home after our day at the ER, I was so depressed about the timing of it all. Yesterday I was supposed to check into my hotel to begin my personal writing retreat, but because I am so uncomfortable with an entirely different kind of pain I decided to just cancel it and reschedule when I hopefully no longer need this medical device. Instead of working on my novel yesterday in the quiet comfort of my own solitude, I went to an appointment with an OB-GYN and an OB urologist and had them check out the Foley. It felt wrong to me, I was afraid that it was inserted incorrectly because I also have some belly pain and back pain. They told me the pain is to be expected and advised I take Pyridium, the prescription version of my over-the-counter friend, AZO, and scheduled me for a follow-up next Tuesday.
I’ll probably need to have this thing in for two weeks. So I guess I’ll be showing up to my new book launch sporting a catheter leg bag fashion accessory (just kidding, I’ll probably wear a long skirt). At least it’s helping. It’s just a bummer, but it’s not the end of the world. I’m trying to have perspective. And I’m sharing this with you because I’m embarrassed about it, but I probably shouldn’t be. It’s just a real thing that happens to some people, and hopefully talking about it helps someone.
oh man! i’m glad you are advocating for your health now you know what to do. having had UTIs that are so incredibly painful with minimal relief, i could feel the pain from the tears in your eyes you described from the first ER visit - there’s just no relief and it’s such an immediate and enduring kind of pain when it happens. i hope it passes quickly, you will feel so much better writing distraction free soon when you heal. 🖤🖤🖤
I'm glad you knew what to do this time around because of last time and so grateful that none of those scary things resulted from it! For it to happen on a plane and a trip the first time and then this time before your planned writing retreat are both horrible timing.