Pre-eclampsia

Today’s post was kindly provided by Ryann, a fellow micro-preemie mom who I have the pleasure of knowing both online and in real life!

About 5 years before my pregnancy, I had a battle with elevated blood pressure. Under my physician’s care, I took medication and engaged in physical activity while also watching my diet more closely. Over time, I was able to get my blood pressure under control and my doctor said I no longer needed the medication. We still monitored my condition every year at checkups. When Nick and I found out we were expecting the weekend after Thanksgiving 2006, I was happy that I didn’t need that medication, as it wasn’t healthy to be on while pregnant.

Of course, my OBGYN was aware of my medical history, but my blood pressure remained normal until my 24th week of pregnancy. I started to feel heaviness in my chest and I had become more exhausted than usual. Dizzy spells were hitting me several times over a couple of days. The swelling of my feet, ankles, legs, hands, and face really started becoming obvious and painful.

I called my sister (who was also pregnant and to be induced that Saturday) on Wednesday, April 18th after leaving work early. I knew she had a blood pressure cuff at home and I asked if I could borrow it. I had Nick pick it up on his way home from work. I took my blood pressure and couldn’t believe my eyes. Thursday morning my OBGYN asked me to come straight to the hospital. After running some tests, the doctor told me to go home and rest, and they gave me a jug to collect my urine for 24 hours (TMI, I know, but pertinent to the story because they needed to monitor the amount of protein spilling into the urine). A prescription was written for a blood pressure medicine. I got the prescription filled and before I took the first pill, I read the info they staple on the front of the bag. I never do this, but for some reason, I thought to this time. The pharmacy had given me the wrong drugs. They gave me a medicine for diabetes instead of high blood pressure. After a few hours on the phone with the pharmacy and the doctors on call, we finally had the right medication. Remember it is very important to read that prescription information! If I hadn’t, things could have been even worse for us! On Friday, I returned the jug to the doctor’s office and went back home to rest. They told me I could go to work, but I really didn’t feel up to it. They told me I had pre-eclampsia, so I started doing my research.

Saturday morning, April 21st, I met my parents over at my sister’s house. They had come into town to be with my sister when she gave birth to my niece, Grace. We were all worried about Amy and Grace because Grace was breech and they were afraid they wouldn’t be able to turn her, but they were going to try before settling on a C-section. The hospital told my sister they would call her when they had a room open, so we had some time to spare. My parents and I decided to let her rest, so we went to breakfast. I wasn’t feeling well, but I tried not to focus on that because I really wanted my sister’s day to be about her. After breakfast, I decided to go home and rest and I would meet them at the hospital later, since it was just down the road from my house.

I was home alone and started to have headaches and dizzy spells. I took my blood pressure and called the doctor. She again instructed me to meet her at the hospital and NOT to drive myself! Nick was working so I called my mother in law. She picked me up and drove me to the hospital where I was met at the doors by a team of nurses and doctors. They quickly started monitoring me and had grim looks on their faces. I was told that I would not be leaving the hospital pregnant. At first I didn’t understand. Then it started to sink in… ok, I’d be on bed rest at the hospital for the remaining 16 weeks of the pregnancy. Then they informed me that because of the lack of a Level 3 NICU at the hospital, I needed to be transferred to a larger hospital in downtown Indianapolis.

I was scared and felt alone. My mother in law called my parents, who were now with my sister at another hospital where they had just taken her into the OR for a C-section. Mom and dad rushed over to my hospital to see me. I told them I’d be fine, to get back to Amy and Grace. I felt bad for stepping in on her special day! My mother in law then called my husband, Nick. He had a while left before work was over and then he wanted to go home and clean up before heading to the hospital. She told him just to come straight over instead. He did and when he got there, we told him what was happening.

The nurses needed to measure my urine output, so I had to have a catheter, a most uncomfortable experience! Diuretics were also given to help my body get rid of the liquid in my body. My kidneys were working overtime. A medicine called Magnesium Sulfate was started by IV. Believe me when I say I hope I NEVER have to be on that drug again. The Magnesium Sulfate is used to prevent severe pre-eclampsia from turning into eclampsia. It causes all sorts of nasty side effects such as “flushing” (ok, this is one of those words they must have used in the Victorian era, but really should be called flesh-burning!) and nausea along with the constant state of confusion. It was like someone was running hot needles across my entire body, punching me in the stomach, and taking a potato masher to my brain. I really don’t remember much of what happened while I was on the Magnesium Sulfate, which is probably a good thing.

I was loaded into an ambulance and taken 20 miles away to IU Medical Center located adjacent to Riley Children’s Hospital where a Level 3 NICU awaited us. I was admitted into the OB-ICU on Saturday evening. I was immediately attached to monitors and oxygen and IVs and the like. Nurses and doctors were coming into my room constantly to ask questions and check the machines. Many of the questions I heard over and over were: “Are you having any headaches? Any blurred vision? Seeing any spots?” I later learned that they were constantly monitoring me to make sure I didn’t have any seizures or strokes. They tried their best to keep the room dark and quiet. No TV, no reading, not very many visitors, no phone or computer. They tried to keep me as calm as possible with as little stimulation as possible. Urine output was monitored and tests showed my liver and kidneys were being affected. Ultrasounds were taken of the baby and a constant fetal monitor was on. Because of the pre-eclampsia, Addyson’s growth had stalled. She was measuring as though she was the size of a 23 weeker. The only way to really stop the pre-eclampsia is to deliver the baby. My life was on the line, but so was our baby’s.

Neonatologists and other specialists from Riley Children’s Hospital came over to visit us. They delivered the grim news. If Addyson was born now, there would be a 50% chance of survival with an extreme chance of major disabilities. If we could hold the delivery off for any longer, the prognosis would get better with each passing day. I was fully intent to lay in that hospital bed for the next 16 weeks if that is what it took. Deep down, I knew the doctors knew better, but I tried to remain positive. I don’t remember all the details, because I was so drugged, but I’m sure at one point, they asked us to what point we wanted to go as far as life saving and life maintaining measures for Addyson. We had a lot to think about and a lot to worry about. A research team visited us and they were asking us to participate in a breathing study for preemies. We discussed it and decided that we wanted to help in any way we could. No matter Addy’s outcome, we wanted to be able to let her help the medical teams learn more about caring for preemies. We’ve since participated in several studies and will continue to as long as we can.

I went through the entire gamut of emotions at this point. My husband runs a garden center and this was the busiest time of year for them. Since we didn’t know how long I’d be in the hospital, he continued to work during this time. While I’m sure I had visitors, I felt mostly alone and scared. I worried that my husband blamed me, which I know is insane! I worried what other people would think… had I done something wrong to cause this? Should I have taken better care of myself through this pregnancy? Should I have asked more questions of the doctor when I started swelling a week or so before? Would I have to say goodbye to my baby? Would I be able to live if she didn’t make it? I even thought I might not make it at one point. I wanted to visit my sister and my new niece who was born on April 21st, the day I was admitted to the hospital. Would I be able to afford this? What am I going to do for the next 16 weeks in this hospital room? Irrational thoughts to most of you, I know, but I’m being honest. I’m sure there are others who have been in that position and thought those same things.

The doctors came into my room the morning of Wednesday, April 25th and said that my body was starting to show signs of major distress. They needed to deliver the baby. I thought they meant that week. Quickly, they corrected me and said they needed to take me to the OR immediately. I remember asking if we had any say in the decision. They informed me that if we didn’t deliver the baby, neither of us would make it. I begged to call my parents. They were able to hold off on the surgery until my parents made the 2 ½ hour drive down to Indianapolis.

At 12:31pm, Addyson was delivered by C-section. She weighed 1 lb, 7.9 oz and was 11 ½ inches in length. Doctors said a vaginal delivery wasn’t possible, a baby her size and with our circumstances wouldn’t survive a vaginal delivery. Nick was able to be in the OR with us and said he watched the whole thing! I was awake, but scared. I remember the two people that were monitoring the anesthesia were having a conversation like nothing was happening… it was surreal. I remember hearing the nurses count all of the instruments in the room before the surgery and after the surgery… I’m sure they had to account for each piece so nothing was left inside me. I wish I could say the birth was a beautiful moment in our lives and that it was a bonding experience, but it wasn’t.

Addyson was placed into what Nick said was a Ziploc bag. This helped keep her body warm and her skin moist. It was a vital part of the first few hours of her life. Because of all the drugs, I wasn’t very aware of what was happening for the next day or so. My blood pressure, even though they delivered Addyson, was still too high and the doctors wouldn’t allow me to visit Addyson in the NICU until we got it more under control. The NICU nurse that welcomed Addyson to the NICU took a few photos and hand and feet prints. She sent them over to my room so I could meet my baby Addyson.

I was released from the hospital on April 30th on blood pressure medication. I was followed by the high-risk doctors at the hospital for the next month until we were finally able to control the blood pressure.

Addyson remained in the NICU until July 19th and then was moved to the Special Care Nursery at the IU Medical Center until she was finally able to come home on August 21st (just 4 days shy of 4 months old!). You can read more about Addyson’s rollercoaster life at her CaringBridge page.

I’m sure other mother’s have had to deal with the feeling of guilt in not being able to carry a healthy baby. I know there are mothers who have lost babies at all stages of pregnancy. While I didn’t lose my baby, I did lose a part of being pregnant that I’ll never be able to experience. I’ll never know what a contraction feels like. I’ll never know the feeling of being so pregnant that I waddle. We didn’t get a chance to take those beautiful pregnancy photos that I wanted to take.

Doctors aren’t sure what caused my severe pre-eclampsia and aren’t sure if I would be prone to having issues again so Nick and I decided that we had our hands full with Addyson anyways. We could never put my life on the line to have another child. I couldn’t bear to leave Addy motherless in the hopes of having another baby. Our family is now complete and we couldn’t be happier with her progress.

Pre-eclampsia can sneak up on you so quickly, but it’s important to know the signs and symptoms so you can be prepared and inform your doctor. You can read more about pre-eclampsia here and here.

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Ryann is a 29-year old kitchen and bath designer from Indianapolis. When not busy cooking, camping, or scoring great deals, she enjoys traveling with her husband Nick and scrapbooking her preemie daughter Addyson’s journey. She can be found blogging at A Little Birdie Told Me.

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