Update: Hospital stay and question

[kkinnell]

Hi Everyone,

I posted several weeks ago after my first trip to L&D to be checked out due to high blood pressure and a +1 dipstick. Sorry it's taken me so long to update. For a long time there it didn't seem like anything was happening! I'm 37 and now 29+3 with my fourth pregnancy. I have a 13 and a 9 year old and had an ectopic pregnancy in 2001.

After that last trip to L&D, I kept my bp journal and at my next midwife appointment requested a 24 hour urine. The midwife also told me that the hospital hadn't done a preeclampsia work up while I was there (this will always be a mystery to me), and so ordered that blood work as well. I ended up in L&D one more time before my next appointment and was checked out and sent home again, after six hours and a little speech from the attending OB about managing stress in my life . At that next appointment, which was last Tuesday (5/22/12), my midwife said that my blood work had come back with my liver enzymes elevated, but that she hadn't been too concerned until she got my urine results which were not diagnostic but elevated (234). So she ordered more blood work and scheduled me to follow up the next week. The next morning I got a call from the midwife telling me I had an appointment with her overseeing OB and to pack a bag because he was going to admit me to the hospital. Long story short(ish), he was concerned I was developing HELLP and so told me to plan on staying in the hospital until I delivered.

They kept me in the hospital for a week, although the MFM felt that my liver enzymes were unrelated to what he eventually said is mild preeclampsia. While I was in the hospital, my blood pressures continued to be labile (107/55 to 161/84 and everything in between, but mostly high-130s/low-80s) and my protein went over 300, but stabilized around 350. They gave me the steroid shots the first and second day I was there, and they also put me on Synthroid for low-functioning thyroid. They also tested me for every kind of liver disfunction or disease under the sun, but most of that lab work hasn't come back yet. Finally yesterday the MFM decided that he felt comfortable monitoring me on an outpatient basis, as long as I felt comfortable with it. I thought of many of you here, and your stories of how doctors ignored your symptoms, etc., and really wished I could somehow share him with you all. I was grateful that he was willing to keep me if I felt safer in the hospital, but I do feel comfortable seeing him twice a week and think I have a good handle on the symptoms that should send me running to L&D again. He even encouraged me to be overly cautious, to call even if I wasn't sure I needed to worry, and to feel free to come in to L&D anytime day or night.

So, now I'm home. The MFM said I didn't need to be on bed rest, but that the more I rest, the better chance I have at staying out of the hospital, which feels very motivating to me right now. I'm so very grateful that the baby has a little longer to cook--though I know this can move quickly, I'm glad we've already gotten a week more than it looked like we would.

So, here's my question: Since I'm in charge of my activity level for now, I wondered what you all think I should aim for? I'm in the enviable position of having older children and, if I decided that I needed to lay in bed all day, my husband and family would make it happen without complaint (I really do know how lucky I am). So, I really am free to make the best decisions for me and baby right now. Any input you have, I would be grateful for.

Thanks to you all and thanks for this forum. Though I haven't updated much, I've been so grateful to read others' stories and learn so much from you all!

Kirsten

[alexis]

In your shoes? I would let your husband and kids do the housework and cooking, for sure, and take it easy. I wouldn't worry about trying to stay in bed all the time, but I would definitely not be exerting myself. I would try, since you're still feeling okay, are early on and not on formal bedrest, to do some light activity to keep up energy (I've had several friends say they had no strength at delivery after protracted bedrest, though I don't know how often this is true). But, like your doc says, rest. You don't need to be scrubbing floors or cooking 3 course dinners.

[tree]

I agree with Alexis. Every day you stay pregnant without getting sick is a blessing at this point. I would suggest doing any activity that makes you feel better. That may mean hiding out on the couch or in bed some days and being up and about more other days. Do you have access to a pool? I was only comfortable in the pool towards the end. Simply walking (or plodding) in the water did wonders for my swelling and mental well being. It might be good for you if you can get to a pool without a lot of exertion. Take it easy, take care of yourself, and see what works for you. I swelled more on bedrest, so I had to move every day. I was much too weak to do much useful around the house, so I took advantage of my husband's willingness to do that and just did whatever made me feel better.
Definitely call your MFM if you start to feel worse, experience any new pain (upper right quadrant is often liver related), or have any of the standard PE symptoms. Good luck!!

[mom29]

I was a similar situation of being allowed to go home with 2x's a week appointments with biophysical profiles & nst's.

I slept in every morning, took a nap most afternoons, and went to bed early. I stopped running several errands in one day. If I went out, it was to ONE place only, grocery store or drs. appt. My older kids lifted the laundry baskets and switched the loads over for me. My daughter handled meal preparation for me.

I woke up feeling extra tired one morning, did a few small things around the house, took an early nap and woke up with my bp 181/100+ . I felt sort of foggy and the MFM told me to come back in.

[kkinnell]

Thanks, all, for the input. My bps were a little crazy yesterday, so I decided I'd done too much. I didn't do much but rest today and things seemed better.

Mom29--did you end up back in the hospital after that? Yesterday I had several bouts of feeling foggy and exhausted and noticed that my bps were up when that was happening. Luckily they didn't stay up, so I didn't have to go in (MFM said to go to L&D if I had sustained bps above 150/100--either number). I'm interested to hear that you had similar symptoms with high bp. I'm afraid I'm disproportionally fearing going back to the hospital. I keep telling myself that the pre-e is the real thing to be afraid of, but that week in the hospital was a little traumatizing.

[mom29]

The MFM came over to see me in triage and admitted me saying they were going to take 24 to 48 hours to determine if it was the chronic hypertension or preeclampsia resulting in the higher bp's. If it was the cht, they would have kept me on bed rest at home or in the hospital to buy a bit more time for my baby.

He came in the next morning and said "It's baby day today. You are going to have your baby today." They did one of those dips to check the protein level on the 24 test already in progress and it came up at 500, so it was apparent that things were going downhill.

I think when a mom delivers early she always second guesses if she could have done something different to stay pregnant a little longer. I know I sure did! Pre-e can get worse in a matter of hours so when you deliver early you don't know what kind of tragedy you avoided. When you don't feel "that bad" you think you can keep pushing the envelope and that can be risky.

Seven months old now, my daughter is happy & healthy and I am here to enjoy raising her. Both of us being healthy is far more important than getting to the end of that week like I was hoping to (dh was quite busy with work).

I'm glad your doctor is watching you closely. I will be checking here to see your birth announcement. A newborn in your arms is one of life's wonderful moments.