Can HELLP pain linger off & on for 2 weeks?

[danielsmom]

I had my first pain 2 weeks before I was diagnosed with HELLP. It was epigastric, upper-right quadrant excrutiating pain that radiated through my back and I had horrible nausea/vomiting with it. Seems to me with what I've read, this is classic HELLP pain.

My OB maintains that I would not have lived for 2 weeks if I were actually in HELLP at that time. They believe I had gastritis initially.

The pain would sometimes skip a day, and would always start after dinner around 7 or 8 PM, and I'd be in misery half the night until I fell asleep. In the morning, everything would be wonderful again, each and every time.

When I had one of these episodes while under hospital observation (2 weeks after this started), my blood tests showed severe pre-e/class III HELLP with +20 protein in 24 hour urine and I was delivered the following morning. During the pain episode, one of the doctors said I might be having a gall bladder attack, so they tested 3 days after delivery but the gall bladder looked fine.

Does this sound like HELLP all along for 2 weeks? Or could gastritis have been a factor initially?

[amandaoasis]

It's hard to say what the pain was after the fact. I will say that I had the pain for about 2 weeks on and off before I was diagnosed as well. But my pain was not excruciating...more of a very annoying pressure in the right part of my abdomen. It would come and go which made my midwife think it was a case of indigestion.

[tree]

I had pain off an on for a while, but it was only really intense for a couple of days before I went in. I remember it being annoying before it got really bad. Like yours, it would start after dinner and keep me up until I could pass out. I actually had it before my last doctor's appointment and forgot to tell my OB because it didn't bother me at all in the morning. I was too tired to think and probably didn't remember.
I don't think your situation is all that weird.

[caryn]

This ebbing and flowing of symptoms is characteristic of hypertensive pregnancies. The way it's been explained to me is that we have "decompensating systems" -- which means the negotiation between mother and placenta is sometimes stabilizing and sometimes getting worse, and that when it is getting worse, we have some body system that is more sensitive and more prone to break than the other ones given the unique chemicals being produced by this placenta and our underlying susceptibilities.

Put another way, when the disease gets a little worse and the setup is for our livers to get hit first, we could start experiencing symptoms of HELLP acting on the liver (including the pain), and then they could go away for a while if the mother and the placenta reached a temporary agreement. Or if we're chronic hypertensives, our pressures will get spiky. Or if we've got underlying kidney issues, we could spill more or less protein. Or migraines and visual disturbances, or whatever.

Some of the researchers working on this really like the analogy of an arms race, where no one *wants* the all-out thermonuclear war, but sometimes the diplomacy just doesn't work.

[danielsmom]

Caryn,
So I could have experienced elevated liver enzymes with this pain? But maybe it wasn't full blown HELLP yet?

If there ever was a hypertensive day in my pregnancy, it was the day this pain started. This was the day my OB was confident that we had a chromosomal abnormality because of 6 look-ats on ultrasound, and we did an amnio to prepare for delivery (what team of people needed to be present if baby wasn't compatible with life). I was so stressed and all I could do was cry. I hate that I couldn't be emotionally stronger. I believe that the way we feel has an effect on us physically. If only I could've known then that everything would be fine.

Why is it common that HELLP pain hits women in the evening?

[atvlady]

DanielsMom....I had the pain late in the evening as well. Day time was fine but about 9 p.m., he** would break lose. By the next morning it was gone but towards the end it was 24/7. And yes, those pains are the same I had with HELLP but for me I had no nausea and vomiting. Each time i have the URQ pain, I would go get BW done and my enzymes would be elevated.