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Fortunately my story has a happy ending, my son who was born at 33 weeks |
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Fortunately my story has a happy ending, my son who was born at 33 weeks gestation due to preeclampsia is now almost 2 and half and doing really well across the board. This was my first baby and my husband and I took a holistic approach to the pregnancy, we chose a certified nurses midwife practice that did homebirth, we wanted to deliver our first child at home using waterbirth. We chose not to have an ultrasound, I didn't want to see the baby until it was born and we didn't do the quad panel test, but I had regular prenatal exams, we heard the heart beat, checked my urine, measured my fundus and of course blood pressure. Month after month everything was fine, I was fine the baby was fine, no preexisting medical conditions to worry about. I read books like Birthing From With In and other books about natural childbirth, I didn't give much thought to hospital births or epidurals and that kind of thing, I just assumed that like most women I was having a normal healthy pregnancy until the day where I wasn't. I should also add that during my entire pregnancy I vomited, I had to go to the ER twice for IV's because I couldn't make it stop and needed IV anti nausea medicine. My midwives continued to give me tips to combat the vomiting but nothing I did ever made it better. I was able to eat and drink but would usually vomit at least once or twice a day through the whole pregnancy. I did get a prescription for phenergan which I used on days that I thought were going to be particularly bad. I was around 29-30 weeks when I started to experience pretty severe edema. I went for my prenatal appointment at 31 weeks and I was feeling really run down and had been eager to see my midwife because I was concerned about the swelling. The urine dip for protein was negative and my blood pressure was 130/82, not exactly high, but slightly elevated for me I'm usually 110/70 give or take. My midwife gave me some tips to help decrease the swelling, put my feet up, eat diuretically friendly foods and so forth. But didn't give me any education on preeclampsia or ask me to come in again sooner for another check up. I had a baby shower coming up and my best friends was visiting from California so I continued to stay pretty busy, in hind site I should have listened more to my body and slowed way down. At 32 weeks my feet were so swollen they were distorted to the point where I couldn't put any shoe on regardless of size and my fingers looked like sausages. I called my midwife again to express concern about my swelling and was again advised that swelling is normal in the third trimester and again given a list of things I could do to help. I was also feeling run down but didn't have any headache or visual disturbances. My husband returned from a trip to Germany and gave me the worst cold I had ever had in my life. I was so sick and even though I hadn't been able to convince my midwives over the phone there was cause for concern I chose to bring myself to the ER. In the back of my head I was eager to see how my blood pressure was doing but I used the cold as an excuse because I had a really bad earache from it. And so much fluid in my head I couldn't even hear unless you yelled at me. The triage nurse registered my blood pressure at 165/95, I was stunned and commented on how high it was but she shrugged it off and said that I was probably just nervous and they would take it again in a little bit. The ER I went to also has a convenient care section for non-emergency medical needs, most patients are seen by a PA, which for the most part I think is a really good idea and a great service to the community. He confirmed that I had fluid in my ears but refused to prescribe anything and told me that if I could just get by with Tylenol that I should call my midwives or OB in the morning. He was going to discharge me but before he could I suggested that he check my blood pressure again and that I would feel more comfortable leaving if he checked my urine for protein as well. I could tell by the look on his face when he came back with the results of my urine dip that he realized he almost let a woman with preeclampsia walk out the door. My blood pressure was still 165/95 and I was at the highest reading on protein urine stick. Since the hospital didn't do premature deliveries I had to be transferred, but my midwives had a back up OB, I was suppose to meet with her that week actually and she delivered babies at a hospital that had a level 2 nursery and felt confident to handle a 33 weeker so we went there. I checked in on a Sunday night, they started me on magnesium sulfate the next day and of course that stuff is awful. None of my labs were coming back well and I felt like total crap, how much was the preeclampsia and how much was the cold I'll never know for sure but what I do know is I was pretty concerned about my life at that point enough so that when the OB told that she felt we should start the induction Monday night I didn't even argue with her. I was very disappointed that I was going to have a full medical delivery instead of the natural childbirth at home that I wanted but I felt sick enough at that point to understand it's what had to happen. She started the dilation Monday night and the pitocin Tuesday Morning, I was 33 weeks and 1 day. I had the baby that night at about 10pm. I got about a 2 second glimpse of him before they took him to the NICU because he was having trouble breathing. Thankfully they didn't have to intubate, he only needed CPAP. I wasn't allowed to go and see him that night because they didn't want me out of bed. I saw him and held him the next morning but again I was still so sick it was exhausting just being there for a half an hour. But I couldn't believe how good he felt to me when I held him. It was tough over the next couple of days because I was trying to see him as much as possible and get myself better. I was frustrated that I could hold him more or breastfeed him and I didn't feel like the staff in the NICU was communicating very well his condition and what we should expect from him being so premature. By Friday I was being discharged and decided to go home for the night to sleep in my own bed, take a shower and then return the next day prepared to camp out in their family room for as long as possible. We didn't even get out of the area when my cell phone rang, our son's apnea was so extreme that they didn't feel comfortable treating him there anymore and decided to transfer him to a Children's Hospital with a higher level of care. I was devastated because I thought he was doing well and this meant he wasn't. We turned around and went back and awaited the transfer team. They wouldn't let me go with him because I was post partum and they didn't want the liability of me. We followed the ambulance back to the hospital and stayed while the checked him. He was in a room with about 10 other babies of varying degrees of health. I was like a fish out of water, i had never even been in the hospital myself, and now here my son was hooked up to all of these monitors, on oxygen and about to receive something called TPN and I had no basis for understanding what was going on or what I should be worried about. Now that is all behind me I know a lot more about what was going on, but at the time I felt like I was on a different planet. He went through the basic preemie stuff, he had to learn how to eat, maintain his own body temp, get over the jaundice but his biggest problem was the apnea. He would stop breathing all the time and needed stimulation or blow by oxygen to get him going again and they wouldn't release him until he stopped. So we waited and waited but his condition didn't change much. After five week I insisted on some more extensive testing form the pumonologist and the cardiologist, I just didn't buy it anymore that this was due to his prematurity and he would stop doing it any day. As it turned out he had Chronic Lung Disease and the condition would only get better with time but how much time couldn't be determined. They changed his oxygen protocol and he was able to come home on oxygen and a pulse oximeter. He did so well once he was home. I could tell he was relieved to be somewhere quiet and be allowed to sleep and eat at will. He grew quickly and didn't have to spend much longer on the oxygen. We chose to use the pulse oximeter until we were sure he was out of the woods completely. Ever since he's been a healthy boy. As most women who experience preeclampsia we are told not to worry about it happening again because it's usually a first time pregnancy thing. So I chose a different practice, but again I chose to use a midwife, this time though we chose to have the baby in a birth center that is one door over from the hospitals labor and delivery ward and the midwives and OB's work in the same practice. Again my prenatal appointments are fine, we went ahead with the ultrasound this time because I wanted to know the sex and everything was great. Except of course the vomiting again, I couldn't stop several times and had to go to the ER for IV's. It just so happened around my 16th week I met with the OB about the results of my ultrasound he asked how things were going and I said except for the vomiting I was fine. He offered me Zofran and I accepted. What a difference having this medicine has made for me, I've only vomited about 3 times total from 16 weeks to 34 weeks and just because I forgot to put it by my bed side. I don't have to take it every day but I can usually tell when I am going to need it. That's the biggest difference so far between my two pregnancies, it's been so much easier not vomiting all the time. I really thought I was going to be totally in the clear but at my 34 week prenatal appointment my blood pressure was elevated and I was showing a trace of protein in my urine. Not too bad, only about 140/90 and the protein only shows up on the urine stick not in the lab and all my other tests are good as well. I put myself on bed rest this time, and as long as I actually rest which can be difficult at times with a 2 year old I can keep my blood pressure in the 135/85 range. Since I know how quickly things can get out of hand I insisted on going into the office more frequently to be checked and I'm taking it easy and listening to my body. I am hoping to make it full term without developing preeclampsia again. But I know my body and I know I'm on the edge. I really belove that if it wasn't for the Zofran keeping me from vomiting that I would have already gotten preeclampsia. That was so stressful for my body and I don't vomit like regular people do, my insides practically turn inside out and I break all the blood vessels in my face and sometimes my neck and chest if it's really bad. Again I found that my initial increase in blood pressure and edema where not given any significant attention even given my history. Not having ever been normally pregnancy I don't know what the difference is, maybe because preeclampsia is such a small percentage of women that they just don't see it often enough. Mostly it seems like they expect you to have headaches and visual disturbances if you have preeclampsia which is not something I had last time or this time. I was annoyed that I had to advocate for myself to get them to take me seriously about me being in danger of preeclampsia again. They keep telling me not to stress about it because that will make things worse. My response is I don't want to be naive like was last time and think I'm ok when I'm not, I would rather be a little to cautious and be healthy then ingnore the signs and be dead. I get the impression they they think I have some kind of control over it, like if I don't think it will happen then it won't. I find generally people think that this is something you can control with diet and exerise or getting good prenatal care, there is a lot of misconception and misinformation about preeclampsia. People really say the silliest things to me like at least you'll get to see your baby (refering to me having it early) or I went to the gym and ate grilled chicken everyday and had a great pregnancy and my favorite visualize having a healthy pregnancy. I hope I make it to full term and go into labor naturally but I'm not taking anything for granted, I have my friend or my spouse check my blood pressure a couple of times a day and I bought my own uristix to check my urine for protein and unless I have to be up, I'm in bed a resting. I'm 34 and half weeks now and grateful for every day I get closer to having a full term baby. I really hope for future generations that we start to break through some of the mystery of preeclampsia so it can be treated properly and women don't have to worry about loosing their lives or their babies to it. I am healthy and in good shape, I don't have any preexisting medical condition but for some reason between the vomiting and the eventual rise in blood pressure my bod doesn't handle being pregnant very well. Maybe someday through research I'll know why but this will be my last pregnancy. I wanted a bigger family but I'm going to be content with two healthy children and not risk it again. |
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