Two time HELLP survivor

Post On Sunday, August 18, 2013 By Joann

Two time HELLP survivor

I have had HELLP with both my previous pregnancies. And now I am expecting my third child. I am wondering when the other shoe will drop. When will I get sick this time?  The farther along I get, the more I worry. I have been lucky though with my previous pregnancies. I and my children have survived without problems.

With my first child I had a very normal pregnancy until I was diagnosis with gestational diabetes. It was difficult at first to adjust to the diet and medicine, but as a nurse I understood the need for good control of my blood sugar. I also knew that having diabetes put me at a greater risk for preeclampsia. But I had hope everything would work out okay. Everything was fine until about 34 weeks when my blood pressure increased slightly. My doctor ordered lab tests and they were normal. But she insisted I be put on bedrest at home. Over the next 5 weeks my blood pressure stayed slightly elevated but my lab tests were always normal. I would have mild headaches and a mild right-sided ache, but both of these came and went. At 39 weeks my lab tests suddenly changed. My platelets dropped and my liver enzymes increased. Although I didn't feel any worse my doctor told me I needed to be induced. As soon as I got to the hospital I was started on magnesium. During my labor my lab tests continued to get worse. But I was lucky, I did have a vaginal delivery. My son did spend a week in the NICU for hypoglycemia. Within a few days of delivery my lab tests were improving and my blood pressure had returned to normal.

Fast forward to 5 years later,  I had remarried and we were expecting. We were cautiously optimistic that things would turn out okay this time. Other than a little morning sickness in the first trimester I had a very normal pregnancy. I passed my blood sugar test. And we both breathed a sigh of relief. I was getting regular growth ultrasounds and they were fine as well. I was feeling the best I had ever felt being pregnant. I had tons of energy and really enjoying being pregnant. And then I woke up on a Saturday morning at 31 weeks and 2 days and didn't feel so good. We had a wedding to go to that day. All that day I felt worn out like I was getting sick. I didn't think much of it. On Sunday I continued to not feel so good. That night after dinner I started having epigastric pain and I was a little nauseous. I thought at first it was indigestion since I do suffer from reflux. I went to bed and in the morning it was gone. On Monday I still didn't feel well and I was still nauseous. I took some nausea medicine, but it didn't help. Then that night after dinner I had the epigastric pain again and a mild headache. I started to worry now. I had that feeling of dread in the pit of my stomach. The pain was a little worse. But all my symptoms were still vague. I did wonder "Am I getting sick again?". I had a doctor appointment the next day. I decided to wait and see if my blood pressure was elevated. Then I would know for sure. Tuesday morning  the pain had resolved again. I continued to not feel well. After a busy day at work, I rushed to my doctor appointment. My blood pressure was slightly elevated and I told the nurse practitioner about my symptoms. She told me it was just indigestion and I should go home and take it easy. If the symptoms return and get worse to call my doctor.  I didn't work until Saturday again. I decided to take her advice and take it easy. But I still had that feeling that something wasn't right though. The next few days I felt a little better no more pain, and the nausea and headache weren't as noticeable. On Saturday I woke up feeling worse again, just that overall not feeling well feeling. It was another busy day at work with little time to sit down. But I continued to feel worse as the day progressed. Finally at the end of my shift things had calmed down. I decided to ask one of my co-workers to check my blood pressure. (I'm a labor and delivery nurse by the way.) Just a quick check and then I could go home knowing everything was fine. But everything wasn't fine. My blood pressure was 190/110! My sweet co-worker asked me very calmly to put my feet up and relax and she took another blood pressure. And it was still high. She then helped me lay down on my left side and took it again. I started to cry as each blood pressure was just as high. She called the admission desk to get me checked in. The doctors who I had worked with all day now rushed in to take care of me. My lab results came back and my platelets were 57 (normal is 150-400) and my liver enzymes were high too. I cried harder. I was very ill and I knew I would have to be delivered. I called my husband at work and told him to come to the hospital. Luckily, my mom was watching my son while I was at work. They gave me medicine to bring my blood pressure down and steroids for the baby's lungs. Then they started the magnesium and we waited.

My friends and coworkers came in to visit, looking so worried. I must not have looked very good. I had labs drawn every 4 hours and they kept a very close eye on me. My blood pressure had gone down. The next afternoon I started having right sided back pain. I just thought it was from lying in bed so much. My wonderful husband rubbed my back. But over the next hour the pain became so intense and wrapped around to my right upper abdomen that I asked for pain medicine. The pain meds only helped for a little while and the pain came back stronger. The doctor came in and said it was time to have a baby. We couldn't wait any longer. As they got me ready for my C-section the pain became unbearable there was so much pressure and pain, it was hard to breathe and impossible to lay down. They gave me my second dose of steroids just before they rushed me down the hall to the operating room. As I laid on the OR table I cried and prayed by baby would be okay. I worried my liver was rupturing and I wouldn't wake up from surgery. A wonderful nurse anesthetist held my hand as they readied me for surgery reassuring me I wasn't alone. It was such a small thing but it calmed me.

They put me to sleep and the next I remember I was being wheeled back into my room and they said the surgery was over. I never heard Noah's first cry, but my nurses said he did cry. My husband and my mom were able to be with him in the NICU. But I didn't see him until the next night after the magnesium was turned off. All I had was a few pictures the wonderful nurse in NICU had taken for me. I had Noah at 32 weeks and 5 days. He spent the next 23 days in the NICU. We were lucky. He did well and just kept getting better without any setbacks. My blood pressure continued to be elevated and I had to take blood pressure medication for 3 months after my delivery. Luckily, after time we both recovered.

I had always thought I would have more children, but when I got so sick so fast with Noah I wasn't sure anymore. My husband and I discussed having more kids but we were both scared. And then fate decided for us. In April of this year I found out I was expecting. I was so scared. My doctor said he was optimistic that since this was my second pregnancy with the same partner my chances of developing HELLP were lower. So, now I am 24 weeks into my third pregnancy and I am having a hard time enjoying it. The memories of my second birth flash through my mind. I am scared. I have a great doctor and he is being very cautious. But still I wonder how this will end.

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