I sealed my fate with a text message. "I'm really scared that I have preeclampsia," I wrote to my mom. She replied back, "I don't think so. You'd be really sick." It did little to calm my fears. At my doctor's appointment the next day (September 10) , my blood pressure was slightly higher than usual--but considering my blood pressure had been relatively low my entire pregnancy, it wasn't shocking. I was also incredibly stressed out and having anxiety attacks. My doctor wrote me a note to reduce my work hours (which I didn't do) and I moved on.
But something in the back of my mind told me that it wasn't right. I knew something wrong. I didn't really know what.
It was little things. I felt terrible most days, but then, who doesn't in their third trimester? I got headaches. My hands puffed up so bad some days at work that I couldn't bend them and drove home with my thumbs hooked in the steering wheel, my fingers completely straight. My feet hurt all the time; some mornings when I got out of bed, I could feel the fluid in them slosh as I walked. My ankles and calves were so swollen by September 20 that my Uggs barely fit. None of my socks fit on my feet.
There were other signs too. At recent doctor's appointments, my weight gain had suddenly, massive shot up. Nothing too extreme: I went from gaining maybe 2-3 pounds a month to 10 pounds in one month, followed by 4-5 afterwards. However, I could feel it: in the appearance of my face, the puffiness of my ankles and feet.
Something was wrong, but I thought, hoped, that it was just typical pregnancy pains.
However, after a 48-hour headache last week, I knew something was seriously coming on. I either had a cold or something was wrong with me. Not Forrest... he kicked and spun and rolled around like a champ. I asked my mom if she would take me to my doctor's appointment; I tried to act very nonchalant, like "Oh, just another fun girl's day!" But I was worried about driving myself; I was worried about how the appointment would go.
At my doctor's appointment, my blood pressure was 165/101. If you know anything medical, you know this is devastatingly high--especially for someone whose blood pressure has always been on the "lower side" of normal. My doctor immediately explained the dangers of preeclampsia--a condition that, if left untreated, can lead to eclampsia, a seizure disorder. I asked her why caused it: was it because I had gained too much weight? Was there something wrong with me? The answer isn't really simple because no one really knows anything about preeclampsia. Like gestation diabetes, it is not caused by anything a pregnant person does: it's caused by the placenta.
My doctor wanted me to go, immediately, to Labor and Delivery at Riverbend. She further explained that, depending on a NST (basically, a fancy way of saying "we'll monitor your baby's heartbeat for 20-40 minutes") and a blood test, I may have to stay overnight for further monitoring and a 24-hour urine catch (glamorous). And, if things seemed especially bad after the blood test (such as signs that my kidneys or liver were in the early stages of failure), I would potentially be induced to give birth. That night. At 35 weeks, 6 days.
I agreed to go to Labor and Delivery and numbly walked out to my mom in the waiting room. I'd opted to not have her go with me to the exam room (I knew my doctor would do a cervix check and there's just a line sometimes, you know), but part of me wished I had: how could I explain everything I'd just been told?
"I'm glad you came with me today," I said. "My doctor is sending me to Labor and Delivery because my blood pressure was very high."
At Labor and Delivery, I was admitted and spent about two hours in one of the triage rooms: they aren't delivery rooms, but they aren't recovery rooms either. It's the room where you go when you think you're in labor: they check out the baby, monitor your contractions, maybe do a cervix check, and then make a decision. It was different for me. I was hooked up to the monitors so Forrest could be watched (like I said, this is referred to as NST and is something I would repeat at least three times a day for the remainder of my time in the hospital). I was also given an IV line (a first for me) so that I could have blood taken. My nurse, Erin, explained that she was doing an IV line because if I ended up staying the night or they decided I needed to go into labor, it would be much easier to give me any medications with an IV already in place.
The blood test results came back quicker than I expected: my liver and kidneys were still functioning, but my doctor still wanted me to be kept for 24-hours (overnight) so that I could do a urine catch. Basically, they run a test to see how my kidneys function for 24-hours and see exactly how much protein they are leaking. I knew I was leaking protein, but it's hard to say, from one or two samples (which may be diluted from my drinking water or being nervous), what exactly that means. They would also be taking my blood pressure and vital signs every 3-4 hours to gauge what my average BP was and to make sure it didn't spike.
I was admitted to the Mother-Baby unit (Recovery unit, essentially). My mom ran home to get my hospital bag (something I had, thankfully, packed in the weeks before with brand new sweatpants I expected to wear after I had a baby) and to collect Danny, who was surprisingly good at acting like he was not totally freaked out.
For 24 hours, I peed into a "hat" in the toilet and a CNA or nurse emptied it into a medium-sized bucket nestled in a tub of ice. Have you ever had to collect all of your pee for 24 hours? Let me tell you, it gets to you after a while. It's also embarrassing to hit the Call Nurse button every time you pee to say, "I have urine to collect."
On Friday morning, I excitedly waited for noon to hit so I could be done with the 24-hour urine thing. I was pretty over it by then. My nerves were frazzled, I was bored and achy and generally wanted to be home with my dog and husband and things. At noon, everything was sent to the lab for testing and so the waiting game began.
Unfortunately, the waiting game happened to intersect with a high blood pressure reading. The machine they use to run the 24-hour urine test had malfunctioned or broke, so a test that normally took only 2 hours hadn't been completed by 3:30. At 3:30, I had one higher-than-my-current average BP reading (150/100, as opposed to around 145/85 or 95).
At around 6, my doctor finally came in to tell me that I had had 500mg of protein in my urine. Anything over 300mg suggests mild preeclampsia and over 1000mg is severe (and would require immediate labor inducement), so I was still in a safe zone. However, my doctor was very concerned about my one elevated BP reading. She felt that it was possible my blood pressures would start climbing and, given that it was a Friday evening, if I started to get incredibly sick, there would be no where for me to go to have my blood pressure or urine tested... other than the hospital. She wanted me to stay another night and, of course, I cried.
To my credit, at this point, I had slept a total of maybe 4 hours since the day before and that's if I'm being generous. I'd also spent all day, hoping against hope, that I would be released from the hospital and able to go home and have a real dinner.
My doctor explained something really important to me then: the goal of having a baby isn't to just have a baby. The goal of having a baby is to achieve optimal health for both mother and child. If one's health is compromised, then there is no point to continuing the pregnancy is the benefits don't outweigh the risks.
The thing about preeclampsia is this: it doesn't really do anything to babies. Preeclampsia (and eclampsia) are primarily damaging to pregnant women. It is only when the symptoms become so severe that women begin to experience multiple organ failure and seizures that the baby's life is jeopardized. The entire time that I've been plagued with feet the size of bear claws and headaches and a general feeling of unwellness, Forrest has chugged along like a happy little clam.
I begrudgingly agreed that it would be best to stay another night, but I was still mad as hell. My mom picked up Five Guys for Danny and I; Nate and Amy visited; I did another NST on Forrest; and I took an Ambien. I don't know what combination of these things caused the planets to align and my blood pressure to be extremely stable throughout the night, but it happened.
At 9:30 Saturday morning, my doctor came into excitedly tell me that I could go home. She was impressed by my blood pressures, but wanted me to take my own twice a day. (Danny and I had previously purchased a blood pressure cuff for his use.) She also wanted me to be on complete bed rest: no cleaning, no cooking, no shopping. I could get up to go to the bathroom, brush my teeth, shower, that kind of stuff. But nothing intense.
For an active and antsy person like myself, this was surprisingly not daunting or unpleasant sounding. I would have done anything to get out of the hospital for at least a few days at that point, however. So maybe it was just perspective. I happily agreed to one last NST session on Forrest. Then, my IV line was taken out and I was sent on my happy little way with discharge instructions.
Remus, who had been alone for approximately 100 billion hours in his world, was overjoyed to see me and, admittedly, I was excited to see him.
After my mom left and Danny got home (he'd left the hospital separately), I cried lying on the bed, holding my dog. Everything I'd learned--about my body, about my baby's now very, very close exit into the world--terrified me all once. It didn't help that, 10 minutes after lying down, I'd pulled my computer onto my lap and googled "preeclampsia."
However, I started to see that all the little warning signs I'd thought of had added up to something big. My puffy feet and hands were "normal" of pregnancy, but the degree to which they had swollen in the past two weeks had become scary. My headaches, my weight gain, my suddenly low number of trips to the bathroom... little warning signs that don't seem like they add up to anything other than pregnancy. I thought I was just being anxious and weird (which, to be honest, I always think I have something potentially deadly lurking), but I was really seeing tiny fragments of a big picture.
What this means for Danny, Forrest, and I is very simple: for the next few days, I monitor my blood pressure religiously and go to the doctor every two days. If I get a high BP reading, I call my doctor; if I feel weird or start getting an even worse headache, I call my doctor. I'll be doing another NST on Tuesday and an ultrasound on Thursday.
The biggest, scariest part is this: Most likely, Forrest will be born by Friday.
Let that sink in for a minute. I've lived in relative sureness that I would go over my due date. In fact, I think if it was up to Forrest and his wishes, he'd be in there for a long longer. However, as my doctor has told me multiple times, at a certain point, the benefits won't outweigh the risks. His health, at a certain point, can't trump mine, because there isn't much point into bringing a baby into the world if I die in the process.
I'm really lucky to have caught my preeclampsia early in its onset (it can start incredibly suddenly and skyrocket in days) and to have developed it so late in my pregnancy. Forrest is lucky too: if he is born on Friday at the latest, he will be 37 weeks, which is passed the typical need for a NICU stay. I'm lucky that I have an excellent doctor and access to incredible Mother-Baby services. My stay in the hospital was unpleasant, but each and every single nurse and CNA I met was amazing. I'm lucky that I have a great husband to fetch me more water and a great dog to "babysit" me. I'm also lucky to have a mom and dad who bend over backwards to make sure I'm ok and have what I need. I'm surrounded by really great friends and family, so Forrest and I couldn't be any luckier, preeclampsia or not.