“135 over 85,” said the nurse, as she removed the blood pressure cuff from my arm. I looked at her in surprise. I was 32 weeks into a perfectly planned, perfectly healthy pregnancy. I was 32 weeks into a pregnancy with perfect blood pressures of 115/70. That’s higher than normal, I thought to myself.
The doctor came in and did a brief exam. I waited for him to address the blood pressure, but he simply smiled and said he’d see me in two weeks.
“I wanted to ask you about my blood pressure,” I said. “It was higher than normal.”
He looked surprised and checked my chart. “Well, it’s not too high, and since you didn’t have any protein in your urine…” he flipped the page, “Oh, wait. You did have some protein in your urine. Why don’t we have you come back in one week instead of two.”
Seven days later, I was back in the office, this time with hours worth of googled preeclampsia knowledge crammed into my head. My feet and legs had started to swell, and I had gained about a pound a day. Yohannes was with me this time, standing beside me as the nurse took my blood pressure once again. I could feel the cuff grow tighter and tighter – not a good sign.
“180 over 140,” the nurse said.
From there, everything was a bit of a blur. The midwife informed us that there was now “quite a bit” of protein in my urine, and I was taken over the Labor and Delivery Triage, and then admitted for severe preeclampsia. For the next seven days I was confined to a hospital bed, while Yohannes and my parents tried to balance work, taking care of Nati, and being with me at the hospital.
My number one job was to lay as flat and still as possible – to try to keep my blood pressure down. But I had frequent visits from a sweet 2 year old Nati who was eager to jump on my bed and touch the many beeping machines in my room. We had never been apart for more than 24 hours, and the extended hospital stay was hard on both of us.
My number two job was to collect all of my pee in a plastic “hat” to be measured against my fluid intake and tested to determine my kidney function. The goal, we were told, was to postpone delivery for as long as possible. But if my symptoms progressed, labor would be induced. They explained the risks to the baby if it was born prematurely. They explained the risks to me of continuing the pregnancy.
I can’t explain the guilt I felt, as my body continued to deteriorate. The baby was measuring small. It wasn’t ready for the world. But I couldn’t keep it safe like I was supposed to. I remember late one night, after getting up to use the bathroom, I stood in front of the mirror in my hospital room and framed my 33 week belly with my hands. See? it’s not that small, I told myself. But it did seem quite small.
Eventually, I began to experience disturbances in my vision, and my creatinine levels hit the magic number: my kidney function was too low to safely continue the pregnancy. I was induced. I cannot give Yohannes and my mom enough credit for staying by my side during the
Armageddon events that followed.
A Recipe for Labor and Delivery with Preeclampsia:
- Hang saline solution and start IV line for various fluids and drugs that may be required.
- Give Magnesium Sulfate to reduce risk of seizure. Note: May cause patient to remain in a semi-lucid state for duration of treatment. Also Note: May cause profuse vomiting. Not for the faint of heart.
- Give Pitocin to induce labor.
- Give antibiotics to mitigate possible Strep B infection, which could not be ruled out in advance.
- Bring second IV pole.
- Give Nubain to relieve blindingly painful hypertension-induced headache. Note: When patients says, “Wow! That’s amazing!” she is undoubtedly referring to the pain-relieving function of the drug, not her first experience with a narcotic.
- Give oxygen to counteract low O2 levels due to patient forgetting to breathe courtesy of Nubain induced sedation.
- Give epidural because what in the heck could the patient possibly be trying to prove at this point by going “natural.” Note: If the long-awaited anesthesiologist appears, opens the back of the patient’s gown, spies a bra, and says he will come back later when the patient is properly undressed, THANK THE GOOD LORD for the nurses who insist that he stay while they hurriedly remove it.
- When patient says, “Something is coming out!”, the lack of specificity is due to the aforementioned epidural, and the thing that is coming out is, in fact, the BABY! Please call the doctor.
They had prepared us for what would happen when the baby was born. That the doctors from the NICU would be waiting to whisk it away. So when she came out (SHE!) so small, and pink, and crying, and they wrapped her up and laid her on my chest, I could not believe my good luck. I must have asked 4 or 5 times in disbelief, “I get to hold her?!” Those few beautiful moments in the midst of chaos were priceless.
But the doctor was having a hard time stopping the bleeding due to uterine atony. She had to perform bimanual uterine compression, which was…unpleasant, so I asked them to take the baby from me. Yohannes followed the baby to the NICU, and I remember very little of the next 24 to 48 hours. My recovery was slow due to medication side-effects and blood loss, and I hardly got to see Lily at all. When I did see her, there were always so many people – nurses, doctors, lactation consultants – that I was flustered and nervous. Even though I had cared for a baby before, I felt unsure of myself with someone always watching over my shoulder.
I was released from the Hospital after a few more days, and my life became a cycle of caring for Nati, pumping, getting a ride to the NICU (I was still having vision problems), feeding Lily, getting a ride home from the NICU, taking care of Nati, pumping, etc., etc. There were days when we thought she would come home within 24 hours, and then she would have a setback and have to stay another week. I shed tears of exhaustion, tears of guilt for being away from Nati, tears of guilt for being away from Lily, tears of disappointment when I spilled a hard-earned bottle of breast-milk all over the NICU floor.
But as difficult as it was, we were lucky. She was healthy. She was strong. And she came home from the NICU exactly 5 years ago today.
We love you, baby girl!