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Tag Archives: Preeclampsia

News Roller Coaster

12 Monday Nov 2012

Posted by amomentinmarch in Uncategorized

≈ 2 Comments

Tags

HELLP, Preeclampsia, pregnancy complications, Rainbow baby

I have never been a big fan of roller coasters, and last week featured way too many ups and downs.  Tuesday we found out we were having a pair of boys.  I foresee baseball and boy scouts in our future. The ultrasounds looked great for both boys; strong heart rates, 20 fingers and toes accounted for, no soft markers for any issues!

The following day I saw my regular OBGYN.  By her line of questions as she entered the room, I could tell something was amiss.  Turns out, her in office quick screen I tested positive for proteinuria.  Basically that means my kidneys are spilling proteins for some reason. While this is one indicator of preeclampsia, alone it would not lead to a diagnosis for preeclampsia.  She was very surprised the specialist hadn’t caught it the day before.  She decided to have me do a 24 hour screen, which is a much more accurate test to be sure there was not an anomaly.   She also decided for the time being it would be best for me to work from home.  She stopped short of putting me on bed rest and stressed I was not yet confined to the house or the bed for that matter, I just need to take it easy.

Thursday, things were looking back up again.  All of my routine blood work came back and everything looked great.  My platelet count was holding steady.  This was great news!

But then came Friday’s news!  I got a call from Dr. Reed.  When I was pregnant with Ansley, I saw him once.  I had not seen him since, but I knew when I was in the hospital he was the one requesting tests for research purposes and had been following my case.  I was yet to actually see him in this pregnancy, so you can imagine my concern as I am listening to his voicemail and he is asking me to call him.  Before I called him back, I called Chris and gave him a heads up.

Dr. Reed had been calling to discuss my sequential screen results.  The sequential screen is a test that is done in multiple parts to screen for Down Syndrome, Trisomy 18 and neural tube defects.  He started by discussing the Down syndrome results, I tested just outside the norm… again.  I tested the exact same with Ansley and it was a false positive.  He stressed they didn’t see any markers on the ultrasound, twins often throw the numbers off and as stands it was .2% chance based on my numbers.  All in all, I was not too concerned about this result, but it is something I will keep in mind.  There is another blood test I can do called MaterniT21, but it is only 95% accurate with twins.  The bigger concern for him was my high Alpha Fetoprotein levels, aka AFP levels.

Typically, high levels of AFP would be indicative of a neural tube disorder like Spina Bifida.  However, in reviewing my ultrasound he could see about 90% of what he needed to see to rule that out.  He said they will check again in my next ultrasound, but he wasn’t concerned about a neural tube disorder.  His largest concern was based on newer research that has shown a strong link between a poorly functioning/ weak placenta and high AFP levels.  A weak placenta can cause pregnancy complications like preeclampsia, small gestational age, preterm labor, early preterm labor (28 weeks or earlier) and HELLP.  Mixed with my history, the fact I am having twins, and now high AFP levels, he felt strongly that, at a minimum, I will develop preeclampsia during this pregnancy.

This was not exactly new news; my OB has done a good job of making sure we understand all that this pregnancy will likely encounter.  She told me the day we found out about the twins that this would not be a normal pregnancy.  She told me to expect bed rest, hospital bed rest, and that I would possibly deliver preterm via an emergency c-section.   I have done the best I can of preparing myself for whatever happens while trying to remain optimistic.  To me, this is just one more road bump to get past.  That being said, this road is getting awfully bumpy!

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The Moment- part 2

20 Tuesday Mar 2012

Posted by amomentinmarch in Pregnancy

≈ 8 Comments

Tags

health, HELLP, perinatal loss, Preeclampsia, Pregnancy Loss, Stillborn

 

We arrived at the Emergency Room at Emory John’s Creek Hospital.  They told us that since I was in my third trimester we needed to go straight to labor and delivery.  It was standard procedure.  Having not done our hospital tour yet, we were unsure where we were going.  A nice young lady escorted us upstairs where we were greeted by Nurse Linda.   Nurse Linda asked what brought me there.  I gave her my same list of seemingly minor issues: my back hurt, I just did feel great, and my blood pressure was up 160/89 at home and 220/212 at the urgent care.  She said well let’s get you in a room and check a few things.

She began to put me in one room and then changed her mind, one of the many things that only made sense in the days to come.   She had me change into a hospital gown, collected a few samples, checked my BP it was now 189/96; she hooked up a fetal baby monitor and advised that we make ourselves comfortable.

We debated calling family, but there was really nothing to tell. We were sure it wouldn’t be long before they would send us home.  Instead we watched a little TV, I believe the 6 o’clock news.  A quiet room with TV, defiantly a benefit of being in L&D rather than the ER.  It was neat to lay there listening to Ansley’s heartbeat on the fetal monitor.   I had heard it many times before in the doctor’s office, but only for a minute or two.  Ansley was way more active than usual.  I told Chris we must have a little gymnast because she is doing back hand-springs.

Hours passed and nobody was really telling us much.  Finally, Nurse Linda came back in and advised they would be coming to drawing more blood and may start and IV line, just incase the doctor wanted to use it.  She was very nonchalant.

A few minutes later the anesthesiologist came by.  He said, “I hear you have stubborn veins”.  Story of my life, nurses and lab techs always have a hard time finding my small deep veins.  He was not much older than Chris and I.  He hung out in the room for a while making small talk.  He explained it was a slow day at the hospital and he prides himself on getting a good vein every time on the first try.

He plunged the needle into my arm much like someone throwing a dart.  Before he could get the tube on, a volcano of blood erupted. It went everywhere, all over me, all over him, the bed, the floor, I am pretty sure even the ceiling.   It was a shocking sight, but he made a quick joke and laughed it off.

He said while he was there he was going to put and IV line in my hand in case they wanted to give me some fluids.  Then for good measure he added a line to my other hand as well.

I bit more time past before Nurse Linda reappeared, she wanted to introduce me to the night nurse, but explained she was going to hang around for a bit.  The doctor should be in soon to talk to me.

It was now after 9:00, Dr. Betty Anthony finally stopped by my room. She told me I was very, very ill.  I had a condition called HELLP Syndrome.  It was serious.  My platelet count had dropped to 30,000 and was continuing drop.

I may as well have been listening to Charley Brown’s teacher.  MAW, MAW, MAW, MAW.  What she said meant NOTHING to me.  I had never heard of HELLP syndrome and 30,000 sounded like a big number to me.  Not to mention, I didn’t feel ill, my only real complaint was my back hurt.

There was no questioning the next words out of her mouth.   They were prepping the OR for an emergency c-section; I was going to deliver Ansley that night.  They were waiting on the blood bank and the neonatologist would be in soon to speak with me.   In the mean time, they were giving me a corticosteroid injection-every little bit would help.

Moments later Chris and I were alone in the room again, both of our heads spinning trying to wrap around what just happened, or more what was about to happen.  It was time to call our families. Chris picked up the phone and called my parents.  My mom answered the phone.  I heard him tell her we were at that hospital, I was very sick, and I had to deliver Ansley that night.  I heard my usually soft-spoken mom scream “WHAT!!!” through the phone across the room.  She and my dad wold be right there.  He told her what hospital we were at and then proceeded to call his parents with the same news.

My parents and Chris’s mom arrived what seemed like moments later.  My parents live an hour away, but it couldn’t have been more than 30 minutes.  The doctor and nurses hadn’t been back in the room yet.  I tried to explain I had a condition called HELLP syndrome, but that was really all I knew.  I heard Nurse Linda say as she entered the room, “yes that is right. We are pretty worried about your liver”  This still didn’t add any clarity to the situation.   Chris had seen the name in his Google search the night before, but it was described as the most severe form of Preeclampsia and since I didn’t have Preeclampsia he didn’t click on it to read anymore.

Nurse Linda brought me an ice-cold towel and told me they were going to be starting a Mag drip.  The first push of medicine would make me hot.  Hot, that was an UNDERSTATEMENT.  As soon as the meds hit the IV my veins burned like crazy followed by insane sweating.  My mom pulled my hair up it was soaking wet instantly.  Nurse Linda explained the Mag would prevent me from having a seizure or stroke and while uncomfortable it was necessary. About this time my brothers showed up.

Nurse Linda assured me I was in good hands, and that she had been off for 3 hours now and really did need to leave.  She told me she was off the next day, but would call me to check on me.   As she left the room it was filling with other people.  A tech brought me the phone, my doctor was on the line. She told me that while she couldn’t be there tonight, she has been informed every step of the way and fully supported the decision that was made to deliver Ansley.  She told me I was in great hands with Dr. Anthony and she would be there first thing in the morning.  By this time the room was full.  The night nurse Sharon, who I soon learned would be my personal nurse for the night, two additional nurses, a tech, the anesthesiologist, the neonatologist and Dr. Anthony along with my parents, my brothers, Chris’s mom and of course Chris and I.

The neonatologist told me he was going to scrub up.  That at 24 weeks Ansley would have a less than 10% survival rate.  They were prepared and would do everything they could.  He told me that if it were up to him I would wait 24-48 hours get a few more corticosteroid injections and that would raise the survival rate immensely.  I was game, lets wait!  I was quickly told that was not an option and the choice was not up to me.

They began to prep me for surgery.  They removed the fetal monitor to wipe down my stomach.  The incision would not be a normal one it would be vertical because she was small and had not dropped yet. They put a surgical cap on my head and placed the fetal monitor back on my stomach but couldn’t find her heartbeat.  I panicked! “Oh there it is” a nurse said with relief in her voice, but then it was gone again. The second nurse took the monitor and was moving it all over my stomach.  It only took a second for the doctor to get frustrated.  She requested the print out of heartbeat and took over.  She dug the monitor deep into my stomach.  I wasn’t even breathing at this point.  And, I don’t think anyone else in the room was either. On several occasions they heard a beat or two, but then it was gone again. Her heartbeat was weak at best.  Dr. Anthony requested an ultrasound machine, this would be better anyway.  She could see exactly where she was.

Instantly the neonatologist appeared with the ultrasound machine.  There seemed to be even more people in the room now.  Dr. Anthony wasted no time getting it set up.  She stared at the screen for a while.  Sharon my night nurse shoved a thermometer in my mouth, still getting ready for surgery.  I could see Ansley out of the corner of my eye.  She wasn’t moving.

Dr. Anthony took a deep breath looked up at Chris and said.

I am so sorry, she is gone.

I heard the words, but I didn’t react at all.  I felt like I was an audience member simply watching a show.  I saw Chris drop his head into his hands, tears stream down my mom’s face, shocked looks by all in the room.  I even saw myself, the nurse was prying the thermometer out of my mouth telling me I had to stop clenching my teeth.  Time was moving in slow motion.  Chris’s mom told the doctor she was wrong.  The other nurse found the heartbeat why couldn’t she.  Dr. Antony left and returned with a second ultrasound machine, in so much disbelief herself, she thought perhaps the first machine was broken.  It wasn’t broken.  My daughter had died practically before our very eyes.

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