Where to start? My mom says that I should define pre-eclampsia.
Pre-eclampsia or preeclampsia is a medical condition in which hypertension (i.e. high blood pressure) arises in pregnancy (pregnancy-induced hypertension) in association with significant amounts of protein in the urine.
We went for an ultrasound on Wednesday at my OB where they were going to check the growth, and Gracie had dropped from the 24th percentile to the 13th percentile. She had gained about a pound, but obviously the drop in percentile was concerning. My doctor was out of town (ugh) so I saw one of her partners, who reminded me of Billy Bob Thornton. They took my blood pressure (normal) and my weight (which said I had gained 5 pounds in the last week). I was surprised by the amount I had gained but figured it was because I was weighed on a different scale than I normally weigh there. Due to some mixed messages, they didn't actually take a urine sample that day.
The doctor I saw said it was a concern, but we weren't in dire straights until she dropped under the 10th percentile. He sent me to the perinatologist that day--I wasn't able to get into the same one I've seen twice before, so I saw another one (that I didn't like as much). He also agreed that it wasn't a concern until she dropped under the 10th percentile. My frustration was 1) why do you wait until you hit rock bottom to do something and 2) why can't anyone tell me what's causing this? I was very upset by everything that day. All that they told me was to come back in 2 weeks for a growth scan.
Apparently you can't do growth scans more frequently than that (which is super frustrating).
I already had an appointment scheduled with my OB for Friday, so I went in with three pages of notes and the intent that we were going to leave with a plan. They took my urine sample and my blood pressure before I saw the doctor. My blood pressure was higher than average--my blood pressure normally runs on the low side, so I noticed and made Corey right it down.
Then Dr. O came in and said there was protein in my urine (+2) for the first time ever with them testing it. She did a Blood Pressure check as well and it was even higher than it had been with the medical assistant. All my questions, some of which I had already started into, were no longer the focus of the appointment. She told me that she thought I might have pre-eclampsia and that we needed to do some further testing. She wanted to do another biophysical profile (with the ultrasound) and then send me over to the hospital (which is next door to her office) to monitor my blood pressure for awhile and do a non-stress test. She said that she would likely put me on bed rest through the weekend and have me come back to her office on Monday for further testing.
She said that this could definitely be the cause of all of the issues we've been dealing with in the last 4 weeks. She said that sometimes, the blood vessels will be affected internally and cause problems with the placenta. The placenta can then cause low amniotic fluid and the baby's growth before it shows up with the classic external signs--i.e., high blood pressure and protein in the urine.
Corey and I both looked at each other after she left the room and talked about how relieved we were--finally, an explanation for what might be the root cause of the issues. I had heard of pre-eclampsia and I know people who survived to tell the tale and have very healthy happy children, so I knew that it can often be managed with bed-rest.
We went for our biophysical profile ultrasound, and the baby looked great. Then we went over to the hospital and they started monitoring my blood pressure. The also did a blood test. Once the blood test results came back, Dr. O came to visit us and told us she wanted me to stay overnight to do a 24-hour urine collection (gross) to get a better idea of how things look and see where we should go from there. I was a little bit disappointed that I didn't get to go home, but prepared to stay and do whatever we needed to find out what we needed to do.
The next day, which was Saturday, was covered by the on-call doctor--who happens to be my doctor's husband. This was my first time meeting him, and I liked him a lot. He's very focused and detailed which appeals to my need for data and information. He also gets the opportunity to talk to my doctor at home about what is going on, which I like. After we got the urine collection done, he made the decision to keep me in the hospital another day for observation. My numbers definitely made it clear that I had pre-eclampsia, my blood pressures were still fairly unpredictable, and they didn't feel comfortable sending me home. They still don't, and I'm 99.9% certain I will be in here until Baby Gracie is here.
Since Saturday, I've done 2 more 24-hour urine collections. They've taken my blood 3 times now (and will again tomorrow). They test my blood pressure every 4 hours and they do Non-Stress Tests twice a day. The baby is still looking fantastic. My blood pressure is really good sometimes, and other times it's totally crazy, but never at the levels that they send you straight to delivery for. And every day it seems there is another concern with something that comes back from my labs. My creatinin clearance is higher than normal, definitely in the pre-eclampsia range, but it isn't at the point that they have to deliver. My platelets are low, but not low enough to where they would deliver. Some of my other numbers are a bit wonky. I've got the swelling associated with pre-eclampsia. I haven't been dealing with any headaches which is good and I'm not seeing spots. So far, so good.
So basically, we are in a holding pattern. I'm getting to know the nurses. The baby is still breech, so I will likely be having a c-section. The latest I will go is 37 weeks (February 28th) but if enough things are a concern or one of my numbers gets too low or high (depending on what it is supposed to be) than it's show time for me. I am absolutely thrilled that we got to the 35 week point. I'm nervous we won't get to 36 weeks, and in some ways, I'm also nervous that we will go all the way to 37 weeks with me still in here--I want to do everything I can for the health of my baby, but 2 weeks more in here might send me to the looney bin (I say that, but honestly, if I could get to 37 weeks, it would be a very good thing and I'm willing to do it if I'm able to based on labs and my symptoms).
So now, here I sit in my hospital bed. 35 weeks and 1 day pregnant. Thrilled that I didn't have a Valentine's Day baby. While this isn't what I envisioned I would be doing in my last few weeks of pregnancy, there is only so much you can control. I am trying to look on the bright side of things as much as I can and trying not to let myself go to some of the scary places my brain can go. I'm trying not to think about what eclampsia means (seizures). I'm trying not to worry about my baby possibly having to spend weeks in NICU if she is born with problems related to prematurity. I'm trying not to cry my eyes out about how much I miss my cats. I'm trying not to worry about using too much of my FMLA leave before my baby is born. I'm just trying to let go and realize that nothing I can do at this point other than following doctor's instructions is going to change things.
Bed rest is really much more difficult than I thought it would be. I'm not allowed to get up on my feet except to go to the bathroom and I can take a 5 minute shower once a day. Today I finally got permission to go on wheelchair rides twice a day around the hospital, which is thrilling, as I hadn't left my room since Saturday (when I moved to a bigger room). It's fun getting to see the babies all swaddled up. They look like little burritos. I'm getting a little bit stir crazy. I'm starting up deep conversations with my nurses and talking a little bit too much to the cleaning staff. I feel sick at the idea that I'm not getting to put the finishing touches on my baby girls room--instead, Corey is having to do those things on his own or with the help of my family. It's hard to give up control of something like that for me. And I can't think of a time in my life when I've felt such an urge to do so many things--definitely that nesting instinct kicking in. It's hard handing it over to others, and I really appreciate all that they are doing to help.
I'm overwhelmed by the amount of support I've received from friends, family members and coworkers. My room is beginning to look like a floral shop. I rarely spend anytime alone without my family around. My husband has been a rock star throughout this whole experience. Overall, the staff here is incredible and so warm and caring. I feel very lucky that me and Gracie are where we are.
My mom has been amazing--she has done all of the laundry for the Newborn and 0-3 month clothing, and all of the sheets and blankets. She has also been helping us with our laundry and so many other things. She spends the night when Corey needs a break (starting a new job in the midst of all of this has been an interesting challenge-lucky he really likes it and the people there are great). My sister has been so great--she gets my mind off of things, she brought me a computer charger because mine currently doesn't work, she brought me great magazines to read and Designing Women DVDs. My dad comes over to the hospital and spends a lot of time with me--he tells me stories and makes me laugh and helps get me centered. My husband has been so sweet and amazingly supportive. I have never loved him more than I do right now. He got me roses for Valentine's Day. We had a romantic Italian dinner last night to celebrate Valentine's Day and the fact that we haven't had a baby yet (woohoo!). We had our favorite dessert and talked about how someday, we would tell Corey about how special this Valentine's Day before her birth was. Last night Corey climbed into my hospital bed and spooned me and Gracie for quite a few hours--eventually he had to go to the cot because the bed can be pretty small, especially when shared with a 8 1/2 month pregnant lady. My blood pressure is consistently lower when he is here.
A couple of nights ago, Corey and I met with the NICU Nurse Practitioner for about an hour. She went over a ton of information and was very helpful--a few things she said stood out, though. One funny thing--she said for a baby to either avoid or be discharged from NICU, they have to act like a "grown up baby." Then she had a whole list of things that defined a grown up baby for them. For some reason, that made me giggle. She also said that if our baby had been born at 34 weeks and 6 days, it's hospital policy that they have to go to NICU. At 35 weeks, it then becomes more about how the baby does and not about their age. Finally, she said that baby girls are much stronger than baby boys. They tend to do better than their male counterparts if they are born early.
I think Grace is a fighter. I think she is a very strong, smart girl. And I know that I love her more than I have ever loved anyone. I can't wait (but I really can wait so don't get any ideas) to meet her.
--Elizabeth
