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Pre-Eclampsia Watch Dog on the loose. - Page 7

post #121 of 601
I just found this thread and am sooo glad that this info is here for pregnant mamas to read.

I was diagnosed with HELLP syndrome during my first pregnancy, at 23 weeks. I had no idea what was going on with me. I felt a little "weird" but didn't have headaches, epigastric pain, nose bleeds... I just happened to have my regular monthly OB appointment that day. They immediately knew I had pre-eclampsia because my BP was something like 180/125 and my reflexes were hyper-sensitive. After a blood test showing that my liver enzymes were also very high I was admitted to the hospital and placed under the care of specialists.

They immediately induced labor and after 48 hrs of labor I delivered my son, stillborn. He weighed only 13.8 ounces and was 11 1/2 inches long.

I had no family history of pre-e or any pregnancy complications really. My doctors later determined that I have an auto-immune disease called Antiphospholipid Syndrome, a blood-clotting disorder.

Since then, I've had second and third pregnancies that ended in healthy baby boys!!! I had HELLP syndrome again with my second. He was delivered at 34 weeks after my being on bedrest since my 29th week. We were both in the hospital for 8 days after delivery (he was in the NICU). I only had pre-eclampsia with my third. He was born at 37 weeks perfectly healthy and I didn't have to be on bedrest at all!

I was on aspirin therapy and daily Lovenox/heparin injections with my second and third pregnancies. I was also watched VERY closely, I went every other week from the start of my pregnancies, then every week, then twice a week with ultra-sounds at every appointment. Once I was in my third trimester I was doing non-stress tests every week also.

I feel that I owe my life and the lives of my boys to my excellent doctors. They were awesome during everything.

A couple weeks after my third pregnancy I had a blood clot in my leg (DVT). A week later it traveled to my lung (pulmonary embolism). I was at increased risk for this due to my Antiphospholipid Syndrome. They tried treating the DVT with the same Lovenox/heparin therapy that was used during my pregnancies, but I'd developed an allergy to it due to being on the medication for such long periods of time. So, I had to be admitted to the hospital for 9 days (this was when my third ds was only 4 weeks old) on intravenious treatment to thin my blood. I couldn't breastfeed him, so he was on formula and I was pumping and dumping to keep up my supply. It was a very stressful time for both of us because we were separated for that length of time.

Anyway, I'm now on Coumadin for the rest of my life. At 26 years old, that is scary, but better than the alternative!

I hope that all pregnant mamas at MDC read this thread. It helps so much just to be in tune with your body so you know when something is not right.

Thanks for letting me share my story!
post #122 of 601

starting to worry

I'm new to the MDC boards but unfortunately I'm not new to Pre-e. My first was born at 36 weeks due to a sudden onset of pre-e. I went from feeling perfectly fine one week to a week later spilling protein (+3 on the strips, and 2.5g at the 24 hour urine collection), having headaches and seeing spots. So they delivered right away. My OB at the time lied to me to perform a cesarean after only 6 hours of induction (which was progressing well, though slowly) so that he could begin his weekend. My son was taken to the Children's Hospital of Philadelphia (we live about an hour away in Southern NJ) and put on a ventillator. We were able to bring him home after 16 days.

This time around I'm seeing a perinatologist, Dr. Debbs, and a different OB, Dr. Bredin. They've both been great so far. I was really hoping for a VBAC this time around but it's starting to look like that may not be in the cards. I had an OB appointment today with a CNM, Monica. This was my first time meeting her. Dr. Bredin wanted me to meet the other staff though she's the only one who can do my delivery because I'm high risk and where I'm delivering. Today my bp was 130/83 (normally 112/60) and there were trace amounts of protein in my urine. I've been swelling the past couple of weeks in my face and feet, and I've been having headaches and nausea. I've also been having nosebleeds pretty often, which didn't happen the first time. The CNM is being pretty relaxed about it and wants me back in a week instead of 2 to check my protein levels again. Dr. Debbs told me he wanted to see me if I started showing any signs of pre-e again. So I called his office and scheduled an appointment for Tuesday. I don't feel that the CNM was taking it seriously enough at all given my history. I'm 31 weeks 3 days along right now. I'm so scared that I'm going to have to go through all of that again and having a preemie 75 miles away with an almost 2 year old at home who needs me as well. I'm dreading having to schedule a repeat cesarean. We just moved into a 3rd floor apartment with no handicapped access (dumb, I know). I have no idea how I'll get up here after a cesarean. I had enough trouble shuffling around after Aidan without adding 30 stairs to the mix. I also dread having to be away from one of the kids at all times. I'm going to feel horrible when I'm at the hospital with Ryan because I know Aidan will be missing me and not understand why mommy is gone all the time but I'll feel just as bad at home when I know my helpless little newborn needs his mommy too. I guess it wouldn't be so bad if the NICU wasn't over an hour away. I don't know how people do it.

Anyway, I just wanted to say I'm glad this thread is here. I didn't realize the stomach/rib pain was also a part of it. I had it pretty severely when I was pregnant with Aidan and for a few weeks after and my OB said it was normal. I would have insisted on further evaluation if I realized it was a sign of liver dysfunction. I have had it again the past couple of weeks but had written it off because of last time. It's something I'll definitely bring up with the perinatologist on Tuesday. I've had swelling/headaches the past couple of weeks and had a feeling things were going wrong again. The elevated bp and protein in my urine have me even more worried. I'm trying to stay calm and relaxed but it's definitely hard. I'm hoping the earlier symptoms this time aroud means it will progress more slowly and we'll still be able to make it close to full term. I'm definitely not ready to have him yet!

post #123 of 601
Jillene, when is your appointment with your OB, I think you are very right to be concerned, however, I honestly don't know that I'd wait too long, you have a spike of 23 points in your lower number and that is serious. Are you currently on blood pressure medication?? One thing to consider is if you insist on being taken seriously, it is often possible for them to control things with blood pressure meds for at least a little while to get the baby further along--the problem from my understanding however is that once it's gone too far, it's just too late for attempts at control. I definitelywould not suggest waiting until the appt with your peri on Tuesday. Do you have a home bp monitor?? Trace protein is no big deal, but headaches, facial and upper extremity swelling, nosebleeds and nausea are far too many red flags in my opinion. Couple that with upper quadrant pain (which side is the pain on????) and I really think you need to be getting liver enzymes and a 24 hr urine done NOW, not next week, especially at only 31 weeks.
I'm not trying to scare you (well, yeah, I guess I am trying to scare you, but better scared for no reason than sorry)
post #124 of 601
Jillene, I'm no expert but I agree with Shannon - I think Tuesday is too long to wait to get checked. Please call your OB TODAY and insist on being seen. Otherwise go to the ER. Please don't wait. Better safe than sorry.
post #125 of 601
Thread Starter 
Dear Jillene,
I am so sorry to hear about your first experience with pre-e. After Aidan was born did your Dr.s do any dna blood work on you to test for blood clotting factors? Have you been on any aspirin therapy of heparin shots this pregnancy? I am sorry that it looks like pre-e is rearing its ugly head again. PLease keep us posted on your progress. I am glad you called your doctor back and made an early appointment but I think maybe you should see your doctor sooner than that if possible. I would have some words to say about the CNM's lackadaisical attitude. Especially since you have so many sypmtoms. We have a member here, Kimberlylibby, who was on bedrest for a few weeks and managed to stave off pre-e until her daughter was ready. I will keep you in my prayers.

Thank you so much for sharing your story with us. It is always so encouraging to read stories with positive outcomes. I hope you stick around to be an inspiration to the rest of us.
post #126 of 601
Hi Jillene,

You've gotten some great advice so far, I just wanted to say hello and that I've struggled w/ pre-e & HELLP. My boys were born at 31 & 32 weeks...so if you go that early, I'll be thinking of you.
post #127 of 601
Shannon, I had an appointment today with the midwife and I have an appointment for next Friday to follow up on the protein, again with the midwife. The OB is apparently completely booked all next week (I asked to see her instead of the midwife again). I was told I could try calling each morning to see if she's had a cancellation but otherwise it would be a couple of weeks before I can see the OB. That's why I called the peri directly instead of waiting until after next Friday. The soonest they could get me in is Tuesday.

I am not currently on any type of bp medication or treatment. My bp never spiked the first time and has been normal up until today. I think the reason I'm more concerned with the protein is that I do have a genetic condition that predisposes me to kidney problems (Nail Patella Syndrome - http://www.nailpatella.org) and because that was the only measurable sign they had the first time around - the sudden spilling of large amounts of protein.

The pain is on the right, just under my ribs. There isn't any atm, it comes off and on. I can't lay on my right side though because it hurts too much and makes it really hard to breathe. I'd just figured it was the way the baby is positioned because his butt and feet are on the right. His head is right down in my pelvis.

I do not have a home bp monitor. I was told by my insurance case manager that I can get one and a nurse to show me how to use it for free if the doctor says it's needed. I may just have dh pick one up on the way home from work though. He has to go to WalMart anyway.

Gossamer - I did not have any DNA testing done for clotthing factors. No aspirin therapy or heparin shots. I did have a moderate hemorrhage between the uterus and the placenta in the beginning (around 8 weeks), but it's since cleared up. Not sure if that's related at all. Other than the developments of the past couple of weeks everything has been going perfectly. The baby is even measuring more like he's due 5/26, which makes me feel slightly better because my first ds was always measuring at least a week behind the due date.

Thanks for your prayers! I will definitely keep you all updated!
post #128 of 601
Jillene, I know it's a huge pain, especially with a toddler, but I would strongly urge you to go to emerg and be seen earlier than tuesday, as you saw the last time, symptoms can escalate extremely quickly--in some of Gossamer's earlier posts you'll see she says eclampsia is latin for lightening (I think, I think!)
At least they can run blood work to have a base line and perhaps they will put you on bp meds--or I'll warn you now, they may put you on bedrest, but it's well worth it.
My guess is that if they find anything on the blood work, they can then call your OB and ask her what she wants to do--and I'm quite sure that miraculously there will be a way for her to see you early next week.
Please take care and please let us know what happens. Just so you know, I was on heparin injections, baby aspirin and blood pressure meds for my pregnancy adn they managed to hold me off to 37 weeks (although the span between 36 & 37 were spent in hospital) anyway, she was just fine at birth, not a single issue.
post #129 of 601
I definitely would not wait until Tuesday. At 31 weeks the baby should still have plenty of room to move around and not be so high up and so stuck in a position that would cause you pain like that. Please call the doctor and tell them you need to be seen now or else go to the ER. Again, much much better safe than sorry - Tuesday is too long to wait.
post #130 of 601
Thread Starter 
That pain you are describing sounds like liver pain. YOu can't breathe because your liver is enlarged and your lungs cannot expand. Your liver is in danger of rupturing and with your nosebleeds I would be cautious of low platelets. If you have no platelets and your liver bursts you could very easily and quickly bleed to death internally. My vote is for going to the er immediately. The life of your child is worth a trip to the er. Pre-e can also result in placental abruption and if you are not in the hospital being seen, it can almost certainly mean death to your unborn. Again, my vote is the ER IMMEDIATELY!
post #131 of 601
How are you this morning Jillene??
post #132 of 601
I'm feeling okay. I went and bought a blood pressure cuff last night and it's been back down to normal all night. It's been staying around 116/70. That's a relief at least. I ordered some protein test strips online since I couldn't find any at my local pharmmacies. They kept trying to give me ketostix, but ketosis is more of a diabetes thing than a proteinuria thing. All the presence of ketones will tell you is if you're burning fat cells. Not quite the info I need. So I ordered some URS-3 strips online. Those do protein, glucose and pH.

I do have some liver pain but it's nowhere near as bad as it was when I had Aidan. I don't think they ever checked my enzyme or platelet levels. If they did, they never mentioned it to me. On Tuesday I'll ask Dr. Debbs to check those when he orders the bloodwork for the 24 hour urine.

I know a couple of you want me to run to the ER now but instinctively, I don't feel that level of urgency yet. I prayed about it a lot last night and I feel comfortable with waiting until Tuesday so that's what I'm going to do.

On a side note, for the past week, I've had pain in my cervix like the way it felt when they did the cervadil and had me on pitocin the first time around. Like it's ripening already. Honestly, I don't want to do the preemie thing again, but if I'm going through pre-e again and it's going to happen anyway, I'd much rather go through it naturally. If my body is readying itself for an early labor, it gives me further confidence that it knows what it's doing and that it will recognize that it has to deliver the baby to save itself. I'd started dilating at around week 34-35 during the first pregnancy and I wouldn't be surprised if I had had him a couple of weeks early if the doctor hadn't felt the need to do an immediate induction (again, it was because of rapid rise in protein levels. My bp was normal that entire pregnancy).

I also bought an infant car seat last night. That was the one necessary thing we didn't have yet. I was putting it off because I've had this impending sense of urgency to get everything ready the past couple of weeks. I didn't really want to accept what my body apparently already knows, that I'll be going early again. Not sure if that makes any sense. I was just really hoping for a full term, normal, healthy, vaginal birth this time around. So buying the carseat last night was me admitting to myself that it's not likely to happen that way.

post #133 of 601
Jillene, I cannot possibly stress to you enough just how important and urgent this is. You are having symptoms of advanced pre-e and you are having MANY of the symptoms--sometimes it's too late when only one symptom shows up. Your bp does not have to be up to be dangerous, your liver pain does not have to be horrible to be serious. The problem with pre-e is that the later it is caught, the less can be done about it, caught early it can very often be controlled and managed until the baby is further along--but first both the mother and the doctors have to take it seriously! Your concern is having another baby in the NICU, your best way to prevent that is to be proactive about things and not let ANYTHING get out of hand. I can guarentee you and so will my doctor that had I NOT been diligent about my condition--which by the way NEVER got serious, that Molly would have been born well before 37 weeks. You are having liver pain, nosebleeds headaches, facial and upper extremity swelling and have a documented incidence of high blood pressure, in my opinion, you are FAR more urgent RIGHT NOW than I ever was. I'm sure you're feeling like we're trying to scare you, but my God, this is something you simply can't rest easy about--if you go in and they run blood work and it all comes back fine--then great, relax and just monitor it, but the fact is, until that blood work is done--you have NO IDEA how serious you are. Please read Gossamers story of Mary Rose and ask yourself if you can handle that outcome. Please read the story about when my mother had me--she went home from work (in the blood lab at a hospital) with a bit of a headache and 10 hrs later doctors were telling my father that neither she or I would survive.

So yeah, I am trying to scare you here--with the symptoms you describe, you should be scared--and if you mentioned them all to that midwife--frankly, she should be shot! Please do not take this lightly--the outcome of waiting and seeing could very well be the death of you and/or your baby. What is your fear of going in and just making sure everything is alright?? Are you worried they'll put you on bedrest??
post #134 of 601
I'm not worried about bedrest. I've pretty much put myself on limited activity (as much as possible with an almost 2 year old) and I'm drinking lots of water and keeping my feet up. The swelling has gone down a lot. My face doesn't looks so fat and I have ankle bones again. The baby is stil moving all over the place like crazy. I'm convinced he's going to be an acrobat.
Part of why I don't want to go in right this second is that I'll feel more stressed sitting in the ER all day surrounded by sick people than I will if I'm resting comfortably at home. We don't have anyone to watch my son and he's not feeling well. He's had a fever the past couple of days and horrible diarrhea. I don't really want to be exposing him to more germs when his immune system is already working overtime. And I definitely wouldn't want to go by myself, I'd want dh there with me for moral support. The only symptom I'm really feeling righ this second is a mild headache but that could easily be dehydration (just woke up about an hour ago).
I do understand how serious it is. I'm not taking it lightly or being dismissive of it. I did tell the midwife about everything, and I agree that she should be shot. I don't think she was taking it seriously at all. That's part of the reason I'd like to wait until Tuesday. I trust Dr. Debbs to take good care of me. I will call my OB though, and explain to her everything that happened yesterday and that I don't think the midwife is being cautious enough and ask her for lab paperwork. If I can get her to do that without having to go to the ER and deal with a bunch of strangers who don't know my history and who are just as likely to think I'm overreacting as the midwife did, then I'll certainly go in for the labwork. I think part of my problem is that my mother is a complainer. Everyday there's something horribly wrong with her and I'm always wary of coming off that way or of crying "wolf" I guess. I try not to complain unless I really think it's critical because I don't want to be ignored in the future if it is serious. Not that this isn't serious. I just don't want to go through crazy amounts of drama and stress myself out and make it worse than it already is.

post #135 of 601
Can you not go into labor and delivery directly?? I mean at least one OB has to be on call--what if you were having contractions?? Personally, I'd call labor and delivery and tell them you're having cervical pressure and pain and you're concerned something is wrong and you'd like to come in. I know at my hospital at least, once you're past 12 weeks, any problems you go directly to labor and delivery-if I arrived at the hospital and said I had a headache they would send me directly from the ER to be assessed at L&D.
I understand your fears of looking like you're overreacting but Jillene, in my OB's words, there is no such thing as overreacting to fears of pre-e. I don't think there's any such thing as over-reacting to any pregnancy concern and any good OB or OB nurse is going to feel the same way. I remember rushing into L&D because by 11 am I hadn't felt any movement, of course as soon as I arrived she was kicking and rolling, they did an NST anyway and I felt embarassed and said sheepishly to the nurse--"so she was just screwing with me?" the nurse laughed and said--"get used to it, she'll be screwing with you for the next 30 yrs or so. Then she said--"you can never be too safe, there's nothing so tragic as a late loss"
post #136 of 601
I wish. At our hospital you have to go to the ER first, even when in labor, and they evaluate you and decide whether or not you should be admitted to maternity. Then you get sent up to the floor maternity is on and get to wait again and go through another evaluation with the nurse and then she decides whether or not you need to see the OB.
Currently from my doctor's office, the stupid midwife is on call. I just found out when I called there and asked to leave a message for Dr. Bredin. So that's not going to help, although she did say if I start feeling worse to call and they'd see me sooner. But their office hours are M-F 9-4:30 so the soonest they'd see me in the office is Monday. Maybe she'd call ahead so I could go straight to L&D? I'll have to ask about that when I call back. I'll do that after I've eaten breakfast and readied myself for battle.

post #137 of 601
Originally Posted by jillene
I wish. At our hospital you have to go to the ER first, even when in labor, and they evaluate you and decide whether or not you should be admitted to maternity. Then you get sent up to the floor maternity is on and get to wait again and go through another evaluation with the nurse and then she decides whether or not you need to see the OB.
Currently from my doctor's office, the stupid midwife is on call. I just found out when I called there and asked to leave a message for Dr. Bredin. So that's not going to help, although she did say if I start feeling worse to call and they'd see me sooner. But their office hours are M-F 9-4:30 so the soonest they'd see me in the office is Monday. Maybe she'd call ahead so I could go straight to L&D? I'll have to ask about that when I call back. I'll do that after I've eaten breakfast and readied myself for battle.

L&D nurse checking in here. Go to L&D or however it works at your hospital NOW. You need to be evaluated sooner rather than later. If you called me while I was managing the phones in L&D I would tell you to come in for an eval. and we would notify your OB.
post #138 of 601
Jillene, any news yet? How are you doing?
post #139 of 601
I saw Dr. Debbs today. BP was 120/84 and urine was still trace protein, which isn't horrible. I start the 24 hour urine collection in the morning and turn that into the lab on Thursday morning and have the blood work done then. He said he should have results for me on Monday or Tuesday at the latest. So that's good. He is concerned and said I'm doing the right thing by having bought a blood pressure cuff and ordering the protein strips. If it ever reads higher than a 1, he wants me to go straight to L&D. If I get a headache that won't go away or gets worse after taking two extra strength tylenol, he wants me to go straight to L&D. The baby is measuring phenomenally well and everything still looks good and healthy in there. If the labs come back alright, he wants to see me in 4 weeks (when I'm 36 weeks, which is when I had Aidan). If the labs look bad, he'll want to see me sooner. He told me to go ahead and keep the appointment with the midwife on Friday. I told him I found protein strips for $10 online for a container of 100 strips and he said that was a really good deal. :-) I'm such a good little internet shopper. Froogle is my friend. lol

I feel relieved that the protein hasn't gone up in the past few days. My lower number in my bp keeps staying up there but it's not in the danger level yet. It's weird because Sunday night it was 109/80. I think it's weird for the numbers to be that close. But if he's not worried, I'm not going to worry too much. He told me I can go to my last prenatal yoga class tomorrow (though I'm not sure how I'm going to work that yet with the urine collection issue) but otherwise he wants me to keep my feet up and rest all the time. Which will be interesting with a sick 2 year old to take care of.

So that's what's going on with everything for the moment. My symptoms haven't gotten any worse. My swelling has actually gotten better. It's still bad in the morning but by midafternoon I can put my rings on again. I have to take them off before bed or I wake up with my fingers hurting from the circulation getting cut off from the swelling and I have to run my hands under cold water with lots of soap to get the rings off so I can go back to sleep. Not fun at 3 am.
post #140 of 601
Just wanted to give you guys an update.

Monica the midwife called Wednesday night.

She got my lab results and spoke with Dr. Debbs. She told me I should be on bed rest as much as possible and that my protein was a little high and I should watch my blood pressure and if it goes up at all or I have any severe swelling or headaches or blurriness or... the usual list for preeclampsia symptoms then I should call them and go into the hospital. Yup, thanks. I already know the drill. Then she told me that my insurance covers blood pressure monitoring for me but I told her I already went out and bought a cuff. I did manage to refrain from telling her the reason was that I didn't trust her to follow through properly so I took matters into my own hands. Heh. I also told her about the protein strips and that I'm keeping an eye on that as well since that was the big problem last time, not my blood pressure. Though I'm still doing daily blood pressure checks as well, just in case.

So that's what's going on lately. Swelling has been mild for the most part (spurts of yicky swelling but it goes back down within a few hours). The baby is still very active and my blood pressure has been staying down (was 119/77 last night) and my urine has been good. I've been getting negative readings with my protein strips, so I'm not sure if the protein that was there from the 24 hour went away and it was a temporary spillage or what. Maybe my strips are just bad. No blurriness, mild headaches on and off but they go away when I take Tylenol. So I'm not worrying about it too much for the moment. If my symptoms spike up again I'll probably freak out again but for now I'm content to be calm and stay pregnant and let this little guy cook a while longer.
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