Monday, November 1, 2010

The Diagnosis

Catch up on our story: Read the preface here

Let's start from the very, very beginning...
*Warning: these will be quite long posts!*

At 20 weeks, I took a business trip to London with my doctor’s blessing. After a long, overnight flight, I arrived at my hotel and noticed that my feet had swollen a little. Hmm, I thought, that’s weird; but I attributed it to the cabin pressure. Fast forward a week- after being caught in the worst snowstorm in 25 years, I get back to the States and go in for a regular check-up.  My feet were still terribly swollen, but again, I assumed it was due to the traveling and English salty diet.  

We were excited for this check-up because we were finally going to see 4-D images of our baby, who at this point, we just KNEW was a boy. Being the stubborn little baby that it was, we never saw a clear image of its face but just seeing their little hands and their little feet—we were in love. 

After the ultrasound, I had my blood pressure taken. It was a little high. The technician took it three times to be sure and sent me back to the doctor. During my appointment, I mentioned how I had just returned home from an overseas trip and how we were anticipating our ultrasound. The doctor assured us that it wasn’t anything to worry about; that my body just needed more time to adjust to the travel and sent us on our way.

At the next month’s check-up, my blood pressure was again a little higher. Still, not too troubling. The doctor just attributed it to my very stressful job and my inability to relax. With a recommendation to visit an acupuncturist, we were told to come back in two weeks for another check. Two weeks later- my blood pressure was a little higher than the previous visit yet again. Humph, I thought- I’ve been doing EVERYTHING I know how to do to relax, take some stress off and just chill out. It wasn’t working.

My swelling had increased significantly. I had outgrown every pair of shoes I owned and was stuck with wearing “Fugg Boots” (fake Ugg boots) for the past few days. This time, the doctor was more concerned.
This was the first visit that the word “Preeclampsia” was used. I knew what it was- my mother had developed it in all three of her pregnancies; but I was only 26 weeks pregnant at this point. Preeclampsia doesn’t usually develop until after 32 or 33 weeks. After talking about what preeclampsia was, and how it’s cured (delivering the placenta—not an option at that point), I was sent home with a 24-hour urine test to measure the protein in my urine and told to return in a week.

The next week, my blood pressure stayed the same and my urine test showed very little protein; certainly not enough to be concerned yet. We’re in the clear, I thought. Just to be sure, the doctor wanted to continue to see me weekly because I was considered an almost “high-risk” patient.

So, the next week, the next visit—my appointment was late by an hour and a half. I was FUMING mad. No surprise, my blood pressure was sky high. Then, we were informed that our normal doctor was tied up and we would be seeing another, new, doctor. After being rushed around to 4 different rooms, the new doctor flew in, demanded my blood pressure be taken again and (shocker) it was high. I didn’t think it was a big deal considering, anger raises your blood pressure, and I had just been shuffled around for 15 minutes so my heart rate was up anyway. On top of all of this, the new doctor, who turned out to be the worst physician in history, says, “Well, your blood pressure is high and now you have protein in your urine so we’re sending you into Labor and Delivery.”

Wait. What? Labor and Delivery? I’m only 26 weeks pregnant. After I started sobbing from the fear of losing our baby- this terrible doctor realized she should have said “I’m sending you into the Labor and Delivery DEPARTMENT for monitoring tonight.” Uh, well, that makes a difference, Lady. 

So, off to the L&D department for a short bout of monitoring to see what my blood pressure would do when I was calm and collected over a few hour time period. 6 hours later; my blood pressure had stabilized and it was determined I had “White Coat Syndrome”. Meaning- when I know my blood pressure is about to be taken, I get so tensed up because I fear its going to be high… resulting in a high reading. And we were sent back home with yet another 24-hour urine test and told that the OB’s office would call to schedule an appointment next week.

The next week rolled around and no call. So, I called them and asked about my results. I was told that, if something were wrong, you can bet that they would have called me first. Ok, I think, we must be good, and I make a follow-up appointment for the next day.

At this appointment (which I went to alone expecting everything to be gravy), my blood pressure is yet again sky high. This time in the 160/100 range. It had never been this high. Also, as it turned out, my urine test showed extremely high levels of protein (like in the 3000 unit range where less than 300 is normal- you can see why we were researching new practices). My regular OB was very worried and off to the L&D Department I went again- this time for a much longer stay.

After a frantic, tearful phone call to Casey to tell him what was going on, I headed up alone to be monitored. While sitting in triage for 40 minutes having my BP taken every 15 minutes, a (yet again) new doctor from my OB practice came in and asked if I was alone. When I said I was, and he sat down to talk to me I knew it wouldn’t be good news. 

It was official- Preeclampsia. I was being admitted. They weren’t sure how much longer I could stay pregnant; but they hoped at least long enough so that the corticosteroid shots I was given could be administered 48 hours apart. These steroids would help speed the development of our baby’s lungs, which at this point- wouldn’t survive without the injections. 

I was frantic. Casey came rushing around the corner at that very moment to find me in a hysterical, hyperventilating mess.

How did we get here? How could this be prevented? Was it something I did wrong?
No, the doctor assured me. There was nothing, nothing I could have done differently (though, I’ll talk about the guilt that being a preemie mother induces later). Preeclampsia strikes randomly - usually very old or very young mothers, but can affect others too.  

Then we were told, the hospital I was currently at couldn’t care for a baby who was as small and underdeveloped as ours would undoubtedly be. Another larger, more specialized hospital would probably give our baby the best chance for survival. The doctor said he would try very hard to get me transferred; but that we couldn’t be guaranteed anything.  This was the first time I really thought: “We could lose this baby.” At that point- it felt like a very real ending to this situation.

Thankfully, after a sleepless night- the next morning a quick ultrasound reveled that our baby was still receiving enough nutrients through its umbilical cord that I would be allowed to continue with our pregnancy a little longer. Even more encouraging was that we would be transferred to UNC Hospitals, which have a level IV NICU, that day.

A short ambulance ride later and a very, very painful IV insertion- we were admitted to UNC Women’s Hospital in the antepardum floor for what we hoped would be a very long stay.

Tomorrow, you’ll hear from Casey about what it was like to be the husband and father-to-be during the start of all of this crisis. Then, we’ll continue to tell the rest of our story- from my hospitalization, to delivery, our first NICU moments and what life was like for all of us during Beatrice Kate’s first few week s of life. 

Stay tuned…

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