A Beautiful Day

Sometimes it's best to forget

Irish's recent post (April 2) got me thinking. And remembering. And the PSTD came flooding back for a bit and triggered memories of what I thought I had forgotten (or thought I wasn't aware enough to register in my brain).

Excerpt:
But this past week? I'm a crotchedly old bitch. And so I related this much to the social worker who promptly figured out that my lack of memory was likely directly linked to my pissed-offedness. And who suggested that by piecing together what had happened to me, I would feel some semblance of control again and perhaps wouldn't feel so ornery. So we set up a date with my OB's NP who stayed with me in the NICU yesterday, reading over my medical record for me while I held and cooed with my beautiful boys.

A lot came back to me. Most didn't. In summary, I had 2.5 surgeries. I clotted and hemorrhaged again. I needed 10 units of blood. This time I developed full-blown preeclampsia for which I remained on mag sulfate between surgeries. I went into renal failure - platelets dove, hematocrit dove - all went to hell for a while. I blew up all puffy and big and as a preventative measure, was intubated to be sure that we could get me back into surgery more easily again if necessary. I had many CT scans. I was in ICU for 3 days.

I know I said I wouldn't talk about it again, but it's my blog, damnit. And though I am quite happy when I'm not forced to address my lovely disease, I've had moments when the darkness of the post delivery experience comes back and I remember this or that. Irish's post took me right back and I remember now. I remember ICU. I do. The fetanyl didn't make me completely unconscious...I was sort of awake the whole time. I was in this "coma" for three days.

Though I have no idea what transpired previous to it, I am in a room which my hazed mind believes is a living room in a hospital. I know that my hands are tied down, and this makes me believe I am being held hostage somewhere. I don't hear the respirator nor do I realize I'm on one. I know that I am being drugged but have no idea how much or why. I have a vague idea that I just had babies but don't know if they are alive or where they are. I do not feel the tube in my throat but regularly test the restraints to see if I can break free. I am convinced that this part of the hospital must be being managed by a third party entity because no one here is nice. They are condescending and scold me constantly for being "naughty." It's hard to talk and I don't know why. I am scared and trust no one around me. I know something is wrong but my main concern is working on getting the hell out of there.

Now and then S' face comes close enough where I can see him. He's fuzzy and mottled but I can see he's there. ARE YOU IN PAIN? He asks this often. I shake my head no because that's the truth. But then he kisses me, tells me he loves me and goes away. And all I want is for him to stay with me - stay and talk with me, because I am aware and it's so lonely here...no one talks to me and I'm scared and need to know why I'm being tied down and when they plan on letting me go. I have no idea how bad off I am. When S leaves my range of vision I am unaware that he hasn't gone far (he'd moved into my ICU room and took showers in my reserved room back on the postpartum ward). I don't realize that when I can't see him he's actually in a bed next to me. When I don't see him I'm plotting my escape, willing myself to become clear-headed enough to figure this all out and get myself back in the hands of people who know how to take care of me. All I needed was to get someone to stay close enough long enough to get them to understand that I needed help.

The nurses talk to me in really loud voices and this annoys me. They don't tell me where I am or what's happening to me and seem impatient when I try to communicate. They talk to each other as if I'm not there. I remember them shooing S away from me - evidently my BP would go up everytime I'd hear a familiar voice and being that an insanely high BP is what put me there, I guess they figured I'd be better off alone. Now I know my BP went up because I was trying desperately to tell S to get me out of there - to let him know they were mean and to please stay close to me and tell me what's going on. I don't know if I slept or not, but was told later that though you are "out," you don't actually sleep while on fetanyl and the lack of brain rest can cause severe paranoia.

I remember my mom caressing my hand assuring me yes, that nurse was a bitch and she didn't like her either. But Mom too wouldn't stay near long - once I'd get happy to see her, her face would slip away from me.

Three days later they decided to ease up on the drug and take me off the respirator. My mom says as soon as they did that I started talking as much as I could, though in a raspy, frightening voice (the tubes did a number on my vocal chords). I told S that the hospital was plotting against me, and if he paid attention, he'd see it. I asked him to be observant and if he watched closely, he'd notice they did things in threes. I told my mother the whole hospital was a scam...they make the place look like a living room with all these curtains and they tie you up and won't talk to you. He and my mom still laugh about that (nervously). My mother said I told off an intern and gave hell to the head ICU nurse. And when I realized that I had just had babies I remember having to wait an eternity (a few days?) to go see them. This only fueled what Dr. Cutting Edge would later call my "grumpiness."

At some point I was brought back to the postpartum ward. And slowly, my head cleared. And that is when I realized I had no short term memory. I could barely remember being admitted to the hospital, barely remember the day before the C section or anything afterward. To this day, I remember resisting a CT scan at some point and do recall a sense of doom when Heather, Dr. Cutting Edge's fellow, told me they had to go in again. Beyond that, these snippets of ICU are the best I've been able to muster.

My initial point in writing about all this was to let all of you know - to let you know that if you are in the unfortunate position of visiting someone in the ICU and they are on a respirator, when the staff informs you the patient cannot hear or see you, consider otherwise. And if your loved one seems agitated, consider it may be because they want you closer, or want you to talk, or at least try to allow them to communicate. Closer is better. You don't have to yell. Reassure, and tell them why they're there and how long they may have to stay. Keep talking. Stay close. Because being a patient in ICU is lonely and scary and at times, very freaky. Tell them how they're doing, and how you're doing. And tell them you love them.

I know this post is a downer, but it's what's been on my mind.

Luck

Heh.

Feeling smug...dare I say, proud?

Somehow, perhaps with the help of dedicated bedrest, my body has bounced back from being borderline preeclamptic to hypertensive to, just, well, being pregnant with PNH. Today's visit at the ATU was, dare I say, stellar.

Protein in urine: the lowest since we started tracking

Bloodwork: looking good- hematocrit still at 30+

BP: a little on the high side, but far lower than last week

Monkey Man: as usual, loving life

Still no swelling. No dizziness, nausea, headaches or flashing lights. My pulse has stayed under 110. All I can complain about as of late is heartburn and, well, Simon's penchant for the transverse lie. His persistent love for the uterine hammock position has him kicking me over and over and over in the same places, causing tummy tenderness and a seemingly constant inability to get comfortable. And, oh yeah- I've had the occasional Braxton-Hicks contraction, which IS kinda painful and if that's but a trace of what labor feels like, ICK.

I asked Dr. High Risk when he thought I might deliver, as the 32 week mark is almost here.

Dr. HR: If you stay this stable, I think we can push it to 36 weeks.

Me: That would be awesome!

Dr. HR: You know, we're going to talk about you tomorrow.

Me: ?

Dr. HR: Yes - Dr. Cutting Edge, myself, and a bunch of other people are meeting to discuss your case. I'm going to recommend that we hold off on delivery as long as we can.

I consider myself mighty fortunate to have so many Ivy-league brainiacs and specialists discussing what's best for Monkey and me...later on, during the NST, the nurse mentioned that I'll probably be written up in a medical journal or two. Because I'm not following the classic PNH~preeclampsia pattern, evidently I've intrigued enough people to warrant a sit-down in a special room with coffee and donuts. It should be interesting to hear what they had to say.

So now instead of a two-week countdown, we're shooting for another month, and thank God for that. THANK GOD. Monkey may entirely dodge the NICU bullet after all.

Another month. Of bedrest. Um, anyone have any good movie recommendations?

More Limbo, but Less (well sort of)

I made it back from the hospital today.

Non-stress test: fine. Simon the Monkey is under no stress whatsoever, and is, in fact, appearing to be having a grand time in my uterus, sitting breech as if in a hammock, waving his arms and rolling to and fro. He's got plenty of fluid in there. His heartrate is gorgeous though our NSTs have been constantly punctuated by his ability to flee the sonar, taking his beating heart suddenly out of range. This absence of a beat causes alarms to go off at the nurses' station, at which time they will come scurrying in to readjust the little dome on my belly. The nurses there know the routine now - we all call him Houdini. We swear he's laughing at us when we view the ultrasound.

So Monkey is totally okay, and has been, thank God.

BP, taken thrice in the ATU went as follows:
146/83
143/86
160/85

The last and final number had Dr. High Risk giving me the comforting shoulder grab and the so-sorry-shaking-the-head "you need to go upstairs to L&D. I might keep you for a few days." Before we could even argue our bedrest position, Dr. HR was all over it.

So we headed up to L&D
I know the routine.

What we know:

Yes, delivery will be no later than 34 weeks. Because of this, I received steroid shot #1 in the butt today, to help develop baby's lungs so he can breathe better when born. Unless some miracle occurs, Simon will be a preemie. Dr. High Risk seemed very on-board with waiting as long as possible though, admitting it's a judgment call at times. We did a lot of bloodwork today and I'll need to go back tomorrow for a follow-up and shot #2. I'm to bring my bag, just in case.

Delivery could possibly be earlier, even this week, depending on how well I fight off the pre-e/PIH (pregnancy-induced hypertension). Truth is, you never know with this stuff.

Liver enzymes are steadily climbing, but these are falsely inflated when I have PNH episodes, which I still have, though they are barely noticeable as of late. Yesterday I know I had some PNH symptoms, so this LE result could simply be PNH-related and have nothing to do with pre-e.

What is odd:

NO protein in urine today. Nada. Zip. It's got me perplexed too. I'm thinking they switched samples at the lab with some uber-healthy marathon-running fertility goddess. Regardless, I'm once again collecting urine for 24 hours to confirm or disprove this rather strange development.

Believe me, if there's no protein, I'll be doing the alleluliah dance (okay, from my bed anyway), because that would mean that what I'm presenting with are not necessarily symptoms of early preeclampsia but rather simply PIH (hypertension), which CAN be controlled by bedrest. PIH is not good, but unlike preeclampsia, which I've learned today will come get you whether you're resting or not, PIH symptoms will wane with dutiful bedrest. Bedrest can keep it away indefinitely. We control freaks like that idea. It comforts us.

Other good thing: no swelling yet, which is the hallmark of preeclampsia.

Confused? Me too, kinda. The thing is we'll know more tomorrow. Nothing has been ruled out.

After a nice rest in L&D's triage unit, my bp came down to a respectable 128/70. Then an even more encouraging 120/65.

So I was let loose again on society, at least for 24 hours. I returned home and made my phone calls. Sal left to go see U2 tonight, sadly, sans moi, his best concert partner ever (because I get INTO IT). I make no apologies in admitting that Bono is my personal Jesus and whenever I see U2 I start bawling like Tammy Fay, spiritually moved in ways I can't quite articulate. Perhaps it's just simply that U2 has been pretty much the soundtrack of my life since high school, and many of my happy memories of times and certain people come flying back at the slightest rift of Edge's guitar. I will sheepishly even tell you that I have on more than one occasion put the Bose headphones on my belly so Simon can become acquainted with Achtung Baby and The Joshua Tree. I even stole my blog name from them (mostly for the double entendre involving my nickname). Anyway, Sal is clearly jonesing that I'm not there sharing the experience tonight- I know this because of the constant pics I'm getting on my cell phone. I'll post some tomorrow as I'm not well-versed in formatting these on the Mac...they are pretty good though. And, lest you wonder why I don't feel sorry/pouty for not being able to be there with him, we've got tickets again for both the October and December shows.

Good lord, I digress. Eh, prego-brain...what can you do?

Oh, and one more thing- need to vent:

There was a shift change at the nurse's station at L&D while I was there. The initial nurse who took my blood and did my intake was bringing the new nurse up to speed. Mind you, there is only a curtain between me and them. The initial nurse says to the new nurse:

"Oh, and this is important- she has PNH, a rare disease of the bone marrow. This factors in to why she's here, although I'm not entirely sure why."

New nurse (swear to God she said this, VERY ENTHUSIASTICALLY): COOL!

Old nurse: Yeah! You get to find out about a new disease!

New nurse: Oh that is so GREAT! I'll have to ask her all about it!

Now, I'm very used to the fact that I'm a novelty in medical circles, and over time have learned that some professionals do like the bragging rights they garner by having met me and gone over my medical history with me. It's a medical thing...it's like they can tell their medical friends they've treated a person with PNH and somehow to them it's a treat. And it's really ok with me, because I'm all about spreading awareness of the disease, but WHEN YOU EXPRESS ACTUAL FUCKING GLEE AT THE PROSPECT OF YOUR PATIENT HAVING A RARE LIFE-THREATENING DISEASE WHICH FUCKS WITH HER LIFE ON A DAILY BASIS KNOWING SAID GLEE WILL BE HEARD BY SAID PATIENT WHO IS BEHIND THAT THERE CURTAIN AT THE MOMENT FREAKING OUT ABOUT HER SHORT TERM FUTURE, I will just simply hate you. And hate her I did, throughout my entire discussion about my disease which ensued. Though I wanted to call her out on her behavior, I kept quiet, keeping my bp and health of the babe in mind. Sal took care of it though, giving her his coldest, most evil disregard. When he does that, even I get a-scared.

Ok I need to shut up now. More tomorrow. Ciao.

Go read Kat's (click Maternity Genes at left - sorry- I can't create links on Typepad on a Mac) post about her 80's days - I am so loving her writing.

The Plan

My husband and I are scarily alike in one respect: if we set our minds to getting something, DO NOT stand in our way. We WILL get what we want -we may have to wait, but oh we'll get it. When we're together on an issue, you don't want to be an opposing party. It's not like we'll wreak direct holy hell on you; rather, we'll prod slowly and deliberately until you break and we get what we want. Like the dogs, Sal and I can get eerily pack-like on certain things.

The current 32 week issue happens to be one of them.

After some obsessive googling of "32 weeks preemie," I am convinced that Mr. Simon needs to stay in his warm, comfy uterine oven a little longer. Although infertility has done wonders in permanently lowering our expectations of life's situations, this is one area in which we are just not feeling too accepting. My boy started out in a petri dish. Now he'll be welcomed into this world with feeding tubes and IVs and incubators? Ummm...nah. No way.

I'm acutely aware that there are parents out there who would give anything for their baby to have made it to 32 weeks gestation prior to being born. I have read many a preeclampsia/HELLP horror story and know that developmentally, Simon will be leaps and bounds ahead of other babes in the NICU. But acknowledging that "things could be much worse" isn't really enough for us right now. Somehow, the parental instinct is kicking into high gear and we're thinking we want no part of this for our son...the less medical intervention he'll need when he comes, the better.

Understand that together, Sal and I are fighters - we have said FUCK YOU to PNH and refused to let it take over our lives. Together, we said FUCK YOU to infertility, and plowed through 3 years of holy hell of treatment. We said FUCK YOU to miscarriages, and kept trying even though every loved one was urging us to let go and look at other options. We now are saying FUCK YOU to preeclampsia, because that's how we know how to handle things. Of course we know we're not doctors. Preeclampsia may eventually have a larger say over the matter and we're not foolish enough to jeopardize my health nor that of the babe, but still we WILL negotiate the terms of this deal. And in this situation, we'd like to compromise to delaying delivery until 34 weeks gestation. For this, I am willing to concede to complete hospital bedrest for as long as I need to, starting tomorrow if necessary.

Understandably, when it comes to health, things don't always turn out the way you plan. 34 weeks still puts him in the NICU but buys him precious developmental time. And bedrest won't guarantee that the pre-e won't get the best of me anyway.

But we just can't let this issue go without trying...it's too important. Plus, it's our way of handling these types of things...grasp control of whatever we can. Sal is coming with me to my appointment with Dr. High Risk tomorrow. The plan is, well, to present our case to him and see what he says. The poor guy isn't going to know what hit him (though I'm sure he's met his share of crazed, control-freak parents). But we have to hit. It's our boy we're talking about. I don't care how much pain or aggravation it takes - if keeping him in there longer makes his entrance to this crazy world any easier, I'll do it. If I have to pee in a pan and never shower I'll do it. If I have to live on IVs and hospital food I'll do it. If I have to endure lonely long nights and bad television and huffy nurses, I'll do it. Whatever it takes. I'm no stranger to pain nor discomfort - those things are always transient. Whatever it takes.

Why? Because he's once in a lifetime; he's our one and only. And he deserves the finest, healthiest welcome we can give him. I'm packing a hospital bag tonight to be ready in the event Dr. HR takes us up on our offer. We hope it's one he can't refuse.

Stay tuned.

*********

Sal is getting his Typepad 101 lesson from me later this evening. I've informed him he'll need to post updates and photos when I'm hospitalized. He agreed to learning but was predictably more interested in somehow getting me set up with a wireless portable internet connection in L&D. Ah, to be married to a tech-head.

Excuse me - did you just say 2 weeks?

Went to see Dr. Cutting Edge (hematologist) today.

BP- 135/90

hematocrit: 30.9 (wow! - Mom gets credit for that for all her help this past week)

protein in urine: steadily climbing

The Verdict: preeclampsia has not left the building but is rather sneakily and quietly taking over. 

So Dr. Cutting Edge, after a brief physical exam and look at my labs and bloodwork, says to me:

"If this baby is fully cooked, we're going to take him in two weeks."

Me: Wha?

Dr. CE: Your bp is steadily climbing and your protein keeps spilling into your urine.  You're doing great, but we don't want to wait for a crisis.  It's better for both you and baby to take him while you're still stable.  If he has no development issues, then it's what we'll need to do.

Me: But I'm not ready.

Dr. CE: (smiling) You will be.  I'll call Dr. High Risk today.   When you see him on Thursday we'll have a plan.

Me: Two weeks?

Dr. CE: 32 weeks carries an almost 100% survival rate, just like full-term babies.  As long as an amnio shows him to be developed enough, we're going to take him.

Me: Have you and uh, Dr. High Risk ironed out the C-section vs. vaginal delivery thing yet?

Dr. CE: Let's do a C-section.  We'll be able to monitor your heparin levels, we'll be able to control everything, plus we'll just give you a small "smile" scar under your bikini line - it will go well- don't worry about that.  But I don't want you pregnant much longer than 32 weeks, so plan accordingly. 

2 weeks.  That's in like, 14 days.

Oh Momma.

Flashing Lights, Part II

Scary stuff, this PE.

Today I went back to the hospital, only this time out-patient.  I saw Dr. High Risk at the antepartum testing unit, or ATU.  He nixed yesterday's medical proposal that PNH could be causing me to "appear" to be developing preeclampsia.  As far as he's concerned, he's assuming I'm actually developing it, and that's going to guide his protocol.  This is good...means we're not taking any chances. 

First things first:  BP: 155/88.

Dr. HR takes one look at that and says I might keep you tonight.

After seeing that I'm thinking no kidding.

We hook up a 20 minute doppler on Simon.  Heart beats away and we hear continual movement.  Dr. HR then does a non-stress test and u/s - - Simon weighs 2 lbs. 7 oz, which at 26 weeks puts him in the 80th percentile (for those of you unfamiliar with how those figures work, Simon is 80% bigger than all children at this age, or 20% of children are bigger than him).  We are very encouraged by this news; it means that should he need to come into this world early, he's a step ahead of the game.

We discussed giving him/me a steroid shot to help the boy's lung development along, but evidently you can only give a round of steroid shots to a baby once, and you have a 30 day window for them to be effective at that.  The right timing is critical in order for them to maximize his strength and development at birth.   Dr. High Risk feels that although the bp is very concerning, the other labs show stability and that we have some time before things get crazy and we have to induce.  How much time remains to be seen, but it was comforting that he decided to hold off on the steroid injections...it kind of means we have more time, which we definitely need.

Bedrest continues indefinitely, but I am able to get up and fix light meals, shower and go to the bathroom and such.  I need to spend most of my days horizontally though.  Shopping, housework, cooking, travel - all out.  It's okay to sit at my desk two days a week, provided my feet are up and that every two hours I go lay down for 1/2 hour.  I can do that.

I have to take my blood pressure upon waking and before bed every day.  If it comes back high, I have to lay down for an hour and try again.  If the second comes back high, I have to call.

The flashing lights have subsided, thank God.

Word is that if we make it to 29 weeks, we're good to go in the infant survival department.  Before that, it's a touch and go and a very scary situation.   I'm 26 weeks and 3 days today.  That means what - we've got about 2 1/2 weeks to go?  I can do this...I can do this...I can do this...

Oh we're not done- hematocrit? Down to 25.6.  Ulp.  Dr. High Risk thinks it's because I've been subjected to so many tests this past week that my body hasn't had a chance to bounce back. He reiterated that 25 is our cut-off mark, and urged me to rest.

We took my bp until and when we got a respectable 137/87, I was allowed once again to go home, with a plethora of will-call agreements.

Part of me is calm about this; I'm in good hands.  The other part of me is terrified shitless.  But you know what?  Infertility was good training for this...I know my worry is well-warranted but at the same time it's tempered with hope- because I've learned that just when things look their darkest, miracles can happen.  And I'm banking on that miracle.

Thank you ladies for your support and kind comments- they are helping me far more than you can realize!!!

Flashing Lights, Part I

Yesterday morning I woke up to blurry vision.   Strips of flashing lights (very much like a classic migraine's "aura") stretched across my left eye.  At  some point I realized that I really couldn't even see out of it.

I closed my eyes and tried to relax.  Within 10 minutes, the lights were gone and my vision had returned.  I figured it was some sort of migrainish hormonal thing caused by the pregnancy.  I thought nothing of it until later last night, when I was preparing for bed- the strips of flashing lights returned but this time in both eyes.  Once again I relaxed and they went away within 10 minutes or so.  It took me a long time to fall asleep - I also noted some pain in my right upper abdominal area...maybe not pain exactly- let's call it a nagging discomfort.

This morning I woke up to growing strips in my left eye again, only this time they were accompanied by a headache.   Upper right ab discomfort still there.

And so I did what any high risk gal would do- I googled symptoms, saw that yes, they were indeed cause for alarm given my pre-disposition to Pre-E, and I called my OB, Dr. High Risk.  He was not in today, but I was able to speak with the nurse practitioner who I like, who listened to my concern over my symptoms then promptly asked me to head over to Labor and Delivery.  Like, right now.  Right away.

And so I was admitted - wristband and all.

I spent my day in a very nice OB Triage Unit, where I of course had to educate the nurses there on the ins-outs of PNH.  Yes, my flashing lights were definitely cause for concern.  Yes, the ab pain definitely warranted a look-see.

Here are the markers for PE:

* protein in urine

* elevated blood pressure

I've got both of those.

Here are the warning signs for PE:

*  Swelling in your hands or feet

*  Sudden weight gain (5 pounds in one week)

*  Persistent headache

*  Constant spots/flashing lights before your eyes

*  Pain in the upper abdomen

I've got 2 1/2 of those.

I spent my morning and a good chunk of the afternoon giving blood and urine, talking with my assigned NP there and submitting to baby tests.  Once again, Simon came through with flying colors...great heartbeat and lots of movement, lots of amniotic fluid, good solid fat placenta.

BP: resting bp taken periodically throughout ranged from 137/74 (we'll take it) to 149/89 (hmmmm). 

My upper right ab discomfort:  the ultrasound revealed Simon's feet are repeatedly stomping a section of my uterus in this very area.  Given that his feet have been attempting to break free to the outside world by protruding into my uterus and into my skin, I accepted this as a plausible explanation.

The on-call doc reviewed my results and decided to let me go for the evening as my protein levels have seemed to stabilize for now.  The caveat: return tomorrow at 9:30 for more monitoring.  Take Tylenol for any headaches and call with any vision problems.

Me: Um, it kind of stands to reason that since I didn't get any medication here today and we have proven that my blood pressure is definitely elevated, that there's a really good chance my vision issues will only continue.

NP: Yeah, I know.  The on-call doctor though thinks it's okay to go home though.  Dr. High Risk will be in tomorrow, and he'll reassess.

Me: Okay, so at 10 pm tonight when I'm getting ready for bed and I start seeing strips of flashing lights again -

NP: You just call Dr. High Risk.

The NP then explains that evidently, the docs believe that perhaps some of this stuff is just normal pregnancy pitfalls because I don't have swelling and I'm not having long-term headaches.   They admit they don't know how much of this is PNH-related and how much is Pre-E.  There's no way of knowing for sure- we'll just have to watch.

Me: I have to tell you, that if that's the case, I'm going to be here frequently because if you can't figure it out, then I'm certainly not going to make any assumptions involving my baby's health by myself at home.  I've got to take every little thing seriously. I have to assume these things are PE.  I can't take chances.

NP: That's right -that's all you can do (she smiles and squeezes my arm).  We'll see you tomorrow again after the antenatal testing.

And so I headed home and went straight to bed.  My MIL called and offered to take me tomorrow because she felt I shouldn't be alone through all this.  This gesture made me weepy; I realized how stressed and worried I've been and the fact that she's coming with me truly comforts me.  Besides, she'll get a kick out of seeing her grandson on an ultrasound.

There's good news in that the docs are thinking maybe this isn't preeclampsia.  Hell, it's the number one killer of pregnant women and their babies in the world.  I so don't want to go there...who would?   But when you're told you're high risk for it and exhibiting signs and symptoms what are you supposed to do?  This is stressful.

_________________________________________________

The B Word

I saw Dr. Cutting Edge today. 

The good: hematocrit crept up to a very respectable 27.9.  That's almost 28 folks!  No transfusion necessary this week.

The bad: blood pressure taken twice:  139/88, 140/74

The preeclamptic ugly:

You know, there's protein in your urine.

Yes, Dr. High Risk and I talked about that last week.

Your blood pressure- it's high. Higher than we'd like.  It's okay, but it's high.  Are you bloating or swelling at all?

Yes, ankles and feet, and my hands are starting - I can't wear my rings -

Yeah. (feels ankles, checks hands) You're how far along now - 26 weeks?

Uh huh.

Yeah. I think it might be time for some bedrest.  I'll write you a note.

Uh, you mean like tone down my activities?

I mean very little activity - I mean keep your feet up and watch a lot of movies.  I'll write you a note.

Later this evening, Sal and I talk about what this means and how we will manage.  His main concern is my mental health, as he knows I have issues with sitting still...with relaxing (I'm the girl who never gets a good tan because I can't go to the beach and just lay there and bake).  Pregnancy has already exaggerated my normally sensitive nature...I know he's dreading my demeanor after a few days of confinement.  He knows this will stress me out and probably defeat the purpose.  I tell him I can sit up in bed and do all sorts of things - this doesn't have to be such an ultimatum.   We discuss the difference between relaxation and physical rest, and agree I need some mental stimulation if I'm to truly relax - a bit of work would actually do me good here.  So we agree I'll try, at least for this week, to work 2 days a week here from home, and he'll rig pillows and a foot rest to make my desk cushy and as horizontal and restive as possible.  I agree to just let the house go, do my shopping and whatever I can on-line.  We felt the short 4 minute drive to our 2 hour child birth classes once a week would still be doable.  My trips to acupuncture, the hair salon, the supermarket, pharmacy, the office - all out.  An upcoming baby shower for a friend, a wedding- out.

Clearly, I can elect to do this at home or wind up doing it in a hospital.  I'd much rather be here. 

Also, Sal and I are to pick up a home blood pressure kit -the kind where you can take your bp at home so we can monitor me daily.   This should prove interesting... by default my honey is becoming a nurse.  I've always said he would have made a fantastic doctor.  Dr. Sal. 

What I need to be really grateful about:  that this is being monitored and that we know I'm at risk for preeclampsia in the first place.  I've been on Lovenox my entire pregnancy which has ensured clear passage of blood and nutrients to Baby Simon, who at last measurement, was still big for his age and well-developed.  Some googling on pre-e has led me to some very sad stories of women who didn't know their risk- women who didn't know the warning signs who wound up in the ER one day, admitted for an emergency C-section at 24 weeks giving birth to a stillborn or grossly underweight baby.   I'm lucky and I need to remind myself of that over the next few months or so.  We worked so hard for our Simon; to make sure we keep him I will now have to push myself to let go of my Type A tendencies, trust my docs and my husband to take care of me and everything else for a while. 

Bedrest survival tips from those who have been-there-done-that are very welcome and encouraged here!