Lilypie Premature Baby tickers

Lilypie Premature Baby tickers

Friday, April 5, 2013

Flashback Friday: The Two P's

Preeclampsia is currently the leading known cause of prematurity.

I raise awareness about prematurity, mainly by talking about life with Jack and what our family has experienced since he was born early.  But what I don’t often talk about is the cause of his premature birth.  I don’t often share it, because there’s a fine line between raising awareness and creating fear.  Last summer, I was hanging out with a few girlfriends, one of them newly pregnant.  Everyone was sharing their birth stories; isn’t that what all moms do?  Except, I didn’t say a word.  I wanted to say something.  I wanted to tell her about the symptoms.  I wanted to say A LOT, actually.  I wanted to share my knowledge so that what happened to us, doesn’t happen to someone I love.  But I didn’t.  I didn’t want to scare her and I’m pretty sure she didn’t want to be scared.  I get it.  Who wants to know the traumatic and dangerous aspects of pregnancy?  But, I think there’s a big difference in wanting to know and needing to know.  There are just some things that are in the “need to know” category, no matter how frightening. Even though I know this, I’m still more than comfortable sharing our NICU experience and after, but the days leading up to that experience have rarely been disclosed.  Perhaps the memories are too raw or painful, more easily blocked out.  There are actually a lot of moments that I can’t recall.  Or won’t.  Perhaps there’s still too much guilt attached.  I’m still not certain why I have only told our story in bits and pieces, and not in its entirety.

Something as simple as a headache could be a symptom of underlying and life-threatening preeclampsia.

     So, usually I have my Flashback Friday topic planned days in advance, but I had trouble figuring out what to write about this week.  Other things, like the March for Babies and a short-term upcoming job, have clouded my mind lately (along with the every day events of raising Jack).  Jack survived for many reasons, one of them being he was given surfactant, which was developed through research supported and funded by the March Of Dimes.  I’ll support anything that saves babies like Jack.   (Feel free to join our team or donate:  Team Jack Ryan)  But, the more I thought about it, the more I realized that what would save babies like Jack is a cure.  Not a cure for prematurity.  A cure for preeclampsia.  What’s preeclampsia, you ask?  And therein lies the problem.  If I had mentioned gestational diabetes or pre-term labor or even incompetent cervix (IC), most of you would have a general idea of what I’m talking about.   Even though “globally, preeclampsia and other hypertensive disorders of pregnancy are a leading cause of maternal and infant illness and death,” too many women and their families are unaware.  I sure was.  Which is odd, since while I was pregnant I read two “what-to-expect” type books, belonged to multiple pregnancy websites, and never missed a pre-natal appointment.  I was told about gestational diabetes and pre-term labor and a few other common pregnancy issues as well.  But, even though my final appointment was when I was about 26 weeks pregnant (which is more than ½ way for a term pregnancy), not one medical professional or book had mentioned preeclampsia.  

 Typically, preeclampsia occurs after 20 weeks gestation (in the late 2nd or 3rd trimesters or middle to late pregnancy) and up to six weeks postpartum, though in rare cases it can occur earlier than 20 weeks.

     So, when I was 28 weeks pregnant with an unrelenting headache for almost a week, nausea, fatigue, never occurred to me that any of these symptoms were related to my pregnancy, let alone preeclampsia, and I ignored them for over a week.  I thought I had a GI bug or the flu.  I posted on Facebook on August 7, 2010:  “Heather Draper Lesoine feels awful - headache for 4 days, nausea, chills...yet, still hungry. I thought this was supposed to happen in the 1st trimester, not the 3rd. Yuck!”  A friend almost immediately responded that I should check my blood pressure (BP), call my doctor and mentioned preeclampsia because she had experienced it herself.   So I did call the doc, but also sent Jeff on his camping trip.  The not-so-helpful assistant who answered the phone just told me to check the Tylenol bottle to see how much I could take and offered me a Monday appointment (it was Saturday 8am).  She asked nothing about the severity or length of the headache or about any other symptoms.  I said nothing, not wanting to be "that" first time pregnant mom.  The headache and other symptoms worsened as the day wore on and I eventually called the on-call doc whose first suggestion was to check my BP.  I said it might be better if I just came in to be seen.  I guess, at that point, I knew something wasn’t right.  

Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms.  Yet some healthcare providers may overlook symptoms that suggest preeclampsia because they are also hallmarks of a normal pregnancy, or their patients may not report symptoms for fear of over-reacting

As we drove toward the hospital, I actually began to feel better and I now believe that all the signs my body was giving me had receded because I was finally getting the care that I needed.  As the nurse checked my BP, I saw numbers in the 200/115 range and joked, “There must be something wrong with your machine.”  The nurse gravely responded, “No honey, there’s something wrong with you.”   A lot happened in the next few days (see, this is me not sharing our whole story) and Jack was born just 72 hours later, as my BP could not be controlled with medication or bed rest and I was spilling protein in my urine, had a sudden weight gain and I was dangerously close to having a seizure, stroke or organ failure (HELLP Syndrome).  Turns out I had classic signs and symptoms of severe preeclampsia.  Who knew?  Not me.  And the only known cure for preeclampsia is delivery.  Symptoms can be controlled, but delivery is the cure.  So, even though Jack was perfectly healthy at that point, I was not and we had no choice but to deliver him by emergency c-section at just 28 weeks and 5 days into my first pregnancy.    

Signs & Symptoms of Preeclampsia:
  • Hypertension*
  • Proteinuria*
  • Edema (Swelling)
  • Sudden Weight Gain*
  • Nausea or Vomiting*
  • Abdominal (stomach area) and/or Shoulder Pain
  • Lower back pain
  • Headache*
  • Changes in Vision
  • Hyperreflexia* 

(* I had 6 of the 9 symptoms.)

Since then, I’ve asked why I hadn’t been told by my OB and was told that I would have been, had I made it farther into my pregnancy.  I don’t necessarily hold it against them, but I am trying to understand why I wasn’t informed of this very serious disease of pregnancy and how I can get medical professionals to tell patients earlier in pregnancy.  Since we’ve entered this world of preeclampsia and prematurity, SO many of the moms I know delivered early due to pre-e and even earlier than we did at 28 weeks.  (My good friend, Christi, bravely shares her experience with the story of her pregnancy and son’s birth here:  I’m thinking it couldn’t hurt to mention pre-e at the same time pre-term labor and gestational diabetes are mentioned.  I’m not sure if the outcome would have changed for me or for Jack.  But I’m always one that believes knowledge is power, even if the knowledge is unpleasant.  If I had known that my slightly elevated pressure at just 2 weeks before Jack’s birth was a good indicator, I may have advocated for myself and for my baby before it was too late to control my BP.  I might have been able to be medicated or put on bedrest.  It’s not actually something I dwell on often, the “what ifs” of Jack’s birth story.  But, the 2 P’s are always on my mind, as Jeff and I consider and then reconsider and then reconsider some more, the possibility of adding to our family.  There’s that fine line again…I’m more aware, but now more scared than ever for another pregnancy.  But, as for me not sharing what I know, I’m convinced now that I shouldn’t stay silent anymore for this simple reason:  

All pregnancies are at risk of preeclampsia.

Works Cited and Resources:

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