Saturday, May 30, 2009

Tired of the PREs

First, it was placenta PREvia (which has cleared!  Hooray!).  Then it was PREterm labor (managed nicely with Procardia.  Hooary!).  Now it's preeclampsia, which doesn't clear up and can't be managed.  In fact, preeclampsia only gets worse until the "cure" which is delivering the babies.  Since I am 33 1/2 weeks, delivery is not in the best interst for the babies right now.

We went in Tuesday for my first non-stress test monitoring in the doctor's office.  I had gained a lot of weight from my last visit (Sign #1), had really swollen feet (Sign #2), I had trace protein in my urine (Sign #3), and my blood pressure was slightly elevated, but not over the limit of 160/90.  Thursday, when I came back from my second NST, I'd gained 2 more lbs, had swolled feet, had +1 protein and a blood pressure of 160/95.  They immediately sent me to the hospital to be admitted and mentioned that it might be time to deliver the babies.  With the pg at  33 weeks 1 day, I started crying.  

In the hospital, they started monitoring my blood pressure which kept going up and down, but we never as high as in the doctor's office and I had to do a 24 hour urine collection (basically peeing in a "hat" for 24 hours).  They also took some blood work and ruled out HELLP. They decided NOT to give me the steroid to  mature the babies' lungs suggesting that delivery was not imminent.  And with my variable blood pressure, they suggested I would be able to go home if I could monitor my blood pressure at home.  Dave bought the best Ormond blood pressure cup he could find, the nurse showed us how to take my BP, and we determined that it matched very well with the fancy one at the hospital.

At this point, I have mild preeclampsia.  The problem is that it can turn to severe preeclampsia anywhere from a few hours to a few weeks.  They have no idea how to predict what it will do.  It is highly likely that I will be hospitalized again in the near future, so they can monitor me more closely.  I am really taking this day by day.  My goal is that we make it to Wednesday, which would start, Week 34.  Then if we make it past that, I hope I can make it to the Wednesday after that, Week 35.  Week 35 is a lot better than Week 34 as far as NICU goes.  But if my blood pressure or any of the blood work comes back bad, they babies will be delivered.

In the strangest occurence of being diagnosed with preeclampsia, I got very perturbed with some friends who told me to stop worrying because preeclampsia is not that big of a deal.  I would like to point out that the vast majority of people are diagnosed with mild preeclampsia either during labor or at term and then are simply induced.  If I was 36 weeks, I would have been induced and would have my babies.  But I am not in that situation.  My babies are NOT in a good place to be born right now and this IS going to get worse for me.  Hearing those friends tell me to stop worrying actually did more than perturb me.  It angered me.  As psychologists say, you should never tell someone "not to feel that way." Especially not someone pregnant with twins and worried about getting the final PRE she can get:  PREmature babies.    


KMF said...

As a mom of 2 preemies (34 and 33 weeks), I have cheered your approach to doing everything you could do to help your babies make it to term and to have a high birth weight. I've met few people who have been as proactive as you have.

You're right in thinking that everyday they stay is important and developmentally 35 weeks is better than 34. With both my kids we found that 35 weeks was the magic number for mastering the coordination for feeding.

Still, even if they were born today, I hope you can appreciate how awesome and helpful it is that they would have such a high birth weight.

My daughter was in the Presby Main NICU for several weeks (for issues not related to her prematurity). While I don't wish it for you or your babies, if they need NICU support, they will have very good care.

Best of luck in the coming days.

(a Charlotte mommy who now lives in Seattle)

nancy said...

Just thinking of you, and sending you strength. I am just a few weeks behind you (28w 3d) so I relate to how scary these weeks can be.

Time to put all that visualization training to work. Think low blood pressure thoughts. Think of warm little bodies nuzzled up in bed with you. Think of new baby smell. Think of that glass of wine you've been waiting for for months. Relax, relax, relax.

Kim said...

Oh, Anita! Good work on all you have done and are doing for those precious babies. I'll be praying for you and them! And rooting for the 35 week mark!!!!!

OneTiredEma said...

You have been really on top of things in terms of giving those babies the optimal growing space and time. I am glad that you have a whole team of people fussing over you.

Just wondering, though, why not the steroid shot? Obviously every day they are in there is less time in the NICU (I know of twins delivered at 35/36 weeks that spent no time there at all), but isn't the shot kind of hedging your bets because your condition can change so quickly?

Thinking of you!

Anita said...


My understanding is that they only want to do the steroid shot just before delivery and then only if one is delivering before 34 weeks.

They used to do multiple steroid shots, but now they only do one, when they think delivery is imminent.

Of course, that's mostly speculation. I will take it as a good sign that they are not doing the shot and they think if things did go down hill quickly, they could still delay it 48 hours for the steroid to get in and out of my body.

Carroll said...

What?? People are telling you how you should/should not feel?? Grrrrr!

Oh, and of course adding PIA (pertubation-induced anger) to the mix is surely not great for your blood pressure, either.

Hang on, Anita, and hang in there, babies. You're so close..SO close!

Preemie care being what it is today, undoubtedly all will be well no matter what. And heck, I won't be the least bit surprised if those two end up amazing and astonishing your entire medical team whenever they come out. Given the attentive TLC you have already been giving them, I bet they'll both be nearly ready for Kindergarten!

Brenda said...

Just wanted to let you know I've been popping in and now and then and I'm so excited for you and your pregnancy! I am sorry you are dealing with all these "pres" but I know it will all work out.

I can't wait to pop by again and see photos of your new little ones. Congratulations again and I'll be thinking of you.


Anita - Hang in there. It's normal for you to be worried, and preeclampsia is no fun.

I know lots of mom's who have babies at 33 weeks who do just fine --but yeah there's worry, and that's totally okay.

You have great doctors and a super husband -- and you are very smart. So hang in there sister I am pulling for you.

Michele said...

Just wanted to let you know I am thinking of you and sending positive thoughts your way! Hang in there...

Julia said...

I'm sending some prayers your way Anita. Don't dwell on what people say, they really do think they are helping by trying to make you feel better. Probably punching them would make you feel better right?

MoDLin said...

People mean well, but we certainly can "open mouth insert foot" at the drop of a hat. Sorry they've got you riled up, but I don't blame you. Pre-e at this point is no joke. Glad to hear you're hanging in there, though.