March 19, 2017 by Leah
When my therapist assigned me to write about this experience, it ran to 13 single-spaced pages. I’ll try to be more brief here.
My husband and I decided to have a third kid, because the first two were just so fun and great, and we wanted a house full of loving chaos. We felt mildly guilty about this on an environmental/population control front, but reasoned that we are solvent, healthy, moral, community-minded, and decent parents so it probably wouldn’t be the worst thing in the world.
My first two pregnancies were, in retrospect, perfect. I had two 9-lb (and change) babies, vaginally, at 39 and a half weeks. We fully expected the third to go the same way, but it did not. Everything was fine up until my 30-week checkup, which actually happened at 31.5 weeks because my doctor was out of town and the clinic called to reschedule the appointment I had made with her backup and I said, “Everything has been fine, I’m not going to come in two weeks in a row, I’ll see you next week.”
Then my stepbrother Stephen died, and all of us who loved him were devastated. I was not surprised when I went to my appointment and my blood pressure was high (160/105 or something). I was still hoping to get cleared to fly to Stephen’s memorial service. My OB said, “I’m not sure this isn’t grief, but this is too high for me to let you go anywhere but to the hospital for monitoring.”
So I was monitored, diagnosed with preeclampsia, and sent home on a Friday to be on “modified bed rest” (not possible with two small children), during which time I put plans in place for childcare for said children to cover a possible two months of bed rest. I went back for monitoring on Saturday, and again on Monday, at which point I was told my kidney function was failing and I had to go up to Spokane to be admitted to the high-risk antenatal unit there. Before I left I got the first of two shots of betamethasone, a steroid that can help to mature a premature baby’s lungs.
My mom, who was visiting, canceled her flight home to Alaska and drove me up to Spokane, where she stayed for the next week and a half. Baby M was born on Wednesday, 49 hours after I’d gotten the first shot of betamethasone in Walla Walla (it takes 48 hours for the benefits to take full effect). She was 4 lbs, 6 oz at 32 weeks 5 days gestational age. She was also breech, so she was born via c-section. That was something else, giving over all the power in a birthing situation to complete strangers. It wasn’t an easy c-section, but once we heard the baby cry, the tension in the room dropped considerably.
I was put on a magnesium drip shortly before surgery, since that’s the standard treatment for preeclampsia, to keep me from heading into seizures (eclampsia) and to keep the baby from having brain bleeds during delivery. Since they knew about my renal failure, my dosage was carefully titrated to try to keep the magnesium from injuring my kidneys further. It still made me feel like complete shit, and it was 36 hours before I could make it, in a wheelchair, up one flight of stairs to hold my baby.
Everyone told me that my blood pressure would come down and my kidneys would heal. I had a wonderful nephrologist at Sacred Heart in Spokane. He assured me I would get over this and I would not be on blood pressure medication forever. The OB hospitalists didn’t seem to know what to do with me, so they put me on ineffective blood pressure drugs and discharged me three days postpartum with a blood pressure that spiked to 180/120 shortly before I left.
My baby did phenomenally well. Her pediatric nurse practitioner would call me every day and say, “Your daughter continues to exceed expectations,” to which I would respond, “I don’t get tired of hearing you say that.” I sat with her in the NICU during the day, pumping milk every 2-3 hours, and I got up every 3-4 hours at night to pump milk. I was staying at the Ronald McDonald house since we were three hours away from home. It’s a wonderful place, but it was a horrible time when I wasn’t with my baby. Baby M was discharged after 12 days, at 34 weeks, 3 days gestational age.
When we got home, I got back with my OB who knows me, who put me on blood pressure drugs that actually dropped my pressure into a safer range. I had a ton of acupuncture to try to get my kidneys and blood pressure working again. My acupuncturist would get results after the session, but long-term results were not forthcoming. My nephrologist in Spokane called and made me an appointment with a local nephrologist he knows, and my local nephrologist has been keeping track of me since. My blood creatinine, an indicator of kidney function, has plateaued around 2 mg/dl, when 6 years ago it was a healthy 0.92 mg/dl, which means there’s no indication of prior kidney disease. Apparently, I’m just one of the few people for whom preeclampsia leads to irreversible kidney failure, and now I have to figure out how to deal with being “medically interesting.”