Maybe It Wasn’t Unexpected

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May 23, 2017 by Leah

I’ve been doing some detective work regarding my chronic kidney disease and I have discovered several things that make me think this wasn’t unexpected. But of course, hindsight is always 20/20. Apparently my eGFR (kidney function estimate, should be 90 or higher) was 50 the day before I delivered my first baby in 2012. (It was 90 or so the year before, in 2011. ) Did it ever improve? I don’t know, no one ever followed up. On one hand, maybe the terrifying slide into preeclampsia and kidney disease during my third pregnancy was not unexpected, but on the other hand, why didn’t I know this? I remember my OB telling me some results were “off” and she would have induced me had I not come in in labor on 5/23/12, but I don’t think she told me which results those were and I wouldn’t have understood at the time anyway. My BP must have been elevated for her to even order the test, because she told me kidney function isn’t a standard test in pregnancy unless there’s a BP issue. So maybe I should be delighted that my second pregnancy was so uneventful? (There was one test during that pregnancy – a low specific gravity of urine – that could have indicated kidney problems, but with no BP issues I don’t think it was clinically significant.) And then that chronic rib pain I had during my pregnancies – was that rib pain masking liver pain? Or liver pain posing as rib pain?

My liver function enzymes shot up in the weeks after I delivered Malin last fall and were highest the day I went to the ER because I thought I was dying, which actually makes me feel better because I always feel horribly embarrassed for using medical resources like emergency rooms for anything less than a severed limb. The ER doctor figured this was due to dehydration, because they were just out of the normal range, but in looking at the data as it pertains to me, over time, it was a pretty significant jump there. So. Not a hypochondriac. Although quite possibly dehydrated because IV fluids felt amazing.
 
I’m doing a lot of thinking about whether I would have been so gung ho to have a third baby if someone had seen a pattern here. Maybe this was my fault for not seeing my GP for physicals? But with three babies in 4.5 years, there’s not a lot of time for non-OB appointments. When my pre-e was discovered, I was supposed to be having two-week appointments and I had gone over three weeks because my OB was out of town, I scheduled with her backup, and then the clinic called me to reschedule that appointment for a week later and I was like, “screw that, I’m not finding childcare just so I can go in for appointments five days apart,” since that’s what the timing would have been. But I’m not sure that was the best decision. And then when a different backup OB told me I needed to get to Spokane, stat, a couple of weeks later I said, “Can I go to Portland? My in-laws live there, I have support there.” And he said no, because the practice I see and the MFM practice in Spokane have a “relationship.” Which was utter BS because my care in Spokane was actually quite uncaring and I wish I’d pushed harder to go to Portland or had someone with me to push it. But I didn’t, because I never do.
 
Anyway. Malin is THE BEST baby and I love her to pieces. I have kind of started thinking of her as my miracle/bonus baby and being grateful I’m still alive, but hoping nothing happens before I hit the one-year postpartum mark, and that nothing happens to the amazing people who have said they will get tested as kidney donors when the time comes. My blood pressure seems to be stabilizing a bit even without drugs in my system (I take beta blockers with a short half life so I have a pretty clear pattern of ups and downs), but I am trying not to get excited about that because I’ve been a lot happier since I came to terms with the fact that my kidneys are failing and there’s nothing I can do about it, instead of being strung along by intermittent false hope.
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