When Pregnancy Swelling Becomes Something More…

 

After years of trying to get pregnant, our dream finally came true. God had finally answered our heart wrenching prayers for a baby. Getting pregnant had been the hard part-being pregnant was a breeze in comparison. That is, until everything went wrong.

Because we had conceived with the help of IVF, I was already a paranoid pregnant lady. Even though I followed all of the recommendations, I still feared a miscarriage, a physical deformity, or a genetic anomaly. I had thought of most potential complications, and every little ting or pain alarmed my fragile state of mind. Knowing too much as a physician didn’t help. I reminded myself that it was normal to be overly concerned considering all that we had been through. It wasn’t like getting pregnant was a walk in the park for us. All forces of nature had conspired against us for years. Now that we had finally gotten a positive pregnancy test, I was a little leery that it was too good to be true. But, as months passed and our baby continued to be a perfect patient, the hypochondriac in me started to lessen. I resolved that I was going to have a happy and healthy baby.Love and new life concept. A woman's hands forming a heart symbo

Around 26 weeks of pregnancy, I suffered the worst headache of my life. My husband and I had recently moved states, and I had just established care with a new OB/GYN. I didn’t want to be the annoying patient who called about every little complaint, but when loads of Tylenol and sleep just didn’t cut it, I began to worry. Knowing that headaches can be linked with pregnancy induced hypertension and preeclampsia, I quickly checked my blood pressure. It was normal, but the pain in my head was not. With tears streaming down my cheeks, I asked my husband to call the doctor.

The physician on call recommended that I come into the hospital for blood work, to monitor the baby, and to get me something stronger for the headache. I couldn’t have agreed more. Thankfully, my blood pressure and blood work were fine, the baby was active, and the Percocet took the edge off.

After that episode, pregnancy life returned to normal. My follow-up blood pressures were fine. I hadn’t had another headache, and my only real complaint was the swelling in my feet. By swelling, I mean absolutely NO shoes fit my feet. I questioned, joked, and complained about my elephant feet, but I just assumed that it was part of the beauty of getting pregnant.

Since we had just moved to a new state without any family nearby, I knew that I needed to establish a support system before the baby arrived. This gave me the bright idea to join a Mom’s group while still only 32 weeks pregnant-I like to think outside of the box sometimes! I loved my “Real Mom’s” group from the moment that I met them. They applauded my assertiveness in joining the group while pregnant and welcomed me wholeheartedly. They didn’t, however, welcome my swollen feet! Instead, they insisted that I prop them up and have someone take a look at them. I reassured them all that I had a doctor’s appointment later that day, and that I didn’t have preeclampsia. It was simply swelling from pregnancy. I had noticed just the night before, however, that my glasses seemed a little tighter on my face, and my rings were even tighter than usual. I voiced my concern to my husband but then brushed it off as paranoia.

Fetus 7 Month In The Womb. Visible Head And Arms

At my 32-week prenatal visit, my blood pressure checked out fine. The Ob/GYN examined my belly and listen to the baby’s heartbeat. After measuring my belly, she recommended that we get a quick ultrasound of the baby since I hadn’t grown much since the last visit.

I waddled off to ultrasound, my feet aching with each step. The ultrasound confirmed that my baby’s growth had decreased to the 10th percentile from the 40th. Something was making her very unhappy inside of me. When I returned to the exam room, my doctor asked for a urine sample (which being pregnant I was easily able to give.) She reexamined my feet and decided to confirm my “normal” blood pressure. On recheck, my pressure wasn’t just a little high; it was stroke worthy! My urine dip screamed protein. And, when my doctor asked if I had been seeing any floaters, I dumbly responded that I had been having a weird, spotty kind of dizziness for months, but it seemed to be positional. Duh! Floaters! Wow, sometimes being a physician really doesn’t prepare you to be a good patient.

Within minutes I was loaded into a wheel chair and whisked to the OB floor for overnight observation. I voiced my concern that my mom was coming from Michigan to pick me up and take me back for a wedding shower. My Ob politely but firmly replied, “Emma, you aren’t going anywhere. First we have to make sure that you and the baby are safe.” By the time I made it to the OB floor, my blood pressure was sky-high, my head was pounding, and I was starting to get very scared. The nurse poked and re-poked me to start the IVs for the blood pressure medications and the dreaded magnesium. In what seemed like minutes, I had developed sudden and severe onset preeclampsia.

I called my mom to let her know the change of events. Knowing nothing about preeclampsia, she asked, “Emma, is this serious?” That’s when I broke down sobbing. Yes, it was serious. I was getting sicker by the minute, and I knew that my baby needed to be delivered soon…TOO SOON.

For more about preeclampsia head to The Preeclampsia Foundation or March of Dimes. Both have their annual walks all across the country in May and June. Sign up to raise awareness and support women who have had pregnancy complications, and help prevent complications for others.

From,

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Can a Pregnant Mom Trust Modern Medicine?

Pregnant Woman Belly. Pregnancy Concept

The beauty of medicine is that it can fix most things. No, it’s not perfect, but modern medicine saves countless lives. In addition to saving lives, it dramatically improves the quality of the lives we live. Without modern medicine, my 18 month-old daughter and I would not be here today. After sailing through 32 weeks of a healthy pregnancy, I developed sudden and severe onset preeclampsia. I’m a high achiever, so my body decided it needed to start setting records. My blood pressure soared to stroke high levels. The protein in my urine topped the charts at 12 grams (5 grams is considered severe preeclampsia), and I gained over thirty pounds of fluid, becoming the Michelin man overnight. A simple tap on my arm or leg would send my limbs flying into the air. My nervous system and reflexes were in overdrive. The pounding headache, spotty vision, and abdominal discomfort were icing on the cake.Pregnant woman sitting on sofa looking at her unborn baby's ultr

Overnight, I became one sick mamma to a 3 lb. 2 oz preemie. As soon as my daughter was cut from my belly, she required urgent resuscitation. A tiny tube was placed in her airway, and she was whisked away to the neonatal intensive care unit. It took me two days to even make it up to the NICU to see her. Even then, I was hooked up to IVs, countless medications and could only manage to hold her for a few minutes. Although the textbook answer to treating preeclampsia is to deliver the baby, for some women this doesn’t solve the problem immediately. My blood pressure continued to top the charts, my reflexes remained in hyperactive mode, my mind was very confused, and I was pretty sure I had, or was going to have a stroke. My concerned OB/GYN consulted a cardiologist to manage my unimproved condition. She was amazing. She listened, investigated, and made the necessary changes (mega doses of several blood pressure medications), which eventually helped normalize my blood pressure. But, even she didn’t have all of the answers. It wasn’t until three weeks after I delivered that I was able to cancel home nursing and stop my blood pressure medications.Close up of doctor writing on a medical chart with patient lying

Through this experience I started asking questions about why this was happening. What was the physiology behind this crazy multisystem condition affecting my nervous system, cardiovascular system, kidneys, liver, and reproductive system? What caused preeclampsia? What could I do to prevent it in the future? What was my chance of having it happen again? Why couldn’t we prevent it or at least treat it more effectively? I didn’t like any of the answers that I was hearing or reading. They were all just theories, nothing concrete. This condition, which landed me in the hospital for eight days, forced me to have an emergency c-section at thirty-two weeks, placed my tiny baby in the NICU for nine weeks, and which put me at risk for having high blood pressure and a stroke later in life was still not understood.Care For A Sick Child In The Pediatric Icu

One out of every twelve pregnant women will develop preeclampsia according to data from the Preeclampsia Foundation. One in twelve! I don’t like those odds. How is it possible for a condition that is so common and potentially life threatening to mom and baby to continue to mystify us? We have mapped the human genome. We have eradicated small pox. We can identify breast cancer at its earliest stages, ensuring early treatment and amazing survival rates. Why haven’t we identified the true cause of preeclampsia and developed earlier and more efficient and effective screening tests for this condition? If prevention and earlier identification are not yet possible, then why haven’t we developed more effective treatments that will allow for a continued healthy pregnancy?

I have a fifty percent chance of developing preeclampsia again and at an earlier gestation in future pregnancies. I’m not a fan of my chances. I did everything right during my pregnancy. For goodness sake, I was the crazy lady who gave up all caffeine even though it probably wasn’t necessary. I didn’t drink a single soda, and I verified that every item entering my mouth was pasteurized. I was a paranoid pregnant mama! And, although following all of the recommendations probably prevented me from having other complications, it didn’t protect me from preeclampsia.

In a world where I count on modern medicine to fix most things, I have decided that modern medicine has failed to meet my expectations. Yes, it definitely saved my life and my daughter’s, but not all women are as fortunate as I was. Globally, preeclampsia is listed as one of the leading causes of mother and infant morbidity and mortality (illness and death). Worldwide, the United Nations reports that more than 500,000 women die each year due to pregnancy related causes. In the United States alone, preeclampsia causes 18% of maternal deaths. In short, preeclampsia is a killer.

As with any horrific and life threatening disease, the way to beat it is to study it. Research and clinical studies require interest, money, mental power (the scientists), and patients willing to participate. In most cases, it takes years before the results of clinical trials can be used in every day medicine. With only a short window left for my childbearing years, I’m hoping that new preventions and treatments will be available quickly. In the meantime, I’m doing my best to raise awareness and money, educate other women, and save the lives of women and their future babies (myself included). Join me by putting on your tennis shoes for the Promise Walk for Preeclampsia in your area. Or, take a look at the Preeclampsia Foundation or the March of Dimes for other ways to get involved. Push modern medicine to meet our expectations as women, mothers, and future mothers.

Both March Of Dimes and the Preeclampsia Foundation have their annual walks in May! Head to either of their websites to sign up and get involved.

From,

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Our Preemie Journey: Delivery Day…8 Weeks Early!

young pregnant woman sitting on the windowMy mind was fuzzy, my vision blurry, and my body on fire from the magnesium! I felt like I was going to burst like a water balloon from even the tiniest poke. I could barely move my fingers due to the swelling, and I was scared. I was terrified for my unborn child and for myself. Preeclampsia had taken over. It didn’t care that I was just shy of 32 weeks pregnant. It didn’t care about what I had already gone through just to get pregnant! It was mocking my plans for a perfect delivery. I asked myself, “Who attacks a mother and her innocent unborn child? How could a disease be so sadistic…so ruthless?”

I waited for Dave to arrive for what seemed like hours. I was alone, alone with my unborn baby…uncertain of what was going to happen next…uncertain if my child would survive…uncertain if my body would fail me…uncertain of what the future held. A sense of relief washed over me when Dave walked into my hospital room. He hadn’t realized the severity of the situation until he saw me. I was barely recognizable from even the night before. Dave had raced from work, stopping at the house to take the dog out and to throw some overnight clothes together. Little did he realize that our overnight bag would need to get us through the next nine weeks.Fetus 7 Month In The Womb. Visible Head And Arms

The next several hours were filled with ultrasounds from Maternal Fetal Medicine, discussions with the neonatologist (NICU doctor), and constant blood pressure checks and rechecks. I was reassured that 32-week old babies can do very well. They can still have major complications including bleeding in the brain, respiratory distress syndrome, vision problems, and much more; but according to my Ob/Gyn, making it to 32 weeks was a great accomplishment. It didn’t feel like an accomplishment. It felt like a failure. My body was failing my baby and me. Once again, my best efforts could do nothing to change the situation.

Because our baby’s lungs hadn’t gotten the chance to fully develop, I was stabbed with the first of two steroid shots to speed up the process. A plan had been put in place. We were going to wait for my 24-hour urine protein to come back, and we were going to try to get both steroid shots in before delivery (these had to be spaced out by 24 hours).

I was a little nervous about a C-section, but I was willing to do whatever it took to keep my baby safe. Because my blood pressure was so incredibly high, an attempt at a vaginal delivery was out of the question. Starting an induction would be too hard on the baby and on my already stressed body.

The minute that my 24-hour urine protein results arrived the conservative timetable was thrown out the window. I was loaded into a wheelchair and told that the C-section was happening NOW! My urine protein was the highest that my Ob/Gyn had ever seen. The baby was starting to have some dips in her heart rate, and we couldn’t wait any longer. Delivery was the only “cure” for preeclampsia. My leg was stabbed too early with the second steroid shot in a last ditch effort to give our baby’s lungs every chance to mature. The magnesium and blood pressure medications continued to run into my veins, in an attempt to prevent me from having a seizure or stroke.

As the nurse wheeled me down the hallway, I pleaded desperately with God. He had answered my heart’s longing for a child. I had watched my belly grow with awe, wonder and gratitude. This baby was my answered prayer. He had to protect her! If not, then why had he given her to me in the first place? I loved this little being that I had never met more than my mind could comprehend. He couldn’t take her from me now…not after we had made it this far.

The spinal was more unpleasant than I had imagined. For some reason the idea of a huge needle poking into the nerve track in my back freaked me out more than just a little. I wasn’t worried about having my belly cut open with a scalpel, but a giant needle wasn’t my idea of fun. I hunched, I hugged the pillow, and I hunched some more. After three attempts, the needle was finally in the correct position. I was transferred to the operating table, and prepped for surgery. I had assisted in numerous emergency C-sections during residency. I had reassured many panicked mothers that everything would be “just fine”. Now I was the panicked mother, and I found that my own advice fell flat.

I remember the tugging and pulling during the c-section, and that the spinal was just as unpleasant as patients have described. My blood pressure dropped fairly rapidly at one point, causing me to vomit.

My C-section!

The C-section felt like an eternity. Just as they were pulling the baby out of my belly, my blood pressure dropped precipitously from the anesthesia, and I began to vomit. I vaguely remember the attending physician showing my baby to me before she was whisked to the resuscitation table. Her skin was dusky. She wasn’t crying! Was she breathing? I couldn’t see. What was happening? And, then I heard her. I heard her first cry. It was a small cry, but it was fierce. She was a fighter. She was in the lightweight division at 3 pounds 2 ounces, but she was a fighter!

My baby was born at 3 lb. 2 oz. She was whisked away to be resuscitated.

Ayla in the Delivery Room being Resuscitated

Before I could catch another glimpse of my precious baby, she was rushed to the Neonatal Intensive Care Unit with her daddy close behind. I felt physically sick, helpless, and alone. I was her mother, but I had yet to hold my baby. I wanted to be at her side, but I could barely keep my eyes open. I wanted Dave at my side, but I knew that he needed to be with our baby. My mind was heavy, clouded by painkillers, anesthetics, and magnesium. As the last stitch was placed in my belly, I drifted off. When I awoke to a soaring blood pressure and splitting headache, I realized that I was in a fight for my life. Preeclampsia was still my master, and it wasn’t finished with me yet. Delivery had only made it more determined to destroy me, but I was a fighter too!

From The Mom in Me, MD

Our Preemie Journey: The Beginning

Pregnant Woman holding her hands in a heart shape on her baby bu

After years of trying to get pregnant, our dream finally came true. God had finally answered our heart wrenching prayers for a baby. Getting pregnant had been the hard part-being pregnant was a breeze in comparison. That is, until everything went wrong.

Because we had conceived with the help of IVF, I was already a paranoid pregnant lady. Even though I followed all of the recommendations, I still feared a miscarriage, a physical deformity, or a genetic anomaly. I had thought of most potential complications, and every little ting or pain alarmed my fragile state of mind. Knowing too much as a physician didn’t help. I reminded myself that it was normal to be overly concerned considering all that we had been through. It wasn’t like getting pregnant was a walk in the park for us. All forces of nature had conspired against us for years. Now that we had finally gotten a positive pregnancy test, I was a little leery that it was too good to be true. But, as months passed and our baby continued to be a perfect patient, the hypochondriac in me started to lessen. I resolved that I was going to have a happy and healthy baby.

Around 26 weeks of pregnancy, I suffered the worst headache of my life. My husband and I had recently moved states, and I had just established care with a new OB/GYN. I didn’t want to be the annoying patient who called about every little complaint, but when loads of Tylenol and sleep just didn’t cut it, I began to worry. Knowing that headaches can be linked with pregnancy induced hypertension and preeclampsia, I quickly checked my blood pressure. It was normal, but the pain in my head was not. With tears streaming down my cheeks, I asked my husband to call the doctor.

The physician on call recommended that I come into the hospital for blood work, to monitor the baby, and to get me something stronger for the headache. I couldn’t have agreed more. Thankfully, my blood pressure and blood work were fine, the baby was active, and the Percocet took the edge off.

After that episode, pregnancy life returned to normal. My follow-up blood pressures were fine. I hadn’t had another headache, and my only real complaint was the swelling in my feet. By swelling, I mean absolutely NO shoes fit my feet. I questioned, joked, and complained about my elephant feet, but I just assumed that it was part of the beauty of getting pregnant.

Since we had just moved to a new state without any family nearby, I knew that I needed to establish a support system before the baby arrived. This gave me the bright idea to join a Mom’s group while still only 32 weeks pregnant-I like to think outside of the box sometimes! I loved my “Real Mom’s” group from the moment that I met them. They applauded my assertiveness in joining the group while pregnant and welcomed me wholeheartedly. They didn’t, however, welcome my swollen feet! Instead, they insisted that I prop them up and have someone take a look at them. I reassured them all that I had a doctor’s appointment later that day, and that I didn’t have preeclampsia. It was simply swelling from pregnancy. I had noticed just the night before, however, that my glasses seemed a little tighter on my face, and my rings were even tighter than usual. I voiced my concern to my husband but then brushed it off as paranoia.

Fetus 7 Month In The Womb. Visible Head And Arms

At my 32-week prenatal visit, my blood pressure checked out fine. The Ob/GYN examined my belly and listen to the baby’s heartbeat. After measuring my belly, she recommended that we get a quick ultrasound of the baby since I hadn’t grown much since the last visit.

I waddled off to ultrasound, my feet aching with each step. The ultrasound confirmed that my baby’s growth had decreased to the 10th percentile from the 40th. Something was making her very unhappy inside of me. When I returned to the exam room, my doctor asked for a urine sample (which being pregnant I was easily able to give.) She reexamined my feet and decided to confirm my “normal” blood pressure. On recheck, my pressure wasn’t just a little high; it was stroke worthy! My urine dip screamed protein. And, when my doctor asked if I had been seeing any floaters, I dumbly responded that I had been having a weird, spotty kind of dizziness for months, but it seemed to be positional. Duh! Floaters! Wow, sometimes being a physician really doesn’t prepare you to be a good patient.

Within minutes I was loaded into a wheel chair and whisked to the OB floor for overnight observation. I voiced my concern that my mom was coming from Michigan to pick me up and take me back for a wedding shower. My Ob politely but firmly replied, “Emma, you aren’t going anywhere. First we have to make sure that you and the baby are safe.” By the time I made it to the OB floor, my blood pressure was sky-high, my head was pounding, and I was starting to get very scared. The nurse poked and re-poked me to start the IVs for the blood pressure medications and the dreaded magnesium. In what seemed like minutes, I had developed sudden and severe onset preeclampsia.

I called my mom to let her know the change of events. Knowing nothing about preeclampsia, she asked, “Emma, is this serious?” That’s when I broke down sobbing. Yes, it was serious. I was getting sicker by the minute, and I knew that my baby needed to be delivered soon…TOO SOON.

From The Mom In Me, MD

Where Modern Medicine has Failed the Pregnant Mom

Pregnant Woman Belly. Pregnancy Concept

The beauty of medicine is that it can fix most things. No, it’s not perfect, but modern medicine saves countless lives. In addition to saving lives, it dramatically improves the quality of the lives we live. Without modern medicine, my 18 month-old daughter and I would not be here today. After sailing through 32 weeks of a healthy pregnancy, I developed sudden and severe onset preeclampsia. I’m a high achiever, so my body decided it needed to start setting records. My blood pressure soared to stroke high levels. The protein in my urine topped the charts at 12 grams (5 grams is considered severe preeclampsia), and I gained over thirty pounds of fluid, becoming the Michelin man overnight. A simple tap on my arm or leg would send my limbs flying into the air. My nervous system and reflexes were in overdrive. The pounding headache, spotty vision, and abdominal discomfort were icing on the cake.

Overnight, I became one sick mamma to a 3 lb. 2 oz preemie. As soon as my daughter was cut from my belly, she required urgent resuscitation. A tiny tube was placed in her airway, and she was whisked away to the neonatal intensive care unit. It took me two days to even make it up to the NICU to see her. Even then, I was hooked up to IVs, countless medications and could only manage to hold her for a few minutes. Although the textbook answer to treating preeclampsia is to deliver the baby, for some women this doesn’t solve the problem immediately. My blood pressure continued to top the charts, my reflexes remained in hyperactive mode, my mind was very confused, and I was pretty sure I had, or was going to have a stroke. My concerned OB/GYN consulted a cardiologist to manage my unimproved condition. She was amazing. She listened, investigated, and made the necessary changes (mega doses of several blood pressure medications), which eventually helped normalize my blood pressure. But, even she didn’t have all of the answers. It wasn’t until three weeks after I delivered that I was able to cancel home nursing and stop my blood pressure medications.

Through this experience I started asking questions about why this was happening. What was the physiology behind this crazy multisystem condition affecting my nervous system, cardiovascular system, kidneys, liver, and reproductive system? What caused preeclampsia? What could I do to prevent it in the future? What was my chance of having it happen again? Why couldn’t we prevent it or at least treat it more effectively? I didn’t like any of the answers that I was hearing or reading. They were all just theories, nothing concrete. This condition, which landed me in the hospital for eight days, forced me to have an emergency c-section at thirty-two weeks, placed my tiny baby in the NICU for nine weeks, and which put me at risk for having high blood pressure and a stroke later in life was still not understood.

One out of every twelve pregnant women will develop preeclampsia according to data from the Preeclampsia Foundation. One in twelve! I don’t like those odds. How is it possible for a condition that is so common and potentially life threatening to mom and baby to continue to mystify us? We have mapped the human genome. We have eradicated small pox. We can identify breast cancer at its earliest stages, ensuring early treatment and amazing survival rates. Why haven’t we identified the true cause of preeclampsia and developed earlier and more efficient and effective screening tests for this condition? If prevention and earlier identification are not yet possible, then why haven’t we developed more effective treatments that will allow for a continued healthy pregnancy?

I have a fifty percent chance of developing preeclampsia again and at an earlier gestation in future pregnancies. I’m not a fan of my chances. I did everything right during my pregnancy. For goodness sake, I was the crazy lady who gave up all caffeine even though it probably wasn’t necessary. I didn’t drink a single soda, and I verified that every item entering my mouth was pasteurized. I was a paranoid pregnant mama! And, although following all of the recommendations probably prevented me from having other complications, it didn’t protect me from preeclampsia.

In a world where I count on modern medicine to fix most things, I have decided that modern medicine has failed to meet my expectations. Yes, it definitely saved my life and my daughter’s, but not all women are as fortunate as I was. Globally, preeclampsia is listed as one of the leading causes of mother and infant morbidity and mortality (illness and death). Worldwide, the United Nations reports that more than 500,000 women die each year due to pregnancy related causes. In the United States alone, preeclampsia causes 18% of maternal deaths. In short, preeclampsia is a killer.

As with any horrific and life threatening disease, the way to beat it is to study it. Research and clinical studies require interest, money, mental power (the scientists), and patients willing to participate. In most cases, it takes years before the results of clinical trials can be used in every day medicine. With only a short window left for my childbearing years, I’m hoping that new preventions and treatments will be available quickly. In the meantime, I’m doing my best to raise awareness and money, educate other women, and save the lives of women and their future babies (myself included). Join me by putting on your tennis shoes for the Promise Walk for Preeclampsia in your area. Or, take a look at the Preeclampsia Foundation or the March of Dimes for other ways to get involved. Push modern medicine to meet our expectations as women, mothers, and future mothers.

From The Mom in Me, MD