In September 2002, I took a pregnancy test and was shocked to get a + result. It was our first month of trying to conceive and I never thought we'd get pregnant our first month. We were so excited! We told our parents a week later by giving them little Halloween gift bags with a pair of infant socks and a card that read, "Trick or Treat, Here is something for our pumpkin's feet." Of course, our parents were excited too.
I made my first doctor appointment for around 10 weeks after I saw the nurse to confirm the pregnancy. Unfortunately, I had to see the OB prior to that as I started spotting at 7-8 weeks. This led us to our first ultrasound, where we got a peek at the life growing inside me. We got to see the tiny heart beating away. Thankfully everything was okay. I had morning sickness in the first trimester and I couldn't sit as a passenger in the vehicle when Jason was driving as I'd become very nauseous. ;-) I didn't have any really weird cravings, but I did love the smell of alcohol. Don't normally drink too much when I'm not pregnant, but being pregnant made me crave it. Weird. The morning sickness I had just made me not hungry at all, so I lost about 15 lbs during the first trimester. I did gain it all back, plus a couple pounds later on. ;-)
Right around the holiday time, we decided to have the AFP screening for neural tube defects and Down's Syndrome. A few days before the new year, I got a phone call from the nurse stating my levels had come back abnormal and my OB wanted me to have a higher level ultrasound to check the baby out. The AFP has a high false-positive rate in that it can give an abnormal result when nothing is actually wrong. *Later on, I discovered that there is a correlation between an abnormal AFP and certain pregnancy complications like preeclampsia.* The ultrasound was done in the new year, and baby checked out measurement-wise. The radiologist and my OB didn't see anything wrong with the baby. We were offered the opportunity to have an amniocentesis, but we declined due to the risks involved and that we'd get the results around 20 weeks gestation.
At that ultrasound, we found out we were having a baby girl! We couldn't believe it. She was being a stinker when the technician was looking for "parts," so it was about a 90% chance it was a girl. We had her name picked out all along. From here on out, our baby girl had a name...Ariana. I did have another ultrasound around 30 weeks (I think) to check on baby as I hadn't gained all that much weight. We had a perfect picture of Ariana's girl parts as she posed just right for the ultrasound.
During 33-34 weeks gestation, I would occasionally suffer from what I thought were pulled chest muscles. In hindsight, that may have been the start of this illness. I’ll never know. My blood pressure and protein were okay at my appts and I didn’t mention the pulled muscle feeling. As I turned the corner from 33 weeks into 34 weeks I became ill with what I thought was the flu. Over the weekend, I was vomiting and had bad epigastric pains that I thought was from dry heaving. The following Wednesday I had a regular OB check with my doc. I had been feeling better by Tuesday and on Wednesday I felt much better. I did have trace protein in my urine, but I attributed it to being dehydrated from the last weekend. My blood pressure was barely up at 124/76, but not anything shocking from prior pressures. I normally run between 102-110/52-60. Thursday I started feeling my pains again and by Friday I didn’t want to get out of bed. I ate Popsicles that morning and ended up throwing those up. Jason called to see how I was feeling and came home early when he heard I wasn’t well. He wanted me to call the doc, but I said it wasn’t that bad. Two hours later I was ready to call. I knew something was wrong. Since it was 4pm on a Friday, the nurse had me come into the local walk-in clinic. Here I was, not having showered since Thursday morning and walking into the clinic in my pajamas. Once there and we got into an exam room, I got progressively worse. They took blood and urine samples and the doctor felt my chest. It was very tender. At first we thought it was a gallbladder attack, but soon found out differently. The walk-in doc called my OB and conferred with him as to a plan of action. While we were waiting for the news, I was feeling so poorly I couldn’t stand or sit. No position was relieving the pain I was in.
It was decided that I would go up to the birthing center and be checked out. I made it up to a triage room about 6:30pm. By this time, my blood pressure was 151/101 (which is very high for me). My OB came in and checked my cervix. I was already starting to dilate at 1cm. He told us that we would be having a baby this weekend as I had HELLP Syndrome. I was shocked. The last thing I expected was to have our baby girl. HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a serious disease that is very rare and causes liver failure. The damaged liver cannot produce enough platelets to maintain blood clotting, so the mother can bleed to death. Delivering the baby was the only option to save my life. I was admitted and had Cervadil inserted to help ripen my cervix. I was also started on Magnesium Sulfate to keep me from seizing, which is a potential risk with preeclampsia. It took the nurses 5 attempts to get my IV inserted. Ouch! I also had a foley catheter inserted since I was on strict bed rest. I pretty much had to lie on my left side all evening since that is the position that the baby’s heart rate was best in. The lab came in at midnight and again at 6am. I was also having my blood pressure taken every 15 minutes along with my temp and reflex checks every hour.
The pain continued through the night but did get better towards morning. I thought my water broke about 7:30am as I felt this huge gush, but it turns out my foley was kinked up and it was actually urine. Around 8:30am my doctor came in to see how I was fairing. He checked me and I was 2cm and 70%. We decided to see how things progressed for labor as I was feeling much better and my labs were still within reason. He started Pitocin at 9am and we hoped something would happen. During the morning hours I began to have flecks of blood show up in my foley with more coming later morning. Now I know that this is from my platelet level dropping (48,000 at noon--normal is 150,000-300,000 for a pregnant woman). My doc came in about 1pm to check me again and my cervix had not changed at all. I hardly had any cramping. So we decided to break my bag of water. Within 20 minutes the contractions were going. We were actually supposed to have Lamaze class today, but obviously were not there. My labor nurse instructed me a bit on Lamaze breathing to help me through since I couldn’t have the epidural (which I had counted on) because of the HELLP syndrome. About 2:30pm, doc came back in and I was 4-5 cm dilated. The baby was having a few slight decelerations in heart rate, but always came right back up. They had me switch sides and baby did better. Doc said it’d probably be another couple hours and that he’d check back. I was getting a headache, which was from the preeclampsia and my eyes were sensitive to light. The contractions were really starting to get to me and I was trying to focus on relaxing and going to my “happy” place. Jason was trying to be so supportive and kept saying things to me to get me to relax and breath. I could not even catch my breath or focus enough to tell him to shut up, and that I was on my way to a happy place.
Jason went to let my parents know what the latest news was since they were in the waiting room. The contractions were getting worse, but I could still just barely handle them. Kathy, my nurse, asked if I wanted Nubain and I said, “sure!!” A couple minutes later and I started to feel this intense pressure. I told Kathy I felt like I had to go to the bathroom and she said she’d check me after my next contraction. Lo and behold, I was 9.5 cm! She called for the doctor and nurses. Jason had come back in the room right before everything went bonkers. Things went crazy in the room while people were coming in and getting stuff set up. I then had the overwhelming urge to push. They told me not to push as no one was set up. Hello….how do I NOT push???? I vividly remember that out of control feeling I had and not knowing what to do with it. Finally I was able to push and within minute or two our baby girl was born. Thankfully during this time I did get my IV shot of Nubain. With things happening so fast and the Nubain kicking in, I don’t remember a whole lot of the delivery. Ariana had her umbilical cord wrapper around her neck twice. Jason did get to cut the cord. I got to give her a quick kiss before she was placed in the infant warmer. She was checked over and taken to the special care nursery (Jason was able to go with her).
All said and done, my 1st stage of labor lasted 6 hours, the 2nd stage 11 minutes, and the 3rd stage 6 minutes. The contractions got really painful only towards the 3rd stage as I dilated 5 cm in 10 minutes or so. Ariana weighed 4lbs 0.8 oz and was 17 ½ inches long. I was still on bed rest after delivery so the nurses in the special care nursery took a Polaroid for me to keep. Jason came back with it after he had seen to Ariana and what was going on with her. I was feeling better after delivery, but very weak and tired. Had a couple visitors that evening and we made all of our phone calls to family and friends before I succumbed to sleepy exhaustion.
I was wheel chaired down to the nursery Sunday morning where I got to hold my baby girl for the first time. I knew that I had a daughter and loved her immensely, but I did not feel connected to her until I held her. What a moment in time for me. I will never forget it. I remained on the magnesium-sulfate IV through Sunday, and my bp was going back down along with my various labs. I was discharged on Monday late morning and we spent the night in a hospitality room so we could be with Ariana yet for another day.
The next day we made the 10 minute drive home without our baby. It was the most disheartening thing I have ever done. I knew Ariana was fine and was under great care with the nurses, but it was horrible to say good-bye each time. How could we leave her there? What kind of parents are we? The nurses were fantastic and we could always call in to check on Ariana when we weren't at the hospital. We visited our little girl as often as we could. I brought in books to read and spent many times just stroking her head. She remained in the nursery for 15 days. She had some initial oxygen problems and was kept in an isolette for most of the two weeks with extra oxygen. She was also having some difficulty maintaining her temp, so the isolette helped with that too. She was fed by NG tube and was eating 15ccs every three hours. By the end of the two weeks she was up to 45ccs every three hours (30cc=1oz). Ariana also developed a high bilirubin count (common with preemies) and was on the bili blanket for a few days. About one week in or so, she was able to eat from a nipple. At first she was some heart rate decelerations with nipple feeding, as she didn’t have the suck-swallow-breath reflex down yet. She was sucking on a preemie pacifier, but did use the regular nipples. She dropped down to 3lbs 13-½ oz in the days after she was born, but started gaining right away after that. She was 4lbs 5 oz the day we took her home. We were so happy to finally have her home.
Ariana came home on a special preemie formula where extra calories are in it to help her gain weight. She was having some problems digesting the formula about a month later, so our pediatrician switched her to a different formula called Nutramigen to help with colic/reflux. That stuff worked for a couple weeks, but then Ariana was back to her projectile vomiting, arching her back, and screaming after eating. Our pediatrician suspected reflux, so she started Ariana on some medication. It worked for a while, but we kept having to up the dose. Eventually our ped referred us to a pediatric GI doc. He switched her formula and her medications again. We ended up switching formula one more time before we found a winner. Medications were switched another couple times to find the magic dose/meds that worked for Ariana. We had issues with the reflux (GERD) until Ariana was about 15 months old.
We thank our lucky stars that both of us are alive today and that I was not as ill as some women have been. I now want to share my knowledge of HELLP with all pregnant women, as I didn’t know anything about it prior to this happening to me. I am envious of those women who are excited about their families and plan on having the “perfect birth.” I feel a mix of emotions when I hear them talking as I also had ideas of how I wanted things to go, but we are now well aware of how things can change in the blink of an eye. Going through this makes a person realize how precious life is and that a lot can go wrong with a pregnancy. We get so wrapped up in how we want things to happen and lose sight of the outcome, which is a healthy baby.
Premature children are special, determined little miracles. Though I would never have chosen to have my child early, we had the opportunity to watch her develop much as she would in the womb those last few weeks. Her nurses called her "fiesty" and loved the little one in the back corner of the nursery. There was a lunar eclipse during the time Ariana was in the nursery and the nurses took her out to the window to view it and took a photo for us. I got to give my first bath to Ariana on Mother's Day. I remember those days fondly, and wouldn't change a thing.
HELLP is a word we had never heard before, and now I know it intimately. HELLP had and still has a profound impact on my life. Some people look at me and ask why I just can't "get over it" and leave the experience behind me. I don't always know how to reply, but I know that for the rest of my life this experience will be with me, and I can't ignore that it happening to someone else, too.