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HELLP - In The Beginning - A
First Person Account
by C. Picklyk
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I am
a worrier by nature. My worries were only compounded by the fact
that, despite being young and healthy we still hadn't conceived
after 11 months of "trying". God blessed me during my 12th cycle,
but the initial joy and relief upon seeing that 'positive' was
quickly replaced by a whole host of concerns. Carrying a baby was
such an awesome responsibility! The multitude of reasons and ways
that I might lose the baby overwhelmed me. My husband liked to
tease me that if, like in the old days doctors asked which one of
us to "save" due to serious complications, he would choose me.
Fortunately (and despite my husband!) by the time my pregnancy was
well established I had calmed down enough to appreciate and enjoy
the miraculous process of cultivating a new life. I began to
believe that indeed, things might turn out alright.
Like any conscientious
mom-to-be, I flipped through the baby books, reading up on
birthing methods, considering the risks, and deciding what
interventions I didn't want. I, like many women these days, wanted
to "go natural", and even wrote in my pregnancy journal that I
wanted to give birth without all the "benefits" of modern
medicine. To that end, I took hypnobirthing classes, practiced
relaxation techniques, did perineum massages, and generally
prepared myself mentally for the task ahead. Ironically, at that
point I wasn't concerned about the outcome and was actually
looking forward to the challenge of delivery. I flipped past all
the information on preeclampsia and PIH because I seemed to think
it didn't apply to me. Subconsciously I seemed to believe that the
danger had passed and I was in the clear. For some reason it never
occurred to me to worry about delivery complications.
As it was, I had the "perfect
pregnancy". I never had any spotting; I never got really big; I
never got uncomfortable, or excessively tired, or swollen, and I
managed to keep active throughout. I loved being pregnant! In
fact, as labour approached I was regretting the end of this
special time in my life. I didn't want Jacob out, I loved having
him in! Regardless, one certainty of pregnancy is that it is a
finite process. Jacob was coming out.
It was around 36 weeks that I
had my first inklings that all was perhaps not quite as perfect as
I thought. I began having aching pains in my rib cage, which I
attributed to the baby taking up too much room. I had nausea and
vomiting, too, which I intuitively knew was connected to the rib
pain. My sister assured me that she, too, had been nauseous near
the end, however, so I didn't give it much thought. I had one
episode of slightly elevated blood pressure that prompted a
discussion about preeclampsia with my doctor, but a return visit
revealed that my pressure had returned to normal. In retrospect
all of these symptoms speak volumes, but at the time they seemed
quite inconsequential.
After several days of
contractions we went to the hospital at 2 a.m. on my due date,
Saturday August 12th: My labour progressed slowly, but I managed
well with the hypnobirthing techniques I had learned.
Nevertheless, the process was too much, and after 24 hours of
labour (with another 5 hours estimated before opening to 10 cm) I
opted for the epidural. The effect was almost immediate, and I was
told to rest for awhile in order to be ready for pushing. I
couldn't sleep, naturally, but everyone else did! Ironically,
after all that effort I was dilated to 10 cm within the hour. I
pushed for 1=BD hours, and Jacob was born at 5:55 a.m., Sunday
August 13th. It had been a long, but fairly straightforward labour.
I had a headache, but I was wired.
I noticed almost immediately
after delivery that my ribs began hurting again, and asked for
some Tylenol for both my headache and my ribs. I figured that my
rib cage was just re-adjusting itself to it's new found space, and
that was why it was hurting. I had breakfast, Marc made all "the
calls", and my doula left around 8:30 a.m. At 9:00 a.m. Marc
decided he would go for breakfast himself, and he left me alone
holding Jacob. He hadn't been gone 30 seconds when I began feeling
extremely nauseous and realized I was going to vomit. I had Jacob
in my arms, no vessel within reach in which to vomit, and had been
told not to try to get up on my own because of the epidural. I
buzzed the nurse, but she wasn't fast enough and for lack of any
other option, I threw up all over the floor. I was beginning to
crash.
Things start getting a little hazy at this
point. My ribs were very painful and I threw up again about an
hour later. The force of vomiting made me incontinent, but when I
tried to use the toilet afterwards, nothing happened. The nurse
examined me and in a very alarmed voice ordered a catheter. I
think my blood pressure must have begun spiking at this point
because the doctor came in and asked if I or my family had a
history of high blood pressure. Things became increasingly chaotic
in my room after that, and just as things were getting really
crazy my mother walked in. My poor mother! Having received "the
call" earlier that morning, she was coming to visit the happy new
family. Instead she walked in on a host of nurses and doctors
rushing about in a confused and panicky state, taking blood,
administering Demerol, and "consulting" in hushed voices. I
remember giving her my hand and saying "Things aren't going so
well, Mom." I had no idea what was happening at that point, but I
knew it wasn't good. God bless my mother, she took my hand and sat
down beside me as calmly as could be, as if bedlam was exactly
what she was expecting to see.
They called in the OB on call who examined me in
quite a cursory way. His examination seem to reveal nothing of
real concern, and apparently (my husband told me later) he and my
doctor had quite a heated discussion in the hall afterwards.
Nevertheless, my doctor prevailed (thank goodness!) and eventually
came to tell me that they thought ("thought"! This gives you some
idea of how rare this disease is) I had developed HELLP syndrome
and that I should be transferred to the General where they had
more experience with high risk pregnancies. I asked her if I could
die, and she said it was within the realm of possibility. They
gave me a pill to control my blood pressure, which I promptly
threw up. After that, everything was given to me intravenously.
So, with Jacob only about 8
hours old, I was transferred by ambulance to the General. I'll
never forget the sight of my mother bringing my little baby to me
for a kiss goodbye, all dressed up in his "going home"outfit.
Somehow this wasn't how I'd imagined the circumstances of him
putting on his going home outfit; I regretted not being able to
dress him myself. My poor husband was already in quite a state,
his words of having the doctor "save me" in case of complications
coming back to haunt him, and now he had the added responsibility
of taking his very new baby to another hospital. They refused to
take baby Jacob in the ambulance because he wasn't the patient and
they had no safe was of transporting him, so it was up to my
husband to get him there. Marc, consumed with worry over me and
exhausted from the long labour, had no idea how to get to the
General. Nor was there was any guarantee that Jacob would be
accepted into the nursery due to "policy", and to top it all off,
it was about 35 degrees Celsius outside and we didn't have air
conditioning in the car. Under the circumstances it's not
surprising he got lost on the way.
In the ambulance they
administered oxygen, and at the General they set me up in ICU.
They put me on magnesium sulfate and something else for nausea,
drew all the blinds to block out the light, and put a towel on the
door so it wouldn't make any noise. They also installed a device
not unlike a tap in my arm because they would be taking so much
blood. They had to do blood tests every few hours to check my
liver enzymes and my platelets. I came extremely close to having a
platelet transfusion: my platelets dropped to 32 and if they had
reached the 20's I would have had a transfusion. I was allowed
visits from immediate family members, but only 1 or 2 at a time,
for about 60 seconds. Everybody snuck in so quietly, and talked in
low voices. I thought they were all behaving very strangely, but
apparently it was to prevent triggering convulsions. And I was so
thirsty! The doctors wouldn't let me drink anything, but gave me
ice chips and strict orders not to over do it. It was a very
surreal experience to be fed ice chips by my sister ... My husband
would pop in now and again, but then tell me he had to go to be
with my family. I couldn't understand why my family was holding a
vigil outside my room; I had no idea how serious my condition was.
I was in ICU for 2 days, undergoing multiple
blood tests and hooked up to IV's. The magnesium sulfate made my
eyes go all wonky and made me feel like I had lead in all my limbs
and head. It also gave me nightmares, although no hallucinations
fortunately! Finally my counts began heading in the right
direction (platelets up, liver enzymes and blood pressure down)
and I was on the mend. It was only after the danger had passed
that I fully understood how close to the edge I had been. I cried
at that realization. They sent the hospital psychologist to
discuss the trauma with us and to offer her open door anytime in
the future because, like she said: we can never look at pregnancy
and delivery the same way again.
Miraculously Jacob was fine, really fine, the
entire time, and there were never any worries about him. The truly
amazing thing is that throughout all of this trauma I managed to
breastfeed. Well, I suppose in reality it was Jacob that was doing
all the work. I just lay there, and rolled over on cue. Because of
the medication and trauma my milk was slow coming in, but we
managed an extremely successful breastfeeding stint.
Since my bout with HELLP I have
done a lot of research only to conclude that there isn't much
known about this syndrome. The people that are supposed to know
about it seem to have only limited experience with it (the doctor
that delivered me had never seen it before). The only mention of
it in "What to Expect ..." is a very small footnote under the
section on preeclampsia. It is extremely rare, which makes it all
the more dangerous because it is often misdiagnosed.
Would I do it again? Absolutely.
I can say with positive certainty that Jacob is worth it. Will we
have more children? My husband initially didn't want to, and quite
frankly the trauma scarred me more deeply than I originally
thought. However, after much soul searching, we have now begun
trying for a second baby. I will worry throughout any pregnancies
I may be blessed to have in the future, but knowing what to expect
and what to look for is empowering. I have discussed the risks
with my doctor: they very real, but slim. I will be considered
high risk and followed accordingly. I hope and pray that it is all
behind me, but cannot responsibly ignore the possibility of
developing HELLP again. It is out of my hands, however, and I can
only hope that in my case HELLP was truly a "first pregnancy"
disease.
Article reprinted with
permission. |
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