7 Weeks Post Partum

Just popping in to post a quick photo. I am still getting very little time and dealing with a fiesty 5 year old and a very tempermental 7 week old. R is growing like a weed (11 lbs+ at 7 wks) but is quite fussy and we continue to try to seek ways to alleviate it.

I will pop in occasionally and update, and eventually document a bit more about my preeclampsia free pregnancy. Sometimes it is still hard to believe we avoided it, given how bad the first pregnancy was.

3 Weeks Postpartum

Just quickly signing in to say hello. I am shattered - totally exhausted. The baby is doing great but is not a very good sleeper and pretty darn fussy if not on the boob or being rocked. It is very difficult managing him and the 5 year old. Still, grateful for the outcome and on a good note, breastfeeding has gone very well this time. Reed has grown 1.5 inches in the past 3 weeks and gaining around an ounce a day.

Will try to pop in now and then, and also add some final thoughts and a summary. Many folks ask what I did differently this time (what I took, etc) so at some point I will try to post a summary for anyone that stumbles across the blog. Next year I'd really like to get involved with support/fundraising for preeclampsia awareness, so I won't be going away.

Take care and my prayers and best wishes to all those expecting after preeclampsia,

Tiffany

Baby Reed: One Week Old

Little dude has alot of hair!

Doing well, not much sleep but to be expected. Am still being followed 10 days post-partum with daily calls to check my blood pressure because preeclampsia can strike after delivery. Technically it can strike up to 6 weeks postpartum though I believe the most dangerous part is 48 hours after delivery. My BP is definitely higher than when I was pregnant (oh the irony) but not in a dangerous level and not enough to be PIH (about 126 over 75 a few minutes ago but I have had some 130's over 80's). Tomorrow the monitoring should end.

Introducing Reed

As mentioned below we had our son Reed on July 1st. We ended up doing a repeat c-section at 39 weeks rather than attempt a VBAC. I was second guessing my decision not to try for a VBAC up until we went into the operating room. Partway through the surgery my Ob tells me she is rather shocked to find my uterine wall fairly thin and tells us she is glad we did not end up doing a trial of labor. (And this doc is very pro VBAC) So who would've known - probably woulda been okay but glad we didn't chance it.

I ended up having a bad reaction to the morphine or anesthesia and ended up vomiting during the operation and all night afterwards. Not fun! Just lifting my head would make me chuck. That was probably the biggest complication of the whole pregnancy.

Anyway we are home and recovering and my son is a voracious breastfeeder. Breastfeeding a preemie was extremely difficult with my first son, so I am thrilled this is going better, and seem to have enough milk to feed a small nation.

To all of those pregnant after preeclampsia or considering it, I wish you all the best of luck from the bottom of my heart. I am happy with the outcome but man, I would not wish a high-risk pregnancy on anyone. It has been one of the most nerve-wracking times of my life. Don't let anyone downplay your anxiety or not acknowledge your fears. They can't understand unless they have been through the experience themselves.

He is here!

I gave birth to a healthy baby boy weighing 7 lbs 4 oz! Still in hospital out tomorrow. More then!

Letter for My Sons

At long last, tomorrow we meet you son #2. I think some people talk about waiting 9 months. And 9 months/40 weeks is a heck of alot of time. But the truth is the journey has been so much longer. 5 years really. I remember even as early as when Liam was in the NICU wondering if we were ever going to have another child or if the decision had basically been made for us (we felt at the time we could never risk it again). Throughout the past 5 years it's always been on my mind, sometimes in the back hidden away, sometimes actively discussing the risks with the husband. But it's always been there. So many times throughout we leaned more one way than another. Even last June, we went in for a pre-conception appointment with the perinatologist and had alot riding on the meeting, basically if we had no trust in their care and their gameplan, or if they recommended we NOT try again, we wouldn't have gone forward. And I would not be here about to give birth tomorrow afternoon. Ultimately we would have made peace with that decision, because you have to make peace with what life deals you, and in the words of Mick Jagger you can't always get what you want.

But alas, we went ahead. It's worked out. It's been scary as hell at times. I don't take it for granted. And I won't count my chickens until the baby is here and we are released and start a new chapter in our lives. And I can return the darn blood pressure machine to Kaiser.

My second son and my first son will have had the most completely opposite of birth stories and arrivals. I wonder how your personalities will differ. I can't wait to see your bond develop despite the five-year difference. I wish you both could have had the same opportunity to have been born safely and calmly. I wish son #1 could have had the additional 11+ weeks son #2 has gotten in the womb. But your stories are all part of who I am, and hopefully will have made me the best Mother I could be. It is what it is.

And tomorrow we welcome you to the world!

******************************************************
Edited July 1st: Oh good Heavens! Called the hospital. No beds so we have been bumped a couple hours. Haven't eaten since 4am and can't have anything by mouth. Hoping to get in at 4pm. Oh well I suppose this is the irony of having had an emergency c-section 5 years ago and bumping everyone else out of the way :)

39 Weeks

Unless things change, we are looking at 48 hours to go until we meet The Tenant. Tenant has been very active and seems like he is ready to come out. I wish he'd come out on his own volition but am glad he's been healthy. Back in September I could only have dreamed of reaching 39 weeks with no signs and a BP recording taken a few minutes ago of 114 over 66. Feeling very uncomfortable and think I have doubled in size this week but have had an easier time with husband off work and grandparents out. More later. Must take final belly pic. I have my last exam with my Ob tomorrow.

The Last Blood Test....Maybe?

Update below (5/25/10)

Just doing my usual Thursday night wait for my lab test results to come in. We've had labs run at different times throughout the pregnancy and then went to weekly since about Week 34? Can't quite remember. Anyway I go on Thursday and get results emailed that night, which is so nice about Kaiser. While I have no reason right now to be concerned it is always with a touch of anxiety that I await news of what my blood is doing. Can I just say I am so relieved this will be over and I will meet my second son in exactly one week? Enough blood checks, enough urine checks.

Otherwise doing well. Ankles started to swell a tad but seems to be normal at 38 weeks. Not exactly pretty but not abnormal. BP still really good for 38.5 weeks. Still walkin a bit as it helps circulation and then putting my feet up when I can :) At the moment we have a c-section planned in a week, though if we go into labor before then we will attempt VBAC. I would love that but it doesnt seem the fellow wants to come out. Discussed pros and cons of waiting longer than 39.5 weeks for labor to happen naturally. Tough one - this is not a normal situation and lots more potential risks in waiting for VBAC than with someone who did not previously develop preeclampsia so severely last time.

Anyway sorry my writing isn't too clear lately. We have Grandparents flying in tomorrow from England and just an absolute shitload of stuff to get done still. Changing table is still in a box. Oh and we haven't decided on a name yet...or should I say haven't agreed!

Update: Blood tests came back same as last week, ie no change. So good! I believe they may take one more blood sample the day before the c-section but the official pre-e bloodtests are over unless something should suddenly change with my home monitoring. Dealing with insomnia, up at 5:30am. Sigh...

Anyway short prayer to my body, please hang on for 6 more days and continue to support my baby. It's been a long road.

Question re Blood Thinners

Someone asked me a question in the comments awhile back as to whether I am on blood thinners and if I had the underlying tests done. So all the tests were done after I had preeclampsia and HELLP in 2005 and all came back negative for any condition or gene mutation. With my new perinatologist she also tested homocysteine levels (which has something to do with the body not processing folic acid right) and these were normal. I believe if you have the MTHFR gene mutation - which many people do - sometimes your homocysteine level is high (possible link to preeclampsia and increased stroke risk) Anyway truth is I was never tested for MTHFR and my perinatologist's reasoning was that mutation is common in Caucasians and what really matters is whether your homocysteine level is high or not.

So...being there were no known underlying causes we went with low-dose baby aspirin rather than any of the hardcore blood thinners like Lovenox used by many in post pre-e pregnancies. I started the LDA before conception. I know some folks are more comfortable waiting til after 12 weeks and this is something to consult a doctor about - I only offer my take. But I figured if preeclampsia is something that starts to form right at conception and is essentially a problem with bad implantation of the placenta, then I wanted my blood to be in as good a condition as possible from that moment.

Of course it would be nice to not take anything during pregnancy but it's a risk/benefit analysis at end of day. I was encouraged by a smallish study out last year showing no increased risk of brain bleeding in babies whose moms were on LDA: http://www.businessweek.com/lifestyle/content/healthday/634272.html

Less Than Two Weeks Til Showtime

My son celebrated his 5th birthday this week. We hit full-term (37 wks) on Tuesday. Good week all in all (with the exception of England's performance in the World Cup today and US getting robbed of a goal in a separate game. Husband is British so we all get into this :)

This week's bloodwork came back good. Everything stable. Platelets continue to creep down a tad and are at 161K this week from 166K last week.

We tentatively have a c-section planned in 13 days and if we go into labor naturally before that will attempt a VBAC. No really signs that tenant is ready to come out (Why would he? He's been getting ice cream sandwiches every night) Still trying to do daily walks - a bit uncomfortable at times with a head pressing down on the vag, but doin what I can :)

I will try this weekend to answer some of the questions I have been getting in the Comments. My son was off preschool this week so have had very little me time.

You Just Don't Know the Future

On this exact date 5 years ago, I was hospitalized with preeclampsia and rode in an ambulance for the first time ever. On this exact date 2 years ago, I did my first triathlon. Today, we are one day short of being full-term with this bean. You never know what is going to happen in life from year to year. Thus, you just gotta keep on truckin. I've had a rich life because of the good and the bad.

36.5 weeks

Jesus, I have the world's worst acid reflux tonight. Overall felt good this week. Had a burst of energy most of the week (well relatively. A burst being like 15 mins at a time). Today felt exhausted though. Latest weekly bloodwork looked fine though two markers were not ideal. Uric acid has been trending slightly upward each week (this represents kidney function) And platelets still falling (down to 166K). According to doc's email today, both still well within normal levels, just something they will keep an eye on. (I think uric acid falls mid-pregnancy and then rises back to normal by end so this rising may actually be perfectly normal) On the positive side the big markers for preeclampsia still look good. BP trending around 112 over 65, urine negative for protein. Creatinine looked fine (kidney function again) and hematocrit level where it should be (too high means not enough expanded blood volume and correlated with pre-e). Still little to no swelling. Did a mile or so walk this evening waddling around neighborhood, having a big craving for a trail run once I am back in the post-pregnancy saddle.

Cramping and some contractions but no really sign my tenant plans to come out anytime soon.

3 days til full-term. Holy shit we just might make it.

And June 14th will mark the 5 year anniversary since I was hospitalized with preeclampsia.

Thanks!

Just a quick note to say thanks for the comments I receive on this blog! And I haven't officially signed up as a "follower" but I do also follow the blogs of all the Moms leaving comments, and try to check in at least every couple days to see how everybody is. I'm just getting more and more limited on how long I can sit for before my butt goes numb so I don't always comment when I read a new post. And my wireless mouse is driving me nuts this past week making it hard to surf the Web. And I crave birthday cake -- like all the time! Couldn't say no to two pieces last weekend at a party :)

Exercise, Healing and Preeclampsia

This isn't a post about the benefits of exercise in reducing preeclampsia risk or how exercise is beneficial in general before and during pregnancy. No, this is something I have wanted to write about for a long time - how exercise helped me heal in the years after a traumatic train-wreck of a pregnancy. And how it's saved my sanity the past year. I just hope I can put it into words well as it's 10pm and my butt hurts from sitting. Any position hurts lately.


When you have a pregnancy that is troubled, that ends in the worst way you ever imagined, or when things just basically go really really wrong, there is so much questioning afterwards. Anger, sadness, guilt, confusion, helplessness -- all of these feelings that many of my followers I know can relate to -- whether it was preeclampsia or something else that went wrong. You guys know what I'm saying. Especially when you thought you were doing the right things like taking your prenatals, avoiding alcohol, going to your appointments. So many of us end up with a feeling like our bodies failed us somehow. Failed us and failed the children we intended to carry for a full 40 weeks. Comments from folks who do not understand the complex physiological causes of preeclampsia usually don't help either! Some of us recover quickly physically, some of us are left with lingering health issues as a result of whatever developed in pregnancy. Not to mention the huge toll when one has a preemie and all that goes along with that (because prematurity does NOT end with the NICU). Anyway, everyone has their own way of coping. So here's my background:


I was into sports from an early age and in a Track and Field team by the time I was in elementary school. Ran cross-country later, did softball, volleyball, you name it. I did something every season. Got into cycling in high school and did that for quite a while. Went to university and was still a bit active but by my later twenties it was career, dating, other stuff that got in the way and made exercise less of a priority. I got back into running a bit before my wedding in 2002 but it was more to fit into the dress rather than as part of a lifestyle. Husband and I used to mountain bike some in our early years, but then homeownership and working long hours in high-tech sucked more and more time.


I certainly wasn't obese when I became pregnant but looking back wasn't where I had wanted to be. Add in a 1-1.5 hr job commute daily, with somewhat long hours. I think I've already blogged enough about early swelling in my last pregnancy and generally feeling unhealthy plus stress so let's just skip to the next chapter - After Preeclampsia.


In the two years after having my son in 2005, I kept wanting to get into shape but just never found my groove. Well for the first year my energy was focused on my son and his health, after a 76 day NICU stay - getting him to grow, worrying about his preemie lungs, devoting myself basically to helping him recover. My weight and physical fitness were secondary, and I was adjusting to being at home full-time. (I went back to working part-time after a year but from home, ie within 15 feet of the refrigerator).




Finally around October 2007 the stars aligned: a friend took me out on a trail run/walk and I was hooked instantly. She also got me to consider the crazy idea of doing my first triathlon. And another friend was just getting into running (she would go on to lose 100 pounds BTW). We started off with a mile, and tacked it on from there ever so slowly. And then the following June at exactly 3 years to the day I was hospitalized with preclampsia we completed the women's short (sprint) distance triathlon. By that October I ran my first Half Marathon and did two more in 2009 before getting pregnant last October. Attaching a photo from my first Tri and Half Marathon.


Every time I came back from a race, my darling son would see my finisher's medal or ribbon and excitedly ask me if I had won. Because to a 4 year old it's all about winning and being the fastest and nothing else matters. I try to explain to him I didn't, and I probably never will be on the award stand. I will probably never qualify for the Boston Marathon. Of course at 4 he doesn't realize what it's given me.




I don't know how to describe it. A feeling like well I can't control every aspect of my health and why my body developed this crappy syndrome, but I sure as hell can control my weight. I can control my fitness level. I can turn down the odds that say because I had pre-e that my risk of stroke and heart disease are greater. If I want to run 10 miles in one go, yes I have the power to do so if I work for it. If I want to reach the top of this 1,000 foot climb it may take me a year (it did) but each week I will run a bit farther before I stop panting. I cannot control my preemie son's growth nor how long it takes his prematurity issues to resolve but I am in control of my body. And this has given me a wonderful sense of accomplishment and a feeling of taking back what preeclampsia took from me.


I know not everyone gets the same desire, but I can only share what it did for me. Now on to this pregnancy, it has saved my sanity for close to 250 days now. Being in a high risk pregnancy and the worry over the what-ifs. All I can say is when the anxiety has gripped me, nothing has worked better than getting out with my iPod, listening to Desiree's "You Gotta Be" or another tune, getting out of the house, walking with the sun on my face. Putting one foot in front of the other and moving forward.

35 Weeks

Sometimes it's hard to believe the same body can be carrying two pregnancies so differently. As of 35.5 weeks I have yet to exhale completely but things are looking pretty darn good right now. On this date exactly 5 years ago, I was shuttling back and forth to the hospital not quite understanding what was happening and not knowing a heck of alot about preeclampsia. I hadn't a clue it would get as serious as it did and that I would be in ICU with organ failure in just 12 days with a 2 pounder in the NICU.

You can hypothesize about the many reasons why this pregnancy is (so far) preeclampsia free, and I have ideas as to what is helping, but at the end of the day it is a crapshoot and luck of the draw. Nothing, and I repeat nothing, has been proven to completely prevent preeclampsia from recurring. All you can do is reduce your risk through management of blood pressure, reduction of stress, good nutrition and being in optimal vascular health. And getting at a healthy weight if that is a risk factor for you. (Plenty of skinny people get preeclampsia but if you are obese, losing weight helps with blood pressure which is a known risk factor) I'm about to do a post on exercise later today BTW. Anyway I liken it to playing poker. You do what you can to hold the best hand and that's all you can do.

This week's labs looked great. Creatinine is at .58, platelets are back up to 180K from 170K last week.

Went in for appointment this morning and the BABY IS HEAD DOWN! Hooray for turning. Cervix is softening but no signs of effacement nor dilation. Not that surprising. VBAC would still be great if we go into labor and doc is hopeful but doesn't want a long inducement.

I also did confirm if the BP suddenly starts to rise we will indeed deliver the baby. We will not wait for full-blown preeclampsia to strike. Thank God. Pre-e can be deadliest post-partum so I'd rather play it conservative at this point.

Getting a bit better at controlling my nerves at each checkup but white coat syndrome continues to be the bane of my existence (see previous posts) Whereas I am running 110 over 65 at home I get 122 over 68 today in the office. Not bad for me as when I am really nervous it shoots MUCH higher and then we have to do a retest.

So from here on out, we have just 3 weeks and 6 days until the end point at which they will let me go. Continued home monitoring and weekly blood tests. Achy, crampy, and suffering from awful acid reflux but no swelling. Confession - sometimes I wake in the middle of the night to go pee and look down at my ankles for swelling. Hard to believe this was me exactly 5 yrs ago with preeclampsia. Couldn't get socks on, couldn't fit anything. If only we had the magic key to preventing preeclampsia every time.

34 Weeks Plus a Few More Days

LOL my son took this and as usual cut off my head. And yeah I suppose I need to buy some shirts that cover my stomach. Sorry for the lack of updates. I have all sorts of weird symptoms these days, as I venture into new territory going this far in pregnancy. As I may have mentioned, it's hard sometimes deciphering what is normal pregnancy woes, what's a sign of problems. Overall I feel like I am doing very well. The last couple days I've had some mild cramping, which according to what I have read is normal. By the grace of God I seem to have little to no swelling which is just so bizarre when I look at pics from last time. How can two pregnancies (so far) be so different? The toughest complaint I have had is I tend to get this weird fatigue daily. I'll wake up and be fine for an hour and then a wave of fatigue will hit - not normal tiredness. This feels like weights and I can barely stand up and my pulse races. Lasts a couple hrs and then am fine usually. Hits in the afternoon as well. My perinatologist mentioned something about cortisol levels but didn't indicate it was serious enough to treat. Blood work from last week showed that I am now less anemic so doubt it is that (my anemia hit its highest level at the point where the blood volume had finished expanding) and is now stable.

Anyway I mentioned on a couple boards what the gameplan is now for the next 5 or so weeks:
- Weekly blood tests to check liver and kidney function (CBC, ALT, AST, creatinine, uric acid)
- Usual daily BP checks and urine checks I do myself at home
- Last ultrasound was at 33 wks. No more scheduled. Growth at 55% est 4lbs 12oz.
- Going in biweekly but suspect it will change to weekly after 35 weeks?

Right now the baby is breech and shows little signs of going head down. If things don't change and we don't go into labor the plan is to have a c-section at 39 weeks. However if we go into labor before that and the baby turns and no blood pressure problems then we will still hope to do a natural VBAC. Only time will tell. Just want a healthy baby - experiencing labor ideal but is secondary to our health.

Constantly adjusting exercise level to how I feel, try to get a mile walk in with the dog at least. It actually makes me feel better.

Other times, man, the tiredness is just overwhelming. Lots to do, not much time. Lucky if I scratch one thing off my list. Oh yeah and I have a cold this week. Wow, colds and pregnancy do not go together well. Especially coughing and being pregnant!

T Minus 49 Days

What's Going On:
I had a blood draw this morning which was actually the first since 27 weeks so seems like it was definitely due! My CBC already came back. Overall looks good, still borderline anemic but doesn't look severely so. Hematocrit is down to 34% which is the lowest range of normal, but as I mentioned it before represents hemodilution in pregnancy (in other words blood volume is expanding, which is a good thing. In pre-e it doesnt not expand to what it should and is overly concentrated). Here is a good article on hematocrit and hemodilution. So now I am waiting on the big tests for liver function and kidney function. I love Kaiser and I love getting the results by email but of course it is always a little anxiety-ridden when the results come in. Blood pressure today was still hovering at 107 over 65 with protein negative. So in terms of pre-e we still look good but the blood tests will give an indication of any signs of HELLP syndrome approaching. My platelets were down to 172K from 181K a month ago - so a bit on the low side but still in normal range. (I never run high - 220K at the max anyway). Little to no swelling.

Thursday is an ultrasound to check on growth and a regular Ob appointment.

Today I pre-registered at the hospital and got to see L&D (it's a new hospital). Two women in labor checking in as I was at the counter. I can't wait til this is me.

How I'm Feeling:
Not great but expect much of this is normal for 33 weeks. I've been getting some major Braxton Hicks contractions in the afternoons and evenings that don't stop til I lie flat. I have called the docs and am monitoring. Doesn't seem like a danger just have to take it easy. Also these come on regardless of whether I have walked that day or not. (It's more a case of them coming on when I am housecleaning - bending over, playing ball with my son, etc). Hmm what else: back aches, acid reflux, generally feeling like a whale. I've also had incidences where my heart races and I get very weak and my BP drops quite a bit (like too much). In this case, again not pre-e, but more likely part of all the blood circulating and being a bit anemic. Walking and stretching (ie light exercise) actually seem to be the best things to get the blood circulating and me feeling normal - I just have to time it right.

I'll update once the labs come back. Going to go for a slow 20 minute (1 mile) walk on the treadmill to stretch out my legs and see how I feel. And then a bath!

Thanks for reading. Two more weeks and we may just escape the NICU entirely this time. What a dream that would be.

UPDATE 5/18: Yes, all bloodwork looks fine: CBC, ALT, AST, creatinine, uric acid. Fingers crossed for good ultrasound Thursday

32 Weeks

OMG was my stomach really this flat last October? It feels like such a distant memory! 5 weeks pregnant

And 32 weeks...blimey.

More updates tomorrow. PS I had my 31 week appointment last week and my Ob Gyn says to me, "I hadn't scheduled any more appointments because I didn't think you were going to get past 32 weeks." (This was early on, she is more optimistic now). She didn't have to be quite so honest but the fact is she sees alot of recurrence when you get it as early as I did. Oh well. We're past 32 weeks, that's what matters.

Hello May, It's Nice to See You

Back in October I remember looking at the calendar and thinking about what each month meant in terms of the baby's birth. Feb meant no chance for the baby. March meant a 50-50 chance but a micropreemie no doubt. April meant some relief - an early preemie - but one that would have a fighting chance. And I remember thinking if we could just get to May (June of course would be even better). Especially May 6th which would be just two months left to D-Day. And May 11th marks 32 weeks exactly.

So here we are May. I'm glad to see you. The picture on the left is the urine dip sticks that I use to test my pee every day for signs of protein, a marker for pre-eclampsia. I reckon now since starting at Week 20, I have done this 70 times. The color that appears every morning is a relief but there's always trepidation that one morning is going to be the morning when I wake and it's a darker color, like the colors it was in 2005 when I was diagnosed and doing this at home. (So far it's negative as long as I am hydrated and I dip trace when I have not had enough fluids).

Similar to what I had at 20 weeks (see old post), I had a little bit of irrational anxiety since hitting Week 30. It must be something about hitting the number (10, 20 or 30). If I had known before conception how much better things would go this time, I would have jumped in even sooner. But I still get gripped occasionally with the fear of my body turning against me and the baby. Like I said before, 95% of the time I am fine and upbeat, it's only moments here and there. And I allow myself this. As my high-risk doctor has said it is completely normal to experience some anxiety in a high-risk pregnancy. Honestly to ignore the risks and not ever think about the what-if's would be a bit like sticking your head in the ground to me.

But I'll take a deep breath and head out soon for a short walk (my walks are indeed getting shorter!) and I will rejoice in the fact that this baby is now 50% bigger than Liam was at birth and in another week will probably be around 4 lbs, twice what he weighed.

Thanks again to everyone following our journey and prayers to all those facing similar journeys!

Goodbye 20's. Hello 30 Weeks!

I remember my husband and I telling people months ago that our nervous period would be highest between 20-30 weeks. Before 20 weeks, pre-eclampsia technically does not happen so there wasn't much to be nervous about. And after 30 weeks, our risk for recurrence does not yet go down but at least we have safely passed the micropreemie stage. So here we are at 30 weeks today. I am happy and grateful, though I certainly haven't exhaled you could say. Still plenty of risk to my health.

Also starting to feel the many aches and pains of the 3rd trimester and have to be vigilant to determine what is normal, what could perhaps be symptomatic of problems. Been having some mild headaches for example which in and of themselves are fairly common in pregnancy. But headaches are also a warning sign for pre-e. So I've monitored my BP when I have a headache to make sure it isn't from high BP, and thankfully it's not. BP hasn't changed. Same thing with rib pain - is it upper right quadrant pain that is caused by HELLP or is it just a foot in my rib? Oh it's a foot. Relief.

Feeling awfully tired at times but still walking when I feel well, about 1-2 miles a day. Daily.

Ultrasound Update: 28 weeks 6 days

Quick update. Ultrasound yesterday looked good! Blood flow still normal. Gestation was 28 weeks and 6 days yesterday. The baby's weight was estimated at 2lbs 14 oz which is a whole 12.5 ounces heavier than Liam born around the same time. His stomach was measuring a few days behind, but his head was measuring several days ahead and his legs were measuring a full week and half ahead of schedule! Long and slender I suppose :) I can feel him at both ends (left side and right side) already, must be his hands and his feet moving together.

So again the u/s is looking for drops in growth percentiles which would signify the placenta not giving him what he needs. Fortunately and gratefully, his % increased from the 46th a month ago to the 59th.

He is still transverse and shows no signs of turning head down (I know he still has time) so it's completely up in the air yet as to whether we can do VBAC or have a repeat c-section.

As always grateful for today, hopeful for tomorrow!

The Good, the Bad, It's All Life

On Tuesday we hit 28 weeks. Today I am 28 weeks 3 days. Darn right, I am counting the days! I'm now officially considering this my longest pregnancy! On paper Liam was born at 28 weeks 5 days but we are actually fairly sure he arrived at 27 weeks 5 days as this was his original due date in the early scans, matches my dates (my cycle is very regular) and namely, when Liam was in the NICU and had his eye check at 32 weeks, the eye doctor looked at his eye maturity and dated him the same as what we had. Doesn't matter much now but means I can say I have gotten this baby past L's birth gestation!



Certainly a milestone. Am I happy? Yes, very. This little guy kicks up a storm and his strength is amazing. I love to feel him rolling around adjusting his position. With Liam my placenta was apparently in the front of my tummy (anterior) and hence I didn't feel as much. Plus his activity slowed as the pre-eclampsia worsened. Hitting 28 weeks though does bring back the memories of where we were this time last pregnancy. IVs in each arm, a catheter, unable to move much because of the magnesium sulfate and strapped to a bed in ICU after delivery. Having never spent a night in a hospital to being hospitalized, and then in ICU with organs failing at 32. And in the middle of this I remember the lactation consultant bringing in a breast pump, trying to stimulate the milk into production, and me thinking how on Earth I don't even have a free hand to manage this thing nor have I even seen my son yet. (Fortunately we got things going and though my supply was never great, Liam got breastmilk his first year).

28 weeks and the survival rate seems so promising: 85-90% I believe? Yet I remember my son being very sick just before he went in for surgery at 2 pounds for a heart ligament (PDA surgery), suffering from severe pneumonia, on the ventilator's maximum settings. And I remember thinking shit, we might be that 1 in 10 statistic that doesn't make it out of the NICU. Lots of tears. Endless tears. These are the memories that will always remain. No sense trying to forget them, you just have to move on. And just keep swimming, swimming, swimming.

We are grateful for today, hopeful for tomorrow. My 4 year old's eating a bagel right now, watching Curious George before we head out for his swim class. My 4 year old, whose lungs were so fragile from damage his first year, missed only two days of school the entire school year for illness so far. He had a purple leg one day from a blood clot in the NICU, but still learned to ride a bike without training wheels at the age of 4. Right now, he's into giving the thumb's up sign (we have to reciprocate) and will give me the thumb's up from high atop the park play structure and smiles when I give him the thumb sign back. My precious son, who wants to name his brother "watermelon poo". Grateful for no swelling yet, grateful to still be able to walk every day. Grateful that I am getting so big that this week I've heard several times "You must be in the home stretch", "What are you, 32 weeks about?" and the meat guys at the market asking me when the Big Day is.

Grateful for today, hopeful for tomorrow indeed! And as of today, I am still baking. Monday we have our next monthly ultrasound.

Are We There Yet?

Jeesh the last few days have gone so slowly getting to 28 weeks tomorrow. Anyway my labs all came back. Liver tests (ALT and AST) looked great. Creatinine and something called LDH (lactate dehydrogenase) looked normal. Hemoglobin decreased again as did red blood cells but as explained earlier, at these levels in indicative of hemodilution as blood volume expands and is not a bad thing. (As drastic drop would be). The only thing that changed more than I expected was platelet level which was down to 181K from 211K two weeks ago. Still well within the normal range but we really don't want platelets to fall below 140K. I expect I will have another blood test in one or two weeks to check. I meet my perinatologist next Monday for our next ultrasound.

Blood Tests

Saw the Ob today for our regular appt every two weeks. Went to get blood drawn right after. We are repeating the CBC we did a couple weeks ago and doing the first liver enzyme test since 12 weeks. (In HELLP Syndrome the liver enzymes will be elevated as liver damage starts to occur) I don't expect any problems since we have no other physical indicators or symptoms of pre-e/HELLP but will certainly feel better if the blood work comes back normal. At least Kaiser is great. I'll get the results emailed back by tonight - no waiting around for doctors, etc.

Just Popping In...or Popping Out!

I'm definitely in new belly territory as I was never even close to this big with the last. Doing okay this week. No changes with the daily monitoring and getting used to it all. BP totally normal. A bit nervous approaching 28 weeks. Not nearly the anxiety I had at 20 weeks, but just kind of wanting to get to 28 weeks and get over it, and feel like we really are getting farther each day thereafter. These last two weeks have definitely gone slowly trying to reach the point of last pregnancy's delivery. Hoping my OB doesn't give me any grief about weight gain tomorrow! (I've gained about 21 lbs or so by now). I eat pretty darn healthy (swiss chard and asparagus yesterday to name a bit of what I had) and reasonable amounts of Easter bunny chocolate. I believe in moderation!

God, just please get me past this 28 week milestone so we can sail into new territory!

27 Weeks

Once again because it is so shocking and so amazing to me. Picture in 2005 of my pre-eclamptic self. I was about 27 weeks and would end up delivering in just about 7-9 days from this pic. I will never stop trying to educate people about pre-eclampsia. I was so clueless and thought all pregnant women swelled. We had had a clue things were starting to not look so good, but I did not realize how abnormal this swelling was. And certainly had no idea I'd wind up in ICU in 10 days.

And picture yesterday of me at Easter with my sister. Basically same gestation as above pic, 27 weeks tomorrow. (The paisley dress disguises the bump til you see me from the side). I show these pics not to say look and me and how fab I look (LOL), but rather to show firsthand what the effects of pre-eclampsia are on a regular sized person. I could still end up like the picture above if pre-e sets in, but we'll be on top of it and would most likely be in the hospital earlier on.

So tomorrow we hit 27 weeks. A good point but still need to get this bean much, much farther. I ended work last Wednesday (I was only part-time anyway) and that's been a relief. Trying to get off my butt to go walk on the treadmill in the garage for two miles tonight. Need to go in for another blood test to check liver enzymes this week, an appt on Friday. Chugging along.

Closing in on 26 Weeks

Last week was busy. After Monday's ultrasound with the peri, we had our blood tests and a regular appointment with the Ob Gyn. No gestational diabetes - hooray! The Easter chocolate beckons! CBC was done and platelets are around 211K (For those knowledgeable about HELLP my platelets fell to about 27K at their worst). Interestingly, I was a bit concerned as it looked like I was trending towards being anemic, if I compared the figures to my baseline blood test at 8 weeks. I know it's common for pregnant women, and with all the calcium I am on that can interfere with iron absorption, I would not have been surprised. So I emailed my doctor and she said my levels were still fine within the range, and the range for pregnant women is lower than non-pregnant women. So no anemia. Then she went on to say, " In your particular case, I would be worried if the hemoglobin had stayed the same, since a high hemoglobin can be a sign of preeclampsia (the blood becomes more concentrated). So I'm very encouraged that your blood has become more dilute, just as expected."

I find it all fascinating, the signs and things we can read as predictors. Medicine can tell us so much, but has such a long way yet to go to treat and prevent this disease.

On another note, since all of us in second pregnancies after pre-e share info about what we are doing differently, I am drinking a ton more water than I did before. I don't remember what I did back in 2005 but I dont think I carried around a one-liter Nalgene bottle like I do now (and go through two full bottles minimum a day). Course I was sitting in an office last time and may not have required as much as I do now, where part of the day I work, part of the day I am with my active son out and about. But fluids are so important with expanding blood volume it must be beneficial.

25 Weeks and Ultrasound Update

Quick update that we had an ultrasound with our perinatologist on Monday. I've become very friendly with the ultrasound tech now, being I am in there once a month. But I always look forward to those appointments and seeing my baby twist and turn! Good news continues. Dopplers looked normal, no notches, normal blood flow through umbilical artery and uterine arteries. Baby's growth is on schedule, 50th percentile. Estimated weight is 1lb 10 0z. It is so surreal to think he is only 7 oz away from Liam's actual birthweight at 28 weeks. Looking back, Liam's growth was slowing down as my pre-eclampsia progressed and by the time he hit 28 weeks had slowed down to the 10th percentile. IUGR was clearly setting in.

So thanks for checking in. My peri is always positive and pleased how well it's going -- I love her -- but as usual reiterates the same statement that we have no guarantees yet. But every week we get more and more of a glimmer that we'll go farther. I need to go in tomorrow for the diabetes test and anemia test where they will check platelets as well (falling platelets are a part of HELLP).

24 Weeks

24 and a half weeks as of today! Another milestone as 24 weeks supposedly marks "viability" though there are several 22 and 23 weekers that have survived as well. I believe the survival rates for 24 weekers are around 50-60%, though the majority will go on to have some disability. I certainly saw enough 24 weekers during L's NICU stay that sadly never made it home. Still, this week has made me think of my friends who are parents to 24 week micropreemies. The one who was tube fed his first 9 months after major bowel surgery, who now stands heads and shoulders above his classmates and reading at a 2nd grade level...in pre-K. The other one, whom the doctors said would be a "vegetable" and suffers both hearing and vision loss, but is sharp as a nail, and reading the fine print off the back of DVDs...at 4. I certainly don't want to go down the micropreemie road, but was just thinking this week about these exceptional kids and their parents. I do wish 28 weeks, and then 32 weeks were here already!

We're doing fine. Things are as good as I could hope right now, and am thankful for every day of baking. Just got back from a prenatal massage, its relaxation benefits clearly demonstrated in my blood pressure reading a few minutes ago of 95/60! I've a varicose vein from my last pregnancy that is bothersome, and a few spider veins starting to form in the same area, plus the usual pregnancy woes of heartburn, but all in all, normal.

I bought this running shirt a month ago, but shouldve gotten in back in the 1st trimester when I was still doing a reasonable amount of running! Still at it with my 2-3 miles of walking a day though, interspersed with the exercise bike, and elliptical machines. Basically I don't aim to work up much of a sweat, but just do whatever feels right to hit 45 mins of exercise 7 days a week.

We have another important ultrasound on Monday to look at growth and again blood flow to the placenta. Fingers crossed for my boy to keep baking.

23 weeks

Last pregnancy I only got one or two belly shots of me so forgive me for all the shots I am taking now. I figured at the time I had months left before delivery (haha), but also as I mentioned earlier, I never really looked pregnant. As the stomach grew the swelling started and the water weight pretty much eclipsed any baby bulge I had.

So it's comforting but also odd for me when strangers actually comment on me being pregnant this time. No one noticed last time.

23 weeks. My son took this and was about the best shot I knew I could get from him.



18 pounds gained already

Diving into Week 23

Since having our ultrasound a couple weeks ago, things have been good and I had barely any anxiety the past week, week 22! I have a regular OB Gyn appointment on Wednesday so I'm sure I'll have a touch of anxiety then but all home monitoring seems fine at moment.

It seems though that the first 20 weeks flew by and now every week passes slowly until we hit Week 28 and I breathe a small sigh of relief. Yes 24 weeks is often considered viability, but as one active in the preemie community, we all know that weeks 24-28 are very "fragile" and having a micropreemie, no matter how the media portrays these stories, is downright scary as hell. We'll breathe an even bigger sigh of relief at Week 32, Week 34 and fingers crossed at 38 weeks! As a reminder my son was born at 28 weeks, and while we are fortunate he is doing so well, it has been a long road.

A friend told me at the beginning of my pregnancy how I deserved to go full-term. I completely understand her sentiment, as she knows how much we've done to prepare. But of course the truth is no child deserves to be born prematurely.

Anyway, again right now things are good. BP's been around 104 over 65. Pee looks fine. No swelling. Usual pregnancy gripes. Running is winding down slowly but still walking. Last week I did a spinning class (on the stationary bike) as well as Zumba. These are BOTH exercises I did regularly before pregnancy, and would never recommend anyone start these mid-way. But I'm trying to find ways of staying active, just not on my feet all the time.

Ending Week 22

Gorgeous morning. Getting ready to set out for a breakfast of Swedish pancakes at our favorite diner and then a family hike at one of the regional parks. Update later!

Ultrasound Update

Sorry for the delay - so busy and tired since our appt last Thursday. The ultrasound was good, all normal. Again it was looking at the two umbilical arteries and measuring the flow, looking for abnormalities and something called "notching" which is often a predictor of pre-eclampsia. Best description is here. No notching. Growth also appeared to be on target. My perinatologist reminded us that this is no way guarantees we will avoid pre-eclampsia nor HELLP. We will have no guarantees until that baby is safely delivered, nuzzling and I am released from the hospital! That being said it certainly is good news, and another positive sign (along with the AFP level and other blood-test markers). At the least I think we can safely assume it isn't looming around the immediate corner and we can most likely get past the micro-preemie stage (ie no reason I shouldn't make it to 28 wks).

As expected, I got "white coat" the minute she said she needed to check my BP and it zoomed up. So she had me try a different cuff, relax a few minutes and it came back down to a comfortable 116 over 69. Sigh, at least she realized first-hand how much I am affected by white coat syndrome.

Next big ultrasound in 4 weeks.

Tomorrow!

Thursday morning is an important ultrasound. Praying for healthy blood flow through the cord and placenta!

Had a nice experience in the bath today. Feeling baby kick and seeing the water ripple ever so slightly and seeing just a bit of movement under the skin. Baby's been active, always a good thing.

Do Looks Matter?

Friends and family have been commenting often this pregnancy, "Wow, you look great!!" Which is nice to hear of course, especially when you can't fit into much. The funny thing though is with that comment is also another truth, that I looked pretty darn bad my last pregnancy. Not the image of healthy pregnancy glow. Seriously, true, I'll walk you through the pics and explain.

First off, this was taken last September, about a month before getting pregnant. It's rare these days I curl my hair and find time for much makeup but it was our anniversary, so on top of spending more than 10 minutes to get ready, I even shaved my legs. I'm not skinny but I was a healthy weight and running at least 20 miles a week.




Now let's backtrack to my pregnancy in 2005. I had a one hour commute each way, crappy-ish job, got little sunlight, didn't exercise much. Ate fairly well but didn't pay nearly as much attention to nutrition as I do now. And as the weeks progressed, I got fatter...but I never really looked pregnant? Just fatter. And then swollen. And then more swollen. This picture was taken on vacation in Hawaii at about 21-22 weeks, where I am now in this pregnancy. I wasn't eating like a glutton but I don't know...I just don't look right, and I don't see much baby bump that's for sure. It gets much worse....





By the time 27 weeks rolled around, it looked like you could pop me. This picture was taken at my sister's graduation and was probably about 10-14 days before I delivered Liam. This isn't fat -- this is the face of pre-eclampsia. This is about 25 pounds of pure water weight because my kidneys were starting to not do their thing. At the previous doctor's check there was an indication that things were starting to look wrong (higher BP, protein in urine) but I wasn't on bedrest and had no clue just how bad things were going. I was simply going to come back in a week for another check. It is horrifying to look back now at this picture, but back then I really had nothing to compare it to. I knew many pregnant women swelled.

So what about now? Let's see...

This one was taken 4 weeks ago, so about Week 18 or so. Good bump starting. 14 pounds gained but mostly in the stomach and still able to wear normal non-maternity sweat pants.

19 weeks or so after a run one morning

And then another one sitting a few days ago. (Can't really see how big the tummy is with me sitting). But I look normal-ish, I think??? I don't seem to have any swelling as of 21 weeks.

So the question is, is looking healthier going to make for a better outcome? Has my being in shape this time going to get me to 40 weeks? I sure as heck feel better this time. I've gained 15 pounds in 20 weeks but by Week 19 I already had a bigger belly than I did when Liam was delivered at 28 weeks. On the other hand, this young woman had a major stroke from HELLP and is the frickin picture of good health, is she not?

Pre-eclampsia doesn't just strike the non-fit and I've known several gals with worse cases that were marathoners. Fitter than I will ever be.

But alas, you can only change your own situation and your own variables. And for me, not being fit and not having a good weight clearly didn't help me last time. Maybe it won't prevent it but getting say from 28 weeks to even 32 weeks could be the difference between cerebral palsy or not. Or my baby making it or not.

So I am putting my money on trying to stay healthy.

20 Weeks

So, the truth is this past week, week 20, has been the hardest. I mentioned previously that the past 19 weeks have been fairly easy emotionally. I mean morning sickness was no fun, but I sailed through for the most part. Exercise has been key for me maintaining a good mental state (I ran 3 Half Marathons prior to getting pregnant) and have been walking/running 2-3 miles a day, every day of pregnancy. Then for some reason the mental milestone of hitting 20 weeks has hit like a brick. Several reasons: Home monitoring by Kaiser started (someone calls me to check in on my BP every week now). I am supposed to check my urine for protein daily. And then this week we have an important ultrasound to check blood flow to the placenta. And then of course in the words of my Ob Gyn, "Weeks 12-20 are coasting." In other words, pre-e doesn't happen by definition prior to 20 weeks so there was no cause for worry. I know what she meant but I sure wish we were still in coasting period! I mentioned earlier the monitoring is vital, but it has gotten to be too much at times.

So all of this culminated last week. In 37 years I have had plenty of stress at one time or another, and certainly lots of nervousness while Liam was in the NICU for 76 days or when I've done public speaking. But anxiety is a different beast, the likes of which I can't compare to anything previously. It's irrational, and it grips you at different points. A good friend told me "just relax. breathe." I wish I could explain that it is not that easy. I can only liken it to this: Imagine you almost drowned in a pool. Later you come back to the pool, you have a life preserver, you have people around to help you out, maybe you even know how to swim now?....regardless, you will experience a certain amount of anxiety being back in that situation. And for those that haven't been in that situation, you don't understand the complex physiological reaction triggering anxiety that makes it harder to brush off than just having someone tell you "relax". And of course the real shitter with anxiety is that it makes BP go up, so when I check it and it is up it only makes things worse.

I've been using these strategies: Did yoga one night last week - great. Got a facial and pregnancy bath at a wonderful local spa over the weekend. (I'm convinced if I could live at Burke Williams the next 4 months I'd deliver a healthy 9-pounder no problem!) Trying to repeat positive affirmations when I am out walking/running. Going to speak to a counselor at a local birth center this week. Lots of deep breathing when the "what-ifs" start. Praying. And while in 37 years I have never had a mental health issue requiring professional help, I do plan to discuss it with my doctor this week, and consider all options. Gotta do what I gotta do and know when to get help.

So there you go! Being honest and hoping my words someday help someone else in this situation. And on a fun note, this is my 4 year old and a hint of my baby bump in the corner!

AFP

After Friday's minor scare, I did receive a bit of good news regarding the AFP level. AFP stands for alpha fetoprotein and you can read more about the definition here. When you do the 2nd trimester blood test for Down's and other chromosomal abnormalities, AFP is one of the blood markers. An elevated AFP I believe can signify a neural tube defect and that is usually why it is measured. But an elevated AFP can also be a predictor for pre-eclampsia development later. It's not a definite (ie some folks have high AFPs and do not get pre-e; some folks have normal AFPs and still go on it get it). But...an elevated AFP in the absence of a neural tube defect like spina bifida can mean a placental abnormality (thus the link to pre-e). AFP is measured as a multiple of the median (MoM) so the closer to 1.0 the better, or the more normal I should say. 2.5 is the program cut-off for considering it to be elevated. My number was 1.07! So very positive, and a good sign of being "normal." Again in itself does not mean much but we shall take the good result and move two steps forward in this journey!

19 Week Appointment and First (Minor) Scare

Wanted to post sooner but we headed up to the snow Friday night and just got back. I had my first minor scare at Friday's 19 week appointment. Blood pressure was fine (I get White Coat Syndrome but that is another post), however the urine test showed a trace of protein. Not in itself a big deal, in fact the nurse at first said it was "normal" til I realized it wasn't negative but actually a "trace" amount. Now, "trace" is fairly common and certainly not unusual. For those not aware, pre-eclampsia usually has 3 identifying factors: high blood pressure, swelling, and protein in the urine. The kidneys begin to spill protein and the amount gradually increases from the baseline (negative) to trace, then 1+, 2+, 3+, 4+. So staying in the negative range is ideal of course.

I was discussing it with my Ob/Gyn when she came in, and then she explained how you can get false readings from not getting a clean urine catch. In other words, not first cleansing the area immediately beforehand and not catching urine mid-stream. Well I didn't know this and did neither!! I'm always worried I won't have enough pee so I pee in the cup from the get-go! Why I think this, I do not know as I can normally overfill the cup!!?? So we both agreed this may have been the cause and no need for panic, but I would be sent home with urine strips to test at home, as I do with the BP. Further, given the fact that my BP is still fine it probably wasn't a sign (the rise in BP normally goes hand in hand with the protein).

Long story short I tested it again at home later that day and got "negative". Good.

Overall, I've been fairly positive the past 19 weeks. I had one bad dream, and from time to time I get anxious, but generally I've felt good and remained optimistic. I have a certain peace of mind knowing there is nothing more I could be doing to bake this bun just right. But that day, off and on, I must admit that the panic gripped me a couple times. The old feeling of going down that road, where there is no stopping pre-eclampsia, just trying to slow its path and get as far as you can before your body starts to poison itself and the baby. I try to have the mental fortitude to handle it and stay tough all the time, but I'm no superhuman.

Last night Liam was resting on me while we watched TV at my Mom's cabin after a long day of him skiing and playing in the snow. The baby started kicking, probably upset that he was being squished by his big brother. I remind myself that this is what I am doing it for, my two little boys, and that I can do this. I can do this.

Valentine's

Because in between the blood tests, the blood pressure checks, and the doctor visits (another tomorrow!) life goes along merrily and busily. So we just made mini-cupcakes for Valentine's Day and enjoyed one. Or two. The baby is doing somersaults in me, the 4 year old is doing somersaults down the hallway. Chaos reigns.

19 week appointment with the Ob/Gyn tomorrow.

The Barometer

It's odd how different this pregnancy is. In 2005, I barely knew what pre-eclampsia was and thought, having had low blood pressure my entire life, I was the least likely candidate. This time around, I am monitored closely, and I know so much. I know what PAPP-A and HCG levels in early blood screening can mean. I know that a pregnant woman's blood pressure should dip below normal in the second trimester. I keenly await results of my blood test to learn the AFP number, not just as an indicator for Down's but for what it can mean for pre-eclampsia as well.

Some may say such knowledge is scary. Perhaps. That it's better to simply pray and hope for the best, which I do as well. But I'd rather know. I've read too many stories over the past 4 years of women who weren't aware of the danger signs and passed them off as regular pregnancy complaints, and as a result did not survive or become gravely ill.

While I have a superb team of doctors, they also know how critical it is that I listen to my body. And for this, they all acknowledge that my barometer will be the monitoring of my blood pressure at home. Pre-eclampsia can strike between Ob/Gyn appointments with ferocity.

This little machine represents so much. It's been my companion the past 19 weeks and hopefully for many, many more weeks to come. It's a barometer for whether my little bean's home inside of me is still hospitable. To date my blood pressure numbers have been great, with the usual 2nd trimester dip. (92 over 64 is great at 19 weeks), and I breathe a sigh of relief every day for now.

The Arsenal

First off, there is absolutely no known medicine or method to completely prevent pre-eclampsia from happening again. Search on the Internet and you'll find plenty of scams, herbal remedies and supposed diets. I wish there were. How easy it would be to take X or follow Y diet and be guaranteed an avoidance of this dreadful thing. That being said, it would be just as foolish to eat junk food and not aim for a healthy diet and lifestyle during pregnancy to increase my chances.

So this is my arsenal:

• -Low-dose aspirin: Doesn't work for everyone but has also proven to be harmless to the fetus. Works by thinning the blood to reduce chance of blood clots forming in the placenta. Many of those with pre-e get diagnosed with blood clotting disorders that contribute to the onset. Hence certain women are put on much heavier anti-coagulants like Lovenox and Heparin.


• -Higher doses of folic acid: Some genetic mutations cause women to be unable to metabolize folic acid which causes homocysteine levels to increase which can cause stroke, pre-e and other placental complications.


• -In addition to my regular prenatal, I am also on extra calcium, Vitamin D and take fish oil daily. Calcium deficiencies also increase the risk of pre-eclampsia.

Is all this going to guarantee me a full-term baby? No, but why not try to create optimal living conditions for the being inside? And honestly, taking "something" admittedly makes me feel like there is something I can do to feel like I have some control in this however small it may be. Ahh the power of the placebo!

Our Family Announcement

(This is the note I originally posted on Facebook in December for friends and family)

Well, as some of you already know, we are expecting baby #2. What comes as such an easy decision for many (or no decision - just a fun night!) has been probably one of the toughest we have ever made. But alas, after 4+ years of thinking about it since Liam's harrowing arrival, we finally decided to try again. We look to 2010 with much hope, optimism and preparation for whatever may come.

I tend to get the same questions from concerned friends and family, so I thought I’d provide some info here for anyone interested. Most of you know, when I delivered L at 28 weeks from pre-eclampsia and HELLP syndrome, they had told my husband my condition could be fatal. In fact, the young doctor on call was somewhat freaked out and after telling my husband I could die, rushed out of the room to page whomever he could for more advice. I was in ICU with liver and kidney failure after (what had been) a perfectly normal, boring pregnancy. No exaggeration in the above. So does it happen again? Well the stats range from 20-30% recurrence for pre-eclampsia up to 50-60% recurrence when you have it as early as I did (before 32 weeks). HELLP Syndrome runs a lower recurrence rate at 5%. Generally, if you get pre-eclampsia again, you get it less severely and later. We hope to go full-term but even getting another 4 weeks farther (32 weeks) would help lessen the odds of prematurity complications significantly.

Fortunately I go into this with excellent blood pressure, a healthy weight, and have tested negative to all of the standard blood clotting disorders and auto-immune diseases that are often associated with higher risk of pre-e.

I have a great team of doctors, and my high-risk doc heads the perinatology dept. We’re on low-dose aspirin to prevent clots in the placenta, as well as high folic acid and calcium. I’m still running (albeit very slowly) and walk at least 2 miles a day. And have already cut work back. Does this make a difference? Hard to say. Some of the women I know who had pre-e even worse than me included marathon runners, as well as some of the most mellow, relaxed moms I’ve ever known. Pre-e doesn’t strike just the obese or a certain type. Happens to anyone. Look at the Duggar woman on TLC who got it with baby #19?

Still, for us, we’re stacking the odds the best we can in our favor, and we have put every weapon we can (mentally, physically, etc) into our arsenal for baking this baby longer and without harm to my health. There’s a reasonably high chance at some point we may be on bedrest, and I admit now I will be relying on friends and family for help, given our active 4 year old! Again, last time it came out of the blue and this time we are being prepared. Not being a pessimist. Heck if we weren't optimistic we wouldn't have dared try again. But it would be foolish not to be ready.

As I told some of you, no regrets and no turning back now. And please, never any pity! I’ve learned that life without occasional hardship makes for quite a dull life, and I have been incredibly blessed with a wonderful family already. At the end of the day, it's a leap of faith but I trained for the jump.

Thanks for reading and for your well wishes, Tiffany

Why the Blog?

I hemmed and hawwed over doing a blog for weeks, but finally decided I might as well record my feelings and experiences going through a high-risk pregnancy. I'm mostly on Facebook these days, but never want to be one of those women that posts online about pregnancy incessantly, so I decided I have this forum for friends and family who DO want more of the details. And why not also maybe help other pre-eclampsia survivors plus those considering pregnancy after pre-eclampsia. Whether it's 10 folks following or 50, doesn't matter. Writing down my thoughts as I go through this journey will be cathartic regardless.

I originally developed severe pre-eclampsia and HELLP syndrome in 2005, giving birth to my son at 28 weeks, weighing just two pounds. For those interested in our story in 2005, please see this article I wrote for another blog.