Waiting for you. Week 34. Hello, Preeclampsia. Not so nice to meet you.

I’ll pay for this, trust me. I’ve got my wrists splinted (once again, DeQuervain’s tendonitis in both wrists is the reason), and I am still in pain. But I just have to write today.

As of yesterday, I have crossed the 34 week threshold with both boys and myself mostly intact. I wanted to scream with the relief I felt, seriously. The intense worry about preterm labor over, I felt a sense of power and accomplishment that’s hard to describe. WE MADE IT!

Then last night I got the call with my lab results from a 24 hour urine screen. My results were by no means devastating, but far less than ideal for my taste. See, I have had a lot of borderline symptoms of a lot of things throughout this pregnancy, and the most recent of these scares has been preeclampsia. Of all the problems to have when you’re pregnant, preeclampsia is one you really don’t want. It’s not that its unmanageable, it’s just that it’s potentially very dangerous (if it goes undiagnosed/untreated) and it can sneak up on you. Meaning, I could go from very mild symptoms to very serious symptoms in a matter of hours.

That said, if you’re going to get it, you want to get it at this stage, when you know you can deliver and your babies will have a relatively good chance of having a perfectly normal life. Because delivery is the only cure for preeclampsia.

What is preeclampsia? From the preeclampsia.org website:

Preeclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn baby. Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms.

Those of us pregnant with multiples, have anywhere from a 20-30% chance of getting it.

As for me, I haven’t been terribly symptomatic of preeclampsa, but then I’ve been on bedrest – which is one of the main management strategies for mild preeclampsia. Even so, on bedrest I’ve had issues with my blood pressure fluctuating from normal to borderline high (130s/80s – high for me), protein in my urine and sudden weight gain (7 lbs in 10 days).

And hello, here’s another lesson to you about vigilance in your medical care. Last week during my doctor’s appointment, I was the one who noted the sudden change in my weight gain (usually I gain about a pound a week) and the consistent issue with trace and +1 protein in my urine. I noticed this when the nurse left my chart open on the desk. I was reading it while waiting for the doctor. The doctor, (who I seriously think is about 29 or 32 years old at the oldest), NEVER said anything to me about any of it. She’s not a resident or a fellow. She’s an attending. Since she didn’t bring it up, I didn’t ask because I figured it didn’t matter. But it was nagging at me all weekend.

I went into Labor and Delivery on Sunday night when I was worried I might have sprung a little leak (I didn’t think I needed to come in, but I called and as soon as you call, they make yoy come in). Because this had been on my mind, I brought it up to the attending there as an aside. She thanked me for mentioning the weight gain and ordered the 24 hour urine and some blood work.

Why? Because 20-30% of women with multiple pregnancies get preeclampsia, and I had multiple risk factors (over 35 years old, pregnant with twins is a double whammy). So OF COURSE if I was exhibiting the above tendencies, the doctor should pay attention and order further labs.

For those who are interested in this kind of thing, my results for the 24 hour urine were protein of 400 (400 what? mg? I don’t know, because they never told me and there’s just so much you forget to ask). It should be under 300. While 400 is not terribly high, the doctor told me it was “borderline.” Bloodwork was all normal, but my blood pressures are labile and borderline, my protein counts are borderline, everything is borderline. I suppose that’s better than definitive, especially since I am getting the close monitoring regardless. But I want to be in the, “No WAY do you have preeclampsia” range. And that’s just not the case.

As I was writing this I just got a call from the doctor who ordered the 24 hour urine. They are admitting me for observation. Why? Well, a couple of hours ago I felt like my feet were feeling a little puffy. I asked Alex if he thought my feet looked at all swollen and he said yes, a little bit. Right after that, the nurse from the OB/GYNs office called to answer some other questions for me and I told her about it. She said, “Don’t freak out about that – that’s not a big deal. I looked at your labs and your chart and your protein count is not that bad – we don’t know that it’s preeclampsia. If you face or hands swell, then come in. If you get a persistent headache that won’t go away with Tylenol, come in. But for feet, we’re not that worried about it.”

“Are you sure?”

She was. But then just now I got a call from the doctor, who says because I have some swelling in my feet the team decided to admit me to the hospital for observation. So I guess it’s a bigger deal than she thought. How big, I can’t say.

So I’m now waiting for Alex to get home (and honest to god, he never really goes anywhere but of course – of course – he went down to his mother’s house to get me a blood pressure cuff and isn’t around). After he gets home I’ll shower, get dressed, get my bag together and go over to be admitted.

Keep in mind, if my boys had to be delivered now, (which so far they do not), they have every chance of a good normal life as anyone. They will need more help right after they’re born, yeah. But they are big, strong, healthy, moving, and breathing. Yes breathing, or rather practice breathing since there’s no air in there.  I am told this is a very good sign.

I’ll try to update as I can from the hospital.