35 Weeks: Pregnancy, Preeclampsia and Mack Trucks

Documenting the Trauma

I have this cute little journal that I started for baby boy Brinkerhoff after I found out that I was pregnant, that I would update every month or so with his progress, ultrasound pictures and my latest symptoms- documenting the pregnancy for posterity so he could look back and see what it was like when I was pregnant with him, and so he could get to know his mom and dad a little bit and how we were feeling during the pregnancy. Well it was all fun and games for the first six months, but now I've realized that I can't keep going because anything I write would sound a lot more like a horror story than excitement. And I don't want to traumatize our son. But it's gotten really hard these last few weeks.

So here I am to traumatize you instead. Actually, I've felt like it's important to document this third trimester for awhile, because I know that I will forget. And that's probably mostly a good thing. But I also think that there is some good in remembering. Because it has been such a learning experience. And it will be one of the most defining experiences of my life. And I want to look back and remember.

Waiting to be hit by a truck
One of my friends recently described awaiting your first child perfectly. It's like sitting in the middle of the road waiting for a Mack truck to hit you. At first it's too far away to care too much so you just grab a slurpee and hang out. But as it gets closer you start to realize the magnitude of what is going to happen and you begin to get a little freaked out. You know it's coming, and you know it's probably going to rock your world, and it's probably going to be pretty painful, but you still don't really know exactly what it will be like. I'd say that's about the most accurate analogy I've heard so far about how I feel.

I think some think that the more information about the impending collision, the better. But I've also learned that for me the key to easing anxiety about birth and parenthood is not information. Actually, that seems to be the worst thing because I get totally overwhelmed with ALL the very passionate opinions about everything from pacifiers to how to hold your baby when you nurse to how to handle pain. And the advice and information is given without solicitation by everyone, everywhere. Even strangers in the store! And then there are all the horror stories- "when I gave birth.....", which mostly leaves me terrified. So I've learned there's a time and a place to learn about everything- and it's certainly not all at once. And my experience will be completely my own and it's ok if I haven't prepared for every contingency and haven't researched every detail to death- because your baby probably won't die if you learn from the school of hard knocks which bottles to use or what kind of diaper is best. And regarding pregnancy milestones, you only really need to read up about the things that will be happening in the next month or two, at the most. Because that is what is relevant and real and makes sense at the moment. Anything beyond that is too far and too scary.

Information Overload
I remember when I was about 16 weeks pregnant- I went to a little game night of a friend where there were lots of women I didn't know- most of whom had babies. Of course the conversation always turns to kids and they start asking about my pregnancy. Telling someone it's your first pregnancy is akin to saying "please tell me everything you learned about pregnancy", and for almost an hour I was inundated with information about whether to go natural or to get an epidural, birthing centers, etc. While the information was good, I was totally overwhelmed and terrified. I wanted to go home and cry. Not only did I have no idea what they were talking about, but that was so far down the road it had almost no context to what I was currently experiencing. It felt like a totally foreign experience they were talking about. I was still giddy about the fact I was pregnant at all and just trying to figure out how much longer I could wear normal jeans with a rubber band for the top. I felt totally uneducated and unprepared to talk about labor and delivery, and also totally terrified.

After that I decided to steer clear for the mamma group conversations about pregnancy and birth so I didn't get anxiety about things I didn't need to worry about yet, and take things one step at a time. This was necessary for my sanity because it turns out that anxiety and insomnia are good friends and I would spend all night obsessing about fears and details of things I knew nothing about. And that's not healthy. I  also learned NOT to not inundate newly prego friends with information although it's tempting- until it's relevant later on. Because it's totally overwhelming all you have to learn, and it's best learned a little at a time. And some things are not bad to learn just by experience.

Now, at 35 weeks, I'm ready to talk about labor and delivery, have opinions on child birth, and am interested in other perspectives because I actually have context and an opinion now. Before I felt like I was just blown around by whoever felt the strongest. And I also recognize the deer-in-the-headlights look on the faces of other newly pregnant friends when other mammas excitedly tell them about their pregnancy ups and downs. So then I can take them aside and say, look how cute you're little belly is, and how do you feel? Instead of, "let me tell you everything you ever needed to know about breastfeeding".

The current state of things- then and now
Ok now back to right now. I am 35 weeks pregnant right now. I'm glad that I'm finally this far along because I finally have context for what people are talking about with pregnancy in all three trimesters, and I can look back and meaningfully compare my experiences with theirs and what I thought, etc. And that gives me some confidence in my own experiences.

And one thing that I can say quite confidently now - I had a really easy first and second trimester. I didn't have any morning sickness. I would get a little queasy if I didn't eat some protein every couple of hours, but nothing major. I didn't have backpain. I was a little tired. About half way through the second trimester I started to get a little bit of anxiety and insomnia, and that was was difficult emotionally. Some high blood pressure started to show up occasionally too from working on my feet I think. But those things resolved as soon as I quit working at Wells Fargo. But other than that, if I hadn't been obsessively waiting to get a positive on that pee stick, I see that I probably could have gone 4 or 5 months without even knowing I was pregnant. There weren't really that many symptoms. I didn't have crazy cravings or hunger. My mood was pretty stable. "This is a cinch" I though, "and I'm more than half way there! Easy peasy, I'm gonna have 12 kids!"

But let me tell you what. This third trimester is kicking my butt. Like. It's been bad. I've earned my stripes and then some. It has by far made up for the first six months. Let me just give you a roll call of the symtoms, can I? Just so one day I can look back and laugh at how hilarious it is that someone could be so miserable.

First we started with the peeing every hour. This started from the beginning but never really let up. So goodbye solid night sleep. We are visiting the lou 5 or more times a night. Sometimes I go through an entire role of toliet paper in one day all by myself. It's kind of ridiculous. Then there's the heartburn. The constant heartburn. I sleep with Gaviscon by my bed (highly recommend over Tums or Rolaids by the way, it lasts longer so you only have to take 1 every few hours instead of constantly popping them in). And there's a bottle in my purse, and  in my car, and on the table, and in the camper, and pretty much every place I could ever be, because life is miserable with heartburn. And it never goes away for longer than a few hours. Also acid reflux means propping yourself up in bed at night with about 28 pillows or, in my case, sleeping on the recliner most nights. Goodbye snuggling with the hubby. Which is probably just as well since I would keep him up with my constant trips to the bathroom all night long. Insomnia sets in as well. Not that it's hard when you have to get up every 1.5 hours to pee. But then you start thinking obsessively about things like- what if you die in labor? What if you're a bad mom? What if you hurt your child? Ah pregnancy anxiety. Insomnia and anxiety are good friends- and they basically turn you into a monster when you can't sleep. Then there is the carpal tunnel in the  hands. You can't sleep on your back, but if you sleep on your side, then you wake up with your hand and arm asleep, which it probably would be anyway, but is made worse by the fact that you have pregnancy carpal tunnel which means your fingers and hands go numb and aren't very useful for doing things that require pressure- opening things, putting on clothes, etc.

And that's just the night time side of things. There's also swollen, way way way swollen  hands and feet, aching pelvic bones and spreading hips, a bursting belly that fits no clothes, aching legs and feet, skin sensitivity, hemorrhoids, being hot all the time, violent sleepiness and inability to function without naps. Also, apparently pregnancy creates congestion. I already felt like I had constant congestion before I got pregnant, but pair congestion with the fact that you can't breathe and it would literally feel like I was gasping for air all day and night. I never felt like I could get a full breath of air, and sometimes it was alarming. I felt like I needed to invest in an oxygen take to take around.

Basically, there is not a single part of my body that is not somehow significantly affected by pregnancy.

Preeclampsia or Toxemia
Now, the blood pressure. I haven't really known much about blood pressure because I've never had problems with it. And even when it started going up, I didn't really know why that would be an issue because it didn't seem to be affecting much. Well, now that I am several months into preeclampsia, let me tell you a little about blood pressure. It affects a lot apparently. But preeclampsia is more than high blood pressure- which many women get during pregnancy. The best and most informative article I've found about it is here.

Preeclampsia typically doesn't start until after 20 weeks of pregnancy, but I started having elevated blood pressure about week 17. Not a good thing. Luckily it has progressed slowly to allow me and the baby to have a relatively normal pregnancy. No one really knows why some women get preeclampsia. Many women get hypertension, or high blood pressure at some point in pregnancy. But preeclampsia is a progressing condition where the blood pressure worsens and that is accompanied by other symptoms like having protein in your urine. It means that your cells are leaking, as my doctor explained. Bottom line: preeclampsia causes your your blood cells to constrict, causing the high blood pressure, swelling and restricting blood to your other organs- including to the placenta.

Your blood cells are leaking and that causes edema, or swelling of the hands and feet- pretty typical in pregnancy as well, but more severe. But as preeclampsia progresses, other organs "leak" as well. When your liver leaks, it leaks protein into the blood and your urine. Mild preeclampsia can generally be managed without much incident and many women have normal deliveries without things progressing to a problem state. However, moderate to sever preeclampsia means that your body is progressing toward a seizure and you need to deliver immediately before vital functions of your body shut down. Eclampsia means stroke or seizure, so preeclampsia is the prelude to that- which typically is resolved before the stroke by giving birth. That's the key though, allowing it to continue as long as possible to let the baby develop but before it causes a seizure.

Severe preeclampsia is determined by the breakdown of red blood cells, elevated liver enzymes, and low platelets- which are checked by taking blood. High blood pressure and protein in the urine are a precursor to this. Once the other symptoms of the blood are displayed as well, the induce almost immediately, for the safety of mom and baby.

Where I'm At
In addition to the high blood pressure I've had for months, in the last 4 weeks my urine has had protein in it, and my body has recently (as in the last week) exhibited symptoms of lower platelet levels and elevated liver enzymes, causing concern about severe preeclampsia. When my blood pressure is particularly high, I can tell because I feel feverish and nauseous, start to get dizzy and just feel really sick. When I say high, I mean my blood pressure is sometimes 160/117. Other symptoms that are a precursor to a seizure are intense upper abdominal pain, mental confusion, vision changes, etc. which I haven't experienced yet, thank goodness. However, those things are imminent given more time, and it's a risky game playing with seizure possibilities. Although I'm not full term yet, they'd rather be safe than sorry and deliver the baby early. Luckily, I am as far along as I am (35 weeks), because the baby at this point would survive delivery without many complications and is almost full term. We're still going to try to get him to 37 weeks though if possible, with a lot of monitoring.

The doctor started me on some blood pressure medicine this week that seems to help a little bit, and has ordered me on bed rest, and to come in and see him and do lab and observational tests twice weekly. He's keeping a very close eye on my now and has said we'll probably have to induce and he can't imagine me being able to go past 37 weeks. Even with the bed rest and blood pressure medicine, it seems that most of the symptoms are persisting, so it is just a matter of days before I'll be induced.

So I go in twice a week now to see my OBGYN and also do extensive lab tests and monitoring (NSTs) twice a week as well. Each NST (non-stress test) takes 3-4 hours so that means I am spending a considerable amount of time in the hospital at labor and delivery these days. Which is a good thing in a sense- I'm getting comfortable with the place that I'll be giving birth, and get lots of practice packing my bags and hanging out there to determine if I'll be having a baby immediately, or get to go home for a few more days. And I'm glad that I get to come home and don't have to be hospitalized for the remainder of my pregnancy, which happens in a lot of cases. I'm much more comfortable at home with my cute little kittens keeping me company.

Ticking Time-bomb and Mother's Intuition
So now you know what I mean when I say I'm literally a ticking time bomb. Although I've sensed from many of my family and friends a lot of concern about the situation, I feel at peace about everything. I feel relieved actually to finally know what's going on and what to expect, because I felt like I wasn't getting those answers for a long time from my doctor, although I've had preeclampsia for awhile. I just assumed he would give me the information I needed, but I had to be pretty pro-active in figuring out my symptoms and what I could and couldn't do that would make it work.

But in the absence of that medical information from the doctor, and in the physical distress of the symptoms I've had, I feel like the Lord has been helping me to find the information I need and prepare me for the possibilities that were coming. Just 2 weeks ago at my friend's  house I very distinctly got the impression that our baby would be born early, probably before the end of June. This has been important to know because I've been so determined not to get too ahead of myself on things, and also to not expect him to come early so as not to be disappointed if he came late for some reason. I needed something to kick me into action to get ready faster than I would otherwise. For example, I hadn't intended to learn much about breast feeding until July. And we still have had a lot of supplies that I needed to order as well- a crib, breast pump, diapers, etc. So it's a good thing I've had a few days' heads up.

Also, before I received the official diagnosis of preeclampsia and orders for bed rest this last week, I felt like that's exactly what I needed to do to manage the symptoms, and that I likely had severe blood pressure problems. I haven't had a lot of communication with my OB about what's going on and I often would leave the hospital after hours of tests with no answers or communication from him, and with more questions than answers- which made me anxious. So I finally prayed that the OB would spend a little more time with me this last week so I could understand better the gravity of the situation from his perspective and what I could do or what I needed to prepare for. And for the first time in all the months I've been seeing him, I felt like that's exactly what he did.  He took time to explain things to me, how the preeclampsia had progressed, what I needed to do, why the symptoms were happening and that I would need to prepare for an early induction.

It's made me realize that when I am distressed or in the dark or don't know what to do, I can always turn to the Lord- although I don't do it often enough. I really want to be the kind of mother that turns to the Lord to figure things out, because there's so much I don't know and I want so badly to do things right. I'm so grateful to know that in starting this journey to Motherhood, I'm not alone and I can find the truth and comfort in situations that are intimidating. As I have felt distressed or worried about the future or how to handle things, I feel like I can turn my worries over to the Lord, ask for his help, and trust that he will guide me, because he is my partner in the raising of his precious son. He loves our son more than we do, and cares and will give help if I'm willing to listen and ask, even about silly things. Because he has helped and keeps helping in the ways that mean the most to me.

So now we just wait. We wait and I try not to be too grumpy and make the best out of how miserable I feel most of the time. I have to sleep a lot. I feel sick a lot. I have high blood pressure often and that exasperates all the other pregnancy symptoms. I can't stand for long to make food for myself or my husband so there's lots of frozen meals and pizza. And lots of movies and reading and TV. And mostly lots of sleeping. But I just remind myself this will be over soon. And there's meaning to this suffering, and an end as well.

Michael and I are reading in John right now, and it's interesting to me that as the Savior approaches the Atonement, there is a sense of foreboding and even a bit of hesitation in him about the Atonement and the path he's committed to. He says, "Now is my soul troubled; and what shalI say? Father save me from this hour? but for this cause came I unto this hour." (John 12:27). He, like me, feels a little bit overwhelmed of what will be required- although he has committed to the task and is determined to go forward. And that gives me some comfort to know that even the Savior has felt a sense of....hesitation about doing the most sacred, yet hard things in life. He, like me, was a person committed to the importance of the task at hand, but it's still ok to be a little worried, a little intimidated by the magnitude and difficulty of the task. And he, like me, had access to divine help and reassurance when he was feeling uneasy.

It's made me realize that in a sense, pregnancy and delivery is very much like our own little walk into Gethsemane, where we are literally sacrificing our bodies and life for another person, even coming near to the door of death. It's made all this suffering a little more meaningful for me to think that it is helping to sanctify me and help me understand the Atonement better and the kind of sacrifices we make when we love others. And because of that we always have an example to turn to, and help we can receive from above.

But with all of that said, I will be so glad when it's over. And we have a little bundle of squish to love on and play with. Not that it won't be hard then too. But different hard. I guess I'm looking forward to the change.

And really looking forward to kissing little baby toes.

Wish us luck in the next couple of weeks welcoming Baby Brinkerhoff into the world!