Betrayed by My Own Liver

This week saw an ominous trend. We re-ran the 24 hour urine test (my current least favorite thing) and did blood work on Monday. The blood work was looking at kidney and liver functions because there’s a nasty thing called HELLP syndrome, which occasionally pops up when you have preeclampsia. Also, I *think* the preeclampsia by itself is no good for the liver and kidneys. The entire thing is much more medically complex than my high school anatomy class can help me understand.

The good news is that I don’t, at this point, have HELLP syndrome. My kidneys look ok. But even though the liver results are all still in the normal range, three weeks ago they were low normal and this week they’ve all jumped to high normal, so my liver is definitely going south.

I asked if the liver by itself would justify inducing me early, and the nurse said calmly, if it goes to hell, it’ll all go to hell at once. The liver, the protein in the urine–which is stable this week–and the blood pressure, it’ll all fall apart at once. They think we have two weeks left, although of course, at any time my body could give up and we could need to induce immediately.

Meanwhile, we’re trying to get the end of school stuff handled, which is always miserable and difficult. We’re just about done now, we’ve done field trips, field days, talent shows, open houses, and one of the awards ceremonies. Just one more awards assembly and we’re done for the year, thank God.

I feel pretty terrible all the time, which is making doing all the things that need to be done much harder. I used to do things in ten minute bursts with breaks in between and in the past week I’ve had to cut that down to five minute work sessions and longer breaks between. I’m not doing well over here at all.

 

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Between a Rock and a Hard Place

Yesterday we saw the perinatologist again. He looked at my blood pressure chart and said that he’s pleased with the results we’re seeing from the blood pressure meds, but the thing is, the meds make me super groggy. Like…it’s not safe to drive, groggy. I mostly sit quietly and blink or nap when I’m on the meds. As a result, on days when I definitely have to drive–like today, for example–I can’t take the blood pressure meds. Instead of taking two doses, one in the morning and one in the evening, I have to go to just one in the evening. As a result, my blood pressure jumps during the day and it’s borderline dangerous. But I have to get the kids from school. Hence the rock and hard place issue.

That also means that days where I’m driving are the only days I can count on getting things done. I’m only about halfway done with the baby afghan and I need to sew down the edges of the fabric I bought for receiving blankets, six of them. I’m hoping to do the three green ones today and the three yellow ones tomorrow. We’ve washed sheets and baby clothes, and installed the car seat. We’re as ready as we can be.

Which is good, because what the perinatologist says is that there’s a 20-30 percent chance this baby will come in the next two weeks. His best guess is that the baby will come in three weeks, and he’s not intending to let me go past 37 weeks, which is 5 weeks from now. We’re 33 days or less from a baby, is what they’re saying.

As a result of the chance of imminent induction, we did steroid shots yesterday and today. These help the baby’s lungs, brain, and intestines develop more quickly and leads to better outcomes.

The good news is that the baby is nearly 5 pounds already, running big, and babies who are more than 5.5 pounds get out of the nicu faster because they can regulate their own body temperature faster. If we can get to 35 weeks we shouldn’t need ANY nicu time.

I also see the perinatologist every week from here on out, in addition to the weekly visits with the OB. I’ll see the perinatologist on Tuesdays and the OB on Fridays. Basically, I’m going to be living at the doctor’s offices.

I hate that I have to use these few days of feeling good doing work, but things need to get done.

More Things I Don’t Need

This week saw a nasty flare up in the hostilities between me and my ex.

We have a simple and standard arrangement that includes the very reasonable requirement that you need to have the permission of whichever parent it will effect before you sign the kids up for an extracurricular activity.

This generally means you always need to get permission from the other parent. I always give my permission for his activities because I know the kids want to do them (with the exception of this spring, because of the high-risk pregnancy) and he has never given permission for any activity I select, because he’s a dick. The end result is that I have to cram any extracurricular activities into a single day per week, which is the only guaranteed time I have the kids.

You can, therefore, imagine my surprise when I discovered that he signed the older child up for sports, which requires her to participate in games. The games are only on my one day a week. It’s a done deal, he’s signed her up, she’s already registered. I’m also responsible for the sports physical this month and six weeks worth of training camp in the summer (AND the expense that goes with that) which will be great with a newborn, or a preemie, or on bedrest, because those are the choices I have.

And it means that neither kid can continue with Scouts, and it also means that the discussions I have been having with the little one about starting gymnastics are now moot because how can we make that work with games that are, in some case, an hour away.

I offered to switch him days next year, because that’s a reasonable solution. But he refused, because he already has them in a church activity that night and he doesn’t want to give that up.

Pause. Yes. He has something planned that he doesn’t want to give up, but he’s ok with forcing me to give up my plans.

And when I protested, he went straight to extortion. Say yes right now to this, or I’ll tell the schools you can’t have the kids and I won’t give them to you in the summer.

The schools have a copy of the court order, and that should be the end of that because obviously he can’t tell them to ignore the court order.

Unfortunately, he somehow managed to do just that. The school refused to give me the children yesterday. The little one went to the counselor with a stomachache and a rash, both caused by stress over this, and the counselor said, “It’s too bad, but that’s what the court order says.” Which, 1) who says that to a little kid, what the hell kind of counselor is that?? and 2) THAT’S NOT WHAT THE COURT ORDER SAYS.

But it’ll be different in the summer, you might be thinking. Unfortunately, no. The police in his city are the only ones I’ve ever heard of that outright refuse to enforce custody. It’s basically legitimized kidnapping.

Obviously, we have to take him back to court for this, which sucks because of course we don’t have the money for that. And I can’t really take this much stress.

The blood pressure–possibly as a result of this, possibly not–keeps getting worse. We’ve been in and out of the doctor’s offices, measuring it constantly, and we’re finally to the point now where they had to put me on medication for it. They said I’ll get used to it in time, but for now it’s making me really groggy. And so far, no noticeable decline in my blood pressure. We can go up to triple my current dosage before we have to go to the hospital for IV medication, so it’s looking ok for the baby to get to 34 weeks or more.

 

Moderate Progress

The most recent test results are in and the 24 hour protein is still stable, down slightly but not enough to change it from stable to decreasing. Despite failing the 1 hour glucose, I did pass the 3 hour glucose, although the test made me incredibly sick for the rest of the day. But the bottom line is, no gestational diabetes.

The anemia continues to be a problem, since I am having trouble keeping the iron pills down, and basically every evening is a carnival of nausea with the occasional vomit session for variety.

The blood pressure is trending upwards, with several readings high enough to require a trip to the doctor for a second check, but the overall numbers are still mostly borderline with the occasional decent result to keep hope alive.

The doctor said this week–we’re now on weekly visits because I’m high-risk and getting worse–that the goal at this point is to get me to 34 weeks. That’s 3.5 weeks away. On the one hand, I’m definitely ready to be done with this pregnancy, but on the other, at 34 weeks I’d expect the little creature to spend between a week and a month in the NICU and I have no idea how that will work from an out of pocket cost perspective. Whereas, if I can get the baby to even 36 weeks, the odds are much better that the baby can come home with me.

My sister, concerned that the baby could come at any moment without warning, bought us our car seat, thank God, that sucker was the most expensive thing on the registry. Without friends or family locally we’re not doing a baby shower so we’re on the hook for baby supplies ourselves. And since I’m 9 years and 3 moves out from the last baby, we have almost nothing leftover. All we have is a crib that requires modifications to meet current safety standards and the mattress. We’ve been trolling craigslist for cheap supplies but we’re still short a lot of fairly necessary items. At least now, the biggest thing we’d need is some clothes and maybe some more cloth diapers, and once the baby comes and we know the gender I expect various family members might buy some clothes. And of course, if the baby does come soon, we’ll have the time that it’s in the NICU to get things together.

Meanwhile, planning is incredibly difficult as well. The older kids get out of school around the 34 week mark. We have all the end of year stuff to get through, awards assemblies and spring concerts, and they’re due for their summer therapy session in June as well, and that can’t be moved earlier without taking them out of school.

Basically, this week represents a slight shift forward in the battle to survive. I never expected this pregnancy to be so awful.

 

 

Everything is Going to Hell

I saw my regular OB this week, a week after the visit to the perinatologist. The perinatologist wanted me to start taking my blood pressure at home twice a day-as indeed a helpful reader of this blog also recommended–and I was able to borrow a high quality home blood pressure machine from someone who had also had preeclampsia recently. The numbers all week were mostly borderline, with a slight trend upward. And there were a couple of good readings mixed in there, too.

The blood pressure was borderline at the OB’s office, and the quick protein in the urine was a +2, which is pretty bad and exactly what it was at the perinatologist’s office the week before.

As a result, we’re having to do another 24 hour urine this week and the standards for when to call the doctor for help moved from when both of the blood pressure numbers are high to when either number is high if I have any symptoms whatsoever.

I took the first glucose test as well on Friday and we’ll know the results tomorrow. I’ve never had a glucose issue in either of my previous pregnancies but obviously this kid is a different beast entirely, and I have real concerns about my ability to escape without gestational diabetes.

Last night, I had a terrible headache and when I took the blood pressure it was not great, sitting at 138/100. Anything over 140 on the top number or 90 on the bottom number is a real problem. I waited 20 minutes and tried again and got 132/95. Not a significant improvement. I had to call the perinatologist, who told me to take some of the good pain medicine for the headache and try to sleep. Successfully sleeping would be good till morning and if I couldn’t get the headache to go away with the pain meds, to re-take the blood pressure in two hours and call if it was still high. Thankfully I could sleep, and we managed till this morning.

The blood pressure this morning is still bad, but not as bad. It was 128/91, but without a headache or vomiting it’s not a crisis. Unfortunately, it means I can’t go places today, I have to sit quietly and try to keep the blood pressure from getting out of hand. This is a real crisis because I was supposed to take the kids to the mother-daughter tea for their girl scout troop and now that isn’t going to happen.

Hopefully, this is a terrible period of randomly high blood pressure and it’ll get better from here on out, but I seriously doubt it. I think I’m headed back to bedrest and possibly looking at some hospital time.