Late Postpartum Preeclampsia

*I am thankful for those that share their stories here–we can learn so much through it.  Big high five to my sister Maria for bravely sharing a piece of hers.  I know this makes her uncomfortable but sometimes it's good to stretch.* 

In 2010 I was pregnant with my third child. I had a normal pregnancy, just as I had with our first two girls. On September 14 our little baby girl (9 lbs 7 oz) was born at 5:30 AM. The following week I developed pain in my abdomen and swelling in my feet.  They suspected a uterine infection, so I went for an ultrasound which they found no sign of infection (no debris left in uterus.) A few days later, 9 days post partum, I got a headache, a REAL headache. That Friday night I lay in pain from the pounding, Tylenol did not help and I could not sleep. I thought it was probably from having a newborn and a 2 and 4-year-old and being exhausted.

The following day, Saturday, September 25th, I could barely open my eyes; the sun bothered me and the headache was still present, even with double doses of Tylenol. I was sitting outside and my husband started the lawn mower and I had to go back inside. I finally caved to my husband's request and called the midwives. A short while later one arrived and walked in the door and immediately noticed something was wrong. She did a bit of checking and noticed an elevated blood pressure. She called and left a message for the Ob/Gyn at Langley hospital and told me she would call me as soon as she heard from them. She called me back a short while later and said they were not responding to her but she felt I should check myself into the ER. I texted a friend who came to pick me up, as I did not feel well enough to drive, and my husband had to stay home with our three little kids. I fed my newborn once more and off we went.

Once in the ER, I do not remember a lot. They did admit me immediately as my blood pressure was 190/110 at that point. I remember a lot of doctors and nurses coming and going as they were trying to figure out what was going on, medicine being administered and then waiting to see if any changes were happening. I slightly remember my husband bringing me my newborn baby to breastfeed and he looked shocked at the sight of me.

Finally around 11 PM the hospital moved me to the Intensive Care Unit: I had Postpartum Preeclampsia.  One thing stands out: seeing a nurse on the unit that I knew personally and the sight of her bringing some peace to a very scary situation – every time I see her, I still remember seeing her that night. My blood pressure remained high and I was quite anxious and so tired and ill. The pain was unbearable and they could not get my blood pressure down. My amazing friend stayed by my side through all of this. Kris remained at home taking care of a 9 day old baby.

My sister, who also happens to be a nurse, showed up in the middle of the night and told the nurses to get the cardiologist in NOW (the cardiologist was given info about me over phone and directed nurses how to treat without seeing me.) I vaguely remember the nurses having to put in an arterial line, which is a catheter inserted to your artery to monitor blood pressure in real time, used in critical care situations, and my sister asked them to use EMLA cream to dull the pain (topical cream they use sometimes for IV or shots.) The nurse said using the cream makes it harder, to which my sister responded "For who?" I appreciate so much that she was there to be my medical advocate. I was being pumped with drugs for blood pressure and pain medication and throwing up numerous times. My friend said my eyes were shut the whole time and every time my heart beat my eyes squished due to the pain. Finally around 3 AM  my blood pressure started to go down. At 4 AM I finally told my friend “I will be okay, go home.”

I was in the hospital for 3 nights and 4 days in Intensive Care Unit, all of which I could not leave the bed, except to use a commode to pee (after just having a baby…yuck). I also remember the nurses and doctors saying how surprised they were that I did not have a stroke or worse. My husband had to take care of our newborn baby for those days pretty much solo, bringing her up during the day every few hours for feedings. Luckily she was still in newborn sleepy phase so she was pretty good for him.

I remember going home and barely being able to walk down the street. My body had shut down. My heart had build up on the walls due to the prolonged elevated blood pressure. I spent a lot of time at appointments with the cardiologist (I requested a change and was referred to my dad’s cardiologist) and had a few ultrasounds on my heart. The first few days were tricky–trying to figure out blood pressure medication and monitoring my blood pressure every hour. Oh, and taking care of a newborn, a toddler and a 4-year-old.

A few months later, when my heart had “healed” and my blood pressure stabilized without medication, my cardiologist and Ob/Gyn told me the situation was so rare and unlikely to occur again when I asked about if okay to have another. We got pregnant in October 2011. The midwives worked along side the Ob/Gyn. I also had a few appointments at Women's Hospital for testing to see if it would happen. They advised me the likelihood was slim to none as the uterine artery notching did not seem to be present (that can be a sign of preeclampsia.) With all my previous pregnancies I was induced around 40+ 9/10 days. So they induced me on June 29, two days before my due date, to try to eliminate another factor.

June 30th I gave birth to my 4th daughter.  Nine days later as we were walking back from the park I said my husband "I feel the weird pain going up my neck".  We went home and my blood pressure was elevated. I tried to lie down, but could not sleep. I took my newborn and went to my family doctor. Immediately I received a note from my doctor and went to the ER where they promptly admitted me. They looked over my files from 21 months prior and started treatment immediately.

In this second instance I was very on top of it, as I knew the symptoms, and got put in the Maternity Ward for the next 4 days on magnesium and blood pressure medication once again. I had a nurse in my room 24/7 while on the magnesium. Recovery was so much easier this time around as it was caught earlier. The hospital stay was again a complete blur. People were coming and going and my husband was taking baby back and forth to stay with our other three kids (she could not stay with me unless there was another adult in the room.) Going home was so much better this time around. I felt a lot more energy and there was no damage to my heart. 

Why do I share this story? I am not a big “sharer” of my story. I have tried to block it from my memory as it was the scariest time of my life.  Louise, my sister, mentioned I should share so that if this is to happen to someone else the symptoms may be recognized, and that person may get treatment early so their recovery would be so much better and less traumatic. Perhaps this is being read by a midwife, doula, doctor, husband, friend or future mother themselves. Post Partum Preeclampsia does happen, most of the time it’s within 48 hours after having the baby, but can occur up to six weeks post partum, just very unlikely. If promptly treated, it will substantially reduce the likelihood of complications. So, if sharing this helps one person I am glad I did!

What I am most grateful for:

• the friends and family that helped out during these difficult times.
• that I am still here to help raise our daughters.
• most importantly, that the Postpartum Preeclampsia did not happens with our first or second baby otherwise we would not have our third or fourth in our family!

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