When I was little, my Dad used to get fed up with my incessant fidgeting and offer to give me a quarter if I stayed still for five minutes. I don’t remember earning a single quarter, and not because I didn’t try. ‘Still’ just isn’t something I do with any grace. I am fundamentally un-serene.
We’ve known from the beginning, when I got pregnant using the same donor we used when Penelope carried Hank, that preeclampsia might be an issue. Preeclampsia, aka pregnancy-induced hypertension, or PIH, is a prenatal disorder usually marked by high blood pressure, proteinuria (protein in the urine), elevated uric acid, edema (water retention) especially in the hands and face, abdominal pain especially on the right side, headaches, and blurred vision. If left untreated, it can worsen and develop into eclampsia, the seizure disorder that (spoiler alert) killed Lady Sybil in a recent episode of Downton Abbey.*
Our doctor said there is some chance that the risk of developing preeclampsia might have some genetic link to the donor sperm. She wasn’t at all surprised when we learned that some of the Sister-Wives had also developed preeclampsia during their pregnancies, and so she’s been watching for it all along. (Penelope and I also suspect she’s a little bit hypervigilant about it because she feels bad about missing Penelope’s diagnosis until her pre-e was so severe, but in Dr. Dalton’s defense, Penelope’s condition had a very unusual presentation in its early stages: she was vomiting and had severe heartburn, but she didn’t have high BP, much swelling, proteinuria or headaches until just a few days before she delivered Hank, at which point she was already dangerously sick.)
At almost every prenatal appointment so far, Dr. Dalton has frowned worriedly as she noted the presence of protein in my urine. Last week (32 weeks, 5 days gestation), I had a slightly-higher-than-usual (but still normal) blood pressure, but I had not had any of the other symptoms (except the proteinuria): no unusual swelling or chest pain (some swelling and heartburn are both typical in late pregnancy), no blurred vision, and my headaches have actually improved with pregnancy. Doc was worried enough to order a 24-hour urine collection (yup, that’s just what it sounds like: I peed in a jug for a whole day), and when the results came in, they only worried her more. More than 300mg protein in a 24-hour urine test is considered high; my results last weekend exceeded 750mg.
But, yeah, enough about my pee. Anyway, Doc’s office called and asked to see me ASAP, and I went back yesterday afternoon. I knew from Penelope’s go-round with it that preeclampsia can be ‘managed’ with medication, diet, and bed rest, but it only has one cure: almost always, the condition resolves itself once the baby is delivered. Penelope was diagnosed at 36 weeks, almost full term, so they skipped the treatment and went right for the cure: induction of labor. I was, yesterday, only 33 weeks, 4 days, so I knew if they diagnosed me with pre-e, the rest of my pregnancy would take a very different course than that which I’d planned — I’d probably be on bed rest until delivery.
I spent the last few days at work trying to get my work load in order so that my colleagues could take over if I had to leave suddenly. It’s funny: looking back over the last few days, I had a rational understanding that I might be put on bed rest, but I also had a contradictory confidence that this wouldn’t happen to me. I feel much better than Penelope did at the end of her pregnancy. My BP is fine. I don’t have any symptoms except for proteinuria, but I’ve had that since the first trimester, and so maybe that’s just some quirky personal trait.
Yesterday, Dr. Dalton ordered more labs. My uric acid is elevated, too, so that’s another symptom of pre-e. Doc says that’s enough for her to believe that if I don’t have full-blown pre-e yet, I’m “headed down that path” and she’s treating me as if I have it. That means an evaluation with the high risk OB-GYN specialist at DHMC, 3x weekly doctor’s appointments to monitor BP, weight, and urine, 2x weekly non stress tests, and ultrasounds to monitor fetal growth every 1-2 weeks. That’s a lot of obligations to heap on a gal’s plate, and then in the next breath tell her she’s not allowed to drive. My poor mother-in-law is now not just Hank’s daycare provider, but has also just become my personal chauffeur (to my shame).
-And yes, when I’m not at the doctor’s office, I’m on bed rest. I don’t know how I’ll manage, especially with Hank running around, urging me to play with him and take him on adventures. We’ve tried to explain it to him, and he’s a bright kid, but he’s two. Hank’s not the biggest problem, though: the biggest problem is that I am as unserene as ever, and stillness is not a thing I do with any grace.
*As my mother so helpfully pointed out when I told her my diagnosis. Gee, thanks, Mum.