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Signs of Pre-Eclampsia in a Diabetic Pregnancy.

Dear Baby,

I know you can hear me in there.  You are about 5 lbs of baby girl and when I sing to you while we're driving, you move around from side to side.  (I hope you aren't trying to escape the sound of my tuneless voice.  In my mind, and in my car, alone, with the windows rolled up, I'm fooled into thinking I sound pretty decent.)

So make sure you're listening now, because I need you and I to work together pretty closely for the next few weeks.

Yesterday, at the doctor's office, we were there for a routine visit but my damned blood pressure was a little spikey, coming in at 140/90.  Much higher than what we see at home, which is closer to 125/73.   (White coat syndrome, anyone?)

Our OB reacted immediately.  She sent the nurse for my urine cultures and confirmed that protein was spilling into my urine.  They took three more blood pressure readings, all which came back in the 130-140ish range.  And then they did a quick measurement of you and your heartbeat.

"I know you have an ATU appointment today, but I want to send you over to labor and delivery for monitoring.  Basically, I think you're showing signs of pre-eclampsia.  I do not want to take any chances."

"Okay, what does that mean in terms of what happens next?"  The words "labor and delivery" and in my vocabulary, but I wasn't planning on using them until ... oh, say the end of April.

"I want them to hook you and baby up to monitors and keep an eye on both of you for a few hours.  If your blood pressure continues to climb, or if the baby shows any sign of distress, we may need to have her come today."

Baby, you feel enormous sometimes, all rolling around in there.  I can feel your legs up about four inches past my belly button, and I can feel the swell of your pretty head closer to my pelvis.  You take up a lot of room in this belly now, and when I'm trying to get up from the couch at times and need to roll a little on my side to launch myself upwards, I laugh because it's just ridiculous how big my pregnant belly has become.

But when the doctor said that you may need to come early - 33 1/2 weeks along kind of early - depending on the stress on both of our bodies?  I couldn't help but picture just how small you are.   We have five weeks left.  I want you to stay put as long as possible.

"Today?  That's like instant panic.  Today?  So should I call Chris?"

"Yes.  Once we have you over at labor and delivery, and they monitor you, we'll be able to determine if you can go home today and tackle bed rest for a few weeks, or if we should keep you overnight and monitor you both, or if you should be admitted for a few days, or, and this hopefully is NOT the case - that she's coming today via c-section instead of in a few weeks."  

Lots of information to digest.  I called your dad from the foyer as I waited for the elevator and gave him the details.  "Basically, she is probably not coming today.  But she might be.  And I'm freaking out a little bit.  I think it's okay for you to wait to come up, just until I know what their plan is.  They're not going to make any fast decisions - more ruling stuff out and ... honestly?  I have no idea what's going on."

Little girl, I was confused.  But after spending a few hours having blood drawn, blood pressures taken, and non-stress tests performed, things were looking a bit better.  They did an ultrasound of you and you look strong and healthy (and round in the head, you cute little mess).  They also scanned the placenta for any signs of detachment or calcification, and took measurements of the fluid level in your uterine apartment.  Everything was looking good, except for the protein spill and the elevated blood pressure.

The doctors came to evaluate me.  Us.  And their main concern was the protein.

"We'd like you to do a 24 urine collection and stay overnight."

"Stay overnight for monitoring purposes?  Are there concerns for me or the baby?  Or are you just really eager for my pee?" It had been a few hours, I was hungry, and my hands were sore from texting Chris and keeping him updated on our situation.

"At this point, just the ... um, we just want your pee."  (Baby, I love making doctors repeat back the odd things I've blurted out.  Those awkward moments from them almost make the initial awkward moments from me worth it.  Wait until we're at the pediatrician.  I'm sure I'll embarrass you endlessly.) 

"So can I do the collection at home instead of being admitted?  And bring it back after 24 hours?  Or is that risky in ANY way?  I don't want to tell you guys what to do, I just don't want to hang out in the hospital purely for urinating purposes."  (And also, I didn't have any back up pump supplies or clean clothes or anything to even read, so the idea of being trapped in the hospital for 24 hours, purely to offer up constant urine samples, made my head spin.)

"No, home is fine.  So long as you can bring the samples back after 24 hours.  And we'll need you on modified bed rest until further notice, because if pre-eclampsia progresses, we don't want any problems.  You'll need to keep an eye on your blood pressure, and any headaches that might crop up, and if you have any pain in your upper right quadrant, you need to call your doctor immediately."  

"Got it."

After discussing a few more items, they worked through my discharge paperwork and handed me two, enormous orange jugs for "collecting."  "Here - you pee in this hat and then pour it into thYou pee in a HAT?e jug."

"Excuse me?  Into a hat??" 

"Not an actual hat - this plastic thing.  It's called a hat."  The nurse tried to control the grin tugging at the corners of her mouth.  They must have thought I was completely unscrewed.

"Ah, okay.  I can do that."  

And off we went, toddling back to the parking garage and heading home to your dad.  Baby girl, we're almost there.  If you can hang tight and stay strong for a few more weeks, that would be the best for both of us.  It seems like we're not sure how soon you're coming these days, so it's up to you and I to try and hold out as long as we can, in good health.  Everyone at the hospital is keeping a very close eye on us, and we're under the best care possible, so it's up to you and me for a little bit.  We need to stay calm.  And hydrated.   And keep tabs on blood pressure.  And stay calm.  Did I mention calm?  Calm would be good.

I love you so, so much.  And when they tell me that "she looks beautiful" and "healthy" and "strong," I feel so proud of what you and I have done, and how far we have come.  Daddy and I will take the best care we can of you, and we're almost ready to have you as part of our family.   Almost.  You just need to stay put and keep growing for a few more weeks, so when you arrive, you are as strong as you can be. 

Be good.  (And if you see my pancreas, give it a kick, would you?  Maybe you can jump start that lazy thing.)

Love,
Mommy

Comments

I hope this is just a caution and nothing major. SIL's twin pregnancy hit this bump around the same time and remained borderline until 38 weeks.

(And about kickstarting that pancreas - found out my good friend's T1 sister didn't need any insulin for the year she nursed her second child - wow!)

I'll be sending "stay in there" thoughts for the baby all day. I also have "white coat syndrome" and have to mentally calm down every time I arrive at my doc's office.

Oh Kerri - she is almost here. I understand - you want her to stay put for a few more weeks, to grow more gorgeous I suppose. You will both be well. You are strong. You are courageous, you are already a great mommy, looking out for her. I am sending all positive, calming, blood-pressure-lowering and healthy stay-put thoughts your way.

Kerri:

Thoughts are with you! Good for you though that you advocated for yourself. Sometimes those situations can be so scary that it contributes to the issue. This is exactly what happened to me with both my first two pregnancies, but with my second, I was only 13 weeks pregnant, and they did whisk me away into a hospital room, with my 2 year old little girl in my lap, handing me an orange and a syringe at the same time. I made it through all those weeks of modified bed rest, and as long as I kept cool and calm, no protein in the pee pee! When I developed preeclampsia with the oldest, the one who's giving me all that trouble driving and not telling me where she's going!, she hung on until 37 weeks when my water broke, and she came through, with a 24 hour stay in the NICU, to be a healthy and feisty thing.

I know what you're going through, and as usual, you are handling it with grace and elegance, which is just a perfect testimony to how you and BSparl will come through this to be one momma-daughter duo!

Hang in there, girl, and hope your fam is bringing you lots of reading material and fluids!

hopefully the 24 urine will be ok and you will be able to keep baby cooking a few more weeks - but just in case they decide that baby needs to come sooner, just wanted to reassure you that my sister (also t1) had her first baby this past oct., and he ended up coming at about 33.5 wks. due to pre-eclampsia, and everything was fine - both mom and baby came home 3 or 4 days later.

Wow, you are already such a good Mommy. My husband also has white coat syndrome so I know how that feels. He will check his bp before we leave the house and it's always lots higher there. I am hoping that the baby stays safe and warm and in you "belly" for as long as she needs to grow.

Oh no - I too got the dreaded orange jug at my OB appointment yesterday. However, I am only 7 weeks along. I tried to refuse it, but the doc demanded to get a baseline picture of my kidney function for the duration of the pregnancy... But I didn't get a special hat!! I was told to use a dixie cup and aim well... ah the things we do for our children!

Mine was 170/110 when they decided to induce me at 36 weeks. My kiddo was fine, breathing on her own, and didn't even need to spend any time in the NICU.

But even if they decide that today's the day, or tomorrow, she'll be fine. They'll have plenty of time to give you that shot for her lungs. She may spend a couple days in the NICU, but she'll be fine, and so will you.

Breathe, and hang in there, and try not to hate bed rest too much (I hated bed rest - ugh). Make sure you have a good book or ten. Have you read the Outlander series by Diana Gabaldon? They're tomes - coming in at over 750 pages each - and there are 7 or 8 of them. Those will keep you busy (and off of Dr. Google!).

You are doing such a great job of taking care of yourself and your baby. You're already an amazing mother, and your adventure is just beginning. Trust yourself and your doctors. It's going to be ok.

Oh, boy, does this bring back preeclamptic memories... somewhere between weeks 36 and 37 and preggo with my first, doc is checking me over head to toe and all parts in between, got a boat-load of "Good, good, good, good" so I'm thinking, "Good!" Then he says get dressed and come in and see me. Apparently, "good" is doc speak for not good. "Your baby's coming today. Call your DH." Sean was delivered the next day after a 27 hour labor. :D

Kerri, I will pray that Bsparl hangs in for a few more weeks. Please, take it very easy. And from here on out, I'd be ready with packed bag and pump supplies (and reading material). Just in case.

Good luck, Kerri. As a type 1 who is just starting to plan for my first pregnancy, reading your thoughtful blog has been eye opening, and I appreciate your willingness to share your experiences with pregnancy. I'm wishing you all the very best, and hope that she stays put a little while longer!

All the best for keeping that little bun baking for a bit longer! Take care of yourself and um...good luck peeing in the orange jug!!

I'm sending tons of prayers your way. You and BSparl will be fine. Stay safe and listen to those doctors!
Oh, and by the way, my blood pressure always runs higher at the doctor's office.

I had the same thing happen to me at 35 weeks with my first daughter. After the 24 hour urine test, I did have a c-section. My daughter weighed 5 lbs 2 oz and was perfectly fine when she was born. Everything worked out fine for me so I have no doubts that everything will be fine for you and BSparl.

Kerri i am so amazed at your take charge attitude!! Bravo to you for not falling to pieces. You are so worthy of this healthy baby!

Ahh, the hat! I've seen those a lot, too! Loved the part about kicking the pancreas! :) We're all so excited for you and BSparl!

Keep baking, BSparl. Baking is good. Besides, you really don't want to come out now; wait a few more weeks. It will be warmer and there will be flowers.

Hang in there, Kerri. *hug*

I know how stressed you are, but she's going to be fine! I had the same thing happen and was just put on bed rest for the remaining 6 weeks. Good luck to you; I hope she isn't being evicted any time soon!

Maybe BSparl just wants you well-rested for all the precious wiggly trouble she's going to cause. Good luck and best wishes for clean pee and five more weeks as planned.

Oh, I remember those visits -- I had three of them with Kiedis, and I just did my 2nd 24 hr urine for Baby #2 a couple of weeks ago. I started with those admittances and crazy "he might be coming today" phone calls at 28 weeks, and God, the fear and confusion and shock and then more confusion at "Nope, nevermind, go home with your baby still inside" discharges.

Hang in. It'll all be okay and you'll have her home when she's good and ready and you'll be missing your bellybean something fierce when she's hungry at 3AM and all you can remember is what it felt like to have her kick you at that hour and not scream at you.

Just try to keep a positive outlook -- your body and your baby do know what they're doing and it's all going to be fine -- it's just the doctors and the science that make it scary. Trust yourself, and know that you can say no if it doesn't feel right. I wish I had.

BIG GIANT DIABETIC PREGGERS HUGS FROM OHIO! :)

Kerri-
Baby K and I are praying for you and Bsparl. Hopefully your pee will be an outstanding vintage and you and Bsparl will get to stay at home and watch all those movies you haven't gotten around to watching yet.

my oldest decided he was done baking at 36 weeks. other than needing to go to the tanning booth (bili lights) for a day at 3 days old, he was perfectly healthy; 10's on the apgars and all that. oh, until the damn D started up at age 9. but i'm blaming that on piss-poor genetics. his sister was born on her due date, and from my perspective, that last month was a bitch and completely unneeded.
sending good thoughts your way and knowing that bsparl will have a fantastic mommy & daddy watching out for her.

Good luck!

Hello Kerri. Glad everything was ok. My BP was perfect throughout my pregnancy.. except when I went into labor at 35 weeks, then it went sky high. They treated it during larbor and my son Lukas was fine at 5 lbs 11 oz. My whole expereince is another story but everything was ok. Best of luck!

Here's hoping that everything is good on the pee front.

I have been embarrassing doctors with my frank discussions about pee (and pain in my butt cheeks) lately, too :)

I got the hat when I did my baseline 24 hour urine early in my pregnancy and it took me back to the early days when we tested urine for sugar. I was five years old, and we collected my pee in a hat.

Even if you do end up delivering early, you should be in good shape. A friend of mine just delivered her baby at 29 weeks and mom and baby are doing very well.

Hang in there! Thinking good thoughts for you and BSparl. Everything will be okay.

Please be careful girl!! I had pre eclampsia with both of mine (I know I've said that here like a million times, it just makes me so nervous having been through it first hand!) and it's nothing to mess with. I was active in a PE support group during my second pregnancy with Zoe, and though of course I'm not a doctor, I feel like I know almost EVERYTHING about the condition!! I was obsessive about keeping it mild after PE almost took my life the first time around! Feel free to email with any questions!

Kerri - I will be sending good thoughts your way, I know everything will be fine for you and BSparl. Thank you so much for sharing your journey, it is so meaninful for our community!

OMG! I couldn't help but laugh about "the hat". I remember mine vividly. My mom held on to that thing after my diagnosis FOREVER just for me to check keytones with.

I just know you and baby will be okay. :-) Keep us up to date with the test results.

Kerri, My son came at 34 weeks because of the same reason he was 4 lbs and 8 oz. I too was spilling protein, so they induced me early...if she is 5 lbs it is better to let her come early than to continue to hurt your kidneys. I 5 years later am still spilling protein, it never went away but it reduced. So plan for early, I had to stay overnight to have steriod shots for my little guys lungs to develop better since they new he would be early. I too ended up with a c-section because I had an abruption. But you can do it!! You have done so well, if I were you I would let them take her a little early it is safer for you!! GOOD LUCK! And if you have questions let me know.
Heather type 1 for 23 years

Good luck to you and BSparl!!

I hope everything goes smoothly for the rest of your pregnancy, and that she can stay in there a little longer. You have a ton of people praying for the best for you and your baby. Try not to worry too much, and keep us updated!

Thinking of you Kerri! I know how you feel because I've been there too - not even a year ago! Sending positive thoughts/vibes/prayers your way!

My sister had pre-eclampsia and had an emergency c-section. Like the kind you see on tv - the bed rushing down the hallway so fast that it actually ran over a nurse's foot! She delivered 9 weeks early and the baby was 2 lbs 6 oz. She is now a very healthy, yet petite, 14 month old. At least BSparl is viable and healthy and I know she will do great. Stay in bed and do exactly as the doctors advise and you will be fine! Best of luck!

You are almost there, amiga. You will be fine and BSparl will be a gorgeous and healthy baby. Don't worry.

BIG HUG!

Hang in there Kerri! Keep cooking BSparl! Lotsa internet strangers and friends are pulling for and praying for you.

Kerri, I seriously admire your strength, determination, and sense of humor. BSparl is SUCH a lucky girl to have you for her Mommy!

Oh Kerri, I am praying for you and that sweet little baby!
FWIW, I did 2 things to keep my bp in check when I was expecting: (1) lie down (as often as possible!) on your LEFT side (that's when your bp is at its lowest), take deep breaths, and think about sipping a drink on the beach :) (2) try checking your bp in both arms. My bp seemed to run a bit higher in my left arm, so I always offered up my right arm to the nurses at every doctor visit. :)

Hi Kerri,

I am loving your blog! I just discovered it last week. It is so nice to hear about your pregnancy. It gives me a lot to be hopeful for in the future. Good luck with the next few weeks!

Amanda

You know, in 5-6 years you're going to be telling her to stay in her room all over again...but for different reasons! Hang in there ;-)

Both my girls came early. One at 35 wks and one at 36 wks. Both were fine but did do a tanning bed stint for 2 days each (due to Jaundice)They are now 13 and 10 and keeping me BUSY!! Prayers for health and safety, plus wisdom for all doctors involved, and calmness for Mommy and Daddy to be!!

Kerri - Thinking of you and BSparl, and hoping you can keep her cooking for at least a few more weeks! Hang in there! We're both almost to the end!

Good luck we are all rooting for you and the beautiful baby girl.

Kerri your journey through pregnancy has been incredibly inspirational and gives me such hope and excitement for my future. Sending lots of prayers and thoughts your way. You and Chris will have a beautiful daughter, whether she arrives slightly early or not. Keep up the great writing. You have no idea the kind of support you provide for other women with T1 who want to have kids.

Fingers and toes crossed that the little one and you safely see out these last few weeks.

It seems scary but 33.5 is 'old' by NICU standards ;) From a positive note, PE at this stage is oh so much better than if you'd developed it at say 23.5 weeks - your baby will be great. Have they mentioned steriod shots yet? That's the clincher.

My daughter arrived at 34+1 and was 6lb3. Had breathing assistance for 1 hour and then we took her home 12 days later - a combo of stabilising her sugars and feeding issues. I was petrified, but it all works out in the end.

LOL jump starting the pancreas - wouldn't that be the bestest thing ever?! All the best :)

Kerri, I had preeclampsia with my daughter and they had to induce labor at 36 weeks after I did a week of bed rest. She was perfectly healthy and we both did great. I wish you the best!

I am T1 - had my son @ 34 wks. - he is now 12 years old and perfect! Best of luck to you - hang in there!

Brendon was born 3 weeks early because I had preeclampsia. He was born healthy and everything was fine afterward.

Let me know if you want to talk. You know where to find me :)

Whew, Kerri. I'm sure that the calming situation of being sent to L&D out of the blue must have really helped your BP numbers. You are amazing. How can you write so well and be so funny after going through such a gnarly day?

Sending you and BSparl (and Chris..oh, and the cats...) the happiest and mellowest thoughts of peace, joy, and good health.

I will keep you, Chris and Bsparl in my prayers.

Sending positive vibes to you and BSparl!
Hang in there Chicklets!
Kelly K

Kerri - you have such an amazing attitude and are doing such a good job staying calm, even when the situation is uncertain. Best of luck with everything!

Kerri, I can only imagine how stressful this must be, but I know you and BSparl will be fine. Whether she's in the oven or out, I'm sure you girls will take care of each other. Hugs and soothing thoughts from me, Mer, and LT. :)

Keeping you and BSparl in my thoughts. Kerri-you keep resting and BSparl, keep cooking just a little longer now!

Oh my god! This is one of the funniest things ever - i love the last line about giving the pancreas a kick - thanks for the laugh today.
Best of luck, stay calm and stay healthy.

K - I'm thinking of you and baby.

Hang in there, lil one - let mama and you have just a little more time to keep you growing!

Also - it was good to see you the other day. You looked gorgeous! Although I can't wait to meet baby, I hope she holds out a bit longer!

xoxoxoxoxoxoxoxo - N

I am sure that everything will be fine. Kerri you are so insperational, informative for so many Diabetic Preg woman. I wish they had this type of connection, communication in my day. Relax.....

A similar episode happened to me right around the same time with my daughter. It was a little alarming, but my doctors were great. She ended up staying put for another 4 weeks. ;) Relax and enjoy the last little bit. Tell Siah to start serving you for a change. ;)

Thinking calm thoughts for you and your blood pressure. I'm so glad the doctors are taking such good care of you and BSparl. All the best for the bed rest and the test. I'm anxiously checking your blog and twitter to keep updated and judging by all the comments so are a lot of others. Hugs

You are an inspiration and a everything you write is like...is like you write my thoughts.
I am praying for u and your baby. I can't wait for the day BSparl comes out!Everything is going to be just fine!

Hey Kerri! You CAN do this! I don't know how closely you've followed my story, but (as mostly everything else) this sounds exactly like me... for the past 6 or 7 weeks. My bp is always high at the doc's (150/90), but better at home and I am doing HELLP Panels and 24 hours WEEKLY to monitor everything, and you know what? We are hanging in there, and you will, too!! Protien goes up each week, but my doc still feels okay about it and I figure they can poke me and take all the pee they want if it ends up letting baby girl stay in a bit longer. So, we've been doing this for the past two months are so, and slowly it's gotten us to where we are: full term (37w2d today) with baby girl scheduled to arrive on the 31st!! Rest, stay as calm as possible and I promise you will make it there, too!! If you have questions, please do not hesitate to let me know!! I'd be happy to compare notes if you think it would help!

Thinking of you and the baby girl. Thanks for sharing!

You and your family are in my thoughts and prayers. Hang in there, Kerri.

As much as I hate reading about this scary time, I LOVE reading all of the comments from those who have been there and have given birth to healthy perfect babies. And you and BSparl will be yet another happy ending!!

Take care, both of you. And seriously, let me know if you need anything at all. I'm not so very far away.

Kerry, you are in my thoughts and I'm praying for you and BSparl. I'm sure that everything will be fine. Hang in there!

You lucky, lucky gal. When I had to do my 24 hour collections, I didn't get a hat.

Unfun. Really unfun.

Lots of prayers for you and your baby girl!

That made me cry! i dont even know but your writing makes me feel like i have known you for years...thank you for talking to us.
Im keeping you in prayer (if thats ok with you)

much love sent your way..

i haven't had a chance to read your blog in a few days - getting caught up - i don't comment often, but i felt the need to today - i am so impressed with you in so many ways - i know things will work out for you - love your blog - love the way you write - love that you share your thoughts and actions with us - i'm not the pwd, my husband is... hang in there - you rock

Kerri,

I am just so happy for you guys!

Blessings always....

xoxoxoxo

Make sure they check for HELLP Syndrom. I developed it with my second preg.

damn you, kerri.


tears.

lots of them.

BSparl is one lucky little girl already.

Praying for you both,
love, amylia

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