Birth #1 Part 1

November is Prematurity Awareness Month. I planned on doing a blog entry for everyday of the month leading up to the 17th, which is Prematurity Awareness Day, but I haven't had it in me. This is a tough topic to discuss. Nearly four years have gone by and I'm still not over it.

December 9, 2006 5:26pm Maryam was born at the gestational age of 25 weeks and 2 days. She weighed 1 pound 10 ounces and was 13 inches long.

A little perspective on the photo above. The diaper that the nurses placed over Maryam is actually roughly the same size as a maxipad.

Maryam was born prematurely because I got preeclampsia with HELLP Syndrome.
Definition By Mayo Clinic staff
Preeclampsia is a condition of pregnancy marked by high blood pressure and excess protein in your urine after 20 weeks of pregnancy. Preeclampsia often causes only modest increases in blood pressure. Left untreated, however, preeclampsia can lead to serious — even fatal — complications for both you and your baby.
If you have preeclampsia, the only cure is delivery of your baby. If you're diagnosed with preeclampsia too early in your pregnancy for delivery to be an option, you and your doctor need to allow your baby more time to mature, without putting you or your baby at risk of serious complications.
HELLP syndrome which stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count — syndrome can rapidly become life-threatening for both you and your baby. Symptoms of HELLP syndrome include nausea and vomiting, headache, and upper right abdominal pain. HELLP syndrome is particularly dangerous because it can occur before signs or symptoms of preeclampsia appear.

The days leading up to December 9, 2006 (Part 1)
November 4, 2006 Brett and I went to Kaiser for my "Big" ultrasound. At this ultrasound the ultrasound images can help your doc evaluate your baby's growth and development and determine how your pregnancy is progressing. This is the day we found out we were having a little girl and decided on her name, Maryam Lee.
December 1, 2006 (Friday) I had lunch with my sister Sarah at The Macaroni Grill. I was SUPER swollen. We talked about my pregnancy, talked to the waitress about her new pregnancy and I guessed that Sarah was pregnant. She denied it, of course. We had a nice lunch. This would be the last time I ate at The Macaroni Grill.
After lunch I went back to my office where my good friend Jessica told me that my face was REALLY swollen, to which I replied, "Are you sure I'm not just fat?" Ignorance. The bridge of my nose was swollen into my cheeks. I took her advice and called L & D at Kaiser in San Diego. The RN that screened my call asked several questions, I answered all of them honestly and she determined that the mixture of my high sodium lunch, my gestation and the recent heat wave contributed to my swelling, suggested I go home, put my feet up and rest for the weekend. Well, I went home, I put my feet up, but I certainly didn't rest all weekend. Ignorance.
December 4, 2006 Brett left in the morning on a business trip to Las Vegas. I went to work like any other day. I was told that I looked puffy. I felt horrible. My swelling in my feet had now gone all the way up my legs. The swelling in my hands had now gone all the way up my arms. My face and neck were both swollen. I looked like a 250 pound version of myself. I couldn't type or hold a pen anymore. At 5 I went home for the night. I laid down in my bed and didn't get up again until the next morning.
That night Sarah and Scott called to tell me their wonderful news that Sarah was pregnant with my niece Charlie Mae! Yay! I was so happy for her that I didn't tell her that I was in excruciating pain in my chest and was having trouble breathing. I called my dad and asked him what I used to take when I'd get pleurisy as a kid. He told me I'd take Tylenol with Codeine. We both knew I couldn't take that pregnant. So, I just took regular Tylenol and went to sleep. Ignorance.
December 5, 2006 I went to work like any other day. When I got there I was told that I absolutely have to go to see the doctor. My co-workers insisted. The branch manager wanted someone to drive me, but I assured them I was fine! I called the appointment line for Kaiser to see if I could be seen that day. I was asked if it was pregnancy related and I said no, that I thought I had pneumonia or pleurisy because it hurt when I took a breath. I was scheduled up in Rancho Bernardo at 11:10 with the doctor who was about to save my life and Maryam's life.
I checked in at reception and waited to be called in. I was called in within minutes and that's where the blur starts. Everything happened fast, or so it seemed. Looking back I know it took more time than it seemed, but at the time, wow! I was seen by the nurse first, typical right? She checked my temp, weight, blood pressure....blood pressure...blood pressure...blood pressure. That's when I knew there was a problem. She said, "I'll be right back with the doctor." Seconds later, or so it seemed, the doctor was in the room with me taking my blood pressure manually. 220/180. He must have said it 4 or 5 times. He said that I need to go into the bathroom and pee in a cup, then come back and lay in this bed. In the meantime, he was going to call the hospital and talk to a specialist.
Again, what felt like seconds later, the doctor came in, told the nurse to call 911 and told me that I was going to the hospital because he and the specialist at the hospital were worried I was going to seize. My response? "I don't have a history of seizures, so I'm just going to go ahead and drive myself there." His response? "Lay down and wait for the ambulance, you're very sick." He left and told his nurse to not leave my side. I asked her if she thought I should call my husband and she said, "No, go ahead and wait until you get to the hospital, it may end up being nothing." Ignorance.
Again, what felt like seconds later, the ambulance was there and I was being carted off on a gurney. When I got into the ambulance the nice EMT was trying to get an IV in my super swollen body and just couldn't. He tried for what felt like forever and a million pokes. Eventually he gave up and we were on our way.
I can't remember if I called Sarah first or my mom first, but either way, the next thing I remember, I was in the hospital and Sarah was there. She says she backed out of the In-N-Out drive-thru to get to the hospital immediately. In fact, she was there waiting when my ambulance got there. I remember saying something like, "I think this is all a little over blown." and I think she said something like, "I think you're very wrong."
Triage. My Triage doc took my blood pressure again and it was the same. I remember some of the things he said to me. "We're going to give you a steroid shot to help the development of your baby's lungs. You're very sick. You're not leaving this hospital until your baby is born. You have what is called preeclampsia and the only cure is to deliver the baby." To which I said something like, "doc, I'm not staying in your hospital for 4 months, that's absurd." To which he said something like, "4 months? You're lucky if you get 4 days, right now our short term goal is 2 days for the steroid and our long term goal is 3 weeks." He walked out to get someone or something. I turned to Sarah and said, "I think that's just worst case scenario." She said, "You're wrong. You're very sick, he just told you. You need to call Brett now." Damn.
The rest of that night is a blur. At some point my mom got there, Brett's mom got there and Brett got there. I was surrounded by family. I was put on Magnesium to help stop me from seizing. I really can't tell you all the meds I was on. Again, its pretty blurry.

I'll write about days 2, 3 and 4 in my next post. This has been more emotionally taxing than I anticipated. If you have any questions please comment. I'll answer them!