Saturday, June 2, 2012

Survivor Saturday: Sima's Story

I had the privilege of running 14 miles in honor of Sima and her children this morning. This story takes us from the tragedy of losing a child to the triumph of a successful second pregnancy. It also highlights a woman taking charge of her health and actively improving her risk status.

Sima's Story

I just wanted to share my story to give hope to those who've lost a child to PE and are on their 2nd pregnancies. I lost my son seven years ago due to severe PE. He was born sleeping at just 500g (Severe IUGR) at 23weeks! My protein level if I remember correctly was 3++ and my BP was reading 190/95 or so. Having no knowledge of this condition, we were completely shocked and heart broken, the most traumatic incident to have happened to me and my husband.

After that we were so put off that we decided not to get pregnant for a while. I was on BP meds for at least a month after the delivery. The initial diagnosis was that I was obese and should lose the excess weight before going for a 2nd pregnancy. We decided then that we would just enjoy life and forget about having children for a while.

After a couple of years (still obese) one day I experienced severe headache. I went to my doctor, and she found that my BP was elevated 150/90, gave me some meds to get it down, and asked me to go home and rest. In the middle of the night I found my heart to be beating extremely fast. My husband and I decided to go in, and I was admitted. They performed an ECG / blood tests / 24 hr urine tests and found absolutely nothing. I was kept in for observation for a couple of days and was then told, as I was still young in my early 30's, that meds were not the right way to go, and that I must lose weight. I was then referred to a dietitian.

At the same time, I was asked to go in for an ultrasound of the kidneys just for reference. This is when we found out the 2nd shocking news that one of my kidneys was extremely small in size. No one could say if it was congenital or if it happened over a period of time. In any case, I was told by the doctor to definitely consider losing weight.

I lost around 18 kgs in a span of a year or so with lots of exercise and just a good diet. After that, we found that my BP levels had become normal. I was advised to have the small kidney removed if I could, as it was only functioning at 2% capacity. I had a laparoscopy to have that kidney removed.

We then consulted with the MFM to check to see whether we could try to get pregnant and were advised that all should be OK, and that I would be on LDA (low-dose aspirin) from as soon as the pregnancy is confirmed up to 34 weeks. I was advised conceiving with a single kidney was not a problem, either. While trying to get pregnant, I maintained a healthy diet and also worked out regularly.

And finally last year I became pregnant once again. I was very closely monitored by a good MFM throughout my pregnancy i.e. regular ultrasounds / doppler scans etc. There were no signs of any protein throughout the pregnancy, my BP level remained pretty steady i.e. within acceptable levels up until 24 weeks. Thereafter there was a slight increase, however more so due to anxiety and in some cases perhaps what is described as "white coat hypertension". The BP machine would beep whenever I was at the doctor's but absolutely fine when at home. I was asked to closely monitor my BP at home as well.

The anxiety levels were so high that my doctor asked me to find a means to relax and just think positive, as the pregnancy was going very smoothly. I did have quite a few braxton hicks plus a lot of acidity. I was also experiencing severe shoulder / arm aches on both sides during nights, which did cause a lot of nervousness, but after doctor's assurances that there was no way it would be what they call an epigastric pain, we relaxed a bit. Anything little that happened triggered us off, as the first time PE struck, it was very sudden with extremely high BP and proteinuria. I also had repeated UTI's but was told it was normal. The 1st time around the water retention in my feet was severe, this time around I was amazed to see that I could fit into my normal shoes. 

I was asked to get myself admitted immediately if my home BP readings were anything higher than 140/90 and also if I experienced blurred vision or extreme water retention. During my pregnancy I was also doing yoga, though only up until week 16 as that's when my braxton hicks became quite painful so I was asked to stop. My pregnancy as per the doctors was basically pretty much uneventful (phewwww).

I was asked to come into the hospital on the first sign of labor pains. Come week 40 I was still hanging around waiting for the contractions. Since I was considered high risk, the doctors admitted me when I was 40 weeks 2 days. I was still not yet dilated and my cervix didn't seem ready at all even for an induction, so I opted for a C-section. I gave birth to a healthy baby girl at 40 weeks 4 days.

Words cannot describe our happiness! All the anxiety / nervousness etc. was worth it, as in the end we were blessed with a little bundle of joy. Though we waited over 6 years to conceive, it was well worth it. I believe my lifestyle change i.e. diet / exercise & weight loss also played a big part, though I firmly believe that obesity was NOT the cause of PE. In my case it was probably renal related as I had one small, improperly functioning kidney which was also the cause of repeated UTI's.

There is hope, ladies. We are now considering another baby, but the doctor thinks it's perhaps too risky as my bp levels after pregnancy have been slightly elevated, but then again only at the doctors. At home it's always fine. I have been asked to start taking hypertensives, but I think the better option would be to exercise and get back into shape as I did the last time, as it did help with my BP.

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