HELLP. Me.

My slippered feet slowly shuffled across the carpet. The pencil in my right hand rapidly beat a tiny invisible drum in the air. Sunlight streamed in the window, and I waddled over to adjust the Venetian blinds. A pocket of cool morning air found my face, and I was grateful for it; my body seemed to be running too warm.

Bright yellow lamp.

Glancing at my desk, I was comforted by some familiar objects: the Russian nesting dolls, the inspirational quotes flip calendar, the mug given to me by my third grade teacher Mrs. Rosenberg. Also adorning the desk was a pile of 120 composition books awaiting my perusal. Reading logs were not my favorite thing to grade.

Cold white ceiling.

Back in the center of the room, I tucked the pencil behind my ear. My fingers resembled breakfast sausages. The day before, they were fine, and my rings fit. This day was a different story and it concerned me. I would have made myself a cup of chamomile and put my slippered feet up to relax, but there was just one problem. I was in my classroom and there were 33 tenth graders waiting for me to begin the lesson.

Slippery metal table.

Usually confident at this time of day, in this location, with all eyes on me, I felt some trepidation. The observant ones in the room would notice the Dearfoams on my feet and wonder if being pregnant made me forget to put on shoes. The class clowns might joke that I couldn’t reach my feet to put shoes on! The always-polite ones would do their best to not look at my feet. And in my slippers, I had to face a full day of fledglings and attend an after school faculty meeting.

https://www.pexels.com/photo/pregnant-woman-wearing-marled-gray-sweater-touching-her-stomach-54289/

Flimsy cotton gown.

I wasn’t one to call the Ob-Gyn with every concern or symptom. The sudden swelling of my hands and feet did prompt a call to my mom though. None of my shoes fit when just 20 hours earlier, they did. Our conversation comforted me, and her advice to take off my rings and leave them off until the baby was born was sound. That afternoon I bought myself some wider shoes and took the swelling in stride. After all, I knew friends who swelled up during pregnancy. And I was healthy. I ate well and exercised. I kept regular prenatal visits. I felt that I’d know if there was a problem.

Nasty IV needle.

Weeks later, as Easter Sunday approached, my belly burst forth with new growth. The weather was warm and my body was hot (not that kind of hot; hot like sauna hot). My feet were large, my hands were large, my face looked large. The longer I stood up, the more labored my breathing became. I did express these concerns to the Ob-Gyn, as I was due in June and it was April. They checked a few things and told me I was fine. When I began having pain in my side, I expressed concern again. They checked a few things again, and they told me I was fine. It’s your baby’s elbow in your side, that’s all. Not sure how they knew that, but I trusted them.

Smelly hospital soap.

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Post-Easter, my weight drastically shot up. It wasn’t due to Cadbury eggs. My blood pressure skyrocketed. I received an orange jug and a sheet of instructions on collecting urine. I dutifully peed in the collection cup and stored the jug in the fridge for two days. They checked what they checked and declared me fine. A small amount of protein in the urine, but nothing to worry about. I wasn’t feeling fine. An eerie sense of foreboding grabbed hold of me, and I felt the need to get those reading logs graded sooner rather than later. If these symptoms were indicative of an early birth, then I had to be ready. The nursery wasn’t done, and I hadn’t prepared my dog (my first baby) in the way I wanted to (which involved using a baby doll and a tape of a crying infant). I tried to stay positive but my gut told me something was wrong. I found myself taking more frequent deep breaths and still felt like I couldn’t get quite enough air. That’s normal they said. There’s a baby taking up space around your diaphragm. I continued to trust.

Freezing cold feet.

Britney Spears was belting out “Oops, I Did It Again” on SNL when my abdomen tightened like a vice and back pain set in. Convinced I was in labor, we dashed to the hospital. The dog didn’t understand the late night departure, and it made me nervous to leave him home. But guess what? They checked me and declared me fine. It wasn’t labor. Maybe something I ate. Or the fact that I was watching Britney Spears, joked the nurse. They never said Braxton Hicks. I was sent home.

White surgical mask.

A day went by, and a craving for Udon noodles crept up on me. As quickly as they were eaten, that’s how quickly they came back up. Then came the nausea with a worsening pain in my right side. Unable to keep anything down and with an intuitive sense that the pain was not the baby’s elbow, we drove to the hospital again. They checked me and declared me sick. Some kind of virus, they said. Perhaps the flu. You are dehydrated, they said. The remedy? Two hours of an IV drip and a blanket. Go home, they said. Get some rest and no working. Damn. The reading logs were not done. But at least I could sit on my couch and grade them.

Count backwards from 100.

With fluids and rest, my body felt better. My husband and my golden retriever took care of me, both offering kisses. I figured I needed to arrange a substitute at least for a few days. I coordinated lesson plans and felt badly that I would be missing some presentations in my Shakespeare class. When Monday morning rolled around, my brain told my body to get up for work. I opened my eyes and felt horrible. My right side felt like someone planted a pitchfork there, and the nausea was unbearable. I vomited and crawled back to bed after looking at my bloated pale face in the bathroom mirror. My husband checked on me and said he’d stay home from work…I urged him to go. Sounding like the Ob-Gyns, I told him I was fine, just dealing with a virus, and I’d be okay. Little did I know.

Trembling all over.

Unbelievably weak, I dragged myself across the carpet to the bathroom to vomit again. I could barely hold my head up. My body felt heavy and limp; every move I made was strained, slow, and sickly. I gathered my sticky hair into a ponytail and threw up. Bile. There was bile in the toilet bowl. Pain in the right side. My pulse swooshing in my ears. This was getting downright scary.

Struggling to breathe.

My husband ignored my go to work I’ll be okay comment. He helped me dress in pink sweats and wide sneakers. Leaning on him for support, we poured my poor body into the Volvo and returned to the hospital. They have to help me, I thought. They have to help both of us.

Tubes everywhere.

I swear I detected a look of back so soon?? on their faces. My face must have told them something was very wrong; I was taken by wheelchair to a private room. No less than 12 hours of hell followed. Prodded, poked, punctured, probed. IV lines wouldn’t go in. Blood tests wouldn’t show much. Pitocin wouldn’t bring on contractions. I didn’t know it at the time, but my body was failing. I was dying and no one knew why.

Call loved ones.

I read so many books about pregnancy. I took excellent care of myself. I didn’t drink. I never smoked in my life. I kept journals. I went to every medical appointment. I was aware of the common problems that could happen in pregnancy. This wasn’t fair! Something was wrong and no one knew what and we had no answers. For weeks I was swelling. I had some protein in the urine. Some shortness of breath. Elevated blood pressure. Pain in the right side of my rib cage. Nausea. Vomiting. Back pain. Pallor. Why didn’t anyone see it? Why didn’t they test for it? It couldn’t have been hard to see preeclampsia set in. It affects 2-8% of all pregnancies globally; the condition is estimated to account for 10-15% of maternal deaths worldwide. If allowed to progress without treatment, then eclampsia could lead to convulsions. My body skipped over that part (fortunately?) and did a swan dive right into HELLP syndrome. The person who decided to use the next blood draw at 9 o’clock at night to check platelets and liver enzymes finally made the right call.

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Please call my mom.

more blood needed more testing liver enzymes blood pressure rising catheter yes we have to do that now no we cannot wait yes it will hurt sorry we need to prep you for surgery yes a c-section have to get the baby out it’s in distress we don’t know hi mommy something’s wrong here’s the nurse why is this happening what is help syndrome what does that mean the pain is my liver this whole time that was happening why didn’t anyone know just breathe general anesthesia is that okay for the baby will i be okay i have to throw up the room is spinning where are we going do i have to go now can’t we do something to keep the baby inside shattering blood cells levels like an AIDS patient what are you talking about can i have a hamburger how long will this take will my doctor be here why not who is the doctor we don’t know him a pediatrician no we don’t have one a neonatal specialist why do we need that where is my husband can he come with me i can’t stop shaking will i

Breathe deeply now.

Ninety nine. Ninety eight. Nine ee sev. Ni

Keri. Kehhhhhriiiii. Come on. Open your eyes Keri. Wiggle those toes for me.

My head felt disconnected from my body. I had no sense if the baby was still in my womb or if he had been taken out. There was a numbness to everything.

It’s a boy.

Are all his fingers and toes there? That’s the first thing I remember saying. Strange. And for some reason, I still wanted a hamburger. My husband’s face appeared over my head like a helicopter hovering. He was speaking but it seemed to me that his words did not match his lips. He might have stepped out of a badly-dubbed foreign film for all I knew. And where was my baby…I couldn’t muster the strength to ask.

Yes, his hands and feet are fine.

Watching the ceiling tiles rhythmically roll by as I was wheeled to a room, I was regaining the sense that my body was one unit from head to toe. One messed-up, very sick unit. I heard the nurses talking about my kidney function and how they would keep checking the urine output. As weak as I was, I knew that concerns about kidney function were serious. The bed was bolstered on all sides by pillows which I thought were for my comfort. Wrong. I later learned that the pillows were protecting my body from bumping the metal bars which could have caused internal bleeding. There were not enough platelets in my blood to assist in clotting. The lights were kept low and the curtains closed, which I thought was for inducing restful sleep. Wrong again. They were trying to keep my blood pressure down and reduce the risk of seizures. I was having trouble seeing straight; I saw “multiple faces” on people’s heads. A pastoral watercolor painting on the wall looked like blueprints to me. And in another peaceful picture, I saw black bats. I was hallucinating; probably a side effect of the mag sulfate drip to keep me from seizing.

Where is my baby.

The severity of my illness was so high that I was under constant watch, and I could not hold my baby boy by myself for days. Someone would bring Zach in and sort of cradle him up against me or try to get him to suckle. I wasn’t producing any milk though. No milk, no urine, no platelets, no tears. No tears that is until the night I felt my soul separating from my body.

I am dying.

No one had really told me what was wrong, what HELLP syndrome was, or how close to death I came. They didn’t want to worry me. Looking back, I guess that’s a good thing, but the learning I did later on about the condition gave me an eternal case of shivers. There’s mild preeclampsia, where a pregnant woman may have mildly elevated blood pressure and mild edema. There might be protein in the urine. There’s severe preeclampsia, where the woman has elevated blood pressure, extreme edema, nausea, vomiting, and pain on the right upper quadrant of her abdomen. (Sound familiar? Remember, I was declared fine). Eclampsia is all of those symptoms plus the possibility and/or presence of convulsions and coma. And at the top of the ladder comes HELLP syndrome, where all of those symptoms wreak havoc and can lead to organ failure and potentially death. These are all hypertensive disorders of pregnancy with HELLP being the most serious. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. It was discovered and named by Dr. Louis Weinstein in 1982. Symptoms are mistaken for gastritis, flu, and even gall bladder disease in the absence of specific testing. HELLP is now classified into three categories: Class I – severe thrombocytopenia, platelets under 50,000/mm3; Class II – moderate thrombocytopenia, platelets between 50,000 and 100,000/mm3; Class III – mild thrombocytopenia, platelets between 100,000 and 150,000/mm3.  Normal platelet count ranges from 150,000 to 450,000/mm3. Where was I?  Below 40,000. With HELLP, the maternal mortality rate is 1-24%. Infant mortality can range from 10-60% depending on several factors including promptness of treatment. To improve prognosis, an early detection and aggressive treatment by obstetricians with expertise in hypertensive disorders are required. Zach and I had exceedingly late detection with only one option as treatment: C-section and magnesium sulfate. On top of that, expertise in handling HELLP syndrome was nowhere near. If they didn’t operate, we’d die. If they did operate, I might bleed out. If they saved the baby, there was a chance he wouldn’t survive.

Six inch slice.

One cannot tell what time it is inside a hospital, and being in intensive care warps the way time moves anyway. It was dark outside, and my husband was asleep on the makeshift bed of chairs. I was in and out of sleep for days as the nurses waited for urine to appear in the receptacle. I wanted to take Zach home and nurture him properly and enjoy those newborn moments that everyone said were so incredibly precious. I didn’t get to experience childbirth in the way I anticipated, and I wasn’t getting to experience my newborn in the way I wanted to either. I had IVs in both arms and a catheter. I hadn’t eaten much due to nausea and an inability to go to the bathroom. I was given a sponge bath but felt disgusting. My hair was plastered to my head in a grisly ponytail that I had for over a week. And as I laid there in the darkness, still bolstered by a dozen pillows, I felt what I can only describe as a splitting of my being. There was a hollowness in my core that gathered into itself into a fullness and shifted and flitted its invisible borders beyond my bones. I had a sensation of coming undone but remaining whole. I wanted to be still and I wanted to move but could not do either. I called out to my husband and said something is happening to me.

My voice felt like ghost breath. My hands looked and felt much farther away than they were. And I lingered there like that, suspended like tender curls of fog on a moonless night, for seconds…minutes…an hour…I don’t know. A voice said you’re here, you’re not going to die. Someone came in with a calm but concerned face and stood above me, taking my pulse. No one really spoke. If there was commotion, I sensed nothing.

The next thing I can recall is seeing a thin band of morning light coming through the curtains. I wanted those curtains wide open. I had enough of darkness. Green grass and sunshine were a tonic to my soul. Later that day, a nurse announced Urine! We have urine! And I saw the tension in my mom’s face subside. But I was still too weak to high five.

You can go home soon.

©KeriMeHome

Holding my baby in my arms and being able to see him clearly was amazing. The nurses didn’t hover with bated breath. The IV needles came out along with the dreadful catheter. I was over the crisis but not past the pain. The Caesarian left me with stitches that felt like I was being nail-gunned with any turn, sneeze, cough, or laugh. My left leg was uncooperatively dragging. My skin was the color of expired tofu. And I felt sad. Just plain, soul-draining sad.

PTSD

Music to my ears was the announcement that I was being released. We could all go home, Zach included. I was too ill to tend to him while in the hospital (and honestly, once we got home, too). I relied on my husband and my mom and the nurses to care for him…his tiny, fragile five pound jaundiced body that had experienced its own trauma. I felt as if I failed him. His entrance into the world was a frightening crisis. Having read the lines in my Shakespeare class, he was “…from his mother’s womb/Untimely ripped.” There was no breast milk for him. No tears of joy delicately cleansing his peach-fuzzed head after coming through the birth canal. No lovely photos of the moments after birth where a joyful but tired family cradles a new and pure soul in blankets of white. Rather, there were scalpels and gloved hands and panicked people. There were monitors and medications and moments of terror. He spent more time in the NICU incubator than in my arms, warmed by artificial lights rather than by mother’s skin.

We survived.

©KeriMeHome A grandmother’s love

I barely walked for six weeks. Zach barely slept. He cried. I cried. We were nurtured back to health by my mom who moved in for a while. Her breakfast plates of scrambled eggs, fresh berries, Brie cheese, sourdough toast, pancakes made from scratch, and orange juice nourished me. Her care and constant presence from morning to night reassured me. Her New York style hugs and kisses (she was gentle not to press the stitches!) helped me regain life force. I was unable to return to work to bid a glorious summer to my students. Unable to see my seniors graduate. Unable to clean out my classroom. Heck, I was not able to go to the mailbox and retrieve mail! Those reading logs…well, they grew legs and walked away.

About six months later, my body still trying to heal, I turned on the TV and a soap opera was on. An actor portraying a doctor was telling a glamorous woman in a waiting room that “it didn’t look good.” The instrumental music heightened the suspense. “It’s HELLP syndrome. We may lose her.” I practically dropped the remote. In a flash it all came rushing back in flickering silent-film-like segments. Half a year had gone by rapidly, and I was immersed in life with an infant. I hadn’t had time to face what happened, emotionally and spiritually. I hadn’t the energy to delve into research. I began to do so shortly after that soap opera scene. Quite honestly, the healing of my body, mind, and soul continues today, with my baby boy now a teenager. The same Ob-Gyn doctors I saw while pregnant were of no help to me after HELLP “resolved.” They told me it was “over” and to “get on with my life.” I asked for reasons, I asked for articles, I asked for information on long-term health effects. I got half smiles and pats on the shoulder. It’s been shocking to find little support and scant research on the subject. About 5 to 8% of pregnant women develop preeclampsia, and about 15% of those women go on to have HELLP syndrome.  The perinatal mortality rate associated with HELLP is 51 out of 1000 pregnancies.

Were Zach and I lucky? Yes. And no. I often wonder how things would have been different if, upon hearing of the swelling, shortness of breath, and pain in my side, a doctor hadn’t dismissed me. If ER nurses hadn’t thought of me as fine. If anyone at the Ob-Gyn office had thought, back in April, this isn’t normal. If someone who examined me prior to 9 PM that night, when my platelets were shattering, had said this is eclampsia. I’ve been left with a firm sense of disenchantment in regard to mainstream health care. Equally balanced with that is a keen awareness of the fragility of life. Every year when we celebrate Zach’s birthday, I do feel joy combined with sadness. It’s as if bubbles float by carrying specks of grief on their surface. They surround me. But if sunlight catches those bubbles, you can see a beautiful array of colors forming shimmering rainbows in those perfect, magical orbs.