I developed HELLP along with pre-ecclampsia during my first pregnancy in 1992. I was approximately 23-24 weeks when I was diagnosed and entered the hospital. I had never heard of either HELLP or pre-ecclampsia before that time.
In the days before I was diagnosed, I was exhausted, emotional, and stressed out. I remember the night before I went in the hospital, crying and wishing I could get put in the hospital so I could rest. I was extremely puffy and swollen, even in my face and hands. I felt headachey and just generally ill.
I was 20 years old and pregnant with my first child. I was in nursing school full time and driving to campus and back, a 40 minute one-way drive every day. I wasn't married at the time, and although my boyfriend was there, I was dealing with the stress related to being unmarried and pregnant, due to church things.
I was approximately 23 or 24 weeks, and went in for a regular appointment with my doctor. I knew I was extremely puffy and just generally felt unwell. The night before, after church, I had sat out in the car and cried from sheer exhaustion and wished that I could be admitted to the hospital so I could rest.
When I woke up the next morning, my swelling was just unbelievable. My face was so puffy. I wish I had known what a significant sign that was. I do now, but then I didn't. I had an appointment at my regular doctor that afternoon, but even if I'd gone straight there when I woke up that morning, it probably wouldn't have made any difference.
When I went to my appointment, I had all the markers. My blood pressure was high and my urine showed significant protein. They told me to go straight to the hospital, which was right across the street, because I needed to be admitted.
It was Monday night, Nov. 9. I was admitted to the hospital and they continued trying to treat and monitor me. I don't think they started any IVs when I first got there. I lay there in our small local hospital for a couple of days and soon had started having upper gastric pain. They kept asking me if it was gas. Finally, I guess my local doctors decided they didn't know what was going on with me, (or maybe they knew all along, but thought they could handle it) and they called a specialist in a larger teaching hospital about 100 miles away. The specialist said, in effect, "Put her on an ambulance and get her up here, NOW." They started an IV of magnesium sulfate and sent me from Ardmore to Oklahoma City in an ambulance, and that was the first time I ever got any IVs.
I don't know how high my blood pressure was at the time, but I'm thinking my bottom number was at least 100 or 115. I know that my mother, who rode up there with me in the front seat of the ambulance, claims hers was higher.
They admitted me to OU Children's Hospital, and continued treating and monitoring. They couldn't find any good veins for IVs because I was so terribly swollen. They were searching in the tops of my feet, if that gives any idea. Also they considered starting a line in my neck. I was incredibly thankful they didn't have to do that.
All this time, to the best of my knowledge and recollection, the baby was fine. She was not as big as she should have been, but I don't think they thought she had any other serious health problems. If they did, I don't remember them telling me. Unfortunately, the years and the illness erased a lot of the details.
They began doing all the tests, and I still had sky-high blood pressure, still had protein, still had upper gastric pain, and now they also knew I had HELLP. They did a scratch test to determine clotting time, and a scratch that should have clotted within a minute took 22. C-section was ruled out, and delivery was a must. They gave me medicines to start contractions, tried to start readying my body to do something it wasn't supposed to do for another 3-4 months.
At one point, they were trying to dilate my cervix using something I remember them calling "mechanical dilators" which they said would be painful so they gave me morphine or something. I remember waking up from my medicated haze, legs in the stirrups, lifting my head, and there at the foot of my bed was practically an entire medical school class, observing this procedure because I was at that time, an incredibly rare case. I just closed my eyes and dropped my head back to the pillow and tried not to care.
I wasn't making progress, and they decided they needed to rupture my membrane. They had put monitors on me and on the baby, and I didn't know at the time what they knew, that once I had my membrane ruptured, the cord, which was ahead of the baby, would probably become compressed as the fluid rushed out, and as she moved down toward the birth canal, and she would probably die. They came in and turned the volume down on the monitors, but I didn't know that was why until later.
They had asked me if I wanted to be enrolled in a study they were doing with the use of surfactant, a substance premature babies don't have yet in their lungs that makes them expand. I gave them permission to use the baby and give her this surfactant if she was born with any attempt at breathing.
My poor mother had finally left the hospital to go shower and rest, and they called her back because they were taking me to delivery. I couldn't push. I didn't know what I was doing, didn't know what it was supposed to feel like, and I was sick and exhausted and scared. The nurse helped push down on my stomach and all I remember was that my mom's surgical suit was white and the rest of them were blue, and her green eyes stood out. I thought she looked like an angel.
It was November 15, 1992. Finally they managed to pull the baby out, and I remember the doctor putting her face right in front of mine and saying, "Baby has no heart rate, no breathing effort." Ok, then.
They delivered the placenta, which I remember hurt worse than the baby. (Because it was actually bigger.) Katrina DeAnne was 11 inches long and weighed 13 ounces. She seemed to have suffered some significant trauma during birth because her head was misshapen and squishy. I think they told me she had some water on the brain or something.
They fixed me up and wheeled me back to my room, and here I was, holding this oddly colored, deceased baby. I felt embarrassed. I felt that people were looking at her and seeing her as scary or disturbing. I didn't hold her as long as I later wished I had, because I thought people would think it was weird to spend time holding a dead baby. I wish now I'd been a little more sensible about that.
I stayed in the hospital a few more days, and I don't remember any of my numbers- my blood pressure or my platelets or how fast they returned to normal. I just had to go on with my life. I had to quit nursing school because they won't let you make up clinicals and I had missed some. I finished the semester of my regular non-nursing school class and life went on.
I have since been pregnant twice. The next time was with twins, who were born healthy and perfect a year and two weeks to the day after I lost Katie. Their baby brother was born in May of 2001, and he too was healthy and I had no serious problems with either pregnancy. But my experience with Katie will always be in my mind.