We were supposed to be sweating buckets in Indianapolis today.
We are not.
On Tuesday, we packed up A and headed to an ultrasound appointment to check on Tiny’s size. This was the first of the additional monitoring L would be getting due to the gestational hypertension diagnosis. At the US, I wrangled Ansel while the very sweet tech did her job, measuring Tiny’s head, his belly, his femurs – over and over again. She left once and came back, asking to get a few more pictures – just in case. She left and came back again and told us the radiologist was calling L’s OB because Tiny was . . .well, tiny. In the 7th percentile, to be more specific. The radiologist spoke to L’s OB, who asked her to go over to the OB office (located in the same hospital complex) so we gathered the family and traipsed on over.
Once there, a nurse set L up with a non-stress test and I took Ansel to get some sandwiches, since we were now definitely past lunch time and edging into nap time. We brought L back some food just as she was being released from the NST. We waited another 15 minutes for the on-call doctor to see L. Once called back, the nurse took her BP. It was high. Scary high. (I can’t recall exactly, but in the 170 over 107 type of range) We asked the nurse to use the bigger cuff, but she said that the one she used “technically fit” and then left to get the doctor. The OB came in, took L’s BP again (this time with the bigger cuff) and got a slightly lower reading, although still in the scary high range.
Super high BP + tiny Tiny = L being sent to L&D triage and the doctor telling us in no uncertain terms we would not be flying across the country the next day. The doctor also said it was very likely that they would admit L for overnight observation and a 24 hour urine collection. This is, in fact, what ended up happening. I took A home to nap, then we returned in the evening with a bag full of clothes, cell phone charger and laptop for L. She dutifully peed in a container and got her blood pressure taken every two hours.
ALL of those BP readings were normal. Not even “high normal” they were like normal-normal. So, we were feeling pretty good. The OB in the antepartum unit, where L was admitted, also told us that Tiny’s abdomen and head size were small, but not crazy small (20-30th percentiles) it was his femur size that was skewing things. Apparently, when this is the case (average head and belly, short femur) it usually just means a “short baby” – not dwarfism short, just . . .short. However, since he was in the 40th percentile all around at the 20 week ultrasound, and because of L’s high BP readings at various points, they were going to need to watch his growth pretty carefully.
When she got released yesterday evening, we were feeling pretty ok about things. Normal BP readings, a reasonable explanation for Tiny’s tininess (sidenote: we nicknamed him Tiny and he ended up small; we nicknamed Ansel “Seafoam” and he ended up a pisces instead of an aries – maybe we have magic powers?!) Being in the hospital overnight isn’t pleasant, missing our trip to see family wasn’t awesome, but it seemed like things were ok.
This morning, L got a message from her doctor: the 24 hour urine collection showed small, but measureable, amounts of protein. Protein in the urine + high BP readings = pre-eclampsia diagnosis.
Pre-eclampsia is way more scary than pregnancy induced hypertension. It is especially scary at 29w5d. The only way to deal with pre-eclampsia, once it becomes serious (and it almost always escalates sooner or later) is to deliver a baby. There is a very real chance that Tiny will be coming before even the 37 week date we’ve been planning on. Maybe very soon. Maybe very early.
L will be having twice weekly NSTs, once weekly utrasounds, and weekly OB visits. We are also attempting to transfer care to Tacoma since we are moving in a couple of weeks, which also feels hard and complicated, especially in this scenario when things are not quite as simple as moving every other week appointments from one doctor to another.
I think we are both scared, but know the best we can do is just keep showing up for each other and the kid, do the next right thing, trust the doctors and medical care staff, keep our eye out for the signs of escalating pre-eclampsia (I guess it’s good that I had it so we know what we’re looking for? I’ve never felt lucky for having pre-E before, but I certainly feel lucky that I didn’t get it until 36 weeks) and pray that Tiny keeps growing and stays put for a while longer.
If you’re the praying type, we’ll take it. Or woo, or thoughts and prayers, or candles. Whatever you do, could you do it for us now too?