Notes on a hospitalized pregnant woman Pt. 20

Dr. Lukenaar comes in every morning to check on me. Most of the time everything is looking good and we end up chatting for a few minutes about politics, the bureaucracies of the hospital administration or the conservatives of Utah.

Today, again everything looks good- NSTs are good, the ultrasound this morning was good, blood work is good. She even wonders if maybe Jackson could have held on to me a little longer. Was I really that close to my deathbed? A helicopter for some high blood pressures. Seriously! Was it necessary?? But then I think about it- the move and my parents and Charley- and the mix would have given me a stroke. 

Rixt (Dr. Lukenaar) is half The Dude and half Dr. Ross from ER, with a dash of witch goddess. I wish I had more to talk to her about concerning my health, but we’ve talked about all of it and I’m not plummeting into a delivery room or my deathbed yet. We just have to wait and see what happens. Always waiting. The preeclampsia, the pressures, the size of my cervix, these are all just doing okay, but that’s with monitoring and rest. So all I can do is keep doing what I’m doing.

Meanwhile my legs are getting weaker from being in bed all the time. My day centers around NSTs and three meals a day which I choose every morning from a paper menu. Today I choose street tacos for lunch and spaghetti for dinner.

My gums are swollen on the right side of my mouth and it’s just popped up overnight. I have this swelling and flushing. These headaches and this hemerrhoid. I’m healthy but I’m falling apart.

I call mom but she’s busy getting groceries again. I swear she spends 90% of her time getting groceries. She’s visiting Nana in Tennessee and right now she’s with her sister in Kroger. I imagine their conversation:

When is Claudia going to learn to take care of herself,” Aunt Starr says (with southern accent).

“I don’t know, her husband Charley’s a drunk!” mom replies (with feigned southern accent that returns every time she returns to Tennessee).

“I just can’t believe everything you do for them! Moving all her stuff. You shouldn’t do it. They need to take car of themselves and leave you alone,” Starr says. (Okay, so when you’re saying this in your head you have to use a really thick southern accent, but it’s very dynamic and bubbly because Starr is very pretty, very social, and a successful real estate agent. Mom is a little less “cool” because she was the older, more self-conscious sister, the serious nurse who joined the Air Force with bleach blonde hair and reminded doctors of “Hot Lips” from MASH, and then later gained a lot of weight. She’s a little more, I don’t know, neurotic?)

“I swear she’s sending her dad to his grave,” mom welps. “Always with some new emergency.”

“Well she needs to grow up. Both of them do. That man she married is a little boy, Charley!” (So growing up my mom, whose middle name is Charlene, was also called Charley).

“He’s handsome,” (they laugh), “but he’s a mess!”

“You should just cut her off. I can’t believe she’s having this baby.”

“I know.” (They shake their heads and go to some all-you-can-eat buffet with fried okra and cheesy mac.)

Well I can’t do much about family gossip  or the fact that half of my family is likely voting for an orange monkey named Trump. I also can’t work right now seeing that I’m stuck in a hospital. All I can really do is continue to stay calm and stay pregnant, right? And watch shows.

I got a mini laptop to write and watch Netflix, and after being reminded by the ultrasound technician the Lady Sybil in Downton Abbey had died from preeclampsia, (or eclampsia), of course I have to watch the related episodes and read up about it.

I find an article from the Washington Post: “Lady Sybil died of Eclampsia, a condition of unknown cause that used to be called “toxemia of pregnancy.” It is most common in the late stage of first pregnancies. Sybil Branson, 24, was nearing the due date for her first child.

Eclampsia, strictly speaking, isn’t present until the woman has a seizure (so I don’t have eclampsia). By that time, the patient, the doctors (and the baby, if not yet born) are in deep trouble. The job is to diagnose what’s happening before then, when the condition is known as “preeclampsia.”

Sybil’s death occurred about the same time of year that I’m stuck in a hospital waddling through halls, (August, September 1920). 

1920- this is the same year in history that the League of Nations was established, a terrorist bomb hit Wall Street from a horse-drawn cart, women gained the right to vote in America, and the KKK regained its power with new leadership. In England, where the fictional Sybil lived and died, WWI is declared over Austria and the first women are admitted to study for full degrees at Oxford University.

Sybil is a fictionalized version of an illness that affected many women of all demographic backgrounds. In 1920, for example, statistics suggested 1,200 of 6,000 maternal deaths each year were caused by eclampsia. Like doctors will tell you today, the only “cure” for preeclampsia and eclampsia was delivery.
Morphine and chloral hydrate were administered to keep patients sedated and to decrease frequency of convulsions. Magnesium sulfate was introduced. 

Women were just starting to go to hospital for their labors, but many stayed at home with midwives or family doctors. For Lady Sybil, her fate rested upon the decisions of her father and their male family doctor.

Today, preeclampsia affects as many as 8 percent, (about 300,000), pregnant or postpartum women in the U.S. every year. 75,000 experience serious outcomes such as organ failure or even death. Well fuck. Luckily my organs are on point and my placental fluid is on point and my urine is a little high in protein but nothing insane yet.

“It’s a very serious complication of pregnancy that puts both the mother’s life and the baby’s life at risk,” says Eleni Tsigas, executive director of the Preeclampsia Foundation. 

Very young mothers or older mothers (i.e., mothers under 18 and over 35) are at higher risk for preeclampsia, says Tsigas, as are women who are obese, diabetic, carrying more than one fetus, or suffering from preexisting hypertension or autoimmune disorders. But the condition also strikes women who don’t fit into any of the risk categories. 

“I can give you a litany of risk factors but the fact is even if you don’t have any risk factors, you’re still at risk,” she says.

I personally don’t fit into these categories. I’ve always had normal blood pressures, normal weight, and health. And I’m 33, so not yet an old bag.

While my symptoms aren’t entirely like Lady Sybil’s, (my thinking isn’t “muddled” more than any other pregnant woman’s), I do have regular headaches and increased exhaustion. The skyrocketing blood pressures are being suppressed by alternating medicines every four hours.

Lady Sybil was every Downton Abbey fans’ favorite daughter- the only daughter who wasn’t annoying to be honest. But preeclampsia doesn’t pick favorites I guess. I’m not sure what would have changed for Sybil today. Probably everything? She would have been given priority over the baby, but with modern medicine and monitoring and the NICU, (and of course insurance, like my high-risk Medicaid), both would likely have survived. 

The NST technician tells me she had two hard pregnancies. One with preeclampsia and one with pre-term labor and 17 weeks of bedrest. That was twenty years ago and her kids are now grown and healthy. She’s another beautiful SLC woman who looks too young to have children much less a 26-year old. “It’s the hair dye,” she says.

I call Charley. He’s “stressed, depressed, and can’t do this on his own,” he says. “I can’t afford my half of rent, I don’t feel good, Dukes chewing up the wall again, and I don’t feel good about anything.”

I try to tell him he can do it. I believe in him. “Is that all you have to say?” Yes.