*Disclaimer: This is rather long. It also might have a couple TMI moments for some people if you're uncomfortable with baby poop and/or breastfeeding.
Despite all the issues Kaylin had during her birth, she hasn't had a problem really since. They had me make her cry for a little bit right after they gave her to me to help clear her lungs, but she's had a clean bill of health ever since. I, on the other hand, wasn't so fortunate.
We were discharged on Saturday, June 23. My blood pressure was still elevated and the minor swelling in my ankles hadn't gone away, though it's not unusual for that to take a week or so to go away. The first 48 hours after the birth are the most crucial when dealing with preeclampsia, but I seemed to be stable. When they discharged me I was on bed rest and they told me to limit visitors and take my blood pressure two or three times a day. My doula, Liz, had a blood pressure cuff that I could borrow so that I could do that. I was told to call the doctor if my blood pressure went above a certain threshold, or if I experienced headaches, blurry vision, or epigastric pain.
On Monday I started having headaches. I am prone to sinus headaches, so I did my usual things to relieve a sinus headache, and it didn't work, so I called the doctor and went in that afternoon. I had a slight fever from my milk coming in, which we decided was the likely culprit for the headaches. My blood pressure was still holding steady in its elevated, but not dangerous range. So, he sent me home and had me make an appointment to check up on me on Thursday.
Tuesday evening I started having blurry vision. Michael had a job interview the next morning that he was already not wanting to go to, so I elected not to say anything and see if it was better in the morning. My blood pressure was still where it had been, so I figured I was safe to wait. After he left for his interview I called the doctor's office again and they scheduled me to come in that afternoon. When Michael called on his way home from the interview I told him what was going on. He wasn't very happy when he found out it had started the night before. Also, my blood pressure had started creeping higher. When they took it at the doctor's office it was 178/110. They had me relax in a recliner in a dimly lit room for 20-30 minutes and took it again. It was 150-something/102. The doctors decided that I should go to the hospital and start magnesium sulfate, Lasix (a diuretic), and Labetalol (a blood pressure medication). I was allowed to go home and pack a bag, and we got to the hospital around 5:30.
I was admitted to Labor and Delivery, as they are the ones familiar with the preeclampsia protocols. This also made it easy for Kaylin to stay with me since they have bassinets and diapers and such. (We cloth diaper at home, but used disposables in the hospital since it was just easier.) They started me on a 24 hour drip of magnesium sulfate at about 7:00 pm. The nurses emphasized that Michael would be responsible for Kaylin and I would basically only be able to feed her. Magnesium sulfate is an anticonvulsant, so it dampens the central nervous system. I was allowed to sit up and go to the bathroom per doctors orders, but I was encouraged to lay down as much as possible, even when nursing. One of the nurses offered to put in a catheter so I wouldn't have to get up and use the bathroom so much (because of the diuretic), but I declined. I already was essentially confined to bed with the iv hooked up to a pump in one arm, a blood pressure cuff on the other (my blood pressure was being taken every 15 minutes at that point from an automated thing, so the cuff stayed on), and an oxygen saturation monitor on my toe. While getting up to use the bathroom was a bit of an ordeal (I had to be unhooked from the blood pressure and oxygen saturation monitors and have help with the iv pump) I wasn't about to fully live my worst nightmare by having a catheter as well (plus, my lady bits had been traumatized quite enough at that point, thank you).
At first I was doing okay with the medicine (lying in my padded bed in case of seizure or stroke), but by about midnight the magnesium had reached therapeutic levels and I needed help walking to the bathroom, not just with the pump. Throughout that night and the next day my hands and feet were hot, I felt like I had a heating pad along my spine, and I was tired and wanted to sleep all the time. Michael stayed all night the first night, but barely got any sleep. He's used to being the one in the hospital, not the one watching the person in the hospital (he's been hospitalized twice since we've been married - this was the first time for me). Apparently I looked pretty badly, too, so I'm sure that was hard to watch. Thursday morning he was so exhausted that he asked if I minded if he called my mom to come sit with me so he could go home to take a shower and get some rest. I said that I didn't mind at all and that I understood. (When we were in the hospital following the birth I made him go home on Friday night for that reason. I knew what it was like to sit with someone in the hospital and we didn't have a newborn to care for when his stuff was going on. Sitting with someone you love in the hospital is exhausting on many levels - add a baby into the mix and it's even more so.) My mom came for a while that morning and part of the afternoon. The doctor came in at some point and said that I wouldn't possibly be going home that day (I had been hoping it would just be a one night stay until then) and we devised a schedule for people to be with Kaylin and me. My mom did the first night shift from 8 pm to 2 am, my mother-in-law did the shift from 2 am to 8 pm, and Michael was with me during the day from 8 am to 8 pm. They held Kaylin while she slept, gave her to me when she got hungry, changed her diapers when she needed that, and kept me company while I was awake. I was taken off the magnesium around 7 pm on Thursday evening. My vision had still not returned to normal at that point and I was beginning to worry that it might be permanent. I was very, very near sighted. I could only see clearly about 12 inches in front of my face, beyond that everything was really blurry. I could tell time from the clock on the wall because I could see the black blotches for the numbers on the white face and could make out the black blurs that were the hands and I know where the numbers go. If it had been a digital clock, I would've had no idea what time it was.
While I was on the magnesium sulfate and Labetalol my blood pressure was under control. Once the magnesium left my system, my blood pressure started spiking again. So, they upped my dosage of Labetalol from 100 mg twice a day to 200 mg twice a day. By Friday evening I was still not responding well to the medication, so the OB brought in a Hospitalist to consult on what to do about my blood pressure. She wrote orders to increase the Labetalol to 300 mg twice a day and added Procardia with orders for an iv push of Enalapril if my systolic blood pressure went above 175. The next morning it spiked to 179, so they gave me the Enalapril, which brought things back to normal rather quickly. That evening they decided to add an oral dose of Enalapril and add a third dose of 300 mg of Labetalol (plus the Lasix and potassium that I was still on). That combo brought things under control, and I was finally discharged on Sunday evening. I was so glad to finally be home. My parents brought over a pizza from Papa Murphy's for us to have dinner and I finally got to hold my little girl as much as I wanted. By the end of the hospital stay, as I was feeling more like myself, I was able to hold her more. But it wasn't the same as being home with just her and Michael.
One of the hardest things about being in the hospital (besides it being one of my worst nightmares) was not being able to hold Kaylin. From the time they gave her to me after she was born, the longest I'd gone without holding her was when they weighed and measured her and got us ready to go to our Postpartum room a couple hours after she was born. She slept on me in the hospital then and at home before I got readmitted. While I was in the hospital for the postpartum preeclampsia, I couldn't sleep with her. I couldn't be trusted to even hold her for very long for the first 36 hours or so (because of the magnesium sulfate). Even after the magnesium wore off, because of the blood pressure spikes it was safer for others to be in charge of her care for the most part until my blood pressure was back under control. At one point, while I was still on the magnesium, I had been nursing her side-lying, she had fallen asleep, and I was nearly asleep myself. My mom was there at that point and I had her take her so that I could go to sleep. Since I was not very awake at that point, I dreamed that Kaylin was still lying next to me. When I woke up it was only a pillow, and I started crying. I so wanted to just hold my baby. The only time we slept together in the hospital was a short nap that I took on Saturday or Sunday before I got discharged. I had my bed so I was more reclined than lying down and Kaylin had fallen asleep on my chest. I turned my head to the side and fell asleep as well, and my mother-in-law just let us sleep there like that. She knew I needed my rest since I barely slept in the hospital once I was off the magnesium. Between feeding Kaylin, the nurses coming in to administer medications and/or check my vitals, and the doctors coming in to check on me, I was lucky if I got four hours of sleep a day, and that wasn't all at once.
After I finally got discharged I was on three different blood pressure medications, a diuretic, and potassium (lots of it) to replace what was being flushed out by the other drugs. Monday morning I woke up and took one of my blood pressure drugs. Within a half hour I started feeling dizzy and light headed. We still had Liz's blood pressure cuff, so we were taking my blood pressure before I took each medication and again about an hour later. I took it a half hour after my first pill and my diastolic pressure had dropped like 12-15 points. But, they'd only given me instructions for what to do if my systolic was below 100 (skip the next pill, but resume after that), so I called the doctor's office to figure out what I should do. (There was also some confusion over how much potassium I should be taking. The amount they gave me in the hospital and the amount the instructions on the pill bottle were for were very different, so I needed to ask about that as well.) While waiting for the nurse to call me back so I could ask my questions, it was time to take another medication, so I did. Michael had a Cisco certification test, so he wasn't home, but his mom was with me. We also still needed to go pick up a couple of prescriptions because the pharmacy that was open Sunday evening didn't have them. The hospital had given me enough of the blood pressure medication that I needed to get through Sunday night, but I needed to pick up that one and the diuretic (which I only took once a day). I spoke to the nurse and she told me not to take my next pill (which it was time for while we were on the phone) and that she would talk to the doctor and call me back. While we were getting ready to go to the pharmacy to pick up my other prescriptions (we were literally in the car putting Kaylin in the car seat) the nurse called back and said the doctor had said to stop taking everything except the Labetalol and the potassium (and told me how much of that to take, which was less than either the pill bottle said or I had been given in the hospital). So, we got back out of the car and didn't go pick up the prescriptions because I didn't need them anymore. Tuesday morning I woke up and took my one medication and potassium and a half hour later my blood pressure had tanked from 120/70 something to 98/58. I called the doctor's office again and they told me to just stop taking everything because I obviously didn't need it anymore (this time my mom was with me because Michael had a second interview for the company he'd interviewed with the week before). So, within 48 hours of being discharged from the hospital I was off all my medications. I think a lot of that had to do with the fact that I was able to sleep more and be in my own space. I understand why they kept me as long as they did - they couldn't very well send me home with such high blood pressure spikes because of the risk of stroke. And they couldn't know that just being home and getting more sleep would definitely get my blood pressure back under control that quickly. So, we still monitored my blood pressure a couple times a day for the rest of the week until my follow up appointment the following Monday. My blood pressure had been somewhat elevated again, but not in the danger zone or in need of medication, and it was on its way down. My vision slowly started clearing up on Saturday and Sunday, and was completely back to normal within a day or two of coming home. It was so nice to be able to see people's faces again.
The other really crappy thing that happened because of this was that the diuretic I was on affected my milk supply without me really realizing it. When I first got readmitted I was leaking milk everywhere (at one point, I was lying down nursing Kaylin and milk was leaking out and pooling on my neck - fun times). By the time I was discharged, I was no longer leaking. Having never done this before, I just thought my supply had regulated (I didn't know that it doesn't happen that quickly). It turns out that Kaylin wasn't getting enough to eat. The last two or three days in the hospital she was really fussy and wanting to nurse constantly. I thought she was going through a growth spurt (one often happens around 10 days, and that's where we were). Sometime Monday after we got home I realized that she hadn't pooped all day and I was pretty sure she hadn't the day before either. In fact, I wasn't really sure when she had last and neither was Michael (that's what happens when three different people change her diapers - no one really keeps track and they didn't always tell me what was in her diaper when they changed it, especially if I were asleep). At first I thought maybe she was constipated, but her tummy was soft and according to everyone on the internet breastfed babies very rarely get constipated. Everything said that you know your newborn baby's getting enough to eat if they have at least four poopy diapers per day and 6-8 wet ones. She had plenty of wet ones (at that point), but no poopy ones. At that point I decided that she hadn't been getting enough to eat (that was sometime Tuesday), but my supply was starting to come back because I'd been off the diuretic for a couple days. She did finally poop once a tiny bit on Wednesday. We had her two week well check on Thursday and she was five ounces under her birth weight (she weighed 7 lbs 8 oz at birth and only 7 lbs 3 oz that day) and they like them to be at or above birth weight by the two week mark. I'm fairly confident that she had actually started to regain a bit of weight by then and was probably even lower at the worst point. We explained to the pediatrician what had been going on and she was sympathetic. She told me to nurse Kaylin every two hours minimum, that they wanted to her gain at least an ounce a day, and that we were to come back on Monday for a weight check. I had my mom make me some lactation cookies (cookies full of ingredients that help increase supply). She brought them to me on Friday and on Saturday there was a noticeable increase (I was leaking again and spraying Kaylin in the face when she popped off). By Monday she weighed 7 lbs 9.5 oz, so she was given a clean bill of health and hasn't had a problem since. I felt really awful though when I finally realized why she'd been so fussy. It was because she was hungry and I wasn't giving her enough to eat. It still makes me sad when I think about it.
The only good thing about postpartum preeclampsia was that it was postpartum. We were really worried about me (I did wonder at one point if I might die - my doctor has a tendency to understate the severity of a situation, so I really didn't know how bad off I was. On the other side of things, I think it was bad, but not that dire, or I wouldn't have been allowed to sit or have bathroom privileges, and I might've been in the ICU), but we didn't have to worry about the baby, really. Preeclampsia often severely restricts the growth of the fetus, but since I was no longer pregnant, that wasn't an issue for us.
A couple of lighthearted moments from the hospital, and then I'll wrap this up. At one point a nurse walked into my room while I was feeding Kaylin and said, "Well, since you're nursing, you obviously don't have a baby on the inside anymore. I'm in the wrong room." All of the nurses also commented on how big/mature Kaylin was. At 6-10 days old, she was the oldest baby on the floor. They're all used to dealing with moms with babies that are 0-2 days old. I thought it was funny that they kept telling me my tiny baby was so big.
Also, Michael got the job and passed his certification test.
