Seven months. 32 weeks. I won’t bother with trying to figure out how many days or minutes are in that time span. At 32 weeks a baby is taking its first practice breaths in the womb, its skin transforming from translucency to look like actual flesh. An ideal pregnancy has roughly 8 more weeks in its timeline during which babies get nice and fat in preparation for the work of outside life.
32 weeks is by no means an ideal point at which a baby enters the world, yet it happens to so many people. And it happened to me.
Let me preface this by saying that I had a textbook healthy pregnancy. Yes, the nausea and the heartburn were bad throughout, but that was to be expected. My blood work, vitals, and nonexistent medical history were all mundane in their normalcy. After the fact, I found out that preeclampsia is completely unavoidable. There is no special tea to drink, no extra amount of times to measure blood pressure to somehow catch and stop it in the act.
Once it starts, its like you’re on a runaway train and the only way to get off is to give birth.
A word on preeclampsia. No one really knows where it comes from (Herndon, 2018). It happens in about 5% of all pregnancies. The syndrome is characterized by high blood pressure and a high urine protein after week 20 of pregnancy. Ladies also get ridiculously swollen (but really, who isn’t swollen when they’re pregnant?), get vision changes and headaches. If left untreated, it can progress to eclampsia, which means all of the aforementioned symptoms plus seizures. Ultimately, it can result in long term organ damage as well as maternal and fetal death. It’s pretty bleak to think about.
I knew about preeclampsia from nursing school, of course. The symptoms to watch for were engrained in my brain long before I was ever actually pregnant. But as that particular individual with a nonexistent medical history and textbook pregnancy, I felt I had nothing to worry about.
The day before I realized I was on the runaway train was a great one. Vlad and I spent the morning putting the house in order. I remember bending down to pick a bag off the floor only to notice my ankles. Or should I say, where my ankles used to be. That area had gotten so swollen that it was as if my calf grew directly into my foot. I laughed about it and sent a photo to some friends. In the afternoon we finally made it out to Buy Buy Baby to make some returns and spend our store credit on baby necessities (a.k.a. pink pig ottoman). Vlad’s friend, Eugene, was in town from Colorado, and the three of us went to Mindy’s Hot Chocolate for an indulgent treat paired with excellent conversation. We ended up getting home around midnight and I fell directly into bed because I had a shift the next morning.
I awoke with back pain, which was a typical occurrence for me in those days. It was so common that I had a routine worked out that would pep me up before I started my shift at 11 – I would get in as hot a shower as I felt was appropriate for a pregnant woman, take two acetaminophen and sit on the couch eating my breakfast with a heating pad. It tended to work like a charm and that day was no exception. With the pain subsiding, I used the remainder of my morning free time to check my baby app. It was a fun little ritual that happened every Sunday as the weeks flew by. This Sunday I was 32 weeks and wanted to know everything going on with Baby Girl, who was supposedly the size of a squash. After a satisfactory scroll through the app, I squeezed into my non maternity scrub pants and made sure my work bag was packed before setting off for my 12 hour shift.
I felt delightfully peppy as I walked into the Emergency Room. It was November 4th. The weather outside was frosty, meaning a lot of patients would not venture out unless absolutely necessary, keeping the waiting room nice and empty. My favorite day shift charge nurse was working. I had been assigned to the fast track along with some of my bestie coworkers. The goal of fast track was to weed out the minor complaint patients so that the nurses and doctors working the main side for the day could focus on the critical cases. It was a nice mental break that my 32 week pregnant self did not mind at all.
The first four hours flew by uneventfully. Then, the backache came back with a vengeance. I stiffly walked around from room to room, a fake smile plastered on my face for the patients’ sake. The pain was a relentless, tight ache radiating from my waist to my shoulder blades. Additional acetaminophen was doing nothing for me. I toyed around with the idea of asking to go home early but brushed the thought aside. I needed to save my PTO for maternity leave and didn’t want my coworkers to think of me as less capable simply due to being pregnant. At the urging of my fast track teammates, I conceded to a 15 minute lie down in one of the patient rooms.
As I lay on the stiff ED cart, one hand on my belly, I remember wondering how much more it could stretch in the next 8 weeks. I remember hoping that this baby would come a few days early. I made a mental checklist of all the things I still needed to get done before she arrived – finish decorating the nursery, pre-wash all the clothes, pack a hospital bag.
Fifteen minutes and I felt like I hit a second wind. I came out with full resolve to finish out the mere 6 hours I had left in my shift. The department felt mine for the conquering.
That lasted only about an hour or so.
When it became clear that the pain was not backing down easy, I finally waved the white flag. If I felt better after laying down for 15 minutes, then clearly I needed to continue doing so…but in the comfort of my bed. I waddled over to the charge nurse desk and conceded my need to go home. Before I knew it, I was punching out on the time clock and heading towards my car in the parking lot.
On the drive home, I actually began to feel better. I called my mom and we had a nice chat about the goings on of the past few days. As I got off the highway on the exit towards home, I chided myself for wimping out on the rest of my shift. No matter, it was too late to turn back now. I was going to make the most out of my night off.
Vlad met me at the front door of the house. We had a nice long hug and I made a beeline upstairs to our room. There was nothing I wanted more than to put on my comfiest, softest pajamas and snuggle under the covers. Netflix and early bedtime were waiting.
I’m not certain exactly when the change in pain happened. Maybe it had steadily been building throughout the day and I wasn’t paying attention. Or perhaps it hit me like that runaway train. All I knew was that suddenly the pain had shifted from my back to my head.
When I say this was the absolute worst headache of my life, I am not exaggerating. It felt like someone was playing whack-a-mole in my temples. Tension headaches from stress were not unusual for me and I tried to tell myself this is all it was.
I tried my best to ignore the gnawing tension of an internal alarm telling me something about this was not right.
Vlad, in his sweet and supportive husband mode, brought me a bowl of cut up fruit and Tylenol. The headache was making me nauseous. I took a few bites of fruit and collapsed back onto a pillow, praying the Tylenol would work quickly. It wasn’t long until I was urgently walking to the bathroom as my body rejected the food I just ate. Throwing up at all times of the day from random meals was nothing new to me; I had gotten extremely good at knowing just how long I had from the time I felt the vomit coming to make my way to the nearest toilet in an orderly fashion. Typically, one such episode would make me feel instantly better and I could continue about my day. As I watched my stomach contents get flushed down the toilet bowl, I was elated in thinking the worst of my day was behind me.
Nothing got better. The headache seemed to be only worsening in its intensity. I threw up twice more. I could not think or speak coherently any more. Even laying in bed was getting difficult – there was no position of comfort. My internal alarm grew more intense. At some point I had the idea that Vlad, who was sitting helplessly beside me, should take my blood pressure. Since headaches were a sign of high pressure, the nurse in me reasoned, I needed to prove to myself that my pressure was normal. That would mean that this is just a silly headache and nothing to worry over. All we had to measure with was an old manual cuff I had left over from my nursing school days. Vlad had never taken a manual blood pressure before that moment. Talk about a high pressure first experience (pun intended). I tried my very best to walk him through how to use the cuff. He followed the directions as I laid there, tying to relax through the pain.
“It’s high. Like 190, I think.” He said as the cuff was deflating from around my arm. Cue internal alarm. If true, that was extremely high. Like getting close to having a stroke high. I brushed it off and told him that he was probably doing it wrong. Next, I had him hold the dial as I pumped up the cuff and listened in the stethoscope myself. My result was only slightly better – 160 systolic. Still I refused to believe what I was seeing. Obviously I couldn’t be trusted to take an accurate pressure in my current condition, I thought. Vlad was asking what should we do.
I imagined all of the pregnant patients with headaches I took care of in the ED. Usually, they got re-hydrated with a bag of IV saline and a cocktail of pregnancy safe medications for their pain. Within a few hours, they were feeling much better and on their way home. I so badly did not want to be one of those pregnant women who rush to the hospital over nothing and subsequently become the subject of eye-rolling discussion in the unit break room. On the other hand, the prospect of getting some kind of relief from this pain was very enticing. Vlad and I came to the consensus that we would call my doctor’s office and see what they had to say.
Within minutes I was talking to the ob-gyn on call for the practice I belonged to. I explained my symptoms without trying to sound as if I was actively dying over the phone. The response came without any hesitation – I should report to labor & delivery in the hospital as soon as possible for an evaluation. As soon as I got off the phone, Vlad and I jumped out of bed and got dressed. Ok, he jumped and got dressed. I barely rolled out and could not even think of wasting time putting on clothes. Now that I knew we were going to the hospital, I suddenly could not wait to get it over with. My super soft comfy pajamas (which were that way from years of washing and stretching) were very appropriate. I threw up a fourth time (one for the road) and tried not to dwell on the internal alarm, now loudly shrieking, inside me.
We drove silently, hand in hand, through the dark streets to the hospital. It was already dark and the roads were mostly empty. The chill of winter approaching was thick in the air.
“I guess I’m probably not going to show up to work tomorrow either.” I tried to joke as we turned into the hospital parking lot. My first day of being 32 weeks pregnant was coming to a close.