I thought I'd post about the dramatic and scary week we've had!
After the twins were born, my blood pressure came down. Then over the next couple of days, it slowly creeped back up, to even higher then before I delivered. I also swelled up extremely bad post delivery. My legs were double in size, and I had swelling my my arms, hands and face worse then it ever was in pregnancy. Because of all of this, my Dr. sent me home on a medication called labatelol to help control my bp. He told me to take it for a couple weeks, and come into the office every few days to follow up and check to see how my bp is doing.
Throughout the next couple days, my swelling got worse. I kept telling Devry that my entire legs looked like they belonged to someone on the biggest loser! The skin was so tight, I thought it was going to split open. And they ached terribly! I just assumed it was from being on my feet so much walking back and forth to the NICU, and hoped it would improve once I got the twins home.
Well Thursday was busy bringing the twins home, and I finally felt like I could relax thursday night. But then I started having difficulty breathing when I was laying flat. I thought I was maybe just getting the cold back that I had before I delivered, so I brushed it off.
Friday morning I went into the office to check my bp and see Dr. Meredith. When I first went in, my bp was 173/100. Really not good considering I had taken the bp medication an hour earlier. Dr. Meredith told me to sit for 15 or 20 minutes and then they would recheck it. A nurse came in 20 minutes later and took it manually. She said it was 140/90, which was ok. Looking back, I really doubt that was what it was, but I had no way of knowing because she did it manually. I talked to Dr. Meredith about my shortness of breath. It had worsened since the day before. He listened to my lungs and said that he didn't think it was an infectious thing, but that my body was holding on to way too much fluid, so it was starting to accumulate in my lungs. He sent me home on a medication called lasix, that would help get rid of the extra fluid. He told me to take it for 2 days and call him if it didn't improve.
So I came home and took the lasix right away. It is supposed to make you pee a TON. I never noticed a difference at all throughout the day. I never peed more, my swelling never improved, and my breathing got worse. Friday evening I talked to my brother about it, who is a medical student. He was pretty concerned and kept talking about this rare condition that can occur from pregnancy that I was having most of the symptoms of. He said he was probably being over cautious and looking for the worst, but recommended I go in to the ER. I put it off for a while, thinking that I could wait it out until the morning and go see my Dr again. Then by midnight, I could hardly breathe unless I was sitting up perfectly straight and not doing anything. If I even reclined, I could not breathe at all. If I took a drink, it took me 2 minutes to catch my breath.
Devry kept trying to get me to go in, but I hated the idea of having to call and bother someone in the middle of the night. Plus I didn't want to leave the babies! Finally I agreed to go in right after their 1 am feeding, hoping it would be nothing and I could be back by their 4am feeding. Devry's parents came down so quickly when we called them, and we headed in.
When I arrived to the ER, the first thing they did was weigh me. I was only 4 lbs less then my weight before I delivered. That was concerning, since I had delivered 11.5 lbs of baby, plus 2 placentas and all the amniotic fluid. My weight should have been much less. Then they come and took my vitals. My blood pressure was 180/125. Not good. At all. Especially because I was taking labatelol. My heart rate was normal, actually on the low side. The Dr. came in right away and listened to my heart and lungs. He said he could hear lots of fluid in my lungs. They immediately ordered nitroglycerin (as a pill), to try to get my bp to come down. They did blood work, a chest X-ray and an EKG. The blood work came back and was looking like I might have a pulmonary embolism (blood clot in my lungs). So they took me for a CT scan. In the meantime, I had 2 more doses of nitroglycerin, but my bp wouldn't budge. The CT scan came back negative for a Pulmonary embolism, but showed that my lungs were full of fluid.
At that point, the ER Dr. decided I needed to be started on Nitroglycerin through my IV. He also ordered some lasix to be given in my IV to get rid of fluid. It was 4x the dose I was taking at home, so it worked well, and very fast. I have never peed so much in my life! I seriously would go every 15 minutes and pee a full liter! He came in and told me they were really concerned with what was going on, and it was time for me to be admitted to the ICU. My OB and an internal medicine Dr. would be taking over on my care and working together to figure out what was going on. This was really hard for me, but not for the reasons I would have thought. Of course I was concerned with what was going on with me, but more then anything, the thought of being away from my 5 day old babies was the most difficult thing. I worked so hard to nurse them...and now they would have to be given bottles for who knows how long. And I couldn't even pump and send it home to them because the nitroglycerin wasn't safe. I sat and bawled about being away from them. It truly is amazing to me how much love you can have for your child, even after only 5 days. The role of being their mother becomes the most important thing in the entire world. Of course I knew I needed to stay in the hospital, so they could figure out what was going on and treat it, but it was so hard!
My OB wasn't the one on call for the weekend. Actually a new guy was! His name is Dr. Codd, and luckily I had worked a very busy weekend with him a few weeks earlier, and knew how wonderful he was. He came in right away, and we were so impressed with him. He came and talked to me about how most of my symptoms were suggesting I had a condition called pregnancy induced cardiomyopathy. This was exactly what my brother had been concerned about. It is a pretty rare but serious condition, that is mostly compared to congestive heart failure, but resulting from pregnancy (it can happen in pregnancy, or up to 5 months after). Dr. Codd said that the way to confirm it was with an echocardiogram (ultra sound of the heart). He really impressed us when he told us that he didn't have enough experience with this condition to feel comfortable treating it alone. He spent hours on the phone with Dr. Meredith, plus other specialists to figure out the best plan of action. Being at a small hospital, there wasn't a tech on the weekends to to an echocardiogram. At first they talked about sending us to Idaho Falls to have it done, but thankfully Dr Codd simply said it was unacceptable to not have it done there, and they needed to find someone to come in. So I had the echo done at 9 am Saturday morning. Then we waited. A cardiologist in Idaho Falls had to read the echo and send the results, and being saturday, it took almost all day. Although it was a day of waiting, lots of other things were going on. They were concerned with my blood counts, and talked about doing a blood transfusion. They decided to wait and let the lasix work, thinking that the counts were falsely low because of my blood being more diluted from excess fluid. The CBC was repeated later that day, and luckily I didn't need a transfusion. Throughout the day I was given lasix again, plus I stayed on the nitroglycerin drip. It was the worst because it gave me the most horrible headache imaginable. I get extremely bad migraines, and none of them even compare to this pain. I laid there for hours with my eyes closed, trying not to move so it wouldn't hurt worse. I got 800mg of motrin and 2 Lortab several times throughout the day to try to help, but it never did. I was so glad at noon when they decided to try to wean down the nitroglycerin, and start me on oral blood pressure medication. Slowly, my headache went away as the medication was turned down then off.
I started taking a bp pill and a heart medication, plus a potassium pill. The bp medication got my bp down to around 150/95, bit it never got much lower then that.
Around 4pm, Dr Bates (the internist) came in and said the cardiologist had sent the report of the echo. The really good news was that something called the ejection fraction was normal. This was the main thing they were looking at, and a abnormal result would have meant I had the cardiomyopathy. So a normal result was FANTASTIC news! He was concerned however with "leaking valves" and some enlargement of my heart.
So the outcome....basically was that I had "severe, unresolved preeclampsia." Normally it resolves with the delivery of the baby, but in my case it didn't, and got worse. He said several times how surprising it was that I didn't have a seizure from it. Thankfully!
So although the outcome was still problematic, and something to watch very closely, it wasn't nearly as bad as it could have been. The cardiomyopathy would have meant my heart was having major problems that was causing all of the other problems. But instead, in my case it was my blood pressure and preeclampsia that was the #1 problem, and was causing the other problems, including swelling, fluid accumulation, leaking valves and enlargement of my heart. So since I was started on blood pressure medication and heart medication, they decided to watch it for a few more hours and as long as it was controlling things ok, I could be discharged home. They also had me keep taking lasix at home.
So the plan is to keep me on these medications for a month. I am supposed to monitor my bp very closely and return to the hospital if it gets and stays 160/110 or higher (right now it is staying around 150/95..still not great but much better then before). I am following up with my Dr.every few days, where they will monitor everything very closely. Then after a month, I will have a repeat of the echocardiogram. By that point my bp should be lower and things should be back to normal, or close to it. If the echo isn't normal by that point, I will have to see a cardiologist and determine if there is in fact a problem with my heart itself.
Hopefully everything goes back to normal. Dr. Cod told me that if it was the cardiomyopathy, my "reproductive career would be over." As it is, with the severe preeclampsia he said I would have to consult with a perinatologist before deciding to have anymore kids, but at least I potentially have the option in the future, and wasn't told straight up that I couldn't. That would have been very hard for me to deal with.
I was so happy to come home Saturday night. It was a very very long and stressful day, and I can't even explain how wonderful it was to sit and hold my precious babies. I still couldn't nurse them for another 24 hours so all the nitroglycerin was out of my system, but it was amazing to cuddle with them!
We have had such an incredible amount of love and support from family and friends. Devry's parents were here from 2am until 9pm the next night, with hardly any sleep. Devry's Brothers were extremely concerned and supportive, and helped us in anyway they could. Rachelle left her own kids for the day and was here all day saturday and saturday night to help with mine, and of course Carissa was here being as helpful as she always is. I never worried for a second that the kids weren't being well cared for. Even after we came home saturday evening, Rachelle and Carissa insisted we go sleep for the night and they would take care of the babies. It was so kind of them, and we both really appreciated getting some sleep after such a long day. My family showed us so much love and concern. I know they all struggled not being able to do more from far away. My brother was incredibly helpful with his medical knowledge and really was the main reason I went to the ER. Devry's brother Joe is doing a cardiology fellowship right now, so of course it was wonderful to tell him what was going on and get his input. We have had people from our ward bring us meals several days, and have had so many kind and concerning phone calls and visits. It has been so amazing to have such support through everything.
I have been feeling so much better. Getting rid of so much extra fluid made such a difference. I can breathe again, and the swelling all over my body has gone down so much. I stepped on the scale on sunday morning, and had lost 20 lbs since the day before! And another 5 since then! It's amazing how much fluid I was holding on to, and its not all gone yet! It has been so nice to be home, enjoying my sweet babies, and of course Payton and Devry as well.
It is wonderful having Devry home for such a long time. He gets another week and a half, which will make a total of 4 weeks straight that he is home! He has been so helpful and loving. He was the perfect labor support person, has helped in every way possible with the twins, and of course has spent a ton of time playing with Payton. Plus he has let me relax and recover while he has taken care of everything around the house. He never left my side when I was in the hospital. I was grateful my nurse ordered him a guest meal tray for every meal, because it would have been a fight to get him to go get something to eat. I could tell how worried and scared he was, but was so strong for both of us. I just love him so much! He is amazing!
I am so incredibly happy right now, being home with my 4 boys! Enjoying all of the changes and adjustments that have come from adding two babies. I hope nothing takes any of us back to the hospital for a very long time!
Here are a few pictures of our growing family!






