I love the unending diversity of humans. I also find it humbling because it places you in a position, when you don't fit the norm, to be completely dependent on God. There's always a center ground where most people fall in certain aspects of life--intelligence, health data, and even years spent alive according to life circumstance. Because we don't call the shots, there are also extreme outliers...those ones that caused your math test to be "dumbed" down a notch, giving you a B instead of a C, or who made it impossible to achieve valedictorian...and the ones who died far too young. You know you're one of those "medical" anomalies when your physician spends 2 hours with you alone for a clinical visit, verbally spouting off the clouds of thoughts entering his mind and then spends additional time talking to your other physicians about you--intrigued by your case, but still dumbfounded. I'm grateful my career is in medicine, because my doctors and I can talk in acronyms without having a visit last twice as long because of important lessons on the "why's" and "how's" of physiology. I'm also incredibly grateful for all the knowledge I've gained up to this place in my life. Everything I've learned as a nurse (and that's a lot), but most importantly my real time experiences with patients who were the "outliers", has prepared me to fight for myself, understand by mere knowledge what I can do to gain ground without researching the internet or asking a doctor for answers, and has allowed me to most recently come to understand that I'm not in control. I can give it my best shot, and by all means there is incredible pain that may cause me to feel frustrated, alone, and desperately trying to find more answers....but, I am not the ultimate keeper of my plan. My plan can be manipulated and influenced by my choices--and I will continue to strive to make choices that feel right--but relinquishing the idea that I can control everything brings me peace that I cannot have when I'm caught up in too many "why's" and "how's". Sometimes it's good to just sit and be content with what is, even if what currently is feels impossible. "What is" has been painfully hard to many, and will continue to be for many more to come--how else could we be refined?
I've been in the hospital too many times through this pregnancy. It is a draining experience. That, on top of running from the Maternal Fetal High Risk OB's I see, to picking up the critical specialists who need to monitor me through this rapid changing time for me, working still, and running the kids around for school and activities--it's one busy life. I LOVE being busy, but being busy when you are reaching a state of needing to lay down most of the time in order to prevent more complications, sickness, and hospital admissions is far too much. My pregnancies have always been complicated, but this one came unexpectedly in the thick of some dire medical attention. Aside from the paralytic episode in June, I ended up in the care of many specialists because of the nature of this idiopathic disease process worsening. I was in the hospital in January as well for acute kidney failure. I have since been placed on higher doses of diuretics in order to stabilize my blood pressure and take off the fluid that literally just sits on me and doesn't come off without medical assistance. Blood pressure problems are usually a result of poor health and advanced aging, but my issues started over night and are, as of now, idiopathic in nature. Gratefully, I have a nephrologist, endocrinologist, and OB who have all brainstormed my case and they believe that I am suffering from a very organic condition indeed that could even possibly be remedied. If it does pan out to be what they think it is, which is fibromuscular dyplasia, they would need to surgically repair the arteries in my kidneys. Normally, our main arteries which supply blood to our organs are large and have plenty of space and elasticity to allow blood to flow smoothly. In this case, the arteries leading to the kidneys would be narrow, reducing the blood that flows to the kidneys. If left untreated for years, there would inevitably be kidney disease and death. At this time, my kidneys may be mocked into believing that my body is dehydrated or hemorrhaging, all because of this possible narrowing of the arteries. Naturally, the body would do everything it could in order to preserve fluid if there was true dehydration or blood loss. The kidneys send signals to the adrenal glands and the brain to hold onto the fluid that is in the body--making it less likely that you would naturally discard it in urine. This is a self preserving mechanism of the human body--one of the many that God has instilled within the body so that we can have our best shot at a long life. It is amazing. So, when someone like me--who drinks a ton of water and has never had the desire to put a cup down even of I'm not truly needing water, has this preserving mechanism activated, there are only so many places the fluid--which isn't being peed off--can go. Once the veins are overloaded with fluid, the blood pressure rises. The kidneys are STILL having reduced blood flow because the arteries are small--a stirring straw verses a big round McDonald's drinking straw--so the fluid builds and builds regardless of what is happening in the rest of the body. Eventually the fluid builds up too much and starts to leak out of the veins and into the tissues of the body--into the legs, hands, face, brain, and around all the organs you have. Heaven forbid it builds to the point of spilling into the lungs. I have always been brave enough to seek emergent care before my lungs are wet, but because the water has to go somewhere, it places pressure on all of my organs and I end up having much less room to breath, digest food, etc. My heart has been very strong, although the fluid build up tends to open the valves, causing a backwards leakage--regurgitation--which is why I have been watched for pulmonary hypertension as well. The valves that protect the fluid from putting an increase pressure on my right heart have been leaky and causing more resistance for the lungs--resulting in a secondary pulmonary hypertension. I have been blessed to explain my symptoms to a few doctors who are very understanding of physiology and they naturally understand what I mean when I tell them it's hard to breath when the fluid is building up-- any activity feels like death, literally. Keeping the fluid off is the only way to keep my heart and lungs in better shape. Of course, the surgical repair could be done once they can definitively diagnose the problem via MRI or CT scan with contrast--both of which they desire to hold off on for the safety of the baby until after pregnancy.
That being said, my body is not handling the pregnancy well at all. Up to and at the end of the first trimester in the natural physiology of all pregnancies, women produce hormones that are a safety mechanism for the baby--these hormones allow the blood vessels in our body to expand more than usual and relax so that blood can freely flow to the baby, assuring growth and development. I had one week fo a close to normal blood pressure, ut for the most part, I have suffered with high blood pressure--even higher than my baseline with these problems prior to pregnancy. I find myself frustrated, knowing there is very little I can do to change that. In combination, the first time they checked my urine at 12 weeks, I was already "spilling" protein. High BP and spilling protein are really the only two traits you need to be diagnosed with preeclampsia. Come 20 weeks, they will officially put that in writing--grrr. Because I have been dealing with more fluid than a normal pregnant woman, I am also having an increase in vomiting which has left me to "spill" ketones as well--a by product of the body using itself for energy because I am not able to keep enough food down. Being 16 weeks and having all of these complications has placed me in a state of weariness, and even some bitterness. I feel worse than I ever have, and this little boy has had some pretty bad conditions to grow in from the start. I have felt him move--though the movements do slow down a bit each week. When I am not keeping anything down, I don't feel a single movement. As soon as a few bites stays in me for 15 minutes, he kicks. I'm almost tempted to stuff lots of good food down on the better days. LOL The doctors did warn me at 12 weeks that every week will change and be challenging in my particular case. We will be chasing a process that has a mind of it's own, At 12 weeks, I could laugh through that. Now, at 16 weeks, I'm crying though it. Yes, every week has brought new challenges, and I am not looking forward to them getting harder.
