Musing: pre-

Pre-eclampsia

I sat with clasped hands in the passenger seat, watching but not seeing the buzz-cut hills along Interstate 279 slip off of the front windshield.  My legs were shaking uncontrollably, a symptom of shock that would come and go with annoying frequency over the next six weeks, prompting concerned nurses to offer two, three maybe?, more blankets to ward off what they mistook as a chill.  It wasn’t a chill.  Not in the “I’m crazy enough to take the Polar Bear Plunge” kind of way.  The chills I was experiencing were more along the lines of “I’m in a horror movie and someone just rang my door bell at midnight so I think I’ll grab this kitchen knife” kind of thing.  In the time that it took for a blood pressure cuff to puff itself up and then deflate, my life (and pregnancy) had gone from predictable, non-descript even, to a horror movie.

At 30 weeks into the pregnancy of my first child, my doctor removed, not too gently, the tattle-tale blood pressure cuff and abandoned her sweet, semi-detached manner that usually accompanied her chatter about our latest vacation or the start of the school year.  Now she was serious, brusque.  She didn’t look at me.  “Can you take her to the hospital right now?” she asked my husband.  Somewhere in my brain, in a little compartment where I could not hear the clanging alarm bells, a voice quipped, “Do not pass Go.  Do not collect $200.”  So off to the hospital I was shuttled.  More tattle-tale blood pressure cuffs and nurses with concerned raised eyebrows.  My blood pressure was too high.  Preeclampsia was launching the opening assault of a four-week war on my body.

According to The Preeclampsia Foundation, “[Preeclampsia] can cause your blood pressure to rise and puts you at risk of stroke or impaired kidney function, impaired liver function, blood clotting problems, pulmonary edema (fluid on the lungs), seizures and, in severe forms, maternal and infant death.”  It’s not exactly comforting to find out that one is developing a condition that could end in maternal and infant death.  I was far from comforted.  Less comforted when I found out that the only cure for preeclampsia is delivery.  As far as I was prepared, my due date was marked on a day of next year’s calendar.

In the six weeks between diagnosis and delivery, friends, family, co-workers, my church community all tried to pitch in with cheer and comfort for me as I lay morosely on bed rest.  Their comfort spread with all the success of thick natural peanut butter mauling a slice of fresh wheat bread.  Overnight I quit my job teaching and took up a full-time position incubating.  While I couldn’t control when or how high my blood pressure decided to climb (and trust me, it climbed with a success that made me suspicious it had Tenzing Norgay as a guide), I was under orders to try my very hardest and put all my energy into doing…nothing.  Try that for a moment.  Do nothing.

Success?

Nope.  You failed.  I saw you.  You flinched a nose muscle.  You thought about the laundry you neglected to switch from washer to dryer this morning.  You scratched at a hang-nail absentmindedly.  It’s an unfair test, really.  We’re all doomed to failure when told to do nothing.   The problem with preeclampsia is that the stakes are so blasted high.  Maternal and infant death, remember?  Each day I awoke thinking that if I couldn’t succeed at doing nothing and my blood pressure decided to take off with the speed of an Indy 500 winner, my day would end with a premature baby in my arms instead of womb.

The day I failed for good, I had woken at 11 am (customary during those weeks when nocturnal sleep evaded me and my lids only closed with the first rays of dawn), watched two and a half episodes of West Wing, Season Three, eaten two-thirds of a salad and raspberry crème brulee from my favorite French restaurant (many thanks to a gracious friend who brought me comfort food in my comfortless state), and placed three calls to my doctor.  It was on the third call that I heard the concern ratchet her voice up a notch: “Can you get to the hospital?”

Pre-mature

So one emergency c-section later, there she was.  Isabelle Taylor Hendrickson.  Born six weeks early.  Placed not in my arms but in an incubator.  Destined to serve one week’s penance in the NICU for her early arrival.  While I fought through the comatose depression of magnesium sulfate (a medication commonly dished up to moms with preeclampsia to prevent seizure for the first 24 hours after delivery but which should be, I maintain, considered an acceptable penal substitute for water boarding, solitary confinement, or electric shock treatment), Isabelle took her first breaths, flapped loose skin on her knees as she kicked this way and that, and shook her embryonic fists at a world too new, large, and brilliant to yet understand.

Here’s what’s triggering my thoughts of preeclampsia and prematurity: We recently visited friends whose son arrived with little to no warning a full eight weeks before the due date circled on the calendar.  I recognized in them the same grit and determination birthed by necessity in all parents of premature babies.   It’s a grit and determination that will twist the corners of eyes like discarded sandwich bags.  Outwardly, we NICU parents often appear showered, presentable, shockingly great considering our circumstances.  It’s a duplicitous life, this uncharted territory of prematurity.  The outside does not, can not, reflect the inside.

We premature parents charge forward with MacBeth’s admonition, screwing courage to the sticking place in the face of the unknowable: Why did this happen?  What did I do?  What could I have done differently?  Why didn’t I [fill in the blank with some piece of ignored advice]?  What happens next?  Why me?  Outwardly we smile, coo, change a diaper, realign the heart monitor leads trailing from a chest smaller than a hormone-plumped bone-in chicken breast.  Inwardly, we are ineffective Davids throwing question after question at the Goliath of the universe.

We cry at the ambivalent Goliath, “But I’m not ready yet!”

I guess that’s why they call it premature.

Pre-vent

Twenty one months after my last meal of French salad and raspberry crème brulee, I still lob the occasional unanswered question toward the universe: “Why? “ And the universe finally answered back.

It said, “Fish.”

Fish?  I can blame fish?  Yes, says Nina Plank, spokesperson for the Universe in this instance and author of my new favorite food book, Real Food: What to Eat and Why.  Plank explains, “Our brain is particularly hungry for the omega-3 fats found in fish.  […] Lack of omega-3 fats causes preeclampsia, eclampsia, premature birth, low birth weight, difficult labor, and postnatal depression” (129).  Nina may have something there.  I don’t eat fish.  Not out of any warm and fuzzy feelings for the scaly, ectothermic creatures but simply because I’d rather have a nice oozy slab of lasagna on my plate.  So why did I get pre-eclampsia?  Maybe the answer is a severe lack of fish.

Truth is, the medical community at large has one big head-scratch, throat-clearning conference when propositioned with the question of what causes preeclampsia.  They simply don’t know.  But I’ve already spent six helpless weeks in bed doing nothing while preeclampsia conquered my body and altered the course of my life unimpeded by any rallying cry from me.  With future pregnancies, I plan on having a half decent war whoop in my bag of tricks.  Namely, fish.

Can I prevent preeclampsia from hammering me down again?  Can I prevent the sun from rising at 6:50 am on September 5, 2010?  Can I prevent Little Friend from turning into a young woman in a white gown walking down an aisle away from me?  I’d like to ignore the tiny answer coming from the Universe in response to questions such as these.   Obviously, I’m a little short staffed in the Control Department.  Preeclapmsia at least forced me to recognize that much.  However, if preeclampsia visits again in the future, I do not plan to go gently into that good night.  Before I do nothing, I can do something.

Who am I kidding?

Wasn’t this whole preeclampsia/prematurity circus supposed to teach me that Future + Control does not and will not = Me?  Apparently I have not learned my lesson if I’m sitting here doodling on about eating fish.  Sure, it’s one thing to refuse to go gently into some night (good or otherwise), but here I am, still attempting to control when said night will and will not occur.

Let’s just change the title of this section from “Pre-vent” to “Pre-sent.”  As in, I should start taking Thoreau’s example to heart, endeavoring to “live deliberately,” putting worries about the uncontrollable future to rest where they belong–in the unknowable, uncontrollable future.  I should start living deliberately in the now, the present.  Put the memories of and worries about preeclampsia and prematurity up on a high shelf, someplace where I have to stand on my tip toes and then jump a couple of times to push it far out of reach.  Just enjoy today.

Then again, you won’t blame me if I sneak a bite of fish on my plate every now and then, will you?