Wednesday, August 31, 2011

Liver

Well, the labs are in. It took some doing to get them. The perinatal center was as helpful as usual (read: not at all) when I was a little confused that they weren't back yet. So I called my OB's office as I knew they'd been copied on the results. They were also as helpful as usual (read: extremely) and after one of the staff called and chewed some ass at Quest, they called me back with the results.

All were normal. Except one. My ALT (a liver enzyme) was slightly elevated. It should be between 6 and 40 and mine was 47. The nurse said that Dr. G was not concerned about that number, but would like to have it repeated in a week to make sure it wasn't getting worse. She confirmed when my next appointment is (Thursday) and said they'd give me the order then.

I immediately googled ALT (what DID people do before the Internet Age?) and found that that particularly enzyme is associated with a number of other conditions that I fall into. Obesity, fatty liver syndrome & Tylenol usage, specifically. So there are a lot of reasons that it could be a little high that don't mean HELLP. I tried to tell myself to chill out and wait for more answers. I took my blood pressure and even in the agitated state I was in, it was 120/75.

Less than 5 minutes after I hung up with the nurse, I had to join a conference call for a project I've been working on for a few weeks. I told myself that it was time to get back to work. But it wasn't long into the call before the tech I was working with commented that I seemed awfully quiet today. She sort of chuckled because both she and her work partner were really off their game yesterday and today it was the client and me. (The client had been up with his post-surgical puppy all night. We all had baby woes today!) Guess it's a rough week.  But clearly I wasn't putting on my game face as well as I'd hoped. I tried to rally myself a little more.

Fortunately Chello was very active tonight, which never ceases to make me smile. Even now that she's getting big enough to punch me in the stomach occasionally and make me feel like puking, it's still pretty cool. I told myself that I was otherwise symptom-free. By the point that my liver enzymes were elevated with Robbie, I was already hospitalized and near kidney failure. Everything else was fine, so it wasn't that. Relax, Trish, relax. I willed myself to feel it even though I was so tense that the muscles in my shoulders were burning.

As much as I tried, I couldn't help but think about this baby in the NICU. Surely we can make it to 25 weeks, right? That's still too early, though. I remember Robbie in the NICU when he was born. I remember the guilt I felt every time they pricked his heels for blood or peeled off another lead from his see-through skin. I remember his silent cry when they disturbed him to change a tube or roll him over so that his head didn't get too misshapen. You couldn't hear either of us crying- Robbie because of the tube down his throat, my weeping kept silent so as not to upset the other parents. I said a silent apology to Chello for anything she would suffer because we selfishly decided to get pregnant again.

By the time I left work, I had worked myself into quite a state of self-pity. All I wanted to do was climb in bed and watch crappy TV. My side was hurting (probably psychosomatic) and I just wanted to lay down. I got home and found that the cat had puked all over the bed. I had a temper tantrum and yelled to David about how all I wanted to do was lay down and now I can't even do that, all while stripping the bed. David busied himself helping and talked to me in a soothing tone. My tantrum had little to do with the vomit (though seriously, 90% of our house is wood floor. WHY can't they puke on a freaking solid surface?) and more to do with a different kind of injustice.

Finally I did lay down and watch crappy TV (latest addiction: Awkward. on MTV.) and then took a long bath and read a little while and seem to have worked through the worst of the self-pity. The truth is that I don't know what this lab results means. My blood pressure is still excellent (tonight's reading: 110/65) I'm not swelling, my head doesn't hurt, and all my other labs were fine. Whatever is going on isn't coming to a head tonight. And whatever does happen is out of my hands. Wallowing isn't changing that.

I worked on picturing my next peri appointment at 28 weeks. Then seeing 30. I needed to write myself a different ending. Not at 25 weeks or even 26. I want to see full term. I don't want tubes and wires and statistics and guilt and tears. We all, particularly Chello, deserves better. So that's what I'm thinking about tonight. I'm going to pray for a health liver and a full term baby. And I'm going to believe it can happen, even if my liver doesn't like it.

Trish

6 comments:

stdonexus said...

::::hugs:::::

Mrs.Spit said...

Trish - repeat after me. The standard, well tested wisdom is that pre-eclampsia in a subsequent pregnancy occurs both later and takes a milder course.

This means that you will be further along and that they will be able to manage you for longer.

Say it again you WILL be further along and they WILL be able to manage your symptoms before delivery for longer.

Your Rx for today? Repeat this 10 times today.

FWIW - my liver enzymes are still elevated (a bit higher than yours) and I'm almost 4 years post partum. Has nothing to do with Pre-e. I have fatty liver.Not a big surprise, the rest of me is fatty too ;-) )

Trish said...

Thanks MrsSpit. I've BEEN reminding myself that. Along with "this baby is not coming until November. This baby is not coming until November. This baby is not coming until November."

And thanks. I have a fatty liver, too. That's what I'm blaming it on. I'll be glad to get to the OB tomorrow and find out what my level was at my baseline tests both pre pregnancy and at 12 weeks.

Ruby said...

I do not have a fatty liver, but this lab periodically is out of range for me. I'm overweight, but not obese. I don't use Tylenol (for a medical reason, I can but then I can't use my glucose monitor for 12 hours). The lab has came back high both pregnant and non-pregnant.

I say go full term. Work on your speech why your peri should allow you to go for 38 weeks instead of taking Chello at 37 ;-) (I always had a similar speech planned for why I should be allowed to go to 38, unfortunately I never got to try it. Pre-e struck at 37w3d my first pregnancy, and pregnancy 2 I went into labor and delivered at 35w5d.)

S said...

You can do it. You will do it. One foot in front of the other.

Hugs!!

The Blatchford Family said...

Love you Trish! Keep ypur chin up!!