In hindsight, my first true preeclampsia symptom was nerve compression in my arms, I think from the fluid retention. This may have been after my first 24h urine protein collection, I don’t remember, but it means my BP was already trending upward to trigger my midwife to order the urine in the first place. as a patient, I remember waking up with bilateral numbness and tingling from the elbows down on Christmas, very early in my 2nd trimester (due date was the Tuesday after Easter 2013). Or what I usually refer to as bilateral cubital tunnel syndrome. It’s like carpal tunnel syndrome but more proximal (and I’m not sure if it’s a real condition name, I may have made it up using medical knowledge).

But let me set the stage since those are not typical patient words! I was in my second year of residency at the time, having switched from EM to FM just the year prior, thus my title.

My preeclampsia was gradual but early, preparation pree is like a train, everyone had their own velocity and acceleration, but we share the same station. I did 3 urine protein collections, each gradually worse than the last but only the last crossing the medical decision point for pree. I was oncall working in the hospital during my first 24h urine protein collection. I’ve NO IDEA how I managed to get my 2nd TM pregnant self back to my call room to make sure every drop went in to that collection device for a full 24 hours. The hospital spans multiple city blocks, call rooms were on the far side, patients spread throughout the rest of it.

I was due April 1st and by early or mid January was admitted for 1 overnight, which meant I was pulled from work and sent home to bedrest. Which meant my residency program director received the news in OB Triage, the same space in which I was staffing OB patients with him a week before.

I went home to my cats and dog for about a week until it dawned on an HCP that if I did seize during the day when my child’s father was at work, that I had no one to help. So I spent a week of my bedrest at his elderly grandparents’ home when he worked…I don’t think I told them I was there so they could call 911 if I seized…but they had spent their lives involved in the special needs community, they would know what to do if it came to that.

After a week of this, I had the slightest light-sensitive headache on a bright January day and my son’s father made me go to OB Triage (HCPs are often great at denial) where I was admitted. I stayed for up to 2 weeks (I don’t remember exactly how long) until my (thankfully) slow moving preeclampsia train got close enough to severe preeclampsia that I was C-section-ed at 33+2 weeks. Let me tell you, IV Push Labetalol (or maybe it was Hydralazine, I can check the medical records I got printed out years ago) is no fun! I felt short of breath and happily took the first nebulized albuterol of my life for it.

My son was born at 3# 6oz and went to the NICU on CPAP with an OG tube. He was diagnosed with IUGR, and given that my birthweight as a term twin was 7# and his father’s term birthweight was over 10# to a nulliparous 21 year old, from a genetic perspective Sam had very significant IUGR. I have a whole Shutterfly book that tells his story better than I think I tell mine : )

Ultimately, my son had a VERY positive outcome vs. what Neonatologists warned me about, all the terrifying things from NEC to the vent to the bizarre wimpy white boy syndrome, which I am pretty sure they would have used a different term for if I was not also an HCP. Sam came home 2+3 wks before his due date, spending just 28 days in NICU. Never required a single repeat of the battery of tests required to get out of NICU. A precedent he’s continued to maintain as an avid reader and now 6th grader. I’ve heard that often pree babies ‘know it’s coming’ and can have good outcomes like this, I’m sure those steroid shots I got for lung development helped Sam’s body figure that out.