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04/19/2009

Sweet and sour

...Not in that order.

First the sour:

A few days ago I read a post that made me angry.  When I read something on the Internet that pisses me off, I usually do one of a few things:

  • Respond immoderately in the heat of the moment, which I tend to regret almost instantly;
  • Respond snarkily after some reflection, which I tend to regret eventually; or
  • Not respond at all and wait for my annoyance to dissipate, which I tend to regret when that sublimated rage inevitably boils over onto some poor hapless bystander, like, oh, I don't know, just as an example selected purely at random, let's say Paul.

The third option seemed indicated.  So I wandered around all weekend snarling, "GRRAAAAAAAH."  Paul would eye me warily, then brightly suggest he take the children out somewhere.  Anywhere, in fact, backing out slowly, not making any sudden moves.  "GRRAAAAAAAH," I would gratefully agree, and then in the quiet of the empty house I'd sit in front of my computer, reread the post that had bothered me, and stay as mad as I'd started.  Charlie would then come scampering back in, eager to tell me what adventures they'd had.  "GRRAAAAAAH," I would reply in tones of interested inquiry.  And so on.  This went on for a couple of days.  My family got spooked, my throat got sore, and my anger continued undiminished.

So now, in an attempt to get it out of my system and to correct what I feel is hurtful misinformation, I'm going to try something different.  My self-imposed cooling-off period has ended, so I'm not responding in haste.  I care too much about this to be flippant, so I'm not whipping out the sarcasm.  I trust in Cecily's good intentions, so this isn't a personal attack.  Straight and sincere, it's just a few things I believe about preeclampsia and prevention.

My pregnancy with Charlie ended early because of the sudden onset of HELLP syndrome, a variant of preeclampsia.  Because of that, we knew I was at risk for developing preeclampsia or HELLP in a future pregnancy, so my pregnancy with Ben was managed differently.  I took low-dose aspirin.  I took calcium supplements.  I took anticoagulants daily, from 7 weeks gestation until 6 weeks postpartum.

I'm not even counting the extra monitoring we did — the blood pressure checks, the daily stick-peeing, the weigh-ins, the Doppler scans, the non-stress tests, the growth checks, the 24-hour urine collections, the biophysical profiles — because, gosh, those were a lot of fun, but in no way are they preventative.

Given my history — infertility, miscarriages, an inherited thrombophilia, and the way things went down with Charlie — all these interventions made good sense.  But I would not dream of saying that because I didn't get sick, they worked.

Plenty of women at risk for preeclampsia or HELLP take these precautions and more, and still get sick. 

Any or all of what I did may have contributed to the uneventful pregnancy it turned out to be.  Or you know what?  Maybe none of it did.  Maybe everything was all lovely pelvic sunshine and trophoblastic roses upon implantation, when the process of preeclampsia is believed to begin, and I wasn't ever going to get sick to begin with.  We don't know.  We can't.

There's still so much science doesn't know about preeclampsia.  There's so much work to be done.  We don't know why some women get it and some don't; why some women get it once and then never again while others get it repeatedly; why some women stay well with interventions and some don't; what role factors like heredity and race play; or how to predict before a pregnancy who'll be stricken.  We don't know how to halt the progression of preeclampsia once it begins.  And despite some small steps in that direction — some encouraging, some initially promising but eventually disappointingwe don't yet know how to prevent it.

I did not develop pre-eclampsia or HELLP.   The only factor I can credit with any degree of certainty is luck.  I can't say it's because I took my medications as directed, or because I was under closer medical supervision, or because I was "careful, diligent, or proactive."  I got lucky.  And it drives me absolutely bugfuck insane to hear anyone claim otherwise.  Because the implied converse — that women could have avoided developing an illness about which so very little is known if they'd only done things differently — makes me really fucking furious.

There.  Finished.  That was the sour.  Now to refresh the palate, the sweet:

Charlie-eggs

Ben-pirate-chair

Ben-charlie-shirts


Tomorrow, some umami, when I'll post about a giveaway.

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