Mother’s Day seems a good time to remember origins and to give thanks. First, a thank you to my own mother, The Secret Hero, for setting an example that all her children have strived to emulate: even my little bro, in the middle of Japan, cooks a roast beef and Yorkshire pudding and bakes a cake from scratch for Christmas and birthdays. This, in a country where beef is hard to come by and sometimes you can’t get butter. The food is of course also a metaphor for the emotional nourishment mom provided. She loves us more than, in the words of Mbot, a cactus loves its prickles.
It’s also a day to remember the origins of my own motherhood: First, a miscarriage, and the realization that motherhood–and the love of that new life–can begin when you first see the + on the little white stick. And when my body bled out that promise, the betrayal I felt from my own body, and the hopelessness of my desire.
Mbot was conceived six months later, and early pregnancy–an experience I had expected would be joyous although perhaps uncomfortable–was tarnished by the daily fear of false hope. Husbot preached “cautious optimism”–a state possible for him, maybe; it was not his body that had invited into itself and was now responsible for a very real and capricious soul; it was not his blood circulating through its veins and back to his heart.
After four months, there was less fear and more exuberance, and a moment of horror when I finally saw myself in a full-length mirror and realized that my sexy new pregnancy swimsuit didn’t make me look sexy and pregnant at all–it made me look fat. Husbot went out and brought home two pints of ice cream, with hot fudge sauce. That made me feel better. And then the ladies at the pedicure place gathered around to point at my newly abundant and impressive varicose veins and babble about them in Vietnamese. But I had bigger concerns–I had to poop, and when I had to poop, I mean I had to poop right now.
Then, at seven months, I began to feel extremely tired. Everyone said it was normal. I was after all, in biological terms, old. The prime years for Homo sapiens to bear children coincide with the prime years for us to become Olympic gymnasts, and I was thirty years beyond that.
At eight months, I was still extremely tired, I had a headache, and I felt sick to my stomach much of the time. I had diarrhea. I would dream I was having painful contractions but wake up with only a stomachache. The doctor said, “You’re older. You’re pregnant. it’s normal.”
One week before Mbot was due, I went in for the scheduled check-up and my by now enormous-looking bump, that felt so big and so low I could only waddle in an irritatingly stereotypical pregnant-lady way, measured too small. For some reason, Mbot had not gained the weight he was supposed to in the last seven days; he possibly had even lost weight. They did an ultrasound and found the umbilical cord was wrapped around his neck. I was sent to the hospital for a fetal nonstress test. McDowell Road hadn’t seemed so long since Husbot had driven me to the ER, doubled over in pain, just over a year before.
Now, thirty-nine weeks pregnant, during the hour that I was hooked up to a nonstress test machine that measured our heartrates and my bloodpressure, it was determined that Mbot was fine. He was fine. I was so relieved that it was with little alarm that I received the news that I, on the other hand, had a bloodpressure that had, in sixty minutes, risen from 110/70 to something like 168/90. Blood was drawn. It was not as it should have been. I was handed a cloth gown, off-white to blue, with a tiny blue pattern, a four-petaled floral motif, each petal the shape of a tear–of sorrow? of joy?–and I was admitted.
I can’t remember exactly when, during that evening or night or the next early morning, I was diagnosed with HELLP Syndrome–I would have to look at my chart–but by five a.m., my platelet count had dropped from 250,000 to 100,000, and the nurses were drawing blood to see if it could clot.
HELLP Syndrome is a variant of preeclampsia. The acronym stands for Hemolysis (which means the breaking down of red blood cells), Elevated Liver Enzymes, and Low Platelets. (Platelets are the blood cells responsible for clotting.) It was discovered just in 1982. According to The Preeclampsia Foundation, morbidity and mortality rates have been calculated at as high as 25%–partly because it is so difficult to diagnose. It presents in different, subtle ways that can easily be mistaken for flu, gastritis, hepatitis, or just…being old. It usually occurs in women under thirty and over forty. It is currently impossible to prevent, except in subsequent pregnancies–during which a single baby aspirin a day lowers the chances of recurrence almost completely.
By seven a.m., my platelet count had fallen to 90,000 and I was finally rolled into the OR for an emergency C-section under general anesthesia. Blood was on hand in the event that I needed a transfusion. My father (the Guru), a retired surgeon, had sounded unworried and confident over the phone a few hours before. The fact that he had not boarded a plane from Idaho to Phoenix was a source of comfort. And so I believed I was being dramatic when I feared that I might never meet my son. Ninety-five percent of me believed. The other five percent was genuinely terrified that I wouldn’t wake up.
But I did. I hadn’t even needed a transfusion. My first thought upon waking was “I’m awake. I made it.” My second thought was the one I expressed aloud, as Husbot handed me a six-pound, six-ounce squinchy-eyed thing in a hat: “He’s even cuter than Tesserwell.” I was floored by that realization because I have always claimed the antique cat was fashioned from my own rib. I loved Mbot–we already knew his name–immediately and fiercely and unreservedly. I was relieved by and completely unprepared for the depth of that connection.
The normal arc of HELLP Syndrome is that, once the baby is delivered, the mother’s body continues to deteriorate for two days, and then it begins to heal. This does not always happen. In some cases, there is permanent liver and kidney damage. In the worst cases, the mother seizes due to high blood pressure before delivery, and the fetus dies. Or the mother dies. Or both. Often, the onset of HELLP occurs in the second trimester, and the mother is kept on bedrest and magnesium for as long as possible to give the fetus more time to develop. But delivery is the only cure. Mbot and I got very, very lucky.
For three days, I was on medication to lower my blood pressure and had IV drips in both arms, one dripping magnesium sulfate, a muscle-relaxant, into my bloodstream to eliminate the possibility of a seizure. I was catheterized, and I was on pain meds for the C-section incision. I was voraciously thirsty–a side effect of the magnesium. For the next forty-eight hours, my platelet count continued to plummet. Seventy-five thousand. Sixty-thousand. Fifty-five thousand. When it hit twenty-two, and then eleven thousand, which indicated that my liver was still ripping apart my blood cells as they passed through it, the nurses began to ask every hour if I felt pain in my upper abdomen, which would further indicate that my liver was failing. I didn’t.
I couldn’t change my newborn’s tiny diaper, which was the size of a pocket handkerchief, but I could hold him when he was placed in my arms. He only opened one eye in the first twenty-four hours, and it stared up at me like the eye of a whale surfacing, dark smoky blue and unblinking. It was very unnerving. Sometimes it was downright frightening. He seemed to know everything, see everything, even though I knew he really couldn’t see much at all. On top of that, he seemed to be accusing me of something, but I didn’t know what. Welcome to motherhood.
I was tired, I hadn’t washed my hair in days, and photos from that time will show that I looked like hell. In spite of Husbot’s presence every night (he caught a terrible cold from sleeping directly under the air conditioning vent, on a fold-out sofa we theorized was filled with iron filings–I vowed I would never, ever, get mad at him for anything, anything), I wasn’t sleeping more than a few hours out of every twenty-four. There were interruptions around the clock. Along with almost constantly nursing Mbot, who was an impassionate grazer, my blood was drawn every four hours–which more often than not entailed several painful attempts, as my veins are master get-away artists in the presence of a needle. The IVs were checked and adjusted several times an hour, the bathroom was cleaned, drinks replenished, pain pills brought in, the catheter bag emptied, the garbage can emptied, my nursing record studied, and the damned alarm on the heartrate monitor kept going off because my resting heartrate is naturally so low. (They never seemed to be able to readjust it.) I kept a chart for one two-hour period which showed an interruption on the average of ten times per hour, and then I gave up keeping track.
My hemmorhoids, which I hear from about once every ten years, chose the first night to rear their fiery heads and when I became irrational with pain, a nurse, fearing a seizure, shot me full of some tranquilizer to keep my blood pressure down. Husbot will report that I babbled to invisible people for an hour afterward. But I tell you, they weren’t invisible.
On day three, to everyone’s intense relief, my platelet count began to climb. My blood pressure dropped to still high but less-than scary numbers, and I was eased off both the blood pressure meds and the magnesium drip. A nurse came to help me relearn to walk. I stood up and almost fell over–muscle relaxants will do that. I shuffled down the sterile hallway feeling euphoria at being out of bed, at moving, and, (melodramatically, I’d like to believe) for being alive. For Mbot’s being alive.
On day four, we went home. Mbot was much smaller than most of the newborn clothes we had. He was completely outmatched, size-wise, by his orange car seat, whose elaborate five-point harness was still a mysterious, magical thing to me. It was 112 degrees outside when we exited the hospital, but it was so good just to be outside again, with a healthy baby, and regaining my own health, that I forgave even the Arizona weather, at least until sleep deprivation really set in, and I couldn’t even forgive Husbot for using too many paper towels to dry his hands.
To my fellow mothers: Happy Mother’s Day. We are a fucking lucky bunch.
For more information on HELLP Syndrome, go to The Preeclampsia Foundation.