Friday, November 27, 2009

Eclampsia

Here is what the medical people say:
http://en.wikipedia.org/wiki/Eclampsia

http://www.umm.edu/ency/article/000899prv.htm

Here is what the mother-in-law witness has to say.
First of all, and rather calmly, let me say that convulsions are terrifying to witness.
The person convulsing has no memory of the 'incident,' which is merciful. No one would want to remember the utter helplessness of that. Elana started to convulsive and was instantly 'outside' herself in the sense that whatever makes her herself was overcome by the electrical storm in her brain and the resultant physical spasms.
She had gotten up with a headache and blurred vision. She had had an odd headache a couple of weeks before and not been herself for the past week. I knew immediately (see my earlier post)
what was happening, so I did what we all do these days; I went to the computer. Seth started yelling "Mom." When I ran up the stairs, Seth was holding her up, barely, trying to lower her onto the floor of the shoebox-sized bathroom they were in. This was hampered by the fact that both of them are tall and there is a giant stuffed bear in the corner because that room is usually only used by his younger sister.
Ron drove up, at that moment. I yelled out the kitchen window for him to come. He was walking, tired from a night shift, but instinct and training will override most anything. In an instant, he broke into a run, dashed up stairs in time to help Seth get her to the floor.
By this time, I was on the line with 911, a maddening experience for the caller. The operator asks all these questions without telling you she had all ready hit a panic button somewhere on her end and the EMTs are rolling out of their station, while she wants to know the color of the patients toenails or some such other stupid thing. I was yelling that we needed an ambulance, Ron is yelling from up stairs, Seth was silent. After she said the EMTs were on their way, I calmed down a bit and was able to give them information in a polite, businesslike way, which I had NOT been doing up to that point.
The EMTs rolled in, looked at Elana and said we don't have the drugs for this. They called another ambulance service and opened their cheat sheet for what to do with mothers in full blown eclampsia. By this time Ron and I were in their bedroom, trying to stay out of the way.
J was in her room, where I had also stuffed the dog. I think J just cowered under the covers. Elana breathing was so loud, J said later, that she could hear it through the closed door. It was awful: load, laboured, grating, as if it came past the coarsest sandpaper you can imagine. They started an IV and gave her Mg to control the seizures and start to reduce her blood pressure which was somewhere over 280(top number, I kid you not).
The EMTs are pros, but clearly they were freaked out too, consulting a guide book of some kind for dosages. The other service arrived fairly soon. By that time, time was, to use a bad metaphor, dilating and contracting. The EMTs stabliized Elana as best they could and then tried to move her down the stairs. Elana is tall and the bathroom is quite small. They couldn't turn her. They couldn't get the stretcher in the bathroom. They dragged her out, almost literally, turned her in the hall, while I waited for one of them and her to fall down the stairs. Finally they got her on the stretcher, and then couldn't get it down the stairs. They couldn't grip it or they were afraid she would fall. So they back up into the bathroom. A stair chair seemed to be what was wanted next. They get one and bring it upstairs and manoeuvre it into the very small bathroom behind her. This then requires them to lift her again, this time into a sitting postion, and this time they can carry her down the stairs. Outside they transfer her to the stretcher again. She lolls, her head and arm off the side for a moment. She looks dead.
At that point, I think we've lost her.
The ambulance takes off, Seth follows in another. While all this has gone on, I have called work to tell them I won't be in, called a neighbor to take J to work and to watch the dog. Ron and I dress and get in the car. I've talked to Amy, pediatrician daughter, who says they will deliver the baby and everything will be all right. Not so sure, we head for the hospital.
What I can't reproduce here is the terrible gurgling, rasping breathing, the seizing, and then the deathly stillness after. She was totally unresponsive, limp, just like a body, not a person. My response to terror is to go cold. I don't cry and I don't go hysterical. I drove. Ron and I talked, but we didn't know much to talk about. I had heard of eclampsia, Aunt Mattie had nearly died from it and her baby had. Among older women it was whispered about. Now it is so rare that pregnant women hear about it, out there in the distance. "Oh yeah, eclampsia" seeps in from the remote reaches of the pregnancy universe. But I know nothing. And Ron, though he has been an ICU nurse for 35 years, knows nothing.

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