Emily Hamm

 Peripartum Cardiomyopathy Support Network

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Our Birth Story

We had a very rough start to this whole ordeal. I went in on Friday night, 04/22/05 at 12:45 to the ER because I was having difficulty breathing. They took all my vitals and rushed me upstairs to labor and delivery triage. My BP was 193/130 and I had lots of fluid in my lungs. They started me on a magnesium sulfate drip so I wouldn't have seizures because my BP was so high. They also gave me hydralazine to bring my blood pressure down. I had some pretty significant protein in my urine indicating that I indeed had severe preeclampsia. I immediately started feeling icky from the magnesium sulfate. Once I was stabilized, they rolled me down to my labor and delivery room. I started labor on my own at 2:30 Saturday morning and was having consistent contractions and then my water broke at 5:30. They started my epidural at 7:00. I wanted to go natural but the doctor felt I could potentially have complications because of my high blood pressure, etc. They started my pitocin drip at 9:00 and then had to redo my epidural at 4:00 because my first one fell out. The doctor came in at 6:00 and I was completely numb and asleep when he said "let's do this." I started pushing at 6:00 and Isaac was born via forceps delivery at 6:49. The doctor didn't want to wait any longer because he was fearful of my high BP, etc. I then was continued on the mag for another day. I felt like total crap, like I had the flu, because of the mag. Finally Sunday evening I was feeling better. Monday I did fine but Isaac had to be taken to the special care nursery Saturday evening because he was having apneic episodes where he would forget to breathe. He stayed there for the week and was monitored. The conclusion is that he just needs to learn how to suck, swallow and breathe at the same time and that it is most likely a maturity issue. However, there is also speculation that it could have been due to the mag that I was on as well as my other complications.

Tuesday evening I started feeling short of breath and so my nurse called the resident on call to listen to my lungs. I had been coughing for awhile and Steve had to bring me back down to my LDR room from the NICU because I couldn’t breathe. I again was full of fluid so they wheeled me up to telemetry (cardiac floor) for monitoring as my heart was racing (rate of 144), my BP was up (140s/100s) and my pulse was crazy due to the fluid in my lungs. They gave me Lasix to get the fluid off. I lost 19 pounds of fluid in 36 hours. Can you believe that? What a weight loss program! hehe, just kidding. While on telemetry, I had a Foley bag so that my body could get rid of all the fluid without me having to live on the toilet for a few days. I had bouts where I would have to receive a little bit more Lasix when my fluid would go back up. Luckily, my body responded quite well to the Lasix and it did the trick. I did have to get a potassium supplement because I was getting rid of so much fluid and they didn’t want my electrolytes to be depleted. I had to have an order from the cardiologist to allow me to take my heart monitor off so I could get a shower. I felt so gross and stinky. However, the worst part was that I felt like a prisoner on the telemetry floor because of my heart monitor. Isaac was on floor 3 in the NICU and I was on floor 4. I couldn’t even go see him. The nurses were nice enough to bring him down to my room so that I could visit even though the visit was only about an hour. It devastated me to be away from my baby for so long. After all the diuretics I received on Tuesday night/Wednesday day, my body decided that it was going to cooperate and finally started to feel better and I could eat a regular meal, walk around in the halls, etc. I felt like I was 95 because here I was, a 25yo with a Foley bag and catheter in a hospital gown walking around the cardiac floor. I could only go slow because I had been in bed and got dizzy easily with exertion as well as not wanting to stress my heart because the nurse would come find me to see what was going on on my heart monitor. Sheesh! What an ordeal. I was determined though and made a few rounds of the cardiac floor. I remained on the telemetry floor until Thursday afternoon when I was sent back down to postpartum. I could finally be free to go visit Isaac in the NICU whenever I wanted. Thank God! I was so tired of not being able to see him. Though I had to take things slowly, on Friday I was able to actually walk up to the NICU and not have to be wheeled up in a wheelchair (due to my BP escalating). This was one of the major accomplishments for me and was what made me feel like I could beat all odds J. Friday was a very lonely day as Steve had to go to work. Mom spent most of the day with me that day which I was very grateful about. She spent time with me up in the NICU with Isaac and time in my room when I got tired and had to go take a rest.

I had to stay in the hospital until Saturday to make sure my blood pressure was fine on the meds and that I didn't fill up with fluid. I was started on Toprol to stabilize my blood pressure as well as Lasix to keep the fluid out of my lungs. My unofficial diagnosis was preeclampsia induced pulmonary edema. Little did I know that I was going to be diagnosed with peripartum cardiomyopathy.

Now to my PPCM story.

So now that you know my birth story, here is what happens next. I was given the unofficial diagnosis by one doctor in the hospital of PPCM. My OB wasn’t thrilled about the diagnosis and thought everything was related to my preeclampsia. I had to follow up with the cardiologist the week after for a blood pressure check, etc. Everything had returned to normal now that my excess fluid was gone. He said I needed to come back in a month to get an echo of my heart to see how things were going. When I went back at one month postpartum, my heart function was decreased with an ejection fraction of 30-35%. He said that he wanted to put me on medications but I really didn’t want to be on anything because of breastfeeding so he allowed me to try and get better and improve my function just by exercising and eating right. He said that the only thing that will really improve it is time, that is if it’s going to improve, but that I could go ahead and give it a try. I was feeling great and asymptomatic.

When I went back at three months postpartum for my next check, I was encouraged to find out that my EF had gone up to 40-45%. The normal range is 50-55% or above. He said that he wanted to see me back in January to get another echo and see how my function is then.

I am happy to report that after seeing the heart failure specialist in August, I was given the good report of my EF being at 54% by MUGA. I went to the cardiologist in January and he said that everything looks great and normal and he will see me in a year. We will talk then about a future pregnancy. Though it’s a scary subject, I am hoping that I can go through with another one so that Isaac has a sibling. I have enjoyed being a mom so much! Steve and I still have to discuss everything but we will eventually come to a decision.

So that’s where I’m at for now. I’m busy and keeping up with my beautiful little boy and enjoying being a WAHM and wife. God has truly blessed us and I couldn’t have asked for more. We are shown every day of his goodness and mercy on my life/our lives and are ever grateful for giving me a second chance at life.