Pregnancy Blogging - Preeclampsia History

Rather than just blog about places to eat and things to do with your kids I have decided also to blog about my current pregnancy.  I have been inspired by a blog that was recommended to me by a friend.
It is all about a mom who had pre-eclampsia with her first two pregnancies and how she prevented it in her third pregnancy.
http://pregnantafterapreemie.blogspot.com/
Her blog inspired me and made me realize that it is time to get serious.
This post will be about the history of my first pregnancy:
After this I intend to talk about what I'm doing for prevention, symptoms that arise and how I manage them.
Here is my story in brief.  With my first pregnancy I had an easy time of it.  I had hardly any nausea, and some fatigue that all evaporated after the first trimester.  I went to pre-natal yoga at blooma (thanks to a chinook coupon) at least once if not twice a week, and starting in about week 20-25 I began following the Brewer diet.  It was during a pre-natal yoga session that I noticed that my ankles were swelling.  I rushed to my midwife's office, they checked my blood pressure and reassured me that everything was ok.
Disclaimer: I am a family nurse practitioner and can tend toward over-self-diagnosis sometimes
The swelling in my legs increased and I began to wear compression stockings from morning till evening which was easy to do considering it was the fall-winter.  Next I noticed my hand was swollen, and I had to go to a Jeweler to remove my ring.  I proceeded to wear this lord of the rings style for the next four months or so.  I also began to measure large for dates by about an inch or so.

Still everything seemed fine and normal until my check up at 35 weeks - suddenly my blood pressure was 135-140/90.  My midwife told me to go home, rest, and not worry (Ha!), come back the next day for a blood pressure re-check.  At that point my blood pressure was 140-145/95.  The inevitable 24 hour urine protein collection was a sad affair with less than 1000 cc's of urine and greater than 900 of protein.

I transferred out of Health Foundations birth center and to Dr. Hartung at Hudson Hospital in Wisconsin.  He works with the birth center midwives and is renowned for being the most midwife friendly doctor in the area.

I had a foley bulb induction with pitocin and the requisite magnesium, as well as large doses of labetalol and hydralazine to keep my blood pressure to 160 systolic.

After 10 hours of active labor I managed to give birth vaginally to my son who weighed 7 lbs 7 oz, and was spot on 37 weeks gestation that day.
So far so good, except then I had a retained placenta which had to be manually removed - ouch.

Following this I lost about 2 liters of blood.
Ok now, I'm good with my supportive husband and newborn baby right?  Except that by day four post partum my milk has not come in and my little boy has lost almost a pound - not to mention he looks like an oopa loompa because of neonatal jaundice.

And I am swollen up like the michellin man from all the IV fluids I received in the hospital.  Nothing like cankles to make a new mom feel sexy.
As it turns out being intravascularly dehydrated with a hemoglobin of 6.2 (low normal is 12) makes it hard to produce breast milk.
So it's back to the hospital for 2 Units of packed red blood cells, that is after they stick me 12 times (last three with ulrasound and a PIC nurse - not only is it hard to make breast milk it is also hard to find your veins) and mull over the fact that I have a positive antibody screen (because I just received rhogam duh).
While this is going on we've started giving our son supplemental feedings with an S&S tube.  We are using donor breast milk because I just cannot give him formula.  If you asked me now if I thought a little formula was the end of the world I would say no, but at that time in my life when I felt so out of control and so lost I just could not bear it.  With nursing 10 minutes on a side, and pumping for 10 minutes, and feeding with S&S tube, and changing diaper etc each feeding takes 90 minutes - that's every two hours.
Also I still have high blood pressure so I have to go on bed rest and continue taking Labetalol for an additional two weeks.  Minor deal considering this is my first baby and I don't have other duties to perform.
Six weeks later thanks to a lot of Lactation support and donor breast milk and a post-partum doula, and domperidone I have established a healthy breastfeeding relationship with my son.
I also gained about 25 pounds that would not go away - it's hard to know how much I gained during the pregnancy since after I began retaining water I stopped paying attention.  Also my midwives' scale would blank out after 200 lbs (ouch!).
On the whole although I had a very wonderful birth experience almost everything that happened afterwards was deeply traumatic for me and I would like to prevent it if at all possible this second time around.
It's a double edged sword that pre-eclampsia is a disease of first timers, but also the number one risk for pre-eclampsia in a subsequent pregnancy is a previous history of pre-eclampsia.  It is still a poorly understood phenomenon but is thought to be caused an autoimmune reaction to the placenta (read allergic to your husband).  I'm still married to the same guy, and I'm older now (another risk factor).  So here we go.  If I get it so be it, I just want to feel I did what I could to prevent it.
for More information on preeclampsia go to http://www.aafp.org/afp/2004/1215/p2317.html