Postpartum puzzler - edema + more after pre-eclamsia

[Guest guest]

Adrienne,

I hope this doula has already received this advice, but I think

this woman needs to see her OB or hospital immedately!

 

If she was preeclamptic prenatally, she still has a significant

postpartum risk AND she is exhibiting serious sypmtoms:

 

significant edema

headaches

dizzyness

nausea

vomiting

shortness of breath

jaundice

 

Of course, these may all be unrelated, but given this woman's history

and what is going on, she could be very, very sick and I think she

should be seen NOW. IF she is still preeclamptic, things can go

downhill very fast and that is why prompt care is SO important!

I hope she receives proper care and I will be sending my prayers for

her and her babies.

 

~Erin

 

 

>> As of today, her edema is definitely worse than it was last

week. ....She's had headaches, been very queasy and has vomited, and

sometimes experiences a great deal of dizziness that is periodic but

doesn't seem related to what she's doing........ She's also troubled

by shortness of breath, moreso now than right after giving birth.

Finally, the whites of her eyes are slightly yellow.

 

ayurveda , " Adrienne "

<greenhands@k...> wrote:

>

> Hi,

> This came from another doula list I am on. I would love to hear

some feedback. I feel this lady is suffering from profound

malnutrition, lack of minerals, good fats, proteins, etc. combined

with possible liver involvement. And major lifestyle issues...

> Thanks and Blessings,

> Adrienne Leeds

> Certified Clinical Herbalist

> Holistic Doula

> Apprentice Midwife

> www.charlestondoulas.com

>

> -

>

> wildbeachdoulas

> Tuesday, January 31, 2006 11:50 PM

> [wildbeachdoulas] Postpartum puzzler - edema + more after

pre-eclamsia

>

>

> I need some expert advice. I've been working all kinds of hours

with a mom of twins, who has started having some very odd and

unreassuring postpartum symptoms. She's been to see both her OB/GYN

and her primary care doc, had a liver profile done ( " some of the

numbers were a little off " ) and CBC (no results on that yet), etc.

She's also scheduled for an echo-cardiogram next week, and they are

testing her thyroid levels. However, the docs seem to be doing a lot

of this " just in case, " and really believe that she's fine.

>

> My intuition says that's not quite accurate.

>

> Here's the background:

>

> * Mama is a lovely 40-year-old African American woman. This was

her first pregnancy. She has a very Type A, driven personality, and

is an executive at a home improvement store's corporate

headquarters. She intends to return to work at 6 weeks postpartum.

>

> * The twins were conceived while she was on fertility medication.

Four sacs originally appeared on the u/s, but one embryo apparently

never developed. One fetus was miscarried at 12 weeks, leaving the

twins-- a fraternal pair, boy and girl.

>

> * Mama was put on bedrest at 25 weeks after going into preterm

labor twice, the second time dilating to 2 cm and effacing to 100%.

>

> * Preterm labor was stopped both times by mag sulf.

>

> * Due to the bedrest, her appetite was low and it was always a

struggle to eat well. By 35-36 weeks gestation, she had some

moderate edema that was constant no matter what she did, and her BP

began to go up. I interviewed with her for postpartum doula work

during this period, and encouraged her to eat (esp. more protein),

drink plenty of fluids and salt her food to perk her appetite. She

was too miserable to hear me well, and the Christmas holidays (she

was allowed to go off bedrest and got pretty busy-- too busy to eat,

sometimes) didn't help matters.

>

> * By 37 wks+ 5, the doc was talking induction because her BP

continued to rise, swelling was increasing, and they felt she was

showing signs of pre-eclamsia. I repeated the encouragement to eat

more protein, which she finally began to do-- by this time she was so

uncomfortable with the swelling that she was willing to try

anything. A day and a half later, the swelling had begun to improve

some but her BP was still up. The doc sent her to the hospital for

immediate action.

>

> * She birthed at exactly 38 weeks, Dec 31, cesarean with an

epidural. Baby A, Chloe, was breech at this point so there was no

offer of induction and vaginal birth.

>

> * Everything seemed fine immediately postpartum. Caleb was just

under 5 lbs and Chloe just under 4 lbs. Both nursed well and had no

problems related to their birthweight or gestational age. Both went

home with mama when she was discharged, though they were re-admitted

a day or two afterward due to an inability to regulate their body

temps.

>

> * Mama was not readmitted w/ babies, so she spent 4 days on a couch

in the waiting room. Breastfeeding assistance from staff wasn't

adequate. Her milk came in but staff didn't want the babies out of

the incubators very long... with predictable results. By the time

the twins came home, she was down to nursing each baby once per day.

>

> * Lochia and involution seemed to be WNL, but healing of her

incision was slow and difficult. The wound drained profusely and had

to be packed until the latter part of last week. As of now, 4

weeks+2 pp, it's still not completely healed.

>

> * Her edema (primarily lower body) initially seemed to be resolving

pretty well, but then hit a plateau and just stopped improving. Her

OB gave her a prescription for a moderately strong diuretic on Monday

of last week, when she went in to have her incision checked.

>

> * She began taking the diuretic that day, and either coincidentally

or not coincidentally, that is when things seemed to take a turn for

the worse.

>

> * As of Wednesday of last week, just two days after starting the

diuretic, she had /gained/ weight. In fact, she gained a total of 9

lbs last week. This, despite eating very little-- her appetite is

still low. In addition, while her abdomen had gone down a good deal

by Monday, I noticed on Weds that it was swollen and distended to the

point that she looked 8 months pregnant again. She said it felt

uncomfortably hard and tight, especially up high (just below her

breasts).

>

> * As of today, her edema is definitely worse than it was last

week. Her abdomen is slightly less distended, but not by much.

Still larger than it was a week ago. She's had headaches, been very

queasy and has vomited, and sometimes experiences a great deal of

dizziness that is periodic but doesn't seem related to what she's

doing. She wants to crunch on ice, and says everything tastes like

it has soap in it. The thought of food repulses her, and she's

currently subsisting on oranges and protein shakes. She says she has

increased her fluid intake but her urine output has /not/ increased.

She's also troubled by shortness of breath, moreso now than right

after giving birth. Finally, the whites of her eyes are slightly

yellow.

>

> Her docs told her to exercise (they feel her breathlessness is due

to the extra weight she's put on!), to eat bland foods (they think

she has a GI virus that's been going around), and to " get some

rest. " Yeah, right.

>

> Like I said, based on my intuition and observances, exercise and

bland food and rest (while it would certainly be good for her) are

not going to address the root cause here. She /is/ stressed-- with

twins, low endurance from prolonged bedrest, and a poorly healing

cesarean wound to complicate her recovery, that's pretty

understandable. Although her Type A personality is softening some

and she's learning to relax a bit, she's also sometimes very hard on

herself. Unfortunately, extended family members are being hard on

her too, apparently feeling that she should be " feeling better " by

now. This isn't the type of woman who can easily allow herself to be

lie around, so her prolonged recovery and worsening physical symptoms

say to me that something is wrong.

>

> Fortunately, she is no longer taking the diuretic. Her only meds

now are an iron supplement (although her hematocrit was WNL today--

in fact, higher than it had been just before she gave birth) and

prenatal vitamins.

>

> So, dear wise women... that brings us to the present. What do you

think? Any and all suggestions, advice and information are VERY

welcome. The sooner, the better. I'm concerned.

>

> Much love,

>

>

>

>

>

> " The most powerful thing you can do to change the world is to

change your own beliefs about the nature of life, people, and reality

to something more positive . and begin to act accordingly. "

> --Shakti Gawain

>

> Sullivan, CBE, CMHD, EFT-CC

> Childbirth Education, Holistic Doula Services, Reiki, EFT

> Shekinah Birthing Co. - http://www.shekinahbirthing.com

>

>

>

>

[Guest guest]

Dear Erin and Adrienne;

Of course my exhortation is also for this woman to have qualified

professional care immediately, you must also realize this I'm sure,

Adrienne. I would be looking for nearest MD/ayurvedic woman physician

or doing phone consult with one of the most skilled practitioners on

the list at www.sacredwindow.com/resources.html. I am thinking

specifically of Dr. Jay Apte who works out of the SanFrancisco Bay

area, or Dr. Aparna Bapat who works out of NY and neighboring states.

Both also teach. I know there are others, these I know a bit

personally.

 

We do have several group members who may qualify, but I do not believe

they check in very often. OH! Including, in Maryland just outside of

DC is MD/Ayurvedic physician Dr. Kummuda REddy who coauthored the

book, For a Blissful Baby available on her website

http://www.allhealthyfamily.com 866-ReddyMD or 301 770-0610

 

This is the only reason I checked in so late tonight, to second Erin's

wisdom and offer these contacts in addition. WE can discuss the

concepts soon and hope we have more to work with by then ... please

keep us posted, Adrienne? As I understand it, this is not your client

but another doulas?

 

Low agni, before not only creating some of the problems, compounded by

bedrest, and the natural very reduced agni after childbirth have added

up to serious proportions for this woman, without going into any other

factors! high ama, congested kidneys and liver function, blockiing

urine output and raising BP yes it is secondary.

 

Not healing well is also sure sign of low HGH function, probably has

been on antidepressant of some kind which coat the brain

glands/availability although even the ama from low activity/exercise,

cold foods/drinks, etc will reduce appetite and complicate/clog body

channels and glands, but excess SSRIs do it mightily.

 

Anyway, high cortisol levels contribute significantly to all these

symptoms. In her case I'd probably be using a product called

Cortistop (just thought of it, all natural excellent product by Yound

Living Essential Oils)_in supportive addition to the more significant

balancing items for digestive fire, diuresis, BP etc. BLand diet will

create more problems also, she needs significant " middle of the road "

spices including browned garlic, fresh ginger, so much more to map out

a program for her even with what we know much can be done in support.

 

But medical supervision is an IMMEDIATE must. Unfortunately, without

the ayurvedic support to build her balance and function the problem

will likely get worse before better.

 

Yes I have had very good success with a couple of PE clients and

including one we had access to this herb. After strong disclaimer I

can only support, within a week the literally biggest one was

experiencing so much relief, reduced edema, etc. She gained almost

less than 2 lbs I think it was the last three weeks of her pregnancy,

after being a high risk balooon. We used essential oils of

lemon/grapefruit or peppermint, not sure in her drinking water,

shifted her diet and digestive supports, reduced water intake, and

herbal formula ... I'll have to look it up, but it was personalized

also.

 

My personal experience with gokeshura, it makes the urinary channels

feel like silk! And it is a rejuvenative tonic, unlike other

diuretics. I purchase mine from www.banyanbotanicals.com who offer

practioner wholesale accounts with $40 order minimums. Again, not to

use alone, other things are needed. Some confuse it with another also

called goats' beard or puncture vine very effective as galactagogue,

but I have not had access to that one to use, favor shatavari (wild

asparagus root) for that one.

 

To be continued!

Ysha

[Guest guest]

Hello dear Ysha,

Yes another doula's client, in Charlotte NC.

 

She has been seeing her OB and general practitioner regularly. They

have more or less dismissed her symptoms and failed to run simple

diagnostic tests like urinalysis. Both tell her to get some rest and

exercise! Humph. So your recommendation to find qualified medical

professional must emphasize " qualified " .

 

Fortunately her doula is a very wise woman and networked to find a

homeopathic remedy. Within a few minutes this morning, her picture

began to turn around. Urine went from brown to yellow, back pain

cleared up, appetite returned, abdominal pain significantly less

tender, edema abating. Prior to late pregnancy her nutrition &

appetite had been very good, so she had some reserves from which to

draw. However it is high time to refill her cup, er, cups!

 

This doula is unfamiliar with Ayurvedic PP nutritional specifics and

I will link her to your website, plus share what I can. I had also

recommended a very gentle lymphatic-style massage for all benefits we

know, incl. symptomatic relief of edema.

 

Thanks all for your concern and wise counsel.

Adrienne