Recently, we took care of Caren, who had severe preeclampsia. She was brought to the hospital at 28 weeks gestation; she was seizing at home off and on for 8 hours. She was still having seizures on presentation. Her blood pressures were markedly elevated and she was unaware of her surroundings. Initial lab tests of her liver and kidney functions and platelet count were very abnormal. Sadly, she was also diagnosed with an intrauterine fetal demise (stillborn). She was given IV medications to stop her seizures and lower her blood pressure. Upon placing a foley catheter into her bladder, frank blood was noted.
Since she was not in labor and needed to be delivered, she underwent a C-section and was then transferred to the ICU. Fortunately, she had minimal bleeding during her C-section. All of her organ systems slowly began to recover, except for her kidneys. She developed renal failure. Her creatinine was 10X the normal value. A family conference was held with her husband and her brother to recommend transfer to Moi University Hospital (3 hours away) where she could get dialysis. The family agreed and went back to their home village to try and gather funds for dialysis. Each dialysis treatment would cost $100 and Caren would need 3-4 treatments per week. This was a large amount for her family to raise.
Caren became more stable and was transferred out of the ICU while we waited for the family to return. One of the many frustrations and difficulties of practicing medicine here is that there are sometimes available treatments, but they are unaffordable. During our wait, Caren became more alert each day. We were pleasantly surprised when her kidney function started to normalize even without dialysis. As we rounded on her this week, we helped her out of bed and she was able to stand (the first time we saw her upright since admission). She was recently discharged home after spending 3 weeks in the hospital. It is very likely she will have an element of chronic renal failure, but she has three children that are blessed to have their mother home.
Caren prior to discharge
I was looking for an e-mail to send this to Dr. (Bryan) Popp but didn't see one, so I'll have to post it here...
ReplyDeleteLast year you delivered my son Jack at St. Joe's. He was 8 weeks premature and my husband and I were so incredibly worried. From the moment I spoke to you on the phone from my home, you did such a wonderful job making a very scary situation so unbelievably calm. My son's birth was the best experience of my life, largely in part to you. My husband and I are just so grateful to you for making it such a wonderful experience for us. Your willingness to answer our questions, and your calm demeanor meant the world to us. I couldn’t have asked for a better doctor.
Jack had to be taken to the NICU right away, but you allowed me to hold him for a quick second before they took him. You have no idea what that meant to me, and I will forever be thankful that you understood the importance of that quick moment where I got to tell him that I loved him, that everything would be okay, and that I would be with him soon. It still means the world to me, and I think about how grateful I am for that moment every day.
My husband and I decided to start trying for #2 a few months ago, and I recently found out I am pregnant. I came online in hopes of finding out that you were back in the U.S. I was praying that you would be here to deliver this baby in November. Unfortunately for me you're still overseas, but I realize that the work you are doing over there is far more important.
I just wanted you to know how thankful we are to have had such a wonderful birth experience with our firstborn. As I said, it was in large part to you. We cannot thank you enough for being so wonderful to us. You having made the experience so amazing was one of the reasons we were so anxious to have another. We are truly blessed to have had you be the one to deliver our son.
Do you know when you’re planning on coming back to the States? Maybe you’ll be able to deliver our third baby! :)
Thank you again! We appreciate you more than you know!
Stephanie and Zach Patterson (and Jack too!)
Oh, and Jack is doing so well! After a two week NICU stay he came home. He went from being a tiny, preemie baby to a big, loud, sassy, boy overnight! He took his first steps last night. You'd never know he entered this world so early! :)
ReplyDeleteThank you for your kind words. I am so thankful that Baby (or should be say toddler) Jack is doing so well. We will be coming home this summer! It has truly been an amazing experience for me and my family in Africa. Best wishes for a healthy (full term) delivery. Bryan
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