by Josi Kilpack
Kate nodded.
“And Dr. Carmichael is your regular OB?”
Kate nodded again.
“I received your records but haven’t spoken directly with Dr. Carmichael.”
“Good,” Kate blurted out, then felt silly. “Sorry.”
Dr. Lyon laughed. “Why don’t you tell me, in your own words, what happened with your last pregnancy.”
“Okay,” Kate said. “I was fine until about thirty-two weeks, when I started getting headaches. The doctor said I had pre-something, or toxemia, so I was put on bed rest and had a home-health nurse come take my blood pressure every few days. I felt okay though.”
She hoped that telling him she felt okay would make an impact, but his expression was impassive. “At thirty-six weeks I had to be hospitalized because my blood pressure was getting higher and they couldn’t bring it down. The next day they induced labor. Four hours later Chris was born healthy and strong with no problems whatsoever.” She smiled to emphasize the happily-ever-after part.
Dr. Lyon nodded. “Do you always have such fast labors?”
“Yes,” Kate said, as if it were a badge of honor. “My first baby, she’s almost sixteen, was eight hours, and every baby has been a little shorter. Perfect deliveries. Perfect babies. My mother-in-law says I was just made for childbearing.”
“And what did Dr. Carmichael tell you about any future pregnancies?”
Dang! She’d hoped he wouldn’t ask, though that seemed silly. She had no doubt he knew all this. “He said that the complications—toxemia—could happen again.”
“Did he explain why toxemia, or preeclampsia, is such a serious complication?”
“Uh,” Kate searched her memory but couldn’t bring anything up. “I’m sure he did but I can’t really remember. I really felt okay, other than the headaches.”
“The reason your blood pressure went up was because your body was having a kind of reaction to the baby. The pressure builds up in your circulatory system and causes all kinds of problems. For instance, you probably did a urine test right before you were sent to the hospital, and it probably said you had proteins in your urine.”
Kate nodded. She did remember that.
“That’s because your kidneys were unable to filter correctly—it’s early stages of kidney failure.”
Kate furrowed her brow. Kidney failure wasn’t good. Dr. Lyon continued. “Had they not induced labor, your body would have responded to this sloppy circulating and intense pressure by attempting to thicken your blood, sending out mass amounts of blood platelets—the part of the blood that forms clots, to close a wound, for example. But this influx of platelets into the compromised bloodstream causes hundreds, thousands, hundreds of thousands of blood clots to form in the veins all over your body. It only takes one to travel to your brain and cause a stroke or a seizure, both of which are extremely serious complications for you and your baby.”
Kate swallowed. A stroke. Had they told her that?
“Mrs. Thompson,” the doctor said. “You probably know other women who have had preeclampsia.”
Kate nodded.
“And you likely don’t know of anyone that’s had a stroke.”
That was true. She’d never heard of anyone having a stroke.
“But that doesn’t mean it doesn’t happen. You have an excellent doctor, and he did everything right. You were otherwise healthy and you have good deliveries—you are a success story. But that doesn’t minimize the risk.”
“But you say all this as if I will for sure get it again.”
“You’ve had several children—that’s a risk factor. You’re close to forty years old—another risk. You’ve had toxemia before—yet one more risk. Your chances of getting toxemia again are high.”
“How high?”
“I’d say you have a 60 percent chance of getting it, but if you do, it will likely be worse than it was last time and will likely manifest sooner in the pregnancy.”
“How could it be worse? If I’m monitored and medicated, then when it gets bad enough we can induce labor again—right?”
“Probably,” Dr. Lyon said, leaning back in his chair. “But what if it manifests itself at thirty weeks, and you have to deliver your baby two weeks after that? Even with weekly appointments you could be okay one day, and the next day your body could start reacting, and the only actual cure is to have you deliver your baby.”
“But last time I had headaches. That’s what got the doctor’s attention. If I had a headache I’d go in.”
“You might not get headaches this time,” Dr. Lyon said.
Kate swallowed, not wanting to get emotional, but this was . . . huge. “So you’re telling me that I shouldn’t have another child.”
“No,” Dr. Lyon said, causing Kate’s head to snap up. “I’m telling you to make an informed and educated choice. If you were determined to get pregnant again, I would recommend you lose some weight first and get in as good physical shape as possible—some studies have shown that optimal health seems to lessen the risk of preeclampsia in some cases. I would tell you to follow a strict diet and plan on partial bed rest by your fifth month to take any pressure off your heart. You would have weekly appointments from that time on, with the added stipulation that you monitor your blood pressure at home on a daily basis. Once you hit thirty weeks, I would see you twice a week, and you would be on full bed rest—that’s allowing only two vertical minutes every three hours every single day. It would mean finding care for your other children, and depending a great deal on your husband, and it would be difficult both lifestyle-wise and emotionally. After the baby is born, you’ll need to take it easy for another six weeks in order to get healthy again.”
Kate absorbed this as best she could, but among the details was hope. This could work. She could make arrangements; she could learn to take her own blood pressure. “And if I could do all these things, then you think I could do this?”
“As long as it’s clear to you that doing all this still guarantees nothing,” he sat back in his chair and looked at her. “You need to understand that regardless of all the things we may do, the monitoring, and the medications—you are taking a risk both for yourself and your baby.”
Kate looked at her hands and tried to absorb it all objectively. The fact remained, however, that she felt that they could make this work. Dr. Lyon seemed very competent and she would do everything in her power to ensure things went smoothly. She wouldn’t take extra risks and she’d follow his instructions to the letter. Dr. Lyon continued.
“I have to tell you, Mrs. Thompson, that it’s women like you that gave me this.” He pointed to the silver hair at his temples. Kate couldn’t help but smile even though she knew she was being reprimanded. “But I have treated hundreds of women in your situation, and if you are determined, and I have a feeling you are, then I could help you—with the understanding that both you and your husband are perfectly clear on the risks and the requirements of seeing this through.”
“So the first thing I need to do is lose some weight,” she said.
Dr. Lyon nodded. “At least twenty-five pounds,” he said. “And I’d need to do blood tests before I gave you the green light, to be sure that you have no other issues going on.”
Kate nodded. She could do both of those. She mentally canceled the shepherd’s pie she was planning on making for dinner. A nice chicken salad would hit the spot just as well.
“And,” Dr. Lyon added. “I’d want to discuss this with your husband.”
13
——Original Message——
From: [email protected]
To: [email protected]
Sent: Thursday, April 20, 7:52 PM
Subject: Re: dance
Jess,
britney—being nice—i don’t buy it. i’d be careful if i were u, cause she’s so totally two faced that u can’t trust her. but i am glad yr feeling better. y do u even want to go to the dance with her? believe me once u get to know colt u won’t want
to ever see another boy as long as u live.
my parents didn’t let me date til i was 16 either, so it’s not just the mormon thing. It’s a good rule i think—y date if theres just one person made just for u?
i can’t believe yr mom did that, i mean i can, because she’s just that way—always paying more attention to the little kids and ignoring u—but how horrible to get mad at u for something Britney did. I’m so sorry, Jess. how do u stand it? it must make u feel horrible that yr so unimportant to her. u know she’ll say no if u ask her about the dance and u might even get another lecture. i’m so sorry—sometimes families are more hurtful than helpful, ya know?
i was invited to go to the movies with a friend today and my mom won’t let me cause she has a meeting and i have to baby-sit. it makes me so mad. she doesn’t even care that i have no life. i feel like a servant.
Em
“Did Chris finally fall asleep?” Kate asked when Brad came into the bedroom that night. Jess was still baby-sitting for the Jensens, but it was almost ten o’clock so she should be home any time.
“Finally,” Brad said, his frustration evident. She’d offered to put Chris to bed, but Brad had assured her he had it covered. Kate appreciated the help, but it also made her uncomfortable, as if he were helping out because he thought she needed it. With her current goal to convince him she had this motherhood thing wrapped up enough to make room for one more, she wanted to prove herself.
Kate finished putting away the laundry she had folded on their bed while Brad went into the closet and began getting undressed. “So how was the appointment today?” he asked.
Kate took a breath. “Good,” she said, keeping her tone upbeat and light. “He seems like a wonderful doctor.”
“What did he say?”
“Well,” Kate said, picking her words carefully. “He said that, like Dr. Carmichael said, there is a risk, but,” she hurried to add before Brad cut in, “he gave me some specific requirements I would need to meet and he was really quite positive.”
Brad came out of the closet, undoing the last button of his shirt and shrugging out of the sleeves. “Really?”
It wasn’t an excited “Really” as in, “That’s really great!” it was more of a “Really?” as in, “I don’t believe it.” Kate hurried to strengthen her case. “Yeah, he even pointed out that though I know a lot of women who have had toxemia, none of them has ever had a stroke.”
Brad’s eyebrows went up. “A stroke?”
Oops. “Well, that is a risk—but really only for women who aren’t otherwise healthy or don’t take their condition seriously. I’m neither of those things. He gave me a play by play of how the pregnancy would be handled and really educated me on the condition. But he also said there is almost a fifty percent chance that I would have no complications at all, that this pregnancy would be just like my first five.”
Brad turned and disappeared back into the closet. She heard the hangers move on the rack and bit her lip, praying for him to be open-minded about this. Brad returned with a T-shirt in hand. “So what was the play by play?”
“Well, I need to lose some weight and get in shape; then he will monitor me really closely. I would need to be careful, take my blood pressure at home, and plan ahead. But I can do all that stuff. Julie already said she’d help with the kids if I needed it.”
“You talked to Julie before you talked to me?”
Double oops. “She watched the boys for me, so we talked about it when I picked them up.”
Brad let out a breath. “I wish I could have been there.”
She didn’t like his tone. “What, you think I didn’t ask the right questions?”
“I think you want this so badly that you can’t be objective.”
“What a horrible thing to say!” Kate shot back.
“Well,” Brad said, shrugging one shoulder and looking at her. “This is what you want, you meet with the doctor, and he basically tells you everything you want to hear—what am I supposed to think?”
“You’re supposed to trust me,” Kate said, but she was squirming. She wasn’t telling Brad everything the way Dr. Lyon had told it to her. “And you’re equally unable to be objective because you don’t want this.”
“Which in and of itself ought to mean something,” Brad countered in sharp tones, putting on his T-shirt. He took a deep breath, and when he spoke again his voice was softer. “What about us, Kate? What about just enjoying this life we have right now, not adding another baby to it. Can’t you just be happy with what we have?”
Kate was saved from having to come up with an insufficient answer by Chris’s wails. She’d never been so happy to hear a cranky toddler. “I’ll get him,” she said quickly, making her escape. Brad didn’t try to stop her.
Several seconds later, she lifted Chris from his crib and held him against her chest, his cries turning to whimpers as she rocked him in her arms. In another year Chris wouldn’t even be in a crib; he wouldn’t mold into her the way he did now. Thinking about it filled her with such sorrow. No more babies. Ever? She simply couldn’t imagine it. Brad had no idea how important this was to her. Chris shifted in her arms, reaching a chubby arm around her neck, and she nuzzled her face into his curly blond hair. How can I not have more of this? she thought as tears filled her eyes. How can I give it up?
She heard the front door open—Jess—and listened to her and Brad have a muffled conversation. Eventually they both went downstairs. Presumably to watch the news. Kate put a now-sleeping Chris back to bed.
She shut the door to her bedroom behind her a minute later, glad to be alone. Kneeling by the side of the bed, she pleaded with the Lord to soften her husband’s heart, to help him understand. Had he any idea how eternal his decision was?
It seemed like hours before he came to bed. Kate pretended to be asleep. Friday morning, they were cordial to one another, but things were tense, each of them waiting for the other to make the first move. The drawback of not fighting very often was that when they did, they were sorely out of practice.
“Mom?” Jess asked the next morning after she finished her practicing.
“Yeah.” Kate didn’t look up from the dishes she hadn’t washed the night before. She was tired and frustrated by the argument. She even felt a little sick to her stomach. What a great way to start the day. She couldn’t remember the last time she’d been in such a bad mood.
“Um, Britney is going to Spring Fling with like this huge group and she asked if I can go too, so can I?”
“What’s Spring Fling?” Kate asked, putting a cup in the dishwasher only to realize the dishes already in there were clean. Great. Which ones had she just put in?
“It’s the last dance of the year,” Jess said. “It looks so fun and there are no couples or anything—just a big group.”
Kate tried to tune in, but her thoughts felt far away. “You’re not sixteen, Jess; you know the rules.”
“Well, I’ll be sixteen in a few weeks, and Britney’s not sixteen until July and her mom’s letting her go.”
“That’s her mom, not your mom,” Kate said, paying a bit more attention now. What was Julie thinking, and why hadn’t she told Kate? She’d have known the issue it would create for Kate when Jess’s best friend got to go.
“Mom, please,” Jess begged. “Julie’s going to drive us everywhere, and we’re having dinner at one of the girl’s house with her parents there and everything. I promise you it’s just a group.”
“A group date,” Kate said, inspecting a handful of silverware before realizing she should just run the load again. Washing already clean dishes made her feel wasteful and intensified her frustration.
“No, Mom,” Jess said with enough venom in her voice to get Kate’s full attention. Kate looked up in surprise. Jess never talked to her that way. “It’s not a group date; it’s a group of kids going to a dance. That’s all. Why do you have to make such a big deal about it?”
“I’m your mother,” Kate said, putting one hand on her hip
and staring Jess down. Jess didn’t react to the power stance Kate was going for. “It’s my job to make a big deal out of things, and it is a group date and you are not going because you are not sixteen.”
Jess stomped her foot and Kate was further surprised by the attitude. Caitlyn was the one with dramatic reactions, not Jess. Kate was in no mood for Jess’s . . . mood.
“That’s so not fair!” Jess said loudly.
Ha! Jess had no idea what fair was. “And I so don’t care,” Kate returned with sarcasm that may have been a bit too thick. Jess’s eyes hardened and Kate attempted to redeem herself. She softened her voice and tried to repair her expression. “Look, I know you want to go. I know it’s hard that Britney gets to, but—”
