The Morning Reminder

I look at it every morning when I wake up. A floppy-eared, brown and white stuffed puppy sits on my jewelry box and I'm immediately taken back to being in a hospital bed, alone, after having the worst medical news I've ever heard– "Your lab levels are indicating a growing concern towards the need to consider our options, the most likely being a liver transplant. We must prepare for the worst as your health is in critical condition and we're not seeing the improvement we anticipated by this point in time."

After a week of experiencing extreme nausea, vomiting, splitting head pain, unexplained fullness, body aches, dry mouth, dark urine, weight loss, and an inability to stay awake for more than 2 hours, I realized this wasn't the normal 'flu bug'. An urgent care visit, two ER visits, and an ambulance transport to a hospital with a digestive team intervention and oversight led me to question everything I'd known about my 'health' over the past decade.

I was admitted to Mercy Hospital for complications from an unfortunate Mother's Day Hepatitis A exposure and subsequent infection. (Did we not learn anything from COVID?! If you don't feel well, please avoid gatherings.)

After hearing from my care team how critical my situation was, images of what the next three days, six months, and six years could look like for me crept into mind. "Will I survive? Would my son grow up without a mother? Or even worse, would he grow up with a sickly parent who couldn't share in his achievements? Could I still coach baseball? How would my husband maintain his career with my next set of health barriers?" I was thankful my mom lived just blocks away.

My then eight-year-old son and husband walked into the room with biohazard suits, carrying an adorable stuffed puppy dog. My son appeared terrified and teared up as he handed me, what I can only assume, was a $50 hospital gift shop splurge. My worries stopped for 30 minutes until they had to leave and allow me to rest. I snuggled it close, imagining my real brown and white rescue pup, Dexter, as I lay in my uncomfortable, sterile hospital bed.

There have only been reported cases of Hepatitis A in 0.0012% of the U.S. population in recent years and about 100 deaths annually. Few cases require hospitalization as it's usually an uncomplicated, self-limiting infection with full recovery. Knowing hepatitis mainly targets liver structure and function, I can't help but wonder if prior health incidents impacted my liver negatively enough that it rendered me helpless against combating this self-limiting infection on my own.

This health crisis led me to review more than a decade of small (and not-so-small) indications of liver insufficiency early on, when I was "healthy". All the red flags seemingly missed.

Red Flag #1: At 29 years of age, I was preparing for pregnancy and wanted to purchase a life insurance policy (how responsible, right?). Simple enough- I was "healthy". A simple blood draw, hand over payment info, and plan granted, right?

I was a bit surprised to see my liver enzymes come back elevated as pre-indicated non-alcoholic fatty liver disease. The recommendation was to wait a few weeks and simply retake. After all, I was "healthy".

I took matters into my own hands and did a liver flush as an attempt to hack the system. It worked: Liver enzymes within normal range and life insurance policy granted.

Fast forward one year.

Red Flags #2, 3, 4, & 5 surrounding pregnancy: I wanted a preconception set of blood work to know my baselines…uh-oh, a few more alarms sounded— MTHFR Mutation and low HDL. I started pregnancy under a maternal and fetal care team, but was released from this specialized care team because I was "healthy" with no concerns for complications at this time. Nearly 30% of the white and Hispanic population has a variation of this mutation and most women aren't proactively tested for it. It just so happens that it can also impact liver function.

20 weeks into pregnancy: Full-on contractions started. It felt like Saran Wrap so tight I could see fetal features. Insert fetal monitoring, then the question, "Is bed rest an option for you? You need to manage your stress levels and take it easy until this calms down." Nothing else is recommended at this time. After all, I was "healthy." I started working a hybrid schedule from home so I could rest periodically throughout my day. I began to feel human again with normalizing energy levels and the contractions stopped. All good!

32 weeks: My husband's company offered an all-expenses paid trip to Mexico. We gained clearance from our OB/GYN and took advantage of this opportunity before our world was turned upside-down (in an amazing way). We go to Mexico, have a great time in a luxurious villa, and get on a plane en route back home when I start having heart palpitations. "I must be tired and thrown off." Heart rhythm normalized in a few hours and I went back to normal living.

33 weeks: While working, I begin feeling worn down. I call my husband, and lie down to nap. I slept through the night before waking up at 4:23 AM to what felt like someone stabbing me (later realizing that was my liver becoming inflamed to the point of nearly rupturing), so I moved to the couch attempting to get comfortable. I proceeded to roll over and start vomiting. I'll spare the rest of the details over the next 20 hours, but it ended with me arriving to the ER pantless (hey, pressure on an inflamed liver is extremely painful) having an emergency c-section: strapped down, intubated, and told to say goodbye to my husband and that we had only a few minutes to get the baby out. "We need to act swiftly." At 2:23 AM I counted backwards from 10 before being intubated and at 2:27 AM, we had a healthy sub-5 pound baby boy.

It wasn't until I left the hospital a few days later that I really understood what happened. I had HELLP Syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets). This used to be considered a severe form of preeclampsia, but has recently earned its own starring role as a standalone syndrome as more research has led to understanding the vast differences between the two conditions. I was released 4 days post-birth with instructions to "only sit to care for your baby. This syndrome can reactivate up to 6 weeks postpartum. After that, you'll be cleared for normal mothering." After all, I was "healthy" just as I'd been told my whole life. HELLP affects one half of one percent of pregnant women. (Maybe I should start gambling?)

The signs were there. My risk was known, but I was "healthy" and had no high blood pressure during my routine checks. Had someone (or even AI) followed the warning signs across all providers…it could have been different.

Being nearly 3 years post-hospitalization for Hepatitis A, I'm just beginning to consider myself "healthy" again. I'm not who my prior care providers have labeled me. Being someone with all the access, all the resources, all the expert recommendations, all the products, and all the knowledge, I couldn't beat a virus that 95% of those who contract it can without intense support and oversight.

While I'm not fully confident in my current healthcare, I'm functioning and improving as much as I can in the hustle and bustle of daily life. I've set healthy boundaries. I go to bed early. (If you text after 8 PM, you won't hear from me until 7 AM the next day.) I rest more often. I rely on my husband to do more than I used to. My house is messy. I say no to tank-draining obligations (and people). I don't exercise as frequently as I used to. Walking the dog is the best I can do some days, and some days I deadlift 130 pounds. I fill my non-work time with the rewarding experience of volunteer coaching my son's baseball team. I eat pizza and hotdogs at the ballpark but balance it with salad, lean meats, leafy greens and veggies at home. I cook when I have energy, I order food when I don't. I sit outside when I can. I don't work on weekends. (That's sports time, people!) Most would see a snapshot and label me as "healthy".

And while they see "healthy", I realize that's not the point. Instead, I'm focused on living — being present to my husband, my son, and myself — and keeping the floppy-eared puppy on my jewelry box as a reminder of how far I've come.