What is HELLP?

Today Katrina is sharing my birth story on her blog, Mama's Organized Chaos. I'm so thankful for the opportunity to share our story and raise awareness about HELLP syndrome. So I thought I'd take the opportunity to share the sign and symptoms of HELLP Syndrome, for any readers who would like to know more about it. 

HELLP syndrome falls under the umbrella of Hypertensive Disorders of Pregnancy, this includes disorders such as preeclampsia, eclampsia, and gestational hypertension (chronic high blood during pregnancy). These complications are estimated to occur in 6-8% of pregnancies, with the prevalence being higher in 1st time moms. Preeclampsia is the most well-known of these complications, effecting 3-6% of pregnancies. Preeclampsia is characterized by high blood pressure and protein in the urine, usually striking after the 20th week of pregnancy. All though preeclampsia is very treatable if caught in time, untreated it can be fatal to mother and baby.

HELLP syndrome for a long time was thought to be a severe form of preeclampsia, but new research is showing that it can occur independently. Unfortunately this research is so new that most doctors aren't aware that it happens independent of preeclampsia, and can miss diagnosing HELLP if they don't see the signs of preeclampsia first. I was one of these misses-- I didn't have unusually high blood pressure, mine was still in the normal range (but it was elevated compared to my normal) and when first tested there wasn't protein in my urine.  

For me and many others, HELLP is first caught by noting certain markers on blood tests. Usually it's severely elevated liver enzymes (normal is about 30, mine were 600+), and severely low platelets (normal is 150-400 bil/L, mine was 35). These indicators weren't caught until 18 hours into my preterm labor. But had I known the signs of HELLP, it may likely have been caught sooner as I had many of them.

So what is exactly is HELLP? 

HELLP is a severe life-threatening pregnancy complication that is classified by these three signs: 

1. H: Hemolysis (red blood cells are being destroyed)
2. EL: Elevated liver proteins (liver is shutting down)
3. LP: Low platelets (losing the ability to form blood clots) 

HELLP can range in severity, but all told affects 0.5-0.9% of pregnancies. Most occurrences of HELLP happen between the 27th and 37th week of pregnancy, but it can occur before week 27 and up to 6 weeks post-delivery (often in women who had preeclampsia). The only known "cure" for HELLP syndrome is immediate delivery. Up to 25% of women die from HELLP or complications stemming from HELLP (such as liver or kidney failure/rupture, hemorrhage, or stroke). Up to 60% or infants die from complications of HELLP (such as very low birth-weight, or poor-functioning placenta).

The causes of HELLP and preeclampsia are poorly understood. More research is needed. Some current research points to problems with the placenta that occur as it forms in the early weeks of pregnancy. Research has however established that HELLP is a genetic disorder, but they have yet to pinpoint a specific gene or set of genes. This means that if a woman suffers from HELLP syndrome her female relatives (aunts, sisters, daughters, nieces, etc.) are also more likely to develop HELLP or a related Hypertensive Disorder of Pregnancy.

The risk factors for HELLP syndrome are believed to be:

• obesity/poor diet/lack of exercise
• maternal age of 25+
• previous pregnancies
• multiple pregnancy (twins or more)
• diabetes
• hypertension (high blood pressure)
• being Caucasian 
• having a hypertensive disorder of pregnancy in a previous pregnancy

Women who have had HELLP have a 19-25% of having it again in a subsequent pregnancy.

What are the symptoms of HELLP?

The symptoms of HELLP may include (* indicates symptoms I suffered prior to being diagnosed, some for weeks prior):

·       Severe headache*

·       Pain in the shoulder or neck or when breathing deeply*

·       Nausea/vomiting/indigestion*

·       Vision changes*

·       Upper right quadrant pain (pain in the right rib cage, often confused as heartburn)*

·       Swelling (especially hands and face)*

·       Seizures

·       Higher than normal blood pressure* (mine was in the normal range but was high for me, which highlights the importance of knowing your “normal” and speaking up)

·       Fatigue*

·       Bleeding (including nosebleeds)*

Unfortunately many of women who suffer from HELLP attribute their symptoms to normal pregnancy. But having a group of these symptoms should urge women to be seen by a doctor. And some of these symptoms warrant being checked even when presenting alone (such as seizure, upper right quadrant pain, vision changes, high blood pressure, and severe headache). 

I hope that this post has been informative, and can help save a life. Remember to trust you gut, if it bothers you get checked. And if you see these signs in a loved one, please encourage her to get checked. The embarrassment of a false alarm is much more tolerable than potentially losing your life or baby.

 

image source

**I am not a medical professional, this post is informational. It is not intended as to treat, diagnose, or provide medical advice. Please always consult a doctor if you have concerns about your health. **

Sources for this post include:

www.whatthehellp.com

http://www.preeclampsia.org/health-information/hellp-syndrome

http://www.healthline.com/health/hellp-syndrome#Overview1

https://www.nlm.nih.gov/medlineplus/ency/article/000890.htm 

Un-Vegan Mac 'n Cheese {dairy, soy, and gluten free w/paleo and vegan adaptations}

This post contains affiliate links, which means if you click on a link and make a purchase I'll receive a small commission at no extra charge to you. To learn more you can view my full disclosure here.

Say what?? Isn't all mac 'n cheese "un-vegan" well yes, but most mac 'n cheese isn't dairy, soy, and gluten free. For five and a half months, I've been dairy and soy free. I started on a full Paleo diet, but have eased up quite a bit. Finding "comfort" foods that fit our diet, can be rough. Most dairy-free foods contain soy as a dairy replacer, and most soy-free foods contain dairy...which puts us in a pickle. When I found this tasty recipe and adapted it to our taste preferences I was overjoyed. Does it taste just like mac n' cheese, no. But it's super delicious in it's own right!

But why dairy and soy free? Well, we discovered my boys are milk and soy protein intolerant. They simply cannot properly digest the proteins found in either of those food groups. So as a breastfeeding mom I've been avoiding dairy and soy in my diet, to help alleviate their symptoms. Is it hard? Sometimes. Is it worth it? Without a doubt.

By nature, I'm dairy-a-holic even though I've always known I was "lactose-intolerant". My first trimester of pregnancy, dairy was a go to, it filled my constantly churning stomach. Huge bowls of cereal with organic milk twice a day, delicious cubed cheese for lunch and snacks, and massive bowls of tasty ice cream for dessert. Don't judge I was pregnant with twins after all. And don't even get me started on breastfeeding twins- no one knows hunger like a breastfeeding mom of multiples. Seriously I ate #allthefood and would still be starving at bedtime.

But by the time the twins turned 6 months and still weren't sleeping well {and by that I mean not sleeping at all, ever} I knew something was wrong. Add that to the fact that they were also constantly spitting up, had terrible gas, multiple screaming spells a day, poor weight gain, constant congestion, nursing strikes, and weird bowel movements {tmi, i know, sorry!} and you had a recipe for some seriously unhappy twins and one exhausted set of parents. After trying acid reflux meds, and quickly seeing how often we'd have to increase the dose to keep it working, I knew I needed to research other options. That's when I stumbled on MSPI (Milk/Soy Protein intolerance). My boys totally fit the profile for MSPI babies. So I talked to their pediatrician and she agreed I should try at least a dairy-free diet. I went all in and started a Whole30 (a strict 30 day Paleo diet- dairy, legume, grain, processed-food, alcohol, and sugar free) so that I didn't waste time in trying to find all of our trigger foods.

All three of us started to show signs of improved digestion after a few weeks. My acne and eczema disappeared. I even felt less tired, still mom-tired but no longer not exhausted, zombie tired. My boys stopped spitting up as much, started sleeping well and gaining weight better. Once we got their lip-ties removed (if you want to know more about that-comment below), nearly all of their symptoms were gone! I got solid two hour naps, people!

I slowly began to reintroduce foods like grains, sugar, alcohol. We've tried dairy, but so far only small amounts of butter are tolerated. I've tried soy, but I got a HUGE migraine! It seems I'm most likely MSPI too. I've just always though I was lactose-intolerant and that it was the MSG in Asian foods that bugged me. I've also suffered from acid-reflux and IBS since I was a teen. Both have practically disappeared since I've been dairy and soy free!

It's been a life-changer around here. Seriously.  Who needs cheese, when you get sleep?

So now that I've blabbered your ears off, here's the delicious recipe. I'd show you a picture, but we ate it all before I thought to take one!

un-vegan pumpkin mac ‘n “cheese”

adapted from: the vegan version at thelean clean eating machine

total time:  25 mins 

serves: 4-6, depending on appetites! 

mac ‘n cheese that's mspi- safe and gluten-free, and can be paleo with adaptations.

ingredients

• ½ cup unsweetened canned coconut milk (preferably from a bpa-free can, i like natural value organic coconut milk)
• ½ cup water
• 1 cup soy-free chicken broth 
• 1 tbsp. melt butter 2.0 or any dairy-free butter substitute (paleo: ghee)
• 1 tbsp. gluten-free corn starch (paleo: arrowroot starch)
• ½ tbsp. gluten-free brewer’s yeast ( paleo: you may want to omit, the paleo community is split on yeast)
• 1 tsp. spicy brown mustard
• ¼ tsp salt
• ¼ tsp pepper
• 2 cloves minced garlic
• 1 tsp. onion powder
• 1 tbsp. low sodium worcestershire sauce (paleo: coconut aminos or red boat fish sauce)
• 2 cups canned 100% pumpkin (not pumpkin pie mix)
• 1 (16oz) package of gluten-free noodles (paleo: use zucchini noodles)
• 1 tsp. olive oil
• 1 lb ground turkey (optional, obviously this is the 'un-vegan' part)

instructions

1. in a large pan, bring 4 quarts of water to a boil with 1 tsp olive oil.
2. add in pasta and cook according to package directions. do not rinse off finished pasta unless otherwise specified. (if using zucchini noddles, lightly saute in olive oil until soft); brown ground turkey if using.
3. in small saucepan, melt 1 tbsp of melt butter 2.0.
4. add in cornstarch, water, and coconut milk. whisk thoroughly and bring to a gentle boil.
5. once mixture begins to boil, turn burner to low and add in yeast, mustard, salt, pepper, garlic, onion powder, and worcestershire sauce. whisk thoroughly until mixture is smooth.
6. once mixture has thickened, add in pumpkin and broth, and whisk until smooth. remove sauce from heat.
7. once pasta is finished, drain water and return noodles to pot.
8. add in the pumpkin sauce, optional ground turkey, and thoroughly mix.
9. enjoy!

notes:

to reheat the left overs, add a little coconut milk and reheat over medium-low heat. and don’t forget to stir.