Lovenox and Heparin During Pregnancy

I've complained mentioned before how much it sucks that I have to give myself injections everyday during pregnancy but never in full detail. I've done a 'My Pulmonary Embolism' story on here before wanted to do a more detailed post on my PE and my experience with Lovenox and pregnancy. After it happened to me I turned to Dr.Google and wanted to hear more about people who went through what I went through. I'm sharing my story because there aren't/weren't a ton of people like me (28, young, a generally "healthy" person) and this is a you're-not-alone post. D'awww hugs all around.

Background:
October 3rd, 2013 I woke up feeling not quite right. I still can't describe the feeling. I wasn't sick to my stomach or starting a cold, I just felt different. Rich (my husband), Olivia (my daughter, just 3 months old at the time), her nanny, our friend and I went shopping. After only a few stores I had to sit down because I was starting to have a hard time breathing and my chest and back hurt. I'd had pneumonia before and part of me thought I was possibly getting that again because of the chest pain. The other part of me thought I just had a bad back and was being a bit of a wimp about it.
We went to lunch after shopping and the pain was starting to intensify. I googled chiropractors because my back is what hurt the most. I had never had an adjustment but thought it might be what I needed. I made an appointment for the next day then carried on.
I tend to be a bit of a whiner/complainer in nature so nobody was taking my complaints seriously (naturally.) Since I just had a baby 3 months prior I was almost always bitching: I'm tired, my back hurts, I'm tired, I'm hungry, my legs hurt, my boobs hurt, you get the idea.
That night I went to bed with the pain intensified even more but not yet unbearable. I tucked in for the night feeling good about the fact that I'd go to a chiropractor the next day for the first time.

Oct. 4th, 2013: 4:00am - Woke up in excruciating pain. I laid on the floor and cried. Hard. I was crying just about as hard as I was giving birth. My ribs all felt like they'd been broken. It felt like someone kicked me in the chest with a steel boot. Rich woke up to me crying on the floor and helped me downstairs to the couch. I couldn't lay flat and wanted to be propped up. I don't remember much of the rest of the night other than sitting propped up watching TV falling in and out of sleep.

7:00am - My best friend dropped her son off because I was just going to be starting to watch him every other Friday for her while she was at work. I told her I wasn't feeling great but didn't know what it was. I assured her everything was fine and I probably wasn't contagious. Since Rich and our nanny were home she knew her son would be taken care of with two out three adults able.

8ish am - I called the Dr. and said I needed to come in and be checked out. Something wasn't right. No Dr. was available and they suggested I go to an ER. I took this as an overreaction on the nurse's part and said no thanks while hanging up. I finally had an appointment to be seen that day around 4pm.

9:00am - Pain like I'd never experienced before. Remember, I had just given birth 3 months prior. This was worse than childbirth. I decided 4pm was too long to wait and drove myself to a clinic.

At the clinic I waited and waited, I was told I would be seen in about 20 minutes and after 45 minutes I couldn't take it anymore. I walked back to where the Drs and nurses were without a nurse escorting me back. I was bawling. I begged the first nurse I saw to please see me and help me because something wasn't right. She pulled me into an office and after only a couple minutes of seeing how much pain I was in she insisted I go to the emergency room immediately. She was going to call an ambulance but (once again, me being so stubborn) I told her I could drive myself. I couldn't walk out of the office myself. She propped me up on her shoulders and wheeled me out to my car. I called Rich crying saying I couldn't breathe and they wanted me to go to the ER.

I ALMOST DIDN'T GO.

I'm that stubborn. I thought, everything will eventually go away and I'll be fine. Thank GOD Rich told me no and told me to go to the hospital. He called his mom to come to our house to help our nanny take care of the kids (both just 3 months old) and drove to meet me. I drove myself to the ER and checked in. Rich arrived shortly after and so started the dozens of tests.

I can't remember them all other than lots of blood tests, an EKG that came back normal, and the CT scan. The CT scan was painful because I couldn't lay flat. Laying down flat hurt more than anything but I had to do it for at least a minute, but what felt like an hour. The nurse told me I'd feel like I peed my pants when I was in the machine but assured me I probably wasn't. When I felt that feeling I thought "Oh no, whoops! I actually did it. I peed!" She helped me sit up when I got out and she said, "It's ok, you can check." I put my hands down there and nope- no pee. She laughed and said everyone does it. The CT Scan confirmed what doctors thought was possibly going on: I had blood clots in both lungs.

Sidebar: This post is getting a little too serious for the blog. I need to throw in a bit of humor to shake it up a tad. I was breastfeeding at the time and by the time I was in the ER I was majorly engorged. I needed to pump - bad! I didn't want Rich to leave my side to get my pump and trying to express the milk by hand wasn't working since I didn't have any strength. I buzzed a nurse to please find me a pump and she got right on it. After about 30 minutes and two rock hard, painful boobs begging for release a young-ish kid came into my room holding a Medela pump.
"Do you know what this is for???" he asked.
"GIMME!!!!" I said reaching for it eaglerly.
"Good, I went to a couple different rooms because I forgot where this was supposed to go and nobody knew what it was."
I whipped them out before he left the room. I still have that pump today so now I have 2 Medelas.

That was one of the last times I ever pumped/breastfed. Being that I was in so much pain I was on morphine and Oxycontin. Very. Very. Very serious pain meds. That's how bad it was. I didn't want ANY of that reaching my baby so I dumped everything and decided we would be strictly formula. I had already been supplementing with formula because of our busy summer work schedule so this was the final straw in telling me that formula was the way to go for us.

When we knew what was wrong I got my very first Lovenox shot and Warfarin pill of MANY. The doctor came in and told me that they would need to keep me overnight so they could closely monitor me. I broke down crying. It was my very first night I would be away from my new baby.

They needed to find a room for me on the surgery recovery floor because 1. I wasn't contagious and neither were those patients so we wouldn't infect each other and 2. surgery patients are high risk for blood clots so that's where I belonged. While I waited for hours for a room to open up Rich went home to get me an overnight bag and bring Olivia to see me.

I couldn't hold my little 12 pound baby. I couldn't pick her up. Rich propped her up next to me in bed but even her tiny little weight leaned against my ribs sent shock waves of pain through me. I cried some more because I couldn't hold and snuggle her. My hair fell out of my ponytail holder and I had to buzz the nurse to help me because I wasn't strong enough to even fix my own hair.

Visiting hours were cut short when they needed to take me to do ultrasounds on my legs to see if there were any more clots forming in my legs. I cried again. I kept her little pink blanket that smelled like her. It smelled like her hair, her diapers, even her spit up and I loved every little scent in it.

That night I didn't sleep well obviously. I was in a lot of pain still even though I was drugged up. I kept googling all about PEs and the scary mortality rate. It really sunk in and was emotional for me that I literally almost died that day. I wouldn't be here today writing about this and chasing after my 17 month old while expecting my second child if I hadn't listened to my body (and my husband) and went to the hospital. Untreated pulmonary embolisms can and almost always will result in death.

I was released from the hospital after a 24 hour hold; my dad came to get me because I wanted Rich home with Olivia. Here I was 28 years old, almost 29 and I could barely dress myself. My dad needed to put my shoes on me, my sweatshirt, I let the nurses help me with my bra and pants :)

Following release I was on Lovenox shots every 12 hours and Coumadin pills once a day. I had to get my INR tested multiple times a week and seriously monitor my Vitamin K intake. Think spinach, broccoli, dark leafy greens. My INR levels were never in order and I hated having to drive to the clinic multiple times a week to get pricked by needles. I felt like a human pin cushion. Meanwhile I was sent to multiple specialists to figure out WHY it happened to me. Me, a young, healthy, never even had a surgery before person.

To this day after 5 or 6 different specialists we still don't have an answer why. All blood tests show no signs of a clotting disorder. I did test positive for the lupus anticoagulant protein but was told this does NOT mean I have lupus. A few weeks later I took the test again and it showed negative. Insert head scratching here.

Today during pregnancy:
Immediately at my first doctor's appointment (I'm too high risk to be seen by a midwife again) I was put on Lovenox. I have to inject myself in the stomach once a day until 36 weeks. At 36 weeks I will be put on Heparin and will have to inject myself in the stomach TWICE a day until birth.
When the baby is born I have the option to switch to Lovenox or back to pills. It may seem like a no-brainer to switch to pills right? Well my Hemotologist told me a lot of women continue with the shots because
1) They're used to having to do it everyday anyway
2) Going to get your INR tested multiple times a week with a new baby is a huge hassle.

I don't want to have multiple appointments a week after having the baby, especially in the winter and having to wrangle a toddler with me as well so I've opted to just stick with the Lovenox again. At this point I'll be doing injections for 3 months post-partum and from there we'll do all tests all over again and see what we do from there.

My current stash. Only two and a half weeks worth

Injections SUCK. They frickin suck. Did I mention how much they SUCK? My stomach is bruised and has little black and blue bruises all over it from the injection sites. Sometimes I hit a vein and being that they're blood thinners, I get a fun mess to have to bandaid up. Now not only are there bruises everywhere, but bandaids as well. My stretch marks I got while pregnant with Olivia are reappearing and my belly button is flattened out and looks like a cat's butthole. I feel gross. The other day Rich was looking at my stomach and I said, "Gross right?" He's not typically emotional and he said, "No it's perfect". Go ahead, admit it, your heart melted.

People joke around asking when #3 will be coming and honestly, I don't know if there will be a #3. I've always wanted a bunch of kids (a bunch meaning 3 or 4- let's not get Dugger crazy) but this is so trying on my body physically and emotionally. Maybe there will be a #3, maybe there won't. What I do know is I never take life for granted. When Olivia is having a meltdown and testing my patience and I just wanna crawl in a hole and quit- I am still thankful that I'm here. I get to enjoy every smile, every hug, every laugh, every dance party, every cry and every meltdown.

If you've made it this far - wow! You and I can either relate or you have a lot of time to kill right now. Either way thanks for reading this enormous novel. As your reward I promise the next posts will be back to being filled with our thrilling IKEA adventures, horrible cooking recipes and blurry selfies.

You Lucky you, you.
PS: Today my blog hit 100,000 views. WHOA! Thank you readers so much. Hugs, kisses, winks, uncomfortable back rubs all around!

4 comments

  1. I read the whole thing - I can't relate - and I never have enough time to kill, but, alas, here we are. (I hope I was view number 100,000 - we can pretend). What a scary thing to go through! And I can't imagine having to give myself daily injections. This baby better sleep really well - something as payback for all you are going through. ;) Such wonderful things you are doing for those two children of yours! Makes me really appreciate my pregnancy - I was sick most of it, and had very, very low iron which went untreated for too long - but absolutely nothing like yours.

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    1. With how calm this baby is compared to Olivia I'm crossing my fingers for a good sleeper and an overall mellow child :)
      Olivia was the world's easiest pregnancy- I was never sick, tons of energy, I gained a ton of weight but that was about it. This is a completely different story.

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  2. Hi. Thanks for writing this blog. I can totally relate. I had a PE in 2006 (they think it was due to stopping smoking cigs and birth control at the same time. The PE happened 2 weeks after I stopped both of those things). I was on blood thinners for 1 1/2 yrs after the PE. Anyway, I got pregnant in 2010 and was put on Lovenox injections throughout my pregnancy. I was induced so they would have better control over my labor. After 17 hrs, I had a beautiful healthy boy, who just turned 4 last week. Anyway, I just found out I'm pregnant again. I'm waiting on a prior auth from my insurance for my Lovenox. I'm really nervous to go through all of that again, but seeing your blog and hearing from others that are going through it too, really helps. Thank you! :-)

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    1. Hi Kim,
      So glad I could help and congratulations on your pregnancy! I too was nervous to start Lovenox again but knew it's what I had to do for this and every pregnancy in the future. I just picked up my prescription for Heparin which I'll be starting this Monday and I'm not too excited about it but like you said, I need to be induced so they can closely monitor how much medicine is in my system during delivery. The needle is bigger and the shot happens twice a day now rather than just once. Eeek! But Kim, we can do this! Just think of the reward we get at the end!

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