LETTER

AN AWFUL EXPERIENCE WITH AN UKRAINE GIRL

Dear Valdo, I need your precious help. For my knowledge and for all those who read. I have been through an awful experience with one of my friends, a young Ukraine girl (35 yrs old) looking very healthy, except that she wasn’t falling easily pregnant.

ARTIFICIAL INSEMINATION AND THE NIGHTMARE AFTER 5 MONTHS

Her husband has only one testicle and they gave it for granted that he had a far too weak sperma for her to remain pregnant. Moral of the story, my friend had to have artificial insemination, in order to fall pregnant. The nightmare began after 5 months, with nausea and vomiting. Not a happy and carefree experience, I would say. Her legs put an elefant to shame from how swollen they were!

THE RAW ATTITUDE OF A MEDICAL DOCTOR

Three weeks before her term end, she went for her routine tests, where one of the nurses said to her “Hey young one, I don’t really like the colour of your eyes”, but her superior, the doctor in charge on shift ushered her out saying that she can investigate alltogether when she comes for the rest of her blood tests (a day and a half later). She’s JUST PREGNANT!

CAESAREAN AND INTENSIVE CARE

Well, on the outcome of the blood tests of that later appointment, my friend was rushed to hospital for an emergency caesarean, and now she is still in Intensive Care today, 11 days later. Diagnosis? HELLP Syndrome! She was saved by her guardian angel I think.

THE EMERGENCY IS NOT OVER YET

Today she is looking less okra. She started eating yesterday. Bilirubin is still at 10. She is on all kinds of machineries and has seen her child only in the last 5 days (a beautiful 3 kg little boy!). Breastfeeding is a dream. She’s thrown away. Her hopes to get out of there quickly are still on a thread for the moment, as her pancreas is still swollen.

WHAT IS THIS PATHOLOGY AND WHERE DOES IT COME FROM?

What is this HELLP syndrome, Valdo? Do you know anything of it ? Was she under risk having lived Chernobyl completely and from very near (she’s been here in Italy only 10 years)? She does eat meat and dairy products. How can she help herself when she does come out to fully recover her organs that seem so severely damaged now?

ALL PREGNANT MOTHERS HAVE THE RIGHT TO BE INFORMED

Not only for me, Valdo, or because I care for your thoughts and count on your help, but for all other pregnant mothers, to be aware of when your skin and eye colour changes, when your legs swell a little too much over the average!

I AM DOING MY BEST TO ASSIST HER

Thankfully I have the authorisation to keep her company when I am not working, where I spend my time massaging her feet which are still swollen. Her skin is like cardboard and she has shocks on her footplant when they make her stand up. Thanks for your precious thoughts. Angelcatia

ANSWER

PRE-ECLAMPSIA AND HELLP

Dear Angelcatia, first of all my compliments for your aid to this mother in deep pain, and also for your prompt information on this luckily uncommon but terrible disease. HELLP syndrome is a serious pregnancy complication, with a 1,1% rate of mortality, and is considered as a variant of PE, or pre-eclampsia. Pre-eclampsia and HELLP can both occur during the later stages of pregnancy, or even after childbirth.

HYPERTENSIONAL PREGNANCY, PRE-ECLAMPSIA AND ECLAMPSIA

In the past, many denominations had been proposed to describe hypertensive syndromes in pregnancy. The most exhaustive seemed to be the EPH, meaning edema, proteinuria, hypertension, and divided in IG or Ipertensione gestazionale (a normal hypertension after the 20th week of pregnancy), in PE or Pre-Eclampsia (IG plus a proteinuria of 0.3 g/L in sample taken in the 24 hours), and in Eclampsia (PE plus convulsion crisis).

HELLP IS THE DENOMINATION GIVEN BY LOUIS WEINSTEIN IN 1982

HELLP Syndrome was finally named by dr Louis Weinstein in 1982, according to its basic characteritics: H, which means hemolysis (breaking down of red blood cells), EL, meaning elevated liver enzymes (abnormal peripherical smear, lactate dehydrogenase >600 U/L and bilirubin >1,2 mg/dL), and LP (low platelet count or thrombocytopenia, which can be class I or severe, with platelets under 50000/mmc, class II or moderate 50-100000, class III or mild 100-150000).

EARLY DIAGNOSIS IN ORDER TO AVOID RISKS, BUT PREVENTION IS EVEN BETTER

Early diagnosis is critical as the morbidity and the mortality rates have been reported as high as 25%, among the total HELLP cases, due to liver rupture and due to stroke (cerebral edema or cerebral hemorrhage), conditions which can be prevented by adequate medical techniques. Better than early diagnosis, I should say, should be a proper prevention. Going for a maternity is a real proof of wisdom, of health preparation, of good shape, of excellent food knowledge.

WE SHOULD AVOID CREATING FURTHER PANIC

Honestly, it is very good informing all women of this case. But I would not agree in creating further fears to the population for a pathology that can be easily prevented and avoided with simple and basic health strategies.

THE SYMPTOMS ARE VERY CLEAR

The symptoms of HELLP are quite clear, and include headache, nausea and vomiting after eating, fatigue and malaise, shoulder pain when breathing deeply, bleeding, visual disturbances, edema or swelling, protein presence in the urine, high blood pressure, upper right abdominal pain.

THE IMMEDIATE DELIVERY BY CAESAREAN SEEMS TO BE A MUST

The treatment is to procure and facilitate the immediate delivery of the baby (caesarean), plus eventual blood transfusion (red cells, platelets and plasma), plus use of corticosteroids. Regarding the newborn, if she or he has a weight superior to 1000 grams, the survival rate is near to normality, when inferior, the situation changes dramatically.

NO WORD AT ALL ABOUT THE ETIOLOGY

Little words, if nothing at all, are spent about the causes of this syndrome. But that’s quite typical of the medical mentality. Quite clever from your side mentioning the fact of Chernobyl, which has for sure to be considered as one of the ingredients. Prolongued radiations have probably got remarkable effects on her organism. But her diet, absolutely crazy and inadequate, has caused even deeper damages, not helping your friend to complete her pregnancy in the right way, without jumps in blood pressure.

A DEEP CHANGE OF CULTURE IS NEEDED

What to do now? First of all coming out of the emergency as soon as possible. Then, in the right progression, adopting a new diet philosophy, understanding what is the meaning of protein, what is the real value of food, in all the basic components. A change of culture is absolutely needed for her and for the proper development of her little boy. Luckily we are in Summer, and she can exploit the rich natural resources of the season.

LUCKILY THE SEASON IS GENEROUS AT THE MOMENT

Watermelon, melon, grapes, new apples, blueberries, raspberries, peaches, plums, can be easily eaten without limits. Carrots, celery, pineapples and watercress, can make fabulous juices. Almonds and pine-nuts can be transformed in excellent milk for her and her baby. Raw salads, followed by potatoes, cabbage, Bruxelles sprouts and legumes as lupins, can help her to recover at lunch and dinner. Obviously fruits in the morning and in the late afternoon only. Fresh orange juice and fresh grape juice can be given to the kid in addition to her own milk (if she has got any) or to the formula milk necessarily given for the time being to her little creature. For the mother’s diet, tofu and seitan can be allowed initially, as well as some soya-milk ice-cream.

ELIMINATIVE EFFECTS ARE INEVITABLE, BUT SHOULD NEVER REPRESENT A REASON OR AN OBSTACLE

Oatmeal plus pumpkin seeds, sunflower seeds, wheat germ, in cereal milk, or home-made pop-corn with banana or figs or dates, can complete her plan of recovery. No meat, no milk, no sugar, no salt, no coffee, no the, no smoke, no cola. Staying on nature, as the best of us and even better. All this keeping in mind that the change of diet will bring initially to eliminative effects. This is inevitable, as too many poisons have been accumulated inside her. She has got to be aware of that. Some prudence and some step-by-step progression are to be considered. Resisting and sacrificing at the beginning is a must.

Valdo Vaccaro