PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

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Expand view Topic review: PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by blythe » Sun Apr 29, 2007 02:39 am

I've been away for awhile but wanted to see if Mom and Baby are healthy? Come back and share your birth story!

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by rerskine » Tue Apr 17, 2007 12:49 am

Hello Again,
We are at 37 1/7 and we went in to L and D today. Julie's NST was great, baby is great and two ultrasounds since my last entry have confirmed that Eamonn is growing right on track (although we know that those can be off by 2-3 weeks in the third trimester. Julie has been maintaining great BP's at home (120's over low 80's). Until we are at the doctor's then 145/98- 155/101. We spent five hours at L and D tonight. Urine came back negative for protein, Blood work normal, no headache, no upper right abdominal pain, no edema. Just PIH. They did a pelvic exam and she is +2. Her BP finally went down after relaxing and an hour of hand and foot messages (I am glad we went to a class on this with our Daughter's pregnancy). BP settled at 121/82 and we are home with another 24 hr urine test. Appt on Wednesday, Then next Monday. If all remains the same they will probably induce at 39 weeks. I predict April 24th. Thanks for all the advice over the last few weeks.

Robb

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by blythe » Tue Apr 03, 2007 09:39 am

Just wanted to add congratulations on defending your dissertation!

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by anathor21 » Tue Apr 03, 2007 10:19 am

The dual check of the 24hr is interesting - especially with the change that they reported. In any case I would certainly be asking for the actual numbers going forward and not settle for "negative" or "It's ok" as an answer. Knowing they do it twice (for whatever reason - I'm eager to learn about that process as I've not heard of that before, perhaps it is common and I just never ran into it...) I'd be asking for both results.

In any case it sounds like the race is on - but you are well along having reached 35 weeks and already having good support in place as well as generally knowing what is going on. This puts you in such a good position compared to so many unfortunate folks out there who just don't get the information in time. Can't let your guard down, but at least you know the game.

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by aundapenner » Tue Apr 03, 2007 08:25 am

I just wanted to pop my head in here and say how much of an awesome husband you are!!! Your wife and son are fortunate to have you as an advocate. Keep up the good work!!! (My husband also learned this during our first pregnancy last year.)

When my BP spiked, my doctor sent us to L&D where we spent all day Easter Sunday last year. Finally, he came in and told me to quit work! Ha! But he was serious. Bedrest worked for me. It bought me 5 more weeks until 34 weeks. (Super big congrats for taking it one day at a time and hitting 35 weeks and counting!)

My BP readings gradually became worse, even though I wasn't doing anything all day. It even got to the point that when I was move from a lying down position to a seated position to take my BP I had to wait 15 minutes or so to lower my BP. (And by lower, I mean to get a reading of 140/90 instead of much much higher.)

Keep up the good work and remind Julie that we're all pulling for you guys!!!

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by rerskine » Tue Apr 03, 2007 01:40 am

I forgot to note the induction date. We have talked about 38 weeks as a goal, but should her BP go up and she has urine positive tests or if a sonogram shows that Eamonn is beginning to become developemntally hindered we will reevaluate and possibly induce. We really want to get to a minimum of 37 weeks. Our daughter was right at 36 or 35 and 4 days and she was great, but she weighed 4 lbs 12 ounces and as many posters here know that can add additional postnatal stress.
quote:
Originally posted by Blythe

I'm so glad to hear Julie's at 35 weeks with everything good except bp so far!

I'm also glad your docs are taking the bp spikes seriously - too many docs actually seem to ignore it, and these boards are filled with women with "just" high bp. "Just" high bp can still cause lots of damage to mom and baby... But I can absolutely appreciate how stressful it is for both of you.

Anathor's info was great, so I'm just going to offer some unsolicited advice [;)]. Julie sounds like she's absolutely petrified when that bp cuff ramps up and my heart goes out to her. From my old, long-past life as a therapist, I'd suggest a therapy technique... If she's so inclined, she could write down the thoughts and related emotions she's having as she's waiting in the doctor's office and getting her bp taken. Then she could look at those thoughts, see if she can "talk back" to them, and see if she gets an emotional change. (You could try it, too, to help you calm any anxiety and stress when they send you both to L&D again!)

(for example: Thought - the longer I sit here, the higher my bp is going to be; Emotion - fear; Scale 1-100 - 100; Change Thought - even if it's high and we're stuck at L&D again, every other time the numbers have come down and all the labs have been good; Emotion revisited: fear; Scale 1-100 - 50 (not cured, but a little better). She probably has TONS of thoughts going around her head, and changing any or all of them may not actually help the white-coat high readings, but dealing with the thoughts differently might help her feel a little better...)

Unfortunately, this really is more in the line of "therapy" (cognitive-behavioral), and it's not something you can really help her with. If she's at all inclined, I'd suggest the book Cognitive Therapy, Basics and Beyond by Judith Beck - or a good C-B therapist!

Then again, she has 2, maybe 3 weeks of this left, so maybe it's easier to just endure the panic and not try to deal with it any further!!!

Regardless, have the docs given you an induction date? 37 weeks? 38? Or at least list what they will look at in deciding when to induce? And if they give you that crap (sorry, just my opinion [;)]) again about "but would you understand the lab values if we told you?", you or Julie (whoever is interested) could say no, but it would help my anxiety level to know them, I'd appreciate it so much if you or a nurse could take the time to explain them to me. You can always bring the numbers back here, too, but I'd bet you'd feel better about your doctors if they involved you in understanding what is going on. Sometimes in PE they have to move very fast and can't take time to explain, but it sounds like right now there is time.

Good luck and keep us updated!

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by rerskine » Tue Apr 03, 2007 01:33 am

Thank you Blythe and Anathor,
Both of your responses were wonderfully informative and uplifting. THe nice thing about this cite is that no one sugarcoats the reality of PE. Some of the other cites are too positive and others give little hope. I am so happy to be one day past 35 weeks. Julie is doing great. Her BP when seated with a slight recline is about 115-125 and 74-91 diastolic. Her urine samples at home have shown trace amounts on a few occassions, and we have learned that her 24hr urine test came back positive from the local lab and negative from the regional lab. I have sent in an email asking the doctor to explain this duo lab process and why we were eventually told that the results were negative only.[?] The score was apparently around 100 by the first lab and 20 by the second. Sounds off to me, but I do not claim to be a doctor. Actually, as of last Friday I successfully defended my dissertation for my doctorate, so I guess I am now officially a doctor. I digress anyway. Thanks for your great responses.

rerskine

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by blythe » Mon Apr 02, 2007 10:11 am

I'm so glad to hear Julie's at 35 weeks with everything good except bp so far!

I'm also glad your docs are taking the bp spikes seriously - too many docs actually seem to ignore it, and these boards are filled with women with "just" high bp. "Just" high bp can still cause lots of damage to mom and baby... But I can absolutely appreciate how stressful it is for both of you.

Anathor's info was great, so I'm just going to offer some unsolicited advice [;)]. Julie sounds like she's absolutely petrified when that bp cuff ramps up and my heart goes out to her. From my old, long-past life as a therapist, I'd suggest a therapy technique... If she's so inclined, she could write down the thoughts and related emotions she's having as she's waiting in the doctor's office and getting her bp taken. Then she could look at those thoughts, see if she can "talk back" to them, and see if she gets an emotional change. (You could try it, too, to help you calm any anxiety and stress when they send you both to L&D again!)

(for example: Thought - the longer I sit here, the higher my bp is going to be; Emotion - fear; Scale 1-100 - 100; Change Thought - even if it's high and we're stuck at L&D again, every other time the numbers have come down and all the labs have been good; Emotion revisited: fear; Scale 1-100 - 50 (not cured, but a little better). She probably has TONS of thoughts going around her head, and changing any or all of them may not actually help the white-coat high readings, but dealing with the thoughts differently might help her feel a little better...)

Unfortunately, this really is more in the line of "therapy" (cognitive-behavioral), and it's not something you can really help her with. If she's at all inclined, I'd suggest the book Cognitive Therapy, Basics and Beyond by Judith Beck - or a good C-B therapist!

Then again, she has 2, maybe 3 weeks of this left, so maybe it's easier to just endure the panic and not try to deal with it any further!!!

Regardless, have the docs given you an induction date? 37 weeks? 38? Or at least list what they will look at in deciding when to induce? And if they give you that crap (sorry, just my opinion [;)]) again about "but would you understand the lab values if we told you?", you or Julie (whoever is interested) could say no, but it would help my anxiety level to know them, I'd appreciate it so much if you or a nurse could take the time to explain them to me. You can always bring the numbers back here, too, but I'd bet you'd feel better about your doctors if they involved you in understanding what is going on. Sometimes in PE they have to move very fast and can't take time to explain, but it sounds like right now there is time.

Good luck and keep us updated!

Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by anathor21 » Mon Apr 02, 2007 02:06 am

Ok - just the facts here this time - try to keep the editorials to a minimum for you since you are likely busy and going to need all your reading time anyway [:)]. Lots of questions in there, hope I get them all.

BP readings - how to take them:
http://www.preeclampsia.org/forum/viewtopic.php?t=321

Also note here the response from Dr. Easterling in reference to the Labile phase - some of the variances you are seeing may be attributable to this as well.

Editorial note - if you read comments here you will get a sense that many folks feel that L&D and other nurses (and others also) may prefer to take BP readings laying on the side to get 'nicer' numbers - to reassure themselves and/or the patient. It seems generally to not be all that helpful from a diagnostic standpoint to do this (to put it mildly) and in fact may be dangerous if seated readings are ignored in this context. If you find yourself in a situation where someone is trying to adjust body position to lower BP and just record lowest possible reading it is likely time to challenge that act and advocate for a better approach (i.e. note the expert responses in the thread above).

re: bedrest
http://www.preeclampsia.org/forum/viewtopic.php?t=10150 (ask the experts statement)

http://www.preeclampsia.org/forum/viewtopic.php?t=12455 (link to research and more debate)

Editorial comment: Well, the debate rages - but essentially the question seems to come down to what works well for the particular patient. Some folks do well on bedrest, others end up laying there stressing out more than if they could get up and do things. Although PE is not considered a disease process caused by stress/anxiety, adding stress or anxiety to a body that is going through a difficult physical challenge is never likely to be a good thing for overall health (note, this is opinion still) so take from this what you will. If bedrest seems to be helping your wife and not causing undue harm (and it sounds like you are getting good support) then I'd keep it up as best you can.

re: diet
Editorial note: (getting this in first) There are so many bits here it's hard to know where to start. I'll focus on the sodium question since you asked about that specifically, but understand that the whole diet and PE thing opens up lots of different avenues here. There are various folks who will claim this or that diet can prevent or cure PE - not one has been validated in any reasonable manner to have truth to them that I can find. Folks of course WANT to believe that diet can prevent/cure it as it is something we can control, but it seems highly unlikely given the current understanding of the mechanism of PE development that diet really will play much of a role in the ultimate cure/prevention strategy. Perhaps it will - never say never, but don't hold your breath. Anyway - on to the salt question...

http://www.preeclampsia.org/forum/viewtopic.php?t=1305 (Expert remark - sort of side issue...)
http://www.preeclampsia.org/forum/viewtopic.php?t=1826 (Another Expert comment)

http://www.preeclampsia.org/forum/viewtopic.php?t=17822 (Perhaps useful from an inverse - note the ommision in expert response - i.e. they don't include salt reduction in their response)

Editorial note: So on the salt question, research of available expert opinions here doesn't seem to indicate that there is much support for reducing/elminating salt for PE alone. Obviously if there are other things going on there could be reasons... this actually syncs up well with what I recall from other readings I've done and with our own experience with our doctors during our PE experiences (we were told to salt to taste, but keep it down in general as it's not good for her health to over salt - pregnant or not).

Glad that other signs/symptoms appear stable. 35 weeks is great - keep an eye on things! Changes can and do happen rapidly.

E.





Re : PE 1st Pregnancy/Now 34wks2nd Preg BP jumped

Post by rerskine » Mon Apr 02, 2007 05:26 am

Checking in again.
So here is the current situation. My in-laws, now officially saints, have been coming over everyday and helping take care of our daughter Isabel, allowing me to focus on the many tasks we had planned to finish before the baby arrived.

Julie has been on bedrest since Tuesday of last week. Her BP is much better, but we have been unable to get consistent readings. This seems to be directly linked to her postition. When she is in a more reclined position(on back, left or right side)BP is 110-129 over 78-85, but if she sits up straight her BP goes up. The perinatal call in service tells her that she needs to be sitting up, but when we have gone in to L and D she has always been reclining slightly when her BP is taken. What position should she be in? What are people's thoughts on bedrest. There seems to be quite a bit of contradictory research about the benefits of bedrest. She has been told to reduce her activity, stop going to work and try to rest as much as possible. Is it dangerous to have too much bed rest? What about diet? The doctor said to reduce sodium intake , but other sources online suggest that for PE one should not reduce sodium, which is better?

All of her blood tests and her 24 hr urine came back negative and she is not showing signs of any additional symptoms.
35 weeks today. Two more weeks.

Robb

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