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Worried when worrying is the last thing I need...

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Worried when worrying is the last thing I need...

Postby lories » Sat Jan 10, 2004 08:26 pm

by lories (66 Posts), Sat Jan 10, 2004 08:26 pm

Hi. I was hoping you all could help either put my mind at ease or give me some information. I'm 22 weeks pregnant and after having good bps all pregnancy (averaging about 115-120/70-80), I had a high bp reading last week. I had an extremely stressful morning: I'd had a lot of anxiety that morning about a big exam I was taking later that day, and was in a huge rush to get to the office. My bp at the beginning of the appt (I was also extremely hot and hadn't had enough to drink) was 144/80. The nurse got extremely worried about that, and her anxiety sent me panicking. The nurse practicioner came in, and the two of them started asking if I could still feel the baby and checking me for swelling, and I was absolutely terrified. My heart rate was through the roof and at the end of the appt my bp was higher than when I came in (although the bottom number stayed at 80). I was told to rest in bed the rest of that day and the next, and come in the next day to recheck my bp. Well, being as neurotic as I have been, I spent the entire day reading about high blood pressure in pregnancy, and got myself into an absolute panic about having pre-eclampsia, being particularly worried since I'm only 22 weeks. By the time the following evening came around I was convinced I was be sent straight to the hospital, was a wreck, and of course my bp was even higher. It was 160/80, briefly went down to 150/80 when I lay down, and then went back up a few minutes later. The np I saw that night was slightly less alarmed, given that I have no other symptoms of pre-eclampia (no swelling, good urine, no headaches, no pain, etc). I was sent home for three days of bed rest and she suggested I monitor my bps at home.

By the end of that night, my bp was already way down, varying between 110-135/65-85. Since then, I have been monitoring my bps rather obsessively, and I'm not sure what to think about what I'm finding. In the past four days, I've had one period of extreme anxiety (I have panic disorder), and my bp was up to 148/82. If I take my bp right after climbing the stairs, it is usually 130-140/80-85. When I change positions (laying down to sitting up), it goes up to around 130-135/75-80. But, in all of those cases, as soon as I calm down/settle down, it quickly drops, often getting down to 115/70 in a matter of minutes. In general, it has been staying around that level, and most of the day it is between 110-125/65-80. If I lay on my side, it can go down as far as 90/50, and in the morning it is pretty low, even sitting up, usually around 110/60.

Yes, this is insane, I realize. But, I'm really scared because I have a history of panic disorder, and have been having panic attacks while pregnant. I was NEVER warned that a high bp caused by anxiety could harm either me or the baby (instead I was reassured that panic attacks could not hurt either of us), and I'm still not sure if that's the case. I don't have a problem with chronic anxiety, and the vast majority of the time I am relaxed and calm, and my bp is at a totally normal level. But I do have panic attacks on a relatively regular basis, and I am very scared that either my bp will rise to a dangerous level during an attack and cause serious harm to the baby or me, or that the high bp during periods of anxiety will turn into pre-eclampsia.

Do you all know anything about this? Is high bp from panic/anxiety that comes down quickly once the person calms down a problem? I am working on handling my anxiety, and I think I'm doing a relatively good job of it. However, I do still have anxious periods and occasional panic attacks. Is it possible that bps elevated from a panic attack could cause serious harm or develop into pre-eclampsia? Or is the kind of high bp had in pre-eclampsia different from that had during a panic attack?

I'm also confused because I know bp fluctuates quite a bit during the day, but I'm not sure how much fluctuation is normal. Is a higher bp after periods of physical activity normal?

I guess I'm just looking for any feedback you all might have.

Thanks,
Lori
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Re : Worried when worrying is the last thing I need...

Postby alimarie » Sat Jan 10, 2004 08:58 pm

by alimarie (530 Posts), Sat Jan 10, 2004 08:58 pm

Lori,

Unfortunately I do not have any medical advice for you but I didn't want your question to linger long before you got a reply. I know some of the other ladies will be able to share their knowledge with you. Try to stay calm as much as possible. It sounds like you had every reason to be anxious the day of your big exam and all. Keep us updated and welcome! The ladies on here are very wise about Pe and will give you comfort!

alison

AliMarie---mommy to Madalyn Anne-born at 35 wks due to severe pe (9/18/2001 4lbs. 14oz.)
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Re : Worried when worrying is the last thing I need...

Postby lories » Sat Jan 10, 2004 09:05 pm

by lories (66 Posts), Sat Jan 10, 2004 09:05 pm

Thank you for your reply. I should also add, the *only* time I've had a bp over 130/80 since I've been home has been when I've taken it right after going up the stairs. (The monitor is on the second floor of the house.) My husband took *his* bp right after going upstairs and it was also elevated. As I said, it drops immediately when I rest and is down to 120/75 or less in a matter of minutes. I just got scared because earlier tonight I was having a panic attack *and* just went up the stairs and had a bp of 148/82. It was down to 124/80 in less than two minutes, but it does scare me that it goes up. But, like I said, I know bp varies throughout the day--I'm just not sure if what I'm experiencing is normal variations, or if I should be concerned.

I should add, too, that unless I am anxious, my bp is relatively stable, ranging from 90ish/50ish while lying down on my side to 115/65 while sitting. It only varies more when my pulse rate is up and I'm feeling more anxious, and that rarely happens--I've had one anxious episode in the last four days. Also, my bp is NEVER high unless my pulse rate is high, if that means anything. Also, the bottom number has risen to 90 once (after being rather active *and* anxious), and other than that has stayed below 82 at all times, even at the doctors when I was extremely anxious.

Again, I know I am over-reacting, and I *know* I need to put the bp monitor away and relax, but I really want to make sure that if there is any chance my baby is in danger (or I am) I take immediate steps to stop it.

If there is *any* chance that what's happening to me could result in pre-eclampsia (which I do not have right now), I would like any advice on how to prevent that from happening.
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Re : Worried when worrying is the last thing I need...

Postby laura » Sat Jan 10, 2004 09:29 pm

by laura (5139 Posts), Sat Jan 10, 2004 09:29 pm

Hi Lori, Welcome to the forum. You know I have to confess that I am not familiar with how BP from anxiety is different than BP caused by other thigs, if there's any difference at all.

What I do know is that preeclampsia is a multi-system disease specific to pregnancy that includes, among other things, intrinsic changes in how the placenta is formed, attaches, and works, it includes changes in blood vessels and the cells lining the blood vessels. Hypertension is one of the facets of preeclampsia, but not the only one.

I think that any hypertension, regardless of the cause, is not good for babies and moms. On the other hand, I'm not familiar with anything that says that anxiety can trigger or cause preeclampsia.

That's not to say that you don't have PIH, or are not going to develop it, but I think that you probably should be sitting for a good couple of minutes before you take your BP. Here's a link from the Ask the Experts section that includes how to take your pressures:
http://www.preeclampsia.org/forum/viewtopic.php?t=321

If your hypertension persists, I would suggest consulting with a perinatologist to map out a plan for the rest of your pregnancy. You can find a perinatologist at http://www.nasshp.org or http://www.smfm.org It may be a good idea to speak with an obstetrician or perinatologist anyway to discuss how your anxiety influences your pregnancy, and how you should handle it.

In any event, I hope you're feeling better soon, and have a nice healthy and long pregnancy uncomplicated by all this high blood pressure stuff. Please let us know how you're doing!


Laura-28
DH Jack-31
Allicia 5-13-98 (35 weeks-pre-e)
Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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Re : Worried when worrying is the last thing I need...

Postby lories » Sun Jan 11, 2004 06:21 am

by lories (66 Posts), Sun Jan 11, 2004 06:21 am

Thanks. This morning I had a bp of 115/67 after first getting up to get the monitor, and in then in about 1 min it was down to 101/61. That's a normal morning bp for me, when it's a lot lower. I don't think that's anything to be concerned about at all. As I said, it only rises when I am anxious, or when I am active, usually only to 130/80 or so, and then goes down immediately upon resting.

I'm just so paranoid about this! Lately I've been noticing a lot of floaters in my vision, but I know it's just because I'm looking for them. I'm very nearsighted and have always had them, but suddenly I notice everything single one :(. I don't want to make it sound like I'm freaking out over every little symptom, but I AM noticing things that I normally don't notice and I AM concerned about the safety of me and my baby over the next 18 or so weeks.

Again, a lot of this is just because I do not understand how any of this works. Pretty much everything I've found on high blood pressure in pregnancy equates that with pre-eclampsia, and I'm not sure if there's a difference between high bps induced by anxiety and those induced by the pregnancy, or if having even very occasional high systolic numbers can cause a problem.

The basic treatment for panic attacks, generally, is to do things that bring on the panic and assure yourself you will be fine and wait for the feelings to pass. If I was assured that periods of anxiety where my bp was up would not hurt my baby, I'd be fine with that. However, if it could, I'm wondering if it would just be better to avoid any situations that cause anxiety for the rest of the pg.

A lot of my fear too is from the reaction at my nurse practicioner's office. My bp was 144/80, my pulse was up, and I was obviously stressed, and they started asking if I could still feel the baby move! Personally, I think they over-reacted a bit, but after reading some of the posts here, I'm very glad I have health care providers who are erring on the side of too much caution. It does make me feel more secure about the rest of the pregnancy, and sure that if anything does develop, they will act quickly, which will hopefully help prevent any serious problems. I've just been so scared of my bp going too high and having to deliver the baby way too early.

Thanks again,
Lori
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Re : Worried when worrying is the last thing I need...

Postby lisac » Sun Jan 11, 2004 12:12 am

by lisac (247 Posts), Sun Jan 11, 2004 12:12 am

Hi Lori,
I really feel for you because I also deal w/anxiety, and I know how that can really confuse things since it can have an impact on bp on pulse. I know that when anxious, my pulse can go as high as 120 and w/it bp can increase as much as 20 pts (bottom & top number).

That said, it's good that you're aware. Have you been given any perscription drugs to take during an episode of anxiety? I just wonder if there's anything that's safe for pg women to take. I understand your concern about how excessive anxiety will impact the baby.

Keep in mind what Laura said-- that PE is multi-system disease. In addition to high bp there is usually swelling, headache, protein in the urine.

It's good that you're vigilant, but I know it can be a fine line between being aware and obsessing to the point of extreme anxiety.

I hope you start to feel better.

Lisa
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Re : Worried when worrying is the last thing I need...

Postby lories » Sun Jan 11, 2004 12:35 am

by lories (66 Posts), Sun Jan 11, 2004 12:35 am


Thanks. I appreciate the replies. It *is* confusing trying to figure out what is just anxiety and what might be a problem. I know my bp is fine most of the time, I just worry that it will go extremely high during a panic attack and cause damage (I don't have chronic or generalized anxiety, but panic attacks). When I'm having a panic attack my pulse will sometimes go as high as 140 or 150! I've always been told it is nothing to worry about, since it goes down very quickly, but I'm still worried about the pregnancy.

The medication question is a good one. I had been taking 50 mg Zoloft a day until last April. It worked relatively well, but my current therapist tells me the dosage was so low it really wasn't doing much at all. Plus, I have an extremely hard time going on it (insomnia, weight loss, shaking, an increase in anxiety for several weeks, heart palpitations) which I think would be worse for the baby than not taking it! BP meds don't seem like a great idea since my BP tends to run around 115/65 or so and I wouldn't want it to get too low and be tired and dizzy all the time (when I was first diagnosed with panic disorder they tried putting me on a beta-blocker and I had a serious problem with low BP). And I'm pretty sure all anti-anxiety medications are out of the picture. My nurse practicioner has recommended resting, more frequent visits with my counselor, and possibly trying biofeedback. I'm fine with all of that, I just worry that the next panic attack I have will harm me or the baby because of the BP/pulse increase, and of course it is exactly that kind of worry that brings panic attacks on :(.

That I'm a total hypochondriac doesn't help either. Ever since finding out that headaches and vision changes are part of pre-eclampsia, I've been having (extremely mild and short-lived) headaches and seeing floaters (which are always there but I usually don't notice). Of course, my BP has been way down, so I know that's not what's causing it. I'm just worried that either my np will overreact to what is in fact just anxiety, or that she will underreact to what could be a more serious problem because she and I are both assuming it's just anxiety and that I'm being a hypochondriac. Argh! I'm just trying to keep my mind on other things as much as possible :).

I'm glad to see that others here have had the same kinds of questions, though.

Thanks again,
Lori
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