New to BP meds - questions

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aundapenner
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Re : New to BP meds - questions

Postby aundapenner » Tue Sep 28, 2010 03:36 pm

ITA! With Henry, I gained over 50 pounds before delivering at 34+2. With Sofia, I don't think I gained more than 20 total.

alsgirl2002
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Re : New to BP meds - questions

Postby alsgirl2002 » Tue Sep 28, 2010 02:00 pm

Thanks Alice. The growth scans were 2 weeks apart. I also have not gained hardly any weight in four weeks now. About a half pound, only after literally gorging myself this past weekend. I should have mentioned it to my MFM, but we had already spent so much time discussing BPs and test results that it slipped my mind. I don't think I would be so worried about growth if I could just gain some weight. I gained 55lbs during my last pregnancy and this time I can't seem to break the 20lb mark even though I am almost 31 weeks. So I was worried about amniotic fluid levels and growth and my tech just completely blew me off. Wierd to be worrying about lack of weight gain and pre-e at the same time, huh?

aundapenner
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Re : New to BP meds - questions

Postby aundapenner » Tue Sep 28, 2010 01:09 pm

Lauren - you've gotten excellent information so far. Just wanted to add my 2 cents.

Medicating BP in PE cases is one of those grey areas in medicine as far as my layman's understanding. Some docs won't do it for the reasons your doc mentioned. In both pregnancies I was medicated, though it was significantly later in my 2nd pregnancy when they decided to medicate.

My peri for the 2nd pregnancy was of the opinion that the increase in BP was helpful to the baby's growth and they suspected (and were correct) that I was hypertensive outside of pregnancy.

As far as meds, I didn't have much of a negative experience to being on them. With Henry though, I just felt crappy overall - more from the pregnancy and water retention (and grieving the loss of my dad) than BP meds IMO. With Sofia, I generally felt great but my labs weren't good, nor were my pressures.

About the growth percentiles, you said he was down from 90 to 65%? When was the first versus the second growth scan done? (My peris here all stated that the growth scan was only effective in showing a trend when it was 2 weeks apart - that the baby sometimes would "fatten up" then grow in length and so forth. Does that make sense?)

alsgirl2002
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Re : New to BP meds - questions

Postby alsgirl2002 » Tue Sep 28, 2010 09:34 am

alvarin - "My understanding is that BP meds don't improve blood flow, but they can help protect mom and placenta from damage due to uncontrolled high blood pressure."

I think this must have been what my doctor was inferring when he said that meds just mask what's going on.

So far my BPs have been really good since my OB appt, other than a wierd outlier or two that I got after spending too much time at target the other day. Not been feeling great, but what's new?

Anyhow, maybe he'll hold off on the meds since my BP has been good, nothing even close to 160/110. Thanks for the input!

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mrss
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Re : New to BP meds - questions

Postby mrss » Tue Sep 28, 2010 07:18 am

quote:Originally posted by korie

I especially feel bad when my BP is dropping. I get a racey heart, can feel faint, and I get weak and too tired to do anything.

This is how I feel, too. The way it was described to me was the BP meds should take the edge off the high upswings and the really low numbers, but they won't stop the progression of the disease. For me, they don't make my pressures "normal." With super high numbers there is a real brisk of abruption, seizure and stroke in mom and growth restriction in the baby.

rachelc
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Re : New to BP meds - questions

Postby rachelc » Mon Sep 27, 2010 08:53 pm

I think that the bp meds work better for some than others. Sometimes it is just a matter of getting on the right med or group of meds. I think that most doctors would still consider you to have PIH even if your bp is controlled with medication. If you started to have protein in your urine then you would be considered preeclamptic even if your bp was being controlled with medication. My own personal experience is that bp medication kept my bp under control for a while but, then it would start to go up again and we would have to increase the dose. I also had some side effects that went away after a couple of weeks.

alviarin
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Re : New to BP meds - questions

Postby alviarin » Mon Sep 27, 2010 07:42 pm

Sounds like you have already met the half the criteria for a preeclampsia diagnosis: two high BP readings (140/90, either number) at least 6 hours apart. So even if your pressures were controlled on meds, diagnostic amounts of proteinura would put you in pre-e camp.

My understanding is that BP meds don't improve blood flow, but they can help protect mom and placenta from damage due to uncontrolled high blood pressure. Different docs have different numbers where they want to medicate at, in part depending on normal baseline, but most will medicate once you get in the severe hypertension range (160/110).

Blood pressure meds make me feel a little dopey, especially at first.


korie
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Re : New to BP meds - questions

Postby korie » Mon Sep 27, 2010 00:04 am

I only know the answers to a couple of your questions, sorry. I know everyone seems to have a different reaction to the meds. For some, it is just what they need to hold them off and it won't even take a very high dose. I would say with you being almost 31 weeks, you are in a good position for them holding you off long enough for a full term baby...depending on if pre-e sets in and progresses.
As far as how they make you feel? I can only answer for me and a few other people I have heard from. I get pretty miserable, but I am on a lot. I especially feel bad when my BP is dropping. I get a racey heart, can feel faint, and I get weak and too tired to do anything. I basically feel very tired from pretty much anything, I often have to sit down while shopping even. I am not sure if it will be this much for you, since i assume you will start out on a smaller dose. But I think even small doses can cause some reaction.

alsgirl2002
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Re : New to BP meds - questions

Postby alsgirl2002 » Sun Sep 26, 2010 10:00 pm

Another question - what should I expect from the BP meds? How will they make me feel?

alsgirl2002
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New to BP meds - questions

Postby alsgirl2002 » Sun Sep 26, 2010 02:04 pm

Earlier this week at my OB appt my BP was 132/98, it had been 140/90 upon waking, went down enough for me to not have to call in, and back down to 117/74 by bed time. My OB was clearly concerned and ordered me to quit school, but said I could still work for the time being. Did not order any labs or 24hr. I did just have a bunch of labs run 4 days earlier by another dr, they show minor increases in AST/ALT from my baseline, but nothing of serious concern. AST slightly out of range at 34, ALT still within range. Protein looked good on basic urinalysis.

Saw my MFM on Friday, BP was 120/86. He was pretty happy with that, but clearly concerned about the two other bad days I've had within the last 2 weeks. He said he'd see me in 2 weeks since he's out next friday, but to email him with my BPs and he would decide on bed rest and meds then.

Last time around he never put me on meds. He said that they would only mask what was going on and not really help. I went on bedrest at 34 weeks and was delivered promptly at 37w. My daughter was small at 25th precentile, but she had been that way throughout the pregnancy.

He said he's considering meds this time because its starting earlier. I agree that my BP is higher earlier this time. I tend to spike into diagnosic range here and there - right now its about once per week. But this time my spikes last longer, like the whole day is bad. Last time I would spike at wierd times and never stay elevated, I had maybe 2 L&D visits and 2 dr appts where my BP was diagnostic, one of those was at 37w, but the visits were after the 34w mark, I'm only 30+4 now.

Anyhow, I thought some background would help, here's my question. Will the BP meds actually help to dialate my blood vessels and improve blood flow to the placenta and baby? I think that the baby is being affected already. He had been consistently in the 90th percentile for growth, and this visit he's down to 65th percentile. I had not gained any weight so I wasn't surprised. Also, are the meds effective for everyone? Or do some respond better than others? Finally, if I do go on meds, is 140/90 still diagnostic, or does that change?


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