Postpartum - trying to get BP under control. HELP - UPDATE

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libby123
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Re: Postpartum - trying to get BP under control. HELP - UPD

Postby libby123 » Wed May 23, 2012 07:12 pm

With my experience, it took about 8 weeks for my pressures to drop within an acceptable range. At my hospital, they didn't even want to check my pressure and protein, but I finally requested the BP check and it was in the 170s/100s even days after delivery. I remember sobbing at home because I had been told that pre-e would end with the pregnancy, but my BP was still so high.

Now my daughter is 15 months old and my blood pressure is well under control and sometimes gets too low for me. I am on 50 MG Toprol XL for palpitations, not for blood pressure, but it does bring my pressure down. I am normally in the 120s/low 70s now.

Before I got pregnant, there was a few instances when my BP was high at the doctors but I remember thinking nothing of it. Now I am almost overly aware of my BP. That is what this disease will do to you I guess!
Mommy to Sailor Ann, born on February 17th 2011 at 36 weeks by c-section due to PIH that slowly turned into preeclampsia.

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caryn
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Re: Postpartum - trying to get BP under control. HELP - UPD

Postby caryn » Wed May 23, 2012 03:51 pm

Postpartum it is still possible to develop preeclampsia symptoms, as the chemical proteins that cause the damage are being swept out of your system. It can take weeks or months for this to happen, which seems to be because of underlying genetic tendencies to manufacture a certain protein that cleans up the other proteins, and because of the tremendous amount of variability in the level of damage that is caused to each woman.

Some people see their pressures drop as the placenta is removed, certainly, but then there's women like me. I was still at crazy high pressures on the full dose of meds 6 weeks postpartum, finally weaned off the meds at 120/80ish ~3-4 months postpartum, then kept trending down. The fact that my pressures were very high still for a long time postpartum makes me a chronic hypertensive, with the idea being that a long recovery "unmasks" that genetic tendency to be a chronic hypertensive. But my pressures have kept dropping for *years* - I just had my pressures taken at the doc last week, where I rang in a beautiful 114/62.

So even though I'm technically a chronic, I'm not on any meds. Being diagnosed as a chronic had one significant impact on me, which was restriction of my birth control options.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

alviarin
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Re: Postpartum - trying to get BP under control. HELP - UPD

Postby alviarin » Tue May 22, 2012 05:09 pm

We have had posters whose BP recovered in a matter of hours, days, weeks and even months postpartum.

After my second pregnancy, my BP peaked a week postpartum on the max dose of Aldomet. It gradually came back down, but not not quite back to normal. I'm still on a low dose of BP meds to this day. However, I am also heavier than I have ever been & hopeful I can wean off the medication if I lose the extra weight.

Usually you aren't diagnosed a chronic hypertensive unless your pressures are still high twelve weeks postpartum.

Good luck, please keep us posted on your progress.
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

mrsjdm08
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Re: Postpartum - trying to get BP under control. HELP - UPD

Postby mrsjdm08 » Mon May 21, 2012 01:30 pm

Thanks for your responses - quick update.

I stayed on just the labetalol for about 4 weeks (100 mg/2x a day). It only took my BP down to about 130s/150s over 90s. The OB had me go to my primary care physician (of course I had to find a new one, as my old one stopped taking my insurance). I was prescribed 5mg lisinopril to take with the labetalol. This finally took my blood pressure down to 120s-130s/80s....approximately about my normal pre-pregnancy blood pressure. I go back to my PCP on Friday to see if the lisinopril will be increased (I am not nursing, btw).

Now that I am back to a somewhat-reasonable blood pressure, I hope that I am not on bp meds for the long-term, and I am hoping the preeclampsia did not cause long-term damage to my body. Long-term experiences, anyone?


Cyn

alexis
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Re: Postpartum - trying to get BP under control. HELP

Postby alexis » Tue Apr 24, 2012 08:15 am

Procardia and Labetalol are two different categories of drug, so it's unlikely you'd have the same reaction to both.

As for controlling your BP: It's rather tricky now as you are still so recently postpartum. This might be the preeclampsia, or you might be an unmasked chronic. The important thing is to get it stabilized, and meds will do that quicker than anything else.

Long term, the things that have been demonstrated to make a difference in hypertension:
- The DASH diet will give a small, but statistically significant, drop (something along the lines of 10 mmHg systolic and 5mmHg diastolic in hypertensive patients)
- If you are overweight or obese, losing 5-10% of body weight
- If you are sodium sensitive (not a majority of the population) a low sodium diet
- More exercise

However, unless your hypertension is very mild, these approaches are not likely to treat it completely.

Getting the meds right may be tricky. If you have developed chronic hypertension, it's likely that your family doctor or internist will switch you from labetalol as its primary use these days is in pregnant patients. Many blood pressure medications are safe for nursing, if that's a concern for you (diuretics may reduce milk supply), though some of the most popular drugs are not pregnancy safe (ACE inhibitors and ARBs) so your doctor may not give them if you are not on reliable contraception. (Mine would not switch me to an ARB+HCTZ until I told him I was having an IUD placed.)
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

mrsjdm08
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Re: Postpartum - trying to get BP under control. HELP

Postby mrsjdm08 » Mon Apr 23, 2012 06:46 pm

I don't have any experience with PP pre-e... so just my 2 cents... If you haven't already I would give your doctor a call about your pressures. I'm sure they'd want to know and might want to adjust your Labetalol dosage...
Thanks so much for the response. I have a blood pressure check appointment tomorrow, so hopefully they will adjust the dosage. I am paranoid about that since the Procardia reaction. I hope that was a one-time thing.

MomTimesThree
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Re: Postpartum - trying to get BP under control. HELP

Postby MomTimesThree » Mon Apr 23, 2012 04:18 pm

I don't have any experience with PP pre-e... so just my 2 cents... If you haven't already I would give your doctor a call about your pressures. I'm sure they'd want to know and might want to adjust your Labetalol dosage...
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w

mrsjdm08
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Postpartum - trying to get BP under control. HELP - UPDATE

Postby mrsjdm08 » Mon Apr 23, 2012 02:08 pm

This is my first post to the board. Basically, after having my bp rise from about 120s/80s to 140s/90s, I was given a urine test which came back at 339 mg, which gave me a diagnosis of mild preeclampsia at 34 weeks. Went on bedrest, was able to stablize my numbers for the most part. Was induced at 37 weeks (my bp started in the 140s and got down to 120s and 130s) and had a healthy baby boy.

Unfortunately, the story does not end there. One week after giving birth, I went back to my OB/GYN office for a BP checkup, and I had a blood pressure of 165/95. I was put on Procardia (30 mg extended release), but after I took it, I started to get a monster headache, and my BPs were in the 170-190/90s range and a pulse of 40. Went back to the OB/GYN, had a bp of 173/100, sent to triage and was admitted to the hospital. I ended up being put on magnesium sulfate and got a CAT scan of my brain, which came back normal. They think the headache was a bad reaction to the Procardia, so now I have been put on Labetrol (200 mg a day). My resting bp is 150s/80s and when I'm up and about, it's still 160s/90s if I am up and about. I'm not seeing much progress with the Labetrol, and it's been 5 days since I started it.

I understand it may be a few more weeks before my bp goes down. I just wanted to know what any of you did to get your bp numbers to go down besides medication. During my pregnancy and now, I tried diet modifications, bed rest, etc. etc. without getting much results. I would really like to exercise again, but I'm afraid my bp would really hit the roof.
Last edited by mrsjdm08 on Mon May 21, 2012 01:23 pm, edited 1 time in total.


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