Concerned at 35+2 wks

[evp12]

So I had my appt this morning and I'm even more frustrated. The on call dr's instructions to add caffeine to my Tylenol w/ Codeine and treat my headache as a migraine did NOT work for me. And my bp didn't go down at all the rest of the weekend (I home monitor my bp three times every day -- lowest since Saturday was this morning at 168/96). At my appt today my bp was 170/100. When my OB came in to talk with me, he took my bp while laying on my left side and it was 135/86, which he said was good. So since my bp lowers when I lay down, he's not concerned. He sent me home with a prescription for Fioricet and said it's probably a migraine.

What do I do? Or really, what can I do? I'm so frustrated because I know something is not right, but my OB has me feeling like my hormones and anxiety are getting the best of me and that I should just follow his orders and go back in next Monday at my next regularly scheduled appt.

And this Fioricet prescription -- while it seems common to be prescribed for tension headaches and migraines, it's a Cat C drug (combination of acetaminophen, butalbital, and caffeine). My OB says it's "perfectly safe" for me and baby, but when reviewing the side effects on drugs.com, it reads "Barbiturates in general have been reported to readily cross the placental barrier. Withdrawal seizures have been reported in a two day old infant whose mother had taken a butalbital containing drug during the last two months of pregnancy. Butalbital was found in the infant's serum. Animal reproduction studies have not been conducted on butalbital." (http://www.drugs.com/pregnancy/acetamin ... feine.html) So NOW I'm second-guessing his orders AGAIN and think maybe I shouldn't take it and just continue to suffer through my headache, nausea, vomiting, and shortness of breath.

Thanks for reading...

[MomTimesThree]

Urgh, that is so frustrating! I can't believe with the pressures you were having all weekend that your doctor wasn't more concerned.

Any chance you can get a referral to an MFM (high risk doctor)? You might even consider next time you go to L&D to choose the hospital with the level 3 NICU which most likely will have MFMs on staff 24/7.

I'm so sorry your concerns are being brushed off. When were your last labs taken?

[aajatwins]

Sorry to jump in the middle of the thread
I wouldn't be satisfied with your doctors orders, if I were you. A general feeling of something being wrong is actually a significant indicator. Call it maternal instinct. I would do as others have suggest and go straight to L&D and ask for bloodwork. Most people get great BP readings laying on their left side, but we don't do that all day, do we? That just means your BP *can* come down, not that it *will*. You need to say whatever needs to be said to make your husband and doctor aware of how uncomfortable you are with your symptoms. Or call a cab, mama! maybe it is nothing to worry about (doubtful with those numbers), but maybe it is something very serious that could move very quickly. don't worry about looking silly or even crazy, worry about your health and that of your baby.

[sam10]

Please don't 'suffer through anything. As has been suggested, please go to L&D and insist on blood work and a proper assessment of your situation. Thinking of you.

[sam10]

How are you doing? Thinking of you

[tree]

I'm hanging in there. I've been trying to take it easy this week since my appointment on Monday. My head is still hurting me and my bp is still up there (this morning it was 144/92), but I'm really trying to hold out until my next appointment on Monday. My headache goes from okay (dull ache) to feeling like my temples are caught in the middle of a vice. Though when I described where the pain was and what it felt like to the on call doc last weekend when I made the visit to L&D to be monitored, he told me that it "didn't sound like anything more than a migraine. Worrisome headaches are 'different' and the pain is all over." My nausea is a little better, too -- I went from vomiting every other night for almost a week to only vomiting once this week and a few bouts of nausea in between.

While I await my appointment on Monday, I bought some urine dip stick tests to settle my own mind in the interim -- everything has been looking good (negative to trace readings of protein) though my leukocytes have been medium to high (possible infection, I assume?). My little guy is quite active, so that's also reassuring.

I'm now 36+2 weeks -- at my Monday appointment I'll be 36+5. If my bp is still up and my headache is still hanging around, I have half a mind to request an induction. Is that completely out of line?? I just don't know what else to do, since my OB doesn't seem overly concerned. All I know is that I can't continue to feel like this. Thankfully, in response to MomTimesThree's comment, my hospital that is literally 6 miles from my house (********) has a great Level 3 NICU - so I feel that I would hopefully be well taken care of if I needed to go in.

Does it make me crazy that I feel like I need to do all of this self monitoring? I feel like I sound like a hypochondriac or something. I do appreciate you ladies reading and providing your feedback -- I feel so much more comfortable "talking" through some of these issues with you all then I do with others that don't "understand" why I'm concerned. So thank you for your support!

[MomTimesThree]

I don't think you are being a hypochondriac about anything. Not at all. I commend you for taking monitoring into your own hands since your OB clearly isn't stepping up to the plate. Trust your mommy gut- it's smarter than any MD on the planet.

I'm glad you know where a great hospital is, typically the ones with the highest level NICUs also have the best high risk docs, and I think they'll best be able to read your symptoms for what they are- worrisome, not just regular ole' pregnancy related things. Most pregnant mommas taking it easy don't have BP in the 140s/90s, nausea and awful headaches... make sure hubby knows that too!

Thanks for the update- I was worryin' about you!

Lauren

[tree]

I am sorry to hear that you are still so miserable. You are definitely not a hypochondriac. It is impossible not to worry when you have every "worry now" symptom in the book.

It is perfectly reasonable to start discussing a delivery plan with your doctor at your next appointment. If you want to go in with some data to support your argument that delivering sooner is wise, you could ask about the HYPITAT study (http://tinyurl.com/mkpeza). This study recommends inductions at 37 weeks for women with hypertension or pre-eclampsia because it results in much better maternal outcomes. I agree with Lauren's comment above that the best NICUs and best doctors are often at the same hospital. You could just go into L&D and see the on-call doctor if you don't have confidence in your doctor's approach. Hang in there. I really hope this gets easier for you.

[evp12]

I had my appt this morning. My bp was still high - at 168/102. The little guy looked great on the NST, so my OB took blood and is running new labs. If the labs are abnormal, or if my bp or headache gets significantly worse he plans to induce this week. If the labs are okay, but my bp stays up through my next appt, we'll most likely induce next Monday. It's a balancing act between the maturity of the baby and my symptoms. In the interim, he told me to "call him and come in if I feel bad or my bp is continuously over 100..." my answer to him was that I've been feeling TERRIBLE for over 2 weeks now and my bp is fairly consistent over 100 at home. He just looked at me and said if I start to feel worse to call. So, in other words, I'm still confused about what the threshold is before I call him, but at least he should call me with the results from the blood work tomorrow -- maybe with some answers to why I'm feeling so terrible.

Thanks again to everyone for being so supportive!

[tree]

I am glad your little guy is doing well and your OB is running labs. I would call if you feel any worse at all or if you just can't take it any more. If nothing else, they could monitor you in the hospital until you hit the magical 37 weeks. PE doesn't really care how far along you are, and it is a very delicate balancing act between giving the baby as much time as possible and keeping you safe. Sometimes, it is better to try managing that in the hospital.
I waited much too long to call and go in because I thought that the end of pregnancy is supposed to be miserable. I assumed that everyone suffered as much as I did and you are now. They don't. Don't be afraid to tell him that you are increasingly miserable and cannot do this anymore if that is the case. Your OB might consider in-patient monitoring a reasonable compromise between toughing it out at home and delivering now. There is also nothing wrong with staying home if you genuinely feel better. Nobody likes to be in the hospital (one sign that you are not a hypochondriac), but many of us would rather gestate there than at home when things start to go crazy.