Help! I really dont know what to do :/

[melissaa]

Last week at my ob appt, my nurse practitioner (who is concerned I may be headed for pre-e) diagnosed me with PIH after seeing my reading of 148/79 in the office paired with my at home readings that were really all over the place but quite a few high numbers (its been slowly climbing for a few weeks. Normal of 95/60 and then it stayed about 120/70 for a few months.. then a few weeks ago reached 130s/80s). She warned me to keep an eye on my bp and head to the hospital if it hit 140/90. This weekend I really started feeling like crap. I started feeling completely exhausted the entire day with worsening headaches (at times it feels like someone is stabbing a knife into my skull repeatedly), swelling in hands and eyes upon waking up in the mornings and my bp has been rising even more. I was consistently getting readings of 140s/high 80s even after laying down to rest. The past two nights I have felt like death warmed over and last night I had HORRENDOUS heartburn right in the middle of my chest that radiated to the right under my right breast and would not go away with tums and a perscription dose of Zantac) with nausea especially when I rested my right arm on my belly. The baby moved about 3 times in 3 hours dispite eating drinking and laying on my side (Ive been told to look for 10 movements in an hour). I was awake a lot in the night with a headache and my ears ringing and my bp this morning was 144/88. I called in today even though I have an appt tomorrow and the nurse thought I should be seen. I went in and got the same nurse I had previously who took my bp wrong with the cuff on my elbow and her hand up under it holding the stethescope and she said my bp today was 133/70 (it hasnt been that low in WEEKS). She asked me how the headache was and did I have any swelling and I mentioned those to her. When the Dr came in she made a laughing stock of me. She totally blew me off and said that I absolutely did not have PIH or did she think I was headed there anytime in the near future. She told me that my BP's didnt concern her in the least especially given "I didnt have any other symptoms"... HELLO.... what about the relentless headaches and swelling??! She said that since I have no protein on the dip, she wasnt worried... even though I was dipping negative when I got 500 on a 24 hour with DS and was sent to the hospital overnight. So I asked her how much of a concern was BP alone when you dont have protein.. and she proceeded to tell me that you can have preeclampsia without protein but since I still didnt have any other symptoms, she wasnt worried at all. She basically laughed at me the entire time I was there and told me she thought I wanted her to tell me that I was sick. Im seriously FED UP with being treated like this! OBVIOUSLY I dont want to be sick.. OR have a preterm baby.. but good grief, I'd much rather have a preemie than a stillborn!!! It really concerns me after being blown off so much with DD's pregnancy at a different ob, that she would have been stillborn within 24 hours had I not PUSHED for care. This dr also told me that since my labs were fine 2 weeks ago that im fine. I asked her if nothing bad could happen in 2 weeks and she basically didnt even answer me. It was all I could do to keep from slapping her and walking out!

Im nervous about tomorrow. I have a growth scan in the morning and HAVE to see the other dr who also blew me off a few weeks ago b/c shes the only person who has an opening in her schedule (obviously no one else likes her either). Im really nervous that she too is going to blow me off. Today I have been getting readings of 154/87 and other 140s/80s along with having the headache and blurriness, fatigue, a little nausea starting this evening, and the annoying uncomfortable feeling is back in my shoulder blade.

[sam10]

I am so sorry you are experiencing all these difficulties with your care. This is very frustrating. I am sure you told the doctor about all the symptoms you are having including the decreased movement, head ache, swelling, heartburn and your BP readings from home?

Is somebody accompanying you tomorrow? This often helps to advocate for yourself, especially if the doctors and nurses hear the same thing from two people rather than just one. Another thing I would do tomorrow is bring your BP monitor, so you can check with the nurse if your monitor gives you the same readings as the one in the office. I would also insist on lab work.
I will be thinking of you and let us know how your visit will go tomorrow.

[sam10]

How did your appointment go today? How are you feeling?

[melissaa]

Thanks for checking on me
It went pretty well,the baby was in the 50th percentile and weighs 4 lbs 1 oz. My bp was 140/70 so they had me lay down and talk with the dr. about my bp's yesterday and my symptoms and concerns. She had the nurse come in and take it again and it was 132/80. She initially said she'd see me in 2 weeks but I told her I wanted labs redone, so she agreed and said she'd get those started and see me in a week instead. She did appologise for the bad appt with the other dr yesterday. She also told me that she thinks my bp is just going to stay in this range now and that now I should only go to the hospital if it reaches 160/110... which seems CRAZY high for me considering my baseline in early pregnancy was 90-100/50-60. My bp wasnt even that high when my son was delivered at 36 weeks, it was 150/100 the morning I went in for my csection.
In other news though.. i have been waking up between 2:30 and 3 am for the past 3-4 nights and i cant figure out why bc i normally sleep soooo deep. Last night when it happened, I heard ringing in my ears and my right hand was really swollen. When I got up this morning my urine was almost rust colored.. darker than Ive ever seen it. It was practically back to normal by the time I gave my sample at the ob though and still dipped negative.. seems weird, idk what was up with that. It was dark yesterday morning too (not near AS dark) but i assumed it was dehydration, so i drank more water yesterday but it didnt seem to help from the looks of this mornings.

[jean]

Oooh..rust colored urine is a bad sign. I had that when I had gone into HELLP. I would talk to your doctor again...that makes me very nervous...

[melissaa]

Was it all day for you? Its only happening in the morning for me so far..

[blythe]

Search the archives about coca-cola colored urine, or cola colored urine to find out more. When Caryn was spilling 17,000mg of protein her urine looked like cola, I think she explains that it was because the kidney damage was so severe at that point that red blood cells were spilling through. We've had other women, like Jean, report dark urine who also had severe disease, but also women with dark urine who turned out to be fine. I think it's just one more thing to report to your doctors - and if they can share more insight into what's going on, pe or not, please come back and tell us what they say. I'm glad your appointment went a little better than your last one. 160/110 to go to the hospital does seem a bit high to not-a-doc me, especially with your history of near-stillbirth. My doctor put me on bp meds when I reached 150/100 with my third.

I forget, are you seeing an MFM practice or just OBs?

[melissaa]

I am seeing an OB only right now :/

I havent gotten my protein results back yet but I requested a print out of my boodwork when I turned my urine in today and my platelets have gone from 173 to 144. Isnt under 150,000 considered class III HELLP? My AST and ALT are 17 and 13 (so still under 40) but up from 13 and 12.

I am going to ask for a referral to MFM today when they call me.

**EDITED**
Yeah, my dr isnt concerned (what I expected). She said my bp and the other symptoms arent a concern unless my protein is elevated (It came back at 175) and the platelets are completely normal. I requested to see MFM but im sure they'll deny me that too

[melissaa]

I noticed last night that im also experiencing some hyperreflexia too. I barely laid my hand down on my right knee and my foot jumped up. I seem to have the reflex even ABOVE my knee cap.

[melissaa]

A Dr from my practice (Im thinking possibly the head dr) called me today to discuss my concerns. I was so relieved that he told me exactly what I already knew and didnt try to discount anything. He said from the looks of it and given my history, hes pretty certain that pre-e is imminent and that I definitely DO have PIH. I know its normally not relieving to hear such a thing.. but I feel relieved that they understand where this is going and that I DO have someone who will be keeping a close eye and not 7 different dr's with differing oppinions who are treating me like I DONT have a history or even PIH right now. They are also sending me for a MFM consult.

The thing that confuses me now is just that the headache has been horrible and relentless the past two days.. but my bp hasnt really been higher than 130/80. I thought the two were pretty much related. I just hate feeling so crappy without a real reason behind it.. scares me a little.