worried, but my doc doesn't seem to be

[outracheous]

Hello all,
9 years ago I gave birth to my little girl at 34.5 weeks due to preeclampsia. Now I am pregnant again, 32 weeks along. My last couple visits my bp has been elevated and I have also been having problems with my heart racing and shortness of breath. The did an echo to check things out due to the fact that cardiomyopathy runs in my family. My echo came back fine, but my heart rate was very high the whole time, in the 130's for most of the test and did not go below 107. They did labs and found that I have hypothyroidism, put me on meds and said that would help with my bp eventually. I called on Monday b/c I my heart felt like it was beating out of my chest. My hr was in the 130's for most of the day with my bp 160/100. They said if I still felt bad that I could come in and be seen, well, duh! Everything was still high in the office, so they admitted my to run test. I was going into tachycardia and my bp was very high. The nurses changed shifts and the new nurse came in and put a very large cuff on me. At that point my bp went down drastically, from 157/103 to 118/59. I felt exactly the same and I know that my bp was still high. They sent me home due to a couple bp's low. Did a 24 hour urine and I am still waiting on the results.

I am starting to get frustrated b/c I know what can happen in the blink of an eye and that it can be serious, but I feel as though my doctor isn't taking it as so.

Now I am starting to have problems with pain in the right side of my abdomen. I am just scared

[caryn]

Nurses seem to love that "bigger cuff" trick, but as you say, it just introduces an error into the measurement, which doesn't make you better.

I would put a call in to your doc and report that pain on your upper right side and ask about bloodwork to rule out HELLP syndrome, and to follow up on your proteinuria. That level of tachycardia must be making you miserable, and pressures that high are enough to qualify you as a severe gestational hypertensive, even if you're not preeclamptic. I'd expect at least a tighter monitoring schedule (like biweekly appointments) given that 160/100 score, and maybe some bp meds (depending on your medical history - I'm definitely not a doc! - and whether or not meds are appropriate depends on a lot of factors.)

Please keep us posted as you're able.

[aajatwins]

Sorry to hear you're having these problems. I would be bordering on obnoxious as a patient, if I were you. If you still feel like your BP & HR are high and not coming down, go back in. Go straight to L&D if you think your doc won't do anything.

...I just saw Caryn's reply! so I ditto everything she said

[caryn]

We must have been typing at the same time!

[outracheous]

well, they finally called me and told me that I do have pre eclampsia. I go in in the morning for a NST and to discuss my options with my doctor. I am really almost thinking of going to the hospital now b/c my head is hurting so badly.

And yes with my heart beating like that i am miserable, absolutely exhausted! Thank you for your advice!

[caryn]

Tomorrow? If your proteinuria came back over 300 mg and you've scored a 160/100, IIRC you're a severe preeclampsia patient - and usually that means immediate admission and monitoring at 32 weeks.

The NIH Working Group Report (which is a decade old, so people should be up on it!) is somewhere in these links: http://www.preeclampsia.org/forum/viewt ... 28&t=35000

It says Hospitalization for the duration of pregnancy is indicated for preterm onset of severe gestational hypertension or preeclampsia. The decision to prolong the pregnancy in these women is determined day by day. The women should receive intensive maternal and fetal surveillance, usually at a tertiary care facility. Laboratory studies are performed at frequent intervals and include serial determinations of platelet count, serum liver enzyme levels, renal function, and urinary protein. Assiduous attention is given for worsening hypertension; evidence of central nervous system involvement that includes severe headache, disorientation, or visual symptoms; and hepatic involvement indicated by epigastric pain and tenderness.

And yeah, I remembered right, it says which drugs to give by IV (so inpatient) if you're running a consistent 160/105.

I'm no doc, but I think I'd head in to L&D and tell them your headache is bad and you're a diagnosed preeclamptic.

[blythe]

Just echoing Caryn and Anna! With pressures like that *and* URQ pain *and* a headache (did tylenol touch it?) *and* a history of PE, *and* a diagnosis of PE - I'd go to L&D and be very firm about talking to an MFM and having bloodwork run again at the very least. We've had members go from "fine" to "full organ failure" in less than 12 hours, and bloodwork is the only way to catch some of the scariest stuff.

Do you have a flexible tape measure, one to accurately measure your upper arm? The cuffs have measurement ranges printed inside of them so you can know for sure which one is right for you - and prove it to the nurse.

I hope you're fine and you're just having a rotten day of being pregnant, but in your shoes I would not wait until the morning to go in to get checked out. Please let us know what the MFM says!

[outracheous]

I am a ppl pleaser and I am concerned about being overbearing. I know crazy, especially as I lost my 3 year old almost 6 years ago. I sure do feel like crap and tylenol isn't doing anything. I am so torn, I don't want everyone to hate me:(

[blythe]

http://www.preeclampsia.org/health-info ... ptoms#head
Dull or severe, throbbing headaches, often described as migraine-like that just won't go away are cause for concern.
What you can do...
If you have tried taking over-the-counter medication without relief, if the headache is very painful or you have light sensitivity, call your provider immediately and ask to see him/her that day.

Headaches are a red flag to get checked out because they can be warning signs of eclampsia - seizures. Do you have any visual changes? Those can also be warning signs if so. You might just have a migrane, but even in that case, they could hopefully give you something for the pain! Since you're diagnosed with pre-eclampsia your headache that isn't going away with tylenol is making not-a-doc me very, very nervous. I'm a people-pleaser too but in your shoes I'd rather them be mad at me than risk seizures.

PS I don't think they'll be mad. I think that sometimes what we see as annoyance and anger is that they feel helpless. They don't want us to be sick! Most health care providers are in the business because they want to help people! I wonder if it's also that the treatment options - premature delivery - can be pretty grim, and in practical terms, a sick mom who can die is very stressful on them. But that's one of the reasons we really push for patients to advocate for themselves and work *with* your health care team as much as possible. Even if that sometimes means reminding them of the diagnostic criteria and push for bloodwork, NSTs, etc, to be done.

How is baby moving, by the way? Decreased movement is something else to watch out for...

You are the best judge of how bad you feel, but in your shoes I wouldn't wait until morning. At least call L&D or the doc on call and see what they say, if they think you should come in. Check out our signs and symptoms and make a list if you think you need the extra ammunition -
http://www.preeclampsia.org/health-info ... d-symptoms

[sam10]

I would not wait either! I'd go in and "risk" being "annoying". It's the nurses'/doctors' job to help people, any time of day or night. You already have a diagnosis that should give you a free pass to sail in there any time. Please don't wait!