PIH Concerns

[tjeason]

Hello all. I am fairly new to the website and have a few questions. I am 33.5 weeks pg and was preeclamptic with my previous pregnancies (delivered at 32 and 34 weeks). I've been on again/off again with the facial swelling and proteinuria, but have consistently had high BP. My baseline BP is around 110/60. I've been to the hospital several times with BP spikes and 1+ urine, but all my other labs are checking out okay.

I had a non-stress test done last Friday and my BP was up again along with 1+ urine so my OB admitted me again. My BP was 150/105 and the diastolic stayed in the low 90's throughout my stay. My OB decided to put me on Aldomet 250mg three times a day to keep the BP under control. I've now been on the Aldomet for 4 days and am not seeing a decrease in my BP. I am wondering how long it should take to see the decrease? My OB told me that if I had been 36 weeks along last Friday, we would have probably delivered the baby. Do you think we are just buying time? I'm really not sure what to think. Any input would be greatly appreciated!

[laura]

I'm sorry it's taken me so long to even get back to you and say that I don't know how long it takes the meds to work[:I]?
Is your BP starting to respond yet? I do remember one member (paljane- Nancy) mentioning that for her, she took labetolol and it did take a while to 'kick in'.

My other thought on the meds if they're still not working is 1) they need to increase your dosage or 2) try a different medicine. Diastolics in the 100's are just plain not good. When I started atenolol, I was feeling better/BP went down within hours, so there's the whole spectrum of ways to respond to the meds.

take care, and let us know how you're doing!



Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/

[jjbeck]

Why are diastolics in 100s not good? Mine was 147/105 today. My norm is 100/70.
I am only 12 wks but my BP continues to rise. What is the earliest Pre e can begin? I know it is usually around 24 wks. But is it possible to come sooner?
I really worry about this. I have hyperemsis now. No fun.

[annegarrett]

This is an important link about blood pressure and the new research that calls for keeping a close eye on even "lower" numbers than previously. The impact of that blood -pressure can cause damage to the placenta and then compromise the pathway of nutrients from the mother to the baby. Some doctors would consider medicating such blood pressures with antihypertensives. Given your BPs you might ask for a consultation with a perinatologist. To find someone near you--check out the websige www.nasshp.org and look under ADDRESSES.


http://www.nih.gov/news/WordonHealth/aug2003/prehypertension.htm

Take care,


Anne Garrett
Executive Director
Preeclampsia Foundation

[kimb]

If the aldomet isn't working for you - talk to your doctor - it did nothing for my blood pressure. I started on 250mg 3x's a day and within the next 7 weeks changed to 500mg 3x's per day and then 1000mg 3 x's per day - with no improvements. Luckily you are into the latter weeks of your pregnancy! Someone else asked about when it can hit. Most drs say 24 weeks - but there are those rare cases - and I have met a few others through this site that were before 24 weeks - I had pre e and HELLP at 20 weeks. The best thing I can say is be proactive with your doctor and if you don't like the answers you get - find someone else. There are a lot of women here who have been through it and will help. Good luck to both of you and let us know how you are doing.

[jjbeck]

I have a peri for my HG, but he was only for the HG and managing it with steroids as my OB never had a case of refractory HG. Anyway, should I contact him regarding the BP or wait for my OB to suggest it?
It is frusterating. I have a hard time even being able to reach my OB. When I call the will not put me throught to her ever. I have to go through the nurse. The nurse and I do not get along at all. From the beginning of my pg she has given me a hard time with my HG. After explaining to her that I had HG severly a few years ago and that I felt it coming on again and I wanted to be treated early, she told me that every PG is different and that it was not policy to treat it unless I was sicker....eat crackers ( even though before I got PG my OB agreed we should be very proactive and treat early). I had to wait until I was vomiting uncontrollably before she would give me the Zofran and even then I had to beg for it. All this time, they would never put me through to the OB. When the 8 mg per day of Zofran did not work, I went right up to max dose of 32 MG which my OB had suggested the last time. WHen I called for a refill, the nurse said she would could not refill, 32 mg was not their policy, only 16 mg. It wasnt until I told her that it was thew OB that told me I could go this high. Everytime I had to call, the nurse was always saying policy this or policy that. At one point she ask if this pg was planned when I told her yes, she said so you are sure you want this baby? I just broke down. Even on max dose of zofran, I was still vomiting a lot and losing wt fast. I lost 12 pounds in a week and a half and was spilling ketones and dehydarated. The last time I spoke with the nurse, she actually laughed at me when I began crying. For me this was it. I finally screamed at her and hung up. My DH spoke with the Ob and the nurse is no longer allowed to call my house, but I still cannot call and get a direct line to my OB and they say I have to go through her nurse. Now if I had a bit more brain funtion and was able to drive, I would have switched OBs because of this. But I dont. Not only that, but I really like my OB and at this point do not know if it is a good idea to switch.
Anyway, I am rambling and apologize but I get so frusterated thinking about that nurse.
Thanks for listening...or reading.
Jen

[akemt]

Jen,

So did you tell the OB what she said? And what was the dr's response to that? Especially about whether you wanted the baby and then laughing at you...I would be SO riled up. ARGH! My goodness. And, yest I would look for healthcare elsewhere if it were me. I had to deal with my dr's nurse just as much if not more than the doctor. Luckily my ob's nurse was fabulous. AND, If you do switch doctors, I would write a letter to your now doctor outlining what happened and that you would have stayed with the doctor because you liked them but didn't want to deal with the nurses crap. Well, obviously don't quote that! lol This kind of stuff irritates me to no end. Good luck in your decision. Maybe your peri can suggest an OB? And yes, you should see the peri for the BP too.

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo

[tgenco]

Dear tjeason,
I took the aldomet my first pg, it did NOTHING for me. I dont think it is verry effective at lowering bloodpressure. Case and point, my cardiologist says no one ever uses it outside of pregnancy because of this. The only obs that still use it are worried about side effects of other meds. Aldomet has been tried and true for several years, thus safe, not aggressive. Tenormin works for me and controls it right away. Optimum bottom numbers should stay below 80, high bp according to my specialist will cause kindey problems in mom and placental infarctions, abruptions ect in the baby as well as iugr. My two cents, if the aldomet does not work in a couple of days, ask him or her to try something else.2[8D]

[jjbeck]

Hi Catherine. Yes, my husband told my Ob some of the stuff. I have not talked to her about it, I get too worked up right now. The doc told my dh that I would not have to deal with the nurse anymore and she put a note in my file for the nurse not to call my house. Dhe also told my dh she knows " how this nurse can be" So when I go in my poor OB has to do everything. I did not have the hyperemesis right now, I would certainly switch docs. But with the HG I cannot drive, I dont have the best brain funtion, and my dh has to take time off anytime I have an appt.
After this PG, I plan on writing a letter to my OB and explaining everything. It is all very frusterating.
Thanks
Jen