Anxiety making doctor gloss over my symptoms?

[expert@preeclampsia.org]

How should patients with a history of anxiety talk to their doctors about possible preeclampsia symptoms?

I am 34 years old and 29 weeks pregnant. I have 2 children already, both boys, and both pregnancies were healthy and normal. This baby is a girl.

I was diagnosed with hyperemesis gravidarum in my 2nd month. Currently, I am feeling much better and have even lowered my zofran to 8mg / day.

I also have anxiety and depression for which i take zoloft 150 mg / day (for years), but have weaned off it for my last trimester. I am obese and have been most of my life, but weigh a few pounds less with this pregnancy than my last due to the hyperemesis. I was a smoker for about 12 years, and quit completely 3 years ago. After quitting I was able to go up stairs without breathing heavy.

For the past 3 weeks, my blood pressure, usually 114 / 70, has been testing 120 - 125 / 78-85. My feet, ankles, and lower legs get very swollen and stay that way for 24 - 48 hours at a time. My hands swell slightly, enough to make my rings not fit. I am having trouble breathing, and get out of breath just reading to my son. I cannot lay on my back and sleep with my feet up to alleviate the swelling, because I wake up gasping and feeling like someone is sitting on my chest. Last week I went to L & D after calling my doctors office, and they said I was fine, only with slightly elevated uric acid in my urine. everything else was normal, including my blood pressure which dropped while I was there to my normal levels. I then went to my obs office a few days later because 1 ankle / foot was way more swollen than the other, and they said everything, including my uric acid, was fine, but I had gained 6 pounds in a week. My doctor ordered an echocardiogram and PFT test, which i took, but will not get any results until i see her again on 3/4. She also ordered support hose, which I will be picking up in a few days.

My problem is that I just don't feel right. I feel like my body is telling me that something is wrong. So I research what I am feeling to ask questions, but I feel like my doctor is not taking them as seriously because I am off my anxiety meds. It seems the general attitude with everyone (sometimes including my husband) is that I read too much into things because of my anxiety and worry too much about any little thing. But I have been pregnant 2 x before and have never felt this off. I never had any swelling in my hands / feet until I was about 37 weeks along, and even that was minor, only if I was up walking around a lot. My blood pressure, even with my anxiety, was always low, and I can feel the difference when it is elevated to what it has been testing, even though that is a good blood pressure for other people (slight dizziness, heart beating faster, on edge, loud and multiple noises REALLY bother me - which is totally untypical of me). I never had this much trouble breathing, even when i was a few pounds heavier.

I am hoping that you can tell me if what i am experiencing is typical of early preeclampsia, or is it just typical of pregnancy. Should I keep researching and pushing for someone to take me seriously, or should I sit back and either get worse or deal with what i am feeling since it is normal. Other than this issue, I have always been happy with my doctor and her responses to me. Any advice would be greatly appreciated, as I feel like I am in limbo here just waiting to either get really sick or feel really silly for worrying. Thank you for any info you can provide!

[expert@preeclampsia.org]

I would be concerned about the weight gain, the preHTN levels of BP, the shortness of breath and the general sense of "not being right." This has to be taken in context of gestational age. How well is the baby growing?

They ordered an ECHO and PFT's which suggests that they are paying attention. A blood test called a BNP may be helpful is defining her fluid status. Sleep apnea should also be considered.

I would encourage her to continue to report her symptoms.