Feel like my OB's are waiting for me to get worse

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audrey s.
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Re: Feel like my OB's are waiting for me to get worse

Postby audrey s. » Mon Jul 25, 2011 00:10 am

Bumping this back up, been worrying. Hope things are going better, and you're getting the care you need!
Mom to Rebecca, now 16 and honor student. 37-week, two months in NICU for her thanks to NEC and meningitis. One month in hospital for me, HELLP syndrome and severe hyper-reflexia. All healthy now, more or less!

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caryn
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Re: Feel like my OB's are waiting for me to get worse

Postby caryn » Wed Jul 20, 2011 00:03 am

Update us when you're able, please! I've been checking this thread for news. :)
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

spec
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Re: Feel like my OB's are waiting for me to get worse

Postby spec » Sat Jul 09, 2011 09:25 pm

thanks everyone for the input. I'm the Original Poster. so I was in the hospital for 2 days last wk and 2 days wk before for 24 urines. 1st week I got in I presented with BP of 136/80, had gained 8lbs in 1 week, had 2+ proteins in urine dipstick and reflexes were very brisk. my protein came back 226, on bedrest in hospital the rn's were literally laughing at me b/c my baselines were 90/60.

This week at my OB appt, lost 5lbs, reflexes were still very brisk, 1+ proteins, but, my bp was 130/80 AND I felt lousy. Very drowsy when sitting, no energy to stand, and daw floaters. was admitted for days. at rest bp's are 90/60's. walking 110-120/70-80. 24 hr protein was lower, 153. but still saw floaters and had shortness of breath, difficulty getting deep breathe at rest, palpitations. The baby has had 8/8 on bpp but i've had 2 NST's that were borderline non-reactive.

I was released from hospital this time and literally,
felt dumb. Maybe the hormones are making me sensitive but I had a few residents come in and talk to me like I was a 6 yr old. One said you are not preeclamptic, period. You're not even borderline now. So, you can go home, do activity as tolerated, and just relax, everything is fine. My reply was, " hope you are right".

I am hoping to make it to my next OB appt on Wed as I will be 36 wks. I feel lousy but would just like to have a plan.

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caryn
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Re: Feel like my OB's are waiting for me to get worse

Postby caryn » Wed Jul 06, 2011 10:34 pm

The thing about bedrest is that the evidence says it doesn't help broad populations of preeclamptics and has negative consequences like bone demineralization and a tendency to increase clotting, so all anyone has to go on whether or not it seems to be helping her. It did exactly nothing whatsoever for me, and I know we've had a number of other posters say the same thing - so I always suggest that anyone trying bedrest log her pressures while up and about for a day, then try logging her pressures while bedresting (sit up properly to take them, of course, with your cuff at heart level.) Talk to your docs too, of course, especially if you have an underlying clotting disorder.

How are you doing today? When are you scheduled to be seen next?
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

steffthomas
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Re: Feel like my OB's are waiting for me to get worse

Postby steffthomas » Wed Jul 06, 2011 12:18 am

I had the same issues with my daughter when she was born. 32 w 1 d. Although I know there are some people out there that are not exactly believers of bed rest helping, I am one of them, as I have seen it help with a lot of people.
When my little girl was born--I was like you-my baselines had been in the 90's/60's, then jumped to high 130's/low 140's over high 80's/low 90's..my husband was in the military at the time and they are VERY by the book. Because I didn't have many BP's that were greater than 140/90, I didn't "have any of the signs," (perhaps they missed the swelling, higher than baseline bps?!) I was pushed aside. I was sent home with a 24 hr urine and told that I could "do it if you want but it's really not necessary..." Needless to say 9 days later I was back at L&D--severe h/a, higher bps..They ran a p/e panel and yep..liver enzymes came back all out of whack. I found out that day that my 24 hr urine (which yes I should have called about but was reassured that they would call me if there was an issue) was at 331. Man, I was MAD.
Honestly, I believe if I wouldn't have been pushed aside like I was that perhaps bedrest maybe would have helped and my little girl WOULDN'T have had to spend 5 weeks in the NICU (Thank you **** for being WONDERFUL)
It sounds to me like they're monitoring you quite well-I would just go with what everyone is telling you-the longer the little peanut bakes--the better off-BUT if you feel like ANYTHING is wrong--go with your gut. I wish now that I would have been more persistent. (Which is why with this pregnancy, my OBGYN is probably ready to kill me!)

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riehlism
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Re: Feel like my OB's are waiting for me to get worse

Postby riehlism » Tue Jul 05, 2011 12:26 am

I would be concerned as well. We do have posters here on the site who went straight to HELLP without getting high BP readings.

That is a rather large rise between your baseline and what you are measuring now. I am also wondering if you are starting to see labile BPs. In the beginning I had huge spikes from my baseline BP. Eventually the spikes became more consistent and my new baseline would be at a higher level.

So while your BPs make look ok sometimes, I would suggest doing a log to see if it is indeed labile. When I was admitted they checked every 15 min. That's a bit overkill once you are discharged to home. But I would personally check once an hour for patterns. If anything is off, turn in your log so they can see the labile pressures. Maybe they will take you more seriously then.

Even though they should not have laughed off your conerns, they may be waiting to see what happens because there is no real treatment right now. I don't even know if mag sulfate would even be necessary with you being so borderline at this time. Fingers crossed for you. Keep us updated.
Jasmin: Severe PE/HELLP and delivered at 24+6 & PCOS (29) Hubby Bubby, Frank (29)
Baby Blue stopped in to say hello and goodbye on 6/3/10
Baby Lucas was born on 10/13/11, PE and HELLP-free! Thank you baby aspirin and Lovenox
http://www.ehd.org/pregnancy-calendar.php?id=18192

z1ggy23
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Re: Feel like my OB's are waiting for me to get worse

Postby z1ggy23 » Mon Jul 04, 2011 09:06 pm

With my second I was much like a previous poster, a slow moving Pre-E... though my BPs and proteins came on early, we spent 5 weeks watching carefully for things to get worse and playing the risk/reward game to decide when to deliver me. That is probably all your MFM is doing. Are you still seeing your regular OB or just the MFM now? (I see both and my OB is still my primary, but I know that is not the case is other places).

Do you know what your BP's were while NOT on bedrest and in the early part of pregnancy? As a PP said there is a threshold for a rise from the "norm" (I have heard 20 points in either Systolic or Diastolic, but as with everything it is up to the practitioner to decide their comfort level) that is sustained. Also if your BP is spiking, but going down w/ bedrest (which is what mine would do) then they will chance letting you go a bit longer.

Your body will tell you when things are getting worse. Pre-E is NOT a silent condition (at least not once you get past the protein and the BP)! And as always if you are concerned call your OB/MFM.
Brandilyn, loving wife and mom to three PIH/CHT/PE babies
M (8/07) 38w1d
L (9/09) 37w3d
E (9/11) 37w

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caryn
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Re: Feel like my OB's are waiting for me to get worse

Postby caryn » Mon Jul 04, 2011 01:52 pm

The Working Group Report (it's linked from the News forum) says that a rise of 30/15 above normal pregnancies should be watched carefully. I expect your MFM is aware of that and is relying on you to report any worsening in symptoms, since you're not term yet. Are you monitoring your pressures at home and doing kick counts?
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

libby123
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Re: Feel like my OB's are waiting for me to get worse

Postby libby123 » Sun Jul 03, 2011 10:32 pm

Yes, I totally understand, this happened when I was pregnant with my daughter (who is now a healthy 4 month old!) I was a slow moving preeclamptic, and basically I was on bed rest waiting to get "sick enough" for them to deliver me (I finally delivered at 36 weeks exactly). I developed PIH at 26 weeks and was officially diagnosed with pre-e at 35 weeks, so very slow moving, mild pre-e.

It is a balancing act, because each week you can stay pregnant makes such a difference for the baby. You aren't even officially pre-eclamptic yet, and it seems like you have the slow moving sort. My protein was at 500 when I delivered and my blood pressure was in the 170s/100s.

Because I waited to 36 weeks, my daughter needed no NICU time and was very healthy. A week earlier, this wouldn't have been the case. She was 5 pounds, 11 ounces.

My advice is to be proactive and monitor your blood pressure and weight at home. I got a home BP cuff from CVS pharmacy that worked great. You can take your BP a couple of times a day and then know if it spikes suddenly. How often are you seeing your doctor? I went 3 times a week at the end, getting a BPP and NST each time so they could catch anything quickly.

But from what you are describing, your doctors are right to wait and not deliver you, I know its hard to wait and so hard to hear that you have to get sicker first, but it is the cruel truth. It is better for your baby to be in there right now. In a few short weeks you will have your little baby in your arms, time will pass and there will be an answer soon.
Mommy to Sailor Ann, born on February 17th 2011 at 36 weeks by c-section due to PIH that slowly turned into preeclampsia.

spec
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Feel like my OB's are waiting for me to get worse

Postby spec » Sat Jul 02, 2011 10:13 pm

I'm almost 35 wks pregnant. I'm a nurse, and have been seeing a high-risk MFM OB since the beginning of this pregnancy. My 1st, was a partial previa, which had a partial abruption, and then I hemorrhaged during the scheduled c-section and needed blood transfusions postpartum.

With this pregnancy, I have a low-lying placenta, but everything has been good. Last week, a few days before my scheduled OB appt., I called the office because I noticed I had some blurry vision and felt a little "off". My blood pressure was fine. This week, I went to my OB appt, got weighed and right away we knew something was off. I had gained 7lbs in 1 week. My BP was 140/90 (my baseline usually runs around 100/60) and I had brisk reflexes. I had some vision changes but not in the last few days and did not have a headache.

My OB did a dipstick urine and I had 2+ proteins. She admitted me for a 24 hour urine. My labs came back that I am anemic (hgb 9, hct 27.8), and my 24 hour urine was 225 (>300 is the criteria for preeclampsia). My reflexes are still brisk, and I sometimes see floaters. I have mild swelling in my ankles/feet.

Here's where it gets weird. At bedrest in the hospital, my BP's were very low. Even though I run low, at rest I was about 98/53. My resting HR was 100. My question to my high-risk team was that I have A LOT of signs of preeclampsia (proteins, weight gain, vision changes, brisk reflexes) but not high blood pressure. They all laughed I had such low BP (I don't find any of this funny) and said I could be discharged and they'd see me next week at our regular scheduled appointment.

My concern is that I'm a ticking time bomb. My other concern is that everyone is expecting to see my BP high (over 140/90) but since I run low, they aren't realizing that 120/80 IS actually pretty high for me.

I'm very afraid I'm going to get very sick before they realize or the baby will be in distress. Any suggestions/advice????


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