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24 Hour Urinalysis Results.. Confused

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24 Hour Urinalysis Results.. Confused

Postby amberstrika » Thu Jul 12, 2012 07:27 pm

by amberstrika (31 Posts), Thu Jul 12, 2012 07:27 pm

Hello all,

I am currently 30 weeks along with my third pregnancy. Baby 1 - I was diagnosed with severe PE AFTER I had a c-section and had left the hospital. I went in a few days later not feeling well and all of a sudden I was told I had PE, pulmonary edema and pneumonia. Baby 2- At my 37 week checkup my BP was elevated and there was significant protein in my urine. I was delivered via c-section the next day. So here I am with this new pregnancy and I seem to have come down with a serious case of white coat syndrome. I monitor my BP at home twice a day and it rarely ever gets above 120/70. Yet every time I go to my docs, it likes to hover around 140-150/85-90. This happened to me again yesterday (156/98), and with my past history my OB had me admitted to the hospital for a 24 hour urinalysis for protein. She is very hesitant to give me BP meds, because at the hospital they had me relax and did serial BP readings, and the average reading was 100/55! (Done by an automated machine with no medical staff present) If they were to give me meds they say I would most likely bottom out. When I am relaxed and comfortable my pressure readings are outstanding. Yet every time I have a reading taken with a doctor in the room it shoots up. I think I'm so afraid they will be high I make them high myself! So it appears that my BP is actually doing great.

My big question has to do with my 24 hr Urinalysis results. My doctor came into the room with the results and was quite pleased that my reading were only 1g for the full 24 hour catch. But as I was discharged, the nurse who was pushing me out the car seemed a lot more concerned. She told me that it was not dangerous for me now, but that a reading of 1g at only 30 weeks spells trouble for the future of this pregnancy. Here I thought that my results were great! I know a lot about most of the tests they ran, but I do not know at hand what would be considered normal protein reading for a 24 hour catch... All my other test came back great. Liver, Arterial pressure, BP.. etc. Does anyone happen to know if my doctor is pleased that the results are not terrible right at this moment, or if I really should be expecting the worst at this point, given I'm only 30 weeks. I'm a bit at a loss because of the fact that none of my doctors will now take what my BP readings in office are at face value. Which I agree with because they are always superb at home. So my readings in the office won't be raising red flags with my OB. She's pretty much relying on my BP charts I take at home (I also check my protein with reagent strips)... This is all driving me nuts, and probably not very healthy for me in the long run. I'm just hoping for some advice and input from any knowledgables out there as to whether a 1g protein reading for a 24 hour catch means I should expect the worst.

Thank you!

EDIT-
You know.. The more I think about this, the more confused I get.. I am now reading that a result of 1g of protein in my urine would be significant proteinuria. I may be wrong though.. I'm a bit confused. All I know is that my doctor is over-the-top OCD about my every symptom. I love her because she takes me extremely seriously, and every time I so much as say I have a headache it's off to the hospital for tests. She has told me that she has no problem ordering me being admitted to the hospital for the rest of my pregnancy if I am at all in danger.. She even told me I'd just have to "deal with it" if it caused me to be inconvenienced. She seriously means business. That's why I am now so confused at her being so pleased with all my lab results. She NEVER would have let me go home if there was significant protein. I confirmed with my husband that she did in fact say I had "Only 1g in the whole catch" but now we are thinking maybe she meant a lower number. Then again, maybe I'm just wrong in what I'm reading and it is a normal number... <sigh>.. and help would be so grateful. I just checked my BP for the first time since I got home and it was 105/65.
amberstrika
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Re: 24 Hour Urinalysis Results.. Confused

Postby blythe » Thu Jul 12, 2012 11:36 pm

by blythe (3060 Posts), Thu Jul 12, 2012 11:36 pm

Maybe she meant 1 *miligram*? Because 1 gram would equal 1000mg, and 300mg plus your bps readings would make you diagnostic for PE... In your shoes I'd call her and clarify. She sounds very attentive and proactive, I hope she would be glad that you're taking an interest in working with her to watch your health!

The "white coat" bp readings - search our archives a little, in general it's my understanding that our experts are still concerned when bp is that high, regardless of the reason. They're glad when it doesn't *stay* high, but getting bps that high probably means that the mechanism that keeps your bp steady is broken to some extent, and that may mean a higher risk of developing PE.

It sounds like you're a reader - if you have more thoughts search the archives and the Ask the Experts, and holler if you need help narrowing down your searches! And if you want to bypass the searching or need a little help, please feel free to keep asking questions!

I hope you get many more weeks staying safely pregnant!
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
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Re: 24 Hour Urinalysis Results.. Confused

Postby angieb » Fri Jul 13, 2012 08:46 am

by angieb (1192 Posts), Fri Jul 13, 2012 08:46 am

I agree with blythe, definitely call and get that number clarified. I think 1000 mg protein is criteria for "severe" pre-e, but as you mentioned, I can't imagine that they would let you go home/be happy with that number. But still, doctors are human and mistakes are possible. I'd rather know for sure that your number is normal.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/
angieb
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Re: 24 Hour Urinalysis Results.. Confused

Postby blythe » Fri Jul 13, 2012 10:06 pm

by blythe (3060 Posts), Fri Jul 13, 2012 10:06 pm

5000mg is one of the criteria that could get a "severe" diagnosis, but 1000mg would still be a bump up from diagnostic. There are also women who normally spill protein without any other symptoms, due to undiagnosed minor kidney damage or disease that doesn't give them trouble outside of pregnancy (but can be a big risk factor for PE in pregnancy). But I would be surprised if that's the case with you since your dips have been normal. The dips are notoriously unreliable at diagnostic levels of 300mg, but I would think 1000mg would show up even in the dips.

Anyway, let us know what your doc says and hang in there!
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
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Posts: 3060
Joined: Sun Mar 21, 2004 10:24 am

Re: 24 Hour Urinalysis Results.. Confused

Postby blythe » Sun Jul 15, 2012 11:20 pm

by blythe (3060 Posts), Sun Jul 15, 2012 11:20 pm

Have you found out if who misspoke or who misread the results? 1gram vs 1mg?
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
Registered User
 
Posts: 3060
Joined: Sun Mar 21, 2004 10:24 am

Re: 24 Hour Urinalysis Results.. Confused

Postby amberstrika » Mon Jul 16, 2012 03:19 am

by amberstrika (31 Posts), Mon Jul 16, 2012 03:19 am

Hello!

Thank you all so much for responding. I have an appointment tomorrow with my OB specifically made so I can get some confirmation. I will let you all know what exactly is up with me. I hate being so confused and feeling like I'm in limbo. Will update tomorrow!
amberstrika
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Re: 24 Hour Urinalysis Results.. Confused

Postby amberstrika » Mon Jul 16, 2012 07:35 am

by amberstrika (31 Posts), Mon Jul 16, 2012 07:35 am

Just a quick question I thought of just now. If my protein levels were really that high, wouldn't it be reasonable to assume that my dipstick tests would be picking up something? I check it myself at home every day, as well as getting it done in office, and it has been completely negative in office, and only one showed up at 15o mg first thing in the morning (I was also so dehydrated my pee was almost brown!) So aside from that one time, months ago, I've been protein free for the dipsticks. With a level of potentially 1000g, wouldn't I be seeing more? Or am I just grasping at straws?

:( :(
amberstrika
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Re: 24 Hour Urinalysis Results.. Confused

Postby angieb » Mon Jul 16, 2012 09:00 am

by angieb (1192 Posts), Mon Jul 16, 2012 09:00 am

In my non-medical opinion, dip tests are slightly better than worthless except for women who have no other signs of pre-e. We had a poster who had no trace of protein on the diptest who did a 24 hour urine and had 400 mg. I have a friend who just a few weeks ago had no trace of protein in the office dip test and was spilling 250 mg on a 24 hour urine. But still, if you really spilled 1000 mg, it would surprise me if they were *that* bad, but it wouldn't be completely unheard of. But my guess is considering they let you leave and everything and considered it normal, odds are it was probably more like 100 mg or 1 mg.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/
angieb
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Posts: 1192
Joined: Mon Sep 28, 2009 01:38 am

Re: 24 Hour Urinalysis Results.. Confused

Postby blythe » Mon Jul 16, 2012 10:38 pm

by blythe (3060 Posts), Mon Jul 16, 2012 10:38 pm

It's been awhile since I've done a lit search, the dipsticks are *definitely* unreliable compared to the 24-hour, but I just don't remember if they're unreliable to the extent of missing 1gram. I supposed if you're really hydrated... Hoping for good news for you...
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
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Posts: 3060
Joined: Sun Mar 21, 2004 10:24 am

Re: 24 Hour Urinalysis Results.. Confused

Postby amberstrika » Wed Jul 18, 2012 07:49 am

by amberstrika (31 Posts), Wed Jul 18, 2012 07:49 am

I had my appointment yesterday for the protein discussion. Turns out, even though my husband and I both CLEARLY heard her say 1g. The lab results showed there was 120 mg in the whole catch. They expect to find between 50-80mg, so I was higher. But still below the 300mg for a preeclampsia diagnosis. This explains why my OB wasn't worried but the nurse was concerned.
amberstrika
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Posts: 31
Joined: Mon Apr 09, 2012 03:07 am

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