Protein!

[mychaelelaine]

Hi everyone!

So, my 24 hour lab yesterday reported 280 for protein. My bp is staying at 120/80 and below. I was in the hospital since Monday because baby isn't passing NST's and got 6/8 on his BPP. One Dr thought this could be due to being over medicated (60 mgs procardia twice daily and 300 mgs of labetelol twice daily). Anyway, they took me off labetelol completely and gave me procardia only yesterday morning. By 6 pm, my bp was as high as 157/85. Anyway, the attending on staff was being very oppositional... long story and convo but basically I wanted my labetelol back. He wouldn't. I ended up discharging myself seeing that they were no longer monitoring baby, just me because of dropping labetelol. They weren't even monitoring good enough imo. I went from hourly checking to them wanting to check every 6 hours. I was highly upset. Checked myself out last night at 12, took my labetelol, bp's been great ever since. So, now I'm wondering, should I be worried? I know I have to have 300 protein score to even be diagnosed as having preeclampsia but, is this something that can progress really rapidly... the amount of protein? My bp has been low all day and was the entire 30 weeks until they eliminated labetelol. He couldn't even give me a good reason to not give me an evening dose, just kept saying, "it's not warranted." Huh????? Without going into any details, my last pregnancy ended tragically because a doctor felt bp meds weren't warranted. This time I know more and am not willing to play around with my life or my child's. Im happy I left and took my meds. Now I'll just attend appts and refuse to let that Dr treat me. I don't think he had my best interest at heart. Anyone else with protein who went for a while before being diagnosed???

[heather j]

Bad NSTs were *the* first sign that we were headed south. Fast. My doctors, at the time, were negligent - not maliciously, I guess, but negligent in the sense that I was more severe than they were equipped to care for and wouldn't refer out. I've been where you are in terms of feeling like no one is doing anything. However (and I'm not pointing a crooked finger your way, I promise!) you *need* someone keeping an eye on you and your baby. Can you go to another hospital? I wouldn't check out AMA. I begged my docs to release me (for mostly the same reasons you've listed), threw a loud, teary-eyed fit, and got my way. Three days later, I had an abruption. We had a good outcome, but to think about what could've happened bothers me very much - eight years later. I can't even begin to wrap my head around the heartache and devastation of losing a baby, and I understand you left because you felt you weren't getting adequate care (and that's a good reason to leave), BUT please, please, please check yourself into another hospital. The labetalol can mask your rising pressures, too, so you definitely want constant monitoring with that, too, especially given the NST indicator. I went from limping along for six weeks to Class II HELLP within 6 hours. Hang in there and please consider heading to another L&D for monitoring; or at least having a heart-to-heart with another physician whom you trust within your current practice.

[trish]

I wish you were still in the hospital being monitored! Yes, protein can changed rapidly - in a matter of hours it can go from 100's to 1,000's. But, protein level isn't what would likely get you delivered and isn't what worries me most - baby not doing well on NST's is! If it were me I would not feel comfortable being at home and not having baby monitored. Is there another hospital you can go to? I am not a Dr. but I would sure feel better to hear that you were in a hospital, fighting (if necessary) to keep you and baby monitored more often and on appropriate meds rather than hoping for the best at home.

[caryn]

Oh goodness. I just want to agree with Heather and Trish - I'd want to be monitored in a different hospital by a different team if the babe isn't passing NSTs. It's so frustrating when you can't get an explanation.

I suspect that doc was hoping to raise your pressures to drive more blood through the interface to improve baby's condition. It's at least theoretically possible for BP meds to drop maternal pressures too low and cause problems with pumping enough oxygen through the placenta, and trying a test where your dose is lowered to see if the kiddo gets more active is the only way to check that.

Pressures don't cause this syndrome. Shallow implantation causes this syndrome. Keeping pressures low will not prevent the onset or progression of the syndrome.

I'd head somewhere with a good NICU and a different doc if at all possible. Hugs to you!

[mychaelelaine]

Bad NSTs were *the* first sign that we were headed south. Fast. My doctors, at the time, were negligent - not maliciously, I guess, but negligent in the sense that I was more severe than they were equipped to care for and wouldn't refer out. I've been where you are in terms of feeling like no one is doing anything. However (and I'm not pointing a crooked finger your way, I promise!) you *need* someone keeping an eye on you and your baby. Can you go to another hospital? I wouldn't check out AMA. I begged my docs to release me (for mostly the same reasons you've listed), threw a loud, teary-eyed fit, and got my way. Three days later, I had an abruption. We had a good outcome, but to think about what could've happened bothers me very much - eight years later. I can't even begin to wrap my head around the heartache and devastation of losing a baby, and I understand you left because you felt you weren't getting adequate care (and that's a good reason to leave), BUT please, please, please check yourself into another hospital. The labetalol can mask your rising pressures, too, so you definitely want constant monitoring with that, too, especially given the NST indicator. I went from limping along for six weeks to Class II HELLP within 6 hours. Hang in there and please consider heading to another L&D for monitoring; or at least having a heart-to-heart with another physician whom you trust within your current practice.

Thx Heather! Thing is, they weren't going to be monitoring baby anymore. They concluded that he wasn't doing worse on the NST's but he still was non-reactive. They were releasing me the following morning IF my blood pressure didn't elevate. They even considered me stable which is why they were only checking my bp every 6 hours. So, that's why I left. They concluded the baby was fine "enough" and that 30% of babies don't pass NST's for whatever reason. He passed his last two BPP's. I would've never left if they hadn't been comfortable with my baby.

[mychaelelaine]

I'm headed there now, thanks everyone!

[heather j]

Please keep us posted as you're able. Hope you get good care this time! Neither Ella nor Oliver ever had reactive NSTs, and we always moved to BPPs; I have to admit I'm relieved that everything looks good with your little one. Hang in there!

[mychaelelaine]

I will! We are headed to another hospital. I'm so frustrated now. I'm so happy I told you guys though. I def want to be safer rather than horribly sorry. I just can't imagine why they let me go if you guys think I need to be monitored. What if he passes BPP's but continues to fail NST's and they want to release me at the new hospital??? Then what???

[caryn]

They have to let you go unless you have been quarantined to protect others from transmissible deadly infection - because ethically, no one gets compelled to medical care. (Quarantine isn't being compelled to medical care - you're not given care unless you accept it. You're just restricted so you won't harm others.)

If they think you're releasable, then you are. Am I remembering correctly that you're a lupus patient? They are usually extra-careful with lupus. Do you have a rheumatologist participating in your care?

[mychaelelaine]

Ok, thanks!!!! I'm here now and they are looking shocked that the other hospital let me go with the explanation that "30% of babies don't pass their stress tests." I do have lupus and am seeing a rheumy.