Questions re: Procardia XL and pre-eclampsia

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Questions re: Procardia XL and pre-eclampsia

Postby catrinasweetie » Wed Aug 22, 2012 11:58 am

Hi, I'm new here, but I was hoping for some insight on this whole thing. Here's a little history....
I had my first daughter 10 years ago. I was 18 and had a normal pregnancy up until my checkup at 38/39 weeks. I had been swelling since my last appt and had gained approx 18 pounds in my last week. I went to my appt and the doctor took one look at me and sent me to L&D to be induced. I don't remember if my blood pressure was up or not, I just went to L&D and was induced, having my beautiful 7 lb 10 oz baby girl about 14 hours later. I had major swelling after delivery also, but was never put on medication or anything like that. When I asked what had happened I was told I had developed pre-eclampsia.
Fast foward 10 years and 2 more beautiful daughters later. Both my second and third pregnancies were uncomplicated, with my babies being born between 38 and 39 weeks. I am now 35 weeks 3 days with my first baby boy, and my last baby. I went in for a normal routine appt last week at 34 weeks and my blood pressure was 140/91. I usually run 100-110/60-70. I heard my doctor ask the ma, is this really her blood pressure? He came in, did heart tones, etc, then had me lay down on my left side in a dark room for approx 15 minutes. They came back in to check my bp at that time, while I was laying, and it was 102/62. He came in and told me that I needed to stop working and go on bedrest lying on my left side most of the time. He drew lab work and had me take a jug home for a urine collection. He had them take another blood pressure after I finished getting my blood drawn and it was back up to 142/86. This was all on Wed. and he scheduled another appt for yesterday, Tues. Since about Thursday or Friday I have been feeling really out of it, just fuzzy, if that makes since. I started having pain in my upper right quadrant, just very sporadic, early Mon morning, like 1 am. I went to l&d, where they did lab work and released me, saying everything was fine. I went to my appt yesterday and had a very reassuring NST, but still have been feeling funny. I keep regular track of my b/p (like 10-12 times per day ;) ) and it has been 120-160/70-100, just depending on what I'm doing at the time. I turned in all my readings and started talking to the doctor. He said everything came back good with my labs at the hospital, just an increase of uric acid. Then as he was talking the ma brought in the other labs he had drawn last week and my urine test. He looked at them and said it was weird,my liver enzymes from Wed were elevated, but the ones from the hospital mon morning were okay. And he said my urine came back with elevated protein. He wouldn't tell me the number, but I looked over his shoulder and it was 454. He also told me he could see swelling in my face and hands, which I have noticed also. So after telling me to rest, I started to walk away to schedule my appt next week. He then called me back and said you know, with your blood pressures, I should probably put you on a blood pressure medication. So he wrote an Rx for Procardia XL, which I took my first pill last night before bed. When I got up my b/p was 129/93. I sent my oldest kids off to school and went back to bed. I got up around 10 with my youngest daughter, made her pb and j sandwich for lunch, sat down and took my blood pressure. It was 140/91. This is no different than what it has been lately. Should I expect the Procardia to work the first day or does it take a while to build up? Any other thoughts on my situation. I'm scared to death that this is going to progress, especially since it seems my doctor wants me to stay pregnant until I'm at least 38 weeks or further. Any thoughts would be appreciated... Sorry for the book!!!
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Re: Questions re: Procardia XL and pre-eclampsia

Postby MomTimesThree » Wed Aug 22, 2012 12:44 am

I can't speak to the Procardia, I was on a different medication, but I would absolutely be asking for a referral to a MFM (high risk doc). Those pressures are really high, and with your other symptoms and a doctor that doesn't tell you some results (like your 24), I would want someone who sees pre-eclampsia frequently to give me a look over. I'm also surprised they would let you stay pregnant until 38 weeks, I think most mommas here, myself included were induced at 37 weeks...

Keep watch on those symptoms... did your doctor let you know what pressures or symptoms that he would want to hear about or to go to L&D?

Keep posted when you can,
Lauren
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
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Re: Questions re: Procardia XL and pre-eclampsia

Postby catrinasweetie » Wed Aug 22, 2012 01:15 pm

I asked him when he wanted to see me again or what I should get checked out for, but he didn't really give me any specifics. I'm frustrated because I love my doctor, he's been there for me for 3 of my 4 pregnancies, and he is usually very on it with my care. But I'm not sure if it's because he knows me so well, not to mention knows that I am a RN, that he really isn't giving me info. He started me on this procardia and told me that it could cause headaches, and today I have a terrible headache, but I don't know if it's because I started that med or because of pre-e. But my bp right now is 122/117 in my left arm, 129/101 in my right. And I'm not sure why my bottom number is so high since I'm now on b/p meds... I'm so confused. And I don't want to go to the er cuz the other night when I was there they only took my blood pressure when I was laying, and it's always good then, usually 110-120/60-80, so they acted like I was crazy. They even acted like my doctor was crazy, he told me, cuz he wanted to order labs... Grrr
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Re: Questions re: Procardia XL and pre-eclampsia

Postby MomTimesThree » Wed Aug 22, 2012 01:29 pm

I think those pressures are very concerning, only one number (bottom or top) needs to be wonky to be worried... and 117.. yikes!

Have you tried taking tylenol? Does it do anything for your headache? You might consider skipping ER and thinking about an L&D that is connected to a hospital with a NICU that will have MFMs on staff who would see your situation much more frequently than an ER and be able to do a good assessment.

Good luck!
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Re: Questions re: Procardia XL and pre-eclampsia

Postby alviarin » Wed Aug 22, 2012 01:29 pm

In your shoes, I would call the doctor right now or have someone drive me back to L&D. I know going to hospital sucks but you are far enough along you should be able to bypass ER wait and headup to L&D to get checked out, especially if you are already pre-registered at the hospital.

You have all the symptoms of pre-eclampsia- high BP plus proteinura plus headache, plus your BP is even higher now, so in your shoes I would want to get checked out. If you don't have confidence in your doc you can always ask for a referral to a MFM specializing in high risk pregnancies, either via your GP or OB or the hospital. Your OB could be great normally, but most docs don't see a ton of preeclampsia patients, and if you are high risk you definitely want to have confidence in your doc!

Please keep us posted as you are able.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
alviarin
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Re: Questions re: Procardia XL and pre-eclampsia

Postby alviarin » Wed Aug 22, 2012 01:33 pm

And here is a link to how some of our Medical Board have said blood pressure readings should be taken that you may find useful:
http://www.preeclampsia.org/forum/viewt ... f=19&t=321
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
alviarin
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Posts: 1608
Joined: Tue Apr 18, 2006 12:56 pm
Location: Texas

Re: Questions re: Procardia XL and pre-eclampsia

Postby catrinasweetie » Wed Aug 22, 2012 01:39 pm

Right after i took those pressures i layed down and it went down to 122/77 within 5 minutes. This is why i'm so confused. Is it okay as long as when i lay down the pressures go down?
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Re: Questions re: Procardia XL and pre-eclampsia

Postby catrinasweetie » Wed Aug 22, 2012 01:43 pm

Thanks for that link! That's exactly what I was doing is laying on my side and taking it on my top arm. An it made me feel better cuz it was lower! That's what they did at my ob office also... Also, another problem is all of my spot urines show no protein, but then my 24 hour was 454. Not sure why the discrepency...
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Re: Questions re: Procardia XL and pre-eclampsia

Postby alviarin » Wed Aug 22, 2012 01:53 pm

I'm another lady with "negative" or "trace" dips even with diagnostic levels of protein in my 24 hour urine. By the time I started dipping positive I had basically stopped peeing, and was swelling up like the pillsbury doughboy.

All that is needed for a diagnosis of preeclampsia is 300+ mg proteinura in a 24 hour collection and two high blood pressure readings at least 6 hours apart. (140/90, either number).

During my first pregnancy when my pressures started acting up, my OB put me on twice weekly appoinments in last month of pregnancy.

During my last pregnancy, when my pressures started jumping up and down, my MFM told me to call if my pressures stayed above 140/90 for a 1/2 hour (ie didn't go down with rest) and go straight to L&D if they went up to 150/100, either number. I also was put on twice weekly appoinments as I got closer to my due date.

I wasn't put on BP meds with my first two pregnancies since my pressures weren't consistently high- I'd get some 140s/90s but also some 120/70s and they didn't want my "lows" dipping too low on meds. I was never instructed to take my BPs laying down, just sitting after resting in a chair for a few minutes.

In your shoes, I'd call in or head in to get checked since you are reporting a change/increase in symptoms today. Personally, I went from a negative dip and slightly high blood pressure to severe preeclampsia in under 24 hours so I prefer to play it safe.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
alviarin
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Posts: 1608
Joined: Tue Apr 18, 2006 12:56 pm
Location: Texas

Re: Questions re: Procardia XL and pre-eclampsia

Postby MomTimesThree » Wed Aug 22, 2012 02:32 pm

My protein level was above 400 for weeks (weekly then bi monthly 24hrs) and each dip was negative or trace at most. So I wouldn't put too much stock in them.
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Posts: 548
Joined: Sat Feb 11, 2012 08:54 pm

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