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New, any advise???

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New, any advise???

Postby jjbeck » Sun Nov 02, 2003 03:46 pm

by jjbeck (413 Posts), Sun Nov 02, 2003 03:46 pm

HI. I am now 12 wks pg with hyperemesis. I am on Zofran, Zantac, Ambien, Remeron and steroids.
At wk 8 my BP began to rise. My last HG pg, my BP was always dangerously low.
My BP is now up to 155/90. My norm is close to 100/70. My Ob said it is chronic hypertension, not preg induced because it came on so early. She is not sure it is from the steroids, as it began to rise before the steroids and continues to rise sinse I have been tapering from the steroids. She did say I was at an increased risk of pre e. I also have sugar in my urine and we have to watch for GD as well.
My niece had HG her entire PG. She developed high BP early on too and ended up delivering early due to PRE E.
Is there anything I could do to keep an eye on this? Are there any other EARLY sypmtoms I can watch for. MY OB says Pre e does not show up until after 24 wks.
Some other problems I have are I have an awful pain on my right, just under my ribs and it goes around to my back. My gallbladder checked out to be fine as my liver bloodwork was too. he pain can get very severe and at times causing very forcefull vomiting. I cannot sleep on my right.
Any input would be appreciated.
Thanks
Jen
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Re : New, any advise???

Postby annegarrett » Sun Nov 02, 2003 06:35 pm

by annegarrett (2525 Posts), Sun Nov 02, 2003 06:35 pm

Jen,

Hyperemesis is pretty rough--there are several women on our site who have had to contend with this and I know they have some good websites you can get more information about. The vomiting you describe is no doubt distressing but if the doctor's have done a liver panel then (and I am not a doctor so don't take my word for it) it sounds like it is more likely related to your hyperemesis--still--it would be good to keep an eye on it.

As for the timing of preeclampsia--technically--yes--preeclampsia typically does not occur until after 21 weeks (not 24) but something like HELLP Syndrome (which is extremely rare) could show up about then. Either way--you are pretty early to have either--in fact--I have never heard of a case at this early in the pregnancy for what that is worth.

The hypertension is what they call "gestational hypertension". Basically the only difference is you don't have "proteinuria" which is the presence of protein in your urine and they determine that by dipping your urine with a reagant strip at each prenatal appointment. ANY sign of protein and they should be doing what is called a 24 hour urine--which is where they have you (ugh) collect your urine for 24 hours and keep it refrigerated and then they analyze it in their labs. To have "preeclampsia" you must have a BP of 140/90 (two separate times over a period of about 6 hours) and 3+ or 300 grams of proteinuria.

It is important to note that about 50% of all cases of gestational hypertension go on to develop preeclampsia but both can cause some impact on the placenta and thus the baby. On our home page there is a link to About Preeclampsia--I would recommend you go there and click on Signs and Symptoms and even print that out and hang it on your fridge--keep a close eye on them and report any of them to your health care provider. You may be on the path to getting preeclampsia but being really on top of things will help you be a proactive patient and help your doctor give you the best possible care.

Take care and let us know how you are doing--

Anne Garrett
Executive Director
Preeclampsia Foundation
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Re : New, any advise???

Postby laura » Sun Nov 02, 2003 10:02 pm

by laura (5139 Posts), Sun Nov 02, 2003 10:02 pm

Anne's right... the hyperemesis site I found the most helpful (and I was lucky enough to have hyperemesis with BOTH my pregnancies also[xx(]) was http://www.hyperemesis.org

I hope it eases up for you soon- you're in the worst part of it, hopefully it'll get better! I do know too that when I'd have to go to the ER for the hyperemesis, my bp would spike right after I was throwing up, but would drop back to normal after I'd calmed down for a while. I hope you're feeling better soon!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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Re : New, any advise???

Postby jjbeck » Mon Nov 03, 2003 06:40 am

by jjbeck (413 Posts), Mon Nov 03, 2003 06:40 am

Hi Anne. Yes I am famliar with HER.ORG. I have been in contact with Kimber many times. Thanks.
I didnt really think that I had PRE E or HELLP at this point, but I guess was wondering if I may be headed in that direction having the HG and having the high BP.
Now about the gestational hypertension, my OB said I have high BP too early for it to be gestational hypertension and that it is chronic hypertension. This was confusing to me as I have always been on the lower side and my bo did not begin to rise until I was about 7 wks pg.
Anyway does it make a difference? I am finding much of what my OB tells me conflicts with what I read online....from studies or articles. This concerns me. She told me she would not treat the BP unless it goes above 200/1XX. This surprised me a little. My heart rate is also up quite a bit. Now I know it does go up some with preg because of the increased blood flow, but I thought it only goes up 20 or so. My norm is 60, but it is now averages 100 and goes up to 110 so far.
Thanks so much for your help
Jen
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Re : New, any advise???

Postby annegarrett » Mon Nov 03, 2003 07:24 am

by annegarrett (2525 Posts), Mon Nov 03, 2003 07:24 am

Jen,

I strongly recommend you get a second opinion. It doesn't really matter if you have what they call "chronic" or gestational hypertension--it matters that your BP is rising during pregnancy.

Those numbers sound very high for waiting to treat the hypertension though it is true most doctors don't treat it until the diastolic hits 110. There is increasing evidence that treating it earlier can reduce the impact of the disease. There are specialists who can talk with you and give you other options. Please check out the nasshp.org website and find someone in your area who can check you out. What area are in? We may have some good names for you.

Take care,

Anne Garrett
Executive Director
Preeclampsia Foundation
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Re : New, any advise???

Postby jjbeck » Mon Nov 03, 2003 07:36 am

by jjbeck (413 Posts), Mon Nov 03, 2003 07:36 am

Hi Anne. I am in Maine. I have to make an appt with my cardiologist today. I am hoping to speak with her and get her input. I have mild MVP and a history of 1st and 2nd degree AV block. AV block was brought on by the last HG PG my cardiologist thought was from the meds. She is really good and I trust her opinion. I do have a Peri right now treating the HG and managing the steroids, but he was only for that. Should I just call his office anyway?
It has been a struggle with where my OB now practices with this PG. ( she switch sinse my last PG). She now works for a very large practice and there are so many crazy policies. Despite the fact that I had a history of severe HG and other health issues, I was shocked when they not only schedule and earlier appt with my Ob ( before 12 wks) and when I became horrible sick again, they would not let me through to her and would only let me speak with her nurse. I explained ( whined) about this in another post.
The nurse is a bit less than empathetic.
Anyway, I have developed a great deal of anxiety with this PG and get worked up so easily that I do not even like to call my OBs office anymore because of this nurse. [:(]
I know I should not let it bother me but I do not think my brain is at its full level of funtioning.
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