Who should be managing my condition post-delivery?

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
njpia
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Re : Who should be managing my condition post-delivery?

Postby njpia » Sun Dec 13, 2009 10:46 am

I love this forum so much. I could have written your post to a t. I'm 2 days pp my bp are in 140/90 and 150/100s. Not what they like to see. I'm an anxious ball of nerves in my hosital bed. The ob on call visited me n said they wanted to start me on labetalol twice a day. I totally trust them but they're ob's not cardiologists. I had a cardio.with my first pree baby and felt like they handled me better than ob's.
So in my opinion ask if you can be refered or ask if you can get a second opinion by cardiologists.

alexa5
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Re : Who should be managing my condition post-delivery?

Postby alexa5 » Sun Dec 13, 2009 10:27 am

My doc is a family doc that also does OB...so it worked perfectly for postpartum bp issues. That said, I definitely agree with the others that an internist or cardiologist or GP/fam doc are better equipped to handle bp issues postpartum. When I was in the hospital postpartum I felt like I would be there forever as they had no clear plan about how to handle my bp, whereas with one call to my family doc I was able to leave the hospital and do my follow ups with him. (I had been sent to a hospital with a NICU, so couldn't be delivered by him, otherwise my postpartum care at the hospital would have been better as well)

dbronson
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Re : Who should be managing my condition post-delivery?

Postby dbronson » Sat Dec 12, 2009 09:31 pm

My OB held on to me for twelve weeks then referred me to a cardiologist.

biokatie
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Re : Who should be managing my condition post-delivery?

Postby biokatie » Sat Dec 12, 2009 06:56 pm

Thanks! Yes, the OB's office scheduled me an appointment with my regular internist for Monday.

rebecca2
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Re : Who should be managing my condition post-delivery?

Postby rebecca2 » Sat Dec 12, 2009 10:57 am

My OB saw me for 6 weeks pp. Then he suggested I see my PCP who happens to be an internists to check for underlying disorders causing my BP issues. However, he didn't just kick me out the door; instead he called my PCP to discuss my history so there would be no gaps in my care. My OB also did a workup on me around 12 weeks pp to check for underlying conditions that might have caused the PE. When he did this he also called my PCP to coordinate and see if there was anything else my PCP thought he should test.

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hannahsmom
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Re : Who should be managing my condition post-delivery?

Postby hannahsmom » Fri Dec 11, 2009 11:52 pm

Boy, that sounds familiar....

My bp was still way up after a week so my MFM adjusted my meds but wanted me to see my primary care doc. The primary doc adjusted them again, and now I am 4 weeks pp and am finally getting close to normal, although the bottom number is still up.

Hope you get back to normal soon! Congrats on your new arrival :)

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patty
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Re : Who should be managing my condition post-delivery?

Postby patty » Fri Dec 11, 2009 10:51 pm

The ob should follow things until your 6 week check up. If you are still hypertensive after 6 weeks that is when they consider you chronic hypertensive and refer you to a family doctor or internist. Some women take a little longer than the 6 weeks depending on how severe their pre-e was to return to normal postpartum and some of us never do :( I was lucky mine always went back down eventually until this last pregnancy.

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heather j
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Re : Who should be managing my condition post-delivery?

Postby heather j » Fri Dec 11, 2009 10:45 pm

I completely agree with Melissa's last statement. I would specifically seek a consult from an internist who should be able to offer you a much more aggressive approach to managing your pressures. Requesting (demanding and fighting for it, as it were) a consult with an internist while still in hospital postpartum (ten days at that point) was the single best thing I did for my health. Within 48 hours of the initial consult, I was on my way home thanks to the internist. He handled all my bp issues, though my OB still "required" me to pop in twice a week pp until 6 weeks so they could "monitor" my pressures and get all huffy and condescending because they weren't "behaving" at a level they deemed appropriate. My internist was wonderful during all of this. Honestly, I was thrilled when, at six weeks, my OB "officially" handed my care over to the internist. I was off meds by four months postpartum and headache free; we tried multiple medications, combinations, and dosages before finding the right one for me. Like Melissa, I didn't return to the OB for any follow-up care, well-woman visits, or my subsequent pregnancy. I have complete confidence that my internist can handle any of my issues and refer me appropriately OUTSIDE of pregnancy and that my MFM can do the same inside a pregnancy.

Do you have a doctor you can schedule with already? Hope you can get a start on getting it all resolved! Oh, and welcome to the PF! :)

mellybute
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Re : Who should be managing my condition post-delivery?

Postby mellybute » Fri Dec 11, 2009 10:34 pm

Hi! I am 4 months pp and in my experience, my OB was ready to hand me off to the next doc as well. She didn't as much say that though which left me standing around not really knowing what to do next. I followed up with a cardiologist for my bp issues (at 4 weeks pp). They are much better at handling the medications for blood pressure issues. My OB had tried to wean me off Labetelol around 2 weeks pp and my bp shot back up. I then saw the cardiologist who immediately switched my meds since I wasn't breast feeding and my bp was controlled within an hour of taking the new med.

I also followed up with a GP who is also an internist for bloodwork to see where all my levels were at. I am still following up with her. She has checked various levels (full metabolic panel etc.) and I have submitted a 24 hour urine to her to check kidney function as well. I too had NEVER had any bp issues until the day I was admitted at 37 weeks for delivery. It was very very high after delivery.

I did all of this on my own. I left my OB's office after my 6 week appt. and never looked back because she could have cared less about me pp. I know other's have had better experiences but my doctor really missed the boat with me and knew little about PE in my opinion. She just told me I was RARE and sent me on my way.

Cardiologists and internists are much more comfortable with blood pressure meds then OB's I think.

biokatie
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Who should be managing my condition post-delivery?

Postby biokatie » Fri Dec 11, 2009 09:50 pm

I had severe preeclampsia and delivered my son last week at 36 weeks. However, my BP's are still very high 160/100-180/120. It seemed when I was pregnant everybody was and wanted to take care of me...but now they are passing me off now that I have delivered. Should my primary care doc handle this instead of an OBGYN so soon after delivery? Because the OB/GYN just referred me. I didn't have hypertension before pregnancy. I know it takes awhile for them to normalize...I just feel like I keep coming in because they are alarmed by my high pressures, but nobody is doing anything. I am on 400 2X daily Labetelol.


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