Question about Blood Pressure Medication

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alessels
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Re : Question about Blood Pressure Medication

Postby alessels » Fri Mar 27, 2009 10:04 pm

Thanks Caryn and Patty, everyone here is so knowledgeable.
I have a Dr's appointment on Monday again, will keep you posted.
Thanks again.

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patty
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Re : Question about Blood Pressure Medication

Postby patty » Fri Mar 27, 2009 09:11 pm

I would also ask how frequently they plan on repeating the 24 hour urine test. The numbers can change dramatically from week to week. I hope the meds get your numbers down soon. I know it is worrisome and frustrating.

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caryn
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Re : Question about Blood Pressure Medication

Postby caryn » Fri Mar 27, 2009 08:51 pm

In pregnancy it goes up just because you're pregnant, and you're hosting a foreign placenta. Because it's a foreign organ, sometimes your immune system gets annoyed, and then your pressures go up. They call it "failure of maternal tolerance induction" -- basically the placenta can't hide from the maternal immune system effectively.

So it's not your lifestyle; it's like the beginnings of rejection of a foreign kidney, only for the placenta. And they can't give us immunosuppressants, because they're completely untested in pregnant women and probably muck up all sorts of other things about pregnancy, like the onset of labor.

This stage is a delicate balancing act; they try to get gestational time for the baby without compromising your health, so they will try to get to 37 weeks -- term -- if they can before ending the pregnancy with delivery. But they will also balance the concerns for the baby's lungs etc. with concerns for your health.

I'd ask your doc what your delivery criteria are -- when will she decide you're done? -- and at which point you should call in to the office with bp elevations -- if you hit 150/95 on meds, do you call? -- and about any further surveillance of the baby -- weekly NSTs? biweekly? -- so that you know what the game plan is.

Keep us posted. This bit is nervewracking.

alessels
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Re : Question about Blood Pressure Medication

Postby alessels » Fri Mar 27, 2009 04:55 pm

Hi Guys,

I am starting to get a little frustrated with all this.
My Blood pressure has been high all day today, even with the medication.
I don’t understand, it went down for a couple of days and now it’s high again and I haven’t stopped the medication.
Went to the Doctor and she increased my dosage.
Honestly I am getting a little scared, walking around with High Blood pressure is not exactly safe, I feel like waiting is not being the best thing for me.
I have some beautiful blood pressure readings when I am not pregnant, all of my diastolic readings are in the 60’s, maximum is low 70’s, but I get pg, get to the 3rd trimester and boom, it spikes up.
Thanks again for your care and support, you guys are amazing.
I honestly don’t even want to increase my dosage, I am afraid that they will just keep me pg as long as possible taking medication and I don’t like that.
I am a 35 year old woman who is healthy, don’t smoke, drinks very little (never while pregnant) and definitely no illegal drugs and shouldn’t be taking high blood pressure meds.



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caryn
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Re : Question about Blood Pressure Medication

Postby caryn » Fri Mar 27, 2009 02:07 pm

Technically the research definition requires both proteinuria and two readings of over 140/90. But some of the Experts have recently started to refer to gestational hypertension as "non-proteinuric preeclampsia", because it is thought to reflect the same sort of difficulty with the foreign placenta, just with different symptoms. (Research is moving a mile a minute on this syndrome, and they've got some new data!)

Since you've had this before you probably know all the Signs and Symptoms but I'm linking to 'em anyway. :-) Don't hesitate to get checked out for any changes in symptoms. It's my understanding that if you have it twice, that *probably* means that there's some sort of underlying predisposition that is triggering it -- maybe an autoimmune disease, or chronic hypertension, or straight-up genetic incompatibility between you and the fetus -- so you might want to ask your MFM about that possibility.

Keep us posted.

alessels
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Re : Question about Blood Pressure Medication

Postby alessels » Fri Mar 27, 2009 12:26 am

Hi Kelly,

Thanks for the reply, your story seems scary for sure.
It comes to show that with PE you don’t mess around.

I wanted to update that the results from my 24 urine are in and the protein looked fine, on the stick it showed 1+, but I know that the 24 is more accurate.
Blood pressure is still on the high side though even with meds, it lowered on the first couple of days, now it’s going back up again.

I guess I am one of those cases with Pregnancy Induced Hypertension without the protein in the urine.

With my first, I did have a lot of protein in the urine along with the high blood pressure, but I guess every pg is different.

When you don’t have protein in the urine it is not considered PE, right?


kelly w
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Re : Question about Blood Pressure Medication

Postby kelly w » Thu Mar 26, 2009 10:18 pm

Blood Pressure meds never lowered my BP in pregnancy, I think they really need to be monitoring you closely. Meds never worked for me at all when I was pregnant [except for MagSulfate. That worked great :) ] .

None of us wants a preemie, but you AND your baby are safer with the baby out if things start going downhill fast.

My PE got worse with each pregnancy, so I don't think that is true that it is always worst in the first pregnancy.

I hope you get some answers from your visit today [actually, with what you have going on, I hope they hospitalized you today].

Please take care! I hope you get excellent care today from a doc you feel comfortable with.

Kelly

alessels
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Re : Question about Blood Pressure Medication

Postby alessels » Thu Mar 26, 2009 01:49 pm

Thanks Guys, I have called my Doctor and am going in for some blood work this afternoon. Also have a Doctor appointment next Monday.
Will kepp you posted.
Thanks again for your care and concern.
Adriana

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caryn
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Re : Question about Blood Pressure Medication

Postby caryn » Wed Mar 25, 2009 11:37 pm

Adri, with pressures spiking that high and upper right quadrant pain, I'd head to L&D and ask them to rule out HELLP with bloodwork labs.

Better safe than sorry, you know? That pain can mean your liver is at risk of *rupture*, and that's just no good at all.

Wrt kidney problems, it's thought that any damage from PE will repair postpartum, so they don't treat proteinuria as a hard indicator for delivery or anything. But enough protein plus one reading of 160/100 makes you a severe PE patient, and the NIH Working Group Report (stickied in the News forum) suggests that severe patients are usually hospitalized at a tertiary facility and managed on a day-to-day basis.

Please keep us posted as you're able.

carjashaner
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Re : Question about Blood Pressure Medication

Postby carjashaner » Wed Mar 25, 2009 11:32 pm

I did have this painin the post partum when I developed PE. Very sharp and stabbing. Hurt like the dickens and very scary. Of course I was already scared because I didn't know what was happening to me, so this pain sure didn't help. Not sure what it's from though. Any of you uber smart ladies out there able to shed some light on it???


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