Triage visit...so frustrated!

[mrssilverstein]

I want to add a bit to pp'ers. I had very, very much the same type of neuro symptoms with my twin pg. I was admitted, yes, admitted three different times and sent home because I was not spilling protein, already on high doses of labetalol. Every other symptom pointed to pre-e. At 35 weeks, my kidneys were shutting down and they took the babies out emergency c-section with mag sulfate for three days (one before, two after) to control the bp and possible seizures.

Please be extra demanding with the staff; I know this time I am much more proactive about my care, having to remind everyone at each appointment what happened last time (large ob practice) and I have insisted on quite a few occasions when they were not even considering things like 24 hour urines, blood work, nst/bpp. I see a peri every two weeks now, the one at the hospital I will deliver at and she is awesome. I don't intend to let them tell me I have to wait as long as last time. I don't know if this helps any, but your symptoms sound way too familiar to me.

[lilillini]

Thanks Amanda! I was definitely assertive with the triage doc and nurses (I was kind of a b**ch!) but the doc was very clearly set in his decision as soon as he walked in. He wouldn't listen at all, which was the most frustrating thing. He didn't have anything reassuring to say at all. I did tell him that I wanted it noted in my chart that I came in with a BP log and neurological complaints and that he still sent me home. I'm not a litigious person but he better pray that I don't have a seizure or stroke!

I didn't even think of it yesterday but if/when I go back in, I will ask to talk to the peri on staff and maybe make some more headway. As of tomorrow, it will be 3 weeks with a persistent headache and visual disturbances, plus I gained 2 pounds the other day and have increasing nausea. But since my BPs are somewhat controlled by Labetalol and I am not spilling a ton of protein, it "looks" like I am ok. And I know I am definitely not ok.

[amanda]

Alison -
Jumping in a bit late on this but wanted to say that UGH - I would be frustrated too!
Those neuro symptoms are just nothing to be messed around with (which you know..) My only advice is to go with the plan you have (do you have someone who could maybe help out with Mason) and, when you get there say things like: "I want it noted in my chart" when they don't or won't do the things you feel strongly they should do (as in call the peri). I know it sounds easy to say that but here is the analogy that I gave myself: If this were one of my children would I even hesitate to insist on calling in another doc, etc? Sometimes I know its easy for me to kind of 'shush off' me but I don't with my kids. I don't know if that is true or not for you but thought maybe I would pass along what I did.

Good luck!

[lilillini]

I asked my peri friend about the dangers of such labile pressures, and this is what she said:

"You know that's the scary thing about eclampsia - there is really no good sentinel predictor. I've seen women seize with and without other neuro symptoms, with high BP's, mid range BP's and normal BPs. With your complaints, labile BP's, and history, you need to be admitted. I don't understand why those evaluating you dismiss your neuro complaints!!!! If you're in for triage so much, it's a red flag that you need to be admitted and observed at LEAST for 24 hours.

The danger of your labile BP's is stroke ultimately. The BP's don't predict seizure onset, but do predict risk of stroke and therefore poor maternal outcome."

Good info to have, though scary! This friend was the Society for MFM Fellow of the Year and I've known her since preschool, so I'm extra proud and I trust her implicitly!

[karoliina]

Oh, Alison! I can definitely see why you're upset. I've been treated much the same way, and it makes things even more difficult - like there wouldn't be enough stress dealing with "just" PE. :(

Best of luck with getting through this, and I'm also curious about the strips and if they work (I often have high readings when I wake up, too, and apparently I've started snoring in this pregnancy).

Hugs,

Karoliina

[lilillini]

Thanks Debbie! I used a Breathe Right strip last night and it helped keep my BP down a tiny bit - 150s/90s, so still not good. My husband commented this morning that my snoring was a little bit softer than it had been, but he did hear the classic sleep apnea gasps occasionally. I don't have that problem when I'm not pregnant, and he just started noticing the snoring a couple of months ago.

[debbie78]

Yikes, Alison. It does sound like you have a good plan, but I think you have every right to be frustrated. Doctors like the one you saw in Triage are exactly why so many people have such a negative opinion of PE and OB-related care regarding it. I'm sorry. Please let us know if the breathe right strips helped. Thinking of you.

[lilillini]

No - it wasn't even mentioned that I should be seen by a peri. I thought about calling the peri that I saw when I was hospitalized 2 weeks ago, but wasn't sure if that would accomplish anything.

I have a close friend who is a peri 3000 miles away, and she has been giving me some great advice, but obviously she has no control over my care. She has said that she would hospitalize me and keep me there until delivery.

[caryn]

Alison, did the peri on staff take a look at you?

[lilillini]

Thanks Jen! I definitely will!