chronic hypertension - what should I expect?

[amjon]

Latest update from me is that I have an induction date for March 19th!! I'll be 39+2 by then so drs feel it will be time to call it a day although I'm going to be trying my hardest to encourage baby to come a little earlier of its own accord!! I've been told that I will stop taking the methyldopa the minute the baby is born and just continue with the Nifedipine and possibly an alternative medication if I need it. Have also been told that there are various additional drugs I can be given during labour to bring my BP down before they insist on my having an epidural. Hypertension midwife also said that if my BP sticks around its current level (135-145/95-100) it may be fine in labour as usually only goes up a few points. I think they start worrying more around the 160-170/110 mark.

Mine went down in labor, so I wouldn't really be too worried about it. They stopped checking it frequently and went to something like twice a day after a few hours.

 

[Dinah93]

Midwife sent me back to the ante-natal day assesment unit after my check was at 140/100, took cookies to bribe the midwifes, which got me a scan for reassurance and very fast test results, but readings stayed between 140/101 and 170/112 so at 8pm I was admitted so they could monitor what happens throwing nifedipine into the mix as 2g methyldopa apparently really is finally the limit. Gave me a splitting headache but hopefully that'll stop after a few days as bp wise it did the job. Hoping to be let out again today.

 

[mwah_xx]

Hi girls - not had chance to read through verything! I'm currently about 8 weeks pregnant with chronic high bp (controlled by labetelol and I'm probably running at around 135/80) - just have a quick question! I have my first consultant appt next week and just wondering what goes on there and is it worth my OH taking time off work to come with me?

 

[newgirl79]

hi ladies,

amjon, thanks for your words of reassurance, it's great to know that it's possible for BP to go down in labour!!

dinah- hope you're back home now and headache has eased up. nifedipine is an effective but annoying little drug in my experience- i had lots of headaches with it initially and still get pulse racing/hot flush quite often- for some reason the flush often seems to concentrate itself in my knees- very odd!! Great if your BP has settled though- rest up and take care

mwah- my opinion would be take your other half with you to the consultant appt if you can- just good to have a second pair of ears there as you might be setting up regular monitoring etc. sounds like your BP is pretty well controlled at the mo though so fingers crossed it stays that way!! let us know how you get on
take care all xxx

 

[Dinah93]

Hi ladies. Well I'm out, they didn't let me go on Wednesday as shortly after posting my bp swung from 125/92 to 170/112. Nifedipine didn't suit me, ended up on diacodiene to get rid of the headache/migrane, I'm glad you mentioned about the glushes newgirl as I had those too, also I slept REALLY badly, I kept waking with a pounding chest and racing pulse as though I'd had a bad dream or was being chased, and I was so anxious I couldn't get back to sleep.

Yesterday's consultant changed me to Labetolol, so I'm now on 200mcg Labetolol 2x a day and 500mcg Methyldopa 4x a day, as well as 75cg aspirin. I swear if I jumped I'd rattle. Labetolol suits me better, no headaches, has brought the bp down to a good place, but I do seem to get sort of hot pulsing in the muscles of my neck and back, and numbness/tingling in my face and arms. Very odd.

Annoyed that the hospital only gave me 7 days supply though, and no repeat prescription. My doctors is closed until Tuesday as they're moving building, and then I have to try to get an appointment with the busiest doctor there the same day (she's fantastic but always fully booked) to get her to read my hospital notes so she will put the tablet on a repeat prescription for me and I can get it filled by Wednesday.

 

[W8ing4ours]

Hi ladies. Just wanted to pop in and see how everyone is coming along. Newgirl, looks like you only have 2 weeks left, how exciting! Im so glad you have made it this far, cant wait to hear about your LO and to see pictures! Dinah, glad that labatalol is working for you, I hope it keeps your blood pressure under control. Will be nice when this is all behind you both, and I have prayed that you all have a safe rest of your pregnancy and healthy babies arriving soon.

Maddie and I are well. She is 3 months old already! Time sure has flown by and I find myself already thinking about when to do IVF again to try for number 2! Probably not until November, and I hope I dont find myself with the same issues.

Hope you all are well, look forward to hearing more updates as you progress.

 

[Dinah93]

Back in hospital, readings have been either over 89 or over 104-108 in the 12 hours since I was admitted, nothing in the middle. I don't quite know what to make of it.

 

[newgirl79]

Oh Dinah, you must be so frustrated with it all- aghhhhh!!!! Sounds like it's fluctuating so much they don't quite know what to do, really annoying when it seemed like the labetolol was working well

I have this (admittedly completely unsubstantiated) theory that a lot of people's BP might go up and down more than they suspect. My husband has had quite a few turns on my BP machine and whilst his is always annoyingly low it can fluctuate quite a bit really. I've tried to research this and it seems a 10 point fluctuation is acceptable but anything over that might be concerning- I just wonder how far reaching the research is in terms of how many people they have actually monitored over a prolonged period of days/weeks???? Mine definitely has more than a 10 point fluctuation within a couple of hour period at the mo but may be related to some extent to when I take the Nifedipine which is the fastest acting drug I'm on.

Anyway enough of my ramblings, this doesn't help you at all Dinah, what do you think the docs are going to do next? Hope you're managing to keep your spirits up and hope you at least have some silly magazines to keep you occupied. Thinking of you x

W8ing4, Maddie is so adorable, can't believe she is three months already!!! Sounds like you're really enjoying it all if you're thinking of starting the process again Lovely of you to check in on us all, it's really been sooooo helpful for me to have you girls to chat with xxxx

 

[Dinah93]

They've sent me home again with the cheery words 'we expect you to be back later in the week so you might as well get some time at home while things are bearable'. I agree with you on the 10 point fluctuation. My medication is all evenly spaced (every 6 hours on methyldopa, every 8 hours on labetalol) but I will commonly have a 15 point fluctuation in any given day - I've even been known to have a 25 point fluctuation within 15 minutes while at the hospital clinic the other day.

 

[amjon]

Back in hospital, readings have been either over 89 or over 104-108 in the 12 hours since I was admitted, nothing in the middle. I don't quite know what to make of it.

Dinah, I would consider asking them to give you steroids and induce now. I went into the hospital at 26+1 to be evaluated for pre-eclampsia with mildly high reading. (That was on a Tuesday.) By Saturday she had died and I had to be induced to deliver a dead baby. I'd rather have them out early alive than dead later.

 

[Dinah93]

I am so sorry to hear that amjon, that's just devastating.

If I may ask were you showing any symptoms of pre-e? I don't have any protein in my urine, but I've been told on rare occasions some people don't get this but still have pre-e. At the moment we're going on the belief I 'just' have high bp, not pre-e.

 

[amjon]

I am so sorry to hear that amjon, that's just devastating.

If I may ask were you showing any symptoms of pre-e? I don't have any protein in my urine, but I've been told on rare occasions some people don't get this but still have pre-e. At the moment we're going on the belief I 'just' have high bp, not pre-e.

I had small amounts of protein along with borderline BP. After she died the ultrasound showed low fluid but they didn't do one when I went in to be evaluated. 20 week ultrasound was fine.

 

[miss moody]

Hi all, lots to catch up on.

Dinah you seem to be having a rough time with your BP up and down like a yoyo, how frustrating. I'm sure they are confident that you are ok to come home in between the peaks or they would make you stay in where they can monitor you. Hope things stabilise soon

Newgirl, the 19th is so close!!!!! How exciting, hope you are feeling ok

Not much to report from me as all has been going well with my BP, the consultant was really happy with my progress so far and when I asked about any restrictions for labour was told I would be treated as any other straightforward pregnancy and could use the pool if I wanted. Totally thrilled at this as thought I was definintely going to have an epidural and it feels amazing to have the freedom to choose (assuming all stays well of course). Only problem now is this upside down baby!!

 

[Dinah93]

Hospital admitted me again after my community midwife sent me down after reading 150/110. I was so confident I'd be let out as both my readings in the day assessment unit were 130/80, however the doctor didn't want me to go until she'd spoken to the registrar as she didn't like that it had been 150/110 two hours earlier. By the time the registrar got back from an emergency case my bp was back above the 100 mark again and I was admitted. I had a great midwife last night, who really fought my corner and got my dose made more frequent, so hopefully I won't get the gaps where the pressure rises any more. However I'm so sick of being admitted, I'm going to ask not to be discharged today, as I'd rather they monitored for a few days, checked the dose was right, then sent me home only to come back when it was through the roof.

They did scare me senseless last night. My blood test from the weekend showed some liver enzyme to be 3x higher than the allowed range, and they were worried I was getting pre-e showing up there rather than it impacting on the more usual location of the kidneys. So they retook the bloods, but warned me if it came back the same or worse we'd need to start discussing delivery options, and start me on steroids to get her lungs matured within a few days. I'm suprised I didn't actually have a complete meltdown at that point to be honest, she's only 25+1 - I feel like 30 weeks is this magic number to aim for and until then she must stay inside.

Amjon, I had a scan last week and fluid was normal, but I'm really fighting for every test to be investigated now rather than just let them send me home when no one knows what is going on.

ETA: Trace protein found in urine this morning, coupled with the other things starting to show up I'm getting very scared.

 

[miss moody]

Thinking of you Dinah, keep us posted x

 

[seaweed eater]

How are you doing, Dinah? Hope all is ok.

 

[Dinah93]

Midwife check this afternoon, hoping protein is nowhere to be seen. Will let you know.

I don't know if I'll be sent back to hospital again - my bp isn't so much high as varying HUGELY. This morning it has been between 153/118 and 123/83.... if it's the lower reading I won't be sent in - if it's the higher one I certainly will.

Hows everyone else doing?

 

[WinterKage]

Has anyone of you ever had like 5 people in the room at a consultant appointment? I had a consultant and 4 students and felt bit intimidated. No wonder my blood pressure was high! x x

 

[Dinah93]

Lol my consultant appointments always have him, his two students, a doctor, her student, a midwife and two student midwifes - the joys of being a university hospital.

 

[newgirl79]

Hi everyone,

Dinah really hoping no protein showing up and your BP has stabilised a bit. I wonder if there's any scope for you doing your own BP measurements at all times as recent experiences (see below) have taught me that all this extra monitoring and talk of things being wrong can only serve to make you more anxious and therefore raise your BP!! Really really hoping that everything settles down for you, roll on the 30 week mark

News from me: Baby Reuben John born last Sat March 10th weighing 7lb3! I was admitted to hospital on March 6th after having a few high readings at home. My protein was elevated and luckily I got to see the consultant who had been looking after my antenatal care and she brought induction forward after formally diagnosing pre-eclampsia. I had the induction pessary first off but had a pretty full on reaction to this 12 hrs after it went in (contracting for nearly 2 mins every 30 seconds!)- at which point I was terrified thinking 'if this is only the start there's no way I can handle this'! Anyway my BP and baby's heartbeat were up so they took the pessary out but I continued to contract every 10 mins overnight which took me to 4cm dilated, enough for them to break my waters at 6.30am.

After this things moved pretty quickly with contractions increasing in regularity and intensity until I was fully dilated at around 11am. They were very keen for me to have the epidural due to my BP and as I felt pinned to the bed with the contractions anyway I welcomed it to be honest! Had an hours break to rest and then started pushing at midday. He arrived at 1.15 after some help from a scary man with a ventouse!!

The fun really started after he had safely arrived however as BP was up and down like a yo-yo. I spent the next three days being shunted up and down from the ward to the delivery suite- every time I was down on the ward my BP would go really high (I am convinced in part due to everyone's fussing around and the constant monitoring) so I would get sent back upstairs as the risk assessment tool deemed I needed closer monitoring. When I was up in the delivery suite I would be left alone (with just my husband and Reuben) and hooked up to a monitor and the readings would come down. Unfortunately my consultant was on holiday and the other doctors kept throwing extra meds in to the point where I was feeling completely confused about what my true BP was doing. All the angst and moving about certainly didn't help though- at one point they were trying to get me to sit in a wheelchair despite my insistence that I felt completely fine!! Anyway eventually the midwife in charge overrode the doctors and said I should just have the meds the consultant had written me up for and do my own monitoring for 24hrs. This worked well- my BP was fine and I was finally allowed home!!!

So the moral of this story seems to be if you are concerned about someone's BP being high the worst thing you can do is fuss around them doing constant readings in front of a load of medical staff!! For the most part the staff at the hospital were wonderful but the effects of anxiety and stress on BP seemed to be somewhat overlooked!! Obviously main thing is that Reuben and I are home safe and well though and I just want to say a huge thank you to you all for all your support throughout the pregnancy, it's been sooooooooo helpful to have people who understand to chat to and I'll definitely be sticking around to see how you all get on over the next few months. Wishing loads of luck and love to all xxxxxxxxxxxxxxxxxxxxx