March 25, 2009

And The Complications Begin

As many of you know, my pregnancy with Piper was not entirely smooth. I developed gestational hypertension at 27 weeks which resulted in IUGR (in my case, growth restriction caused by inadequate placenta due to hypertension). I was induced three weeks early to hopefully mitigate potential grave outcomes for both me and baby.

It was an incredibly stressful time. My OB constantly assessed me for pre-eclampsia, which never became an issue, so they were mostly unconcerned. But then I'd see the MFM who was jumping out of his skin over the situation. He talked about things like a stroke in either me or the baby, the quick decline a baby with mild IUGR can take, and the potential risks when severe IUGR develops (which include long term growth problems or stillbirth). The MFM talked very excitedly about early induction while my OB kept saying things like "We'll see, things look fine..." They come from such different perspectives, the OB seeing thousands of perfectly normal deliveries and just a handful of serious complications, while the high risk MFM may see the inverse.

In addition to complete confusion over the extent of the problem between the two practices, seeing a different one of 15 docs at my OB further complicated things. For one thing, I had to explain the situation at each new appointment and there was no one person keeping tabs on the reports from the MFM. In addition, I got conflicting advice each time; one would prescribe medication and the next week another doc would say it can be dangerous to suddenly drop the baby's blood pressure - don't take it. And on and on like this for 10 weeks. In between there were visits to the hospital for monitoring when my BP spiked, off and on bed rest recommendations (depending on the doc), and a general sense that no one was managing my situation - that was left to me.

So my main goal for the first OB appointment was to review this and talk about seeing just one doctor this time. Based on the conversation I would consider whether to stay with them or move to a new practice. That part went really well, I saw the guy I have the best relationship with and he completely agreed I should see just him. He also has a good relationship with the MFM so I feel like we will stay on top of things. I have an appointment in two weeks for the first trimester screening with the MFM, including a hypertension/IUGR consult. Since we know in advance this time, we should be much more prepared to manage the situation.

But the bad news is the hypertension has already returned. Last time at the 8 week appointment my BP was 112 over 60 (normal for me). This time it was 138 over 80. That's not in the danger zone (150/100) but it's approaching it much more quickly than last time. The MFM will probably recommend medication but I remember him saying medication is not likely to bring my BP down, but rather to keep it from elevating further. I don't know if this means we're already screwed and I guess you never know how you'll respond to medication until you try it anyway.

In other news, I just got the worst haircut of my life. Between the too-long side fringe and the too-short bangs that pouf straight out, I look like I could join Spinal Tap. All things considered, that one seems like an easy problem to solve. Taking off for a few days, look forward to catching up with you all soon.

16 comments:

niobe said...

I'll be thinking of you. In my first pregnancy, though everything turned out okay, my son was IUGR and, at my insistance (my OB wasn't worried at all) we induced several weeks early. So, while the situation wasn't exactly the same, I have some idea of how stressful the whole thing can be.

Heather said...

Thinking of you.

I hope if he prescribes it that this medication does the trick!

Lorraine said...

Good for you for insisting on what would seem like the obvious care you should have had last time. Keep it up!

littlebitofsomething said...

bad haircuts are the worst... and hypertension doesn't sound any better. i hope they find a way to manage things for you so you can spend the rest of your pregnancy growing out your locks and just looking perty.

Faith said...

Yikes -- that's a tough combination. I hope they can get a handle on it quickly.

Furrow said...

What a crapload of stress. I hope things get levelled off and you end up with a thoroughly boring pregnancy.

Tinker said...

Okay, this is just too soon to have that much going on. I do hope you find a solution for the BP, because that can be scary.

My Reality said...

Ok, I just commented and don't know what happened. So if you have two comments from me, that is why. :)

Ok, back to my comment. The DASH diet works well to bring down blood pressure through diet. I have done it myself and it works really well.

Your bad haircut will grow back. I had a bad haircut last April and I am still trying to recover from it. One more cut and the mullet will be forever gone. It really was a mullet. It was horrible.

mekate said...

sweet Sarah,
Thinking of you and am SO GLAD you are able to be on this early- but so sorry that you have to be. Have a great few days away. warmly, Kate

Grade A said...

Just when a girl starts to feel a little less terrified...bam! So sorry for the added stress. Hope they get it under control stat. Bad haircuts don't help-hope your pregnancy helps grow that hair quickly.

Sticky Bun said...

Ugh. I'm so sorry that you had a high reading this early. I hope they monitor you very closely--that they're on the same page and pay attention! Good for you for speaking up and being up front about what you need right now. I hope it's what makes the difference.

And, I'm sorry about the haircut. I'm sure it looks better than you think it does, but I'm hair obsessed and I so hear you. When I get a cut I don't like, there's no convincing me. So, I'll just commiserate. Stupid hairdresser!

Red said...

Hope everyhting is going along well. Good news that you'll be able to stay with one carer this pregnancy, I'm sure that will make things a bit easier.

Kate said...

Man, how did I miss this post last week? Yikes, so sorry this is causing concern already. Is it possible that it was a random spike at the dr's office? Do they have you track your BP on a regular basis? Also, how has your BP been since Piper's birth? Has it gone all the way down--or has it been trending higher than usual (that's been the case for me...). I am glad they are paying attention to this early on and that you are firm in asking for what you want. Hope your consult with the MFM goes well. Keep us updated.

mekate said...

me again, just wanted to send my warm wishes your way- hope that your BP is under control and that you are feeling well in every way-- I wish on you simple and good things and I hope the haircut is growing out with your wondrous pregnancy hormones all hopped up. thinking of you- Kate

mekate said...

What I hope most is that you are ok.
And I have bestowed a sisterhood award on you soon to be posted on my blog-- no need to do anything, just know how very much you are appreciated. Warm wishes to you- Kate

littlebitofsomething said...

just wanted to pop in, say hello and let you know i'm thinking of you. hope all is well.