Conflicting advice/ideas

As I've mentioned in my other posts I've been told I have pre-eclampsia/PIH.
With that came an OB, bed rest, NSTs, weekly blood work, 24hr collections,
daily BP monitoring, US, being told my homebirth was OUT the window,
induction would be necessary right after 37 weeks etc etc
Well after having a MW appointment today things seem to be sorting
themselves out a little. Apparently things seem to be controlling
themselves quite well and after going over all of the test results and I was
informed incorrectly about *having to* birth in the hospital as well as my
induction choices! My MWs are quite happy with me following my original
choices IF I continue to stay 'safe'. That doesn't mean I am guaranteed
anything but knowing that I don't have to give up so much control is great.
I have no interest on risking myself nor my little one but the original
information I received was a little.... overzealous. Keep in mind I have no
previous experience with PIH/PE so I had to go on what the OB said before I
spoke to my MWs again.

I am still curious about my BP readings though. Now that I have a monitor
at home it shows my BPs to be at more of a normal level ,even after
activity, yet once at the hospital or MWs they are up again. I've found I
am *very* tense when those annoying straps are on me so I wonder if I am
having some WC Hypertension?
On the plus side I didn't know who I had more fun with when we went over the
US results, the MW was a little shocked that the results were placing the
baby at 36-37 weeks (I was 32 wks at the US) or DH realizing (his face) that
I was right about tech finding the baby big I didn't need a us to tell
me that one, I am pretty sure that this one will be bigger than DS or DD if
I go to term!

I have to admit I am getting excited with that edd getting here so fast.
All of my countdown indicators are in motion....the house renos are just
about done, my SIL had my fourth nephew on the 4th and I got the phone call
last night that my DS's aunt was in labor (she's 36 weeks) and I was next to
pop!

--?

Jenn
-DS Feb'92
-DD Feb'97
-33wks 6days!

Fer wrote:

I am still curious about my BP readings though. Now that I have a monitor
at home it shows my BPs to be at more of a normal level ,even after
activity, yet once at the hospital or MWs they are up again. I've found I
am *very* tense when those annoying straps are on me so I wonder if I am
having some WC Hypertension?

Seems quite likely, unless your home monitor is out of
kilter. Lots of people have it (I do).

Keep in mind also that studies have not shown PIH
(or the more recent term, transient gestational hypertension)
to have much in the way of adverse outcomes unless the
BP is pretty much sky high. It only becomes pre-eclampsia
when you add in the proteinuria (or other symptoms, but
primarily the proteinuria).
With my first pregnancy, my BP was up but I didn't
have other symptoms (protein never got past +1, only
minor swelling, liver functioning fine, reflexes fine,
etc.). I had a perfectly normal, healthy homebirth.

Best wishes,
Ericka

Fer writes:

: I am still curious about my BP readings though. Now that I have a monitor
: at home it shows my BPs to be at more of a normal level ,even after
: activity, yet once at the hospital or MWs they are up again. I've found I
: am *very* tense when those annoying straps are on me so I wonder if I am
: having some WC Hypertension?

Doh! WCH is not uncommon. :-) Do don't say anything about whether
you ever had protein spillage, but if not, I think the pre-eclampsia
diagnosis was a red herring.


Good luck,
Larry

"Fer" wrote in message news:rzSoc.4233$0e6.207@clgrps13...

Well after having a MW appointment today things seem to be sorting
themselves out a little. Apparently things seem to be controlling
themselves quite well and after going over all of the test results and I was
informed incorrectly about *having to* birth in the hospital as well as my
induction choices! My MWs are quite happy with me following my original
choices IF I continue to stay 'safe'.

That's great news! Did they do a 24 hour urine collection, or just
the test strips, when they were telling you you were spilling protein?
The test strips aren't worth much; they pretty much just tell you if
you need to do a 24 hour catch. The catch would tell you how much to
worry.

-33wks 6days!

When I had severe PE I went from just fine at 32 wks 5 days to
incredibly sick and admitted on a mag sulfate drip at 33 wks 5 days
and ended up with a 24 hour protein count of 17000 mg/dl (or whatever
the units are); normal is less than 300, severe PE is dxed at 5000. I
had DS at 34 weeks by c-section because even bedrest, a mag sulfate
drip, and lots of blood pressure meds weren't controlling it. So
you're doing *very* well. :-)

You also might want to supplement antioxidants, like C and folic acid.
Some of the newer research makes that look promising as a treatment.

--
C, mama to eighteen month old nursling

Larry McMahan wrote:
|| Fer writes:
||
||| I am still curious about my BP readings though. Now that I have a
||| monitor at home it shows my BPs to be at more of a normal level
||| ,even after activity, yet once at the hospital or MWs they are up
||| again. I've found I am *very* tense when those annoying straps are
||| on me so I wonder if I am having some WC Hypertension?
||
|| Doh! WCH is not uncommon. :-) Do don't say anything about whether
|| you ever had protein spillage, but if not, I think the pre-eclampsia
|| diagnosis was a red herring.
||
||
|| Good luck,
|| Larry

I've had one strip reading of +3 but my 24 hour collection was only a +1.
My uris acid and creatine are elavated but not passed what is considered
'normal' for pregnancy, sodium & platelets are normal. --?

Jenn
-DS Feb'92
-DD Feb'97
-34 weeks!

wrote:
|| "Fer" wrote in message
|| news:rzSoc.4233$0e6.207@clgrps13...
||
||| Well after having a MW appointment today things seem to be sorting
||| themselves out a little. Apparently things seem to be controlling
||| themselves quite well and after going over all of the test results
||| and I was informed incorrectly about *having to* birth in the
||| hospital as well as my induction choices! My MWs are quite happy
||| with me following my original choices IF I continue to stay 'safe'.
||
|| That's great news! Did they do a 24 hour urine collection, or just
|| the test strips, when they were telling you you were spilling
|| protein? The test strips aren't worth much; they pretty much just
|| tell you if
|| you need to do a 24 hour catch. The catch would tell you how much to
|| worry.

The 24 hour catch was 344, a +1 right? One test strip in the begining of
this was a +3, since then I've had normal trace and +1 strips. My uric acid
and creatine are elavated but not passed the norm and all the other tests
are fine (platelets, sodium etc)


||
||| -33wks 6days!
||
|| When I had severe PE I went from just fine at 32 wks 5 days to
|| incredibly sick and admitted on a mag sulfate drip at 33 wks 5 days
|| and ended up with a 24 hour protein count of 17000 mg/dl (or whatever
|| the units are); normal is less than 300, severe PE is dxed at 5000.

How did you know you were that sick? BP reading? Or did you feel ill? I
ask because the sudden jump (with no warning) is what scares the cr@p outta
me :\

|| I
|| had DS at 34 weeks by c-section because even bedrest, a mag sulfate
|| drip, and lots of blood pressure meds weren't controlling it. So
|| you're doing *very* well. :-)

And how did she do at 34 weeks? Was she a good size, did she breath
alright?

||
|| You also might want to supplement antioxidants, like C and folic
|| acid. Some of the newer research makes that look promising as a
|| treatment.


Oh, this I didn't know. I'll look into it thanks!!!


||
|| --
|| C, mama to eighteen month old nursling

Thanks a ton

--?

Jenn
-DS Feb'92
-DD Feb'97
-34 wks

Ericka Kammerer wrote:
|| Fer wrote:
||
||| I am still curious about my BP readings though. Now that I have a
||| monitor at home it shows my BPs to be at more of a normal level
||| ,even after activity, yet once at the hospital or MWs they are up
||| again. I've found I am *very* tense when those annoying straps are
||| on me so I wonder if I am having some WC Hypertension?
||
|| Seems quite likely, unless your home monitor is out of
|| kilter. Lots of people have it (I do).
||
|| Keep in mind also that studies have not shown PIH
|| (or the more recent term, transient gestational hypertension)
|| to have much in the way of adverse outcomes unless the
|| BP is pretty much sky high. It only becomes pre-eclampsia
|| when you add in the proteinuria (or other symptoms, but
|| primarily the proteinuria).
|| With my first pregnancy, my BP was up but I didn't
|| have other symptoms (protein never got past +1, only
|| minor swelling, liver functioning fine, reflexes fine,
|| etc.). I had a perfectly normal, healthy homebirth.
||
|| Best wishes,
|| Ericka

You give me hope Ericka! My protien levels are 0 to +1 (except for one
reading that was blamed on a contaminated catch)all other levels are
'normal', very minor swelling, reflexes are fine, no headaches etc. The
difference in talking to an OB and then my MWs on how to 'manage' me was so
amazingly different. I forgot how removed the woman becomes in the face of
the medical establishment. On the plus side, if I need the hospital the
nurses there are fabulous and adore my MW group.

Thanks for the help
--?

Jenn
-On bedrest due to PIH/PE
-DS Feb'92
-DD Feb'97
-Jellyfish due June 25/04

"Fer" wrote in message news:jO5pc.5842$0e6.4005@clgrps13...
wrote:
|| "Fer" wrote in message
|| news:rzSoc.4233$0e6.207@clgrps13...
||
|| That's great news! Did they do a 24 hour urine collection, or just
|| the test strips, when they were telling you you were spilling
|| protein? The test strips aren't worth much; they pretty much just
|| tell you if
|| you need to do a 24 hour catch. The catch would tell you how much to
|| worry.

The 24 hour catch was 344, a +1 right? One test strip in the begining of
this was a +3, since then I've had normal trace and +1 strips. My uric acid
and creatine are elavated but not passed the norm and all the other tests
are fine (platelets, sodium etc)

Yes, that's a +1. Sounds like your liver and kidneys are holding
their own -- no HELLP syndrome -- and like the bedrest is really
helping.

|| When I had severe PE I went from just fine at 32 wks 5 days to
|| incredibly sick and admitted on a mag sulfate drip at 33 wks 5 days
|| and ended up with a 24 hour protein count of 17000 mg/dl (or whatever
|| the units are); normal is less than 300, severe PE is dxed at 5000.

How did you know you were that sick? BP reading? Or did you feel ill?

At my appt. with my midwife at 32 wks 5 days I had a trace strip and a
bp of 130/80, which was up enough from my 90/60 at the start to be of
concern (a rise of 40/20). She was a little concerned but not much.
I got dependent swelling over the weekend that was gradually getting
worse, but it was always down in the mornings. Then I woke up one
morning, peed, and there were bubbles. :-( Bubbles means you're
spilling protein; it changes the surface tension. So I looked in the
mirror, noticed I'd woken up swollen, and borrowed my mom's bp cuff,
which gave me a ridiculously high reading of 200+/100+. At that point
I called the OB, transfered care, and dropped by the office long
enough for them to take my blood pressure again and send me to the
hospital.

I never felt sick. I never got epigastric pain. I never got a
headache. I never had visual disturbances. So it can just come out
of the blue, but I don't think that's likely to happen to you unless
your placenta partially abrupts with no warning. I was having a first
baby with a family history of hypertension, and not the kind where
you're all a bit overweight and a bit inactive, but the kind where
when you hit your mid-40s with a BMI of 23 you've suddenly got
reeaaalllly high blood pressure. So, I probably have some genetic
risk factors. Bedrest in the hospital on two bp drugs and a mag
sulfate drip didn't even really slow the progression of the disease
for me.

I
ask because the sudden jump (with no warning) is what scares the cr@p outta
me :\

It's also what scares the crap out of obstetricians. Hypertensive
disease in pregnancy is still one of the two primary causes of
maternal morbidity and mortality and one of the two primary causes of
prematurity in the developed world because we don't understand it yet.
I hope you can stay with the midwives and get a homebirth out of this
still; they seem less likely to overreact to me. The newer research
suggests that a protein released by the placenta when it isn't getting
enough oxygen damages blood vessels, so stay on your left side and
take deep breaths! :-)

|| I
|| had DS at 34 weeks by c-section because even bedrest, a mag sulfate
|| drip, and lots of blood pressure meds weren't controlling it. So
|| you're doing *very* well. :-)

And how did she do at 34 weeks? Was she a good size, did she breath
alright?

He was just fine. They left me on the mag sulfate for 48 hours while
giving me steroid shots for his lungs, so he only had mild respiratory
distress syndrome (I think from the c-section) and spent only 12 hours
under the vent hood. He was in NICU for a week, mostly for jaundice
and a patent ductus arteriosis (very common even in term infants)
which resolved on its own with no treatment. He was 4 pounds 14
ounces at birth, which they said would have doubled over the next 6
weeks in a normal pregnancy...

|| You also might want to supplement antioxidants, like C and folic
|| acid. Some of the newer research makes that look promising as a
|| treatment.

Oh, this I didn't know. I'll look into it thanks!!!

Sure!

--
C, mama to eighteen month old nursling

Adding to the extra C and folic-if you've had severe PE or HELLP in a prior
pregnancy, it's a good idea to get the Anti-phospholipid antibodies checked.
There are several mothers on my PE support group who only made it through a
successful pregnancy after Antiphospholipid syndrome was diagnosed and
treated. Low-dose aspirin therapy, starting before conception, has also
helped in some cases. The Preeclampsia Foundation tracks current research,
and has information on what has appeared to work-they also track subsequent
pregnancies. The HELLP syndrome society does the same with HELLP
pregnancies. And at least in the ones they've tracked, onset is usually
later and less severe, if it recurs at all.

I had Class I HELLP, rapid onset, at 22 weeks gestation with my first. I'm
currently 7 weeks 2 days with the 2nd, and am on prenatals, extra folic,
extra C, and aspirin, checking BP 4x day and sending the chart to the
midwife once a week, appointments every 2 weeks now, perinatologist
appointments and ultrasounds every 6 weeks (so far-both with increase as the
pregnancy progresses). Activity is limited, and I'll be off work by 8 weeks.
So far, they're estimating an 85% chance of coming out of this one with a
living baby.

In general, regular OBs have not been at all positive about a subsequent
pregnancy given my history, but several specialists have been, and my
regular care team is extremely supportive. I'm feeling really good about
this one. So if your advice is coming largely from OB's who don't deal much
with high risk, you might want to check elsewhere.

I'm really annoyed because I see now several things in my first pregnancy
which NOW would be considered definite warning signs and treated-like I had
a 20 point BP rise in both numbers within the first trimester. But, I guess
hindsight is 20/20.