Reply to Pre-E questions....anyone have experience?

Forum Index » Expectant and Postpartum Moms

Reply to "Pre-E questions....anyone have experience?"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous]Friend of JinDC here from separate thread.

First, J is not obese, and if you saw her you'd be like SERIOUSLY?! to the doc for the chubby shaming. I was just thinking of celebrities that plumped up a bit for description and I'd say somewhere between medium and heaviest Kelly Clarkson, at worst. So, maybe not at her fighting weight (which I know you'll get back to, J!) but NOT some serious heavyweight by any means. Also, she's definitely NOT downplaying the blood pressure based on what I know of her!

So, J, I'm sorry, I don't mean to dump a load of crunch on you, but I'd push back hard on this. Not saying push back as in refuse, there's no way I could know enough to advise you on that. But, push back until you are comfortable with the reasoning behind the decisions and part of those decisions.

I know you know some of my personal story, but here it is again: I've now been with two different medical practices through two different pregnancies and my blood pressure has always done the spikey thing toward the end. In both cases, no protein and no swelling, but the spikes are always concerning to me.

With my first pregnancy I started out very slim and gained about 40 lbs. Yes, 40! Maybe even a bit more since I wasn't completely sure of my prepreg weight. With this pregnancy, I started off a good 15 lbs heavier than I was before my first pregnancy, and I have so far gained a scant 20 lbs at 35 weeks, which I am told is absolutely fine, but feels low. As it turns out, I'll probably end up weighing about the same at the end of this pregnancy as I did with my first, though I've gained much less weight to get here. The reason I'm sharing this is that I do think that weight gain / loss is a crapshoot (to some extent).

Oh, also, my BP spikes are identical this pregnancy to last pregnancy (20 lbs 35 weeks, fairly faithful to the GW midwives diet and active vs. 40+ lbs first pregnancy, still somewhat active, but probably not as intentionally so if that makes any sense). With my first, when my BP was spiking, my OB asked me to come in 2x a week toward the end to monitor, and he said if it ever was high and didn't come right down, I'd go to hospital for monitoring. After a few times crossing town for the BP checks, I shared that this was a huge stressor for me, so he allowed me to have my best friend (a nurse) monitor my BP at home. My BP was always way lower at home, and her cuff was carefully calibrated.

This time around, my midwives are likewise noticing spikes in my BP and their approach is that I come in, sit down (feet on floor and supported!) and put my left arm on the table and make sure it is supported. Take a few minutes to relax and calm down, then they take my BP. They also said the same thing as my first OB, if my OB reads high, then they'd simply ask me to sit still and relax to try and bring it down, and if it didn't come down, I'd go to hospital for monitoring. So far this has really worked wonders. But, if someone was up my ass the whole time about my weight gain, or worse, REALLY stressing me out over my BP, I'm sure it would be through the roof! Instead, my midwives have suggested that I come in, get comfortable, and think about something very peaceful, like a pleasant scene, or a person I have great empathy for. It helps so much. Also, the few times my readings are 140/90 or so (notably, after I got the scary ultrasound news and was beside myself, and another time when I was nearly in a fender bender trying to park and running late), they want to reread them in five minutes. When they've been 132/80's, they don't even bother and say that's just fine for me, even remarked that my BP "is behaving today."

In the meantime, your doctor has been gunning for you about your weight since day one. Pre-E is no joke, as we know from our other Oct mom friends. I'd take it very seriously and I know you do. At the same time, your doctor really seems like a classic fat-shamer who almost wants you to have a problem to prove her right. (Am I crossing a line? I'm sorry if so, but that just seems really possible to me). (Further ironic because honestly I do not think you are particularly "fat"). Do you feel it is too late to change doctors? The reason I say this is, if you do NEED to be induced, or develop Pre-E, the last thing you need is to have lingering doubts over the necessity of it all, and you don't want to go into these things not trusting your doctor to be unbiased. To me, that is coming through loud and clear in your message, and even if you LOVE this doc otherwise, it's an issue that isn't likely to go away unless you talk it out, (respectfully above all else, of course!) or find a new doctor who sees you as a person and not a disaster waiting to happen.

My advice: write down ALL of your questions, worries, and concerns. Take them to the different doctor you're seeing this week to discuss. Whether or not you discuss the inherent stress of your doctor constantly doubting your health despite evidence that you are healthy, and ignoring the difference between pregnancy induced hypertension (which is sometimes a problem, and often is NOT), white coat syndrome, and Pre-E. These all have different symptoms and diagnosis, and nothing you've shared indicates you meet the threshhold for any of them, except white coat syndrome. After all, pregnancy induced hypertension is not a blood pressure in the 130/90 range. It's higher, and has to be a repeat reading 2 hours apart, right?

Anyway, yes, as you know, being "overweight" increases your risk of high blood pressure in life, generally, and likewise you have a higher chance of developing gestational hypertension. But this is not always the case, and even if you have that, it does not always lead to Pre-E.

More advice: don't get ahead of yourself with magnesium and don't borrow worries. Find out what conditions your docs would prescribe it under. I'd be asking questions like this:

why would the assumption be that this is Pre-E even without any other symptoms? Under what scenario would I be induced based on my symptoms as they are, or what changes could possibly take place that would make you favor inducing? Would I ever be induced based on worries about Pre-E if my blood pressure stays the same, or is this only if it increases? Would you induce based on blood pressure alone or would we do other monitoring first, like 24 hour protein collection or non stress test / biophysical profile to check on baby? Do you "believe" in white coat syndrome? Is it possible that the doctor asking me about my BP and weight all of the time, and the fact that it's triggering a "fight or flight" feeling when my BP is checked, is having an effect on my readings? Can I be seated and have my arm supported when you take my BP? If my BP did continue to climb, when would magnesium be necessary? I have heard a lot about magnesium and am fearful of the side-effects, is there anything I can do to reduce my chances of needing it? When would you consider prescribing magnesium? If I'm given magnesium, would that require separating me from baby?

Anyway, sorry if any of this is overkill, or if I'm letting my own bias influence a personal issue of yours, and let me make clear again that I don't mean to suggest I have any idea what is medically necessary in your case. I ONLY know that you need to ask questions and get answers until you are personally comfortable and confident in your doctor's reasoning for diagnosis and any treatment. That is your right as a patient and it's called informed consent. You can't consent if you are not fully informed and bullying does not count for informing.

Pumpkin

[/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics