WWYD

mschware · March 2014

I've been in and out of doctors visits for the last week and half. Starting 2 weeks ago, I can not do my job or normally daily tasks without feeling short of breath, having painful cramping, getting awful headaches, abdominal pain, dizziness, lightheaded, and almost passing out a couple of times. I've also been having some issues with my vision. At first I thought it was a compilation of normal pregnancy symptoms, but when it got to the point that I couldn't even drive to work or do laundry without feeling like I was gonna pass out, I knew something was wrong. Every time I go to the OB I see a different doctor because they want me to be familiar with everyone, so I always have to re-explain my story. My hemoglobin is normal, but everytime I get my BP checked it is super high. The highest it's been is 163/113 but generally is fluctuates between 130/90-150/90, still high though! But I don't have any protein In my urine when tested at the office so they don't think it's preeclampsia at least yet. I had an EKG and that came back fairly normal but I have to get an echo done today. I have a follow up OB appt tomorrow with another doc I haven't met yet but I'm sure they will be asking me how it went at the cardiologist and since they've seen me last week. They told me they may have to put me on BP meds if it stays high.. But why give me BP meds when that will only mask what is causing my recent issues and rise in BP?
So here is where I need to know what would you do?! Would you keep seeing the different OB's, taking their advice on the meds and tests they want done, and continue working and pushing through your daily life? OR would you go to L&D when your BP gets really high and when you start to feel awful? At L&D I know they will run more tests so I may have an answer sooner... But I can't decide if I should do that or just keep waiting around for the OB to give me a real answer. I feel baby kick all the time, but I seriously feel lots of pain and struggle to breath when I push myself too hard. My job involves me to be on my feet all day and I've taken the past few days off because I just can't take it. So would you go to L&D or keep relying on your OB? I'm horrible at making these decisions.

FAWKES81 · March 2014

Hmm...I think if I felt I wasn't getting the best care with my OB and my gut was telling me something else could be going wrong I would go to L&D the next time I had a spell. What's the harm in going into L&D v/s the harm of having your multiple doctors miss something for the sake of you being familiar with them all? What does your SO think?

steprozz · March 2014

that's a tough one. I would love to say trust your OB but since they are making you see a different one each time to get you "familiar" you are losing continuity of care which in this situation is pretty important. yes they have access to the records and notes from each visit but seeing you in person and how you are feeling and reacting to the pain is a big part of being treated. also, the symptoms you are describing seem pretty serious in my opinion. I know high BP, sudden changes in vision like blurriness, and extreme abdominal discomfort are all things my OB says to go straight to L&D for so I would say next time it happens I would probably head to L&D if it were me. fx you find some answers soon and I hope you start to feel better!

edited for typos

jaybee11 · March 2014

If you truly feel that your concerns are not being addressed at your OB's practice, I see no problem with going straight to L&D the next time you experience these symptoms. When it comes to the safety and health of your child, it's better to ask too many questions and have false alarms rather than ignore potentially dangerous symptoms for the sake of saving someone the inconvenience of dealing with you right that minute. Good luck--I hope you receive some concrete answers, and please keep us updated!

mschware · March 2014

That's very true... My DH is very concerned about me and baby, but he said I know my body the best and that it's up to me whether I want to take off work and go to the hospital or wait for the OB. He's new to this too and doesn't know what would be best, so he's sort of it leaving the decision up to me! He's been very supportive though. & @stephross88‌ , my OB has never said that to me before.. I've never got a bad vibe from any of the doctors, but I think they seriously overlook my symptoms because I'm 21 and healthy and my whole pregnancy has looked great up until this point. So I think I will probably just go to L&D if it gets bad again just in case... At least to even ease my anxiety and get another opinion?

ADalesa29 · March 2014

I'm so sorry you're going through this. I don't have any experience with similar symptoms but I think when it comes to the high BP and vision issues which can be caused by pre-e you definitely shouldn't mess around. Personally I think I would go to L&D right when you experience an episode and when going in to your OB office I would insist on seeing the same doctor whenever possible. Good luck!

DagnyDoo · March 2014

How scary for you. If it were me, I'd be marching myself into L&D at the next episode. If your instinct is that something is wrong, you need to be thoroughly evaluated at the time of occurrence. So much of OB care is managing risks based on statistics, and it's not worth taking chances if you happen to be having symptoms that don't fit into the standard boxes that are cause of immediate alarm. There have been too many stories of things going terribly wrong very fast, all while the mom knew something was off but the tests weren't coming back abnormal enough to warrant intervention. The hospital will have a different standard of care than your doctor's office. At the very least, going in and being fully evaluated will give you peace of mind if even they find nothing.

Best of luck to you! I hope it's something minor and easily cared for.

FutureMrsW9 · March 2014

Have they tested you for anemia? I was having similar symptoms, just not as bad and they started me on an iron supplement. Bending over to tie my shoes or walking up a small flight of stairs gets me so winded and dizzy that I have to sit down. Either way, it def sounds like something is up and being missed by your OBs. Not to go over their heads, but if you feel that you're not getting answers I don't see any reason you shouldn't go to L&D. You need to do what's best for you and baby, and if your body is telling you something is wrong it's probably right. Good luck!

mschware · March 2014

FutureMrsW9 said:
Have they tested you for anemia? I was having similar symptoms, just not as bad and they started me on an iron supplement. Bending over to tie my shoes or walking up a small flight of stairs gets me so winded and dizzy that I have to sit down. Either way, it def sounds like something is up and being missed by your OBs. Not to go over their heads, but if you feel that you're not getting answers I don't see any reason you shouldn't go to L&D. You need to do what's best for you and baby, and if your body is telling you something is wrong it's probably right. Good luck!

They have tested me for anemia, and it wasn't that. At least that's what they told me! And thank you! I will start listening to my own body more often

catsinawindow · March 2014

I find the symptoms you are describing very concerning. I had PreE with DS and had issues with my BP a few weeks before I started spilling protein. Have they done a 24 hour urine catch?

The BPs you are describing are high enough that my OBs would have me go to L&D. With DS, they sent me for any BP above 140/90 (either nber). Also, my BP issues were largely asymptomatic. They also told me to go in for vision changes or a headache that Tylenol didn't fix.

So, yes, I would go to L&D next time this happens.

steprozz · March 2014

@mschware‌ the blurry vision and high BP are warning signs of PreE that's why my dr said they are concerning to him. but I agree with other PPs that you should trust your instinct and if you feel like something is wrong and your concerns are not being addressed appropriately with the OB then head to L&D better safe than sorry!

kibean · March 2014

First, I really feel you need to do what you feel is best and listen to your instincts about your doctors and treatment. Definitely insist on being seen or get a second opinion if you know that something isn't right.

Second, FWIW I was recently having similar symptoms and was put on BP meds as a result. The first dosage they tried me at did not help at all, but they upped the dosage (60 procardia) and I have felt SO much better: no more dizziness, heart pounding episodes, hearing my pulse in my ear, tingling, feeling like I was going to pass out, or lightheadedness. Last time I went in my BP had gone down from roughly 170/90 to roughly 130/80 (I can't remember the exact numbers but they were in those ranges). I feel like the meds made a big difference.

lauren5482 · March 2014

Do you have a BP cuff at home? If not, it might be worth the investment so you can also start tracking your BP trends at home. Those pressures you mentioned are pretty significant, and if they aren't treating you with meds they should be watching you very closely.

If it was me, I would have no problem going to L&D to get checked out. This will hopefully ensure you get answers more quickly than you could on an outpatient basis. Not to scare you, but some people with pre-eclampsia can have an atypical presentation. Sometimes pre-eclampsia can have a very abrupt onset.

If you go to L&D or your next office visit, and your BP is high, I would insist on PIH labs being drawn and doing a 24 hour urine collection. (The 24 hour urine provides a more accurate picture than a urine dip). I'm sorry that you're not getting answers as quickly as you'd like. I am a big believer in being your own advocate. Go with your gut, if you feel like something's not right, you're more than likely correct. Good luck!

erind228 · March 2014

I go to a group practice as well, and I just see one OB. Is there one that you are the most comfortable with? I know that they want you to be familiar with everyone so that when you are in labor you won't freak out when a new dr. comes in, but honestly, the dr. really doesn't spend that much time with you other than actually delivering your baby.

I think that I would probably stick with what my OB was telling me, but if you feel like they aren't giving you the answers you need then seek a second opinion.

ElTrain5 · March 2014

Changes in vision is one of the big symptoms of pre eclampsia, and you CAN have it without protein in your urine. Have they run blood work to check? Or the 24 hour urine?

ricecakes1216 · March 2014

I go to a group practice as well. They recommend seeing all thr doctors but it is my choice. I've seen 4/7 doctors but only because I was having complications so I went to whoever was available. They all made me feel like I was their primary patient. They'd come in with full knowledge of my situation and I never felt like I had to explain why I was seeing them.

If I were you, I'd go to L&D next time an episode occurred. I would want to an answer and to make sure I was taking the best care of myself and the baby.

cristykaye · March 2014

Go to L&D. I have some issues(not related to yours at all) but I was told that I do not need to wait until I can see OB. Go straight into L&D and get checked out. My OB said that I (and I assume you as well) am far enough along that I shouldn't hesitate going in.
As I'm sure you have seen from this board already, things can happen this early and it's better to be safe.
Fx you get everything figured out and they get you fixed up!

mschware · March 2014

No I have not done any blood work to check or a 24 hour urine catch. I'm not sure why they haven't suggested it... It's a little frustrating. If I go to L&D before my appt I'll make sure to bring that up then, if they don't already offer to do those tests. Thank you girls for your advice and support! I will keep you updated and I'll make sure to write EVERYTHING down and make sure I really drill my doctor at my next visit. And yes I do test my BP at home too and it's been high

curlylocks3 · March 2014

deleted quote because the formatting is screwy. and I have no idea why I'm now stuck in this box. Or underlining everything.
My response begins here:
I would start off by calling your OBs office today and asking to leave a message for your primary OB/their nurse and saying you have questions about the symptoms you've been having and would like some guidance on at what point you should be being more aggressive. I would specifically ask at what point/with what symptoms you should call the after hours line and/or go to L&D (around here you call your OB and they tell you to go in), if they feel it is safe for you to continue working, and how you should treat an attack of these symptoms when they occur. Ask what the plan is- if your echo is normal do they have anything else they want done? Ask what your diagnosis is- is it pregnancy induced hypertension?

And maybe keep track of everything they have tested and the results so that if you see a new doctor (or go to L&D) you know that information for yourself and people are not redoing the same tests that have already been done. Write down questions before your phone call and any appointment and give yourself space to write down the answers so you aren't struggling to remember everything.

As far as the meds themselves, yes, many of your symptoms could be attributed to high blood pressure. And BP meds might decrease or resolve them. Even more importantly, high blood pressure can have a negative affect on placental blood flow, so you want it to be controlled for baby's sake- even if it means medications.

BabyCurtiss2014 · March 2014

Sorry you are having to deal w this!

Trust your gut! Also like some PPs said it does sound like warning sign for preeclampsia...do you have swelling? Limit ALL caffeine if you haven't already! Try to do some breathing exercises and if you feel like you should go to L&D do it! Good luck!!!

mschware · March 2014

Thank you girls! So I ended up going to L&D, after calling the on call doc. Baby was monitored and was doing well. My BP was high when I got there but decreased significantly the more that I layed there. I had blood work done and a urine test and those came back great! So the doc said that my high BP isn't too concerning right now because of the fact that it decreased greatly after laying still for 30 minutes. So they told me they will keep an eye on it and that I just need to make sure I don't over-work myself... But right now it is NOT pre-eclampsia! Which is awesome! I am still currently waiting to hear back from the cardiologist about my echo though. I'm not quite sure why I've been feeling so awful if nothing is wrong. I'm so happy that baby and I are okay, but now I just feel like a wimp for having all these symptoms haha.. Just going to take it easy I guess.

steprozz · March 2014

@mschware‌ you are not a wimp! glad you went in and got things taken care of and everything looked great. just take it easy and relax. thanks for the update

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