Saturday, January 7, 2017

24 Week Update: Hypertension and tachycardia

The week before Christmas and New Years, I began feeling unwell. I felt more tired, short of breath easier, and just... off. I started getting concerned about my blood pressure again and kept making a point to get it checked but then kept putting it off.

Until January 2nd, when I finally went into the drugstore and my suspicions were confirmed: 141/84, up from 104/66 at my last doctor's visit three weeks prior. Panic began to set in as I wasn't even at 24 weeks gestation yet. At my scheduled counseling appointment on 1/4, she checked it again and it was 142/85. I was glad to have my OB appointment scheduled for the following day. To say I was panicking would have been a slight understatement. I realized that in my last pregnancy I was blissfully naive to the true dangers and likely course of preeclampsia, but this time I have been reading and studying, for better or worse.

At exactly 24 weeks, I saw my OB and was able to tell him my concerns and symptoms. Of coarse, my manual BP in his office was within normal limits ( 130-something over 75-ish), so he wasn't overly concerned. Then he listened to my heart. Immediately, he said that it was pounding and then informed that I had tachycardia at 120 beats per minute. So this bought me a trip to cardiology later that afternoon, an EKG, many vials of blood, and a follow-up appointment in the next week.

The cardiologist, upon review of my EKG, didn't seem overly concerned. However, he did order an echocardiogram and a 24-hour halter monitor, just to cover our bases. Of coarse my blood pressure was also within normal limits at this appointment, just making me feel a bit crazy.

The following day, one of my nursing co-workers checked my blood pressure twice. The first time it was 168/79 and the second time it was 139/92. I bought a home automatic monitor and the systolic has ranged from the high 120s up to the 150s and the diastolic has ranged from the mid-70s to the low 90s.

At my OB appointment, he didn't seem concerned about the BP because was good when they tested me, but was more concerned about my heart. I am more concerned about my blood pressure given my past history of preeclampsia. I asked if I should continue to monitor it myself and he said this would be okay, but didn't give me a specific guideline (with my first pregnancy, he gave me specific instructions to check 3-4 times per day when it started raising in his office). I asked when/if I should contact him if it got "too high" and he said to call with anything over 140 or 80. When he told me this, I internally rolled my eyes knowing that I would likely be calling him the next day because it seemed like my readings at home were always higher than this.

I haven't called. I am giving myself a higher threshold because I feel like a complete fool to go into the office and have the manual reading be within normal limits. I will call if it escalates, but in the meanwhile I am working on being content that I have a cardiology appointment (for the echo) on Wednesday and see the OB back on Friday. At this point I will have made it 25 weeks. I did not expect to be so focused on "making it" this early on. That part is terrifying.

On a positive note, the baby seems to be doing well. I am measuring on track and her heartbeat was 151 bpm. Now we just need to keep her incubating.

1 comment:

  1. I had severe pre-eclampsia with my first, who was born at 32 weeks weighing only 2lbs 3oz (severe IUGR- she is fine today but tiny still). I am almost 33 weeks with number 2 and my blood pressures have mostly been in the 130/80 range- with one spike at 26 weeks. I've been extremely paranoid about it (especially around 24-28 weeks) as I feel like it is happening again (nausea, heartburn pain, headaches, etc but BP has been fine). It is a bit of a mind fuck really. Hopefully you will make it to full term or close. I have no useful advice (apart from trust your instincts) but will be thinking about you!