Monday, January 30, 2017

The Body Who Cried Wolf

I kept waiting for a more definitive report to post another update. I may need to accept that nothing is going to be be definitive for a while, if ever. I am beginning to feel like my body is the medical equivalent of the "Boy Who Cried Wolf".

So first there was the rising BP readings at home, at work, and really anywhere besides my doctor's office. Of course because they are normal in the office, the OB isn't very concerned. I've made others verify the readings so I know I'm not making it up, but it still makes me feel crazy. I comfort myself by telling myself that my readings are "stably high", as in they haven't gotten any higher over the last few weeks.

Then there was a tachycardia that prompted a EKG, echocardiogram, and 24-Holter monitoring. The cardiologist didn't seem very concerned by any of the results, although some of the words sound scary to a lay-non-cardiologist-person ("frequent sinus tachycardia", a max HR of 154 on a day where I most active by walking from car into the office, "very rare multifocal ventricular ectopic singles", and "rare supraventricular extopic singles"). The final medical impression that that I will be fine and it is all benign.

The blood-work prompted by the tachycardia also ruled-out thyroid issues and gestational diabetes.

At my last OB appointment on exactly 27 weeks, my BP was again considerably lower then the readings I'd been getting at home (diastolic in the 60s compared with 80-90s), but he asked about my home monitoring and then suggested a dipstick urine test on what seemed liked a whim. This resulted in a protein measurement of 1+, significant for protein and a diagnostic marker of preeclampsia.

However, the dipstick tests are known to be inaccurate and frankly even more baffling given my random BP readings (usually with preeclampsia, BP will rise first and then eventually you will find protein in the urine, not the other way around). So he ordered a 24-hour urine sample, which is considered the gold standard for assessment, and I spent my weekend peeing into a hat and collecting a jug of urine kept cold in our refrigerator.

I am leaning towards the results being negative and the dipstick urine test having shown a false reading. That seems consistent with everything that's been happening lately. My concern is that the trend of "My Body Who Cried Wolf" is going to leave everyone (including myself) to begin ignoring symptoms and discounting evidence. Alternatively, if the results come back positive then this is really not good prognostically considering I am only 27.5 weeks. Mostly, I am being driven insane and the idea of 12 more weeks of this roller-coaster is almost too much to bear and so, too, is the idea of such an early labor.

1 comment:

  1. So sorry that your symptoms aren't presenting anything concerning seems like a really weird thing to type, because why would I want anything concerning to happen? But, I do understand your comparison to crying wolf. Stay proactive, though, even if they all think you're crazy ;)