Sunday, August 19, 2007

The (blood) Pressure is On

On a good day, my blood pressure is 90/70. That's right. Sometimes it goes even lower. I'm practically dead on a normal day, and whenever I get a routine health screen, they always ask me if I'm feeling lightheaded.

Interestingly enough, while everyone seemed pre-occupied with my odd protein dip in June (which resolved itself), the gestational diabetes (ahem) and subsequent premature labor back in July, no one seemed particularly alarmed at a 120/80 BP. You see, that's still in a normal range -- just not for me. But I suppose because there was no swelling, headaches or spots in my vision, nothing could have predicted an elevated post-partum BP.

Our newest is exactly one week old today. Seven days ago, he was six hours old, and I was settling in with my busted-up body for a good night's sleep. Vitals were all in normal ranges, postpartum bleeding, etc., was good, and L'il I was doing great. All quite non-eventful.

Overnight, the BP started going up. Now I usually make a habit of asking, but for some reason, I never asked what the readings were. On Monday afternoon, when the OB (Dr. Good) came by on rounds, she prepared discharge papers for the next day and I was excited about having such a non-eventful recovery. About 15 minutes after she left me to go draw up the papers, she returned to inform me that my BP was rising and that I would require additional monitoring for the remainder of the day and through the night and that I might need some medication to bring it down.

No biggie, right? Get through the night, relax, lower the blood pressure, go home. Not the case.

Over the course of the evening, the BP stayed high. In the morning, the physician's assistant came by to check on me prior to the OB's coming by on rounds. She also pointed out some concern about the BP. When she laid me back to check on my belly, she pressed on the upper right quadrant of my abdomen and I yelped. Uh oh. What do you mean that tenderness isn't normal?!? Isn't it just from being pregnant and having everything shifted and moved and then strained by all that pushing? Nope -- the liver has no reason to be sore from delivery. Time for blood tests.

I'll spare you the track marks that are STILL on my arms from the idiot phlebotomist who couldn't work a butterfly needle right to save her life (she botched the first job and got an inadequate sample -- duh, you went through the vein, dummy, I felt you do it -- and then she came back for more and did the exact same thing. Somehow, though, she managed to get what she needed). Now time to wait.

Later that day, the OB on rounds (Dr. Bad News) came by. I had only seen this one once over the course of my pregnancy and it's never ended well (she was the one on call when I went into premature labor and she kept me overnight when I hadn't expected it. I should note that Dr. Good was the one who put me on bed rest in July and sent me home with a smile).

Now none of this is Dr. Bad News' fault. It's just bad scheduling, I suppose. It could have been Dr. Good, or Dr. Wonderful that had to tell the bored, hormonal, tired-of-being-in-the-hospital mommy that she had another night ahead of her. Hell, I would have EXPECTED it from Dr. Serious.

In any event, this poor woman had to come in and tell me more bad news. Elevated liver enzymes and low platelets. My blood pressure was approaching dangerous ranges and that I needed to go on medication for the short term and stay there overnight for monitoring in case I had a seizure. It all made sense to me at a rational level -- I mean, who wants to go home with a brand new baby, two older children and a bedraggled husband and then have a seizure and end up back at the hospital? (Not to mention that if we had gone home and I had ended up back in, L'il I would not have been with me.) It was sensical, and I knew it. Unfortunately, my hormones didn't, and a serious crying jag ensued -- lasting about four hours. What a great way to relax and lower your blood pressure!

Fortunately for me, my husband kept his disappointment well hidden that night when they came to join me for dinner. The medication was working and I was hovering in the 140/70 range (which apparently is normal, though high for me) and looking good. The vampires would be back at 6 a.m. for another battery of bloodwork to make sure the medicine was doing the trick.

Long story short, it was. We were discharged the next day around 2:30 p.m. by Dr. Wonderful, who pointed out that there are plenty of women who go unexpectedly pre-eclampsic at the very end of their pregnancy, and that what I was experiencing was relatively common. We'll be heading in to get the blood pressure checked on Thursday to see how it's going.

On Friday, while I had L'il I at the pediatrician (still perfect), she had a nurse come to "spot-check" my blood pressure. Still in the same high-ish range, but not dangerous. (The advantage to this is that we all go to the same practice -- its a combo internist/peds group -- so my doctor was right down the hall to run interference with the OB if it was still high.) I felt much better.

Of course, now I've been reading up on this whole issue and before you know it, I'll be diagnosing myself with HELLP syndrome (which I really hope isn't the case). But don't worry about me -- I'll get through it the same way you all plodded through this post holding out for cute baby pics.

So I'll give you three from the weekend:

Still Life: L'il I with Mitered Blankie

"This blankie is so cozy, I could just go right to sleep..."

"Thank you all. I am well aware of just how cute and perfect I am. My Mommy tells me constantly!"


Theresa said...

Ouch on the blood pressure stuff -- been there, done that, know exactly how now fun it is! (I got to spend an extra 24 hours after my delivery on mag sulfate because of it). Glad to hear that everything resolved itself enough for you to go home.

He's still adorable -- definitely a sweet little peanut!

Sherry said...

Congrats on your new addition. I'm here from WendyKnits blog, I printed out your Southwestern sock conversion pattern. (I bet with all you've had going on that you don't even remember converting the pattern).

Hope the BP continues to go down ... I know the low BP story better than the high. I love when they take your BP & they tell you they can't get it or hear it. Mine on a recent appt was 90/60.