Friday, October 4, 2013

Started maternity leave

I'm 34 weeks pregnant in my third trimester.  I started maternity leave early because of my blood pressure.   I have pre-existing hypertension so this pregnancy had been high risk for me.  In addition I was diagnosis with gestational diabetes.  I failed my 1 hour and 3 hour glucose tolerance test, but my Hemoglobin A1C is 5.2 so it is just my pregnancy!  I am not a diabetic!!!  I have to check my blood sugars in the morning and 1 hour after meal.  It's a pain, but at least it's just diet modification and no insulin.

September 17, my blood pressures have been running in the 140/90.  I notified  the doctor via email and had to do repeat 24 hour urine collection that week to check for proteins that could indicate preclampsia (Read more about it here).  I have been doing a urine collection every trimester.  First reading was in the high 300s, but second one was in the 200s.  This third trimester urine collection proteins results was close to border line close 300s again, but I was NOT diagnosis with preclampsia.  They just wanted to monitor me and make sure I had no symptoms of preclampsia like headaches, blurry visions, right abdomen pain and swelling.    

September 18 I started bi-weekly non-stress test to check my baby's heart rate.  So far so good.  Her heart rate is normal, her head is down and amniotic fluid is normal.  I also had a follow up ultrasound.  Baby is a little small, 3 pounds 12 ounces.  The doctors and nurses said it is expected that babies are smaller when mom's have hypertension.  I hope she gains more weight!!!

Last week Thursday, September 27, before I went into work my night shift at the hospital I started having headaches and when I checked my blood pressure, it was 140/100!  I took my medication Methylodopa 500mg.  I went to work at the hospital and checked my blood pressure again and it was 150/110 to 160/120.  I called Labor and Delivery department and had to go in.  I notified the night shift supervisor and left work.

Now I know how it feels like to be a patient.  In August, I had a false alarm due to left side pain, headache and high blood pressure 140/90 but my labs were normal and I was sent home.  This time I was admitted with an IV, fluids, fetal monitoring, lab draws and another 24 hour urine collection.  They had to give me hydralazine 5mg twice to bring my blood pressure down.  It did not come down right away so they gave me Labetalol 200mg.  Finally my blood pressure started to come down, but sometimes comes up 130/90.  I could not leave the hospital until my 24 urine collection was done and we know the results.  I ate hospital food, had to get insulin when my blood sugar was more than 120 and watched MTV the whole day while going in and out of sleep.  Being a patient is boring!  The scary part of my day was when the obstetrician, perinatologist, and neonatologist, talked about delivering early if I had preclampsia to save me, but baby would survive, just be in the neonatal intensive care until breathing and feeding is stable.  It was a scary thought, but in the end my 24 urine was in the 200s again.  I did not have preclampsia and I was able to go home with new blood pressure to take at home, Labetalol 200mg.

I was out of work until my next doctor appointment, but then my blood pressure was still up this past Monday morning at 140/100.  So I called the doctor to ask if I should increase my Methylodopa back to 500mg since they changed it to 250mg, but they wanted me to go back to Labor and Delivery.  I was in the hospital being monitor just for a few hours.  My blood pressure kept going up and down, but they agreed they should increase my Methylodopa back to 500mg.  No IV or labs done at this time.  I was able to go home.

On Tuesday I did my non-stress test in the morning.  My blood pressure was still running high 140/100.  Baby still head down, amniotic fluid is normal, but her heart rate seems like she is still sleepy 130-140s with not much acceleration in the 150s.  They had to stimulate her couple times, and finally had to do an ultrasound to check her heart, breathing movement, and extremity movement.  The perinatologist thinks the blood pressure medications is making her sleepy, but everything was normal.  I went to the obstetrician that afternoon to follow up my blood pressure.  The doctor decided I would benefit from modified bedrest and should be off from work until I deliver.  He did discuss making sure I reach full term, induction and the possibility of c-section.  I would have to be seen weekly to make sure my blood pressure stay below 160/110.

So I got my doctor note and notified my work ASAP.  It is definitely a blessing in disguise.  I would love to work because we all got bills to pay and I wanted to save for baby, but at the same time I need to be stress free for me and baby and control my blood pressure so I don't get preclampsia and deliver early.  The goal is to stay pregnant for as long as I can.  I wanna make sure me and baby is healthy so if bedrest is what I have to do then we gotta do it.

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