Chez Perky

Blood Pressure

So, my normal, non-pregnant blood pressure is about 110/65 or lower. During the first, oh, 29-30 weeks of this pregnancy, my blood pressure ran about 120/70-80. Totally fine and normal. I don't remember exactly when my blood pressure shot up last week, but for the last week or so, my blood pressure readings have been, um, not so great. I take my blood pressure every morning (and now, often several times throughout the day as well, but I'm not typing out every single BP I've taken in the last week). Here's what it's looked like (do note that often I get a lower reading later in the day and I ALWAYS get a lower reading at the doctor's office which makes NO SENSE):

9/5: 125/94 (In doctor's office later, it was 120/84, I think)
9/6: 136/111
9/7: 128/90 (at doctor's office it was 110/63... WTF??)
9/8: 106/85 (with Procardia in AM)
9/9: 121/103 (later 118/92)
9/10: 132/105 (later 146/90)
9/11: 123/105 (later 126/98)

I thought it was maybe my BP cuff that wasn't working properly, but I've got two, and they come out with just about the same readings. (they are both electronic, one is fully-automatic, one is semi-automatic) Apparently, I'm just nice and calm in the doctor's office. Normally, my BP shoots up in the doctor's office. Go figure.

Anyway, my nurse at Matria, the traitor, called my doctor yesterday and again today with my BP readings. Sure enough, I got a call back this morning saying that there's a pretty good possibility that they'll decide at my appointment today to just admit me to the hospital for observation. Careful what you wish for, I suppose. I was JUST coming to believe that maybe it WOULD be better for me to just be at home during Rosh Hashana, since I could always just go to the hospital if I needed to (there's absolutely nothing wrong with going to the hospital in a medical emergency on a Jewish holiday... it's going for something routine and/or not necessarily emergency-status that's a problem). So anyway, I was warned to pack a bag (it's mostly packed anyway) and bring it with me. At least they warned me.

I'm 32 weeks tomorrow. Just 2 weeks to go. I said that to the sonographer/medical assistant person who called me with the news of possible hospitalization and she said, "2 more weeks? Well, we can hope..." UGH. But it's all good. I'm seeing Dr. G. today. I totally trust his judgment. I have absolutely no reason to believe he would lead me astray. I do sort of wish Dr. P weren't out of the office all this week. I find Dr. G. just as comforting as Dr. P., but there's something in the back of my head wishing Dr. P. would be around, just in case. I'm not sure why. And it's not like delivering triplets at 32 weeks is a bad thing. That's the national average. It's just sooner than I'd hoped. And anyway, I still really do believe that I'm going to hang in there until 34 weeks. I'm not sure WHY I believe that, but I really do.

So, yeah. I wouldn't have been updating September 13-15 anyway, because of the holiday and Shabbos. So don't be alarmed if I drop off the planet. If I do end up admitted, I'll have either Jess or my husband update tonight. Okay? But even if I'm admitted, it's likely just so they can keep a closer eye on me, which is fine. So don't freak out if I disappear.

followup appointment

First of all, my Pajama Gram arrived today! Go me! I'm very happy about this.

I saw the doctor again this morning. As compared to Wednesday, I'm relatively stable... my cervix is still about 1.5cm at its longest, which is what it was on Wednesday, so that's good. Dr. P. gave me a prescription for some extra Nifedipine so that I can take it twice a day, in hopes that it will help my blood pressure (today's was totally normal, but yesterday was 136/111...I didn't know BP numbers WENT that high). Other than that, I get to wait for test results to come back (labs that were ordered from Wed's appt. plus the fetal fibronectin they checked today).

Dr. P. didn't want to make any final decisions on admitting me to the hospital next week until they see me next week, so he had me change my appointment from Wednesday to Tuesday. His preference would be to keep me at home and have me in the office Tuesday and Friday, but a Friday appointment would be complicated at best, since that's the 2nd day of Rosh Hashana. By Tuesday all the labwork will be back, and they'll also have a better idea of how carefully I'll need to be monitored through the week, so it makes sense to wait to make a decision, and I'm comfortable with that. I'm totally happy being ABLE to stay home for Rosh Hashana, provided that he thinks it's prudent to do so. His feeling is that he doesn't have all the information today to be able to make a real determination about whether it's prudent to do so, but will know more on Tuesday. That's completely reasonable. He (Dr. P.) will actually be out all of next week (*gasp!* He can't abandon me!!), but I'm seeing Dr. G. on Tuesday and I love Dr. G. so I have no concerns.

Meanwhile, I'm exhausted, so I'm going to take a nap. I have a terrible headache, so I'm hoping it will go away by sleeping some more. I'm not counting on it. It's astounding how much energy growing three babies can take out of a girl. Maybe I'll go put on my new snuggly pajamas. Probably not. That would take a lot of energy. *yawn*

Well, I know what I'll be doing tonight...

Tonight I will be packing a hospital bag. Because, you know, it seems like there's a possibility that I might need it at some point. I probably wasn't clear enough in my last post. In fact, I was downright misleading when I said, "So I'm just going to sit around waiting to see if it's a trend." What I'd been told yesterday by my Matria nurse was that one day of high blood pressure wasn't really a good data point and that if I had two days, then they'd decide what to do. So at the time I wrote my post this morning, I was waiting for my Matria nurse to call (since I'm not doing contraction monitoring anymore, she calls me in the afternoon, rather than in the morning after morning monitoring).

Anywhozit, my nurse called me around 12:30 and told me to take my BP again around 1:30 and see if it was still high. It was (125/94), so she called my doctor's office. They promptly had me come into the office to be seen and the nurse at my doctor's office suggested that IF I already have a bag together I might want to bring it with me, but if I didn't already have it together, not to worry about it. Well, phooey. That wasn't entirely what I wanted to hear. Suffice it to say, I didn't have a bag packed anyway, so it was a moot point. And so... off to the doctor's office. Dr. P. was in the office I went to, which made me happy (he's a very calming influence). My BP was, annoyingly, elevated but not high while I was there (130/84). High for me, but not high enough to be problematic. My cervix has shortened by about half a centimeter. That's not fabulous, but Dr. P. pointed out that at this point we want to get these babies another three weeks, not another three months, so it's manageable (at its shortest, it was 1cm, it's longest was 1.6 which used to be about as short as it would get).

Anyway, Dr. P. ordered some labs and a 24-hour urine collection. He said that obviously they've been doing their best to manage me as an outpatient for as long as possible, and that now they've kind of got a choice, which he left with me. Did I feel more comfortable being admitted now so I can be monitored 24/7 or would I be more comfortable and less stressed at home? I told him that honestly if he'd asked me last week I would have told him to admit me, but I really, really wanted to go home today. Next week, I said, I'm all yours. You can take me. In fact, I said, it's probably best to admit me next week, so that I'm not trying to navigate the issues of dealing with getting to the hospital or doctor's office if I need to in the midst of the Jewish holidays. He said that was a good point, and we'll talk about it again before we get there. He wanted me to still come in for my already-scheduled appointment on Friday and we'll see how it goes. At this point we're just taking things one day at a time, and that's okay.

Right now I'm really uncomfortable. The contractions are really getting intense. I gave myself an extra dose of terbutaline, which I normally try to avoid, particularly at night, but that's the way it goes. But it's okay. Not far now, right?