Hypertension. Still.

As I alluded to in my previous post, I was in the ER myself yesterday.  I had been on a waiting list for an ambulatory blood pressure monitor to determine what my numbers REALLY are, and the nurse from Chronic Disease Management called me to say I could come and get hooked up.  Since I was planning on heading up there to weigh iBean (who turned 6 months), I thought it would be a two-birds-with-one-stone thing. The boys were still in Edmonton with Tony, so it was just us girls. After the hospital, I thought we could go to the swimming pool or something.

I arrived at the hospital and went to CDM. The nurse took my blood pressure before attaching the ambulatory monitor to me.  My reading: 166/112. Huh?  “Are you feeling alright?” She asked. I felt fine.  I was very relaxed, only having iBean in the house with me for 24 hours was like a free vay-cay. No reason for it to be so high.  So she took my pressure on the other arm: 158/108.  Not much better.

“I really don’t feel comfortable putting this monitor on you if your blood pressure is so high already,” the nurse said.  “I think your doctor is in the ER today.  I will let him know I am sending you down there.”

So off we went.  Down the blood pressure path again.  My doctor ordered a myriad of tests (all of which I have been previously subjected to) and put me back on the last blood pressure med I had been taking.  He then directed me to the lab, where I had some blood taken (five or six vials), a urine test AND they sent me home with two 24-hr urine collection tests.  That’s right. Two.

At this point, I am resigned to my fate. My bloodwork has been consistently good, my organ functions have always been good (even at my worst state in the hospital). I know that my preeclampsia was so bad that I was at risk of having long-term hypertension as a result, but I really wish there was something more.  When I explain my condition to people (including doctors) they are floored that my pregnancy blood pressure problems persist even when there is no baby in my belly. How can that be? There must be something else wrong with you.  You don’t feel it when your blood pressure is that high?  Do you have double vision? Headaches?

No.  I feel nothing.  If I was not so diligent about my blood pressure readings, I would honestly have had no idea I was hypertensive at all.  I am an active otherwise healthy person whose blood pressure can climb so high that it is a wonder that I have not stroked out.  And I feel nothing.

How is that possible??

Where is House when you need him…

 

Oh – and iBean weighs 13 lbs 7 oz

Hypertension – the sequel, or rather, the continuing story

iBean will be 6 months next week and my blood pressure has still not returned to normal.  At its peak in the hospital is was 182/133.  Every medical professional I tell that to is simply amazed that neither iBean or I stroked out.  It was a pure miracle that she came out as well as she did and that despite my high blood pressure, no lasting physical damage to my body or organs.

But I am still living with the hypertension. I slowly weaned down from my 17 (!!) daily blood pressure pills to the last one, and went off that last medication 15 days ago.  My blood pressure has not spiked back up, but it is slightly higher than it was on the meds. My diastolic pressure is borderline hypertensive, depending on the time (and day) I take it.  I was originally told in the hospital by the myriad of specialists that if my blood pressure had not resolved within 12 weeks postpartum, that I would most likely have chronic hypertension for the rest of my life.  I guess that is what I have to now face.  I was really hoping that once I was off all of the meds (and when you are on 17 pills a day, it takes a LONG time to titrate down!) my bp would normalize.

I was also told that I was at a substantial risk for this whole preeclampsia thing to recur should I decide to get pregnant again.  The specialists kept using the words conception planning appointments, high risk, specialist appointments, bedrest, hospitalization, premature delivery, possible organ damage, fetal death, maternal death should I decide to get pregnant again, particularly if my blood pressure did not resolve itself.

Or maybe not. I could get pregnant and everything would be peachy, just like my pregnancy with K-Man.

But 3 of my 4 pregnancies have had blood pressure issues.  Not full-on wars like this last one, but chances are, the next one would just make that number 4 out of 5.

Giving me the benefit of the doubt, my doctor (the man is a saint) is putting a requisition for another halter blood pressure monitor and giving me some more time to see if my body will bring itself back to normal.  There are things I can do: exercise (WTF is that?!), eat less salt (moment of silence as I say goodbye to soya sauce) and eat more beets (there are only so many beets I can consume in a day without wanting to yarf).

Tonight, I went for a walk.  I was farking tired, but while Ivy napped and Tony was home, K-Man hopped in the jogging stroller and we went for a brisk walk, about 3 km. The first real exercise I have done in almost a year. The goal to bring my diastolic blood pressure down is to do 20-30 minutes of “exercise” 4 times a week.  Not just running around after kids and up and down the stairs doing laundry.  I’m talking above and beyond that.  It would be WAY easier if I had an iPod that could actually hold all my dance/trance/upbeat music. Right now it is mostly consumed by stuff to listen to in the car while chauffeuring the kids around (Glee features prominantly).

High blood pressure is supposed to be for old people.  Not 29-year old size-4-wearing mothers.

It’s a good thing iBean was worth it.

iBean at her maximum level of medical intervention, shortly after birth

The Bean, 5 months old, trying on her bathing suit to see if it fits. It totally does! We're hitting the pool!

Home Sweet Home

After 18 days in the NICU, Ivy was finally discharged on January 21. She had originally taken her carseat test on the 19th, but to our dismay, she did not pass. Part of that was because the carseat we had, although it is an infant carrier, does not have adjustments small enough for a 4 lb baby. She was swimming in it!
So Tony and I decided to go out and buy a new carseat, and to our great elation, she passed her second carseat test with flying colours. I called Tony at work and told him the good news, and he jumped into his car and drove to Grande Prairie to pick us up. We would surprise the boys when we got home.
The trip home was a bit of a muck up, not because of Ivy, but the roads were altogether NOT cooperative. Ivy slept the whole way, only starting to root around when we were about 10 minutes from home.
We walked in the door and Sacha and Kees were ecstatic! Kees ran around, dancing, wanting to show me Ivy’s room all set up. He wanted to show me all of the trains (Thomas trains) that a friend of Sacha’s had passed down to him. Sacha kept hugging me and telling me how much he loved me and how glad he was that we were home. It was one of the most amazing feelings I have ever felt, finally being reunited as a family.
Ivy had a good first night at home. She wakes up about every 3-4 hours to eat, then falls quickly back to sleep. Preemies need a lot of sleep for their development, and she seems to know that. She also seems to know how to let off some good burps and poops to make room for all the milk she consumes!

I will post more details in the next few days. Thank you all for your prayers and concern in this time.

The Milk Machine Returns

So after yesterday’s bump in the road with nursing, Ivy has made a full comeback. Immediately after I posted on here, her feeding went back to normal. In fact, this morning has been exceedingly good. In the last 3 feeds, she has taken in 50 mL, 45 mL and 30 mL. Oh, and did I mention that she is waking herself for her feeda and not even waiting the “prescribed” 3 hours between feeds, only waiting 2 hours between these good meals!
Ivy also gained another ounce yesterday, putting her at 3 lbs 15 oz. I think the nurses were being overly cautious yesterday, which is their job, I guess. But I am just going to leave that NG tube in for now! Don’t want to jinx ourselves! And we just learned that Ivy has graduated to the next level of breastfeeding supremacy. She is doing so well that she doesn’t need to be pre- and post-feed weighed any more! Yay! Crossing our fingers for a weekend discharge.

Stellar…whoops!

Little Miss Ivy has become a stellar nurser. Unfortunately, she and I may have gotten a little ahead of ourselves. After over 24 hours of exclusively breastfeeding with no gavage feeds, Ivy pulled out her own NG tube. Since she had been nursing so well, the nurses did not put one back in. Then at her next feed, she decided that she only wanted a little milk, after which she pursed her little lips together and did not want anymore! Well, in a NICU, people get panicky when a preemie baby decides not to eat as much as the doctor says she should, so in went a new NG tube. Ivy was livid, so much so that when I tried to nurse her at her next feed, she started to drink a bit and then she came off and screamed. That was the first time for that sort of reaction. I am pretty sure the NG tube was bothering her, which is not good. But as she was not wanting to nurse, the nurses got some of my pumped milk and gave her a gavage feed. It was discouraging
after such a great day and 2 nights of feeds.

Jersey Girl

Ivy is nearly 2 weeks old now. She is 3 lbs 14 oz and in the last 12 hours has really shown that she is a superstar nurser: she breastfed full feeds 4 times of the last 5, taking in even more than what the dr considers for her to be a “full feed.” This improvement means she is one step closer to getting her NG tube removed. Usually oncer the tube is out, you are looking at a carseat test within 24 to 48 hours and then, if all goes well, discharge! Ivy is not on any medications, her vitals have been stable since she was extubated shortly after birth, and she is gaining weight each day. She was moved out of her incubator and into a big-girl bed (ha!) 2 days ago, since she is now able to regulate her own body temperature. I am hopeful that we can go home in a week or so.
On a crappier note, my camera and 2 lenses were stolen from my hospital room when I was upstairs with Ivy on Thursday. The camera had all the newborn pics and videos of Ivy. What a horrible thing for ssomeone to do!

Settling in

We are now settled in at the QE II hospital in GP. Ivy continues to gain weight and exceed the nurses’ expectations, particularly when it comes to feeding. Ivy nurses on alternate feeds, getting every other feed from her NG tube. When she does nurse. She usually takes in 10mL from me, and then they top her up with the remaining 20 mL through her tube. I was a little discouraged that she only takes 10 mL until the nurse told me that for her gestational age, she would really only expecct her to nurse once for every 2-3 gavage (ng tube) feeds, and the fact that she takes in 10 mL each time is even better. So that reassured me quite a bit.
I am being fed hospital food for free while I am here in a boarding room. It is a new thing they are trying out for mothers who are nursing their babies in the NICU. It may not be great food, but I don’t have to cook!