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Wednesday, August 13, 2014

Gestational Hypertension

Gestational hypertension, also referred to sometimes as pregnancy induced hypertension (PIH) is a condition of high blood pressure during pregnancy.  Gestational hypertension can lead to a serious condition called preeclampsia. Hypertension during pregnancy affects about 6-8% of all pregnant women.   
   --The American Pregnancy Association

The last 2 weeks have been a whirlwind. An unexpected one at that. Let's rewind. Andrew and I were planning on taking a babymoon, a mini vacation for just the two of us before baby comes, from Aug 1 - 4 (Friday through Monday). Thursday, July 31, I finished up work, went grocery shopping, got a pedicure and headed home. I had borrowed Nanny's blood pressure monitor after a slightly high reading at my appointment that Wednesday, but was assured it was probably a fluke and we'd be fine. But just in case I was instructed to take the monitor on the trip to keep check on it. When I got home Thursday evening I plugged up the bp monitor and tested it out, to make sure if worked. What do you know? High reading! I don't remember the exact number, but somewhere around 155/95 (140/90 is considered high). I waited about 30 minutes and retook it. Even higher. I think around 165/95. Cue mini freak out. Andrew was working and would be at work until about midnight. I texted my mom and asked her what I should do. Could it be the wrong cuff size? Could the machine be malfunctioning? Could my pressure really be that high? We decided the best and safest option was to go to the fire department down the road from my house to have them check it.

I arrived at the fire station around 8:45, pretty flustered and nervous. The kind men at the station listened to my rambling explanation of why I was there and put the cuff on me. Guy did the reading, had a confused look on his face, inflated the cuff a bit more and said, "Well, it's definitely high." Like 198/120. I was told I needed to go to the hospital immediately. Those numbers are dangerously high. They knew I was alone and asked if I needed a ride, but I assured them I was ok to drive myself. Luckily the hospital I will be delivering at is only about 10 minutes away, less if I need to be there quickly. I thanked the guys, got in my car and headed home to grab a few things since I had no idea how long I would be at the hospital. I got my phone charger, a change of underwear, my glasses and some contact solution. Just the necessities. I called my mom to tell her what they said. Midway through the conversation I lost it. I just started crying. I couldn't reach Andrew, was worried for mine and Hannah's health and was alone. She said she would head to the hospital right away, and I did to.

I arrived at Labor & Delivery at 9:30, checked in and was put in a room with 2 beds for observation and monitoring. They were just getting me hooked up to everything when Andrew returned my 15 calls. I told him something along the lines of, "My blood pressure is really high, I'm in the hospital, the nurse is trying to take my blood pressure, I need to go." I was rocking a sweet hospital gown, a monitor for a Non-Stress Test (NST) to keep an eye on Hannah, a contraction monitor and a blood pressure cuff. They took urine samples, multiple vials of blood, bp readings every 15 minutes. The works. Mom and Kristina arrived shortly after I was situated and helped keep me occupied. Andrew apparently didn't understand the severity of the situation and didn't leave work after we spoke like I thought he had. I guess I was so quick on the phone he thought things were ok. After a late start he finally left work, only to end up getting stuck in the wrong parking deck. Poor guy. Mom bailed him out and he made it to the hospital about midnight. My blood pressure was down, but not enough. Hannah was fine and under no stress. She thought it was a party and showtime because she would not stay under the fetal monitor. She was moving all around and I had to keep readjusting the monitor to keep track of her.


At 12:30 am they gave me a half dose of a blood pressure lowering medicine, labetalol, since my bp had stabalized at a number that was still too high. I had to wait 2 hours after the dosage to see what happened. Finally my pressure got low enough to be released. I think it was about 130/80, something close to that. We got home about 3 am and passed out. I woke up early Friday to schedule an appointment with my OB, and was ready to see her at 9:00 after too little sleep. I let Andrew sleep in since he'd worked a double and sat with me at the hospital. I didn't think the visit would be all that important or bad, so I thought I'd be good on my own. I was mistaken.

After I got in the office and was talking to Dr. Rodriguez I realized how serious this was. She said my body was "heating up" and once it starts it usually progresses pretty quickly. Especially since mine started earlier than usual (apparently she doesn't deal with it until about 35/36 weeks most of the time), I was more at risk for it progressing. There is also a heightened risk for it to turn into pre-eclampsia, which is even more serious. She told me to expect to deliver within the next few weeks. I was 29 weeks and 2 days at that point. She said she would be happy (and surprised) if I made it to 34 weeks. I was sent for a growth ultrasound and ended up waiting almost an hour -- longest hour of my life. I was given instruction to complete a 24 hour urine sample at home, not to move around very much, monitor my pressure every few hours, and if it got over 160/110 to head straight to the hospital. 

I got home and had to tell Andrew all of this news, including what to expect with such a young preemie. We're talking the chance of a 1-2 month NICU stay, risks for cerebal palsy, blindness, and more for her, or stroke and seizure risks for me. Not good stuff. He knew I needed support because he just let me cry. He held me, I cried, we talked about it, and resolved to do the best we could to keep Hannah in utero as long as possible. He looked up foods that lower blood pressure, made a list and headed out to the grocery store. We stocked the pantry and fridge with the healthiest possible foods. While GH is a risk for any first time moms, coupled with my genetic disposition for it (multiple family members have high blood pressure, and mine was borderline high before pregnancy), my diet didn't help either. I have preferred salty foods and sodas over veggies and water. (Although multiple doctors have assured me there was most likely nothing I could have done to prevent this, and my diet did not cause it. But I doubt it helped). Andrew put me on a strict diet and the doctor put me on modified bed rest. No shopping, walking, I could take a shower, walk around the house as needed, but that was it. So we spent our 4 day babymoon at home worried about Hannah and my safety, rather than relaxing in the beautiful mountains of Blue Ridge, GA.

Now let's fast forward. The 24 hour urine sample showed protein in the normal range (236/300, so higher than it should be, but not a real concern just yet), which was great news. In the almost 2 weeks since all of this started I've gone back to work, but still have to take it easy. I check my bp every few hours. I can do short shopping trips, but slowly and calmly. My blood pressure averages about 145/88, give or take. It's a little higher in the mornings then lowers around lunch time. I've actually lost about 4 pounds (mostly water weight I'm assuming) since eating my new clean diet. Coworkers have mentioned that my face looks thinner. I feel better, Hannah is still a raver, and things are going well.

I go to the doctor 2 times per week, and will continue to do so until she's delivered. Once a week I do lab work, growth scan/amniotic fluid check, NST, urine samples, the works. While my blood pressure has been really good considering everything, it could easily spike at any time, or I could start showing protein in my urine which would probably be immediate hospitalization. GH can affect baby's growth or cause damage to my liver and kidneys, so we are being extra cautious and keeping an eye on everything. I told my OB that while I like her, I don't like seeing her twice a week. But we have to know what's going on in my body and with Hannah, so we are going with it. 

I've made it to 31 weeks, which is wonderful. Every day and week I stay pregnant is a huge step for Hannah's development. Someone told me that 1 day of life in a NICU isolette is equivalent to 2-3 days in utero. I'm not sure how exact that is, but it puts into prospective how important each day is for her. The doctor still doesn't think I'll go much past 34 weeks, and I definitely won't make it to full term, but I'm hopeful. If we can keep my blood pressure stable and no protein in my urine, we should be able to keep this up. Babies are considered full term at 37 weeks, so that's my hope, but even 34/35 weeks would be a much better start for our sweet girl. Obviously we don't want her to spend any time in the NICU, but we will deal with whatever happens. Andrew has been amazing throughout all of this. He's been my strength. We have also had so many friends and family offer prayers, support, help and anything we need, which makes us so thankful and humble. We are surrounded by some awesome people. And Hannah has a lot of people here on earth, and her angels, looking out for her. 

While neither Andrew nor I are religious people, we do believe in the power of positive thoughts and prayer. We may not agree on to whom or where those prayers go, but I fully believe they are helping. They are helping my body stay strong, Hannah continue her development, and our sanity stay level. 

Please keep us in your thoughts as we try to make it as long as my body will hold on. 
For now we are holding on strong!

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