symptoms of pre-eclampsia except the high BP readings, the onset can come quick. Prolonged high diastolic numbers lead to stroke and stroke in pregnant women is really, really bad. So even though I feel fine I have this little monster following me around. Okay doc, fair enough - I'll pack a bag.Today was the first check-in of the week and over the weekend I double-checked that packed bag because I had 3 reading that were /100+. But the follow up reading was back in the upper 80's.
Roller Coaster, yeah, ooh, ooh, ooh, ooh. [end song break]
All day Monday I was back down so I took my little sheet of blood pressure readings to my appointment expecting to ask Mernitz about the little jump. In office BP reading was 150/88, still back down from the weekend. Sat through the NST, had to follow him all over my belly as he was on the move and then very, very still. Mernitz came in, checked the NST - looked good, then checked my at home numbers. Well apparently I should've called after the 2nd reading. "Reeda, doesn't look like your BPs going to let us get to 36 weeks." Let me mention here that the wonderful bag I packed over the weekend, grabbed from the bedroom and moved to the couch while I put my shoes on for the appointment...remained on the couch. Gotta work on the follow through! So I'm thinking it can't be today; don't have my bag! Mernitz asked if I had blurry spots, unexplained headaches, pain in upper right quadrant - Nope, nope and nope. He said I was due for some lab work and since it was coming up on 4p it would be quicker to get my blood drawn in Labor & Delivery. And since I was over there and the cutoff for the 2nd round of steroids is 34 weeks and I'm at 33 - let's go ahead and get that started too. Sure thing doc, no big deal. At the time I didn't know I'd still be in Labor & Delivery two hours later waiting on the blood work results and since I was already there "let's just hook you up to the monitors to keep an eye on the little guy and check your BP." Hmm...starting to smell like a trap. But all was good and I was on my way home a little after 6p.
Last week when Mernitz explained all the bad parts of having extended high blood pressure he mentioned doing an amniocentesis if we were 35-36 weeks and flirting with delivery. His primary concern was lung development. And while we were 7 weeks ahead of Madi's delivery and fairly comfortable with our odds that really shouldn't be a factor in the decision to deliver early. I hear ya doc but then again - we are 7 weeks ahead of the game and we do know we're better off every day/week and you betcha that comes into consideration. Today he offered an alternative to the amnio since we're still early - a biophysical profile on the little guy. Double-check his NST passing score and make sure his development since 29 weeks is on track. The biophysical profile (BPP) - keeping up with the abbreviations?? - will be done by Maternal Fetal Medicine. Mernitz explained that any anomalies with one done in his office results in a follow up over at Maternal Fetal so might as well just skip to them. Sounds good to me! We'll have another NST, look at organ function and then grade these 5 components from the ultrasound:
(1) nonstress test
(2) fetal breathing movements (one or more episodes of rhythmic fetal breathing movements of 30 seconds or more within 30 minutes)
(3) fetal movement (three or more discrete body or limb movements within 30 minutes)
(4) fetal tone (one or more episodes of extension of a fetal extremity with return to flexion, or opening or closing of a hand
(5) determination of the amniotic fluid volume (a single vertical pocket of amniotic fluid exceeding 2 cm is considered evidence of adequate amniotic fluid)
So he'll get 2 points for passing the nonstress test, 2 points for kicking or stretching, 2 points for just moving around and the other two I figure we'll pass but I couldn't tell ya what his breathing's like or my fluid volume. At 29 weeks there was plenty of fluid. As long as he scores an 8 or higher doc will be pleased. If we get a 6 or lower that hospital bag better be in the car cuz Mernitz will want to talk delivery. Previous NSTs might have been passing but with the lower biophysical profile score that means the high blood pressure is affecting the little guy. And that means:
The scales are no longer balanced.
Since it was so late in the day when we developed this new game plan we are waiting to hear from Mernitz's nurse on when we can get in tomorrow (today) for the BPP and which office. They have an office across the hall from Mernitz as well as one in St. Vincent Women's.
If I stop and think about it I go back and forth. Yes I don't want to run the risk of "swirling the drain" as Mernitz has referenced a couple times so if the high blood pressure can spike quickly I'd rather not go through another emergency hospitalization & c-section. No I don't want to deliver yet even though we're at 33 weeks...we're only at 33 weeks, 3 more to go and we'll be at 36 and in a much safer place. Yes I want him to continue to develop is the safest environment. No I don't want that to be a NICU. I know God's working the plan He has in place but I'm selfishly hoping that includes 3 more weeks of pregnancy.
Which is the primary reason you're getting this short novel to read at 4:30 in the morning. *wink*
Reeda - turn off your brain, turn on your Faith filled heart and go back to bed. Tomorrow's events will come and there's nothing more you can do than approach things with a calm and rested spirit.
Maybe with all this written down I'll be able to take my own advice. Let's go give it a try.
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