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Hypertension

post #1 of 14
Thread Starter 

I am cross-posting this from my DDC because I am just so bummed about it.

 

 

 

Quote:

Had my 35+6 appointment this morning. Not all good news, unfortunately. My blood pressure was sky-high (147/80!!!!!!) which absolutely floored me because I felt calm and had measured it at home last night at 105/82. She took it again at the end of the appointment and it was still 137/79. gloomy.gif The cuff was down oddly low both times and felt like it was tightening around my elbow, so I'm not sure these are the world's best readings... but still, it was repeatable so I have to accept that it is what it is.

 

So, they did a protein test on my urine and that came out negative, which is at least good. Baby is head down, low, lying along my left side now (weird... she was on the right side for so long), HB in 140s, I feel lots of movement pretty much every day, so MW said, considering that I haven't measured anything over 120/80 at home, there is really nothing to worry about at the moment and her level of concern about this is very low. Still I'm only 36w, a first-time mom so it is really unlikely I will go into labor on my own before my due date, and I know this is likely to get worse quickly instead of better. 4 more weeks seems like an eternity right now when I know even very healthy people often start to have problems past their due date. I am returning next week for my next appointment.

 

Although I know this is probably more a function of my weight, genetics, etc. I am REALLY resenting my job right now. It's a very stressful week where I could probably work 60+ hours if I wanted to. I never really had any intention of doing that (I'm so tired and spacey these days that I end up in tears if I try to work more than an 8-hour day, plus we have baby-related commitments pretty much every night this week so it's not like I can stay here till midnight anyway... of course I am constantly aware of being lucky that I even have a choice, and that weighs on me too) but it's still really stressful to have to tell people no, or to know that other team members are working insane hours and I'm not holding up my end of the bargain.

 

I'm pretty sure now that I'm going to end up with a scheduled induction, which I have been afraid of since day 1, but the pregnancy has gone so well that for a while I started to think everything would be OK. I'm just so disappointed and worried right now.

 

The part I didn't want to get into in the DDC post is that a lot of why I am so upset is that there is also a big selfish part of me that does not want to be everyone's obesity epidemic poster child. If I have ANY pregnancy complications, my mom, MIL, SIL, and everyone I know will be whispering sadly about how they just knew this was going to happen and I'm lucky I made it this far, maybe now I will take my health seriously, etc.

 

I mean, of course I am worried about my baby, and if she needs to be born early to be safe, then bring on the induction. I am 36w now so if it needs to happen, I know it is not ideal for her, but the odds are pretty good; however, she will still be a preemie with all the associated risks. So there's definitely that concern. But just for myself, I HATE when my personal struggles with my health become public for everyone to comment on. I think at least from a Facebook standpoint, if she arrives early for any reason, I will not be offering an explanation or any details about the birth. I can at least avoid having complete strangers judge me any more than they already do.

 

The good news is that my BP measures normal at home, I don't have proteinuria (yet), I've only gained about a pound in the last couple weeks which is nothing to raise an eyebrow over, and I have had no serious symptoms or significant swelling, so there is a slight possibility that if I can get past this week at work, things will be OK. I have had mild headaches but god's honest truth, I really think that is because I worry so much about my blood pressure/pre-e and am constantly obsessing about real and imagined symptoms day and night. greensad.gif

 

Thanks for listening... I figured you guys were most likely to understand.

post #2 of 14

Joining the group to respond to this- sorry you're having to deal with it, mama. hug2.gif

 

Totally get what you mean about not wanting to be a 'poster child'- a lot of people have inaccurate negative expectations about what a plus-size pregnancy is going to be like, and even if you know logically that plenty of thin- and average-weight women have pregnancy-related BP issues, the last thing anyone wants is to be 'evidence' for someone else's misconceptions. I'm not sure if you've had BP issues prior to this? It sounds like things may still be okay, yeah? The only thing that comes to mind other than sending a hug is that you mentioned the cuff felt weird.. It's hard to fight the urge to be an agreeable 'model patient' sometimes, but I'd just urge you not to dismiss that kind of thing if you think it's off, or if your mw forgets to use the larger cuff for you, or if anything else is going on that might be affecting the reading, including the very act of worrying so much about it.

 

And I'm cheering you on re: keeping any details private that you want to- you're exactly right that you don't owe anybody on Facebook, at work, or whatever any explanations.

 

Keep us posted. :)

post #3 of 14
Thread Starter 

Thank you so much for the support. I agree I should probably have said something about the cuff... but the same nurse takes my BP every time I go in, so she knows I have had problems with it, and it would just be so embarrassing if the reading ended up being the same. I just couldn't get myself to say anything about it.

 

My blood pressure actually is a little high outside of pregnancy... often sort of 110/70 to 120/80, but it is not unusual for me to get readings that are more like 130/80 or even a little higher. I know this is not ideal for my health but at least it's not insanely higher now than it used to be (well, except for that 147/80... I about fell out of my chair).

 

It's also hard struggling with the guilt/frustration of knowing that if I had taken better care of my health before I got pregnant or been more careful about limiting my weight gain, I may not be dealing with this right now. I sort of feel like "if I have to be induced now, it's my own fault." Which is not a productive way to think even if it is "true," but pregnancy-related health/weight issues have really been messing with my head.

post #4 of 14

I'm sorry you're stressing over this! I've been through some worries over my BP (& protein in my urine) and found this article pretty interesting: 

http://www.thepermanentejournal.org/files/Summer2009/blood_pressure.pdf

Also, from what one of my midwives told me, the upper number is more variable to things like stress/talking/etc. while the lower number isn't. So if that is staying pretty consistent, and neither number is jumping TOO much, it might not be significant, especially if your BP was on the high end pre-pregnancy. I think I have a bit of white coat syndrome, and they usually take my BP *before* we listen to the baby's heartbeat, which seems kind of ridiculous (especially before I could feel movement, so the doppler was my confirmation my baby was still around and I was understandably anxious to hear it). And most of the time someone's asking me questions, I'm sitting on the table instead of with my feet on the floor/back supported, etc., plus I'm always worried that my BP will be high, so... no wonder if it is! 

 

If you are getting normal readings at home, I say try not to worry too much! And hopefully next time you will get a better reading in the office, too. If it's not done correctly & it's high again, I'd bring it up to your midwife & ask her to take it when you're at your calmest during the visit to see if that helps. 

post #5 of 14

I'm in your DDC, so I've seen some of your concerns about it, and can also empathize with the components of it that you're posting here. I'm starting to have some issues, too. I was actually in the hospital the other night for a few hours for observation after my BP continued to increase over subsequent visits and then was reading at 158/90 over two appointments with different doctors on the same day, along with some headaches. I also had the same concerns about cuff size but didn't say anything. However, I will say that when I was at the hospital they were using a similarly sized cuff and over the monitoring period my BP went down to 110/70, so that makes me feel less like it was the cuff and more like it was either the stress of running around all day or just being worried about the readings.I don't know, but I'm starting to worry more and more about it myself. As my OB put it, I fall into every single risk category for preeclampsia, regardless of the fact that this has really been a very smooth pregnancy (well, aside from the pre-existing diabetes- which has been very well managed) and I've felt great to this point, but I'm guessing I'll either be hospitalized soon for longer term monitoring or that they'll push for an earlier induction.

 

As far as feeling like a poster child, I totally get that and I fight that every day. My family is all in great shape- very healthy and thin, and I've been overweight my whole life and when I was finally diagnosed with diabetes it just felt like there was the "I told you so" moment, plus a lot of pity and concern, leading to a lot of shame on my end. With my last two children, I had an OB that I loved and trusted who made me feel confident and comfortable about who I am and wasn't afraid to manage my pregnancies normally while being matter of fact, not shaming, about my weight. Unfortunately she stopped delivering this year so I'm seeing another OB in the practice and I just don't feel as happy with her. She seems to be uncomfortable about my weight issues and skirts around it, using phrases like "extra tissue", etc. It's really too late in the game to start looking for someone else so I'm just letting it ride but for me the answer is that I'm not going to stop looking. I'm going to keep going doctor to doctor until I find one again that I'm comfortable with and maybe it would be helpful to you to do the same?  When I did have that relationship with someone it felt SO good, and I deserve to have that again so I DO feel comfortable, both physically and emotionally, in being a partner in my long term health care. I'll also say that it has nothing to do with OB to midwife, etc. in my opinion - it's all based on the person. I had an appointment with a midwife in a birthing center once that left me feeling more shamed than any other appointment I've ever had. She was clearly disgusted with me and my body and it took me over 5 years to go in for a well woman appointment after that. 

 

Sorry, this is a long and rambly vent and I'm too tired and grouchy to re-read it and edit it. The bottom line is that I'm with you on both issues. Here's to hoping that we both end up sailing through the rest of our pregnancies with beautiful blood pressures ;)

post #6 of 14
Thread Starter 
Quote:
Originally Posted by eleuthia View Post

I'm sorry you're stressing over this! I've been through some worries over my BP (& protein in my urine) and found this article pretty interesting: 

http://www.thepermanentejournal.org/files/Summer2009/blood_pressure.pdf

Also, from what one of my midwives told me, the upper number is more variable to things like stress/talking/etc. while the lower number isn't. So if that is staying pretty consistent, and neither number is jumping TOO much, it might not be significant, especially if your BP was on the high end pre-pregnancy. I think I have a bit of white coat syndrome, and they usually take my BP *before* we listen to the baby's heartbeat, which seems kind of ridiculous (especially before I could feel movement, so the doppler was my confirmation my baby was still around and I was understandably anxious to hear it). And most of the time someone's asking me questions, I'm sitting on the table instead of with my feet on the floor/back supported, etc., plus I'm always worried that my BP will be high, so... no wonder if it is! 

 

If you are getting normal readings at home, I say try not to worry too much! And hopefully next time you will get a better reading in the office, too. If it's not done correctly & it's high again, I'd bring it up to your midwife & ask her to take it when you're at your calmest during the visit to see if that helps. 

 

Thank you so much for all your kind words! This is very helpful. I had seen that article and I do think it is really informative. I think I'm going to ask the nurse to move the cuff higher next time. I can only imagine that by the time I get done with the stress and embarrassment of confronting someone, my bp will be even higher, but it's worth a try.

 

I have doubled up on my calcium supplement in the last couple of days, and really tried to focus on protein and getting enough water in. I hope these things help. I was worried that the bottom # was creeping up, but then it was lower again yesterday, so that made me feel a bit better for the time being. 

 

Quote:
Originally Posted by Shinyredstar View Post

I'm in your DDC, so I've seen some of your concerns about it, and can also empathize with the components of it that you're posting here. I'm starting to have some issues, too. I was actually in the hospital the other night for a few hours for observation after my BP continued to increase over subsequent visits and then was reading at 158/90 over two appointments with different doctors on the same day, along with some headaches. I also had the same concerns about cuff size but didn't say anything. However, I will say that when I was at the hospital they were using a similarly sized cuff and over the monitoring period my BP went down to 110/70, so that makes me feel less like it was the cuff and more like it was either the stress of running around all day or just being worried about the readings.I don't know, but I'm starting to worry more and more about it myself. As my OB put it, I fall into every single risk category for preeclampsia, regardless of the fact that this has really been a very smooth pregnancy (well, aside from the pre-existing diabetes- which has been very well managed) and I've felt great to this point, but I'm guessing I'll either be hospitalized soon for longer term monitoring or that they'll push for an earlier induction.

 

As far as feeling like a poster child, I totally get that and I fight that every day. My family is all in great shape- very healthy and thin, and I've been overweight my whole life and when I was finally diagnosed with diabetes it just felt like there was the "I told you so" moment, plus a lot of pity and concern, leading to a lot of shame on my end. With my last two children, I had an OB that I loved and trusted who made me feel confident and comfortable about who I am and wasn't afraid to manage my pregnancies normally while being matter of fact, not shaming, about my weight. Unfortunately she stopped delivering this year so I'm seeing another OB in the practice and I just don't feel as happy with her. She seems to be uncomfortable about my weight issues and skirts around it, using phrases like "extra tissue", etc. It's really too late in the game to start looking for someone else so I'm just letting it ride but for me the answer is that I'm not going to stop looking. I'm going to keep going doctor to doctor until I find one again that I'm comfortable with and maybe it would be helpful to you to do the same?  When I did have that relationship with someone it felt SO good, and I deserve to have that again so I DO feel comfortable, both physically and emotionally, in being a partner in my long term health care. I'll also say that it has nothing to do with OB to midwife, etc. in my opinion - it's all based on the person. I had an appointment with a midwife in a birthing center once that left me feeling more shamed than any other appointment I've ever had. She was clearly disgusted with me and my body and it took me over 5 years to go in for a well woman appointment after that. 

 

Sorry, this is a long and rambly vent and I'm too tired and grouchy to re-read it and edit it. The bottom line is that I'm with you on both issues. Here's to hoping that we both end up sailing through the rest of our pregnancies with beautiful blood pressures ;)

 

Hugs to you... I know you have struggled with finding good pregnancy care this time around, and that midwife sounds awful... although I don't really love the idea of the "extra tissue" euphemisms either. I'm not even totally sure why weight needs to come up in prenatal appointments unless they feel we are gaining too much. If they feel like I have risks or conditions because of my weight, then they should treat them, but it's not like I'm going to be able to get thin in 9 months so bringing up weight specifically seems unnecessary. It can be done in a reasonable manner, but most docs don't exactly have that skill set.

 

It does sound like your bp was fine during monitoring, which is great. I think it would stay high if there was a problem. Also, we've made it this far in the pregnancy, which seems like a good sign.

 

I do love my midwife, and she is not even worried (has never mentioned my weight unless I bring it up, and feels that my blood pressure and other indicators are fine and I just need to relax) but I can't seem to turn my brain off. Like right now, I can't sleep because we turned the a/c on last night, which always causes me to sleep poorly, and the cats were being a pain. Fine. But yesterday I stupidly read a bunch of internet stories of otherwise healthy women who had no symptoms but were on death's door from pre-eclampsia in a matter of days, so of course my immediate thought is "Do I have a headache? Are my fingers swollen? Should I get up and take my blood pressure? Why am I awake--am I sick?" By the end I was laying there convinced I was about to have a stroke... and I basically feel fine except for how I can't sleep. irked.gif

 

I feel like at some point it's going to be become a self-fulfilling prophecy. I can't imagine making it through 3-5 more weeks this way. I feel like my baby and I are poisoning each other or something... very different from how most people feel when they are "ready to be done," I imagine. Lately the worry is that even if I make it through OK, there will be something wrong with my baby.

 

However, I like your last comment a lot and agree, I hope we can do that. I have been trying to repeat to myself "My body is strong and healthy and capable of birthing my healthy little girl" when I get anxious. (My other mantra is "This !@#$ doesn't matter" when I get all uptight about my work. lol.gif) And really, we only have a few weeks to go! I will be thinking of you.

post #7 of 14
Thread Starter 

I went back for another checkup today... still zero-to-trace protein in the urine sample, and BP was 133/84. Not great but not completely inconsistent with my numbers at home. They have been running 110-120 over the mid 80s. Again I do not love these numbers, but my midwife is still OK with everything, so I'm going to try and chill out. I have been having trouble sleeping (I wake up just because I need to roll over or something, and then can't get back to sleep for worrying about my health) and just stressing all the time about this issue, which seems counterproductive to say the least.

 

I do feel good that I asked the nurse to move the cuff up a bit. She didn't have a problem with it at all. I copped out by blaming it on my "stubby arms." smile.gif

 

So... 3 weeks to go. We'll see how far I make it. Shinyredstar, how are you doing?

post #8 of 14

I suffer from serious white coat syndrome.  I actually ask the midwife to wait on the bp, let's do everything else (talk, listen to baby, etc) then take the bp.  What was happening when we took it first was that it was high (not alarmingly so, but still higher than we would like), but after the appointment, it was back down to more than reasonable levels.  One of the midwives assists was surprised and said, it's great that your body can respond so acutely.  LOL.

 

Sometimes when you worry and stress about it, it makes it go up.  I have had that problem since EVERYBODY (not kidding, i mean everybody) in my family (extended and immediate) is on high blood pressure medication - with the exception of me.  Everybody except my Mother and sister had diabetes.  Those kind of head games can seriously work on you and your body.

 

I have dealt with it in many ways-from the beginning.  I kept my gym activity up.  At least 3 times a week.  16 glasses of water a day.  1000mg of calcium everyday (liquid calcium supplement).  I think I have a pretty stressful life.  My mother died unexpectedly, I homeschool (and my kids drive me batty sometimes), my husband works all the time so I have the kids from sun up to sun down everyday of the week - and it goes on and on.  I do the best I can - and that's all you can do to.  You are doing the absolute best for you and baby.

post #9 of 14
Thread Starter 

Thanks so much, lisarenee, for the words of support... I know what you mean about stress making the # go up. Even when I'm at home getting ready to take my BP, I will feel my heart flip-flopping around in my chest because I'm so anxious about what the number is going to be. I try to take deep breaths but there is always a little panic there.

 

I need to make the gym part of the lifestyle you mentioned a priority. I do pretty good with water and calcium, but the past 4 weeks or so I haven't been exercising much. I'm sure that is not helping.

 

I can't remember--did your placenta end up moving? I know you were concerned about a previa early on. I hope you are doing well.

post #10 of 14
Quote:
Originally Posted by scowgirl View Post

I went back for another checkup today... still zero-to-trace protein in the urine sample, and BP was 133/84. Not great but not completely inconsistent with my numbers at home. They have been running 110-120 over the mid 80s. Again I do not love these numbers, but my midwife is still OK with everything, so I'm going to try and chill out. I have been having trouble sleeping (I wake up just because I need to roll over or something, and then can't get back to sleep for worrying about my health) and just stressing all the time about this issue, which seems counterproductive to say the least.

 

I do feel good that I asked the nurse to move the cuff up a bit. She didn't have a problem with it at all. I copped out by blaming it on my "stubby arms." smile.gif

 

So... 3 weeks to go. We'll see how far I make it. Shinyredstar, how are you doing?

 

It seems like you're starting to feel a little better about things... I'm glad to hear that (and I hope that I'm right about that?)

 

I'm doing okay- I've continued to have issues with my BP being elevated. It seems to be sticking at around 140/90. Had an appointment with my perinatologist and my OB this week, and I don't have any other symptoms of preeclampsia so she's deciding not to pursue it at this point, with instructions to watch carefully for any developments and call right away. I have been very puffy and have been getting some headaches, but they seem to be more sinus and/or stress related as I can treat them succesfully at home. I had a history of hypertension and was on medications a fw years ago, but lost about 60 pounds and was able to get my BP under control. I've gained a little more weight than I was hoping for this pregnancy (I really, really didn't want to go back over the 250 mark but have gained quickly over the last few weeks and went just over it) so I wonder if a big part of that is just the fact that I've put the weight back on and it just isn't healthy for me. My weight gain is fairly consistent with my past pregnancies (maybe a teeny bit higher) but I lost the weight quickly after they were born and ended up less than my pre-pregnancy weight by my 6 week checkup, so I'm hopeful that will be the case this time, too. I'm just taking it easy as much as I can, cut back my work hours a little bit, and I'm doing some hypnotherapy for relaxation with my mom this weekend that will hopefully help. I think it's a similar situation to what you're going through - I have a hard time relaxing, even if I'm physically relaxing. It feels like it might be smarter to go ahead and start my leave of absence from work but I'm only taking 8 weeks and I'd really prefer to wait until after the baby is born and spend all that time with her rather than sitting in bed.

post #11 of 14
Thread Starter 

Yes, I am feeling a little better about it... not obsessing so much. I slept really well last night, which was nice. It sounds like you and your providers are taking a great approach to this--keeping an eye on it but not freaking out. I think your strategies for relaxation and cutting back at work are also really good ones. I know what you mean about weight probably not helping... which, if that is the reason for my bp going up, I guess is good in that maybe it's not pre-e, but bad in that it's probably not good for me overall. I am getting close to my highest weight ever right now and have gained about 30 lbs. with this pregnancy, which was more than I was hoping for. But, it's too late now.

 

I got a pedicure last night and it was really nice. Also scheduled some other stuff (haircut, etc.) that I won't have much time to do after the baby arrives, so I should be able to get in some more "me time" in the next week or two. It sounds stupid to say that (come on, I don't have any other kids, it's not like I don't have free time) but it really does help to just sit still and relax for a while.

post #12 of 14
I'm glad you seem to be finding some peace with it. I'm a few years older than you, based on the age in your signature, and was about your age when I originally had the BP issues come up, but was also going through a lot if work and personal stress at the time. As much as I would hate to say it would be a positive for you to just have high BP as the result of the extra weight/anxiety, maybe that is some of it and it'll self-resolve after delivery? Add all the extra blood volume and fluids that go along with pregnancy, etc... Could have been just enough to push it to that point for you. Scary, but certainly not as scary as pre-e?
post #13 of 14

Scowgirl - WOW, I can't believe you would remember.  Yeah, it did end up moving, sometime before I hit 24 weeks.

 

One thing, I don't really understand blood pressure.  I just don't.  My last two pregnancies my bp would creep up a bit then go back down when I was in labor (????).  This time, it seems to be going down in the end (????)  What?

 

I am taking a lot more vitamins to keep myself GBS -.  I have also adopted a high protein low carb diet, and I have been eating a lot (like everyday) of steel cut oats in soy milk.  Does steel cut oats cut own on blood pressure?  Otherwise, I can't understand it.

post #14 of 14
Quote:
Originally Posted by lisarenee25 View Post

Scowgirl - WOW, I can't believe you would remember.  Yeah, it did end up moving, sometime before I hit 24 weeks.

 

One thing, I don't really understand blood pressure.  I just don't.  My last two pregnancies my bp would creep up a bit then go back down when I was in labor (????).  This time, it seems to be going down in the end (????)  What?

 

I am taking a lot more vitamins to keep myself GBS -.  I have also adopted a high protein low carb diet, and I have been eating a lot (like everyday) of steel cut oats in soy milk.  Does steel cut oats cut own on blood pressure?  Otherwise, I can't understand it.

 

I don't know about oats cutting it, though I know they are "heart healthy" so maybe, but reducing carb intake and increasing protein is supposed to help with high BP so I bet that helps!

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