Last Friday I had my twenty five week midwife appointment. It’s nice that since changing hospitals, I don’t dread midwife appointments any more and I actually look forward to them. It does make the world of difference.
I made a bit of a boo boo when getting ready in the morning by wearing a long sleeved top. I had done so well up to that point! Picked the good jeans so bump access was easy… but nope had to ruin it with a long sleeved top. Ooooooh well!
The appointment rolled around and my BP was taken by the healthcare assistant. 115/92. I always plug my BP into my pregnancy app at every appointment, and it came up with an alert that this was high. Last appointment it had been a bit elevated too at 141/84, but I hadn’t queried it as the midwife didn’t mention it. This time I decided to query it as the “high” alert was worrying me. The midwife confirmed that my reading was a little higher than they like it (they want under 140/90) so she would check it again at the end of the appointment.
The midwife had a listen to Eden’s heartbeat, which was great. Every appointment makes me more sure that this child is a total drama llama, because of course she kept moving away from the doppler! We found her a few times and then the midwife was satisfied that she sounded great, so we left it. The midwife measured my fundal height, which was right on target at twenty five centimetres and we discussed Eden’s movements.
Then, we took my blood pressure again. It was up further at 142/96. The midwife explained that they prefer it below 140/90, so I should head up to the day unit to be monitored and reviewed by a doctor. I have to admit, this was very bloody scary. She reassured me that it was only JUST over the threshold, but it was important to get a dr to look at it now instead of after my next appointment. She told me to grab some food before heading up there, as it could be a wait.
I called Amy and told her what was going on, and she reassured me that it was all going to be ok. I had been at work in the morning, so had actually ended up going to my appointment with the department’s banking and post (I work in the same hospital), so had to sort all of that out before going to get some food. I phoned my supervisor, who said not to worry and just keep him updated. I grabbed some food at the hospital canteen and then headed up to the unit.
I was a little worried as I know the antenatal day unit operates a lot like accident and emergency, so I would be low priority and likely in for a very long wait. Luckily, I had a book and a phone charger with me, so all was not lost! Surprisingly, there was only one other lady in there, so I booked in with the midwives and took a seat. Before long I was called through to a cubicle and they ran through a bunch of symptoms – none of which I had. My urine had been clear except for a few white blood cells, so no protein. I had the very beginnings of a headache, but nothing severe, and I was negative on every other high blood pressure symptom. She took my BP again and it came up at 135/85, which is within normal limits. The midwife then listened to Eden’s heartbeat – of course she was in a totally different place than before – which was great. Everything looked fine at this point, but they took bloods for pre-eclampsia just to be sure. The midwife reassured me that the results would be back in two hours, at which point I would be reviewed by the doctor and then they would decide whether I could go home. She also gave me some paracetamol for the headache that was continuing to grow.
An hour or so passed in my little cubicle and the dr swung by. I have to say, she was a little bit abrupt and also did that fun thing where everything gets blamed on BMI, but she told me I was VERY unlikely to have pre-eclampsia due to the absence of protein in my urine or any other symptoms on it. She told me I am considered to be high risk for gestational hypertension, which may later become pre-eclampsia, but it was impossible to say what would happen from this point. She then asked me to wait for the midwife to take my BP one more time before leaving and then I could go home – result!
The last two BP checks were 141/85 and then 145/91, which the midwife agreed was borderline anyway, so they were still sending me home. I received an appointment for the BP clinic for next week and instructions to get a BP monitor and monitor at home. If any reading was above 140/90 I should go back, but otherwise just wait for the BP clinic appointment.
I have to admit, my brain was in overdrive on the way home. High BP is pretty scary. The doctor had told me that they normally see onset of gestational hypertension after around thirty six weeks, so this early is a little bit of a worry. It raises need for interventions and risk of emergency caesarean if it continues to rise to dangerous levels as well as risk of placental abruption, growth problems for Eden and her having to come early, which would mean NICU time. Plus it obviously greatly raises the risk of pre-eclampsia, which is VERY scary. All things we want to avoid if at all possible.
A friend very kindly lent me her father’s blood pressure monitor, which saved us a bit of money so is always appreciated. Every reading at home so far has been normal, which is great. I was doing a bit of research, however, and it seems that the hospital may have been using the wrong size cuff. The process of taking my pressure had been really quite painful and had made my finger tingle, so when I measured my arm and realised that they should have been using the large cuff instead of the regular size, it became a little clearer. Apparently the wrong size cuff can artificially inflate readings. So, when I go to BP clinic on Wednesday I will ask if they think it’s appropriate to use the large cuff, as that’s what the Blood Pressure UK website recommends. It may not make any difference at all, but if I’m going to end up with a gestational hypertension diagnosis, I want it to be 100% accurate. With my numbers only just being “high”, I think maybe the cuff may be the problem here.
In the mean time, I intend to keep making healthy food choices with low salt, as well as keeping hydrated and having daily exercise. I’m not sure whether these things will help, as if this IS genuinely high BP, apparently some bodies just react to pregnancy in this way and there’s nothing can be done. But I figure these things are good for me and for her in the long run anyway, so might as well give them a shot!
I have to say, the whole thing quelled my fears about the day unit. It had been a place that I really didn’t want to go, but the care and compassion showed by everyone there means I would not hesitate to visit again if I needed to. It really cements that we made the best decision in terms of changing hospitals, because everyone I have come across at this hospital has just been so helpful. I hardly ever have to ask questions as people don’t hesitate to explain what they’re doing, and I very much feel like I’m treated like a human and not just a “vessel”, which is how I felt at the last place.
Aside from that, my consultant appointment is tomorrow (Monday). It’s basically the same appointment as I had at the last hospital. I’ve been referred because of BMI of 33 and I’m assuming the possible hypertension will now come up. I know what will come of it – I’m expecting to schedule a glucose tolerance test and an extra growth scan at about thirty two weeks, which is what the clinical excellence guidelines say. It’ll be nice to see her again. I’m not looking forward to the glucose tolerance test, but it’s a necessary evil as gestational diabetes is a scary and dangerous beast! We’re hopefully booking a 3D scan for some time next month as well, just for funsies.
Less than fifteen weeks to go and this crazy journey will be done and we will be mummies! I just hope there’s not too many more twists and turns along the way. After three years trying, I might have known this would be a rollercoaster!