Brunette - my chronic high blood pressure has varied in severity over time but I've had it since I was a teenager (it runs in my family and there doesn't seem to be any cause other than genetics as I'm not overweight, work out (and used to be very athletic at the time it was first diagnosed), never ate salt until I met my DH, etc). Anyway, when they first caught it when I was a teenager, my BP was around 160/100. All through my early 20s it was like that; sometimes I'd go to the doctor and it would be as high as 170/100, which is really bad. For years the doctors had a hard time getting it under control even with medication, and it would go up to the levels I just mentioned. Finally I found a GP (who was also a cardiologist) who was more aggressive in treating it. After that, as long as I was on medication, it hovered around 110/70. I should note that this doc takes a very aggressive view on treating high blood pressure; under my old doc, my BP, when I was on medication, was in the 130-140/90 range, but this doc thought that was still too high so he kept fiddling with my meds till we got it to 110/70, which he thought was perfect. Interestingly, I talked to him about what would happen with my drugs and everything should I get pregnant around the time DH and I first started TTC (way back in 2004!). The doc mentioned that I wouldn't be able to take my drugs b/c they can cause birth defects. In fact, he had a patient who was a Broadway actress who insisted on staying on hers when she was PG b/c it also controlled her stage fright, and her baby was born with a hole in its heart. However, the doc said that the pregnancy hormone tends to naturally suppress blood pressure during, at least, the first half of pregnancy, so he said that his first instinct would be for me to go off all of my drugs when I got PG and just monitor things. We never got beyond that in any discussions since I never got pregnant before I left New York.
When I moved to Australia, my BP ended up lowering a bit on its own -- must be the more relaxed Gold Coast environment compared to working at a high-stress job in NYC - lol. My new GP here in Aus. clearly did not appreciate how bad my BP had been despite my telling him my entire medical history and giving him a copy of my chart, so it took a bit of fighting over the course of several months for him to give me the prescriptions I needed. It seemed that he couldn't believe that a young, healthy-looking person needed those kinds of pills; he just told me to exercise more and cut out salt, which was a total joke considering that I never even touched salt until I met my DH, and used to work out 3 hours a day with the varsity crew team when I was in uni (at which point my BP was very high). Anyway, I finally convinced him that I needed some prescriptions even if he wouldn't refill the exact dosages my NYC doctor had been prescribing (very frustrating), and we got things back kind of under control (keeping in mind that he thought it was ok when my BP was at 135/90, whereas my old doctor was adamant that that level was too high). Then we started TTC more seriously again, so I had a whole new rigamarole when I asked the doctor what medicines would be safe if I was TTC (since I was back on the one that causes the birth defects). Basically, the doctor was clueless. I can't believe he had never had to consider the suitability of BP drugs in pregnancy before. He even told me the drugs I was on were fine, although I knew they weren't. After he told me they were class A (safe in pregnancy), I came back with printouts showing that they were both class D (teratogenic -- ie, causes birth defects), and he was just like, "Oh, I guess I was wrong." Great, and imagine what would have happened if I had beenn dumb enough to listen to you, you dope! I brought in print outs from legitimate medical websites listing the handful of blood pressure drug that are known to be safe in pregnancy (Aldomet/methyldopa and labetalol, in case anyone is curious) and he poo-pooed them. Instead, he told me I had to ask an OB/GYN what I should take and gave me a referral to the most clueless OB I've ever met, who just said, "Why are you asking me? Your GP is the person who should know this". Thanks for taking my $220 for nothing, doc. (This was the same OB, by the way, who at the same visit refused to do a pap smear, which I needed, and had me do an FSH test but then didn't tell me till 17 months later when I finally went back for the pap smear that I had high FSH, should have started TTC with AC the year before, and would have no success with IVF b/c the stim drugs wouldn't work on me. Like, thanks for being so on the ball to tell me this at the time I did the test, dude.) Anyway, I went back to the GP with a big stack of research, thanked him for wasting $220 of mine for nothing, and pretty much told him that since no one here seems to have a clue about high blood pressure in pregnancy, you're just goig to have to do what my research says: put me on Aldomet (generic name methyldopa) so that if I fall PG and don't find out right away my baby won't be injured. He then, finally, tapped away at a few medical sites on the computer while I was sitting there and says to me, as though I had never told him about this drug before, "According to my research I'm going to switch you to this drug called Aldomet!". DUH. Anyway, I did switch to Aldomet. It did an OK job of controlling my HBP, but, unfortunately, I had to go off it because I got this bad form of anemia that is potentially life-threatening that is a known complication of the drug in 25% of women who take it. (Then the same GP started telling me I had to spend $$$ working with a hematologist to figure out what was causing the anemia! Needless to say, I refused to go to the hematologist and the anemia cleared itself up once I went off the drug.)
Right after the Aldomet debacle I started working at a local university and was able to start seeing this great GP at the uni medical clinic. This guy, like my old cardiologist, has a much more "modern" view that even levels in the 130s/90 range are too high. So he put me back on the stronger drugs I was on before and I got back down to the 110/70 range. Before I started fertility treatment, he just told me to let him know right away if I got pregnant (since he knew I was trying), and that we would adjust my drug regimen then. Interestingly, when he gave me my referral for IVF, he just told me to mention my HBP to the FS, and indicated that the FS would tell me what to do about the drugs if I got pregnant. However, even though the GP mentioned the issue in my referral, the FS never once even mentioned my BP to me. Granted, I didn't bother asking him either except for at my first meeting with him when I mentioned that it might be an issue, so I can't pin all the blame on him. I should have insisted on speaking to him about it at some point before I got my BFP, but I somehow thought I would jinx things if I did, so I didn't. Anyway, clearly high blood pressure in pregnancy is a bit of a black hole in that the GPs think it's the pregnancy docs' problem, and the OBs seem to think that garden variety high blood pressure (not pre-eclampsia) is the GP's issue.
SO, after this long and convoluted tale, what's ended up happening with me is that I realized about 2 days after my positive blood test that I better stop taking my meds, so I just stopped them cold turkey before I even had a chance to talk to a doctor. I realized that very early pregnancy is the exact time when they do the most damage, and, in fact, I'm kicking myself that I took them at all during the 2nd week of the TWW. Well, I just have to pray that 2 weeks or so on the drugs didn't do the embie too much harm. Then I went in to my GP this past Tuesday to let him know I was PG and discuss the drugs. First, he was shocked that the FS had blown off the stuff he mentioned in the referral about my HBP. He said the FS should I have been on top of that even if I wasn't nagging him about it. After the confusion my with old GP and old OB/GYN, I just said that I wasn't surprised. Second, he mentioned that his natural instinct would have been to put me on Aldomet, since it's safe in PG, but that he couldn't since he already knew I couldn't tolerate it. (How nice to have a doctor who listens to what I tell him, unlike my original GP down here!). Then, he said that his next instinct was to keep me off drugs at least for the first trimester and see how I did. I mentioned to him that that was my old cardiologist's plan, based on the fact that HBP supposedly naturally goes down in PG, and he agreed. However, he said this would all be dependent on my BP actually lowering on its own. If not, he said that he would refer me to a cardiologist to see ASAP, with the idea that the cardiologist would find some other drug to put me on and would monitor me closely during the PG along with whoever I get as my OB. If my BP was OK, however, he said that he would be comfortable not to give me the referral and just to continue monitoring me himself. So, the big moment was when he took my BP. On his first try, it was 136/90. He was that was too high, and that if I was consistently over 135/90, he would be sending me to the cardiologist. 5 minutes later, he took it again, and it was down to 127/79. He was happy with that. He told me I'd have to monitor it daily, however, and if it crept up to the point where it was consistently over 135/90, I had to call him immediately. Since then I've had readings the past few days in the 120/80 range, including 118/80 when I went back to the med clinic on Friday (2 days ago) at the doc's request and had his nurse take it, and 120/72 yesterday when I got back from acupuncture. I've never had my BP that low without medication since I was about 13 years old, so I guess it's true that pregnancy really does naturally lower blood pressure. As for you, Brunette, it's interesting that yours has gone up, but I suppose with all the stress you've been under with your pregnancy, perhaps it's not surprising. Is your doctor concerned about it? 140/80 really isn't all that high, esp since your systolic # (80) is still looking great, and I suspect that if it's only like that for a few months he probably won't do more than monitor you for pre-eclampsia. As for me, that's my biggest concern: the fact that people with chronic HBP like me have a heightened risk of pre-eclampsia. But I'm not going to worry about that until I'm a lot farther along.
Sorry for the long story, but I thought this might be interesting not only for you, Brunette, but also for anybody else dealing with blood pressure issues. (Actually, Brunette, I suspect this level of detail was way more than you wanted to know, but I still put it in just in case it helps somebody out there!!)
LondonMiss - sorry you're feeling sick. I hope you are nevertheless able to enjoy having your best friend out for a visit!
Smithy - nice to meet you.
MissK - thanks for the welcome and nice to meet you!
Lise - you gave me a laugh with the Buttercup story. It must feel quite odd indeed to be leaking before the baby is even born!
Renee - just congratulating you on managing to make it out to breakfast. I hope you continue feeling good!
A big "hi" to Glenny, Leabie, CK77, and everybody else.
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