Thursday 28 February 2013

And my past comes back to haunt me...

No, not that kind of past. Not the slutty, wild and crazy party girl past I somewhat wish I had. Seriously, had I not had such detailed knowledge about herpes, I think I would have been much more promiscuous. So super selective was my screening process that it limited my number to only a handful of special sponge worthy fellows. My genital-urinary tract was kept sterile from any sexually transmitted infections. I never even acquired HPV, as all adventurous women do. Sometimes, it hardly seems that I am reaping any benefits from my selected chastity from a fertilty standpoint, but anyway.. I am digressing...it's my past history of hypertension.

When I was in my early twenties, I had a blood pressure reading of 150/110 at a routine gyn exam. Repeat readings would hold that it wasn't a fluke. I was ordered to stop my birth control pills and my blood pressure returned to normal, thus indicating that the pills caused my hypertension. Although I admit that I don't go to a doctor unless I absolutely need to (and by need to I am referring to my mandated employee physical) I've never had another dangerously high reading...until my recent pre-op visit. I went swimming that morning and arrived at my RE's office early for my appointment, which is unusual as I am chronically tardy. The medical assistant called me into an exam room to take my vitals. Just as she was inflating the blood pressure cuff, I could feel my brachial artery pulsate. Oh shit. "Are you nervous?" she asked before telling me what the reading was. Was I nervous? I was at my RE's office. Nervous is the default setting when I am there. I'm nervous that I'll run into a patient. I'm nervous about what what will be uncovered during my evaluation and nervous about what I'll be told. 146/100. I figured it must have been from the birth control pills. I didn't think my blood pressure would be a problem, as I'm much more physically active now than when I was a student and I would only be on the pills for a short period of time. Add to the list of 'Things I have been Wrong About'.

She sent me back to the waiting room as my RE hadn't arrived to the office yet. There is only one door to the clinic, which is used by patients, staff and delivery personnel. He walked into the office, stopped to grab his labcoat and then called me back to the exam room. After using his stethoscope to confirm that my heart was pumping blood and air exchange was occurring in my lungs, he reviewed the procedure and asked if I had questions. He hadn't looked at my chart to see my blood pressure. I know this because whenever I am running late and don't review the previous notes in the patient's chart, inevitably during the interview something comes up to make me realise that I should have done my research before going in the room. I brought it up and suggested stopping the pills prior to the procedure, which he agreed was a good idea.

The day before my procedure I brought my pills to work and figured I would have one of our MAs check my blood pressure prior to taking the last pill. It was 164/106. Fuck. I checked again a few hours later. 159/108. Double fuck. On my way home I stopped at CVS to use one of their machines. 181/107. I thought alarms would sound and the paramedics would be called. Now I am becoming concerned that my case will be cancelled. I'll have to wait until my blood pressure normalises and I can handle the pre-requisite birth control pills again. In other words, who knows when. I'll beg and plead with the anaesthesiologist like a junkie looking for a fix; "C'mon, just push 5mg of Lopressor in my IV and I'll be fine. 10 mg of Amlodipine orally and I'll be sorted!'

Although the possible cancellation of my surgery is the most prominent concern at the moment, there is a much larger concern looming. If my blood pressure reacts this way to birth control pills, what will happen if I become pregnant? When my cousin announced her pregnancy last year, my aunt expressed how she would spend the next nine months worrying about her high blood pressure. It fueled my false sense of entitlement. This is why it should have been me. I was the healthy one. I wouldn't be causing this kind of worry for my mother if I became pregnant. Ah, once again my delusional thinking gets the best of me. I am being slapped in the face with the reality that I am just as unhealthy as my sedentary cousin who is 40 pounds overweight.

I feel as if the Universe is telling me, 'listen up Bitch, how many more ways do I have to tell you this is a bad idea?' I feel the hypocrisy of my own words. How many times have I told a patient, "first you get healthy, then you get pregnant." I swim four times a week. I run 10Ks for breakfast and I can finish a half marathon in a decent time with only a few weeks of training. I completed an hour postal swim last month. Despite all the exercise that I do, there is something else not in my command. I see Labetalol in my future. If I ever do become pregnant, I will be labelled 'high risk'.

9 comments:

  1. 180?! Yeeks, that is not a good systolic number... I actually have high blood pressure, too, and was getting readings of about 145/100 right before I did my IVF cycle, but they said it wouldn't be an issue with retrieval or the hormones or anything, so I just went ahead and didn't really monitor it (too scared to, I think!). I would seriously look into taking a blood pressure medication that's safe for pregnancy -- there's one that you have to take three times a day, which is annoying, but it's been around for ages and is super safe. ALSO, pregnancy usually lowers your blood pressure at first, and you really don't know what it'll end up doing for the rest of the 9 months... obviously you're at risk for eclampsia but you just need to be monitored regularly and, worst case scenario, you end up on bedrest. But honestly -- lots of women with high blood pressure end up having perfectly normal readings throughout their pregnancies. You just don't know!

    Also, love both the Seinfeld AND Girls reference in the first paragraph!

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    1. Prize for you for identifying both references! Thanks for all your input and insight. I have a friend who did a project for Nursing school where she went around to CVS and Walgreens and found most of their BP machines weren't calibrated. I also have noted that my readings are much higher with a machine reading than a manual one. I have much more faith in someone's ears! While I'm not happy to hear that you also had BP issues, can I say it is comforting to know right now that I'm not the only one! Most importantly, I'm so happy they were able to go ahead with your stims and retrieval and get you knocked up!

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    2. Oh yeah -- honestly, don't worry about it! You will not have a problem with any of the fertility treatments... I'm pretty sure higher estrogen lowers blood pressure, which is why BP tends to decrease in early pregnancy (AND if you're taking estrogen for stimming purposes), so put your mind at ease!

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  2. I don't have any experience with high blood pressure but I hope it doesn't hold you back from your surgery. I do have to say I feel pretty lucky that I never had any problems taking BCP's. I didn't realize how awful they can be for some people until I started reading IF forums and blogs.

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  3. "I run 10Ks for breakfast"...I love it, you are so bad ass! I've heard stories of uber-healthy people with inexplicably high BP, and it seems so unfair! It generally seems to be a genetic thing. But lots of very unhealthy people with high BP manage pregnancies just fine, so if you know what to look out for I'm sure this is something that can be handled. The universe is NOT telling you this is a bad idea. At best, I find the universe to be highly ambivalent about what's going on in our utes.

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  4. Just a thought if you do have to go on medication...you might consider Aldomet over Labetalol since Labetalol is a beta blocker and can impact how you feel while exercising.

    I had pregnancy induced hypertension that never went away after delivery (it's also genetic), so I had to go on medication. I didn't feel bad on the Labetalol, but I was just starting to run again and wanted to avoid that might make it feel harder than it should.

    Anyway, I hope it's a non-issue and that when you get pregnant again, you get to be normal and not high-risk.

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  5. so unfair that you are THAT fit and still have HBP! But if there is one thing Ihave learned from IF it is that life is not fair! Hope that you can figure out what will be safe during pregnancy!! I feel like you might have sme expertise in this area to work with! ;-)

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  6. Yikes! That really is a high number. It really does seem unfair. Good job to you though for staying so fit! Can you imagine what would happen if you weren't?

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  7. That's so frustrating, especially for somebody who is so fit! Hoping you can find a solutions soon, both for the surgery and for what lies beyond.

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