I was a 32 year old woman, with chronic
hypertension since the age of 25. I
became pregnant with my first child in
June of 2008. My entire pregnancy my
blood pressure was better than it has ever
been, never above 110/60. I even
decreased my blood pressure meds. I only
gained 20lbs, but i was 205lbs before
being pregnant.
Due to a previous back injury, i opted to
have a ceasearean section, which we
scheduled 3 days before my due date. On
3/14/08 i went in, was prepped for
surgery, given IV fluids (including a
volume expander called Hespan, as the
anaesthesia doc said i was at increased
risk for bottoming out because of the
chronic htn). In 25 minutes my baby was
here and i was in recovery.
I reacted with itching and shakes form the
morphine in the spinal, so was not aware
that i had lost a lot of blood. By Friday
night I was pretty shaky, and got no sleep
with the new baby. Continued to react to
the morphine.
Saturday morning, i was told i needed to
get up and get moving, so i did, but felt
miserable. By saturday night I was
tachicardic and we called the nurse in.
The doc on call came and said i had gone
from an 11.5 hemoglobin to a 7.5 and he
thought i needed 2 units of blood. They
ran that along with fluid all night.
The fluid continued all day on sunday..and
by sunday night i was hearing fluid in my
ears...it was awful, i called the nurse
and she disconnected it. All in all,
however i felt better, althought i had
become swollen (and never did with the
pregnancy), and my blood pressure was 160s
over 80's.
My doc came in monday morning and said the
swelling would go down that was normal,
but she was keeping me another day, not to
worry about the pressure, it woudl come
down.
Tuesday they sent me home. Early wedn.
morning when lieing down i had rattles,
cracks and couldn't breath. Coughing up
pink sputum. We got in the car and drove
to the ER 1.5 hours away.. They checked
me in and the er doc told me i had a high
bnp, fluid in my lungs and there was a
good chance i had what was called post
partum cardiomyopathy....i needed to get
my family there, this was probably bad, my
heart was dieing.
They called in my hypertension doc who did
a ct for lung clot, nothing. Then they
started lasix to get the fluid off before
the cardiologist could do the echo on the
next day. I became so upset my pressure
and heart rate went to the roof. We were
all just a mess.
By thursday the cardiologist said i was
dropping the fluid and it looked like this
might be a simple case of fluid overload,
perhaps my heart was a little stiff from
the chronic hypertension. All the while
my ob/gyn is checking in.
After the echo they all came in, said
"heart looks fine, ejection fraction fine,
no stiffness seen, but could have been
present then?" The cardiac doc said "i;ll
talk with your htn doc about blood
pressure meds, otherwise good luck, enjoy
that baby".
3 months later i am still scared to death,
i dropped 25lbs of fluid in those three
days, and am not 15 pounds lighter than
that. I have had a wake up call big time.
MY question is this...since they all said
"this shouldn't stop you from having
another baby"....Could it be they simply
gave me too much fluid too fast with the
csection and the blood, and no one is
willing to say that outright? And how
safe would it be to have another
baby....could it affect my heart? I am
just so scared.
Has anyone had an experience anythign like
this? You know, i liked my doc, it was my
choice to do the csection and the weekend
thing....i would never suit anyone.....why
can't they just say we gave you too much
fluid, it would put my mind at ease.
|
OBnursemommy
New User, Becoming EHEALTHy
Joined: 12 Aug 2008 Posts: 8 Location: ,
Posted: 09-11-08 23:03pm
Honestly, can't really know if the fluid
alone caused the problem or an underlying
factor that caused it and the fluid didn't
help. WITH THAT SAID, I will tell you
that I have seen many patients be taken to
the ICU for too much fluid and
edema...especially when it makes it's way
into the lungs. It makes the heart go on
overload and I'm sad to say..it could have
been prevented because it was simply
overlooked or not calculated correctly.
While opening up an IV and pushing fluid
might have been the correct action at the
time; slowing it down a bit would have
been a good approach...especially if you
clearly started swelling. During the
nurses assessments and even doctor rounds,
this should have been followed up on a
little bit better. I would obtain a copy
of your operative report as well as post
operative and go over it with someone that
understands the lingo to see what
happened. You would be surprised at the
things written in those reports that were
not discussed with you.
In fact, I've had 3 sections and 3 weeks
ago, I had a hysterectomy at the same
hospital I work at as a nurse. I knew
that with the pain meds and coming out of
the anesthesia I'd be out of it, so I had
a family member with me at all times. One
thing I alerted everyone to was to watch
the speed of my IV because I didn't want
to over infuse. My husband remembered and
asked the nurse why it was running so
fast-just saline, no meds...her reply was
"oh my, I set it at the wrong level" and
she fixed it. Later that night I felt
horrible pressure in my bladder region
however I had a catheter. I tried telling
the nursing asst that my catheter wasn't
working and she assured me it was. The
nurse finally came in as I was unkinking
my own catheter and almost immediately I
felt relief as I watched 300cc of urine
coming out! My point is.....ALWAYS have
an advocate present to help check up on
things and answer for you when you can't.
I'm sure you'd be ok the next go around
but I'd discuss everything with your
doctor. Good luck.
|
LoriMootsClair
New User, Becoming EHEALTHy
Joined: 30 May 2008 Posts: 7
Thanks: 0
Thanked:1
Thank you. Posted: 09-12-08 08:44am
Thanks so much for your reply, it is good
to hear from an ob nurse that this does
happen to other people. I just went back
in to have everything cardiac checked out
again, and all looks "great" according to
the doc...so i am guessing, it was simply
fluid overload. I loved my doc, and am so
sorry that this happened, b/c now i am
afraid i will be unable to trust her in
the future. And maybe not, because i
realize that with transitions over the
weekend this could have just simply not
been caught from doc to doc and nurse to
nurse. Dr. B kept telling me that it
would go away, that i'd get my ankles
back, etc. perhaps she just didn't pick
up that it only started after all the
fluid, but she should have as my record
indicated it.
|
OBnursemommy
New User, Becoming EHEALTHy
Joined: 12 Aug 2008 Posts: 8 Location: ,
Posted: 09-12-08 10:41am
You're welcome. Here's the thing...before
I started working in the medical field, I
was the type of person that would sit back
and just listen to the dr..not expressing
my feelings, etc. Even when I was in the
hospital having babies, and something
didn't feel right, I never 2nd guessed
anyone because I thought that was rude.
HOWEVER, after crossing over I see what
little mistakes can have such a big inpact
on peoples health. Nurses and doctors are
humans, they make mistakes. Problem is
when they don't own up to fixing the
problem and continue overlooking. I tell
ALL my family and friends....ask
questions, be persistant..YOU HIRED these
people! When I was just in the hospital
and the nurses came in to give me meds,
they would just start pushing it without
telling me what it was...I didn't like
that. You have the right to question and
refuse anything!
So with that little class in backtalking
101-I don't think you'll have the same
problem and if you do...everyone will
know. Make sure your husband stays with
you and keeps questioning and is
persistant.
|
melvis.girl
New User, Becoming EHEALTHy
Joined: 27 Sep 2008 Posts: 2 Location: Fort Collins, Colorado
Thanks: 1
Thanked:0
This sounds very similar to what happened to me Posted: 09-27-08 20:18pm
I just got done typing a long reply and it
didn't post. I'd love to talk to you some
more as it seems we have a lot in common.
I'll add my story later this evening.
|
Users who thank melvis.girl for this post:
LoriMootsClair
LoriMootsClair
New User, Becoming EHEALTHy
Joined: 30 May 2008 Posts: 7
Thanks: 0
Thanked:1
Looking Very Forward to Reading your story Posted: 09-27-08 20:44pm
Would love to hear more about your story.
It is so good to hear someone say they
have had a similar incident. I don't
think anyone can understand the
frustration.
|
melvis.girl
New User, Becoming EHEALTHy
Joined: 27 Sep 2008 Posts: 2 Location: Fort Collins, Colorado
Thanks: 1
Thanked:0
Melissa's story Posted: 09-27-08 21:12pm
My pregnancy had been pretty uneventful,
but I chose to have an epidural and was
told that I was dehydrated, thus they gave
me a lot of fluids. Meconium was present
when they broke my water to attach the
fetal monitor and my son's heart rate
dropped everytime the doctors checked me
(he didn't like being messed with). After
the third time this happened, they did an
emergency c-section. My husband and
sister were unable to be in the room with
me as it all happened too fast. (Looking
back we should have asked for a c-section
instead of waiting for things to get out
of control.)
I was in surgery for awhile because they
found a large dermoid cyst on my left
ovary that had to be removed. I had
severe shoulder pain post-op (apparently
from the trapped gas in my body from the
surgery) and was unable to hold my son for
about two more hours. But once all that
was over, things seemed to be going fine.
My son was born on a Saturday, and I had
some swelling in my legs in the few days
that followed. I pointed it out to the
nurses and they said it was normal. The
doctor that released me on Tuesday didn't
even check me, he just came in and said
"hi" and that he was sending me home. (My
second mistake was not being more
persistent.)
The swelling didn't go down, it continued
to get worse and by Friday I looked huge
and had other complications as well. I
had a random little catch in my breath
(like a gasp or a hiccup), a strange
cough, and I was short of breath. Some of
this was going on before I was released,
but no one seemed to think it was a big
deal. My family convinced me to get it
checked out, so I went to my ob-gyn. I
got in just before 5 on Friday and my
doctor was on call and really rushed. She
checked my blood pressure and it was high,
so she had me lay on my side and rechecked
it. She was ready to let me go and my
husband stopped her long enough to
convince her that something was really
wrong (yikes!). She sent me to the
hospital for a chest x-ray and the order
said something about the possibility of
pulmonary embolism or cardiomyopathy. A
close friend of mine had just died almost
exactly a year prior from a pulmonary
embolism, and I knew that cardiomyopathy
wasn't good news either. I really thought
I was a goner. The x-ray showed that my
heart was enlarged and surrounded with
fluid.
In the hospital, I was put on a blood
thinner and lasix, and bed rest.
(Unfortunately they forgot to give me a
catheter and I had to pee A LOT!) Laying
down made my abdomen hurt something awful
and using a bed pan was less than
pleasant. They ran several tests and
found no blood clot. On Saturday they
sent me home with no answers. The
pulmonologist said he didn't know what I
was doing there and the cardiologist was
very vague. I finally had an ob-gyn from
my clinic tell me that everyone thought
I'd be fine within six months. At that
point I wasn't sure if the problem had
been my heart, my lungs, my kidneys, or
what! My husband called him and asked for
further clarification. He asked what
happens in cases where someone doesn't get
better and he said, "heart transplant."
Well, that was not comforting. I went to
my parents' house to recover and keep my
feet up. (I was still on bedrest) I lost
about 25 pounds of fluid over that
weekend!
I continued to feel better, but was still
traumatized from everything that had
happened. I had several follow-ups with
the cardiologist. He told me there's no
reason for me not to have more children,
that I would just need to be monitored
closely. Then at my one-year follow-up,
he asked if we were planning to have more
kids, and we said yes (mostly to see his
reaction) and he strongly advised against
it, due to the "cardiomyopathy". At
previous visits he said that what happened
to me resembled PPCM, but that my problem
was in my right ventricle, which is not
usually the case with PPCM. I really feel
like there's something there not telling
me.
My husband and I decided that regardless
of the real cause, we were too afraid to
put ourselves through that stress again
and opted for a vasectomy. It was still
not an easy decision because we really
wanted 2 kids. But we thought it was
better to count our blessings and get on
with our lives.
I feel much differently about doctors than
I used to. I was always naive and thought
that they knew best. I had medical
professionals dismiss my concerns and
suspicions that my son had autism, saying
that "some kids just talk late." But we
knew that something just wasn't right and
pursued an answer and some help. We got
him into therapy and explored alternative
medicine and eventually he was diagnosed
with 'Autistic Disorder'. Thank goodness
we didn't sit around and wait. You have
to trust your gut when it comes to your
health.
It's been a little over four years since
my "heart problem" and I'm still confused.
It seems that my problem could have had
more to do with the epidural and c-section
and not a major heart defect. I
occasionally have heart palpitations when
I'm stressed or have alcohol, caffeine, or
aspartame. The doctors have done further
tests and say my heart is fine now. I can
definitely relate to your frustration.
I've just recently started doing more
research on this and I'm very interested
in anything you find out.