Cardiologist update #2

I got a voice mail message from my cardiologist's office on Monday (the 21st), telling me that Dr. F wanted to see me as soon as possible, because he had something he wanted to talk to me about in person. And, by the way, he's already talked to my obstetrician about it too. So please call us back so we can schedule an appointment.

Uh oh. What's wrong now?

When I call back, the receptionist says that the earliest Dr. F can see me is Thursday afternoon (the 24th). Three days later? Hmmm. All right, I say to myself. Can't be all that serious then, if they're willing to let me wait that long to hear the news.

Fast forward past the glucose test to Thursday, and finally I get to hear what all the hubbub is about.

It's not my blood pressure. That's been pretty well behaved lately. It's my heart rate, which hasn't been lower than 100 for a little while now. Dr. F is concerned as to why it's so high. I had been complaining that my pulse has been throbbing in my neck and head, especially when lying down, and also experiencing some palpitations, and it seems that it's related to the increased heart rate. Earlier in March, Dr. F had me come in for an echocardiogram, and at this appointment he went over the results with me.

In comparison to the echo that I had a year or so ago, in which all my heart functions appeared normal, this time my heart showed some less than optimal functioning. Apparently my heart is weakening, and compensating by beating faster. All this is likely due to the extra stress on my system from the pregnancy -- especially the increased blood volume. While this is not dangerous in and of itself, it can become a serious problem if it goes on for too long -- the heart can become enlarged and something he called cardiomyopathy can result. At least this is the gist of what I understood from what he said. So we're looking at something that, should it get bad enough, could affect me even after the baby is born.

In the spectrum of "Don't Even Worry About It" to "OMG Emergency STAT!," Dr. F said we're somewhere in the middle; this is something that we need to take seriously and do something about, but there's no need to freak out about it... yet.

The solution (for now): Dr. F put me on another medication (I'm already taking methyldopa for the high blood pressure), Lopressor (generic metoprolol). It's a beta blocker that will help slow my heart rate, the hope being that if we can get my heart to calm down, it will function better, and we can forestall any damage. He's started me on a low dose, 25 mg twice a day, and I'll see him on April 4 to see how I'm doing and whether that's enough.

As he's telling me this, I'm thinking, but wait, aren't beta blockers contraindicated during pregnancy? I asked Dr. F how safe this medication is for baby, and he tells me that yes, there are risks, but we need to weigh the risks against the benefits. He said the main side effect of Lopressor on fetuses is that it can cause intrauterine growth restriction, or IUGR. The caveat is that I'm far enough along in the pregnancy that the majority of growing the baby will be doing from now on is just gaining weight -- most critical development is already complete. It would have been a bigger deal if I had to start taking this drug in my first or second trimesters, but since I'm well into my third, it will have a less deleterious effect than during those earlier crucial weeks.

So, yeah. I'm not keen on taking this medication, but, if I have to weigh the chance of my baby being a little bit smaller at birth than perhaps he or she could have been against my developing a heart problem that could permanently affect my quality of life (and my ability to be there for my child as he or she grows up), well it seems doing nothing is a bigger risk to my health than the drug will be to the baby's.

Not an easy pill to swallow (pun intended). I think I've just gotten my first taste of that parental willingness to suffer so that one's child doesn't have to. I just hate the thought of taking something that might harm my baby. At the same time, I take some comfort in the fact that baby is already measuring ahead size- and weight-wise, so maybe baby has some growth to spare. Plus, the perinatologist is already doing growth ultrasounds to make sure my hypertension isn't causing IUGR, so Dr. F suggested that they may want to do the growth ultrasounds more often than originally planned from here on out, in order to track how the baby is affected by the introduction of this medication.

Of course, this is all provided that the baby stays put...

Stay tuned for Operation Keep Baby Cookin' Part V ---