Update

So, I saw the electrophysiologist the other day.  I have to admit that I was not initially impressed. I didn’t get any answers as to why this happened again. Despite having a natural increase in blood volume from being pregnant, hydrating very well with electrolytes, and taking an iron supplement to boost my red blood cell count, I continue to struggle with maintaining a decent blood pressure.

Initially, I was told to wear compression hose to prevent blood from pooling in my legs (therefore causing a decrease in blood pressure), have an echocardiogram just to make sure nothing has changed since my last one 3 years ago, and carry a heart monitor to record my heart rhythm during the next “episode”.

My fashion statement for the remaining 2 months!
An email and phone call later, my doctor decided it would be a good time to get a kidney doctor involved.  See, it is possible I have something known as POTS – Postural Orthostatic Tachycardic Syndrome.  It kinda goes along with the type of connective tissue disorder I have.  It is possible that these episodes are manifestations of POTS, which is being exacerbated due to pregnancy.  With POTS, a person will develop low blood pressure when standing for too long.  In my case, I will just suddenly have a rapid drop in blood pressure (though it gets worse when I stand around).  When that happens, the kidneys do not get as much blood as they need, so they will secrete hormones to start a chain reaction to increase blood pressure.  Hence the high blood pressures that follow my drops.  As such, there will be good days and bad days.  That’s where the kidney doc comes in.  Apparently, he is very familiar with POTS, and is comfortable caring for pregnant patients with this issue.  I should be getting a call soon to either talk with this doctor in person or schedule an appointment to see him in clinic.  It’s possible he will follow on the periphery, or start me going to their infusion clinic to get saline boluses (which have helped in the past, but they were always associated with an ER visit and a large copay).
So, how does one prevent another “episode” from occurring?  Well, I’ve been told to continue what I’m doing with regards to hydration, iron supplements, and now compression socks.  I will do my echo next week, and carry the heart card monitor for the next 30 days.  I will also talk with the kidney doctor, in hopes of coming up with a plan for the next time that does NOT involve a visit to the emergency room, or a 10 hour recovery at home.
To be continued the next time…
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