After the complications following Lilianna’s birth, I was hoping not to see the inside of a hospital for quite some time. Unfortunately, just a couple of weeks later, we were back. What ensued was frightening and frustrating, but a great reminder of the importance of being our own advocate.
Three weeks after Lily was born, I started noticing lower abdominal pain while nursing her. When I mentioned this to my doctor, she thought it was likely related to the GI issues and the surgeries that I’d had to repair the hematoma.
A week later I had a pre-scheduled appointment with another doctor and upon hearing about the abdominal pain, they sent me for an ultrasound to check for appendicitis. They also put me on a clear liquid diet for 24 hours.
As a seasoned GPer, I’m no stranger to consuming only clear liquids, but doing that while breastfeeding is another story. I was so hungry! I drank constantly that day to try to calm the hunger and take in enough calories to nurse Lily. I was chugging bottled juice and Vitamin Water (neither of which I usually recommend) like it was going out of style.
The next day I returned to the doctor. I didn’t have appendicitis. The only remarkable thing about the appointment was that I’d gained three pounds from the day before…having not eaten a thing! I was told to transition slowly back to solids, so I continued drinking a lot that afternoon, adding in smoothies and Orgain.
That evening I had just finished nursing Lily when I suddenly felt very dizzy. I handed the baby to my hubby and tried to lay down, but my head was pounding, I felt nauseous, and I was sweating. For some reason I asked my husband to go get the blood pressure machine that we own. The reading was 180/112. I was shocked by the high number since I tend toward low blood pressure, typically 100/60. I was feeling really bad. Not knowing what to do, my husband called 911.
Once at the hospital, they latched on to the abdominal pain, though that wasn’t why I was there. They did a CT scan to further rule out appendicitis. The CT scan was normal. They checked my heart and determined that my problem wasn’t cardiac related. Eventually I was told I was dehydrated and released several hours later with a blood pressure of around 150/90. I explained that I really didn’t think I could be dehydrated, as I always drink several 20-ounce bottles of water a day and lately I’d been drinking even more. I was told that it didn’t matter, I was indeed dehydrated because of the birth, subsequent surgeries, and breastfeeding. The advice I was given was to “pound fluids, especially while nursing.”
So the next day I made it my goal to drink even more. I certainly didn’t want to go through that again. I drank a 20-ounce bottle of water each time I nursed, plus more in between. It felt excessive, but I believed that I must have been dehydrated. That afternoon, just after I’d finished nursing, I again felt suddenly dizzy and very ill. My head was pounding. I checked my blood pressure and it was just as high as the previous evening. I called my doctor and she sent me back to the ER, explaining that blood pressure that high could put me at risk of a stroke. Talk about scary. The 20-minute drive to the hospital seemed longer than it did the morning I was in labor.
This time they did another ultrasound to check for OB issues related to the pregnancy. No explanation there. I was again told that I was dehydrated and that was causing the spikes in blood pressure. In the back of my mind, I had more than a little doubt — both because I knew I was drinking more than enough and because I remembered that they’d given me fluids to raise my blood pressure after I’d had Lily. My husband brought this up to the doctor but she brushed it off and seemed positive that dehydration was certainly the issue, so I went home determined to drink more.
Guess what happened the next day? I drank more. My blood pressure spiked after an evening feeding. Back to the hospital. At this point, while I wasn’t sure what the issue was, I was nearly positive that it was not dehydration. My mom called a family friend who is a physician in New York City. She agreed that dehydration seemed very unlikely. She gave us some good questions to ask, like how they’d made the diagnosis of dehydration and whether the lab work supported that conclusion.
Fortunately the doctor we got this time was very open to our questions. I had immediately gone to the restroom to provide a urine sample (without being asked), to prove that I was in no way dehydrated. When the doctor came in, she took a look and agreed. In fact, she said it appeared that I was overhydrated. She admitted that my lab work didn’t show any signs of dehydration and that doctors sometimes give that diagnosis when they have no other answers. She said they likely noticed that my lips were chapped and that contributed to their conclusion. (Had they asked, I could have told them that my lips are chapped 365 days a year).
She still didn’t have an explanation, but I was given a medication to lower the blood pressure. Eventually it went down into normal range and I was discharged with a prescription and a vague diagnosis of “postpartum high blood pressure.” What stood out to me, though, was the confirmation that I had been consuming too much fluid. (Not just in what I was drinking, but also the fluids I’d been given at the hospital during the two previous visits.)
I realized that this all started the day after I’d been put on the liquid diet and it seemed reasonable to me that it could be related. So I finally listened to my own intuition and decided to hold off on taking more blood pressure medication, instead restricting my fluids to see if that made a difference. That night I didn’t drink at all during Lily’s feedings and the next day I limited myself to just 64 ounces of water, the typical recommendation. I lost 4 pounds. That’s a lot of fluid!
I didn’t have an episode that day or the next. I continued to check my blood pressure every four hours and it remained well within the normal range, 110-120/65-80. I was still nervous that it was a fluke, but I continued with my experiment until I saw my doctor. I told her the whole story and she agreed that it seemed a likely explanation as excess fluid can indeed raise blood pressure. (I was reminded afterward that there are always signs posted at marathons and other endurance sporting events, warning participants about the dangers of overhydration. It’s not an unknown phenomenon.)
As the days passed without another episode, I was at first relieved and then angry. Not only had I been forced to figure this out for myself, but the info I was given by those I trusted to help me had exacerbated the problem and put my health at risk. I initially planned to just put it behind me, but this type of thing has happened to me so many times that I couldn’t help but share this story as another cautionary tale.
So, please, whether it’s related to gastroparesis or something else, don’t settle for an answer that doesn’t make sense to you. Don’t allow someone to brush you off when you know something is not right. Keep pushing, continue seeking help, get a second (or third or fourth) opinion. You know your body better than anyone else and ultimately your well-being is your responsibility. At the risk of sounding like a broken record, the bottom line is that you must always be your own advocate.