24hr Urine Collection for Pre-e question

[ericalee27]

I don't know if it will skew results but I'm a vet of many catches and I was always told to refeigerate. Hope you're able to get some results soon!

[ssm]

I was told to refridgerate as well. Not sure what will happen if you don't. i would call the OB and ask if you need to dump it out and start over, or if it would be ok.

BTW, depending on where you live, you might just be able to stick it on the back porch if it is cool enough. Rather than in the fridge.

[RedAero]

Yeah, it should be on ice or refrigerated. I'd call your lab or doctor's office right away (if you haven't already), you may need to start over.

Sorry they fucked up by not telling you that.

[KMW08]

Feb 17, 2015 16:29:24 GMT -5 RedAero said:

Yeah, it should be on ice or refrigerated. I'd call your lab or doctor's office right away (if you haven't already), you may need to start over.

Sorry they fucked up by not telling you that.

This. 

Refrigeration preserves the pee and keeps it from breaking down. 

[ssm]

@alleykat05, any updates? how ya doin?

[ssm]

@alleykat05, what were your levels?
Platelet levels, were they checked?



Personally, I would be EXTREMELY concerned right now. I would be pushing for more answers as well. The protein level matters a lot. the platelets and clotting ability of your blood is extremely important. I know we always say avoid dr. google, but honestly, you need to know what is going on right now.

ETA - 
Are you checking your BP at home?  Do you have headaches or swelling?  I feel like I don't know much about your situation.  But, I am very concerned for you.  

[ssm]

@alleykat05, I know I'm bugging you, but I really am worried about you....

[ssm]

Feb 27, 2015 0:33:03 GMT -5 @alleykat05 said:

Thank you very much ssm. I really appreciate your concern. been trying to get my head wrapped around this. I'm scared. I had to push my doc to get the exact numbers. He was being vague but I wanted to know exactly where I was in relation to 'normal'. For the dipstick test I went off their chart and it maxes out at +2000. The two random samples I gave went from 113 at my first appointment to 131 at this appt two weeks later (not exactly sure what that number means). The 24 hr was a 1.49 with a 'normal' being 0-0.2.

I never thought to ask about platelets or clotting. I will definitely ask that when I got back. Can you think of anything else I should ask? I haven't been checking BP at home but that's a great idea. I'm going to start doing that right away.

I've been googling which seems to keep leading me to pre-e or kidney disease. Neither of which is good news.

I do have swelling but it's hard to differentiate why is normal for pregnancy and what isn't. It's mainly hands and feet and comes and goes. the doc said to watch out for swelling of the face.

The 113 and 131 are baselines of the protein levels. (if that is the same scale they used for mine and others I know...)  300 is considered pre-e.  Not sure about the scores of your 24 hr test.  Either way, that isn't a good score.   I never tipped the dipstick test.  I took the 24 hr sample and was at 600.  I was 37 wks and they immediately induced (my BP was 160/110).

Definitely check BP at home.  Keep a record of it as well so you can show the OB. 

When it comes to swelling - key questions -

1. Does it go down over night?

2. Is it a dramatic swelling?  Mine was OBVIOUS.  Looking back, I looked swollen.  At 35 wks, my feet were so swollen one day that they went numb.  NOT okay, but I was a stubborn fool who didn't bring it up.  DON'T be like me.  Even before that, looking at my baby shower pictures, my whole face was fat.  It was all water fluid retention.

3. When you press on the swollen parts, does it hurt?  What color does it turn?  How long does it take for the color to fade back to your normal shade? 

4. Can you tie your shoes like normal or close to normal? 

Any headaches?  ANY?

Rapid weight gain?  That is typically due to water retention and related to swelling and BP issues.

A couple tips some swear by -

Lower your sodium intake.

DROWN yourself in water.

When you are sitting or laying, prop your feet up.  Even a couple inches makes a difference.

[ssm]

A couple links....
www.preeclampsia.org/health-information/sign-symptoms#protein
www.preeclampsia.org/forum/viewtopic.php?t=37588
emedicine.medscape.com/article/1476919-overview

[ssm]

ericalee27, I see all your love tits....I see you. I do. Do you have anymore advice? Comments? I hate to feel/seem like an alarmist, but this is serious.

[ericalee27]

Feb 27, 2015 13:50:48 GMT -5 ssm said:

ericalee27, I see all your love tits....I see you. I do. Do you have anymore advice? Comments? I hate to feel/seem like an alarmist, but this is serious.

I think you have it covered -- but I'm also keeping an eye out.  I had pre-e with both kiddos, so I always worry for everyone when they start talking about any kind of symptom related to pre-e!!

[ssm]

Feb 27, 2015 14:15:35 GMT -5 ericalee27 said:

Feb 27, 2015 13:50:48 GMT -5 ssm said:

ericalee27, I see all your love tits....I see you. I do. Do you have anymore advice? Comments? I hate to feel/seem like an alarmist, but this is serious.

I think you have it covered -- but I'm also keeping an eye out.  I had pre-e with both kiddos, so I always worry for everyone when they start talking about any kind of symptom related to pre-e!!

It scares me as well. I had no idea what was coming for us. I was naiive to think I didn't need to be concerned about my BP, swelling, and headaches. I am so blessed to have had such an attentive OB to notice the swelling and order the 24 hr catch.  When she saw me in triage at the hospital, she gave me a look of, "I told you so."  She really is the best.   

[cyclone]

Feb 27, 2015 0:33:03 GMT -5 @alleykat05 said:

Thank you very much ssm. I really appreciate your concern. been trying to get my head wrapped around this. I'm scared. I had to push my doc to get the exact numbers. He was being vague but I wanted to know exactly where I was in relation to 'normal'. For the dipstick test I went off their chart and it maxes out at +2000. The two random samples I gave went from 113 at my first appointment to 131 at this appt two weeks later (not exactly sure what that number means). The 24 hr was a 1.49 with a 'normal' being 0-0.2.

I never thought to ask about platelets or clotting. I will definitely ask that when I got back. Can you think of anything else I should ask? I haven't been checking BP at home but that's a great idea. I'm going to start doing that right away.

I've been googling which seems to keep leading me to pre-e or kidney disease. Neither of which is good news.

I do have swelling but it's hard to differentiate why is normal for pregnancy and what isn't. It's mainly hands and feet and comes and goes. the doc said to watch out for swelling of the face.

Not my home board... and I hope this isn't too alarmist...

But I'd be pushing for more answers, especially for a blood test.

I never turned a dipstick, but my BP crept up over thr last half of pregnancy. I called at 24 and 28 weeks after almost passing out and having stars in my vision. My OB finally did a 24 hour catch and blood test at 38 weeks when my swelling was enough that I could put the first part of my pinky in my leg and leave a large dent.

Blood test came back with elevated liver enzymes and lowered platelets. I was induced an hour later.

Compare photos of before you were pregnant to now to check for favial swelling.

[ssm]

Mar 1, 2015 5:07:26 GMT -5 b said:

Feb 27, 2015 10:01:39 GMT -5 ssm said:

A couple tips some swear by -

Lower your sodium intake.

DROWN yourself in water.

When you are sitting or laying, prop your feet up.  Even a couple inches makes a difference.

This is really fascinating to me.  Common sense says if your BP is elevated to lower your salt, but I've had my MFM, Cardiologist, and Rheumatologist all tell me to be 'liberal with my salt' and get as much as possible.  They're concerned about my blood volume because I've been blacking out when my HR goes above 160, while my HR itself has increased significantly.  The salt is supposed to help increase the blood volume, according to the Cardiologist, which I noticed is part of the Bradley Method to prevent Pre-E.

My BP, at home, is normal but my in office level is tricky because I have severe White Coat Syndrome.  The Cardiologist told me he puts more emphasis on normal at home readings, especially in someone like myself where they've done multiple 24 hour BP studies and they're always fine, as long as I'm not driving to/at a a DR appointment.

At the current point, I am only 'at very high risk for Pre-E', due to autoimmune Mixed Connective Tissue Disease (similar to Lupus/Sjogren's) and probable Anti-Phospholipid Syndrome - I don't actually have it yet.  Does the recommendation for lowering salt come once you actually have Pre-E?  Or just when your BP actually starts to go up?  I honestly have no idea what to expect, so please ignore my ignorance in this subject.

You know, I'm not sure. I just know high sodium intake results in water retention and with pre-e, you already have a bunch of water retention. But, as always, follow doctor's advice over anyone in an internet forum.

[ericalee27]

Mar 2, 2015 13:54:37 GMT -5 @alleykat05 said:

So good news is it's not Pre-e but I'm at high-risk for it. Bad news is I have kidney disease. I have todo 24hr urine monthly for the rest of my pregnancy and keep my BP below 135/90. If it goes over that, they will classify me as pre-e. Turns out I'm also anemic and vitamin d deficient (even with supplements). I'm just a bundle of fun.

Thank you all of you for all of the information and support. I really appreciate it!

Hugs, sorry for the bad news part but it's better to know and monitor, than to not.  Hang in there and try to take it easy as much as you can!

[mamasoup030]

Im just catching up now, and glad to hear the OP got answers and a plan to manage your symptoms for the rest of the pregnancy, FX that pre-e doesn't develop.

It's amazing to hear so many educated women who have had pre-e. I wonder if we can start a board for just pre-e. I am 33 weeks into pregnancy #2. I had severe postpartum pre-e and 2 of the 3 indicators of hellp in my last pregnancy. I'm starting to show symptoms now of pre-e again and they keep telling me they can't do anything until it gets worse, which is a shitty answer. It would be amazing to have a support system in place for those of us going through it and having gone through it in the past and possibly experiencing it again, or just living with the fear of that.

Does anyone know how to make a new sub group happen?

[bcandlm]

I was always told to refrigerate as well or to put it on a bed of ice.

ETA: Oops--should have read all of the other posts before posting! Hope OP is doing okay as well as the other posters who mentioned their health too!

[ssm]

Do they have you on bp meds? Have they put you on bed rest? What is your bp at home resting? Are you swelling or getting migraines?

[ssm]

Apr 11, 2015 19:24:18 GMT -5 @alleykat05 said:

Apr 1, 2015 9:01:07 GMT -5 ssm said:

Do they have you on bp meds? Have they put you on bed rest? What is your bp at home resting? Are you swelling or getting migraines?

I hit 156/98 at home the other night with a brutal migraine and swelling. It's been staying around 140/90 and home resting so I just started BP meds this week. Fingers crossed this will get it under control. The doctor said they expect it to crawl back up again as i get further along so they will adjust my meds as we go along and keep this baby cooking as long as possible.

ETA sorry for the very delayed response! I haven't masted this mobile app yet

im glad it's back down and you are being closely monitored. Hugs!!

[threetexans]

Feb 27, 2015 10:01:39 GMT -5 ssm said:

Feb 27, 2015 0:33:03 GMT -5 @alleykat05 said:

Thank you very much ssm. I really appreciate your concern. been trying to get my head wrapped around this. I'm scared. I had to push my doc to get the exact numbers. He was being vague but I wanted to know exactly where I was in relation to 'normal'. For the dipstick test I went off their chart and it maxes out at +2000. The two random samples I gave went from 113 at my first appointment to 131 at this appt two weeks later (not exactly sure what that number means). The 24 hr was a 1.49 with a 'normal' being 0-0.2.

I never thought to ask about platelets or clotting. I will definitely ask that when I got back. Can you think of anything else I should ask? I haven't been checking BP at home but that's a great idea. I'm going to start doing that right away.

I've been googling which seems to keep leading me to pre-e or kidney disease. Neither of which is good news.

I do have swelling but it's hard to differentiate why is normal for pregnancy and what isn't. It's mainly hands and feet and comes and goes. the doc said to watch out for swelling of the face.

The 113 and 131 are baselines of the protein levels. (if that is the same scale they used for mine and others I know...)  300 is considered pre-e.  Not sure about the scores of your 24 hr test.  Either way, that isn't a good score.   I never tipped the dipstick test.  I took the 24 hr sample and was at 600.  I was 37 wks and they immediately induced (my BP was 160/110).

Definitely check BP at home.  Keep a record of it as well so you can show the OB. 

When it comes to swelling - key questions -

1. Does it go down over night?

2. Is it a dramatic swelling?  Mine was OBVIOUS.  Looking back, I looked swollen.  At 35 wks, my feet were so swollen one day that they went numb.  NOT okay, but I was a stubborn fool who didn't bring it up.  DON'T be like me.  Even before that, looking at my baby shower pictures, my whole face was fat.  It was all water fluid retention.

3. When you press on the swollen parts, does it hurt?  What color does it turn?  How long does it take for the color to fade back to your normal shade? 

4. Can you tie your shoes like normal or close to normal? 

Any headaches?  ANY?

Rapid weight gain?  That is typically due to water retention and related to swelling and BP issues.

A couple tips some swear by -

Lower your sodium intake.

DROWN yourself in water.

When you are sitting or laying, prop your feet up.  Even a couple inches makes a difference.

I'm a lurker, but former pre-e mom.  I had my daughter at 32 weeks after going into pre-e with a hypertensive crisis, leading to diastolic heart failure and pulmonary edema.  Just thought I'd add my $.02 on the bolded.  

Sodium can be tricky.  You have to be careful not to go too low, definitely talk to your doctor about maximum and minimum intake levels.  Increased water intake can also dilute sodium levels too.  The last two weeks of my pregnancy (30-32w) I limited sodium per my OB's suggestion (never going above 2000mg a day), and dropped 8 pounds of water.  My swelling was almost completely gone.  Prior to that, I was not dumping protein, but just dealing with PIH and swelling.  I was also pregnant in the midst of a Texas summer, with temps over 100 daily, so I drank tons and tons of water. This combined with the low sodium diet caused me to have severe low sodium levels.  In turn, it exacerbated some of my pre-e symptoms, and made treatment much more difficult. 

I went too low with my sodium, especially when combined with the increased water intake.  I never worried about a minimum intake level.  I never asked, and was never told until after the fact.  I just focused on the max intake allowed.  There were many days when I only consumed around 1200mg. I realize that I may be the exception to the rule, but please do discuss with your doctor how to safely lower your sodium levels beforehand.