A visit to emergency – pregnancy or bipolar disorder medication?

Mr A, Master X and I headed out at about 10am this morning in search of a good cup of coffee and some refreshments. I suggested that we head to Tommy and Me, a little cafe in West Belconnen that houses a small inside eatery and substantial play area for babies and toddlers while parents can relax on the lounges and enjoy a cuppa.

I devoured the mushroom on toast (the healthy option on the menu. I really love how this place caters to families in their menu) and while I was drinking my delectable iced coffee Mr A pointed to my hand and said, Hey babe, you are shaking heaps. I had noticed trembling in my hands during the week while at a conference. Every time I needed to carefully do something with my hands like pour water or milk, or select something from the buffet, both hands would noticeably tremor. I had just put it down to medication effects from my bipolar disorder, namely the recent increase in Olanzapine. However I had also noticed at brunch today that my vision was blurry on the edges with bright white spots through my lens area and that I was having difficulty focusing on the phone or even someone’s face.

I was slightly alarmed by these symptoms, as was Mr A.

So we did what any educated middle-class people would do and we referred to the experts. According to Dr Google, I could have had lithium toxicity. This is something that my GP had warned me of particularly during pregnancy, as this medication can be diluted and then swing into toxicity at the blink of an eye. I dialled the phone number of the closest hospital emergency department (ED) and conveyed my symptoms to triage. The nurse agreed with the severity of our concern and asked me to come in straight away.

I did not have to wait at all before I was seen through for a set of obs (blood pressure, temperature, heart rate) and a comfy recliner chair. And so began the tedious wait. I sent my family away, knowing from past ED experiences that this can take a lot of time. Break to take my medications before I forget. And so I waited. It took about 1.5 hours for the doctor to get to see me. He immediately took a set of bloods and then asked me a series of questions about my neural history. But I’m only here for lithium. It was not until after my blood results came back that he said, My supervisor and I are concerned that you may be displaying signs of preeclampsia. Wow. It had not even crossed my mind remotely that these symptoms might be anything other than related to my bipolar disorder. To allay any concerns, the proteins in my urine came back negative so they were happy to rule it out at this stage. But I was to consider myself warned.

Both lithium toxicity and preeclampsia have potentially dire consequences for mum and bub, especially at this early stage of 23 weeks gestation. They can result in premature birth, birth complications and developmental issues. I am more frightened of preeclampsia at this stage in the pregnancy as it is has such a sudden onset period and the only cure (according to the ED doctor) is to have the baby. Which would mean minimal chance of survival at 23 weeks.

I am going to have my routine bloods again this week, with it being four weeks since my last set of work. I must have blood tests once a month during pregnancy while on lithium. However, I really do not want to stay on this medication after today’s scare. I hope that my next appointment with the psychiatrist will result in a mutually beneficial outcome – namely stop lithium.

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4 thoughts on “A visit to emergency – pregnancy or bipolar disorder medication?

  1. Oh, how scary! I hope that you don’t have preeclampsia, and that your pregnancy continues to be happy and healthy. Here’s hoping you can safely stop lithium as well. That will help with breastfeeding concerns as well.

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