I have a benign heart arrhythmia. Before I got pregnant, I was taking 10mg/day of propranolol to control it. I stopped taking it as soon as I found out I was pregnant, thinking I'd rather deal with the arrhythmia than expose the baby to any unnecessary drugs. (Also, taking pills made me gag.)
When I called the OB's office to set up a first prenatal, my doctor's partner was worried about the propranolol. My doctor, on the other hand, said, "Oh, no, it's one of the safest things you can take to manage an arrhythmia in pregnancy." I knew that there were risks associated with taking the drug in late pregnancy, but I had thought that I could take it from the feeling-better stage until close to term.
I have been itching to start getting some exercise again, but I have to take the medication for that to work. If I try to go for an unmedicated run, I last about 300 yards. I can push myself to keep going, but after 10 minutes or so I'm going to throw up in somebody's yard. With the drug, I can chug along for half an hour or more -- or at least I could before I spent all that time lying on the couch.
Pregnancy is hard on my mental health -- it really cranks up my usual tendencies toward anxiety and hypersensitivity. Exercise is good for my mental health, and, obviously, my physical well-being too. I went for a couple of gentle runs in the past couple of weeks and was excited to get back in the groove.
So I was really bummed when I went to pick up my prescription refill and the pharmacist cautioned me sternly about propranolol in pregnancy. It's a category D medication in the second and third trimesters. It's associated with a whole lot more problems than I knew.
Some of the difference in her reaction and my doctor's reaction has to be related to dosage. In some of the research they were looking at women taking 16 times the dose that I take. But the pharmacist had that information in front of her -- if she was concerned, shouldn't I be concerned?
I guess if neither my OB nor my CNM is worried about my taking 10mg/day, I don't need to have a cow about the pharmacist's reaction. One possibility might be to take a pill only before exercising, maybe 3 days a week, and live with the arrhythmia the rest of the time. (It's been better than usual since I've been pregnant, which is the opposite of what I expected.) Maybe I could also request a referral to go back to the cardiologist for more information about the whole pregnancy/arrhythmia thing -- my OB said he wanted to talk to the cardiologist anyway.
I'm upset that something I thought was a great idea (getting more exercise, with a little pharmaceutical assistance) met with such a negative reaction. (See above re: pregnancy, mental health, adverse effects.) The list of potential side effects for the baby is troubling, but I don't have good information about incidence, dosage effects, etc. I'm not sure what to do. Any thoughts?
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