Fibromuscular dysplasia: A cause of high blood pressure?

In fibromuscular dysplasia, the muscle and fibrous tissues in arteries thicken and harden into rings — which restricts blood flow through the affected arteries and to the organs supplied by these arteries. When fibromuscular dysplasia involves the renal arteries, blood flow to the kidneys is impaired. This triggers the kidneys to release excessive amounts of the enzyme renin, which increases your blood pressure.

The cause of fibromuscular dysplasia isn't known. But you are at increased risk if you smoke or have a family history of this condition.

In mild cases, high blood pressure caused by fibromuscular dysplasia may be treated with diet, exercise and medication while your doctor periodically monitors your kidney function.

In more severe cases, treatment may include:

• Opening the clogged arteries with angioplasty (percutaneous angioplasty) and possibly placing wire mesh tubes (stents) within the arteries to keep them open
• Surgery to reroute blood flow around the affected arteries

If the renal arteries can be unblocked and blood flow to the kidneys improved, blood pressure usually returns to normal.

If you had an episiotomy or vaginal tear during delivery, the wound may hurt for a few weeks — especially when you walk or sit. More extensive tears may take longer to heal. In the meantime, you can help promote healing:

• Soothe the wound. Use an ice pack, or wrap ice in a washcloth. Chilled witch hazel pads may help, too. Witch hazel is the main ingredient in many hemorrhoid pads. You can find witch hazel pads in most pharmacies.
• Keep the wound clean. Use a squirt bottle filled with water to rinse the tissue between the vaginal opening and anus (perineum) after using the toilet. Soak in a warm tub.
• Take the sting out of urination. Squat rather than sit to use the toilet. Pour warm water over your vulva as you're urinating.
• Prevent pain and stretching during bowel movements. Hold a clean pad firmly against the wound and press upward while you bear down. This will help relieve pressure on the wound.
• Sit down carefully. To keep your bottom from stretching, squeeze your buttocks together as you sit down. If sitting is uncomfortable, use a doughnut-shaped pillow to ease the pressure.
• Do your Kegels. These exercises help tone the pelvic floor muscles. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Starting about a day after delivery, try it for five seconds at a time, four or five times in a row. Repeat throughout the day.
• Look for signs of infection. If the pain intensifies or the wound becomes hot, swollen and painful or produces a pus-like discharge, contact your health care provider.

You may feel contractions, sometimes called afterpains, during the first few days after delivery. These contractions help prevent excessive bleeding by compressing the blood vessels in the uterus. Afterpains tend to occur during breast-feeding sessions and seem to be more noticeable with second or third babies. Medications to control heavy bleeding after delivery can increase afterpains as well.

Usually afterpains resemble menstrual cramps. If necessary, your health care provider may prescribe pain medication. Many medicines are safe even if you're breast-feeding. Contact your health care provider if you have a fever or if your abdomen is tender to the touch. These signs and symptoms could indicate a uterine infection.

Pregnancy and birth stretch the connective tissue at the base of the bladder and may cause nerve and muscle damage to the bladder or urethra. You may leak urine when you cough, strain or laugh. Fortunately, this problem usually improves within three months. In the meantime, wear sanitary pads and do your Kegel exercises.

You may find yourself avoiding bowel movements out of fear of hurting your perineum or aggravating the pain of hemorrhoids or your episiotomy wound. To keep your stools soft and regular, eat foods high in fiber, drink plenty of water and remain as physically active as possible. Ask your health care provider about a stool softener or fiber laxative, if needed.

Another potential problem for new moms is the inability to control bowel movements (fecal incontinence) — especially if you had an unusually long labor. Frequent Kegel exercises can help. If you have persistent trouble controlling bowel movements, consult your health care provider.

During pregnancy, elevated hormone levels put normal hair loss on hold. The result is often an extra-lush head of hair. But now it's payback time. After delivery, your body sheds the excess hair all at once. Within six months, your hair will most likely be back to normal. In the meantime, shampoo only when necessary, and find a hairstyle that's easy to maintain. Avoid hair dryers, curling irons and harsh chemicals.

In addition to physical changes, childbirth triggers a jumble of powerful emotions. Mood swings, irritability, sadness and anxiety are common. Many new moms experience a mild depression, sometimes called the baby blues. The baby blues typically subside within seven to 10 days. In the meantime, take good care of yourself. Try to get as much sleep as possible. If your depression deepens or you feel hopeless and sad most of the time, contact your health care provider. Prompt treatment is important.

About six weeks after the birth, your health care provider will check your vagina, cervix and uterus to make sure you're healing well. He or she may do a breast exam and check your weight and blood pressure, too. This is a great time to talk about birth control, breast-feeding and how you're adjusting to life with a new baby.

Share any concerns you may have about your physical or emotional health. Chances are, what you're feeling is entirely normal. Look to your health care provider for assurance as you enter this new phase of life.