Wednesday, March 25, 2009

Need Your Advice

I am currently very annoyed at the complacency of my OB team. I had my 28 week visit with my OB's nurse practitioner (Dr. OB was unavailable) last Friday the 20th, and after talking with her (she doesn't really know anything about my clotting history or bicornuate uterus), I'm seriously considering asking for a referral to one of the Perinatologist's in this hospital system unless they're willing to start NST (nonstress tests) and grown scans soon. She said they generally don't start NST's until week 34 and only do growth scans if my measurements are off. I'm not scheduled to see my regular OB for another 3 weeks...on April 10th.

My concern? I have not only ONE, but TWO major factors that can cause issues during the 3rd trimester. My thrombophilia puts me at risk for premature deterioration of the placenta and placental abruption...among other things, and my bicornuate uterus puts me at risk for IUGR (intrauterine growth restriction) and pre-term labor. Why NOT be overly cautious from here on out? The last ultrasound I had was my comprehensive scan at 20 weeks, and I've been measuring right on-track at each appointment. I'm up a grand total of 15 pounds and my blood pressure, blood sugar, hemoglobin, aPTT (blood clotting test) and platelets are all great. But honestly, I'd really like to keep it that way! I try to do kick counts at least once a day and baby is pretty predictable with his post-meal and pre-bedtime gymnastic routine.

I'm soliciting advice from other high-risk mommies (parents) who insisted on closer monitoring...no matter what trimester you were in. I'm not sure if I should wait until the 10th to address my concerns, or call OB's office and talk with his nurse about a referral. I have NO idea how long it would take to get hooked-up with a Perinatologist. I know the worry and tears these thoughts are causing aren't healthy for me or for the baby. I just don't want to be one of "those" pregnant woman, but I think this warrants some attention. Help!

On a lighter note...quote has been placed above baby boy's crib. I love it and I'm so in love with him. I can't imagine how much that love will grow once I actually MEET our little guy.



10 comments:

admin said...

You know my story. I heard that little voice of distrust of my OB practice and ignored it. If I had payed attention to my instincts, I may have avoided 4 weeks in the hospital and 4 months on bed - not to mention a lot of heartache.

Trust your instincts. YOU ARE RIGHT! Your doctors should be willing to listen to you and help you to guide your own care. Be a fierce Mama. Insist on the care you think you need and if they will not give it to you find someone who will.

that is my 2 cents.
xo
Meredith

Beautiful Mess said...

I think it's your right to be "one of those patients". Plus who cares when it comes to the health of you baby, right? I'd say call and bug the nurse and she what she has to say. Beautiful quote above his crib. I love it! Hope you're feeling well!
*HUGS*

Heather said...

I also think you need to go with your instincts. I'm being monitored closely at the hospital maternal-fetal medicine department as well as my OB since we're expecting twins. I think you're reasons for being monitored closely are more important than just expecting twins.

areyoukiddingme said...

Get the referral for the perinatalogist. You have all the risk factors to satisfy an insurance company, I'm sure. If your OB doesn't want to monitor you, he should have no problem passing you off to someone who will. It's kinda late in the game to switch to another doctor, but he probably should have sent you to a specialist earlier.

Anonymous said...

Here from LFCA:

I would bypass the nurse and bring your concerns right to the OB. leave a message for the OB to call you back asap. If he/she is worth the degree they have they will call you and discuss these things with you. The NP is just doing what she knows. However, your OB should be more than willing to listen to your concerns and discuss referrals.

And, who cares if you are "one of those" patients? We are talking about the life of your baby and your well being. We must be our own best advocates when it comes to medical care.

-Heather

Anonymous said...

Not that I know anything about pregnancy, but I don't see any reason why you should put up with staying upset, miserable, and anxious when the solution is so straightforward. It doesn't sound like you are overreacting, but even if you are, so what? Get what you need to stay sane and to keep your baby healthy.

Anonymous said...

The quote is beautiful! Well I have no experience with high risk, but I know if it was me, I'd do everything possible to ensure I was receiving the best care. Sometimes you have to be blunt and tell them what you want. I would definitely call your OB with your concerns ASAP.

I Believe in Miracles said...

I would totally call the dr and voice your concerns. You have decent points and you are high risk, regardless of what that NP thinks. There is no problem asking for a 2nd opinion (that's what I did for my lump) and ended up with a biopsy. It's ok to make sure. The question will be - what if your OB says no too? Maybe cross that bridge when it comes? You are the patient and paying for the care. Demand what you need. Can't you tell I'm the annoying patient???
~~HUGS~~

Anonymous said...

Hey Mel- I totally agree that you should push this issue. You read my posts long enough to know how often I went to the peri- my appointments began at 12 weeks monthly, then ended up weekly by the end. On TOP of all my regular ob visits. And I only had one of the risk factors that you do!!

Skip the nurse, go right for the doctor. If you don't make headway (I bet you will though) call the peri office affiliated with your ob and ask to have a doctor call you back. Maybe they could shed some light too.

Big hugs, mama... xox

sara said...

Brynn is crying so I need to feed her but I'm going to type an extremely long annoyingly long post in a few for you. I am really concerned like Meredith that you get the care you need. You are at risk for things and NEED extra monitoring..keep pushing. Let me think of anything that might be helpful...I will return in a bit ((hugs)) My word verification is turds...yes doctors sure are turds sometime, LOL!