Tuesday, June 21, 2011

My First (Ever) OB Appointment

You can’t always get what you want.  But if you try sometimes, you just might find, you get what you need…

After the first half hour of my appointment with my OBGYN, I couldn’t get that song out of my head.  I didn’t stop to think about why until I was lying in bed last night, trying to sleep.  At that point, the events of the day sunk in and I could see why my mind chose that song to fixate on.

When I arrived at the OBGYN’s office, at yesterday, but didn’t get to see the doctor (let’s call her Dr. B) until after   When I finally saw the doctor I was extremely anxious.  I had too much time to sit and think about the spotting and cramping over the weekend, and how The Prince wasn’t with me at the appointment, to get me home if the news was bad. 

When Dr. B entered the exam room, she brought this great, calming presence with her.  I blurted out what happened over the weekend and she told me she wasn’t overly concerned because the high level of progsterone I am taking can cause those symptoms.  I expected her to stop my appointment and say that she would talk with me more after doing an ultrasound to make sure the baby was okay, but she didn’t.  Instead, she forced me to sit and answer questions about my medical history, The Prince’s medical history, our families’ medical histories and the egg donor’s medical history.  She forced me to listen to all of the instructions about what to eat and not to eat, what activities to avoid and what activities to increase.  We talked about my hospital choice and how it is a great choice, but can be changed if I ever become uncomfortable with it (she has privileges at all three of the area’s hospitals).  We talked about how she performs all of her deliveries personally, unless there is an emergency, in which case there is only one other doctor that she allows to handle her clients.  She explained that she schedules her vacations around her clients’ due dates.  She only missed two births last year, and worked 351 days out of the year.  The whole time she was talking to me, I could feel my tension easing…but I still kept bringing up that I was worried about the baby and the pregnancy.  She just kept on making me talk about other issues.

I about died when she said there will be no ultrasounds between week 12 and week 20.  Dr. B explained that you don’t really learn anything by viewing an ultrasound between those weeks.  I blurted out “You learn if everything is okay with the baby…that it still has a heartbeat,” and I started crying.  Without getting angry with me or looking at me like I am a basket case (which I clearly am), she said that she understood my worry, although she didn’t share my increased concern.  She said that we will listen to the baby’s heart beat at 16 weeks and more often if I really need to.  She calmly but firmly explained that she sees no medical indication that I am going to be at a higher risk for losing the baby.  She did say that she won’t allow me to go to 40 weeks of pregnancy because, in her opinion, babies conceived through IVF shouldn’t go past their due date because the placenta becomes more compromised the further along the pregnancy progresses.  So, if I haven’t gone into labor by January 12, 2012 (the week 39 date), we will either induce or do a C-section.  Dr. B also said that I will likely be able to try natural childbirth.  I had previously been told that, because of my multiple uterine surgeries, I would have to have a scheduled C-section, because no doctor would take a chance of me going through labor.  Dr. B said that the three uterine suspensions (a procedure that she made it very clear that she is appalled that anyone would do anymore, as it is archaic in her opinion), will be pulled out during pregnancy and that my pregnancy and childbirth will likely be much more painful because my round ligament is currently tied off and stitched to other structures.  Dr. B strongly recommended that I begin considering what pain management methods I am comfortable with for labor and delivery, as I will likely need some assistance.  However, Dr. B likes to take the most natural route possible for bringing a baby into the world, within reason, and so she isn’t just jumping to a scheduled C-section.  

Dr. B also said that she feels the least invasive prenatal screening is appropriate right now, as we have worked too hard to have a baby to risk a miscarriage because of CV testing.  Dr. B only uses 3D ultrasounds and the ultrasounds at week 12 and week 20 will each last 45 minutes to an hour, so that every possible measurement can be taken.  Dr. B feels confident that the ultrasound testing, in combination with blood work screening, will provide a reliable assessment of the same things that a CV test would test for.  If anything comes up suspicious, Dr. B recommends an amniocentesis, rather than CV testing. 

When Dr. B essentially laid out what we were “going to do” instead of asking me what I wanted to do, I thought “this isn’t going to work…I need someone who will let me run the show.”  But then I realized that I actually trust Dr. B’s opinion and experience, so her confident approach may actually be the best thing for me.  Will I get frustrated when she tells me “no”?  Of course.  I am apparently still a petulant three year-old at heart.  But, will it be a relief to have the pressure of making all of the “right” decisions off my shoulders?  Oh yeah!

At the end of my appointment, as I was packing up to leave, Dr. B smiled and asked if I would like them to do a quick ultrasound for me…just to reassure me that the baby is okay.  If I was still had any doubt about whether Dr. B was the best fit for me, that moment eradicated the doubt.  I am amused that Dr. B appears to have used the “Dog Whisperer” technique on me (display a calm assertive nature until the agitated dog/patient becomes calm and then, after you are done interacting, reward the dog/patient with something it really wants). 

Dr. B’s ultrasound technician is one of the nicest people I have ever met.  A nurse came in “for moral support,” as she had heard that my husband wasn’t able to make it to the appointment.  And as I watched the giant ultrasound TV screen that is hung in front of the table…there was our baby…with a nice strong heartbeat…waving.  I know how crazy that sounds, but the nurse pointed to the waving hand and we actually have a couple of really great ultrasound pictures where you can make out the baby’s little fingers pointing up and then curled over.  I kept laughing an crying at the same time, as the baby would hold still for a few seconds and then wiggle like mad, kicking out its tiny, stubby little legs like a crazy person (apparently, the baby got The Prince’s dancing ability…or should I say…inability). 

Dr. B was right…about the baby being alright and, I want to believe, about our good chances of having a successful pregnancy.  She wasn’t the compliant “whatever you want” doctor I had wanted, but she just might be exactly what I need.  


Anonymous said...

So glad you got to see the baby :). Sounds like a great dr.

Christina said...

I'm glad you like your Ob! It is definitely important to have a good relationship with a Dr that will be apart of such an important part of your life.

Yay for surprise ultrasounds!

infertilenanny said...

I'm so glad your appt. went well and I just wanted you to know your my new favorite blog because I myself am due January 25, 2012 after fighting infertility for almost 4 years! I'm so excited I found someone I can relate to!


China Doll said...

Wow, what an awesome Doctor! She sounds wonderful.. and love the Dog Whisperer technique (it's just come on TV over here and I'm hooked!).

Glad that you have a plan for screening and she sounds really knowledgeable about how your past treatment will affect things which is fabulous.

The scan sounds wonderful too :)

Such good news! xx

ICLW #103

New Year Mum said...

She sounds great... my OB is just like that and after having been through 2 pregnancies with him, I can say from experience that having someone who is up-to-date and willing to make tough decision is the best for anxiety. I just keep saying to myself that we're "paying him to do the worrying for us" and so I do what he recommends and let him take control. Great that you saw your little one :)) How wonderful to see s/he wave. love always xoxo

Lindsey said...

The dog whisperer comment made me laugh so hard! So happy you got "rewarded" at the end of the visit!!

kewiesterrock said...

She explained that her schedule, her vacation, and her clients about the deadline. Last year, she only missed two development to 351 days, was born.

appointment setting

Elli Degennaro said...

I understand why you worry that much, but you should remember that doing so is not good for your condition. Try to relax and be calm. Following your OB's orders guarantees you and your baby will be perfectly fine. Remember that your baby feels exactly as you feel. You don't want your baby getting all worried now, do you?

-Elli Degennaro @ CentennialObgynPA