Appointment Apprehension

costumegoddess1

Has anyone else had a heck of a time with their first appointment with their provider? I went in of Friday, DH at my side, to meet the CNM who came highly recommended.  I wanted to meet her and make sure she was the right fit.  We didn't get to meet her OR the other CNM in the practice with whom she share calls.  She was off at the hospital for a delivery.  So they put us with a PA.  Not the person who will be caring for me throughout my pregnancy or the person who will deliver the baby.  So I am still not sure if the CNM route is even the right fit for me! The ONLY thing at the appointment that didn't cause me intense physical pain was filling out the paperwork.  The blood draw (I am TERRIFIED of getting my veins stuck because it is always VERY painful; shots and finger sticks are fine.  Veins, NO.) So that was painful.  Then a pap smear; also painful (which is usual for me and why I elect to do paps no more often than ABSOLUTELY necessary), though not as much as the blood draw.  The speculum is uncomfortable but doesn't hurt;  its the scraping (I am told I can't feel it because there are no nerves in the cervix, but it HURTS.  A LOT.)  Then a breast exam.  Those don't normally hurt, but this one did, since over the past couple of weeks,my breasts have been sore.  Then a transvaginal ultrasound.  Not so bad at first, but then she started digging around with that thing, looking for my ovaries, and I felt like my insides would be gouged out.  The PA did answer a few of my questions, but didn't really give me any other guidance, and I left feeling a little assaulted, and I cried for 2 days after.  

The other thing they want to do in 6 weeks is another ultrasound and bloodwork.  DH has a business trip that takes him away right before then, and I don't want to do it without him.  He was my rock and the ONLY thing keeping me from being a full on hysterical mess at this appointment.  They said "we have to do it no earlier than 11 wks, 5 days."  I said "He will be gone then.  Could you do it on Friday of the previous week? That's 11 wks 2 days.  But he will be here.  He leaves for work April 15 (11 wks 4 days)."  They said, "No problem; we can schedule all the way up to 14 weeks.  When is he back?"   "May 20" I said. (which is 17 weeks).  After a lot of tears and coaxing, they admitted that the thing they REALLY need to do at that exact date is the ultrasound, and they just schedule the bloodwork for convenience on the same day.  They finally agreed that I could do them as 2 separate appointments so I could have DH there for the bloodwork part, which is the scariest part (scary as in I was shaking and nearly passed out, so the clinic saw how difficult it is for me.)  I burst into tears there at the appointment desk as I was forced to schedule and ultrasound without him, and I left the clinic sobbing.  I don't want the first time I see my baby to be me there all alone.  

I am now VERY apprehensive about going to my next appointment.  I feel like I am sitting awaiting execution, but at least the people on death row have the hope of an appeal.  I am super scared that it will be bad too, and I am scared that the CNM I made the original appointment with will be unavailable again. In fact, I don't know if I am even supposed to meet her at either of these next appointments. I am told that the CNM is very holistic and compassionate in her approach, which is why I chose her based on recommendation.  I am afraid that I am going to be a ball of nerves for the next 5 weeks until I have to go back.  

HELP!  Is anyone else having this hard a time with their doctor situation?

costumegoddess1

Bringing some other support person instead of DH DID occur to me.  I thought about who I might want there.  My sister.  My mother. One of the 6 people I consider to be my dearest friends.  

But the CLOSEST any of those folks live is 500 miles away. 

sammierose464

You need to find a Dr that you're comfortable with. However all of this is routine and things you need to get done for the health of your baby. It's unfortunate that they cause you so much distress. You could opt for genetic testing instead of the 12 week NT scan, that's a blood test that can be done as early as 9 weeks. However, it's not usually covered by insurance. Unfortunately, you can't really control if your Dr will be on a delivery. All you can do is talk to them about ways to make it easier for you.

costumegoddess1

Its not even "my Dr" on a delivery vs just being put with another person with the same credentials.   They put me with a Physician's Assistant rather than with a Dr or midwife.  At least had it been the other CNM in the practice, I would have gotten to meet the "backup" person who would be on call id my CNM was not available when I go into labor.  The PA was nice enough, but did not seem to know all that I was trying to ask about. 

Being over 40, I am opting for both the blood test AND the NT; that is why they are doing the blood test the week before the NT.  I am not sure whether insurance will cover the NT (I have not gotten a hold of anyone on the phone to be able to answer that), but I know my blood test cost will only be $199, and that I can live with for the peace of mind it will bring. 

But all of that is neither here nor there; I am still nervous that I have not yet met the midwife I think I might want, and it still brings me to tears to imagine having to go to the NT all alone.  

Lisa3379

FWIW, I saw my actual OBGYN maybe three times before delivery. Scheduling with my work schedule and her schedule was super tough. I was irritated by this, but those appointments were so routine that looking back, it didn’t really matter. The thing that REALLY mattered to me was that my actual doctor delivered my son - we lucked out with that one, because it depended on who happened to be on call at the hospital. This time around, my first appt was with a PA, and that’s standard with their office. Totally fine. 

Also, I am also super afraid of needles, but my fear gradually got better and better the more blood I had drawn. I still HATE it, but it’s not nearly as bad now as it was at the beginning of my first pregnancy. Hopefully this also happens for you. 

costumegoddess1

Well, at least I know that the PA isn't so unusual.  

As for needles, for the record, I am not scared of needles.  I accidentally drove an industrial sewing machine needle through my fingernail, through my finger, and out the other side, with only an "oh!" And "hey Matt, would you mind grabbing me the first aid kit?"  Wasn't bad at all, though it did require a trip to urgent care to get it cleaned and get a tetanus shot (also no big deal.)  I got allergy shots twice a week for the better part of a decade, no problem.  I have 6 tattoos.  Piece of cake!  Had my cholesterol checked with a finger stick, it was fine!  What I am terrified of is how painful I know it is if someone tries to stick my VEIN.  That's it.  No other needles bother me.  I have tiny veins, and more than once they have had to stick me multiple times to get one.  It hurts more than anything I can think of.  I know I haven't been through labor, but I have been through that sewing machine incident and through gallstones, and of course those hurt, but I would say more like a 4-5 on the pain scale.  Vein stick are like an 8, and 9 if they miss. Only ONCE have I gotten through a vein stick without a full on panic attack, and that was for an IV for oral surgery.  The nurse put something on that made me not feel anything but a little bit of pressure.  It was amazing!!!!  I did ask the phlebotomist who took my blood to do that too, and she said "oh we don't do that here. It isn't necessary." She said " you look like you might pass out; you need to lie down." Then she instructed me "I'm going to need you to stop shaking" As if fear-induced shaking was voluntary.  (I wasn't even aware I was shaking I was trying to just stay focused on DH to calm myself down. ) Then I felt the intense pinch of the tourniquet, which also really hurt, and I started to cry.  I never looked at what she was doing, but I could feel the exact moment the needle went in and I tried to focus on DH more, I kept my eyes on him and talked about a podcast we like,  but I kept interrupting myself to sob "oh go it hurts so much! Take it out!" It felt like an hour that I had to sit feeling that needle in my arm, but I think it was only a few minutes.  And she thinks that numbing isn't necessary??????

 I have to say that I dread the prospect of having to get an IV in the hospital WAY MORE than the prospect of labor and birth. 

kiwi2628

You need to be comfortable with your doctor and the practice in general (as there is always a chance your OB/midwife may not be the person to help birth your child because life happens), but I would also encourage you to maybe seek a therapist for a bit. With pregnancy, you will be put in uncomfortable situations a lot- vaginal exams, a lot of blood draws (a lot, and not a finger stick), appointments that need to happen between X and X date, and your SO may not be able to make it to all of them within the appropriate time frame. Having someone to talk to to help you work through your anxiety may help make this process much easier.

costumegoddess1

I had been seeing a therapist for 2 years.   I opted to stop going so that I could afford to go to the prenatal appointments; that and after 2 years, I felt like she wasn't really helping anymore. I did used to be on anxiety meds but tapered off those to get pregnant, and honestly, I have been off them for 6 months and been fine; the office visit was the first time I have had an issue with anxiety in years.  (A LOT??? The RN who helped me with paperwork reassured me that given my general overall health, they would only need to take blood twice!  )

kiwi2628

@costumegoddess1 I have never been pregnant myself, but I have friends who have been and they all had blood way more often than twice. Especially being AMA, you are at a higher risk for things like GD, pre-e etc... so I know many doctors will screen more often for these things, and if anything starts to look 'off' you will likely have blood a lot more often.

costumegoddess1

@kiwi2628... perhaps the RN was just trying to put me at ease.  This was in the little office where we were going over paperwork when I first got there.  She saw at the mention of the word "blood test" that my hands were shaking enough to where it was hard for me to sign the papers (it looked like my Parkinson's Grandmother's signature!)  It's true, I am AMA, but she did say that since I had no other risk factors and a good personal and family medical history, that I was unlikely to encounter that other stuff.  Here's hoping.  

I spoke to my sister about this.  She offered to call in a prescription for topical numbing cream that I could bring to my next appointment.  (She is a pediatrician)

cdepperschmidt

My first appointment was with a PA. The doctors first priority is delivering babies. I was told that they would try to schedule me with an OB but it’s not guaranteed. They are on call and babies come when they please.

I did find all the exam things were more painful than usual, but I chalked it up to pregnancy sensitivity. All of these things are routine for you and your babies health. Pregnancy includes a lot of discomfort, needles, pain and it’s emotionally challenging. I get blood work every month because of my thyroid, some women have to get extra hormone shots. This is all before delivery, which even if you get an epidural includes pain. Maybe you should look into yoga or other relaxation techniques. 

costumegoddess1

Also, do other women have menstrual-like cramping after this first visit? No bleeding, but definite cramping for several hours afterward.  I would have called and asked that, but of course my visit was on a Friday afternoon and they are closed until Monday.  

@cdepperschmidt So at what point did you finally get to meet your actual OB?

tinattt23

All but one of my appointments last time were with my actual OB. She was on vacation for the one that wasn’t. She’s part of a large OB group, so each doctor is on call for deliveries a certain day of the week and they don’t make office appointments that day. But, that means the odds of my OB actually delivering my baby are pretty low. Which is fine with me, but everybody has then own preference.

I will say, even being low risk, I felt like I was giving blood for some reason or another at almost every appointment until maybe half way through. Then I think it was only once or twice after that. I really hated it at first, but it did become more normal over time. And the IV during labor oddly didn’t bug me at all (way too focused on the whole birthing a baby thing). 

costumegoddess1

I hope that is how it goes for me; I hate that my fear and anxiety is taking over the joy of finally becoming a mom.  My CNM is part of a practice that has several midwives who share calls, and they do recommend you rotate your scheduling with each of them so you will be familiar with the one who ends up attending the birth.  I’m just not fully decided on if this is the route I want to go, as I have never used a midwife before.  Part of what I wanted from the first visit was to meet with a midwife so I could ask questions and decide if I was comfortable with her.  

I did did schedule a pre-conception visit with an obstetrician in preparation for all of this, since I just moved here and I only had an internist so far. The OB I met was rude and abrasive, and when I shared this with a friend, he recommended his wife’s CNM to me.  I was a little skeptical about going midwife over doctor, but the woman who thought she did such a good job is a NICU nurse, so I felt she would know. Still, I would like to meet a CNM to know for sure. 

concreteayngel

For my first pregnancy, I had insurance through Kaiser. Even though I had a designated OB, I never saw her. It was always a midwife or some other doctor. I don’t think I saw the same person twice the entire time I had Kaiser. 

Then my husband switched jobs, and thus, our insurance changed in my 8th month. I had a new OB after that that I saw regularly. She did NOT have a gentle touch. I was so grateful that she took me on at 8 months along, that I just stuck with her, but if you’re early on in your pregnancy, there’s no reason to stay with a provider that you’re uncomfortable with! 

cdepperschmidt

@costumegoddess1 This is baby #2 for me. My practice had 4 OBs and 2 CNM last go around. Currently they only have two, but I met them both last time. I scheduled my 12 and 16 week appointments with them so as long as there is no delivery they should be there. I’m not planning go the midwife route. Most of your appointments the only thing the doctor does is measure your belly and listen to HB, so a PA or NP can totally do that. 

Edit to add. I got REALLY lucky last time because I scheduled most of
my appointments with the OB I really liked and got lucky because she was on call when I delivered.