November 2018 Moms

Appointments and Updates 4/22 - 4/28

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Re: Appointments and Updates 4/22 - 4/28

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  • @MojieJo sorry i have no wise words for you, but i couldn’t read and not comment. i’m sad that your new ob is putting you in such a tough spot. i don’t think you have to commit to changing OBs if you just want to talk to a few others to get a feel for whether you can find a better fit.
    This exactly. Also, sending hugs because that’s a LOT at once. @MojieJo
  • @MojieJo I'm sorry your appointment was such a letdown.  I'd definitely get a second opinion on stopping the meds, especially since right now it's 1v1 as far as doctors opinion on safety.  Obviously not a doctor but I'd definitely agree that this OB is being a bit overly cautious.  Is there a way you can connect your psychiatrist and the OB so they can have a professional discussion about the merits of your treatment plan together and figure out the best way to keep *both* patients happy and healthy? 
  • @MojieJo I think it's great that you're listening to your body, yourself, and your husband to make the best decision for you. I'm glad to hear you're taking care of yourself. Definitely keep us updated after your OB talks with your psychiatrist about the medication. For now, take care of yourself and know that you're making the best possible decision for you and your baby. 
    @wannaflickone So glad to hear your great update! Hooray!  <3
    *TW*
    Me: 31 | DH: 33
    DD1: 8/2014  <3
    TTC #2: 6/2017
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  • @MojieJo - I definitely agree that before changing anything I'd speak with another doctor (probably another OB/MFM and your psychiatrist). I'm sorry you're appointment with this new OB didn't go as well as you hoped. I don't have any words of advice but just wanted to say I hope you and your medical team can all get on the same page and agree that a healthy mom is one of the most important things to getting a healthy baby! 
    *TW*
    Me:35 DH:35
    Dx: PCOS
    DS1 born 11/2014
    DS2 born 11/2018
    3 previous losses
    Rainbow baby due 12/2021 - Team Green

  • blumoon18blumoon18 member
    edited April 2018
    @MojieJo It sounds like your OB may not be comfortable dealing with someone with your medical history. Is it possible to just see an MFM doctor as your primary OB rather than this person? It really does sound like he's being overly cautious to the point of making you uncomfortable, and that is also not a good thing. You need someone who regularly deals with women with high risk issues, a place where your situation would be like the easiest of the day rather than the most challenging. I understand the pre-eclampsia and age as being higher risk, but if you are not carrying multiples, I don't understand why you wouldn't be able to have sex after 25 weeks. It honestly sounds like he's a bit over his own head, so perhaps the person to dictate your decisions should be the MFM rather than the OB. (I'm a physician, and when you described your interaction with him, it sounds like he was *not* comfortable -- and I understand his cautious attitude, but instead of throwing all these things out there, I may have just said, listen I'll defer you to MFM because I just can't handle it, rather than giving you all this advice that doesn't honestly seem that evidence based. I wish I was a more useful doctor, since I'm an ophthalmologist, but I can usually tell when someone is in over their head-ha). 

    When is your appointment?
    It was yesterday

    How far along will you be?
    10w2d

    What is being addressed at your appointment?
    Initial blood work, NIPT (cell free testing), blood work

    Comments/questions/concerns :

    Baby measuring right on track, at 10w3d. We got the NIPT (cell free testing) yesterday, and I go in for my nuchal scan in 2 weeks (I will be 12 weeks 1 day at that visit). Interestingly, the OB mentioned the option of elective chorionic villous testing and/or amniocentesis testing to check karyotyping and test for micro-deletions resulting in certain sporadic genetic syndromes such as Noonan's syndrome. This would be in addition to the non invasive testing/or in place of if I wanted. The overall collective risk for these syndromes is about 1:1200, which is pretty low, but not 0. She also mentioned the ability to test for microarray for genetic abnormalities that are associated with Autism spectrum disorders, MR, and other developmental delays. This is apparently a fairly new test that may not have a very high predictive value since the genotypes do not necessarily correlate with a phenotype everytime. When I go through the forums on this website, I don't see any other women who *elected* to go through this in an otherwise low risk pregnancy. (This is my first time pregnancy, I am 33, and I had genetic testing beforehand that showed I was a CF carrier, but my husband is not). I do not have fragile x, or any of the other 300 genetic disease they test for in pre-conception testing. Basically, this test would be for us (and possibly an out of pocket cost as well), so we can maximize the chances of a genetically normal child. It seems very tempting to do, but obviously not without risk. I am so confused and not sure what to do. Obviously I want a normal child, but are the risks and downtime so early on worth it.. especially if the nuchal scan and NIPT are checking out okay..? I just don't know. I usually think more knowledge is better, but in this case, I'm not sure it would answer more questions or create more questions. Part of me is wondering if this option was presented to me because I live in NYC and everyone here is well, so type A!. I would love to hear people's thoughts. 
  • MojieJoMojieJo member
    edited April 2018
    @blumoon18 Thank you for your input!  I appreciate it! :heart:

    I was starting to think the same thing, that maybe he was overwhelmed by my situation and was acting out of an overabundance of caution.  You really echoed my own thoughts now that I've had time to settle and think about what went down.  My old OB didn't think I was particularly complicated and I was having twins then!  

    I'm definitely looking forward to hearing from the MFM and seeing what his take on everything is, because it really feels like my OB is being extremely cautious, and I don't necessarily think it's all warranted.  I especially don't understand the no sex past 25 weeks thing.  I wasn't ever told to abstain with my twins and never had a shortened cervix, pre-term contractions or any threatened pre-term labor symptoms (just the opposite, those babies were quite happy in there and weren't going anywhere on their own).

    I'll be seeing the MFM at least as often as my OB, so I'm hoping that he can be a voice of reason and help calm both me and my OB down.  Maybe I can ask that he be the one in charge of the majority of the decisions in my care, like you said.  I'm hoping to hear from his office soon to make my first appointment.

    I'm trying to stay cautiously optimistic about this whole thing right now.  I've got a good psychiatrist who has my back and I've yet to meet the MFM, so I'm hoping he'll set my mind at ease a little more than the OB did.

    Right now, I'm basically in a holding pattern until I can get into the MFM and get some second opinions on things.  I figure I'm not a doctor, but I know my body, my mental health (imperfect as it is) and I've been pregnant before, so I'm feeling pretty confident that I'm not doing anything stupid by trusting my gut right now. :smile:
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  • @blumoon18 hmmm I also think that more information is better but in these cases I would really want to know what a positive result means. You say one may not have that high of a predictive value, so why do it? If it came back say positive for a gene that has a higher association with MR but didn’t necessarily mean your baby would have MR, for me it would just increase worry. I would only do a test if the results were definitive and I would have a high degree of certainty either way. 


  • @blumoon18 - You're low risk and if your NIPT comes back ok I wouldn't do any further testing if it were me. You also said you and DH aren't a carrier for the same things, so I'd feel pretty confident your baby is healthy. I think the CVS and amniocentesis are typically done to confirm an abnormal result from the NIPT or NT scan results.
    *TW*
    Me:35 DH:35
    Dx: PCOS
    DS1 born 11/2014
    DS2 born 11/2018
    3 previous losses
    Rainbow baby due 12/2021 - Team Green

  • I agree with PP @blumoon18, CVS has a not insignificant chance of miscarriage or damage to the baby.  While I am firmly pro give me all the info about my baby, the risks of a CVS aren't worth it for the unlikely chance that there's something genetically abnormal after NIPT comes back clean. 
  • Amber1174Amber1174 member
    edited April 2018
    @middleschoolmommy Congrats!!!!

    @MojieJo  I am sorry to hear your appt was so difficult.  I was told I would have to stop my ADD meds once I became pregnant.  It hasn't been easy, but I knew I had to for the health of the baby.  I asked my family to be patient with me for the next few months.  I am glad to hear you are listening to your body.  You know yourself best.  I definitely second the opinion of checking out some other drs.  Pregnancy can be very challenging and stressful without any additional stress from your OB.
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