XP: DH is furious and I'm confused...

lady_chance_99

Hey everyone! I am a pretty regular poster on IF, and I have a question about switching RE's and mistakes. I wanted as much advice on this as possible so I will be xp'ing for sure. I'm hoping you can give some opinions and insight...

I went for my annual today with my ob/gyn and we were going through all the updates since I saw him last and what he suggests and etc. We were having a casual converstaion about the meds I'm on when the ob/gyn says: "You've been ttc while on ______ medication?!" To which I answer: "Yes, I have repeatedly kept my RE updated on all medicines I take and have been on this med since last May..." Ob/gyn says: "So she knows about it?!" Me: "Yeah... my regular family doc put me on it and I have been on it ever since updating the RE monthly that I am still on the same meds." Ob/gyn: "You need to stop taking this immediately. This medicine is not appropriate to use while TTC. It can cause birth defects and increases the risk of m/c..." Me: "I was on it while I was pregnant the last time- and I m/c'd..." Ob/gyn: "Well we won't be able to tell now if that had anything to do with it but since you are about to do your first IUI in a few days you need to stop it NOW."

So I come home and tell DH about it when he asks how my appt. went. He is FURIOUS! He can't believe that my RE's office didn't check this out and tell me about it. He wants me to change RE's because of it. He said it's their job to check meds and know what is okay to be on and whats not... I'm just completely caught off guard and confused on what to do. My regular dr prescribed it to me knowing we were TTC and my RE never said it wasn't okay and for my Ob/gyn to be so vehement about it is really concerning. I want to give them the benefit of the doubt and assume that this is just a slip up and human error but DH is not so easily convinced. It doesn't help that he also hates their wait times (which with an appt can still be over 2hrs sitting in the room without seeing anyone).

I'm sure that part of me just doesn't wan tto have to drive an hour away to find another RE (especially in the middle of a cycle) but could you weigh in on this? Is this something you would leave your RE over? I don't know what to do... Thanks for any/all the advice you can spare... and as always GL

DrRx

What medication? I'm a pharmacist, and there are several drugs that there is a lot of gray area regarding what you are talking about.  Since both your RE and PCP don't seem to think that it is that big a deal, perhaps your OB is just overly cautious? Again, it's hard to give you advice without knowing which drug.  

If you don't feel comfortable posting the drug name, feel free to PM me and I will look into it for you.

lady_chance_99

DrRx:

What medication? I'm a pharmacist, and there are several drugs that there is a lot of gray area regarding what you are talking about.  Since both your RE and PCP don't seem to think that it is that big a deal, perhaps your OB is just overly cautious? Again, it's hard to give you advice without knowing which drug.  

If you don't feel comfortable posting the drug name, feel free to PM me and I will look into it for you.

Someone on 3T suggested I go on drug dot com and I did. It's FDA level D and the ob/gyn is correct, it specifically says over and over again that it causes abnormalities etc. Now the question is: Is this something they should have caught? Should I be looking into finding another RE? Man... I just don't know what to do...

ETA: I tried to PM you with the name but I'm apparently TB message challenged because I couldn't figure out how to send a message once I go to the inbox... LOL

steveandkim2

I think it's important for you and DH to feel comfortable and trust your RE.  FWIW, I switched clinics twice due to "mistakes" by the dr, and they were a lot less severe than what you listed.  Sure anyone can make a mistake, but I felt that if I'm spending large sums of money and trusting these people with the most precious gift I'd want them on their game

 Our first switch was from a large, university affiliated practice where they had residents doing the monitoring.  The resident called and gave me instructions to trigger, then called back 3 hours later and told me that after consulting with the re, he wanted me to wait another day before triggering.  Problem is he called after the time he told me to trigger.  That cycle was a bust. 

Clinic 2 was scarier.  I was near the end of stims for IVF 1.  I was in a ton of pain and heading into ohss.  When they didn't call me with instructions after monitoring, I called them and turns out they lost my labs that day.  When I asked what to do, the RE himself said that since he didn't have info, to keep,on my same doses.  I know something was wrong (and told him my concern about ohss) he said he didn't know what I wanted him to do since I had no labs.  I told him I needed to coast and we did.  DH wanted to strangle that RE because my health was at risk and he wasn't taking me seriously.  When I got to my 3rd re and she looked at my labs from the failed IVF, she told me its a good thing I stood up for myself because had I stemmed like e re said, I would have ended up in the hospital with a drain for severe ohss. 

Our third clinic  was a charm...well organized and an re we both trusted from the first consult.  It was an hour away and actually in a different state, but in the end we felt like she would get us our baby (and she did!). We will go back to her when we want to TTC#2 even though the clinic isn't the most convenient for us.

 I know it's a tough call but I would strongly consider switching if I were you...seems like a big miss to me and I'd be concerned about what else they would miss.  But you've seen my story and can see that I'm not the most patient person with practices  

pooman

Please know this is just my gut reaction and not some well researched answer.

I am the most upset at the doctor who prescribed the medication.  He is obviously familiar with the medication if he prescribed it.  And he knew you were TTC and said it was okay to take?  That to me is where the blame lies.

When I give my RE a list of my medications (and granted I'm on nothing stronger than synthyroid) I see it as her keeping track of what's going on with my body so she can plan my cycles better.  Her recommendations are stuff like more Vitamin D.  Not don't take X drug.

I guess (and once again I plead complete ignorance) I don't expect an RE to be 100% well versed on all drugs just like I wouldn't expect my general practitioner to know how much follistim I should take during my cycle.  I would really like to think if your RE knew the dangers she would have said something.  This could be a case of ignorance and not a mess up. 

That being said if your husband has lost confidence in your RE that is another issue all together and one that might be enough to change practices.  Like PP said being comfortable with your RE is extremely important.

Good luck making a hard choice. 

KYRN

I feel like it is wrong on both your PCP and RE to have missed it.  If it were a class C I wouldn't think it was as big of a deal because those are more of a gray area but a D is pretty standard not to take.  

If it were me I'd discuss it with the RE, and call my PCP for an alternative if necessary.  I'd probably look into a new RE but go ahead with the first IUI since you said it was upcoming, and schedule a consult elsewhere (it may take a while to get in).  Depending on  his response to you questioning it and the outcome of the cycle I would probably switch.

pamela-matt

I would have a really hard time with this one from both physicians.  I was on Lipitor and when I started TTC my PCP immediately took me off it and told me not to start back until I was done TTC.  I was also taking Midrin and my OB (who did my first labs) had me stop taking it immediately because it was very dangerous when TTC.  Now my OB is certainly not a PCP and not Neuro, but he still knew about a med for migraines and for high cholesterol.  It is their job to review your chart completely.  I am so sorry you are going through this.  

I agree with a previous poster that trust is very important.  Obviously no one can tell you what to do, but if you (or your DH) are experiencing any added stress due to lack of trust or previous mistakes made, that is not what you want.  Cycling is stressful enough.  I this mistake going to make you second guess your RE's recommendations?  No matter what you do, I would speak to both docs...it was a mistake that never should have happened.  

DrRx

lady_chance_99:

DrRx:

What medication? I'm a pharmacist, and there are several drugs that there is a lot of gray area regarding what you are talking about.  Since both your RE and PCP don't seem to think that it is that big a deal, perhaps your OB is just overly cautious? Again, it's hard to give you advice without knowing which drug.  

If you don't feel comfortable posting the drug name, feel free to PM me and I will look into it for you.

Someone on 3T suggested I go on drug dot com and I did. It's FDA level D and the ob/gyn is correct, it specifically says over and over again that it causes abnormalities etc. Now the question is: Is this something they should have caught? Should I be looking into finding another RE? Man... I just don't know what to do...

ETA: I tried to PM you with the name but I'm apparently TB message challenged because I couldn't figure out how to send a message once I go to the inbox... LOL

To PM me, at the end of any of my posts, on the lower right (under the siggy) click on "contact".  That will send me a message.  Let me know if you do.   

ela81

I would switch. I switched GI dr. after he gave me a class D drug (that I should take daily for life). I told him i was ttc, more than once.  He also knows of another medical problem I had that would make that med a problem for me and told me several times it was safe. A family friend looked it up for me and called me to tell me it was class D. There are other meds I could have been on. 

 

Like pps have said, I would hold both your pcp and re responsible. Good luck with what ever you decide.   

 

ETA:   

EastCoastBride

steveandkim2:

I think it's important for you and DH to feel comfortable and trust your RE.  FWIW, I switched clinics twice due to "mistakes" by the dr, and they were a lot less severe than what you listed.  Sure anyone can make a mistake, but I felt that if I'm spending large sums of money and trusting these people with the most precious gift I'd want them on their game

Same here. 

readyin07

Um, wow. Just wow. You are a better person than me. I would have freaked out on both of them. Before doing anything, I would call them to see their take on it. I can't imagine there being any "excuse" for this, but I would definitely be upset with my RE too.

lady_chance_99

steveandkim2:

I think it's important for you and DH to feel comfortable and trust your RE.  FWIW, I switched clinics twice due to "mistakes" by the dr, and they were a lot less severe than what you listed.  Sure anyone can make a mistake, but I felt that if I'm spending large sums of money and trusting these people with the most precious gift I'd want them on their game

 Our first switch was from a large, university affiliated practice where they had residents doing the monitoring.  The resident called and gave me instructions to trigger, then called back 3 hours later and told me that after consulting with the re, he wanted me to wait another day before triggering.  Problem is he called after the time he told me to trigger.  That cycle was a bust. 

Clinic 2 was scarier.  I was near the end of stims for IVF 1.  I was in a ton of pain and heading into ohss.  When they didn't call me with instructions after monitoring, I called them and turns out they lost my labs that day.  When I asked what to do, the RE himself said that since he didn't have info, to keep,on my same doses.  I know something was wrong (and told him my concern about ohss) he said he didn't know what I wanted him to do since I had no labs.  I told him I needed to coast and we did.  DH wanted to strangle that RE because my health was at risk and he wasn't taking me seriously.  When I got to my 3rd re and she looked at my labs from the failed IVF, she told me its a good thing I stood up for myself because had I stemmed like e re said, I would have ended up in the hospital with a drain for severe ohss. 

Our third clinic  was a charm...well organized and an re we both trusted from the first consult.  It was an hour away and actually in a different state, but in the end we felt like she would get us our baby (and she did!). We will go back to her when we want to TTC#2 even though the clinic isn't the most convenient for us.

 I know it's a tough call but I would strongly consider switching if I were you...seems like a big miss to me and I'd be concerned about what else they would miss.  But you've seen my story and can see that I'm not the most patient person with practices  

 This scares me to death! We have had issues with this RE but nothing I couldn't handle until this... we had things like waiting for literal HOURS in a room before getting to see anyone (after your appt time) and when I was pregnant and had low betas I asked repeatedly for progesterone support (if for nothing else than to ease my mind) and finally had to BEG before I got it, but again nothing I couldn't handle. Not knowing that the med I am on is cause for serious concern... makes me question everything else.

lady_chance_99

pooman:

Please know this is just my gut reaction and not some well researched answer.

I am the most upset at the doctor who prescribed the medication.  He is obviously familiar with the medication if he prescribed it.  And he knew you were TTC and said it was okay to take?  That to me is where the blame lies.

When I give my RE a list of my medications (and granted I'm on nothing stronger than synthyroid) I see it as her keeping track of what's going on with my body so she can plan my cycles better.  Her recommendations are stuff like more Vitamin D.  Not don't take X drug.

I guess (and once again I plead complete ignorance) I don't expect an RE to be 100% well versed on all drugs just like I wouldn't expect my general practitioner to know how much follistim I should take during my cycle.  I would really like to think if your RE knew the dangers she would have said something.  This could be a case of ignorance and not a mess up. 

That being said if your husband has lost confidence in your RE that is another issue all together and one that might be enough to change practices.  Like PP said being comfortable with your RE is extremely important.

Good luck making a hard choice. 

This is EXACTLY what my gut reaction was especially since my regular dr has now put me on TWO medications that are not safe while TTC... The only reason I haven't changed that dr yet is because the office is within walking distance to my house. I know that's a weak reason but until now i had only known about the one medication issue so i was letting it slide...

lady_chance_99

KYRN:

I feel like it is wrong on both your PCP and RE to have missed it.  If it were a class C I wouldn't think it was as big of a deal because those are more of a gray area but a D is pretty standard not to take.  

If it were me I'd discuss it with the RE, and call my PCP for an alternative if necessary.  I'd probably look into a new RE but go ahead with the first IUI since you said it was upcoming, and schedule a consult elsewhere (it may take a while to get in).  Depending on  his response to you questioning it and the outcome of the cycle I would probably switch.

This is great advice and I think this is probably what I will do. I figure it can't hurt to at least get a consult somewhere else... even if it means an hour drive I guess. Thanks!

perry7285

i think if i were you i would go ahead and finish this cycle with them and then switch. incompetence in missing this drug issue doesn't mean incompetence with other things, so i don't think this means you need to immediately stop any care from them. but i do think that this isn't a great sign about their level of attention to your care, and given that their wait times are a problem too, it sounds like switching is a good idea.

i'm so sorry that you're dealing with this.  

lady_chance_99

perry7285:

i think if i were you i would go ahead and finish this cycle with them and then switch. incompetence in missing this drug issue doesn't mean incompetence with other things, so i don't think this means you need to immediately stop any care from them. but i do think that this isn't a great sign about their level of attention to your care, and given that their wait times are a problem too, it sounds like switching is a good idea.

i'm so sorry that you're dealing with this.  

We have decided to go ahead with this IUI cycle (since we are only days away) and then consult with another doctor. I have already made the appoinment for the consult. Hopefully I will be nice and KTFU by then and won't need it but just in case... Thanks for all your support, and as always GL

google123

DrRx:

What medication? I'm a pharmacist, and there are several drugs that there is a lot of gray area regarding what you are talking about.  Since both your RE and PCP don't seem to think that it is that big a deal, perhaps your OB is just overly cautious? Again, it's hard to give you advice without knowing which drug.  

If you don't feel comfortable posting the drug name, feel free to PM me and I will look into it for you.

 

Since you are a pharmacist, what about Estradiol?  It says it's a category X, can cause abnormalities in urogenitcal areas in  males and in females....yet when doing IVF or FET we are told to take estradiol and progesterone for the first 12weeks.  I was freaked out about it.