Multiples

Worrying

My cousin (the OB) seems to think that I'm getting crappy care from my OB. She said she sees her twin patients multiple times in their first tri with u/s's. Mine said he doesn't need to see me until 12 weeks, which seems so odd to me with my history (5 miscarriages) & the fact that it's twins. Also, my original dr said the plan was Lovenox. The new one didn't think it was necessary. And no progesterone supplements. She said to call in the morning & ask for all of these things TOMORROW including more visits. I can't switch drs because we are on Medicaid SO it's either this nice office or the skeezy clinic downtown. I may get better care there though...

So, of course, I'm PANICKED. I'm worried that it's too late to start all of this & I'm going to end up like I was in August (D&C at 11 weeks). She said not to worry, but every time I talk to her, I feel worse. 
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Re: Worrying

  • I can't speak to the meds, but not having many u/s's or visits in first tri was normal at my OB's office. Was it your RE who recommended Lovenox and progesterone?
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  • No, it was my OB. The one who I've been seeing all year who is out of the office for a month - I'm not sure he's coming back, so I'm seeing the other guy.
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  • Ah ok. Yeah I would call tomorrow about the meds and ask again why new OB thinks they're not necessary and if there is any harm in taking them anyway.
  • Maybe go to the sneezy clinic for a consult and see what that docs opinion is? Or is there an MFM or a perinatologist in your area that's covered? That may just at least give you a few more doc options?
  • RE & MFM isn't covered with Medicaid, but I may just find that we need to pay out of pocket to see someone who is going to really pay attention & give me the care that I need. @hgrosch
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  • edited October 2013
    Was there a reason your original doc wanted you on progesterone and lovenox?

    Your number of visits during 1st tri are perfectly normal.

    sometimes family and friends who are doctors mean well but are just interfering with your care. They so not have access to all your medical history and tests. By all means advocate for yourself but if your cousin is so concerned, let her offer up her services pro bono.


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  • Totally normal on the US.  It's not until later (2nd/3rd) that you start getting regular ultrasounds.  As for the meds, that is worth discussing with your doctor why the first one recommeneded and new one isn't.


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  • My MFM accepted Medicaid. Are you positive there isn't one in your state?
  • I don't know if this will help or not, but I'm having twins. I saw my RE @ 6w when he released me to the MFM. Saw the MFM @ 8w and had a confirmatory u/s for their records. Won't see him again until 12w. I don't remember having many appointments in the 1st tri with my last pregnancy either with mono/di twins. My MFM also doesn't recommend progesterone in twin pregnancies because he says the body already produces the excess progesterone and it's not been proven to help in twin pregnancies either.

    That being said, if you don't feel comfortable with how things are being done be very vocal about it. Also, I know that the MFM I saw in my previous pg and the one I see now accept Medicaid. You should check it out as a multiples pg is considered high risk and MFM visits should be covered.
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  • I called my dr's nurse as soon as they opened today & asked to be put on progesterone & Lovenox. If there is no reason not to, then why not just throw the kitchen sink at this pregnancy?! If he has reasons as to why it won't help or why he doesn't want to, then that's another discussion. I just wish the other dr was around - we liked his plan & felt confident. He was concerned & proactive. This guy literally said to me, "well, now we just wait." Not cool with that with my history. 

    @pinkinprovence I think it was just to buffer everything. All of my b/w came back normal, but I think it was to be extra cautious after 5 losses. If it doesn't hurt, then why not. And my cousin lives in TX & I'm in CO. I'd have been seeing her all along if I she were closer.

    @Caden I searched for hours last night & I think there is an MFM an hour away that accepts Medicaid. Calling in a bit.
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  • ~hugs~  As to the number of appointments, I agree with the other ladies here.  Your doctor's way of putting "we just wait" is kinda the mentality I think exists in the first trimester because there is so little they can do.  I hated it as well.  I went in to the ER almost 3 weeks ago with heavy (hemorrhage) bleeding.  It was so bad I was convinced I was losing the twins and I lost so much blood from around 8:30a to early afternoon that I needed two blood transfusions.  They could do absolutely nothing but check my cervix (was open dime sized) and do an ultrasound for the twins.  Even then, when the u/s sound showed the twins dancing healthily around in there, they still wouldn't let me have food until 2:00a the next morning because they were so sure they were going to have to do a d&c when the twins finally aborted..  Proved them wrong! 

     

    I guess the point of this is to say that more visits in the first trimester don't seem to be the norm because there is so little they can do to keep the little ones in at that point. 

     

    On the med side, heck yes!  Ask why, why, why, and why again.  Anything that CAN be done to avoid losing them should be imo.  ~hugs~  Twelve weeks will be here soon, and then you'll hit the point where you are seeing the OB constantly and get sick of driving to the office :)

     

    Curiously, what area of CO?  We just moved to Orange County from the Boulder / Superior area when I got remarried.  Soo pretty there!  Just so insanely dry :p

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  • @Missi576 I suppose you're right. I just want to do everything humanly possible to make sure these beans are safe.

    I called an MFM office & I am in love with their receptionist. She spent 15 mins on the phone getting my info, talking to me about the practice & telling me what I can expect. They review my info & have to accept me into the practice, but with 5 miscarriages & a twin pregnancy, I'm thinking I'm a shoe-in. I should hear back this afternoon whether or not I've been accepted. After that, I have to have my dr release me into their care for a few weeks, then schedule a viability u/s with the MFM next week. She thinks they'll want to see me ASAP given my history. AND...they take Medicaid! Woop!!

    My dr just called, wants me to do another progesterone blood draw, then he'll give me a Rx for progesterone based on that reading. He said no to the Lovenox at this point - he usually start that at 12 weeks. He said it's one hell of a precautionary measure this early in the game. Which is fine. I just want someone to tell me WHY I don't need it. I didn't test + for MTHFR so REALLY I don't need - it was an added buffer. 

    Anyway, thanks for your help ladies. I should know in a few hours if I get to see this MFM. Hopefully, they'll take me on & I'll be getting high risk care. Which is what I feel I am - my current dr doesn't.
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  • If you don't mind me asking, do you know the reason for your 5 miscarriages? I had miscarriages that would not have been preventable even if I had taken 500 meds. They were genetic abnormalities in the fetus. I am not really of the belief to just throw drugs at a pregnancy and see what sticks. I think it is responsible of the doc to not just prescribe everything, especially this early! However, he should be explaining to you WHY! That being said, progesterone does no harm to you or the babies and is a very good precautionary med in most cases of pregnancy. So there I think he was wrong in not considering it. The rest of the meds are specific to each mothers body/condition. Does he intend to give you shots, gel or suppositories? The form varies on your symptoms.

    Also glad you got in with the MFM, they will be very helpful! Have you had an ultrasound yet this pregnancy? I know Medicaid has limitations to how many you can get covered in a pregnancy. That may be why he is hesitant!

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  • @smscartozzi My original dr said that it was poor ovulation - I was ovulating a bunch of immature follicles. So, he prescribed Clomid for this time around. It worked. The Lovenox was a precautionary measure, I believe. I'm perfectly happy to avoid the stomach injections if I can, but if it's best for the pregnancy, then let's do it. I think, at this point, they are probably unnecessary, but I'm not a dr. Speaking with an MFM OB will make me feel so much better all around.

    I had an u/s on Monday, and I have another this Monday to hear heartbeats. 
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  • Yeah, I am thinking the lovenox would not help in your case. Glad that wasn't a route he took. Progesterone may be somewhat helpful...but the clomid should have helped mature your follicles and progesterone may not even be necessary! Glad you are getting to have a bunch of ultrasounds! Good luck!!

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