Am I out of line here? Why can't my OB prescribe Zofran without me having to make an appt?

madfam0405 · December 2013

Background: 2nd pregnancy with care from the same OB. Pregnancy confirmed in office, and with ultrasound at 6w6d showed strong hb and measuring at exactly 6w6d. First OB appt was 12/6 (nurse only visit). In my first pregnancy I was also on Zofran.

Fast forward to today. I have not kept any food or drink down since yesterday evening - no soup, no water, no ginger ale, no crackers, nothing. It's now 5pm here. I called OBs office at 1pm. They just called me back 5 min ago, and told me my OB would not prescribe Zofran without seeing me first. The first avail appt is Monday, 12/23. If I need something sooner, I could go to Urgent Care. Like I said, it's now 5pm. Urgent Care is open until 8pm, on the other side of town. I am so weak that I cannot drive myself, which means DH needs to get home, and he, DS and I have to go back out. BUT, freezing rain has just started, and will continue until 6am tomorrow, and the roads are going to be dangerous. Oh, and my pharmacy is 2 blocks from my house vs and unnecessary trip across town to urgent care with a $50 copay.

So sick, hungry and tired.

PrimRoseMama · December 2013

Most likely because they want to cover their butts. I'm sorry.

EmR22 · December 2013

I'm sorry that sucks. But docs are doing that stuff now. Their butts are on the line so I can understand. That being said I don't understand why that office can't get you a same day appt. if you call right away when they open in the morning don't they have appt available? My OB has a set number of "emergency appts" that you can't book until that morning but they go for things like this and bleeding, pain etc. Maybe it's time to see someone new?

momthatlifts · December 2013

My close friend had a similar issue. Because she is in her second trimester and almost half way through her pregnancy she thought it was the flu. She ended up in the ER because she couldn't keep anything down, not even water. They ended up diagnosing her Hyperemesis gravidarum and prescribing her zofran. I'm not saying go to the ER , but try your best to drink water even if it's coming back up until you see doc. Also maybe try emetrol until then? I know it's safe to take and it's something you can buy off the shelf.

chloephoebecali · December 2013

That's crazy. It's not like you are looking for an antibiotic without being diagnosed. Or your pregnancy hasn't been confirmed by the office. I'm sorry you are having to deal with all that. And when m/s is that bad, nothing is staying down no matter how bad you want it to. It's not an option. I called every week for three weeks with them offering something else for me to try. I never had to go in.

KSwen719 · December 2013

I would say that the dangers of going without food or water between now and Monday drastically outweigh the rare negative side effects of a drug like Zofran, which has been safely used for years in a variety of populations. The doctor should have at least given you a few days' worth of medication to get you through until your appointment, especially since you were seen relatively recently and have a track record of using the drug without complications. I'd call again if I were you. My doctor prescribed me Zofran over the phone without a second thought and I have been grateful ever since, as I have hyperemesis and it sucks big time. I wish you the best of luck, OP, and I am so sorry you are going through this.

KSwen719 · December 2013

@WhoCanItBeNow Why the attitude? "Oh. Look. Options." Pretty unnecessary. It is possible to get a point across without sounding snotty and/or sarcastic. Sheesh...

KSwen719 · December 2013

Well, that's your (personal, not professional) opinion (unless you're a physician?) and you are entitled to it. I'm not bothered by your opinion though - I'm bothered by the approach you take to expressing it. I will never understand people who choose to go out of their way to be rude on the internet. It's a bizarre 21st century phenomenon. But to each her own. If that's how you want to represent yourself, well, then go have at it. I just think it's unnecessary, sad, and a bit classless.

KSwen719 · December 2013

Anyway, sorry to high jack your post, OP - internet rudeness is just a pet peeve of mine! I'm done with that point now though! I do hope you're feeling better soon - I sympathize with 24/7 nausea/vomiting.

biglewzer · December 2013

Call the after hours on call doctor. They typically always call in scripts

KSwen719 · December 2013

Once again, I was not "degrading" you because of your opinion - I have no problem with your opinion at all. It was simply the way you presented it. I don't know you, so I do not claim to know your actual level of classiness/classlessness - I am simply saying that, in my OPINION, people who are rude on the internet for no apparent reason present a rather low class version of themselves. There are nice ways of saying things, neutral ways of saying things, and rude ways of saying things - you chose the rude way. That's your choice, just know that it gives a poor representation of you to others. Maybe you don't care though, and that's fine too of course. But I don't have to like it.

KSwen719 · December 2013

You acted rude and classless, so it should be expected that you will be called those things. If you don't like it, you might want to consider taking a different approach to your interactions with people.

And I don't think you suck - I don't know you, so really I have no opinion of you at all. I was just saying that your actions leave a certain kind of impression, and that impression is a negative one. I do not assume that this one instance represents you as a whole person - that would be silly. I just don't appreciate rudeness for rudeness' sake. I think that's all I'll say about this. I fear we're beating a dead horse here.

KSwen719 · December 2013

Seriously? You still think that's what this is about? Sheesh...useless, so DEFINITELY done now...I'm such a sucker for a debate, I always get reeled back in!

Manateearmz · December 2013

OP I'm really sorry. Maybe you can call them back in the morning and get a standby appointment to be seen, or find another nurse who is more willing to help you out.

As for the rest of this thread, yikes.

Mamazon2014 · December 2013

Have you tried sipping clear juice?

The reason I ask is that I recently had a severe stomach bug and could not keep anything down including water or ice chips. I went into OB triage at the hospital and they gave me Apple juice to sip very slowly and I was able to hold it down.

The doctor said that the sugars can help settle the stomach and that if I did get sick again, not to eat or drink anything for an hour after.

I'm not suggesting juice as a permanent solution, but if you can keep it down, it may keep you hydrated enough to make it until you can be seen by a professional.

Oh, and doctor recommended white grape as it is supposed to be the easiest to digest.

Good luck OP, I hope you find some relief!

EleanorKr · December 2013

That's frustrating that you tried to make a plan early in the afternoon and it took them hours to come back with a "no".

I don't have any advice but I just want to say, good luck and I hope you start feeling better soon!

biglewzer · December 2013

*shrugs* mine calls in scripts all the time, same with the on call doctor.

I will add that, the on call doctor calling in scripts (and always getting a different doctor) is the reason I ended up with a sever breast abscess while breastfeeding my daughter.

I still prefer having a doctor that will call in scripts.

tinkerbell019 · December 2013

My OB office also had no problem calling in scripts, zofran & prenatal vites, as soon as my BFP was confirmed through blood test and initial appt was scheduled for 2nd pregnancy. I haven't had to take the zofran yet, but just wanted on hand for holiday travel.

MS is awful to deal with, sometimes the juice/syrup from a fruit cup is a good starter for settling an upset tummy, just little sips, 1/2-1 teaspoon to start. Well wishes coming your way! Feel better soon!

colorsplashstudio · December 2013

That really stinks! I wasn't even vomiting and just emailed my dr's office saying I was feeling really sick, got a call from the nurse a bit later and she had called in zofran for me to pick up later that day. Seems like they could be a bit more accommodating especially if you can't even keep anything down!

tealowl · December 2013

The only prescriptions I've been able to get without being seen are antibiotics for UTI's. One of those times I was in CO on my way home....12 hours away. There was no way in fuck I could have been in a car for 12 hours with the pain I was in.

madfam0405 · December 2013

I'm ignoring all the rude comments and giving an update.

We did not make it to urgent care last night. Our neighbors could not even get their vehicle up their essentially flat driveway. Roads were ice. I have been drinking water, but have not eaten much at all since Wednesday. I had a few bites of basically plain pasta last night, and that stayed ok. I tried crackers and an english muffin this morning with no luck though. I called my OB first thing this morning who is apparently now out of the office today.

We are going to pack up and head to urgent care in just a bit once more plowing and salt trucks have been through. Roads are still horrible and over 80 schools in our area are closed today.

I understand my doc having to cover her butt, as mentioned, but I still feel it is a bit ridiculous to have to go to the ER or Urgent Care and have a doc who I am not under the routine care of prescribe this.

And just to reiterate...this is the OB who saw me throughout my first pregnancy and prescribed Zofran. I was had MS so bad through the 2nd tri that I had hardly gained any weight. I am not a stranger to her in any way

Thank you to the supportive ladies...

Blackvelvet · December 2013

Five years ago they wouldn't even give Zofran to pregnant women until you ended up at the hospital on IV's. It is a strong drug and Dr.s should be watch who they give it two it's main purpose is still for Chemo patients and you bet they see the Dr. before they get it.

I had to make an appointment this time to get it even though I was on it until I delivered with my first. I went though hell before they though I needed it the first time I had lost 15 pound and not eaten in a week. They may think you might not need it yet.

madfam0405 · December 2013

Thank you for all of you opinions. I now have the Zofran and am looking forward to finally being able to eat something.

madfam0405 · December 2013

ER

HBirdie · December 2013

I found out I was pregnant in January, had my first appointment at the OB (that I'd never seen before) in mid-February. First pregnancy. Called my doc's office at the beginning of February when my MS hit and I couldn't keep anything down, and they called in a script for Zofran without me even asking (I didn't know it existed). They hadn't even seen me yet, just talked to me once on the phone to schedule my first visit.

I will say I did find it kind of odd, and I wasn't expecting meds, but they helped SO much and I was really appreciative to my doc for doing it. Sorry you're sick, it's the worst. Hope the Z helps.

laurakaz13 · December 2013

WhoCanItBeNow said:

No doctor should ever prescribe meds because a patient calls and asks for them.

This. Seriously. I had HG my entire first pregnancy and I know how awful it is to be that sick. I was that sick for 7 months. Hope you made it to Urgent Care and got some Zofran. I lived on it my entire pregnancy. My doc prescribed enough to last me the whole pregnancy.

madfam0405 · December 2013

I had Zofran all of first and second tri in my first pregnancy. I went to the ER yesterday, and now have Zofran.

TeacherVicky · December 2013

Glad you got to urgent care and found relief.

FWIW, dr's here won't even renew a prescription over the phone, you need an appt and to see a dr.

KSwen719 · December 2013

I'm not asking this to be argumentative, I'm asking this because I'm genuinely curious. Let's say you call the doctor and tell her all your symptoms - puking, nausea, haven't been able to hold anything down in x number of hours, etc. she asks do you have a fever, aches, pains, whatever, and you answer. She says come in, I can't prescribe you anything over the phone. So you go in and...what happens? You can't see morning sickness, you can't test for it - so what's going to happen? Isn't she just going to ask you a bunch of questions which you'll then answer? Why would that need to be done in person and not over the phone? There are such things as phone consultations, and this seems like an appropriate case for one. The doctor takes notes and writes in your chart, just like she would if you were there in person. I feel like doctors make you come into the office because then they can bill your insurance company a few hundred bucks for a 10 minute office visit, even though physically seeing you may not shed any additional light on the subject that couldn't be gathered from a detailed phone consultation. Am I missing something?

PrimRoseMama · December 2013

KSwen719 said:
I'm not asking this to be argumentative, I'm asking this because I'm genuinely curious. Let's say you call the doctor and tell her all your symptoms - puking, nausea, haven't been able to hold anything down in x number of hours, etc. she asks do you have a fever, aches, pains, whatever, and you answer. She says come in, I can't prescribe you anything over the phone. So you go in and...what happens? You can't see morning sickness, you can't test for it - so what's going to happen? Isn't she just going to ask you a bunch of questions which you'll then answer? Why would that need to be done in person and not over the phone? There are such things as phone consultations, and this seems like an appropriate case for one. The doctor takes notes and writes in your chart, just like she would if you were there in person. I feel like doctors make you come into the office because then they can bill your insurance company a few hundred bucks for a 10 minute office visit, even though physically seeing you may not shed any additional light on the subject that couldn't be gathered from a detailed phone consultation. Am I missing something?

Could be to register as an insurance claim so she gets paid. I don't know why you are still pissing & moaning about this. It doesn't work the way you think it should, tough cookies.

The doctor doesn't do prescriptions without seeing you first. End of story.

KSwen719 · December 2013

My doctor did write me the prescription without seeing me first (as is the case with many doctors), and I'm not pissing and moaning about anything at all - I'm not sure where you got that impression from. As my post said, I was curious what exactly people expected their doctors to do in person that they couldn't do over the phone, particularly since so many people seemed completely outraged by the thought of a phone consult. My curiosity led to a question, not a complaint.

Ceridwen21 · December 2013

amy052006 said:

I am confused. The same horrible icy roads you couldn't drive one to get to the urgent are the ones you would have needed to take to get to the the pharmacy if the doc soul have called in a script. What is the difference?

My question exactly.

madfam0405 · December 2013

amy052006 said:

I am confused. The same horrible icy roads you couldn't drive one to get to the urgent are the ones you would have needed to take to get to the the pharmacy if the doc soul have called in a script. What is the difference?

Pharmacy = Two residential blocks away.
ER or Urgent Care = Across the city.

From the OP: "Oh, and my pharmacy is 2 blocks from my house vs and unnecessary trip across town to urgent care with a $50 copay."

PrimRoseMama · December 2013

madfam0405 said:

amy052006 said:

I am confused. The same horrible icy roads you couldn't drive one to get to the urgent are the ones you would have needed to take to get to the the pharmacy if the doc soul have called in a script. What is the difference?

Pharmacy = Two residential blocks away.
ER or Urgent Care = Across the city.

From the OP: "Oh, and my pharmacy is 2 blocks from my house vs and unnecessary trip across town to urgent care with a $50 copay."

I'm lol that the trip to the ER is somehow "unnecessary" when she is apparently, by her own admission, in a dire situation. If I were so sick I needed zofran I would hardly call a trip to the ER "unnecessary". Quite the opposite, actually.

I think OP wanted what she wanted & wanted to piss & moan when she didn't get her way.

AnnaKaie · December 2013

My doc called in phenergan over the phone for me. But she had just seen me and knew my ms was getting worse. Did you ask specifically for zofran? I just told my doc what all I had been doing and taking and asked for any kinda help.

madfam0405 · December 2013

PrimRoseMama said:

madfam0405 said:

amy052006 said:

I am confused. The same horrible icy roads you couldn't drive one to get to the urgent are the ones you would have needed to take to get to the the pharmacy if the doc soul have called in a script. What is the difference?

Pharmacy = Two residential blocks away.
ER or Urgent Care = Across the city.

From the OP: "Oh, and my pharmacy is 2 blocks from my house vs and unnecessary trip across town to urgent care with a $50 copay."

I'm lol that the trip to the ER is somehow "unnecessary" when she is apparently, by her own admission, in a dire situation. If I were so sick I needed zofran I would hardly call a trip to the ER "unnecessary". Quite the opposite, actually.

I think OP wanted what she wanted & wanted to piss & moan when she didn't get her way.

I did not "piss & moan" I asked a question. I did not argue or get snobby with your responses. It seems like some dr's give the rx without a visit and some don't. I got myself to the ER when roads were safe. I have Zofran.

And Prim...not sure where you are from, but when the roads are 1/4" of pure ice, you do not drive. There is no way DH and I were going to put our 10 month old or ourselves in danger by attempting to drive. I went to bed early, and in the am when we were salted and plowed out, we went to the ER.

Have a nice holiday, ladies.

curlylocks3 · December 2013

@kswen719- perhaps they want to see you and do a physical exam/check your vitals/pee and determine that you don't need something more intensive (IV fluids, etc) than just oral Zofran

Either way, I certainly understand why they'd require an appointment before handing something out like candy.

madfam0405 · December 2013

I see all of your points, both for and against prescribing via a phone call. Regardless, it's a bit of a mute point, as it's done and over with. As an aside, further explanation from my OB in her follow up call was that they want to have a billable appointment when issuing an Rx.

Thanks ladies!

Ceridwen21 · December 2013

I think you mean a moot point.

Meery82 · December 2013

And this is why they don't hand it out like candy.

https://www.fertilitycenter.com/fertility_cares_blog/fda-warns-against-zofran-use-in-pregnancy/

I'm not surprised by this. You can't trust that shit. They say a med is okay to take one minute then harmful the next. If you can manage to go without, that's the best option.

PrimRoseMama · December 2013

You guise...she wants it now!

)

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