1st OB Appointment

I had my first OB Appointment yesterday. Maybe the best way to tell the tale is to start from the end and work backwards. I am up at 3 am thinking about all the things I didn’t like about it and having trouble coming up with one thing I did like. I ended the day sitting in a warm bath crying over it. And, I am not much of a crier. Flash back to yesterday when I couldn’t stop smiling when I got to go back to my old RE clinic, even knowing that he could be telling me I had a dead baby. If I had to have that news, I would rather it came from him. I was so excited after the appointment, I couldn’t sleep Tuesday night. It was just so awesome to see the baby that actually looked like a baby moving all around. I forgot to mention yesterday when we first saw the baby he was sucking his thumb and I got to see the ears too. Did I mention that Dr. N said that the brain looked normal? Everything looked normal? Dr. N knows how worried I have been. After the exam, when he looked at me with that smile of his and said, “This is real. You are going to have a baby”. I FINALLY got excited. I’m at 12 weeks now. Something bad can still happen. I know this. However, every day the odds keep going up that I could actually get a baby out of this. This could actually work. I am starting to believe that.

Anyway, I digress. My OB appointment wasn’t horrible. It just wasn’t great. The best way of putting it is that Dr. G’s practice is probably not a good fit/match for me. The more I think about it the more the word “hate” comes to mind, but that is really too harsh for the experience.

As I lay awake overanalyzing everything as is my nature and style, I realized there were really two fundamental things that bothered me and everything else steams from there.

The first is that I never had an opportunity to talk to the Dr. with my clothes on. In talking to several people since the appointment, I guess maybe this is somewhat common and some people are surprised that I am even bothered by this. But, I am. I think it shows lack of respect for the patient/women as an individual. On top of that, who can think when they are naked or half naked and have an intelligent conversation? Not me. I think it is demeaning and rude. My preference is to meet with Dr. first with my clothes on before having an exam, especially if we have never met before. I am also okay with having the exam and having the Dr. say to get dressed and meet in his office to discuss questions. As it was, I had to tell the Dr. that I had some questions and if he had time or could we schedule some time to go through them since I knew he was running behind. He said now was fine and I had to hop off the exam table with my ass hanging out to get them. Granted, he had already answered quite a few, but I only had the heart to ask a few more and then just let everything else go for now. I am a questions person. I usually have lots of them. I like information and knowing. Remember, I purchased 2 OBGYN Text books. I need a Dr. that I can ask questions to either by phone, by email, or in person WHEN I HAVE MY CLOTHES ON. I didn’t realize today how much I took that for granted and that it was important to me.

The second is that one of the first things he said to me was he thought I may need a C-Section. Now, I really haven’t given the actual birth too much thought at this point. I’m still working on the fact that I am still pregnant and may actually get to that point. I HAVE been talking to a friend of mine (who happens to be a Dr. and works in a NICU who attends lots and lots of births) about it. She wants a natural birth with no drugs if possible, etc. and has been explaining why. In fact, she got 2 books on natural pregnancy and natural birth that I want to buy and read. In general, I don’t share her passion for the no drug/ natural thing that she has, but I am pretty ignorant on the subject at this point. I need to think about it and research it. I’m not opposed to drugs or a C-Section if needed or warranted. However, I didn’t really like that this is one of the first things Dr. G said to me. He did have his reasons, but I am just not sure how valid they are.

I have my medical file from my old OBGYN that I have been adding to over the last few years that I brought in along with my film from my pre-pregnancy kidney u/s and the old one of my fibroids (which I figured could just be thrown out, but brought just in case). The only thing he was interested in and asked me about was my fibroid surgery. He asked me not one question about my medical history, my past history, the treatments I had with Dr. N, how I was feeling, or how the pregnancy had been going so far. The only thing he wanted from my file was the fibroid surgery report which clearly states that the uterine cavity was not entered. He saw that I had 4 fibroids removed and made the assumption that I had 4 incisions. This was his main reason why I would need a C-Section. I explained that I was pretty sure that Dr. N only had to make 2 incisions because 3 of the fibroids were all together. He said, “well, he had to scrape 4 of them out”. I let it go. I have read the surgery report several times in detail and he just glanced through it for a minute or two. Hey, I am not a doctor. It’s just my body. What would I know?

Another reason he had for my having a C-Section was advanced maternal age. These are my words. As he put it, I am older and not going to be having tons of children at this point and as you get older there can be more problems with a delivery. A C-Section is safer and more controlled. Yes, I may not be having 8 kids at this point, but I would at least like to have 2 if possible. Okay, I’ll start with one, hope I get that far, and see how it goes from there, but I felt like an assumption was made that this was my one and only shot at this. Maybe it is, but how do we know that now?

The last reason he had for me to have a C-Section was the size of the child. He is making the assumption that I am going to have a big baby. Statistically speaking, he could be right on this. Typically, overweight women or women who gain a lot of weight in the first trimester are at increased risk of a large baby. I have read this in my OB book and I think it may also be referenced in the What to Expect book. The odds really increase if I end up with gestational diabetes. I have actually lost 6 lbs. in the first trimester. Of course, he didn’t know this because he never asked. When I told him, he looked at me like why are you telling me this and just said, well, we will see how it goes.

I am referred out to a specialist to go through a Level 2 U/S and to talk about genetic testing and to “either have or not have amniocentesis”. And, I am to see him again in about a month.

He did see blood when he did the physical exam. Yes, I am still spotting; in fact, it is a bit more frequent than yesterday. This is disconcerting to me. I asked him for the cause and he said not to worry since the u/s yesterday looked good. Of course, he didn’t look at my past u/s’ pictures, he just took my word for it. He agreed with Dr. N that at 12 weeks progesterone supplements are not needed because the baby/placenta has taken over. No explanation given. I think they don’t know. Easy for them to dismiss it. Not so easy for me.

He did take a little hand held monitor like the one I rented. Again, he had trouble getting the heartbeat. He said that he was able to detect it and got a reading of 154. I mentioned as he was searching that Dr. N wasn’t able to get the heartbeat that way yesterday and we ended up having to do it vaginally. I think he was determined to one up Dr. N because he searched and searched around to try and get it so I could hear it. If I hadn’t actually seen the heartbeat the day before, I would have appreciated the effort more and been worried that he had such trouble. I wanted to ask if it was a problem that the heartbeat was 178 at my 9w u/s, 159 yesterday, and only 154 today which is showing a downward trend, which of course, he didn’t know because he never looked. I figured he would just tell me it was in range so I didn’t even ask. I let it go and will just email Dr. N and ask him. Probably, it is nothing and fine, but I need to know. I need to be able to ask.

I didn’t like the fact that they didn’t even look at any of the testing that had already been done. Did he even notice that I am RH -? I am being retested for HIV, Gonorrhea, Syphilis, Rubella, etc. so it can be “their” panel in “their” format from “their” lab, which happens to be the same lab that most of these tests were done. I just let it go since it was $0 out of pocket to me.

I also didn’t like the fact that I had to wait for an hour and a half before I was even brought back. I had t o pee twice and got so hungry that I went down to the pharmacy and got some milk and cookies to hold me over. Don’t they know that pregnant women need regular feedings?

Dr. G comes highly recommended from multiple sources including my RE who I adore (in case you haven’t figured that out yet) and a lady I was talking to in the waiting room that has been seeing him for 10 years, who incidentally had a 10:30 appointment and was seen before me when mine was 10:15. Did you notice I had a handful of dislikes and no likes? I have tried. I can’t think of one thing I actually like (as opposed to being either neutral or disliking). I am not sure if it was just an off day or not, but I think I need to look around for another OB. I’ll keep my referral to the specialist and my next appointment. In the mean time, I am going to look around and maybe talk to another dr. or two. I am thinking about going outside of my HMO benefit and use my PPO benefits. I think it will be worth the extra money to get the care I think I deserve and someone who sees me as a person who is going through their first pregnancy after much effort to get to this point. Maybe my standards are too high? Maybe I am too high maintenance? I just think maybe I can do better.

Dr. G may be a great Dr. and nothing he said was without merit. I think maybe it is just not a good fit for me. I shouldn’t be sitting in my bathtub crying after an appointment.