Getting the brushoff from an OB

S - posted on 04/20/2011 ( 18 moms have responded )

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I saw a different doctor in my practice today. It was the fastest appointment I've ever had in my life and it left me feeling unsatisfied. I am 16 weeks into my second pregnancy. My first ended in preterm labor at 24 weeks. I changed OBs a few weeks ago and everything was great until today. My old OB referred me to a perinatologist who was going to monitor me every two weeks to make sure there was no cervical opening. The doc I saw today immediately dismissed all of my concerns without even knowing me or my history. He was not interested in monitoring and refuted the possibility of cervical incompetence...again without even knowing me. I did start progesterone shots this week to prevent preterm labor but I also remember the perinatologist mentioning that I needed the monitoring because if they started to notice cervical opening they would need to do a cerclage and put me on bed rest. Now i'm wondering if I should just continue to see the perinatologist to make sure I'm getting the necessary care....in this case preventative measures could mean all the difference between losing the pregnancy, preterm labor and carrying to full term. The new OB doesn't want to see me back for 4 weeks which would put me at 20 weeks. All he did at this appointment was check for a heartbeat and basically rush me back out the door. It seems like he thinks the shot is sufficient and whatever else happens will happen. I don't like that feeling since my old OB did that and essentially dismissed me when I called complaining of recurrent pains (labor) at 24 weeks. Their unwillingness to listen resulted in my delivering less than 24 hours later when they might have been able to give me meds to stop the labor and taken measures to prolong the pregnancy.



What do you think? Should i continue to see the perinatologist? I'm tempted to call a nurse from my insurance and ask them, I would think they'd rather pay for ultrasounds than almost a million in claims for another preterm birth

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Krista - posted on 04/20/2011

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So if this jerk doctor is one of multiple OBs at a specific practice, is that the case?

If so, can you just request that any and all future appointments be with the other OB that you DID like? If there's no way of avoiding that one OB, then I would talk to the perinatologist about your concerns, and say that this OB is not actually following the care recommendations, and ask what he would recommend.

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Glynn - posted on 04/22/2011

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If you can,t make a connection with your doctor and they dismiss your concerns I personally woud look for a new ob

Donielle - posted on 04/20/2011

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I would probably stick with the perinatologist since they're more knowledgeable about this stuff and yours knows your history and will insure you have the care that you need.

Dana - posted on 04/20/2011

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Oh damn. :( Yeah, I was lucky with my son, he got the steroids for his lungs. Over all I was quite lucky, he still measured 5lb 11oz and had no real problems. We had to stay at Rainbows and Babies in Cleveland, OH (US) for two weeks while he learned to get the suck/swallow action down to eat - that was it.

S - posted on 04/20/2011

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Lol I don't mind the shots, I've had rocephin before so that barely bothered me although the burning that kicked in about an hour later was not fun. In my case they would have been happy for even 3 more days....plus I would have had time to get the meds to help mature her lungs and get antibiotics for the GBS infection she would ultimately be born with

Stifler's - posted on 04/20/2011

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I would give the doc a big lecture about what happened last time and remind him why you're seeing a perinatologist, because you are high risk. This sounds absurd.

Dana - posted on 04/20/2011

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Oh yes, definitely the progesterone shot will work too! And I'm sure there are doctors out there who say bed rest works and some who say it doesn't.
I was on best rest for 3 days with my son and it didn't do a damn thing...obviously I had him 3 days later. :)
And I never truly understood the bed rest thing. It would have been much easier and less stressful on my body to just get up and walk to the restroom rather than try and go in bed pan. Man those things are a pain in the ass!

S - posted on 04/20/2011

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that's interesting since that seems to be kind of opposite of what the perinatologist said to me. He thinks that I may have started experiencing changes around 19 weeks and that typically most women like that go into labor even earlier and lose the baby. He said that the progesterone is just the first line of defense but with my (running, working [i have to run at times for work too], and going to school) that changes in my daily activities could be significant and that even though a cerclage is not definite it could at least delay me for a few more weeks meaning even if i don't make it to full term any extra day or week they get me could help.



* 24 weeks is on the edge of viability as is so they def don't want me potentially going into labor before then or even at 24 weeks again. I think he is going the route of being aware, at least if they are aware things are going on they can send me to the hospital to get drugs to prevent or stop the labor versus just riding it on out with no intervention what so ever.

Dana - posted on 04/20/2011

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I have to say too from my visit with the perinatologist, he mentioned checking my cervix length, width and making sure it was curved properly and not funneling. Which is what they'd be checking on you. He also said (and so did the OB) that if that happens (funneling or improper length, width), there's really not much that can be done. The perinatologist that I saw also said that bed rest doesn't work and there's really no studies that are conclusive that it does work, if you're going to go into preterm labor, you're going to go into preterm labor. So, it seems to be a case of, it is what it is.



Now that being said...that doesn't mean you should be in the dark either (if your cervix is showing signs of incompetence) but, that may be why the doctor seems to be "blowing" it off.



*edited to add* Obviously you can have the stitch done too though. I'm just not sure on when that qualifies.

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Ditto Krista. If there are other docs there just request to only have the one you like. With your history I certainly wouldn't wait the 4 weeks no matter what that guy said. When he said he wanted to do the glucose test at 28 weeks did you inform him that your last pregnancy didn't even LAST that long?

Don't hesitate to speak up if you are not satisified w/ the care you are receiving. I don't know exactly how you should go about it, so I won't advise you on that but your baby is worth whatever it takes. Good luck and prayers for you and that little one!!

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I think calling the nurse from your insurance sounds like a great idea. They might be able to give you better adivce. Honestly that is one of the reasons I don't trust male OBs... they don't have the parts, they haven't carried a child... they DON'T understand.



Edit: Why the shots btw... why not the pills? I had that for my daughter. You can get them at a pharmicy with a perscription.

S - posted on 04/20/2011

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unfortunately it's not easy just to switch in the middle of injections. The progesterone isn't cheap and this new OB has been shipped a 10 week dose. This is not the kind of medication I can afford to miss for a week or deal with drama between two different offices. I don't know of many practices that will take on a new patient walking in with a med who says btw I need you to inject this today, etc....they would require a few visits first and prob some time to review my records. I may have to check to see if my insurance will cover the visits to both the OB and the perinatologist.
*** as a backup I can always go to the hospital where I delivered my daughter, they were EXCELLENT and they are close to my house so that is always my back up if i don't like the doc on call when i go into labor

Jennifer - posted on 04/20/2011

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If you don't trust this doc, switch now. It's better to switch now, than when you are further along. I had all sorts of trouble with my first OB. He was arrogant and rude. When I was 71/2 months, I started with a fever and I knew something major was going on. I tried calling him, but it was Thanksgiving day, so he didn't wan't to be bothered and said I just had the flu. I tried the ER (3 times) and finally on the third time and after a ton of fighting, I got them to test me further, and it turned out that I had an incredibly bad kidney infection. Then, after three days of hosp. antibiotics, he sent me home on a different antibiotic. After a couple days, once again I knew something wasn't right, and I was terribly sick. I tried calling the OB and once again was brushed off. I had worked in a nursing home and knew that I had C-diff (you see it once, you never forget it). which is a bacterial infection that you can get from being on very strong doses of antibiotics, because the antibiotics also kill off good bacteria in your system. He tried to tell me I was nuts pretty much. Finally after suffering 3 days with it, he saw me in the office, and realized I was in preterm labor from all the infection, and I was highly allergic to the antibiotic (never took it before, so didn't know). He finally admitted that they almost lost me. Since I was so far along, I decided not to change, and he once again proved his arrogance. Once my son was born (3 weeks early) the placenta wouldn't release on its own. He litterally stood down there yanking on the cord and yelling at me as to why it wouldn't release. Once he was finally able to yank it out, I had a ton of issues because he didn't take the proper steps (like surgery to make sure it was all removed).

I have another horror story with my third, but you get the idea, SWITCH til you find someone that cares!!!

S - posted on 04/20/2011

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Basically there are 3 different doctors in this story



the old OB - the ones who ignored me during my last pregnancy



the new OB who I like just not this particular doctor (the one who rushed me out of my appt)



the perinatologist - I was referred to them by the old perinatologist before I switched OB.



***although I am wondering if maybe this doc is kinda funky because he doesn't want me going to another practice, like maybe it messes with his ego? Another sign that kinda rubbed me the wrong way was I asked when we would do my glucose test, he said not until 28 weeks. I informed him again that I have PCOS and insulin resistance so i'm already at an elevated risk for diabetes. I know they did my test pretty early during my last pregnancy and actually were going to do it even earlier this time so the fact that he wants to stick with the standard timeline has me kinda iffy. I mean it's not like i've blown up or anything, I think I've only gained 4 lbs thus far but I know it's still a concern especially since I really didn't eat much of anything until I hit that 13-14 week mark.

Dana - posted on 04/20/2011

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I'm a little confused. The new doctor you got brushed off by today was the perinatologist?



I'm kind of in the same boat as you but, it's a little different. I don't have an incompetent cervix but, I am prone to preterm labor because of my condition -a bicornuate uterus. I delivered my first son 6 wks early.

I'm now 15 wks pregnant and will start progesterone in two weeks. I have a regular OB but, have consulted with a perinatologist. I also had bleeding at 9 weeks (fresh blood) which quickly stopped, followed by 3 weeks of spotting (old blood). Then a trip to the ER 2 wks ago with pains.

So, I understand the frustration and uneasiness that comes along.



I guess it depends on if this doctor you're referring to is the perinatologist or not. If it is, I'd give him/her one more shot. Go in and explain how you felt with the last visit, and your fears now. If that doesn't change things then I'd change doctor's. If it's just a regular OB, I'd probably just change right away.



The reason I'd say try it out one more time with the perinatologist is because they're so used to seeing high risk women and it's normal for them that sometimes they forget that it's not normal for you.



Good luck with your pregnancy!

Naomi - posted on 04/20/2011

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I would definetly get a new doctor. Your insurance should let you switch doctors if you don't like who you have. There is no excuse to put you and your baby at risk, especially with your history. Your doctor should be happy to check you for anything at any time.



It sounds like your new doctor has too many patients and is too busy to give you the care you need.

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