Tuesday, February 15, 2011

26 wks + vent + belly

I'll start with my vent to get it out of my system.

I love my OB and really like her nurse practitioner (NP) too. The nurse practitioner is very nice and thorough and competent and compassionate, etc. etc. But my OB has told me she wants me to just see her, and if/when the front desk tries to schedule me with the NP instead, to remind them that I'm high risk and should just see her.  So today, I was under the impression that my appointment was with the OB (the receptionist had even written down my OB's name and date and time on the card, as if I was really seeing my OB, when you are seeing the NP, they usually write down the NP's name)...so it turns out my OB is never even in this office on Tuesdays. So I was a little bit annoyed that I had been misled. When the nurse mentioned that the NP would be in, in a minute, I said, "Oh. I thought I was just supposed to see my OB since I'm high risk." Nurse looked and agreed that I shouldn't have been scheduled with the NP but said my OB isn't even in the office on Tuesday's, I said it was fine, I like the NP and everything, it was just a surprise to me.

So my appointment was good and I do like the NP. She didn't check for swelling (which my OB would have done), but everything was fine. She agrees that my blood pressure is creeping up (now more consistently near low 120's/low 80's, a month ago it was usually 110-119/ 70's.) But it's not a huge jump, and it's not technically high, and I still have quite a few readings that are still in the previously normal range and sometimes lower, it's just that I'm getting more 120's/80's reasons more consistently then I have in the past. She thinks it may be just due to increased blood flow, baby getting bigger, etc. then pre-eclampsia or pregnancy induced hypertension (PIH) creeping it's way in. My weight gain is "fantastic", no unusual symptoms, everything looks good. But because of how quickly and how severely I got sick last time, we agreed I'm going to start seeing OB every 2 weeks, to go along with seeing my high risk ob (also known as MFM-maternal fetal medicine specialist which is a fancier way of saying high risk ob) every 2 weeks, so I'll be seeing one of them every week. So next week I see my MFM, the next week I see OB, then back to MFM, etc. (Right now I'm 3 weeks farther than I made it with Olivia, but I got sick really fast and it was severe, so I really do want someone keeping an eye on things every week even with things seemingly well. In fact, if they wanted to hospitalize me now just for fun and monitor me 24/7, I'd be okay with that, though I'd really miss my dogs.)

So NP tells the receptionist, "schedule her in 2 weeks with OB." I guess receptionist missed her saying that because she tries to schedule me in 4 weeks with NP again. I tell her that no, she wants me back in 2 weeks and it should be with the OB because I'm high risk. Supposedly OB has no appointments open that week. She schedules the next 3 appointments and 2 of the 3 are with NP. I really don't like that they are tossing me back and forth between the NP and OB. When I got sick with Olivia, we all totally missed how swollen I had gotten in the weeks leading up to disaster. I had seen my ob the week before and she even missed it. (In hindsight there are some pictures of me from that time frame and it's very obvious.) So the inconsistency is really bugging me and I'm pretty skeptical that my OB is completely booked up. (My guess is this would be the same receptionist who scheduled me to see NP for my 2 week and 6 week postpartum check ups, even knowing our baby had died because I asked them to try to schedule me when there wouldn't be a lot of pregnant people there. My OB called me personally to see how we were doing and asked when my appointment was to see her and when I mentioned it was with NP, 2 minutes later she had it fixed so I was seeing her instead.) I don't like using the term "Nazi" lightly but this particular receptionist is seriously a scheduling Nazi. (There are 2 other receptionists and with the other 2, I've never had a problem getting scheduled with the OB. ) So I can't remember which appointments are actually with my OB, I think in 2 weeks I'm supposed to see NP, but it's at least a day that OB is in the office so I'll address it then I guess and I won't be that surprised if it's my OB who sees me. I'm glad I'm at least seeing my MFM every 2 weeks and it's her every time so at least there is *some* consistency. I think my OB is a little more cautious than my MFM at this point because she was there last time and MFM wasn't. But, whatever, I'm not going to stress about it, it's just a little frustrating.

Anyway, now that is out of my system, yesterday was 26 weeks! No obvious swelling, weight gain is fantastic, no alarming pains or headaches, I still get dizzy (thinking my MFM was right and it really might be caused by GD since I'm not anemic, or it might just be normal for me pregnancy I guess), Lucas is moving more steadily. A week or so ago, he moved a lot in the morning and a lot at night, but not so much throughout the day. Now he never really moves *a lot* but it's steady, a few kicks or obvious movements an hour, most hours. No one is concerned about this ("At this point, as long as you feel him once a day it's fine." Um, not for me!)  so I'll try not to be. She did say I should start kick counts at 28 weeks. Upcoming: gestational diabetes class on Thursday, high risk appointment next Wednesday, growth ultrasound next Friday, OB appointment (maybe with NP?) the following Monday when I'll be 28 weeks.

We can get a 3D ultrasound done at my OB's office for cheaper than we can at the elective non-medical place. I'm debating if I want to or not. I'm completely undecided about it, but slightly leaning towards yes because I like ultrasounds. (And the pessimistic side of me thinks that if something goes horribly wrong again, I want as many pictures as we can get. But the cheap/frugal side of me thinks that we could spend that money on professional pictures when he's actually out of the womb.And then the pessimistic side says, but if it goes horribly wrong...saving the money for professional pictures isn't going to matter much...and it's not like we don't have the money for both, it's not really either/or.)  I'm leaning towards yes, let's do it. Joe is ambivalent and has no problem with doing the extra ultrasound if I want to.

Also, she asked if we've picked out a pediatrician yet. I laughed. (And thought, "well, I figured the neonatal doctors will do for now" because we have at least 8+ weeks to go before we are out of NICU territory.) I'm not really looking forward to the pediatrician hunt especially because we (really- I- Joe just shrugs and says that's fine honey) want to delay vaccinations. I'll do some of them on the regular schedule and some of them later and some not at all (no chicken pox vax-it doesn't work for too many kids). The main thing is, I won't let them give my baby 10 different shots at once, or even 4 or 5 different shots at once. We'll do most of them eventually, but I want them spread out. I'm not really looking forward to finding a doctor who will mesh well with that because most of them are used to patients just doing what they say and not questioning anything, and I'm a pain like that. I've seen a few recommendations from the "crunchy"/"natural parenting" crowd online but most of the doctors I've seen recommended are either pretty far away, or family practice doctors and not specifically pediatricians. One of the family practice doctors I've seen that is apparently more laid back about the vax schedule is actually my general practice doctor and she's 5 minutes away, so I guess that would work for now if nothing else. I'd rather have a pediatrician but we'll see. My mom really likes my 14 year old brother's pediatrician so I'm hoping she'll ask him about the vaccination thing for me because it's not something I'm going to change my mind about and I'm not going to waste my time with a doctor who is adamantly inflexible about the schedule. So, blech. I'm not really looking forward to the doctor search.

I'm getting a little anxious about "the class" on Thursday. But I'll save that for a blog post tomorrow because I've rambled enough for today.

Belly shot yesterday, please disregard the spots on the mirror which look like they are on my shirt, and our husky Koda is supervising from the doorway:


Katie&Greg said...

I was no high risk with Sam, but it drove me nuts when the receptionist made me see another doctor because mine was not never available. especially when things got closer! Your doc should have gone up there the first time and scheduled the next 5 with her or something. I hate that they never communicate!!

The doctor search kind of blew, but working in the daycare setting, I just asked the parents. I went with the one they all recommended! Good luck, Angie. :)

And YAY for 26 weeks!!!

Brooke said...

That receptionist sounds totally annoying. Maybe you could try calling and speaking to a different receptionist? Pretend you just realized the appts. are with the NP and you need to switch them b/c the OB specifically said to make you appts. with her--maybe someone else can make that happen for you.

I know there is a list of vaccine-flexible pediatricians in our area, although it may be what you've mostly seen online. I'll send you an e-mail with info about that.

Congrats on hitting 26 weeks. That's so great. I hope you are able to find yourself getting more and more optimistic as the days go by.

*Laura Angel said...

Yay for 26 weeks!! Oh and my belly does have bruises from time to time...the photos are not edited...but I start heprin monday twice a day booo I am sure I will be all bruised soon enough. Oddly enough I bruised more in the beginning of my pregnancy with the shots?

Leslie said...

things sound great and that picture looks like you are really having a baby! Glad you are feeling good.

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