Thursday, July 30, 2009

Meeting the new OB

Will and I met with the new high risk OB yesterday. I had read some mixed reviews about her bedside manner online and so was a little hesitant, but we really liked her in person. We found her to be warm and funny and uber capable and conscientious, which was great and exactly what we need.

The only awkward moment came when I was starting to give her my history and she asked, "Is this your first?"

And I stumbled around for a bit, unsure if she meant first pregnancy (no), or first child (hopefully, yes). So after hemming and hawing, finally, I said, "I have no children, but this is my fifth pregnancy." And then the awkward moment passed and we discussed what happened with the first four.

She had great questions throughout that made her seem really on the ball. She's the only clinician to inquire whether I had a staging laparotomy with my Hodgkin's diagnosis, for example. Good question. And the answer is luckily, no. But if I had, it would be important to know, because during that procedure they remove the spleen. So she got some extra points for asking.

She said a couple of times as we were discussing my history, "Well, we'll do an ultrasound in a minute and see if we've got a heartbeat," which was fine with me. I'm convinced several times a day that the baby has died. Will, however, thought this was a tad pessimistic. In my book, her cautiousness was justified, and made it even better when she did the ultrasound, pronounced everything perfect, and ultimately stated, "Things look promising. I'm feeling very hopeful about this pregnancy." Really, high risk OB? You're hopeful? Awesome! Especially since you weren't all fake hopeful from the beginning. Love it!

Basically, she said that she and we will just be holding our breaths for the next few weeks and that with every week that passes, my risk of miscarriage drops. She offered me ultrasounds every two weeks to help ease my anxiety. So between her and my RE, I'll be having an ultrasound every week until the CVS, which is scheduled for August 21. She predicts I'll start to feel a lot more confident after that. I hope so.

The only other complicting factor is my health history. The chemotherapy I took for the Hodgkin's can damage the heart muscle in ways that only become apparent during times when the body is stressed (like in, um, pregnancy). So she wants me to see a cardiologist for a baseline workup so that later we can make sure I'm not running into any trouble. Hey, no objections here! Better safe than sorry. I like that she doesn't assume everything will be fine and that she wants to check into things a little further. Since so far, nothing about pregnancy has gone fine, this makes me feel much more secure than a doctor who just issues a blanket, "Don't worry!"

We also asked her lots of questions about what labor and delivery would be like since she's a high risk doctor in an academic medical setting. I'm in this tricky situation of wanting (needing?) some extra monitoring up until the time of birth and then having fantasies of doulas and hypnobirthing and walking in labor and bouncing on birthing balls and delaying or possibly foregoing the epidural, etc. And I realize these two realities may be completely incompatible. Sort of the pregnancy/childbirth equivalent of having your cake and eating it too.

So we asked her about how things are likely to go should we get that far (certain that having the hubris to assume I'll ever get to a delivery room would doom the little embryo immediately. Ugh!). And she rolled with it. Was totally cool about it. And in fact, recommended some doulas and said we can try to avoid interventions like pitocin and AROM, and we'll figure the rest out as we go (Hep-Lock v. IV, continuous v. intermittent monitoring, etc.). Good enough by me for now.

So. Great to begin building a relationship with the new OB.

I actually felt very positive and excited yesterday after meeting her and seeing our Little One again. I realized yesterday as we were waiting, me sitting there and Will pacing around like a madman, that we've never had a good OB appointment before. The two times we've made it this far, the baby was pronounced dead on ultrasound. So this happy visit experience is completely novel to us. So strange to have a smiling doctor and leave the office with a free book and a handful of pamphlets and referrals, and a cool aluminum water bottle to boot.

I'm back to my fearful place today, which doesn't surprise me. These next couple weeks are going to be really tough for Will and me. We lost the first pregnancy after seeing a perfect heartbeat at 8 weeks 3 days...so part of me is convinced that we can't make it past that date. I'm hoping to prove that part of myself wrong. Really, really hoping.

Mo

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27 comments:

  1. It is wonderful to see good news. I hope all continues to go well. I had a very similar experience with the 8w u/s that was perfect, losing the baby and then the D&C from hell so I can understand your hesitation. Just live one u/s to the next for now if you have to. At least the pesky defense and dissertation are behind you. :)

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  2. Hooray for a great OB appt! We have an OB who is also long on clinical skills and short on bedside manner, and I honestly am happy to have it that way.

    Hoping that the next few weeks go smoothly and uneventfully for you.

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  3. What a great appointment! I'm so happy for you guys. I cracked up that the OB called it a "hep lock"... and I really really hope you get to have your cake and eat it ALL too!

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  4. I like the sound of your doctor. I agree, I much prefer the hopeful to not be fake. I think the weekly u/s will go a long way to bringing you peace.

    I'm the same way....even after a great appointment, I only relax for about a day, and then I'm right back to worrying :)

    I'm so happy that everything is going great...keep the posts coming!!

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  5. I am so happy that your appointment went well. She sounds like a great OB. She would be just my type. I know it is going to be scary but we will all be here rooting you on. I am so happy and excited for you!

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  6. Dear Mo, can you please clone your new doc? I frankly really appreciate a cup-half-empty kind of bedside manner. I find it soothing and reassuring that things aren't taken for granted. And I love that your medical history wasn't glossed over. Sounds like you have a winner. Nice!

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  7. That is great you get an u/s every week! I'm 4 months along and purchased an inexpensive fetal monitor a month ago to help calm my nerves. I check daily. I can't help it. With my bad history and all. I will continue to throw positive vibes your way!!

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  8. Oh Yay! I totally covet that ultrasound coverage you've got coming up. Enough so that I'd love to know who your OB is. Just in case, you know, I decide to double-dip and "interview" a high risk OB...

    Seriously, so happy that everything's looking good! Can't wait to hear the updates as they come!

    (And I'm scheduled for a CVS with Evans on the 18th. Who are you using?)

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  9. Sounds like you have a great OB. Sounds like everything is great! Hoping the next few weeks fly by in a happy daze - best of luck.

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  10. That sounds great -- am keeping a 3 (!) of you in my thoughts. I'm willing to cut her some slack given her apparent clinical expertise and general good sense, but I'm with Will, either doing the u/s first or perhaps simply saying, "We will check the h/b on u/s in just a minute." ... which leaves open the reality that the "check" could be bad but doesn't make that fact quite so explicit ... would sit better, I think!

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  11. Sounds like a great start with the OB! I am so happy to hear that.

    BTW, I got goosebumps when I read your post about not being alone - seriously, I said the same thing to my husband two days ago. It is amazing.

    Great big hugs to you and Will - and your Little One!

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  12. Hi there! Just wanted to say good for you making it this far and finding a great OB! Just wondering... is the CVS mandatory in your case? I ask because my sister lost her baby from complications with CVS, and I know many docs are indeed moving away from them. I don't mean to scare you, you probably are more knowledgeable on the subject than I am, but I just would hate to see someone in your situation fall victim to the same outcome. Good luck and blessings to you!!

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  13. Your OB sounds awesome! I'm so glad you found a good one. Grow grow grow baby!

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  14. Sounds like a great appointment. I understand the worry, but take a few moments each day to relax and fantasize about a perfect prengnacy and a perfect child.

    Best of luck!

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  15. Interesting...and I really love how you put the whole 'having your cake and eating it too' fantasy. So true. Glad things are going well...holding my breath for you.

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  16. I'm hoping you prove yourself wrong too. So glad all looked perfect today and I have everything crossed for a healthy baby in 8 more months!!!

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  17. I may just have a crush on your new OB :) Sounds amazing! I hope you do have your cake and eat it too :)

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  18. So glad things went so well todayyy!!! Grow Baby Grow!!!

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  19. your new obgyn sounds fantastic - I also hate the blanket approaches that all will be well because hello! we know it's not just about getting pregnant.

    Love that you can see Little One every week - in my early days I had weekly appts and a day or two before I'd be convinced that one of them had died (feels terrible to say that now but it's the truth). Don't know how I made it through the 4-week waits!

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  20. I'm holding my breath with you both and hoping for all things great! It's also wonderful that you found a doctor that seems thoughtful, but also knowledgeable and non-sugar coated. Thinking of you.

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  21. Am glad that you are in the process of developing such a good rapport with your new OB.

    I totally hope that your fears would be unfounded and there would be only cheer from this point forth.


    Good Luck!

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  22. I know how terrifying this whole thing is and I am glad that you had a moment of calm. My wish for you is that you could enjoy every moment and be one of those oblivious pregnant women. But, I know that we know way to much for that to happen. I hope you aren't like me in the anxiety department. But with all that has happened to you I can only imagine that you will be. If I could offer one piece of advice it would be to buy a fetal doppler (not a Babies r us cheapie). I got mine online for around $125. I have used it daily since buying it at 19 weeks. I wished I would have bought it sooner. One day at a time honey. One day at a time. Ugh....

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  23. What great news! After all you've been through, I am so glad you have a competent and honest doc. My MFM is not warm and fuzzy one bit but always honest, so when she is positive I BELIEVE her. That is so important- glad you feel that confidence already too.

    Thanks for stopping by my blog. It was a pride-swallowing-event to scoot around Target but felt great after a while! :)

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  24. I'm just beyond happy for you guys! The new OB sounds very good. I know how hard it is to stay away from that fearful place--if you have to go there every now and then, so be it. You'll bounce back to optimism again as soon as you see that gorgeous heartbeat on the ultrasound screen. Sending lots of good vibes in your direction that all continues to go well~

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  25. Oh man, I have been in your spot. With my last pregnancy (the only successful one) I kept running into nurses or PAs who would ramble down a medical history and toss out the question: "How many pregnancies?" "Three," I would answer. And they would always say something like, "Two kids at home?" Even at the high-risk peri, this happened. And then they'd feel like assholes, I'm sure, when I'd say, "No, no kids at home. Two miscarriages." After a while I would just answer "Three, but the first two were miscarriages."

    I mean, so many women miscarry at least once that you'd think they'd be a little more sensitive about this kind of thing.

    Regardless, I'm SO happy for you that things are still plugging along. Whenever I click on your site, as I wait for it to load, I think to myself, "still be pregnant... still be pregnant..." :) as if that would help.

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  26. I'm so glad that you like your new high risk OB, and that the baby is doing well! Yay for weekly ultrasounds! I wish that more OBs would understand that after going through infertility and miscarriages, having that reassurance is so necessary.

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