I'm not sure what it is or what triggered it but I feel like I'm officially going bonkers. My head feels like it's all over the place but I'll do my best to keep this post coherent. I think I have some legitimate concerns wrapped up in my invented ones.
Perhaps this is all triggered by the fact that I'm 16 weeks today and have never felt less pregnant. The doppler has been great; I know the baby is fine. But:
1. I'm concerned about my risk for an incompetent cervix. I know the condition is relatively rare but so are four miscarriages (statistically speaking), so that isn't any comfort. Apparently one of the causes is trauma from a D&E or weakening of the cervix from forced dilation. My two D&Es and two hysteroscopies both fit this bill (at least partially) I'm not sure why my OB didn't check to be sure that all was ok at my last OB appointment at 14w5d OR want to follow-up with me before my next four week appointment, where treatment wouldn't really work. Anyone have any thoughts on this? At my last regular OB appointment (14w5d) they didn't do an u/s or an internal exam. My last u/s was at 13w5d due to spotting (which is often too early to see this problem) and I won't have another u/s for another four weeks or so (which to me could be too late to fix the problem).
2. Referring to #1, yes, I know I should call my OB. However, I'm thinking that I should switch. It's been a nagging feeling that I've had in the back of my head for a couple of weeks now. Why? Well, in their defense, they were great when I was spotting and fit me right in. They checked me out (via u/s) and said all was fine. But...
- I called over a month ago for my thyroid levels to be checked. I was due and left a message for a lab slip. They literally NEVER CALLED ME BACK. This may not seem like a big deal, by my thyroid always goes wonky when I'm pregnant. I saw a different doctor for my 1st trimester u/s and asked him for a lab slip (after waiting a week for them to call) and it was taken care of, but still.
- When I had my genetic counseling for the 1st trimester screen, the nurse asked if I had been on antibiotics because I had a slightly elevated level of bacteria from my urine test. Um, no. I didn't even know this. She then said oh, it must have been low enough that they weren't concerned.
- My last OB visit was awful. It was with a resident and she was horrible. She pushed me to have the 2nd tri bloodwork. Literally, she said that it's "just a blood test" and "what's the big deal about having it?" Then, she called me back bright and early Monday morning to tell me to set up an appointment with my hematologist (I saw him already...read my chart) and to PUSH, again, for this bloodwork.
So, I feel like if I call and express my concerns and say that I'd like to be checked internally to see that all is ok, I'm not even comfortable that they'll call me back. That's not really a good feeling to have.
If any of you have had similar conversations about this concern with your doctor, I'd love to hear about it. Also, feel free to tell me that I'm half-crazy, too.
You aren't crazy. You HAVE to be able to trust your medical team. It seems perfectly reasonable to me that you would want to switch. At the same time, if it's going to take a while to make the change, go ahead and push your current team to give you the reassurance you need.
ReplyDeleteIf you want to switch, then switch. I wish I had just because I never got to know my OB. I stayed because I wanted to deliver next to CHOP because of the high risk. If I had to do it over again I would have switched. Trust you gut.
ReplyDeleteSecondly, I know that sometimes the don't check you cervix length internally, but do check it via u/s. Is it possible they checked it durning your screening. I was freaking out that they weren't checking mine during OB visits, but they had been checking them during ultrasounds and not mentioning it.
I don't think you are crazy, the concerns you have are are realistic ones. This may be a silly question: is your ob a high risk ob? If not run don't walk to a new one.
ReplyDeletehow quick would it be to switch? if quick, then go for it and raise these issues quickly. if slow, then raise these issues with your current OB (and keep hassling them if you don't get an answer quickly), then switch. because it sounds like you do want to switch, and it sounds like you have good reasons for that.
ReplyDelete16 weeks. amazing. i'm 21 weeks today and can't get my head round it. time is going slowly and racing ahead, both at once.
I suck at switching doctors but I truly believe that if you aren't comfortable with your doctor then you should move on. I agree with what B said about the "quickness" of changing. Good luck.
ReplyDeleteNo crazy here. You absoloutely HAVE to be comfortable with your OB. These people are going to deliver your baby. So ask around, check with coworkers, whatever...and find one who makes you feel comfortable and takes your concerns seriously. It will be a huge load off your shoulders, it really will.
ReplyDeleteHUGS.
You can and should definitely change if it would make you feel better, and I understand wanting to get your cervix checked. I really do. I worry about that too with all of the miscarriages, and the HSG. Assuming I ever make it to the 2d trimester, of course. (not pregnant at this point)
ReplyDeleteI don't think your crazy. your just worried and rightly so from past experiences. If you don't feel comfortable with your ob's office feel free to switch. It's always important to feel comfortable with our docs. I'm going to give mine one or two more visits and then I might switch too.
ReplyDeleteDefinitely don't think you're crazy! I agree with the others, if your gut is telling you to switch. But with whatever doctor, you should ask for some more reassurances. I hope you get that soon!
ReplyDeleteI do NOT think you are even a quarter crazy, you actually made me feel more normal. I too, had the thought about the incompetent cervix yesterday and this morning!! I'm 18 weeks tomorrow, so I feel it would be too late too. I have no reason to have concerns as both of my m/c were done with d&c and I did have hsg, but no one has mentioned that this could cause problems. I would be pissed if my OB had pushed for that blood work! Mine actually asked b/c he said they are required by law to ask, but he did not recommend it and said that it tended to cause false anxiety more than it helped anything. He was concerned that with my history it would only make my anxiety worse and said he did not recommend it (not like we would terminate a pregnancy).
ReplyDeleteIf your gut is telling you to switch, I believe with all of my heart that you should. I felt that with an RE, and with my first OB, so I say move! Also, I would report that resident to someone higher up than her, as that should be addressed in her rotation evaluation, as that is not proper etiquette and she needs further training on bedside manner (I have plenty of doctor friends who've been reprimanded for way less than that, that's why they're in training). With all you've been through you should have a doctor that is highly sensitive to all of that. My OB had literally been a gift from God during this pregnancy, and I want you to have that too! Sending love and cheering you on!
I don't think you're crazy; I think you're a women who has survived RPL and it's totally understandable for you to be concerned. That being said, I didn't have an internal exam until 36 weeks (perhaps they did an internal exam at the very first appointment...I don't remember much after seeing the heartbeat). I'm sorry that it sounds like the OB's office is legitimately flaky. In my experience, it seemed like my OB was looking at a lot more than I could recognize. I focused on finding the heartbeat going strong, and then how cute my baby was. I think that she was looking at everything else (fluid levels, etc.). So I do "trust" that they know what they're doing; but heck--if you can find someone else who will take the time for you, it will make your whole experience so much more enjoyable. Hang in there!
ReplyDeletehaving very similar concerns right now espicially about the incompitent cervix. they can measure your cervix on ultrasound and see if it is shortening which is a precursor to incompitency apparently if it is going to be incompitent it will also do something called "beaking" which they can also see on u/s so when you have your next scan get the sonographer to measure the length of the cervix. pregnancy after loss is not an easy processs. Hang in there Hopefully our babies will be fine and causing us sleepless nights before we know it
ReplyDeleteSwitch fast its your baby and you are in your rights to want to protect it and your body in any way you can.
ReplyDeleteThey don't usually check your cervix until you have either had LEEP's done or cone biopsy which is actually removing part of your cervix or if you have had incompetent cervix before. You could mention your worries and see what they say? I had 2 LEEPS done and was at risk for incompetent cervix. They started checking my cervix by ultrasound around 18 weeks and checked until I was 20 something weeks.
ReplyDeleteYou're not crazy. You're pregnant after a (bunch of) loss(es). I think you should find another doctor if yours is not responsive to your needs.
ReplyDeleteWow, it sounds like you definitely need to look at another OB. I had to switch too and I'm SO thankful I did. I knew I had to have someone I could trust to get through this pregnancy after the loss we experienced last time. Also it worried me when you mentioned that they didn't have you on an anti-biotic, I would request the new doctor check that level again as well to be sure you don't need them. That's how I went into preterm labor was due to an asymptomatic infection and if they would have known my levels were elevated maybe I could have gotten anti biotics in time. I don't tell you this to freak you out further, but to make sure you know that infection can be extremely series during a pregnancy as well. Hoping you find someone who responds quickly to your concerns and provides you with the care you need and deserve!
ReplyDeleteI agree w/what everyone is saying. In fact as soon as I saw "nagging feeling" I was going to tell you to change your OB. I was 100% confident in mine (still am, actually) and he was amazing during my whole pregnancy. He did not take my RPL or any of my sometimes irrational fears lightly. Plus, his nurse was amazing and he was the only doctor in the practice, so I never saw anyone but him. You MUST be comfortable and feel 100% about the people caring for you and your baby. If it's a gut feeling, it's time to switch.
ReplyDeleteOn that same note, my doc didn't do any kind of cervical checks until week 39 (which I, obviously didn't make it too) except for the preterm labor on Christmas Day, and to see how dilated I was on her birthday. I think, had I shown signs of incompetent cervix, he would have, or if I had mentioned it, he would have. Again, this is something, that if it concerns you, your OB should be willing to check it out and put your mind at ease.
Sorry this was so long. Also, 16weeks!! Omg!!
I switched docs 3 times during my pregnancy. Twice in second trimester. So if you're not happy then go!
ReplyDeleteI've never been that far along, so I am not sure I can answer or any questions or ease your anxiety in any way. But, I can say you should find an ob-gyn who make you feel 100% comfortable after all you've been through.
ReplyDeleteCongrats on passing 16 weeks....
Hon, if your gut says switch, then switch. Feeling confident in your doctor's entire office is a huge part of coping with pregnancy after infertility, and especially after loss.
ReplyDeleteYou're not crazy. You're doing AMAZING!
Trust your gut, hun. You really don't want to be second guessing someone about this. Not that you are worried about enough as it is!
ReplyDeleteI don't really have any advice except that I think having confidence in your OB is so important. Go with your gut feeling and find a new one if you need to. I hope that a new OB or your current one can help to ease your worries.
ReplyDeleteHm... I think you may be a little crazy...
ReplyDelete: )
You know I was the queen of the crazies with Hannah Mae, so I can't talk at all. But you sound completely normal to me.
If you think you'll feel more comfortable with a new doctor, then I would switch. If it's something that's always going to bug you then you need to switch. It's not worth the head ache to stay with them.
Praying, Kelly.
love,
ebe
Hey there girl....your concerns are valid and I too had 2 D&E's in one year and was concerned about the cervix....With me because of my losses/clotting disorders I was referred to high risk and it was them that recommended weekly cervical checks via internal US starting pretty early in pregnancy and for me to start my cervix was only a 3.5 which isnt very long and if you remember I did have some shortening/funneling and then put on bedrest...and that worked for me...My high risk/ob did not do cerclage after 13wks because of the increasd risk of infection/membrane rupture/miscarriage...They pretty much just treated it with bedrest and then if that wouldnt help then they admit you and give medications/other medical interventions...Luckily I didnt ever have to go there...Then I did get a break from Internals US and now we started Internals again at 35wks but via the Dr. to check for labor progression....
ReplyDeleteBut as you can see from my post today I would def get a Dr./Plan that you want for you pregnancy/delivery or you could end up like me stressed to the max at 38wks...and let me tell you not a good place to be:(
I don't think you're crazy at all. First off, I would be searching for a new OB. You have to find someone that you feel comfortable with AND that properly addresses your questions and concerns. Returning phone calls would be a nice start.
ReplyDeleteSecondly, I also have the crushing fear of an incompetent cervix due to chryo and leep therapies prior to infertilty (for cervical dysplasia) and my Dr. has been great about it - I'm having bi-weekly ultrasounds where they are doing cervical measurements to make sure everything is ok. I'm also seeing my dr. weekly now (WAY earlier than I should be) and he does manual cervix checks on the weeks I don't have ultrasounds. You should be able to request these things so you can have piece of mind. At a minimum, you should feel comfortable enough to talk to your Dr. about whether they think you're at risk.
I don't think there are many PAL girls, who would not have this major fear. I have it, too. IC is a monster. The good news is, that is still a very rare complication, and if your doctor is aware of any risk they can keep en eye on it for you. And I am sure they will do. Major (((HUGS))) and lot's of happy & positive thoughts your way.
ReplyDeleteGrrrrr...not happy to hear about your OB office's woes. I really hate disorganization when it comes to something so important. I totally think you should call and give them an earful but I also realize how tricky and tough this is.
ReplyDeleteAnd I know how lousy it is to have been constantly caught out on the wrong side of statistics. You give up any faith in them whatsoever.
You are definitely NOT crazy, my friend! I've been worried about an incompetent cervix, and I've never had a D&E. I would definitely voice your concerns and get in to talk about your concerns and your care, and get that cervix checked out. I hope the OB office is responsive to your concerns and you feel comfortable in their care...that is so important!
ReplyDeleteI agree with the other posts, if you are not comfortable with your current OB, I think that you should switch to a new one. GL!
ReplyDeleteI think the issue of them not calling you back is kind of a big deal--like their office might not be well-organized administratively. I would be afraid that something important would slip through the cracks. I don't know how easy it would be for you to switch, but it sounds like it's not a bad idea. Especially if you can get a recommendation from a reliable friend for another good OB practice.
ReplyDelete