The Plan

First, thank you everyone.

I might as well post a post rather than extending my comments. At my last meeting with my current OB, I got a brief description of the plan for a next pregnancy: cerclage at 12 weeks, progesterone starting at 16 weeks. The doctors had no definitive answers for why I went into pre-term labor based on pathology reports. Some thought an IC (incompetent cervix) and some thought there was a problem with the progesterone production in the placenta, and some thought it was just a freak accident not likely to happen again. My doc falls in the IC category, but I fall into the second because I don’t believe my cervix opened “silently.” I was having contractions for weeks, which I went to the ER for and called the office about numerous times, but having not experienced labor before, I believed them when they told me they were Braxton Hicks because they weren’t close together.

So I guess there’s not much reason for me to be seen regularly before then, except that I want to be. And as I’ve emphasized on the phone, my dates are not as clear as they have been in the past because while I had two periods, they weren’t normal for me, so for all I know I’m not 5w 2d but 6w or 4w.

I trusted Dr. M and the university system until now, because I believed that no one could have known what happened would happen. And I thought that given the extremity of my situation, and the number of times doctors and hospital staff said to me that it was totally unexpected and even “scary” that no one would dare to dismiss my concerns this time. But getting jacked around right away with this pregnancy has very much reformed my thinking.

So anyway, I could entertain you all with stories about yesterday’s conversations (such as being told one doctor had an opening in July!), but I’ll just tell you the results from this morning’s conversations: I have an appointment with an OB outside of the university system! Nurses appointment April 26th and doctor’s appointment on May 4th! Earlier if they have a cancellation. As soon as I mentioned my history, the receptionist got very warm and kind and said, “Well, we want to see you as soon as possible then.” And there’s a maternal-fetal specialist they can refer me to right in the same practice.

At least all of this has distracted me from my greatest current fear, that the baby’s already dead.
Still keeping the ultrasound for tomorrow, though. Right now I actually have some hope that I’ll get good care without arguments and tears.


12 responses to “The Plan

  1. I am so sorry you were treated so badly with your previous pregnancy. Those contractions were a sign that something was not right and the practice should have done more than blow you off with the Braxton-Hix explanation.

    I am so glad (and relieved) to hear that you are now outside the system. Good luck tomorrow with the ultrasound and next week with your nurse appointment at the new practice. It sounds like you are in good hands now.

  2. This is some good news.
    Hoping the u/s tomorrow goes well and that you click with the new doc.

    Will be refreshing obsessively tomorrow. 🙂

  3. Good news. Now, if you have any more problems with you doctor, just let me know. I have a bat that I have been itching to use on a doctor, nurse or receptionist.

  4. It’s great that you were able to get this resolved so (relatively) quickly and that you have the u/s tomorrow.

    I’m sure that you’ll be taken much more seriously and watched more closely with this pregnancy, though it shouldn’t have to take a tragedy to make doctors pay attention.

    I’m puzzled by your former doctor’s response to your contractions. It seems like the logical thing to do would be to check your cervix. Or did they do that and everything looked ok?

  5. Sounds like a good plan! (as far as i know, i don’t know much about these things) I am glad you were able to find someone outside the system.

    I had the same question as niobe — they didn’t check your cervix?

  6. The first ultrasound I had at 15 weeks showed my cervix to be 3.8, the second ultrasound at 18 weeks showed it to be 2.8, at my trip to the ER at 19 weeks they found it to be 2.8, but then another ultrasound at 21 weeks showed it to be 3.4. I was told the 2.8 was “borderline” but probably nothing to worry about.

    But after that, when I called to complain about contractions, I was told to just rest and drink water. Not bed rest, just rest. And now I have my chart in hand and I see no one even recorded those calls. Except for one where I called L&D a week before I entered the hospital because I saw a little blood. I feel like such an idiot for trusting any of them.

    For the first time, I guess now that I have some distance and a clearer head, I’m wondering whether things could have ended differently. I can’t believe my worries were dismissed and that there’s only a little bit of a record that I even had them. Until now, I only considered myself as the one who could possibly be blamed because perhaps I hadn’t communicated well enough. I trusted my “world-class” “award-winning” hospital so much….

  7. Glad to hear the good news, Sara. I’ll be thinking of you tomorrow and will be keeping hopeful about the ultrasound.

  8. Sweetie.

    You should just go ahead and DEMAND what you think you will need from your doc! DEMAND what will ease your mind and ask all the questions that you feel you need to ask! Just go for it, because that is what you need to do. Go for it and don’t feel bad about it, you DESERVE to be listened to, you DESERVE the best care you can get and don’t be afraid to tell your doctor that!

    All love and peace.
    Erin, Birdie’s Mama

  9. Well, I hope the U/S goes well tomorrow. And I’m glad you have an appointment and can get a decent referral.

    I’ll be tuning in tomorrow, okay?

  10. Sara- I’m glad there has been progress and that it sounds like you might have found yourself an office that will treat you and your concerns more seriously.

    I understand completely all of your wonderings, and especially those about whether things could have ended differently. At my appointment the very week I ended up in the hospital I told my OB I was feeling a lot of pressure. He said that was normal for twins and that given that my cervix had looked so good (2 weeks before!) he wasn’t concerned. He also flat out told me I didn’t really need to start worrying about signs of pre-term labor until around 26 weeks. I will forever wonder whether there would have been time to reverse things, or halt things, if I had had a cervix check right then and there and he had seen signs of shortening or funneling.

    It’s hard to live with the what ifs, I know.

  11. None of your calls were recorded!?

    I’m going to put on my childbirth educator hat for a minute, okay?

    Sara, I’m so glad you are out of that practice, but I would also (when you are able), urge you to write a letter to the highest-up person you can find. Those folks are not doing the most basic part of their job, which is listening to what people are telling them about their health, and someone should know about it who can make that change.

    You did right by Natan. You knew something was up and you thought you had let the right people know. A pregnant woman, first-time or not, is the expert on what’s going on with her pregnancy. It’s happening in your body, and all the ultrasounds in the world can’t substitute for what you feel happening in your body. It’s their job to listen to what you say, not brush you off.

    You can’t know if there would have been a different outcome, but you do know that you did not get the medical advice you needed.

  12. Good for you, Sara, for getting that other appointment and good luck with your ultrasound today. Whenever you are ready for a new PCP, I totally recommend mine — She.ryl Kur.ze at UHS. She has been so fantastic with me, seeing me as often as I need to, letting me call her at home, sneaking me in without appointments when I was off insurance, etc. She even weighed me once when I went in for something else because I was freaking out about my weight. Too bad she isn’t also an OB!

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