?'s for OB/GYN Intake Appt. Wed. MorningAugust 15 2011 at 7:14 PM
|ALM (no login)|
Good Evening Ladies,
I'm 10 weeks today and have my OB/GYN intake appointment this coming Wednesday morning. That said, I'm coming up with a list of questions. If there is anything else you can think of that I'm missing and may want to ask, please let me know.
1. I have calculated my due date as March 12th (based on 38 weeks) is that correct?
2. When can I schedule my 12 week scan? How long do the results take to come back?
3. What other major milestones or checks are there? 16 week amnio, 20 week scan, etc.?
4. Based on ultrasounds at RE's office, the baby is already moving a lot (I can't feel it yet). Is this normal? The hb today was 180?
5. Cord Accidents in-untero - how common are these? I've heard of them and know someone personally that lost a baby at 7 months. Is there any way to lessen the chances of something like this happening?
6. Do I have birthing options? Given my age (43) is it possible to do a planned c-section?
7. There is conflicting information regarding exercise: Apparently eliptical, recumbent bike, and stairmaster are deemed safe for pg women. That said, I've read not to allow your heartrate to get above 140. Even at moderate settings heartrate with any of these (and likely even a brisk walk) gets into the 150s or 160's pretty easily? Why is the 140 limit set, or is it?
8. How often will I have appointments?
9. How necessary is it to gain 25 or more pounds?
I know there have GOT to be more questions, but this is my initial list. Any input is appreciated.
Already thought of another one!
|August 15 2011, 7:16 PM |
Will the doctor be there during the delivery, or will it end up being an emergency room doctor?
I can answer this one :-)
|August 15 2011, 7:24 PM |
It can go a few ways, depending on the practice you've hired:
1) You go naturally and your doc delivers the baby
2) If there's more than one doc at the practice, whomever the on-call doc is will deliver
3) If there's only one doc and he/she's unavailable for some reason, they will appoint a back-up doc for themselves in advance, so you'd get that doc.
4) If you schedule a c-section, you'll get to pick the date/doc who delivers the baby.
That may or may not cover it
If you deliver at the hospital affiliated with the practice you're seeing, they're sure to ALWAYS have an OB covering, so an ER doc wouldn't deliver.
Hugs, and GL!
|August 16 2011, 11:03 PM |
I appreciate the detailed answer. I'll be going in the morning, so will know more tomorrow. Thanks!
A thought on your 12w scan
|August 16 2011, 7:44 AM |
For the 12w scan, my OB lets you do the b/w starting at 9w and the scan starting at 11w1d. I would ask if you could do the b/w on Wed while you are there and then ask when you can schedule the actual scan. Then ask when you can get the results, as My OB will give you the combined results at the actual scan if you have done the b/w ahead of time.
just another perspective
|August 16 2011, 10:56 PM |
My Genzyme genetic counselor did not allow this - their position is that the results of both NT scan and b/w need to be in sync (meaning b/w drawn on day of NT scan) so that they can provide accurate combined result.
Hmmmm. I'll ask this tomorrow at the intake
|August 16 2011, 11:07 PM |
appointment. It does make sense. All looks good so far, so I'm anticipating everything is fine. I'm so psyched for you as you are soooooo close! Hang in there.....and keep us posted on the birthing plan. I shall live vicariously through you
Do you think RE can do the b/w?
|August 16 2011, 11:06 PM |
They were going to release me on Monday b/c I hit the 10 week mark, then decided to keep me one more week since I'm tapering off the progesterone and they want to be sure I'm okay. That said, I've had blood drawn already this week, and have to have it drawn again on Thursday by RE. My veins can't take it! On Monday, she couldn't get the vein to give the blood and I, as usual in this situation, broke out in a cold sweat and started shaking a bit. The nurse finally got the blood out of the other arm. I hate being poked and prodded. I will ask about doing the b/w possibly next week, and then the u/s right at 12 weeks on 8/29. I'll keep you all posted! Thanks for the feedback!
|August 17 2011, 3:45 AM |
The b/w I had done for the NT scan was a finger prick, so no worries on the veins there. They do send b/w out to a special lab and my guess is your RE can't do it.
My OB, however, did do additional b/w to test for a variety of other things at my first appt. Not sure what your RE is testing on Thu, but you may want to see if your OB is doing b/w on Wed and add in whatever your RE is testing on Thu if he is to avoid multiple sticks.
For what it's worth....
|August 16 2011, 8:07 AM |
I didn't have any (major) questions for my OB during intake. I guess I went with the flow and it's by seeing that you see the kind of care you are getting from your OB.
When I went to my first OB, I realized that he was somewhat forgetful. For instance - I was supposed to get to have my gest. diabetes test, but he forgot that until a few weeks later. (I didn't know I was supposed to have it that week.) And then I went on a tour of the birthing ward of the hospital and the nurse mentioned that he loved to use forceps. I put them together and realized that he wasn't the OB for me.
I switched and saw the difference in care. It wasn't major, but it was enough to take care of the nagging feelings I had....
By the way - my due date was 40 weeks, not 38, (and I ended up delivering at 42 weeks) but that's something you can talk with your OB about.
Forceps??? Aaaahhh. And 42 weeks?
|August 16 2011, 11:13 PM |
Now you've given me a couple of additional questions!
I read your story above in response to Mrs. A's natural childbirth question. Wow. You are a real trooper! I was having to squeeze my legs shut just thinking about that pain, ouch!
The think about this practice is: I've never met the actual doctor, but she was recommended to me by a business associate who is very picky and said they were wonderful. I went there for the first time about a year ago, and to get in sooner met with the Nurse practitioner, who is the Doc's right hand. This NP will also be doing the intake appointment tomorrow. Quite Frankly. I'd just as soon have her from A-Z, but I'm 99% sure she can't deliver a baby. I saw her for regular pap as well as a mild infection I had this past fall. Very nice and calm. And a Mom. See, I just can't go to a man for female issues. I want a woman doctor who's done this herself! Forceps, oh, H**L no!
|August 16 2011, 12:21 PM |
It depends how the office is set up, but they are likely to have a "program" agenda for your first visit. Mine was with a nurse and she automatically went over EDD (40 weeks), how often they would see me, what would be done at each appt, family history, medical history. By the time this is done many of your questions will most likely have been addressed.
IMO the MOST important thing that will happen at this visit, especially given that you are at 10w, is a discussion of your early screen options. You are going to want an u/s for the scan (NT) piece at approx 11-13 weeks so that needs to get on the calendar and it should not be done by the OB - I am throwing my own personal opinion in here, but given IF history and age I would want to see this done by a perinatologist. As far as the b/w is concerned, a PP mentioned that there is a screen with a first tri b/w component which you could ask to be done at this appt. At over 40 I would not elect this version of the test. It has a high rate of false + for our age group (I use the term loosely, since screens are not diagnostic, so strictly speaking no + or - results, just a "high risk" or "low risk" flag).
If you did OE, please be prepared to possibly have the wits scared out of you as an AMA Mom to be. I was very lucky as I was assigned to an over 40 nurse who'd just had a baby at 41. She prefaced the entire screening discussion by saying, "unfortunately we end up scaring the heck out of moms over 40, but keep in mind, A, B, C" where A, B, and C were reassuring pieces of info such as "1 in 35 chance of Downs Syndrome is really a 97% chance everything is fine." The charts in the literature you are likely to get will give something like a bar graph representation that makes it look like the risk of defects after 40 skyrocket. The math still overwhelmingly supports that we will have healthy babies!
If you have lots of questions about the screens, risks, odds, or your family history, you should feel free to ask for a genetic counseling referral, if they don't automatically offer you one. I found my GC meeting extremely helpful.
The baby moving is a GREAT sign but feel free to ask the question if you want to hear it again!
You may want to ask if you aren't doing a planned C whether they will let you go late, if so how late, and what guidelines they will use to induce. My OB will not let me go late at all due to my age. Induction can be somewhat controversial due to med side effects, risk of ending up with a C anyway, increased risk of other interventions being necessary, etc. I am grappling with all this right now, plus I have placenta previa, uterine scarring, and fibroids, all of which make the idea of being induced completely terrifying to me. Of course they won't allow it if the previa persists - what I'm trying to say is that your option of a planned C will be influenced by any other conditions you have, so you may want to save this query for after they have your info.
If you have hard copies of your RE stuff (ID b/w, betas, u/s, etc) it's helpful to take those with you. I wouldn't fax them ahead, I'd have them in hand. You will probably have baseline b/w done but if you already have your HBV, HIV, blood type and Rh, etc etc no sense in having to have those redone.
I hope you will report on some of your other questions, like the cord accident and exercise - I'm curious!
If you are currently overweight with high BMI the recommendation may be for less than 25lbs weight gain. Otherwise, the standard recommendation is 25-35lbs.
Good luck and hope you have a great appt!
|August 16 2011, 11:21 PM |
Thanks for your thoughtful response. I think I do want the official 12 week scan and b/w done on the same day, and I agree with you, NOT by ob/gyn, but by specialist. I am going to get that on the calendar, hopefully for Monday, 8/29. I will be exactly 12 weeks by then. If done in the a.m., I should have the test results back by Thursday, 9/1, rigtht? I will make sure that is the case and if not I'll see if they can do it a little earlier - Friday, 8/26.....
As for c-section, going late, etc.: I've been terrified of child birth since I can remember. I know there are those that think pg and childbirth is wonderful, but for me it's a means to an end. So far, pg has not been bad (except for bleeding scare at 8 weeks) and extreme exhaustion. They're tapering me off of the progesterone support and I am feeling a bit more functional as regards to the exhaustion issue.
I don't have any sort of uterine fibroids/issues. But I'm old! I have no idea what they are going to say, but I've talked with this NP before and she didn't try to scare me to death. I think I'll be okay on that regard. Good Luck to you!!
Sounds good :)
|August 17 2011, 9:42 PM |
Wrt TAT - turnaround time - it's a really good question for you to ask b/c the answer will depend on where you are, where they send out the bw, and how good their processing/reporting system is. I was told up to 2 wks for revised risk ratios, though they came back in a week. But you will go home that day with your NT measurement and your peri's general report, which is some info at least
best of luck!
I think some of the Qs will unfold naturally
|August 16 2011, 11:13 PM |
as you have a conversation and if a good OB office, you should have many questions answered without even asking; I'm refering to Qs you didn't even think of.
Aside from Qs to ask, I think it's important to walk out with a packet of basic info such as what foods to eat/avoid, OTC meds you can/can't take, concerning symptoms to look out for.
As for your due date - that's a really good Q!! I can't imagine you'd calculate due date by first day of last menstrual period when your IVF. I would think it's based on retrieval date being O date. But I'm really speaking out of turn here because I really have no idea.
Bottom line - when you walk out of your intake appt. you should feel like you just fell into the hands of an angel.
Hmmmm. Due date+++
|August 16 2011, 11:24 PM |
Well, the RE clinic even calculated it as 14 days before retrieval date. Retrieval was 5/20, transfer 5/25, which would put start date at June 6th.....I will double check tomorrow. Otherwise, I'd be 8 weeks versus 10 weeks, and baby measured 10 weeks 2 days on Monday....little dude is getting big!
I keep saying dude but I have no idea what I'm having. Of course, I'll be beside myself with either.
|August 16 2011, 11:35 PM |
I was thinking that because there's such variability in IVF with how long (or not) you stim that you couldn't assume a 14 day follicular phase before O. But again, I have no clue.
I call mine a boy too.
|Current Topic - ?'s for OB/GYN Intake Appt. Wed. Morning|