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Archive for May 8th, 2007

I had a tremendous migraine all day and it only got worse toward the end of the day. Having a dentist appointment probably didn’t help matters. Now I’m in slightly less pain, but can’t sleep, as is often the case after a long migraine day. I think that the migraines are actually getting worse, which is almost hard to believe. Suzanne also reminded me that I never updated you all on the other lovely pain in my life… the kidney stone. Well, it seems to be gone. I think I passed it last Sunday and on Tuesday I had a renal ultrasound and all was clear, which is good. Frankly, I’d rather have a couple more kidney stones than these ever-pervasive migraines at this point. Bleh.

Anywho, enough complaining. Last Thursday, of course, was the nuchal scan that I’ve already updated about. On Friday I saw my regular OB. These appointments are rather useless as I basically go in, he asks how I’m feeling, I say I feel like hell, he listens for one of the heartbeats (hard to differentiate on doppler), and that’s about it. I broached the subject that perhaps it made sense to transfer my care for this pregnancy directly to the perinatologist.

Now, I should pause here remind you that this was NOT my initial desire. I love my OB and originally any mention anyone made of leaving him for this pregnancy was met with my icy glare. However, the truth is, it really makes sense to me at this point. The best equipped doctors to handle the ins and outs of a triplet pregnancy are the perinatologists I’m seeing. Having two sets of doctors directing my care, particularly with the perinatologists being the experts but going through the OB to direct critical care decisions, does not seem advantageous to me. The perinatologists (all three in the practice) have all been very, very willing to do whatever I’m comfortable with. They’ve been effusive in their praise of my OB specifically and of the practice as a whole. I’m not concerned about my care, but I do not honestly see any true advantage to having two sets of doctors at this point.

Right. But being that I love my OB and certainly don’t want to alienate him or lose him as my doctor for postpartum care, future pregnancies (hah!), and well-women’s care, I broached the topic very gently. This is in part because I’m sensitive to the fact that I love him, and partly because I completely lack the ability to have any sort of confrontation with a doctor. I’m a wimp, essentially. So I mentioned that Dr P (the evil one, not the wonderful one) had suggested transferring my care, and my OB brushed it off. He didn’t see any need to transfer my care. Oh no, he said, they can totally handle it (and no doubt they can, but still… is there any real ADVANTAGE to having two sets of doctors? Not that I can find!). Since my next appointment with the perinatologist is in two weeks, he suggested coming back to his office two weeks after that, so that we wouldn’t be seeing two doctors in the same week. Except that after this next two-week appointment with the perinatologist, I’ll be seeing the perinatologist EVERY week, so the logic doesn’t hold. But my OB said, no, I don’t need to see them that often. And if they wanted to do cervical measurements every week, well, the OB’s office could handle some of that.

But… but… I don’t WANT two different offices trying to coordinate and compare cervical measurements!! It seems like there are too many ways that can be screwed up. And if the perinatologist tells me to be there every week, I’m going to be there every week, no matter what. I am NOT messing around with this pregnancy! But I’m a wimp, as previously stated. And the OB just seemed so sure of how this should go, and I didn’t want any sort of confrontation, and I love him, so I just said okay and went to the front desk to make my next appointment for four weeks out.

Except I don’t really want to do that. What I want to do is to transfer my care to the perinatologist. But without alienating my OB. I asked a friend who is a doctor (and has five kids of her own… mostly out of the house), and she said I should just transfer my care and tell the OB’s office I’ll be back for my post-partum care. She said there was no reason that should alienate the doctor or the practice, it’s just the way it works. But it feels… underhanded. Sneaky. Deceitful, even. Still, I know I’ll be a lot more comfortable with just one set of doctors to turn to if a problem occurs. Even though I completely 100% trust my OB and I know that he would defer to the perinatologists for any critical care decisions. It still seems convoluted to deal with both sets of doctors.

So… I don’t know what to do. I mean, I know that the right thing to do is to transfer my care. I just don’t know how to do it most appropriately and with the least possibility of alienating my OB. Bleh.

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I had a tremendous migraine all day and it only got worse toward the end of the day. Having a dentist appointment probably didn't help matters. Now I'm in slightly less pain, but can't sleep, as is often the case after a long migraine day. I think that the migraines are actually getting worse, which is almost hard to believe. Suzanne also reminded me that I never updated you all on the other lovely pain in my life… the kidney stone. Well, it seems to be gone. I think I passed it last Sunday and on Tuesday I had a renal ultrasound and all was clear, which is good. Frankly, I'd rather have a couple more kidney stones than these ever-pervasive migraines at this point. Bleh.

Anywho, enough complaining. Last Thursday, of course, was the nuchal scan that I've already updated about. On Friday I saw my regular OB. These appointments are rather useless as I basically go in, he asks how I'm feeling, I say I feel like hell, he listens for one of the heartbeats (hard to differentiate on doppler), and that's about it. I broached the subject that perhaps it made sense to transfer my care for this pregnancy directly to the perinatologist.

Now, I should pause here remind you that this was NOT my initial desire. I love my OB and originally any mention anyone made of leaving him for this pregnancy was met with my icy glare. However, the truth is, it really makes sense to me at this point. The best equipped doctors to handle the ins and outs of a triplet pregnancy are the perinatologists I'm seeing. Having two sets of doctors directing my care, particularly with the perinatologists being the experts but going through the OB to direct critical care decisions, does not seem advantageous to me. The perinatologists (all three in the practice) have all been very, very willing to do whatever I'm comfortable with. They've been effusive in their praise of my OB specifically and of the practice as a whole. I'm not concerned about my care, but I do not honestly see any true advantage to having two sets of doctors at this point.

Right. But being that I love my OB and certainly don't want to alienate him or lose him as my doctor for postpartum care, future pregnancies (hah!), and well-women's care, I broached the topic very gently. This is in part because I'm sensitive to the fact that I love him, and partly because I completely lack the ability to have any sort of confrontation with a doctor. I'm a wimp, essentially. So I mentioned that Dr P (the evil one, not the wonderful one) had suggested transferring my care, and my OB brushed it off. He didn't see any need to transfer my care. Oh no, he said, they can totally handle it (and no doubt they can, but still… is there any real ADVANTAGE to having two sets of doctors? Not that I can find!). Since my next appointment with the perinatologist is in two weeks, he suggested coming back to his office two weeks after that, so that we wouldn't be seeing two doctors in the same week. Except that after this next two-week appointment with the perinatologist, I'll be seeing the perinatologist EVERY week, so the logic doesn't hold. But my OB said, no, I don't need to see them that often. And if they wanted to do cervical measurements every week, well, the OB's office could handle some of that.

But… but… I don't WANT two different offices trying to coordinate and compare cervical measurements!! It seems like there are too many ways that can be screwed up. And if the perinatologist tells me to be there every week, I'm going to be there every week, no matter what. I am NOT messing around with this pregnancy! But I'm a wimp, as previously stated. And the OB just seemed so sure of how this should go, and I didn't want any sort of confrontation, and I love him, so I just said okay and went to the front desk to make my next appointment for four weeks out.

Except I don't really want to do that. What I want to do is to transfer my care to the perinatologist. But without alienating my OB. I asked a friend who is a doctor (and has five kids of her own… mostly out of the house), and she said I should just transfer my care and tell the OB's office I'll be back for my post-partum care. She said there was no reason that should alienate the doctor or the practice, it's just the way it works. But it feels… underhanded. Sneaky. Deceitful, even. Still, I know I'll be a lot more comfortable with just one set of doctors to turn to if a problem occurs. Even though I completely 100% trust my OB and I know that he would defer to the perinatologists for any critical care decisions. It still seems convoluted to deal with both sets of doctors.

So… I don't know what to do. I mean, I know that the right thing to do is to transfer my care. I just don't know how to do it most appropriately and with the least possibility of alienating my OB. Bleh.

Read Full Post »