Archive for December 7th, 2009


Okay, so it’s not like I was *ever* one of the cool kids.  I got left behind when people were picking teams for kickball most of the time.  My red-headed nemesis in 6th grade used to pull on my pigtails to harass me on the playground.  (Joke’s on him – we ended up dating half a dozen years later).  But popular or not, no one likes to be openly rejected.  When someone you thought was a friend stops speaking to you with no explanation in high school, it’s easily attributable to the whims of teenagerhood.  But as an adult – well, no one likes to be disliked.

So I’ll admit it, my feelings are still a little hurt by having been fired by my OB last month.  Sure, I’m worried about what to do about my care.  Sure, I’d like to move on.  But let’s face it:  mostly?  My ego is bruised.  My feelings are hurt.  I feel rejected, and I *hate* that.  No one wants to be broken up with – it’s much better to be the breaker upper than the break-ee.

But, since I am currently OB-less, because the cool kids kicked me out of their practice, I need to suck up the hurt feelings and move on, which is precisely what I’ve been trying to do.  Oh, never mind that my former OB has failed to send me my medical records yet.  It’s not like I requested them two weeks ago or anything.  Oh, wait, yes I did.  See?  Another fine reason for me not to be there anymore.  Their loss, not mine, right?  RIGHT?

So I had a consult appointment with a new OB today.  Everybody loves him.  Four separate women referred me to him, independent of one another, and the perinatologist had him on the top of his list for people for me to talk to.  I couldn’t have asked for better recommendations – everyone has high praise for him, and I was particularly pleased with the fact that he is  a sole practitioner, so I wouldn’t have to worry about getting lost in the shuffle at a big practice.

I didn’t have my medical records with me to provide him, because my former OB’s office still has not sent the records to me, so I gave him a quick sketch of my medical history and brought him up to date on what’s been going on with my current pregnancy.  He asked a lot of questions, clearly didn’t love the answers, and I don’t think he cracked a smile once – well, he smiled when he introduced himself to me, but nothing after that.

And, essentially, he’s not sure he can take me on as a patient.  “It’s a lot to take on, especially this far into your pregnancy.”  He thinks I should be on TPN, but won’t order it himself, because he hasn’t done so since he was a resident – instead he’d want me to get in with a GI doctor pronto to get them to order it and manage it from there.  That would mean juggling three doctors: the OB, my perinatologist, and a GI doctor.  (Nevermind my primary care pracitioner, and my neurologist).  He’s not opposed to a VBAC, but definitely didn’t sound thrilled about it – he said he would insist on an epidural at 4-5 centimeters, and I’d have to be in active labor (no induction) or 2-3 cm dilated by 40 weeks (I would love to GET to 40 weeks!  Right now I’m just trying to get to next week!).  He can (and does) handle a hyperemesis patient.  He can (and does) handle a patient at high risk for PTL.  He can (and does) manage a patient with underlying medical issues.  Etc.  But with me – it’s rolling all of that into one patient, and that… well, that’s a lot to take on.

Frankly, I appreciated his candor.  A lot of doctors would have said, “no problem!” instead of really thinking about the impact of taking on a patient like me.  He seemed to think I’d probably just be better off seeing only the perinatologist (I’m all for it), but he said he’d talk to Dr. P. tonight or tomorrow and he’d call me to let me know how he thinks I should proceed.  Honestly, it was both overwhelming and a bit of a relief to have a doctor look at it all down on paper and admit that it’s just a lot, and an extremely complex pregnancy.  My old OB made me feel like I was hysterical over nothing (I was never hysterical, for what it’s worth).  They made it out to be a pregnancy that was no higher risk than any other, and that I was making a bigger deal than I needed to.  At least SOMEONE is taking me seriously.

Meanwhile, I’m still OB-less.

Honestly, I’m beginning to get a little worried.  How long can I go without a primary OB to turn to?  How long can I hold off on making other decisions about my care (e.g. should I do progesterone shots to mitigate some of the risk of preterm labor?) before it’s too late?  I’m too high risk for a midwife, I can’t possibly have a home birth (not safe for me – though I totally dig the idea, and absolutely understand why other women do it).  I clearly need solid prenatal care.

I just wish I understood exactly what led to my old OB firing me, so that I could at least not do it again.  The OB I saw today has worked a lot with my old OB’s practice and he said he has NEVER heard of them sending a letter terminating care without a detailed explanation and a signature from one of the doctors taking credit/blame for the decision.  My letter was unsigned (just listed the names of the members in the practice) and did not provide sufficient explanation for the termination.  Just “we feel that you need to find a provider with whom you can have a more communicative relationship.”  So I’m left with… a whole lot of nothing.

I see the perinatologist again on the 18th.  I plan to suck it up and ask him to please just take me directly.  I don’t know how much longer I can handle uncertainty like this.

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Still OB-less

I’ll write more later, but the long and the short of it is that I’m still, for the moment, OB-less.  Saw the shiny new OB today and he doesn’t know if he’s comfortable taking me on as a patient because of the complexity of care that I require.


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