They can't make up their mind

[akshatha]

I was diagnosed with gestational diabetes and gestational hypertension. I am also Obese. However despite everything my blood pressure has remained good at every appointment since my diagnosis and I am not being medicated for my blood pressure. Personally I think my highest readings should be disqualified due to the circumstances surrounding my emotional state at the time they where taken but the NP didn't agree.

When the Nurse Practitioner who is seeing me in the steed of a MFM first diagnosed the Hypertension she said they'd want to deliver me at 37 weeks. I passed all the Pre-eclampsia tests and continue to do so. I monitor my blood pressure at home its been under 140/80 since save for one appointment but it imediantly returned to normal after being sent to the hospital for monitoring.

My gestational diabetes unfortunately ended up requiring insulin as I can't control my fasting numbers. At my practice I see a different OB almost weekly given my high risk status. But just this week I've seen Dr. K, Dr. X, & the NP working for the MFM.

Dr. K Said I'd be good to hold off until closer to my due date and we would consider 39 weeks a victory. The NP said I was ok to deliver closer to my due date but apprently wrote in my notes a recommendation for sometimes between 37w and 37w 6d and just today Dr. X said he might not mind 38 weeks as was very dismissive of my concerns for my daughter's lungs given that both he and Dr K confirmed babies mature slower when the mom requires insulin.

I'm too far along and high risk to go to another practice but I'm sick of this divorced parents level of communication style of care I'm receiving.

Dr. X, who is the OBGYN Ive seen the most said we could discuss it further at my next appointment which puts me at 38 weeks along because of how I scheduled it... so atleast, unless he notices and schedules me sooner should put me closer to the 39 weeks I'm hoping for but I'm not even seeing Dr. X at my next appointment I'm scheduled to see a NP I haven't even met yet.

 

[john96]

@akshatha Yikes! I hope they make up their mind.

I’m having a similar issue. Currently 28 weeks. I’ve been given the GD test like four times now. I failed only once because they didn’t tell me I was going to be taking it, and I had just come from Starbucks. Even then, I only failed by two and went on to pass the 3-hour test. But because baby is measuring in the 98th percentile, my doctor put me on the diet anyway. Also, my blood pressure was 130/80 last appointment (probably related to the stress of being told I had to do the GD diet without actually having GD), and even though that’s not high, she diagnosed me with hypertension. She hinted that I might have to have a c-sections because of all this, and I feel very angry. My first baby consistently measured above the 90th percentile, but came out very average at 7lbs 6oz. Plus, I don’t actually have hypertension. At least not at the moment. I think it’s being pushed onto me because I’m overweight and my doctor has already made up her mind that I will need a c-section because of it.

 

[akshatha]

@john96 That sucks. 130/80 isn't even bad. I don't need to call the doctor unless I hit 140/90 either number and a slight increase in your blood pressure is to be expected when you're pregnant.

"Gestational hypertension is diagnosed when blood pressure readings are higher than 140/90 mm Hg in a woman who had normal blood pressure prior to 20 weeks and has no proteinuria (excess protein in the urine). Preeclampsia is diagnosed when a woman with gestational hypertension also has increased protein in her urine."
(https://www.chop.edu/conditions-diseases/gestational-hypertension

And in order to get the diagnosis you need to measure higher than 140/90 on two separate occasions atleast 4 hours apart according to the lady that diagnosed me and a quick google.

And no one has mentioned that I would require a c-section for any of my issues. I even asked. So far they just say that it's more likely if my cervix isn't cooperative which it may not be due to me being a first time mom.

Edited a word.

 

[racyhall11]

@akshatha I feel you. I am obese and have gestational hypertension. I have a history of preeclampsia and preterm deliveries by induction. I loved my OB and specialist that I had for my 1st two babies. I moved and see a new OB and specialist and I honestly don’t care for them. The male dr at my specialist is very quick and dismissive. I like the woman, but I don’t get her as often. I’ve been through several midwives and OBs and there are a couple I like, but I’ve been one a few times that I really don’t jive with. Also the two offices just can’t communicate and ask me what the other one said. I’ve even showed them the reports from my app. And then the Labcorp has messed up several of my test and it’s just been really frustrating.

Now I have a friend who is also pregnant with diabetes before pregnancy and they are inducing her at 37 weeks for the diabetes, but her last pregnancy was sadly a still birth.

I can tell you preeclampsia can definitely happen out of no where so just keep track of your blood pressure and look out for the symptoms. Being induced early was jot bad for me. They will give you steroid shots to help baby’s lungs if they induce you early.

I hope they get this worked out for you and you can all get on the same page, but I definitely feel your pain.

 

[akshatha]

@racyhall11 Well it was when I messaged the NP working for the MFM asking if I could get the steroid shot since they want to induce me that my OB office contacted me instead and threw an extra appointment on my schedule.
It was at that appointment on Monday that Dr. K told me I was right to be concerned about her lungs and that their job as the OBGYN was to consider the WHOLE PICTURE and he didnt believe the NP/MFM was doing that when they said they wanted to induce me at 37 weeks and that due to me being on insulin as long as my blood pressure held they wouldn't be inducing me until closer to my due date and we'd aim for 39 weeks.

Then I saw the NP on Wednesday and she said I was set to deliver closer to my due date, didn't mention anything about 37 weeks which I'm literally officially 37 weeks today, two days after said appointment with her but in my notes it recomends induce me. Which is what Dr. X brought up yesterday/Thursday.

And like I said he said we can discuss it next appointment but I'm not even scheduled to see him at my next OB appointment. I'm set up to see some NP I've never met before. The next appointment is also set for the day I turn 38 weeks pregnant. Although I do have an NST set for Monday the 15th but I don't usually see an OB for those just the nice lady whose job title I don't remember that gets my baby on the monitor. She takes the strip to an Ob to be approved and then I leave.

 

[religonstudent]

@akshatha Oh that is obnoxious. I'm dealing with GD and have been given 3 sets of info from the same clinic. I just wanna be like get your act together then come talk to me. Hope the appointment at 38 weeks goes well!

 

[akshatha]

@religonstudent Me too thank you! And I hope you can get your situation straightened out. It's so upsetting. I almost cried at my appointment today because I'm getting emotional whiplash from all these induction week changes.

 

[abdalla50]

@akshatha Id call them out. Tell them they are all contradicting themselves. Put it back at them.

 

[akshatha]

@abdalla50 I did with Dr. X today and he basically reiterated the recommendation of the MFM and informed me of the risks of Gestational Hypertension and how they like to prevent issues and not react to them. He was overall very dismissive my husband even felt so. I haven't really liked him much the whole time I've seen him to be fair. Imo his bedside manner could use some work. But since they just pass you around to whatever Ob or NP or whoever is avaliable for each appointment I didn't see a point in asking not to have him. Plus if I do go into spontaneous labor the person who delivers me is whoever is on call and thatd be awkward.

 

[abdalla50]

@akshatha I feel the passing around part. Ill have 7 different Drs/OBs by my 36 week appointment. So i get not bothering to say you don’t want them.

 

[akshatha]

@abdalla50 You'd think it'd be more like any other like specialist where you see one doctor. My regular gynecologist doesn't pass me around this much. I saw the same PA for everything except for when they wanted to do a surgery to look around my uterus. Then I saw the actual gynecologist.
My PCP is part of a practice and all my regularly scheduled appointments are with him and the only time I see someone else is for a sick visit.

 

[floyd20]

@akshatha Remember you get to choose when you have anything done to you. If the only reason they want to deliver baby at 37/40 is the PIH and you don't have PIH, just say no.

 

[akshatha]

@floyd20 I know, but they certainly make it seem like I don't get much choice. Plus can't they refuse to continue my in office care if I won't listen?

 

[floyd20]

@akshatha Absolutely not.

https://www.acog.org/clinical/clini...ically-recommended-treatment-during-pregnancy

https://www.thedoctors.com/articles/terminating-patient-relationships/

https://georgiabirth.org/pregnancy-and-childbirth-rights

Please note that being able to provide evidence that their care plan is recommended is a key part but still not definitive. You cannot coerce people into your care plan. It's against the hippocratic oath.

 

[akshatha]

@floyd20 Thank you for the information. It definitely helps me feel better.