Monday, November 1, 2010

Update (again)

Best news first--the ultrasound was fine. My fluid level was normal. Matthew measured in the 75-90th percentile for size, but he said that's normal right now anyway. At 22 weeks, he measured in the 50th percentile. He said at this point, they grow at all different paces, so things could slow down again--it's too early for that to be a predictor and he's not worried. Baby Matthew-slow down! Don't be huge! Go easy on your mama!

We think the appointment went well. I essentially went in and said "I really like you as a doctor and I don't question your qualifications, but I don't think we communicate very well with each other and I leave my appointments feeling scared and under-informed." So we talked through some specifics. We learned some differences in our terminology-what he means by something and what I interpret. For example, when he says "higher" (as in "higher risk") I hear "high" but he said today that overall, my risk for all the various different things is low. It might be slightly higher than an average woman, but not "high." He said if I was truly high risk, he'd have passed me on to a specialist. In other cases, he's using precise, technical language, where we think he's using common vernacular. (Did you know there's a difference between "common" and "normal?" I didn't). That same preference for highly technical communication is also why he's vague on some things and he said he also tries to be vague to keep patients from worrying. He's highly technical in his language (and to be really technical sometimes he has to be vague) and I'm highly specific, and in some cases, those two just weren't crossing paths well.

So I explained to him that my personality does better with more information rather than less, and that if he's going to toss things out, I need a "so what" step. As in "you have an elevated risk for Gestational Diabetes, so I want you to be careful with your diet and exercise" or something like that. Not just "you have an elevated risk of ___________. Period." If it's a "wait and see" kind of thing, we're not really going to go down that road. I told him that I needed to know I had the freedom to press harder for information and know that he knows I don't mean it to be offensive, or undermining and he said he understood.

We also talked about the C-Section thing. He stated that he definitely doesn't WANT me to have one and doesn't even predict that I'll need one-he just wanted me to know it might be a possibility, but that his general practice is to let a woman try vaginally birthing for as long as she wants to (barring emergencies, of course). He said he supported our choice to take Bradley classes (which start next week--eek!) and to have a doula present.

His nurse was already talking to me about visiting me in the hospital and bringing me dinner after he's born. :) She came in during the ultrasound and said "can I watch too? I want to see my nephew!" I really do love that familiarity there. Even at the end, the doctor said "*I* really want to see this little guy be born!" That was cute to me, too. At the end of the day, this staff is committed to us, and that goes a really long way in my book.

As far as the FET/EA risks, this is what I learned from reading, from talking to Nightlight, and from talking to my RE. The risks of miscarriage ARE believed to be higher with embies that were frozen. I knew that part already. And in some ways, all fertility treatment rates for miscarriage are higher because frankly, we know the children exist sooner than people who conceive the "old fashioned way" so we know about it when they die. But we're well out of that window anyway. The other risks are NOT heightened by the FET procedure or the fact that the baby was frozen.

However, I learned from a couple studies linked for me by someone in one of my previous posts, and from Nightlight, that there is SLIGHTLY more risk for preclampsia when the baby is 100% unrelated to you. Preclampsia puts you at higher risk for things like preterm labor and C-Section. So he's not entirely off his rocker. That made me feel a lot better about the information I was receiving from him. Both he and Nightlight confirmed that it's *slightly* higher, but not *high.* I don't have high blood pressure now, so we just have to wait and see. Nightlight told me that the rate among their parents is not high at all and that most pregnancies are normal. And any elevated risks are still better for the babies than the 100% chance of death they have WITHOUT embryo adoption. I think my doctor gets that, too.

He did clarify that he didn't think I was "high risk" for anything. He just said the combination of the genetics and PCOS made him want to keep his "surveillance" level of me higher. So the net point is that a lot of this was just a misunderstanding and that there was a lot of fretting for nothing! At the very least, I now feel freer to be more assertive and not afraid that I'll offend him if I ask for more information or help. Thanks for encouraging me to get some backbone :P ;)

So anyway, all of that is probably more than you wanted to know, but the net point is that he was very receptive, we came up with some specific tools, keywords, and questions that we can both use to understand each other. Today he answered every medical question we had very specifically, so I think it COULD work. Time will tell. DH and I think that the right thing to do is to at least go to our next appointment and see if it worked. By that point, our first appointment with someone else would be at 32 weeks, which I think is too late in the game to switch, so we're going to stay with him. But I no longer feel uneasy or nervous about it. I was impressed today with how receptive he was and I think we got some very concrete devices to help. I just wish I'd done it sooner. Thank y'all for praying and for encouraging me to buck up and do it.

Oh, and I found out that my glucose test number was 112. Passing is 135, so it's not even like I passed by the skin of my teeth--we came through with flying colors so I shouldn't need to retest. Woohoo! Praise God again!


  1. Jen, I'm so glad things went to your satisfaction! Good for you! You have guts! :)

    Just so you know (for your reference, doesn't sound like you'll need it), I have known people to switch providers as late as 40 weeks when it was necessary. Not fun, but possible. But it sounds like it won't be necessary, so hurray!!! I'm so glad all turned out well with him.

    Let me know when you're feeling well enough for our coffee date! :)


  2. I'm glad that you were able to communicate well with him. Keep it up! And it does sound good that he's fine with Bradley classes and a doula.

    How's the nausea? Staying away? Hope so!

  3. Sounds promising and I am glad to hear Matthew is doing well : )

  4. Glad you had a good visit with the doctor!

  5. I'm so glad that you found some solutions for the communication issues! It's not easy confronting someone with a problem and it sounds like you did a great job. Just that he was receptive to your concerns speaks volumes. I hope that the relationship continues this way :)