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I'm just so upset over my appointment yesterday... still! Every time I think about it I can feel my blood pressure rising.
I waited a total of about 75 minutes before being seen. I watch as all of the other women that came in after me were seen before me. By the time my doc came in, she literally saw me for like 2 minutes. She listened to the FHR but never told me what it was, and listened only for about as much time as it would take to get a reading on her doppler. I don't think she even did a fundal height check! We discussed for a minute about my returning to clinicals next week (seriousely I hate retelling the whole story - this is my last semester, I have to have a note to attend clinicals, blah, blah, blah.) Anyway, so she was going to write restrictions for me but if she would have, I would have gotten kicked out of clinicals. I told her I don't want restrictions. Then she started to say about how I would need to go on restrictions eventually, but I cut in and reminded her it was my last semester. Then she doesn't give me time to discuss my SCH, she doesn't give me time to ask questions, she never bothered to mention or talk to me about doing the quad screen or anything which would have to be done by my 20 week appt. I did ask her if she was going to schedule my 20 week u/s and she was like... well, I guess we could do that now. So she scheduled it for five weeks out. Really? Couldn't just stick with normal 4 week appts? Anyway, so I also ask her if she was going to do a cervial length check.
Now we get into the most irritating part of the visit. I'm sooooooo mad. She argues about the CL check, and then tells me that since I didn't deliver early I am not at risk of preterm labor again. I try to tell her that the perinatologist said that I had scar tissue acting like a cerclage which is what kept me from dilating and kept me pregnant. (I effaced, but I was unable to dilate. I also never stopped contracting from 29 weeks until I delivered.) I'm almost certain if I didn't have the scar tissue I would have delivered at 30 weeks or between 33-35 weeks when I effaced the mosted. I honestly believe the ONLY reason I did NOT deliver prematurely was because my cervic was scared so tightly that couldn't deliver. I also think I was in hard labor at least three times when I ws 39 weeks. I mean really, who has diahhrea every 3 minutes at that gestation without being in labor? With each time I went into labor I also believe that it stalled out since I was unable to progress.
Anyway, I'm so mad that she said it was pretty much in my head, she didn't think it would happen again (my old OB said I likely would). If she is right, then I am really REALLY mad that I spent the last trimester of my pregnancy out of work making 70% of my pay on nasty tocolytics for NO REASON.
Oh, and if I'm not at risk, then WHY would I EVER need to be placed on any sort of restriction at either work or clinical??
The peri I saw was in the hospital. I never followed up with one after I was released. Although if I WOULD have had, they would have had documentation that my cervix was shortening instead of doing an internal exam every two weeks (which are highly subjective). At 33 weeks I went back into the hospital to get monitored for contractions, but they didn't see anything. I don't know if it stalled out, or if they just didn't catch it on monitor due to an inexperienced nurse or what, but by my next check at 35 weeks I was suddnely 85% effaced. What if I didn't have that scar tissue to keep me closed and I started to dilate? What if they would have just done a CL at the 33 wk appt or even at the hospital? Would they have cause the thinning earlier?
It doesn't matter now since I couldn't dilate, but what if that happens again this time around?
This time around if it happens again, I think I will just send MYSELF to the hospital I work at (although I really want to deliver at the other one, it doesn't have an NICU), and they would send me to the MFM doc who would at least order a cervial length!!
Seriously, you need a different doc. If you have a history of a thinning cervix, I don't see why they can't do cervical length checks. I mean, they had no idea what caused my PPROM--they certainly couldn't pin it on incompetent cervix, and I still got cervical length ultrasounds every 2 weeks for the bulk of my pregnancy (they stopped at...I think it was 32 weeks? Holy cow am I sleep deprived, I can't even remember!). More info is just better when you have a history of complications. Also, the scarred cervix alone sounds to me like it means a bit more monitoring.
I have a cervical u/s for 2o weeks to "appease me". I think that some of the other docs in the practice are a little more cautious. She is only in the office 2 days a week. I think if I have some problems I might set up an appointment with one of the other docs when she isn't working. (Ooops!) That or I can just drive to the tirtiary hospital and go in myself and say I was having contractions or something. Actually the later might be the best. If I'm having problems and I say I am in town and was worried about making it to the next hospital or whatever and get evaluated, then they are more likely to keep me. If I need to be admitted at the hospital I'll be delivering at (if full term) they will transfer me out (and last time, my hospital turned me away cause they didn't have a NICU bed available). I think it will be less likely to be transfered out if I just go right to the specialty hospital...