[sara~b]

I've been trying to make sense of my convo with my OB today....

At 8AM my phone rang and I ignored it. I listened to the voicemail when I got out of bed and it was my doctor. Not a nurse but actually my doctor! So I'm freaking out thinking something with my bloodwork came back out of whack. I call back and get a nurse so I let her know who I am and she looks up my chart and puts me on hold..... GREAT! So then my doctor gets on the phone and I am SURE something is wrong!

She tells me my bloodwork came back great (I'm amazed because I ate a fast food lunch during the 1 hour glucose test). Then she asks if I have an appointment with the high risk OB and for my first tri screening. I said no, that I had to check with insurance and make sure it was covered. She told me that she had wanted the girls in the office to do all that and it was their fault I didn't have an appointment already. She said she really, REALLY wanted me to make that appointment and have the high risk consult and then do the first trimester screening for Down Syndrome and Trisomy 18. I promised to make appointment ASAP.

I called my insurance and the consult and the screening u/s and bloodwork will only be covered 80% so I really don't want to do it unless there's a reason. I went ahead and scheduled the appointment and called back the OB's office to tell them the date and time. I told the nurse I wasn't sure I wanted to go through with it and she just said to let them know either way. I kind of wish she had let me talk to the doctor again because I want to know WHY this is so important! If my bloodwork was good and we haven't even had an u/s yet then WHY does she think I need genetic screening and a high risk OB?!!!

My mom works for a university medical center near me so I called her and asked her what she thought. She said that maybe because my job exposes me to radiation and chemicals the doctor wants to be sure my eggs weren't extremely damaged. I guess that makes sense but then why didn't my doctor say that? I tend to think that if there were a major chromosomal abnormality that I would probably have an m/c. My mom seems to think they will suggest a CVS/amnio at the consult. I just think that this is all overboard considering I know exactly how much radiation I've received (about 1,000mR over 4 years) and the average person gets about 100-150 mR per year from medical and environmental factors. It's not like I was present during a nuclear meltdown or anything.

Any insight girls? I'm going to do the early u/s Dec. 29th with this doc and then I meet my new OB Jan. 11 and I'm going to question them on whether all this genetic testing is necessary. If they agree or I chicken out of telling off this OB then I go for the first tri screening and consult on Jan 29th. I guess I might stick with it just to feel better now that I'm all worried and get a peek at baby again. I just wish this OB would lay off! I don't need the stress unless we have a reason to think something is wrong! UGH!

[alicenwonderland]

Just to reassure, nothing has to be wrong to have your OB call you. My doc calls me all the time. Usually at like 8PM, just to talk stuff over. They may be thinking high risk OB because of your history of infertility, or if they are concerned over environmental factors. *Hugs* you seem to be doing great so far. Try not to stress it.

[**jessie**]

Just go with your gut. If you really don't want it, then you don't have to do it. If it were me, I would personally decline the high risk consult, but go ahead with the NT scan. There is really nothing bad that can become of the u/s.

I initially declined the genetic screening (bloodwork plus NT scan). Last minute, I decided I would rather have peace of mind that all is well. It was the first time the baby looked like a baby and not a blob, so it was fun! The results came back very very good and I was happy that I had it done. If I have another baby, I will consent to the scan again. I also have some environmental factors (radiographs, scintigraphy procedures, also chemotherapy administration), so I thought it was a good idea.

[LisanAndy]

I personally wouldn't do it. If you need peace of mind about anything though I would do it

[~*Bethy*~]

I concur - and I would also call her back and ask her reasonings why, just in case your over looking something....but until then, I would decline.

[sara~b]

I have one thing in my health history that might be her reasoning but I had it with gem and I wasn't high risk. The March of Dimes, the CDC and everything I can google all says it's not a big deal and doesn't affect a pregnancy. So I'm still in the dark. I give up on this lady. I'm just biding my time until I can meet my new OB. I talked it over with Shane and we're going to do the screening u/s and bloodwork and consult. The consult should give us some insight into what she was thinking. But I won't be going back to her anymore after January. I see the new OB Jan. 11 so by the time I have my second appointment with them I can be done with all of this!

[Mars]

Personally, I would ask the doc why the need for all the tests and express my concerns. Then I'd decide based on if anything she said had merit or not.

[*Amy*]

If you're really that concerned about it, call her back and ask her why she is recommending you do it. If you don't WANT to do it, you don't have to. I'm not sure why it's such a big deal to you if you want to decline it. Your OB and the high risk OB can't force you to do any testing if you don't want to, they can only suggest what they would do in certain circumstances. If you do the ultrasound and it comes back with a bad result, they can't force you to do any invasive testing such as a CVS or an amnio, they can only suggest it.

Also, if the cost is a concern, you could call the high risk dr. and see how much 20% of the scan and bloodwork would be so you can plan ahead since you have about 6 weeks before they'll do it. They might even offer you a payment plan or work with you on the cost.

I understand this type of testing isn't for everyone but I just don't see why it's necessary to make a huge deal out of something that your doctor is recommending. Wouldn't you rather she be thorough than not care at all? Just be honest with her and tell her you would rather not have it done if it's not completely necessary.

[Chelnae6]

I would definitely call you doctor back to see whats up! Just to know why its so important to him and tell him not to omit ANY information. If its going to cost you, and you dont really see it as being necessary then I'd say to go with your gut. When is your first u/s appt?

[sara~b]

Originally Posted by *Amy*

I understand this type of testing isn't for everyone but I just don't see why it's necessary to make a huge deal out of something that your doctor is recommending. Wouldn't you rather she be thorough than not care at all? Just be honest with her and tell her you would rather not have it done if it's not completely necessary.

It's not the testing or recommendation that gets me upset. It's the fact that she is labeling me HIGH RISK with NO REASON! I don't mind getting another u/s or letting them take a little blood to make sure the baby is okay. What I mind is that I'm being put into the high risk category at 4 weeks pregnant with no logical reason! I'm not sure if the other OB or the midwives will take me now just because this witch labelled me high risk!

Doing the tests and even the cost is fine with me but if she had a MEDICAL reason she wanted me to have it all then I might be able to get it covered! This is what's ticking me off!

And I called and asked about the costs. The high risk OB will try to charge my insurance about $1500 for the consult/blood work/ultrasound. But what they charge is not necessarily what my insurance pays and I'm responsible for 20% of what my insurance pays so I'm guessing it will be about $200.

Chel - I get my dating/viability scan on the 29th.

[*Amy*]

Originally Posted by sara~b

It's not the testing or recommendation that gets me upset. It's the fact that she is labeling me HIGH RISK with NO REASON! I don't mind getting another u/s or letting them take a little blood to make sure the baby is okay. What I mind is that I'm being put into the high risk category at 4 weeks pregnant with no logical reason! I'm not sure if the other OB or the midwives will take me now just because this witch labelled me high risk!

Doing the tests and even the cost is fine with me but if she had a MEDICAL reason she wanted me to have it all then I might be able to get it covered! This is what's ticking me off!

And I called and asked about the costs. The high risk OB will try to charge my insurance about $1500 for the consult/blood work/ultrasound. But what they charge is not necessarily what my insurance pays and I'm responsible for 20% of what my insurance pays so I'm guessing it will be about $200.

Chel - I get my dating/viability scan on the 29th.

I would just call her back and ask what she's considering you high risk for and explain that how she labels the referral will determine if your insurance pays for it in full or not. I'm guessing that her concern is the radiation that you've been exposed to but I'd just call and ask. She seems willing to have an open line of communication with you if she's calling at 8 a.m.

[sara~b]

The thing is that I've tried to express my concerns that I am MORE than willing to do the tests but that I don't want to be 'high risk' until we get the results. That's when she told me she really, REALLY wants me to do these tests. I get it! I told her at my 4 week appointment that I didn't want to be high risk without some test saying that it was necessary. She didn't relent so I figured if my CF test and other blood tests came back normal then she would let it go. She just won't give in and she hasn't said 'multiples', 'radiation', 'chemicals' or anything else during any of these convos. These are all reasons that I'VE come up with for her idiocy. I'm waiting for her to try to tell me I need to be on bedrest at the u/s.

I can't wait to switch docs....

[greeneyes]

Ok, question - why have you already had a one hour glucose challenge? Did you have GD with Gemma? If so, I think that's why she's wanting to label you as "high risk". If not, then that just makes no sense to me; most practitioners won't run the test before 24 weeks!

[sara~b]

Originally Posted by greeneyes

Ok, question - why have you already had a one hour glucose challenge? Did you have GD with Gemma? If so, I think that's why she's wanting to label you as "high risk". If not, then that just makes no sense to me; most practitioners won't run the test before 24 weeks!

Nope! I had no problems with Gem other than pre-term labor which was attributed to my young age, dehydration and stress factors. But I held her in til 40+4 and we were both healthy. If I remember correctly her APGARS were 8 & 9 or 9 & 9.

I think I am going to call my new OB's office and ask them what they think and see if they will see me earlier to sort this out. I'm so frustrated right now!

UPDATE: I called the midwives that I want to switch to. I explained everything to the receptionist and she is going to talk to the midwife and hopefully get me cleared to switch my care to them. I should know in the morning! I'm so happy!

[*krista*]

Well, sounds like you are getting this all sorted out. I do think you doctor and doctors in general should explain everything to you, especially any reason for saying you are high risk. Maybe it was your high beta numbers? I dunno... I'd like to hear her reason!